Free Essay

Peaceful End of Life

In:

Submitted By offineer
Words 870
Pages 4
Single Quantitative Study (e.g., Randomized Controlled Trial, Nonrandomized Controlled Trial, Case-Control Study, Cohort Study) Template | Citation (APA) | (Uchiyama, Kurosawa, & Inaba, 2006) | Title | MMR Vaccine & Regression in Autism Spectrum Disorders: Negative Results Presented from Japan | Database Source (& ID number) | PubMed (PMID: 16865547) | Type of Evidence | Non-experimental cohort study/casual comparative research | Hierarchical Evidence Rating Level | Level 4 | Your Summary of the Study/Publication (use paraphrasing, not quotes) | What was the stated research question/objective of the study? | To evaluate the correlation between the MMR Vaccine and Autism Spectrum Disorders | What research methodology was used (e.g., RCT, Case-Control, Cohort)? | Cohort StudyCasual Comparative Research | Describe the sample (including size)? | 904 patients with Autism Spectrum Disorders | How was the sample selected (e.g., randomization, inclusion/exclusion criteria)? | Inclusion Criteria: Young children born between 1976-1999 from the Yokohama Psycho-Developmental Clinic (YPDC) Regression reported from questionnaireExclusion Criteria: Young children who received the MMR Vaccine in foreign countries, reports denying regression in questionnaire, and subjects parents who provided no response or information on the questionnaire regarding regression. | What methods were used for data analysis? | The study analyzed data from clients of the Yokohama Psycho-Development Clinic. All patients diagnosed with ASD born between 1976 and 1999 were selected. A standard questionnaire was used to ask parents view of their child’s development, behavior, medical history, and present status. Patients were classified into three groups: Pre-MMR, MMR, and Post-MMR generations. These groups were classified into two further groups: regression and without regression. Analysis 1 analyzed the odds ratio for the association between regression and MMR exposure using MMR-subgroups above. Analysis 2 used all data across the three Generations and computed an odds ratio for the association between regression in ASD and exposure to MMR by combining data from three periods. All odds ratios are presented with 95% confidence intervals and categorical variables were compared by the two-sided Fisher’s exact test. The odds ratio was computed for the association between ASD and regression using the MMR Generation as the reference group. Comparison of the Pre-MMR and MMR Generations (analysis 3) Comparison of the MMR Generation and Post-MMR Generation (analysis 4) and comparison of the MMR Generation and the Pre-MMR and Post-MMR Generations combined group (analysis 5) | What were the results of the study? At what Level of Significance? | Analysis 1: Rate of regression lower in those who received MMR during the MMR era, but not statistically significantAnalysis 2: Lower rate of regression in children receiving MMR, but not statistically sifnificantAnalysis 3, 4, and 5:Rate of regression did not vary across the sub-group eras | What conclusions/implications for practice were drawn by the authors? | The rate of regression in those who received the MMR Vaccine was not higher than those who did not receive it. No statistical evidence that suggest the rate of regression in ASD was higher during the period when MMR was used compared to the “before” and “after” periods. | Your Critical Appraisal of the Study’s Appropriateness for Application to Clinical Practice | Was the research design appropriate for the research question (e.g., RCT for cause-effect questions, Case Control for harm or causation questions, Cohort for questions regarding prognosis)? Support your response. | Yes, the Cohort Study research design is appropriate. This study followed a group of subjects (MMR Vaccinated and Non-Vaccinated Children with and without regression) longitudinally over a period of time (1976 -1999) to determine the relationship (incidence of regression) across three MMR-program-related periods. | Was the sample size adequate? Was bias controlled with sample selection methods? Support your responses. | The sample size was not adequate for subjects who had received the MMR Vaccine. It was relatively small. Bias was not adequately controlled, as the study was conducted in a private clinic instead of using a population base study. This could potentiate selection bias. | Were the study results significant (level of significance)? Are the results valid and reliable? Is there a possibility of bias or of confounding variables? Support your responses. | The study results have limitations that decrease the level of significance as well as the validity and reliability. Firstly, participants were from a private clinic, thus potentiating selection bias. Secondly, the sample size of the subjects who received the MMR Vaccine was small. Thirdly, confounding variables defining regression were found. The questionnaire was the only instrument used to define regression. Information obtained on regression was reliant solely on parental report. “False Positives” of regression may have been present due to the limited questions and the fact that regression was not clinically assessed. Statistically, the data was accurate and odds ratios are presented with a 95% confidence interval. | Is the study and its findings directly applicable to your EBP question (match all selection criteria)? Support your response. | The study is directly applicable to our EBP question, “Do young children that receive immunizations have an increased risk of autism spectrum disorders than children who are not vaccinated?” The study includes the sample population (children), the intervention (receiving immunizations), the comparison (not receiving immunizations), and outcome (incidence of Autism Spectrum Disorders). However, the study focused on the rate of regression in those who received the MMR Vaccine. |

