Wellness Education Program Proposal

Wellness Education Program Proposal

[Name of the Writer]

[Name of the Institution]

Wellness Education Program Proposal

Introduction

When one talks about wellness, it is basically the process of getting awareness and making suitable choices for leading a healthy and fulfilling life. When put into consideration, it can be taken as a notable process which brings about growth and change. The focus of my previous paper was African Americans; I chose that ethnicity because I believe that they are parts of the vulnerable population like Hispanics, Asians and Native Americans. As discussed in the previous paper, this vulnerable population faces difficulty in getting proper healthcare due to not having insurance, low wages, lack of education, and language barriers. These issues are just a few that impact that quality of healthcare that these people get. The wellness education program has a focus on preventing various illness and diseases among the African American population (Jennings & Slavin, 2015). I will like to explain things in the context of the elderly population of African Americans since they are even more deprived of proper healthcare. The wellness program is focused on providing awareness to the vulnerable population residing in Brooklyn Center and New York.

Cultural Reflection

Cultural reflection is essential for the effectiveness of the counseling approach. When we talk in this context, culture can be referred to as something that distinguishes people on the basis of age, language, gender, sexual orientation, and race. The elder population of the African American community is more prone to illness and diseases due to the old age factor, so it should be essential to create awareness on substance abuse and promote a healthy lifestyle in them to avoid health-related issues. It is to be kept in mind that self-management of various medical conditions is key that can be influential in eradicating the disease from the person's body to lead a healthy life. In Brooklyn Center and New York, there are a lot of private organizations and networks who set out cultural change campaigns. In these campaigns, they listen to everyone's concerns and choice regarding healthcare. In a comparison of the younger people of any community, the elders are the ones who are most likely to be more susceptible to various types of illness and diseases and require treatments as soon as possible due to having lower immunity.

Elements of CAM, Holistic Health, Spirituality and Traditional Medicine in the Wellness Education Plan for Elderly African Americans

CAM

This is a medicinal technique that efforts to optimistically influence the wellness plan by endorsing curative products that are required to be taken in conjunction with your standard medical products. Cam is that technique that further has the involvement of products of the system, healthcare and various practices that are basically non-intrusive and non-pharmaceutical (Collyer, 2017). It was stated by a lot of scholarly individuals that CAM approach is safe yet effective for the vulnerable elderly population.

Holistic Health

The Holistic Healthcare technique can have a positive influence on the wellness action plan as it will create a positive impact on the rounded health and overall environment of the elder patients. Hence, the incorporation of holistic health on various levels aids in embracing the link between spiritual, physical and mental health being. The main focus of the health care in the holistic framework is inclusive of diet, exercise, attitude and behavioral modifications, environmental measures and spiritual counseling.

Spirituality

Spirituality is that one term that holds the ability to influence the wellness action plan as its efforts to answer the three main questions that carry great importance. The questions are; where an individual wants to be? Where had a person been? And lastly where the person is in the present? Putting these questions under consideration and analyzing them can majorly aid in framing the plan and overpowering the issues that are faced. The education program will be structured to understand that spiritual needs of the elders and will develop various ways and techniques to help meet those needs.

Traditional Medicine

This is where the cultural awareness steps in. Traditional medicine can be defined as the collection of knowledge, skills, practices which are on the basis of theories, experiences and believes that are originated and native to different cultures. People from different ethnicities have utilized this knowledge in health maintenance and in the diagnosis, treatment, and enhancement in the diagnosis of various diseases and illness. The incorporation of traditional medicine in the education plan of wellness will assist in promoting traditional practices of medicine for the overall wellness of families and a community as a whole.

Linguistic Consideration

It was identified that hurdles in relevance to various cultural beliefs and linguistics could not be avoided if an institution is targeting to provide quality healthcare to patients from various ethnicities. Living in the United States of America it is obvious that there are people residing in the country from various cultural and religious backgrounds. It is a fact that if there is an error in communication, it can negatively impact the health of a person. Let us discuss a few pointers that need to be kept in mind when starting a wellness education program:

Miscommunication – It is the most apparent error in the world of medicine as it can put the life of a patient in danger. When one is providing education to the elderly of a vulnerable community, it is necessary that the language that is being used is easy enough to be understood by a layman.

