...Evidence-Based Nursing Care for Multiple Myeloma Patients Evidence-Based Nursing Care for Multiple Myeloma Patients Comprised of the blood cells, blood, lymph, and other organs involved in the formation or storage of blood, the hematologic system allows the human body to maintain adequate oxygenation and tissue perfusion (Ignatavicius & Workman, 2010, p. 876). Because every cell, tissue, organ, and system is dependent on blood circulation for survival, hematologic problems involving impaired production, impaired function, or abnormal destruction of blood cells are likely to have wide-reaching effects on the patient's health and wellness (Ignatavicius & Workman, 2010, p. 876). This is especially clear when examining cancers of the hematologic system, including multiple myeloma. A cancer of certain white blood cells in the bone marrow known as plasma cells, “myeloma” refers to a tumor of the bone marrow, and “multiple” refers to more than one area of the bone marrow being affected (Mangan, 2006, p. 64hn1). Because the disease is incurable, and because only 30 percent of patients survive longer than five years after diagnosis, living with multiple myeloma can be difficult for patients and their families (Mangan, 2006, p. 64hn1). As health care providers on the front lines of patient care, nurses must be aware of the multi-system manifestations of multiple myeloma, be able to make the assessments needed to identify and prevent complications...
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...hematological manifestations including thrombocytopenia and increased bleeding risk. Prophylactic platelet transfusion—in the absence of major bleeding—is utilized in DF with thrombocytopenia with the intention of preventing hemorrhagic complications. However, prophylactic platelet transfusion in DF is neither standardized nor supported by clinical evidence. We conclude that risks, costs and poor resource utilization associated with prophylactic platelet transfusion in DF far outweigh any potential hematological benefit, and as such, should not constitute routine clinical practice. Ann Acad Med Singapore 2011;40:539-45 Key words: Thrombocytopenia, Preventitive, Arbovirus, Bleeding, Hemorrhage Introduction Dengue fever (DF) is the most common mosquito-borne human viral illness worldwide, and has rapidly spread to reach hyper-endemic proportions in the urban tropics over the last quarter of a century.1 With an estimated 2.5 billion people at risk and a global annual incidence of 50 million cases, DF has been identified as an example of a potential international public health emergency.2 In understanding the unique pathophysiology of DF, revisiting the terminology is a useful first step. DF refers to the acute self-limited form, which by itself does not account for the mortality seen in this illness.3 Dengue Hemorrhagic Fever (DHF) is a complication which in contrast to other viral hemorrhagic fevers is not characterised by overt or dramatic hemorrhagic manifestations; rather,...
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...Noma Chamberlain College of Nursing NR283: Pathophysiology May 2016, Professor (Name Here) Pathophysiology Processes & Consequences of Noma Noma disease, commonly referred to as cancrum oris, fusospirochetal gangrene, necrotizing ulcerative stomatitis, and stomatitis gangrenosa is a devastating disease that is famously quoted as “the face of poverty”. This rare disease with high prevalence in Sub-Saharan countries is lethal and has been linked to acute and rapid disease progression in persons that are immunocompromised. Evidence based research suggests a high prevalence of the disease is observed in populations experiencing extreme poverty, malnourishment, and exposure to infectious diseases, while living in a continued state of poor hygiene. This gangrenous infection has a microbial origin, often found in the mouth. It is exacerbated by poor hygiene that give rise to the bacterial micro-organisms responsible for aggressive manifestations observed on individuals infected. Etiology of Noma The exact etiology of Noma disease is unknown. However, it is believed to be multifactorial in nature (Ashok, Tarakji, Darwish, Rodrigues , & Altamimi, 2016). The spread of the disease is due to deteriorating sanitation and inadequate nutrition, most common in underdeveloped countries. Noma is an opportunistic infection, which typically show dominance after a weakened immune system is present, preceding multiple risk factors that work together increasing risk potential for...