Similar Documents

Premium Essay

Peaceful End of Life

...Peaceful End of Life Theory of C. Ruland and S. Moore I. Introduction a. Entire lives and careers are dedicated to postponing or avoiding death while caring for the living. Yet each day that passes, death is one day closer, unwavering. It is inevitable and unavoidable. Leaving loved ones behind creates sadness and shakes even the most stoic. Possibilities of pain evoke fear. Questioning faith, even the most devote become anxious when considering what has never been felt or seen. Ruland and Moore theorize that by easing the fears and anxieties, both real and/or perceived for the patient and family, nurses can create a more peaceful end of life, rather than simply complete the tasks at hand in the day to day when caring for the dying. II. Theory Perspective b. Defining “Peaceful” c. Dying is a personal experience and should never be alone. d. Five Outcome Indicators e. 16 Outcome Criteria III. Relationship to Nursing Practice f. Relevancy to Nursing i. Educate ii. Influence iii. Research g. Observe. Look, listen and feel h. Understand and Interpret i. Intervene with dignity, respect and empathy IV. Case Scenario V. Conclusion References Bjarnason, D. (2000, May). End-of-life care: Understanding and enhancing the nurse-patient dialogue. Retrieved May 3, 2011, from Proquest: http://proquest.umi.com/pqdweb?did=732206511&Fmt=2&clientId=14884&RQT=309&VName=PQD ...

Words: 277 - Pages: 2

Premium Essay

Peaceful End of Life

...Justin Sicheri 3/18/12 1 LOTF Poetry Project Poem excerpt | Insight | LOTF Excerpt | “The single clenched fist lifted and ready. Or the open asking hand out and waiting.Choose:For we meet by one or the other.” –“choose” by Carl Sandburg | In the same way that the poem “choose” is saying that the person must choose to be with or against but either way they will meet, So Jack on the island makes the boys choose between joining a tribe that is only concerned about being rescued and a fire or choose the tribe that is concerned about staying alive and hunting and protection. | “I’m going off by myself. He can catch his own pigs. Anyone who wants to hunt when I do can come too.” He blundered out of the triangle toward the drop to the white sand.” (127) | Poem excerpt | Insight | LOTF Excerpt | “From the thunder, and the storm- And the cloud that took the form(When the rest of heaven was blue) Of a demon in my view-“ “alone” Edgar Allan Poe | In the same way the poem says that when the rest of the heaven was blue, there was a demon in their view, so its saying that when everything else is okay there is danger right in front of you. In LOTF it shows the confrontation of the beast and the boys, so its saying that when they are stuck on the island with the beast everybody else around the world is doesn’t even know it’s happening. | “In front of them, only three or four yards away, was a rock-like hump where no rock should be. Ralph could hear a tiny chattering noise coming...

Words: 628 - Pages: 3

Free Essay

The Contribution of Developing a Theory from This Standard of Care Is That It Can Express a New Unifying Idea About the Phenomenon of Peaceful End of Life for Terminally Ill Patients. It Allows for Generating and

...Discrete Structure To be submitted to: Mr. Roger Intong Faculty BITE DEPARTMENT CATHERINE PIANO BSIT2 DESIGN * ------------------------------------------------- Device type: * Tablet * ------------------------------------------------- OS: * Windows (8) * ------------------------------------------------- Dimensions: * 11.97 x 7.46 x 0.39 inches (304 x 189.4 x 9.9 mm) * Weight: * 26.46 oz (750 g) the average is 17.4 oz (496 g) DISPLAY * ------------------------------------------------- Physical size: * 11.6 inches * ------------------------------------------------- Resolution: * 1366 x 768 pixels * ------------------------------------------------- Pixel density: * 135 ppi * ------------------------------------------------- Technology: * LCD * ------------------------------------------------- Colors: * 16 777 216 * ------------------------------------------------- Touchscreen: * Multi-touch * Features: * Light sensor MULTIMEDIA * ------------------------------------------------- Music player: * Filter by: * Album, Artist * Features: * Album art cover, Background playback * Speakers: * Stereo speakers TECHNOLOGY * Data: * LTE, HSPA (unspecified) OTHER FEATURES * ------------------------------------------------- Sensors: * Accelerometer * Voice recording ...