Language Hurdles – language hurdles are crucial when it comes to the elderly members of a community. If the members who are in the wellness program cannot communicate the important guidelines with full impact on the population, the program will go towards the direction of failure. It is necessary that when hiring people, such people are selected who can communicate properly with the people of the United States.

The Marketing and Tactics of the Wellness Education Plan

It is essential to make certain techniques and strategies that stern on educating the elderly of the vulnerable population of African Americans about health promotion and the prevention of diseases. Below are a few tactics that can be integrated into the wellness program:

The Promotion of Health

It can be done by initiating "Campaigns" that are targeted to discourage the use of tobacco, alcohol and other products that can be harmful and have an impact on the promotion of a healthy lifestyle in the elderly. Additionally, rewards can be provided to the elderly in taking part in the program. Secondly, the plan of wellness education can contain a list of "Nutritional products" that can be put under consideration by the elderly population to lead a healthy lifestyle. The list can also include fruits and vegetables that will aid in the wellbeing of the elderly. Finally "Sexual Health" carries great importance as well. This step in inclusive of the promotion of a state of social, mental and physical sexual wellbeing of an individual. It is necessary that awareness regarding safe sexual encounter is incorporated in the wellness education program.

The prevention of Diseases

The elderly need to be guided and made aware of the importance of "vaccination" so they can prevent any illness from attacking them. The wellness education plan should also be inclusive of the delivery of information in regards to "Behavioral and Health Risks", besides effective care tactics to the elders. Lastly, "Premature detection of an illness" is a vital component that can have an influence when it comes to the prevention of significant disease or illness.

The Education and Marketing Plot

There are a few prominent tactics that can be applied to help market the wellness education plan. Firstly the “Market Segmentation,” the market segmentation involves the targeting of the elderly of the vulnerable community of the African Americans residing in Brooklyn Center and New York USA. The elderly will be targeted through various means. Further, "Promotions and Advertisement" can be utilized to make an impact. When it comes to advertisement, it can be done via social media. Majority of the elderly use Facebook, but one needs to be strategic. It needs to be kept in mind that not all social media platforms are a good option. Facebook is older, and awareness regarding it is present, so ads can be posted online which is targeted for the vulnerable elder population to raise awareness for the program. Different banners and pamphlets can be stuck to places where the elderly are most likely to go. This way of promotion should directly talk about the awareness of the program.

Advantages of the Wellness Education Plan

There are a lot of benefits for the wellness education program; they are both long-term as well as short-term. Short-term AdvantagesFor starters, the elderly African American population can make use of the wellness education plan to shed weight by following the guidelines that are described by the plan. Additionally, any disease that has been recently diagnosed can be immediately and effectively catered by following the education plan. Lastly, physical fitness can be improved by following certain exercises which have been described in the wellness program.

Long-term Advantages

The program helps in the reduction of various medical issues faced by the elderly population. It will also help in reducing the healthcare costs that can help save money in the long run. The program can also aid the elderly in avoiding such dietary habits that can lead to bad health. The program can help maintain health in the long-run. This has to be the most significant advantages of the program.

The Impact of Ethical Principles on Preventive Care and Health Promotion

It is essential that ethics are kept in mind by the organization when promoting health and giving preventive care. The following ethical principles can be kept in mind:

Privacy – the privacy of a user is a crucial component that needs to be kept in mind when promoting health and delivery of operational care. The misapplication of the confidential of the user's data can lead to a bad impression of the promotion of health. This is why it is essential to consider the privacy of the patients.

Advertisement Tactics – It is apparent that there are some ethical issues that are in regards to the advertisement. At times there are certain omissions, exaggerations, cultural misappropriation or various emotional appeals are portrayed, or children are used in the advertisement. One should always be careful in regards to that, and further, any appropriate and proper advertisement technique can be used for sure, there is no restriction to that.

Equality – being equal and fair is another crucial factor that needs to be kept in mind (Rock & Degeling, 2015). This part illustrates that there should be zero discrimination when it comes to the delivery of health services.

Laws that have an Impact on Health Promotion

The local and federal laws can have a massive influence on the wellness of the education program. It is important that all the laws of the state are being followed strictly when providing education to the vulnerable population. HIPAA (Health Insurance Portability and Accountability Act) targets to safeguard the privacy of health data in regards to a patient that is transferred or upheld by healthcare professionals. It is inclusive of e-mails, voice mail and oral, as well as paper record. This law needs to be followed by the organization at all costs, as if the elderly face a privacy issue because of the company, it can impact the reputation of the firm.