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...Children and adolescents generally receive the greatest proportion of their treatment through school- based educational programs. The reauthorization of the Elementary and Secondary Education Act of 2001( commonly referred to as No Child left Behind) and the Individuals with Disabilities Education Improvement Act of 2004 have introduced both educators and parents to the term evidence- based practices. The purpose of introducing evidence- based practices emanates from the need for educators to identify treatments that have been clearly defined and tested and that yield clear results about the effectiveness of the treatments. The legislative requirement for evidence has spawned two major responses from researchers in special education. First,...
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...exacerbated by the recent terror attacks in France and Belgium, resulting in the unjust attachment of these acts to the Muslim community. Anti-Muslim racism is now the predominant form of racism in Britain, manifesting itself on an institutional and individual level (Mahamadille, 2005). This essay aims to discuss the reality of anti-Muslim racism in Britain through processes of racialisation and through manifestations of anti-Muslim hostility and discrimination. But first emphasis is placed on how “the Muslim race” has become socially constructed by mainstream British society. Social Construction of “Muslim Race” Social constructionists share the belief that categorisation on the basis of biologically transmitted traits is a pseudo that traditionally was used to justify the unequal treatment of certain groups by others (mainly relating to skin colour) (Machery, 2005). Biology, religion and culture merely provide the materials from which we socially construct the ideas of difference and community. Scholars now widely believe that race is socially constructed as opposed to biologically based (Bonilla, 1997). The “Muslim Race” is arguably the greatest example of a socially constructed race in recent times. Despite major differences in skin colour, nationality and culture, the Muslim community have been categorised on the basis of their ethno-religion. Racialisation The social construction of the “Muslim race” has led to the groups racialisation. Racialisation refers to processes of...
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...Waterhouse extends only to behavior and appearances that manifest themselves in the workplace, and not to private sexual behavior, beliefs, or practices that an employee might adopt or show in a different place. It concludes that Vickers’s bullies were motivated by Vicker’s perceived sexual preferences by his coworkers and not by ‘outward workplace manifestation of less-than-masculine gender characteristics’ (Halbert 127). Explain whether or not there is an ethical difference between harassment based on stereotypes perceived as manifesting at work and those perceived as manifesting elsewhere. There is no difference between harassment based on stereotypes perceived at work or elsewhere. It does not matter if harassment occurs at work or offsite, harassment is unethical and bad. Harassment is a manner involving troubling or unwelcomed commentaries which creates a hostile and unproductive environment. A 16-year old boy was harassed because his voice was soft, his physique slight, his hair long, and he wore an earring to work. Explain whether or not he has a valid claim for sexual harassment. 16 years old boy would have a valid claim for sexual harassment if the harasser made sexual advances, where the harasser is driven by general aggression to the presence of men in the workplace; and where the plaintiff offers “direct comparative evidence about how the alleged harasser treated members of both sexes in a mixed sex workplace” (Halbert & Ingulli,...
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...genetic disorders, such as Parkinson's disease and breast cancer. Share your thoughts on the legal, ethical, and social implications that may be related to genetic screening. How would you educate your patient that is considering having genetic screening? Week 2: Question 1= Choose an FDA-approved prescription medication and discuss the pharmacokinetics and pharmacodynamics of the medication, including any differences that would be expected based on the patient's age, a condition of pregnancy, or lactation. Address any adverse effects the medication may have based on age, pregnancy, or lactation. Question 2= Active acquired immunity can be achieved through the use of childhood immunizations. Many parents voice concerns regarding the safety of vaccinations. What is your opinion on the current use of vaccinations? How would you educate parents regarding the safety and effectiveness of vaccinations? Defend your answers with evidence-based research. Week 3: Question 1= Share a case study of an electrolyte imbalance from your practice or from the...