Words: 1802 - Pages: 8

Free Essay

Copying Isn't Cool

...to take a look at us today, this hour, this minute, this very second. Are we at peace with ourselves or with the individual next to us?Yes. So are we a peaceful species at heart? Yes. Don't mention the Egypt crisis please, thats a different issue and its just a minor percentage of the worlds' population. Yes throughout out history we have fought like maniacs, but are we peaceful deep inside? I think we could be, its just environmental factors or lack of knowledge in my view, like religion, race, territory, wealth and of course the natural factors like envy and jealousy, etc. We need people who can sit still and be able to smile, who can walk peacefully. We need people like that in order to save us. You are that person. I am that person. We are the peace the world needs. We are angels experiencing humanity. You wouldn't know it by current world events, but humans actually evolved to be peaceful, cooperative and social animals. Early man was not an aggressive killer nor fighter, he was a talker. It was just the natural instinct for survival. If they didn't hunt they would end up being cannibals and that's definitely not peaceful. Our intelligence, cooperation and many other features we have as modern humans developed from our attempts to out-smart the predator. Although great freedom fighters did use weapons to free life but the explicit idea and technique of non-violence evolved by Gandhiji was miraculous. Non-violence had been the strongest weapon through which the Indians...

Words: 749 - Pages: 3

Premium Essay

King vs X

...To what extent did the aims and methods of Martin Luther King differ from those of black power activists? There is no question that the aims and methods of Martin Luther King differed from those of Black Power activists. King was peaceful and wanted integration with whites while Black Power activists confronted violence and believed in black supremacism and separatism. But they were also similar in some ways, such as speaking out on the Vietnam War. The aims of king differed significantly from those of Black Power activists. The aims and methods of MLK did differ from those of Black Power activists. For example, King’s campaigns such as the Montgomery Bus Boycott in 1955 and Birmingham 1963 were very peaceful, despite facing violence. King was brought up by a rich black family, with a good education, and a good chance at life. He was a black aristocrat, and a wealthy man. King’s peaceful message was due to him being a devout Christian and believing in love for all mankind. As a result, they were successful because they drew on the support from white people. King also wanted integration with whites, which can be contributed to his ‘love your fellow man’ philosophy. This was clear in King’s March on Washington 1963, where both whites and blacks marched on Washington to hear speeches from civil rights leaders. King didn’t just want integration with whites, as shown in his Poor Peoples Campaign 1968. In this, King called for a coalition of blacks, native Americans, Hispanics...

Words: 1079 - Pages: 5

Premium Essay

Dan's Pride In Peaceful Warrior

...not the destination". Millman The Journey Between Dan and Socrates is the focus in Peaceful warrior, a true story about Dan Millman. In the movie Dan has a strong ego that mixes with his pride. Until one man will show him all the Negative that he will need to let go of and turn his life around. However, the constant troubles that Dan is facing his Pride will get the most of him, which is one of the main theme in Peaceful Warrior. First in Peaceful Warrior Dan’s pride gets the best of him when he keep trying to do the impossible triple flip that no man can do. Since Dan is a very strong athlete he has the ability to do what he desire most. However, he uses his strength and pride to be better than his teammates in the gym. As Dan say, “ Better never begin; once begun, better finish”. Therefore, Dan is senseless about what he is doing . In that case Dan will still be head stuck through the movie until he learns....

Words: 614 - Pages: 3

Premium Essay

A Peaceful Ending

...A dying man lying in the bed is begging his relatives to stop his life. This scene in a movie remains in my brain for several years. There is a famous sentence from Seneca, a great Roman orator, “if I must suffer without hope or relief, I will depart, not through fear of the pain itself, but because it prevents all for which I would live.” Euthanasia is a cure rather than a poison, for it bringing life a peaceful ending. Firstly, euthanasia embodies the respect to life. Some people believe that euthanasia violates the right of living. However, life is not equal to living. “If old age leaves me not life but breath, I will depart from the putrid or tottering edifice,” http://www.51lunwen.com/dxessay/ said Seneca. Life should be a condition of inner serenity and consciousness rather than a process of battling with uncured diseases with unbearable pain. As a result, when the ultimate end is as inevitable as it now appears to be, the individual should have the right to gain a peaceful ending. Secondly, euthanasia rescues not only the dying patients from pain, but also their relatives who are under serious mental and financial pressure. The opponents urge to stop the appliance of euthanasia to procrastinate death, when the dying patients who are suffering from unbearable pain may just feel the endless pain and torment. Francis Bacon used to say, “The duty of a doctor is not only to cure the patients, but also to ease their pain and sorrow.” On the other hand, the relatives...