It is also important to keep in mind the immigrants from different countries as well. Disparities in healthcare which are of a legal nature can have an impact on health promotion as well (Yamada et al., 2015). The people from different ethnicities at times face health care issues and are not given equal rights due to their status. Additionally, the changes that are made in the law can also have a negative impact on the processes of the organization, so it is essential that all the process is kept up to date in light of the changing policies.

The Economic Impact on Clinical Preventive Services and Health Promotion

The economic impact that is brought upon by health promotion and clinical prevention is pretty significant. One of the biggest facts is that health care is delivered to socially disadvantaged people as well. The wellness education can aid the elderly population in saving cost on healthcare as well. Chronic diseases came out strong as core healthcare cost drivers which resulted in economic loss. With the initiation of a wellness education program, chronic diseases can be reduced to some degree.

Conclusion

The treatment costs can be reduced with the help of self-management of a medical issue or condition faced by the elderly. Lucky for them, the wellness education program provides guidelines to self-manage a disease. It can be easily called as one of the most influential and vital ways to cut hospital expenses and healthcare costs. The wellness education plan can also aid in the initial diagnosis of any disease or illness. This fact is very useful as it can help avoid medical costs that are required to treat a bigger illness.

References

Jennings, M. L., & Slavin, S. J. (2015). Resident wellness matters: optimizing resident education and wellness through the learning environment. Academic Medicine, 90(9), 1246-1250.

Rock, M. J., & Degeling, C. (2015). Public health ethics and more-than-human solidarity. Social Science & Medicine, 129, 61-67.

Yamada, T., Chen, C. C., Murata, C., Hirai, H., Ojima, T., & Kondo, K. (2015). Access disparity and health inequality of the elderly: unmet needs and delayed healthcare. International journal of environmental research and public health, 12(2), 1745-1772.

Collyer, F. (2017). The corporatisation and commercialisation of CAM. In Mainstreaming complementary and alternative medicine (pp. 81-100). Routledge.

What Are You Going To Do About It?

What are you going to do about it

Your Name

Institution

What are you going to do about it?

This paper discusses the issue of smoking among teenagers in an American community. Falling into the habit of smoking in early teenage results in addiction. According to America’s health ranking 8.9 percent of the elders are smoking CITATION Ame19 \l 1033 (America's Health Rakings, 2019). Smoking amongst the teenagers is very common throughout the communities in United States. Health-related issues that are related to smoking are sudden infant death, ear infections, lung problems, respiratory infection, and asthma. Approximately 90 percent of people start smoking as a teenager. Health risk from smoking does not only affect the smoker alone, people around smoker also get affected due to the habit of smoking. If a woman smokes while pregnant, there is a chance of premature birth and even miscarriage. People also smoke to reduce depression and anxiety. Severe cases of depression and anxiety may also lead to suicide.

Once the effect of smoking in the community is identified, an important step is to devise a strategy to overcome the issues of smoking. Healthy people are a group of organizations making efforts to improve health quality throughout the United States. With the help of Federal and State government, According to Healthy People, there are 480,000 death recorded annually in United States CITATION Hea16 \l 1033 (Healthy People, 2016). Healthy People has taken many initiatives to reduce tobacco usage. Increasing the prices of tobacco products and reducing smoking advertisements which are directed towards teenagers or children are the most effective strategy put forth by Healthy People.

As a healthcare professional, I would love to participate in an effort to reduce smoking. An awareness campaign is necessary to discourage people from smoking. As a public health professional, I will become an active member of the organization like Healthy People. Seminars in local schools and colleges can be arranged to address the issues of smoking and its effect on health. Cases of chronic diseases caused by smoking can also be presented in the seminars to discourage the teenager from smoking.

References

BIBLIOGRAPHY America's Health Rakings. (2019). 219 Senior report. (U. H. Foundation, Producer) Retrieved from America's Health Rakings: https://www.americashealthrankings.org/

Healthy People. (2016, 8 26). Tobacco Use. (U.S Department of Health and Human Services) Retrieved from HealthyPeople: https://www.healthypeople.gov/2020/topics-objectives/topic/tobacco-use

What Is It About College Of Mount Saint Vincent (CMSV) That Leads You To Believe It Is The Best Choice For You To Further Your Education?