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...Religion guided every aspect of Egyptian life. Egyptian religion was based on polytheism, which means the worship of many deities, except for during the reign of Akenaton. During the reign of Akenaton, more than 3,000 years of development, Egyptian religion underwent significant changes of emphasis and practice, but in all periods religion had a clear consistency in character and style. The Egyptians had as many as 2000 gods and goddesses. Some, such as Amun, Isis, Osiris, and Horus, were worshipped throughout the whole country, while others had only a local following. There were two essential foci of public religion: the king and the gods. Both are among the most characteristic features of Egyptian civilization. The king had a unique status between humanity and the gods, partook in the world of the gods, and constructed great, religiously motivated funerary monuments for his afterlife. The Egyptian "Book of the Dead" contains the major ideas and beliefs in the ancient Egyptian religion. Because their religion stressed an afterlife, Egyptians devoted much time and wealth to preparing for survival in the next world. Tombs were placed if possible in the desert. Vast resources were expended on creating prestigious burial places for absolute rulers or wealthy officials. Tombs contained elaborate grave goods (mostly plundered soon after deposition), representations of “daily life,” or less commonly of religious subjects, and some texts that were intended to help the deceased attain...
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...The eyes could be involved prior to skin manifestations. Skin lesions can present with a wide range of appearances, occurring on the upper torso, limbs and face. Palms and soles are commonly involved. Skin lesions typically begin with ill-defined, erythematous macules with purpuric centers, although many cases of SJS/TEN may present with diffuse erythema.24 Nikolsky sign, which is easy removal of the epidermal surface with gentle pressure, is present. Nikolsky sign is a helpful clinical indicator, however not specific for SJS/TEN. The skin could be tender to touch before lesions...
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...Room 234 | cvena@emory.edu | echa5@emory.edu | 404-727-8430 | 404-712-9578 | Office Hours: By appointment | Office Hours: By appointment | COURSE DESCRIPTION: This course is an introduction to the theoretical and research foundations of advanced nursing practice. Key content to be covered includes the philosophical basis of science and knowledge, the structure and development of theory, qualitative and quantitative research methods, theory and research critique, and the application of theory and research in advanced nursing practice. It delineates research competencies for advanced practice nurses. The course encompasses critique of studies, application of research findings to practice (research utilization) and evaluation of outcomes attributable to advanced practice nursing. Ethical considerations related to research are integrated throughout the course. COURSE OBJECTIVES/OUTCOMES: 1. Understand the relationship between theory, research, and practice. 2. Critique and evaluate theoretical perspectives and research methods used to address clinical problems. 3. Understand qualitative and quantitative methodologies and their appropriateness to examining clinical phenomena in advanced nursing practice. 4. Evaluate the clinical applicability of selected theories from nursing and related fields in providing high quality nursing care. 5. Evaluate the clinical applicability of selected research studies and develop strategies for incorporating the findings into...
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...countries thanks to parents who declined to vaccinate their children”. As we can tell, this outbreak places people at risk, and that’s the biggest problem the medical profession is currently facing. This movement differs from other movements that had previous challenged the medical power, because this movement has a direct affect on the health of people. Along with that this movement seeks to place the blame on doctors for not providing people with the true effects of vaccinations. Overall this movement just demonstrates how people are starting to question the medical power, and its health care intentions. What truly sets this movement apart is that it goes beyond simple rebellion against traditional modes of medicine, but it questions the practices of traditional medicine and seeks to analyze and understand the use of vaccines, and now with the internet around, this anti-vaccination movement is targeting a bigger...
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...information systems. Intrusion detection provides a way to identify and thus allow responses to, attacks against these systems. Second, due to the limitations of information security and software engineering practice, computer systems and applications may have design flaws or bugs that could be used by an intruder to attack the systems or applications. As a result, certain preventive mechanisms (e.g., firewalls) may not be as effective as expected. Intrusion detection complements these protective mechanisms to improve the system security. Moreover, even if the preventive security mechanisms can protect information systems successfully, it is still desirable to know what intrusions have happened or are happening, so that we can understand the security threats and risks and thus be better prepared for future attacks. IDSs may be classified into Host-Based IDSs, Distributed IDSs, and Network-Based IDSs according to the sources of the audit information used by each IDS. 1) Host-based IDSs get audit data from host audit trails and usually aim at detecting attacks against a single host. 2) Distributed IDSs gather audit data from multiple hosts and possibly the network that connects the hosts, aiming at detecting attacks involving multiple hosts. 3) Network-Based IDSs use network traffic...