Words: 482 - Pages: 2

Premium Essay

Loving Your Enemies Analysis

...believed that peaceful protests were the key to fighting the evils of the day, such as racial segregation and discrimination. If violent and non-peaceful protests took precedence over peaceful ones, then the situation would only have grown worse. Violent protests would have proven that the African Americans were unequal to the Americans, and the racial discrimination would only have become worse. The use of nonviolent and peaceful protests showed that not all African Americans were bad people, and they were just looking for a better way of life. Eventually, Martin Luther King Jr. was able to help end racial discrimination, utilizing only peaceful...

Words: 463 - Pages: 2

Premium Essay

August 28th, 1963: Poem Analysis

...August 28th, 1963. Your oxford shirt is damp with sweat as the humid air of summer in D.C. sticks to your skin. Voices shout to the beat of feet marching in unison. The voices beg for freedom, beg for representation. You are surrounded by people you’ve never met but now, they feel like family. They understand you more than you thought anyone would be able to. You didn’t think it was possible for people to be different from you and still the same. None of you sound the same or walk in the same shoes any other day but today, you are one. You fight for the same thing. Today, you all stand together literally and make your voices heard in a world that wishes to make you invisible. 54 years later. January 28th, 2017. The air is cold and smells like...

Words: 687 - Pages: 3

Free Essay

The Quiet Door

...ENG 2D April 4, 2014 The Quiet Door One of the hardest tasks to accomplish in life is obtaining a sense of peace. In a disordered world that circles with fear and confusion, it is difficult to find. The concept faced and feared by all is the idea of death. It is not the act of dying that humankind desires to avoid, but the unknown beyond it. It is obvious through culture how the world fears death; movies, literature, and general behavior prove it. However, there are few who contradict the idea that death is dark and forbidding. In a poem called ‘Death is a Door,’ the author, Nancy Byrd Turner, writes, “Death is only a quiet door / in an old wall” (11-12). Some believe that death can be approached peacefully, rather than unwillingly. In the poem ‘Let Evening Come,’ Jane Kenyon uses various poetic devices, such as imagery, repetition, and symbolism, to create a peaceful mood. The peace the reader feels while reading the poem is the peace that can be adopted when crossing the threshold into death. Imagery is one of the most important literary devices a writer could use. Imagery allows the reader to become a part of the story and to interact with characters. Without imagery, there is no picture or setting, only empty words and actions that cannot be understood. The mood of a piece of writing can be created using imagery. In ‘Let Evening Come,’ Kenyon instills a peaceful mood by creating peaceful, comforting images in the reader’s mind. “Let the cricket take up chafing” (5), paints...

Words: 830 - Pages: 4

Premium Essay

To What Extent Did the Aims and Methods of Martin Luther King Differ from Those of Black Power Activists?

...There is no question that the aims and methods of Martin Luther King differed from those of Black Power activists. King was peaceful and wanted integration with whites while Black Power activists confronted violence and believed in black supremacism and separatism. But they were also similar in some ways, such as speaking out on the Vietnam War. The aims of MLK differed significantly from those of Black Power activists. The aims and methods of MLK did differ from those of Black Power activists. For example, King’s campaigns such as the Montgomery Bus Boycott in 1955 and Birmingham 1963 were very peaceful, despite facing violence. King’s peaceful message was due to him being a devout Christian and believing in love for all mankind. As a result, they were successful because they drew on the support from white people. In contrast, was Black Power Activists who some like Malcolm X, believed that blacks should defend themselves because it made them look weak and allowed whites to take advantage. Malcolm X wasn’t a Christian and so he didn’t believe in King’s Christian philosophy. This is a clear difference in both methods and ideology. King also wanted integration with whites, which can be contributed to his ‘love your fellow man’ philosophy. This was clear in King’s March on Washington 1963, where both whites and blacks marched on Washington to hear speeches from civil rights leaders. King didn’t just want integration with whites, as shown in his Poor Peoples Campaign 1968. In this...