Admission Essay

Your Name (First M. Last)

School or Institution Name (University at Place or Town, State)

Admission Essay

Choices play a major role in designing future and, good choices are more like virtues that can ease life. Choosing an institution for higher education is one of the most critical decisions of student life. I believe in my choice of "The College of Mount Saint Vincent" for my higher education in nursing. There are a lot of things that make me believe that this institution is the one that I always wanted to be a part of. The College of Mount Vincent is a myriad of successes whose faculty are committed to the flawless education driven by enthusiasm and ecumenism. If a flashback and historical account are considered, the college is one of the institutions with the most glamourous history from where 18,000 students have graduated till now. All the students have achieved something praiseworthy in their lives and it ensures the legacy of college. The college is not only providing education but it is one of the major sources of effective and practical services that are not only extracurricular but they are one of the major components of the college’s mission. Both, inside and outside the classroom is full of resources that can help students to develop and groom in all the dimension of life. Also, this institution gives plenty of opportunities to students that can help them explore their passion and work on it. There are a lot of options that position this institution over the other institutions such as programs of distinction, Oxley Career Education Program and other services that can support students both academically and morally. The faculty staff has superb academic credentials and award-winning research that is proof of the excellence and command in the subjects and modules that are taught to the students. The Mount is one of those institutions that prepare students for a better career and not just for a job. Also, this institution is a platform that helps student to be aware of and adopt analytical skills, ethical responsibilities, persuasive and clear communication with critical thinking. All these features are essential for success in all professions and it is one of the most expensive investments that an individual can make to its future. The institution is not just an emblem of perfection in its academics but the location is also commendable. It is evident that a student cannot learn in a monotonous or somewhat hollow place that is empty of natural beauty and aesthetic pleasure. I am not only in love with the academic upheaval that is gifted to the students but I am much impressed by the geographical features as well because a good place with intellectual beauty makes a perfect match. It would not be wrong to call this place a ladder of success and knowledge rather than an institution only. College of Mount Saint Vincent is a place where students take responsibilities and then turn them into reality. I think, this institution is the best choice for my future because this college is a place where ideas are heard, innovations are taught and students are given the ability to fly on the wings of academic excellence. There are a lot of connotations that make this college a perfect place for learning such as, a model that is meant to be admired, success through strategic partnership and an approach to digging the treasures of knowledge. The College of Mount Saint Vincent is a source that can help students play their part in the progression of the world and compete with the intellectual emblems in a more organized, fluent and excellent way, which is all the result of the exceptional performance of teachers and input of the institution.

What Is The Purpose Of Nursing Theories?

What is the purpose of nursing theories?

[Author Name(s), First M. Last, Omit Titles and Degrees]

[Institutional Affiliation(s)]

Author Note

[Include any grant/funding information and a complete correspondence address.]

What is the purpose of nursing theories?

Utilizing a consistent and coherent structure of values, hypotheses, and ideas, nursing theories aim to serve as a foundational structure of professional development, nursing practices, associated research and education in the domains of nursing. The most conspicuous function of these theories is to illuminate the phenomenon of ‘nursing’ through various research paradigms and methods of reasoning. The direction in which this field and phenomenon should develop in the future is also steered by the nursing theories and the growing body of these theories enables personnel associated to distinguish between necessary and irrelevant knowledge. The professional boundaries can also be fabricated and maintained by these theories. Some common examples of theories upon which the profession majorly relies are: General system theory, Developmental theory, and Adaptation theory CITATION Bra19 \l 1033 (Brandão, 2019).

More often than not, nursing is regarded as both a science and an art. Nurses are very well able to relate to this widely prevailing belief. Nurses are thoroughly aware of the patient care plans and disease mechanisms, along with the dynamics of medications and management practices on several fronts. The operationalization of various equipment pre and post-surgery is also critical to know for the members of the nursing and this can be encompassed in the science of nursing. On the other hand, the art of nursing refers to the humanistic qualities and the core principles that guide the practices of nursing. Some of these values are compassion, care, and communication. Additionally, the art of nursing also entails that the nurses should be aware of the cultural, spiritual, and biopsychosocial needs of the patients and should never forget to incorporate these elements in their day-to-day practices CITATION Bar17 \l 1033 (Barrett, 2017). The experience of any patient in a hospital is greatly influenced by the behavioural attitude of the nurse who takes care of the patient. The nursing programs and associated courses offer a plethora of advanced techniques of nursing practices that can enable the interested individuals to reach the zenith of this profession, but in the contemporary era, nurses should also learn to teach and adapt the humanistic qualities through observation, experience, and role modeling.