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...face so as to mitigate them. However, detailed implementation approaches of these strategies are beyond the scope of this paper. HR Strategies There are growing evidence of positive impact HR strategies have on organisational effectiveness and performance (Boselie, Dietz and Boon 2005; Combs et al. 2006; Guest et al. 2003; Huang 2000). Lee, Lee and Wu (2010) quoted Mondy et al. (2002) on the boundary of HR strategies to include five key functions: staffing, human resource development, compensation and benefits, safety and health, and employee and labour relations. Based on Lee, Lee and Wu (2010)’s own study, which extended Mondy et al. (2002)’s HR strategies to include teamwork, HR planning, performance appraisal and employment security, they concluded that HR strategies do attribute to a company’s performances. The espousals of HR strategies are critical in motivating employees’ commitment towards corporate’s strategic objectives (Buller and McEvoy 2012). GM’s HR Director, Susan Maffat, commented on unclear HR strategy offers an indication of GM’s poor or ineffective/inefficient HR strategies. The following problems currently faced by GM are the manifestation of key HR issues due to deficient HR strategies: GM’s Problems and HR Issues 1. Greater workers’ loyalty towards unions A circumstantial evidence to this situation can be ascertain through Susan’s comment on how GM’s managers rescind from HR responsibilities which may have provided the union a chance to infiltrate...
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...March 2012 Pascal’s View on the Interpretation of Good Written in a series of quasi-“tweets”, Pascal, in his Pensées, comments on a plethora of topics regarding human interaction such as human vanity and folly, or the Christian religion. In “Vanity”, Pascal also comments on the variation of justice, “Love or hate alters the face of justice. How much more righteous does a lawyer, well paid in advance find the case he is pleading? (S78)” In ancient Greece, the Sophists were teachers hired to teach members of the aristocracy the art of argumentation for careers in law and politics. Plato disagreed with the Sophists in their belief that any issue could be debated from the affirmative and negative points of view. Today, this is standard practice for lawyers. Rather, Plato promoted the idea of a universal “Good” that cannot be arbitrarily defined because of what one wants or one’s political party. Pascal agrees with Plato and his theory of forms when he states, in “The Supreme Good”, “That man without faith can know neither the true good nor justice” (S181). In these two quotes, Pascal refers to a universal good, and how justice can be construed by money. This does not apply solely to politics and law, but rather to the entire human experience and all of man’s misguided decisions. Pascal would most likely agree to the statement that the profession of attorney is an interesting and variable one. Despite the views of a particular lawyer, he or she may find him or herself advocating...
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...research, this dissertation will aim to systematically review the current literature of evidence for therapeutic hypothermia (TH) post cardiac arrest. The research question is as follows: does therapeutic hypothermia treatment present positive neurological outcomes for post cardiac arrest victims? 1.1a Rationale: Whilst working in the Intensive Care Unit, I had the opportunity to witnessed a patient being cooled (therapeutic hypothermia concept) after experiencing out of hospital post cardiac arrest. I was intrigued to learn more about the concept as I had never heard or seen it done before. This prompted me to research further on the evidence based practice pertinent to TH treatment on post cardiac arrest victims. Patients who have suffered post cardiac arrest are usually cared for in a critical care environment such as the intensive care unit (ICU), and the survival rate for in hospital incidents is considered to be poor (Gwinnut et al 2000). Furthermore, according to Becker (1993) and Rea (2004), approximately 0.04% to 0.19% of out of hospital cardiac arrest incidence occur each year in industrial countries. Around 14% to 40% of these victims regain Return of Spontaneous circulation (Giraud 1996, Finn 2001, Fischer 1997), and only 7% to 30% were able to attain good neurological outcomes on discharge (Jennings 2001, Westfal 1996, Weston 1997). By critically reviewing the literature of evidence on TH, I believe it will help to systematically develop an understanding of the issues...
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