Words: 971 - Pages: 4

Free Essay

Love Calls Us to the Things of This World

...when we aren’t burden with the outside world and still on the outskirts of reality, engulfed in a worry free peaceful zone. As the sleeper is in his peaceful state, the window is open and he hears the “cry of the pulleys” as laundry is being hung and what I envisioned also was him hearing the flapping of the laundry because he says “The morning air is all awash with angles”. That maybe the flapping laundry instead of awakening him even more, reminds him of the flapping wings of an Angel. As the sleeper is in the world of the Angels and harmony, consciousness eventually wins and the sleeper is now aware that it is just laundry flapping in the wind and nothing more. The soul is now descended back into it body and daily life. One then wonders why we would want to wake up from this blissful state of being and the answer to that I believe is love. Just like the title says “Love Calls Us to the Things of This World”. We do things for love and that is why the sleeper leaves the peaceful wondrous state and awakens to a new day. “Love Calls Us to the Things of this World” shows us how different the spiritual world and the real world can be. The man then goes to describe the thieves in the gallows should have clean linens for their backs, the lovers should go fresh and sweet and the heaviest nuns should walk as if floating. And at the end of these observation the man ends the poem with the line “Of dark habits, keeping their difficult balance” showing that difference does not have...

Words: 349 - Pages: 2

Free Essay

The Hobbit-Bilbo Babbins Character

...Bilbo Baggins Bilbo Baggins, one of the main characters of The Hobbit, he was a hobbit who lived a very peaceful, timid, and sheltered life before he was approached by Thorin and the dwarves. They invited him to go with them on some adventures. He was known as a respectable, humble, and an unadventurous hobbit by others. When Bilbo was approached to go on the adventures, he was reluctant to go at first; however, he wanted and found a new sense of adventure and excitement that he was missing previously in his life. During his early years as a hobbit, he always had a sense of curiosity and was eager to learn new things but he never did until later in life. Bilbo wanted to prove to himself that he was adventurous and he wanted to live his life to the fullest. He came out of his shell eventually and some of his earlier adventurous actions with the dwarves were somewhat wreck less and illegal and he lost some respect of others. He wanted to prove that he was capable of great things and he had heroic abilities of one who could help defeat the dragon or his opponents. He gained confidence in himself overtime. He also found himself in life threatening situations through out his adventures. These made him stronger physically as well as mentally. He became more self assured about his abilities as a fighter and adventurer. He changed over time because he learned to fight his fears, became more aggressive and clever. During his adventures, he acquired some treasures, became the ring bearer...

Words: 435 - Pages: 2

Premium Essay

A Final Wish of Death

...should be granted when life has come to its last chapter and all that is sought is a peaceful passing. The decision between a physician and terminally ill patient to hasten their death should be accepted and granted. A terminal illness can be described as an incurable disease which will end the life of the sufferer. If death is inevitable, why must we wait for natural causes to occur? Physician-assisted deaths should be legalized in all states so that the terminally ill can request a final act of dignity. “Physician-assisted death is defined as the physician providing the means for death, most often with a prescription. The patient not the physician will ultimately administer the lethal medication” (Braddock & Tonelli, 1998). If a patient can come to a decision when it is time to stop treatment for their terminal illness, they should also be allowed to choose when to bring death. End of life care has become an equally important issue to physicians as well as the patients. If physician-assisted deaths were permitted in all 50 states, physicians could openly discuss end of life wishes with their patients. With all the advances in modern medicine, people are living much longer which allows for a higher risk in developing a terminal illness. A few examples of terminal illnesses are cancer, strokes, Alzheimer’s disease, renal failure, and heart failure. With increasing numbers in terminal illnesses more options for end of life decisions need to be available...

Words: 2055 - Pages: 9

Free Essay

Song of the River

...his overall idea of the relationship between the cycle of life and the course of a river. He uses such devices to express the revolving cycles of a river and how its life span and rebirth correlates with life, death, and afterlife. The rhyme scheme the author creates in the poem has a rhythm which mimics the flow of life and a river. Throughout the poem Hearst describes the cycle of a river and then describes the cycle of life. He then incorporates a rhyme scheme which flows nonstop from start to finish. Within this scheme lies the evolving message in which Hearst is illustrating. The rhyme scheme also relates closely to the tone of the poem which is a peaceful calm tone following the movement of water into its rebirth and the transition of one’s life into the afterlife. Hearst creates the quotation “and the river flows to the sea, and the water again goes back in rain to the hills where is used to be” in order to demonstrate and clearly express the flow of a river to the sea using both rhyme scheme and tone. Lastly as Hearst’s message continues as does the rhyme scheme and tone seen in the words “till it reached the silent sea.” Hearst is comparing the river as is reaches “the silent sea” and life as it reaches the afterlife using the same tone and rhyme scheme as seen throughout the entire poem. Hearst uses several examples of alliteration throughout the poem closely relating to the analogy of the course of life and water. Hearst once again uses alliteration to help the...

Words: 626 - Pages: 3