There has been extensive research on the conception and prevalence of the public image of the nursing profession. A great deal of diversity and incongruity has been observed in the image of this profession as held by the general public. The identity and public image are significantly based on the traditional cultural and social values, work values and the prevailing environment, and the level of education of the specific region. The nurses can promote the image of this esteemed profession by being more visible in every role and place of employment. There should be a promotion of their accomplishments and researchers and educators should collaborate with the nursing administrators to recognize their efforts and professional contributions. A unified entry into the academic horizons for those individuals who are interested in the profession will be instrumental from an educational perspective. Nurses should also participate in the political arenas to reshape the public image. The increased representation of nurses and their associated issues in healthcare will only be possible if more personnel from this profession are present at the tables of policymaking.

The goals of effective healthcare delivery can only be realized if communication is regarded as an essential and crucial component in all the steps of the healthcare processes. The need for the dissemination of concise and accurate information and communication is present at all times, irrespective of the participants of the communication. If the scenario involves a nurse communicating with her fellow at the shift rotation, or a nurse recording the important bits and pieces of medical history from her patient, if there will be loopholes in the communication process, medical errors will significantly increase. The healthcare institutions that implement and observe strong communication policies have a credible repute for healthcare delivery in sheer contrast to those hospitals and facilitates, where communication strategies and policies are weak. The sincere intention displayed by a nurse to understand the concerns of the patients is a part of effective communication. In a multi-cultural environment, effective communication automatically takes the role of a prerequisite.

There are many reported instances where communication has created a barrier between the nurse and the patient. Communication can be perceived as a barrier between the patient and nurse if there are issues associated with a misinterpretation or if there is a reinterpretation of messages CITATION Nor16 \l 1033 (Norouzinia, 2016). It has been observed that nurses tend to use a lot of medical jargon, and overload information for the patients who are already in distress and their medical condition does not enable them to prioritize accuracy in communication with their healthcare providers or nurses. Using a lot of clinical acronyms and technical jargon can also pose problems for the delivery of accurate information and ambiguity can be avoided. Patients also tend to assume based on their cultural traditions and biases. For instance, if a young doctor briefs the extended family of the patient about his or her diagnosis, chances are that the information may be misinterpreted or even ignored.

References

BIBLIOGRAPHY Barrett, E. A. (2017). Again, what is nursing science? Nursing science quarterly, 129-133.

Brandão, M. A. (2019). Nursing theories in the conceptual expansion of good practices in nursing. Revista brasileira de enfermagem, 577-581.

Norouzinia, R. A. (2016). Communication barriers perceived by nurses and patients. Global journal of health science, 65.

When Communication Fails

When Communication Fails

[Author]

[Institutional Affiliations]

When Communication Fails

Communication is the key for patient safety and effective care delivery within any heath care setting. It is the responsibility of the health care professional to assume their complementary roles and cooperate with each other through proper voicing of ideas and concerns, sharing the liabilities for problem solving and making important health decisions in order to carry out effective plans for delivering the patient care. It is imperative to inculcate the practice of collaboration among physicians, surgeons, nurses, anesthetists and other health care specialists. The communication enhances the awareness and knowledge of the medical team regarding each other’s skills and analyzing their roles. This practice assists in decision making process in the cases of critical cases such as that of Bromiley Case.

Studies over time have established that the social, interpersonal and organizational structures within health care systems add to the communication failures and it has been implicated as one of the major contributor to the adverse medical events and patient outcomes. It has also been found out that there the verbal communication among different health care staff remains inconsistent which eventually leads to complicated cases. Several health care staff is used to have poor communication and ineffective teamwork due to the toxic culture of low expectations developed within health care settings. The lack of communication leads to medical errors because albeit conscientious health care specialists tend to ignore the potential red signals and other clinical discrepancies. However, it is needed to consider such indicators as worrisome and a questionable stance over their objective of delivering care with safety ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"hDp1HZ3d","properties":{"formattedCitation":"(O\\uc0\\u8217{}Daniel & Rosenstein, 2008)","plainCitation":"(O’Daniel & Rosenstein, 2008)","noteIndex":0},"citationItems":[{"id":377,"uris":["http://zotero.org/users/local/9Hfkg8Y0/items/MBEQM2Y4"],"uri":["http://zotero.org/users/local/9Hfkg8Y0/items/MBEQM2Y4"],"itemData":{"id":377,"type":"chapter","title":"Professional Communication and Team Collaboration","container-title":"Patient Safety and Quality: An Evidence-Based Handbook for Nurses","collection-title":"Advances in Patient Safety","publisher":"Agency for Healthcare Research and Quality (US)","publisher-place":"Rockville (MD)","source":"PubMed","event-place":"Rockville (MD)","abstract":"Effective clinical practice must not focus only on technological system issues, but also on the human factor. As shown in this chapter,good communication encourages collaboration and helps prevent errors. It is important for health care organizations to assess possible setups for poor communication and be diligent about offering programs and outlets to help foster team collaboration. By addressing this issue, health care organizations have an opportunity to greatly enhance their clinical outcomes.","URL":"http://www.ncbi.nlm.nih.gov/books/NBK2637/","call-number":"NBK2637","note":"PMID: 21328739","language":"eng","author":[{"family":"O’Daniel","given":"Michelle"},{"family":"Rosenstein","given":"Alan H."}],"editor":[{"family":"Hughes","given":"Ronda G."}],"issued":{"date-parts":[["2008"]]},"accessed":{"date-parts":[["2019",11,6]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (O’Daniel & Rosenstein, 2008).

There are several proposed models in order to enhance the clinical experiences and considering the implications of the human factors. The mental models, according to the theory of Senge, emphasize that these are the assumptions, generalizations or visuals ingrained in one’s consciousness that effect one’s understanding about the world. These factors influence their actions based on either generalization or complicated theories. Within a clinical setting, two individuals with conflicting mental models can impede the ability to learn and bring innovation in the choices. Since a wrong mental model can ultimately lead to a wrong action, a contradictory model among two people would make them interpret the same issue in different ways. In such situations, there exist communication gaps and lack of team work. These conflicts can be overcome by focusing on the Learning Organization and its five components i.e. personal mastery, team learning, shared vision, mental models and systems thinking. These objectives help in the preventing and coping with the severe complications and adverse events that might occur due to lack or failure of communication.

TeamSTEPPS program has discussed standardized techniques for effective communication. The first strategy is SBAR which is used for communicating serious information that might need immediate consideration and actions based on patient’s condition. This technique includes to understand the patient’s situation, clinical background, assessment of the problem and recommendations and requests. Another strategy is Call-Out in which critical information is simultaneously provided to the all the team members. Check-Back is a method of conforming if the information conveyed has been understood by the receiver. While Handoff provides opportunity to ask several questions to clarify and confirm the information transferred ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"T69LxjFS","properties":{"formattedCitation":"(AHA, 2015)","plainCitation":"(AHA, 2015)","noteIndex":0},"citationItems":[{"id":383,"uris":["http://zotero.org/users/local/9Hfkg8Y0/items/ZG44J6D8"],"uri":["http://zotero.org/users/local/9Hfkg8Y0/items/ZG44J6D8"],"itemData":{"id":383,"type":"report","title":"Improving Patient Safety Culture through Teamwork and Communication: TeamSTEPPS®","publisher":"American Hospital Association","author":[{"family":"AHA","given":""}],"issued":{"date-parts":[["2015"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (AHA, 2015). It has been contemplated through research that following these protocols and ensuring the proper channel of communication within a clinical setting can prevent medical complications. It is important to deliver all the information to all the team members. The observations and recommendations by the nurses and other staff should not be ignored, rather their say should be given due attention. A collaborative team can avoid aby adverse clinical events by maintain the flow of communication in the health care setting.

References

ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY AHA. (2015). Improving Patient Safety Culture through Teamwork and Communication: TeamSTEPPS®. American Hospital Association.

O’Daniel, M., & Rosenstein, A. H. (2008). Professional Communication and Team Collaboration. In R. G. Hughes (Ed.), Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK2637/

Where In The World Is Evidence Based Practice

Title page

Evidence-based practice

I agree with the post that Evidence Based Practice is important for healthcare organizations. The NCCH website has highlighted 2016 Clinical Practice Guidelines for TB Diagnosis. I think by using guidelines it is possible for the healthcare providers to offer accurate care that will eliminate the possibilities of errors in administration. Nurses would be able to perform accurate diagnosis by relying on evidence based practice. This improves their efficiency.

I agree that organizations must teach nurses to use evidence based practice. The teaching plans at organization are focused on building professional nursing skills and for using evidence based practice in healthcare settings. The nurses will administer the characteristics explained by different nursing theories to develop positive interaction with patients. The nurses learn under different the nursing models that are focused on the elements of building positive attitudes. The plan will allow them to learn developing positive moods during their encounter with the patients and showed concerns regarding their health conditions. Nurses will gain experience for assessing the patients’ conditions and their views about their illness and treatment CITATION Hil92 \l 1033 (Peplau, 1992).

Peplau’s quote “relationships are characterized by personalities, moods, concerns, needs, personal values and views of person brings into each interpersonal encounter” (1994) illustrates the elements that lead to effective interaction between patients and nurses. By gaining insights about therapeutic interaction model the student nurse were able to learn techniques for reducing anxiety and depression among patients. The establishments of the effective interaction process are essential to cope with symptoms of anxiety. As a student nurse I developed competency for helping patients to deal with anxiety and provide them with adequate care that leads to improved health.

References

BIBLIOGRAPHY Seyhan, A., & Özbaş, E. (2018). The effect of education of nurses on preventing catheter-associated urinary tract infections in patients who undergo hip fracture surgery. . Journal of Clin Nurs , 27, 5-6.

Varvogli, L., & Darviri, C. (2012). Stress management techniques: evidence-based procedures that reduce stress and promote health. Health Science Journal .

Coehlo, K., Tabacco, S., & Hanson, H. (2015). Family Health Care Nursing: Theory, Practice and Research. F A Davis Company.

Dwyer, L., Patrick, H., & Hennessy, E. (2015). Promoting family meals: a review of existing interventions and opportunities for future research. Adolesc Health Med Ther, 6 , 115–131.

Kemppainen, V., Tossavainen, K., & Turunen, H. (2013). Nurses' roles in health promotion practice: an integrative review. Health Promotion International, Volume 28, Issue 4 , 490–501.

Where In The World Is Evidence- Based Practice

Title page

Evidence-based practice

I agree with the post that Healthy People 2020 initiative uses Evidence Based Practice (EBP). These practices can be used by healthcare provides to attain the goal of promoting health and wellness. Nurses have a significant role in providing health to the families. Nurses can use EBP that has an effective role in helping the family that improves the quality of life CITATION Placeholder1 \l 1033 (Seyhan & Özbaş, 2018). The nurses focus on the totality by improving internal and external family environments. The nursing intervention adopted for family health’s promotion emphasizes on family integrity, maintenance of the process, empowerment, exercise, physical activities and parental education.

The nurse educates the family about the healthy meals, physical fitness and psychological health. Nurse educates the family members about sexuality, sleep and rest patterns. She encourages parents to socialize with children and promotes healthy behaviors. The nurse encourages family spirituality and motivates them to remains composed and calm. The main role of the nurse is to unite family and develop a feeling of oneness CITATION a10 \l 1033 (Coehlo, Tabacco, & Hanson, 2015).

The nurses can rely on databases for promoting dietary interventions and provide information about healthy eating patterns and encourage the family to use more vegetables, milk, and beans in their diets CITATION Amy08 \l 1033 (Dwyer, Patrick, & Hennessy, 2015). The nurses promote the physical fitness’ by encouraging family members to engage in physical activities such as sports, exercise and walk. In case of elderly people, the nurses encourage regular walk and simple exercises’. Nurses promote the adherence, knowledge of family about illness and promote self-management CITATION DJG10 \l 1033 (Kemppainen, Tossavainen, & Turunen, 2013).

The mental condition influences the overall health of the members, so the nurse emphasizes on stress management CITATION Var12 \l 1033 (Varvogli & Darviri, 2012). The nurses guide the family to create a friendly environment and encourage communications. The nurse plans night activities such as gaming with no telephones. All members of the family participate in the games that improve interaction between members. The nurse evaluates the results for two months and compares the health outcomes.

References

BIBLIOGRAPHY Seyhan, A., & Özbaş, E. (2018). The effect of education of nurses on preventing catheter-associated urinary tract infections in patients who undergo hip fracture surgery. . Journal of Clin Nurs , 27, 5-6.

Varvogli, L., & Darviri, C. (2012). Stress management techniques: evidence-based procedures that reduce stress and promote health. Health Science Journal .

Coehlo, K., Tabacco, S., & Hanson, H. (2015). Family Health Care Nursing: Theory, Practice and Research. F A Davis Company.

Dwyer, L., Patrick, H., & Hennessy, E. (2015). Promoting family meals: a review of existing interventions and opportunities for future research. Adolesc Health Med Ther, 6 , 115–131.

Kemppainen, V., Tossavainen, K., & Turunen, H. (2013). Nurses' roles in health promotion practice: an integrative review. Health Promotion International, Volume 28, Issue 4 , 490–501.

Why Do You Want To Be A FNP?

For me, nursing is the likely and natural choice. Throughout my life, I have seen my close relatives often hospitalized due to multiple illnesses. As my nature demanded I spent countless nights with them. I would watch the exchanges between the patients, doctors and the nursing staff. I have always found the nursing staff being very compassionate and caring for all the patients, which would make the patient feel better and forget their pain for a while. Even though I did not see anything extraordinary about my childhood, I did recognize, how surprisingly caring the nurses usually are in the darkest times of a patient and their families. That is why I decided to become a nurse to give so to people in need the same compassionate support that I have personally witnessed and admired.

When I started nursing education, I grasped the role played by training and proper management in inhibiting difficulties for the patients and the difference they can make for someone’s family. I see this program as an opportunity for myself to give something back to society, to attain peace and happiness as well as progress in this career. With the training from the Family Nurse Practitioner program, I can give other families a chance for an extended and improved life. I believe I owe that to my community.

As a young child, I have felt that I need to heal the world and have always visualized of becoming a family nurse practitioner to offer primary healthcare for those in need. I also believe that now more than before the need for primary care is vital. I strongly sense that <Institute> family nurse practitioner program will permit me to experience my dream and give me the opportunity to live q purposeful life.

I look forward to furthering my profession by concentrating on primary care and prevention as a nurse practitioner. I will forever be appreciative for the opportunity, and I believe I will surpass the expectations of the institution.

Why I Want To Become A Nurse Practitioner

[Name of the Writer]

[Name of Instructor]

[Healthcare and Nursing]

[Date]

Why I Want to become a Nurse Practitioner

I believe that nursing is not only the job of taking care of sick people but it offers invaluable support to people having life-changing injuries, people who are in great pain or people at dying stage of their lives. To play a larger role in managing my clients I have decided to broaden my scope of practice as a registered nurse. I have realized the importance of increased responsibility and I enjoy the concept so far. Through my education in health care, community care, and geriatric health I wish to help more and more people.

I can provide more individual attention after becoming a nurse practitioner. I have greater knowledge in the history of personal health and it would make a path for me to develop in-depth plan for specific needs of my client. I feel proud to have the knowledge in the health care industry which would allow me to take care of more people when they are in need. There are different people you care about outside the clinical setting like friends, coworker, and family. I can provide them direction towards better health care options and advise them on their health problems. It would also help me to take proper health care decision and improve my own personal wellness.

Nurse practitioners are having a leading position in providing health and wellness services. Considering the needs of clients these Nurses have flexible working style, can see patients in clinical offices or when some patient needs care facilities at home. The knowledge I can gain by working as a practitioner could further refine my skills and make me a resourceful person that I wish to become. I would dedicate myself in providing the best services to the people in need and strive to become a better person and professional nurse.

Why Neurodiagnostic Technology Is Important In Medicine Today?

Neurodiagnostic technology importance in medicine today

[Name of the Writer]

[Name of the Institution]

Neurodiagnostic technology importance in medicine today

Neurodiagnostic technology refers to the medical diagnostic field that records and analyzes the electrical activity in the brain and nervous system. It assists in tracking problems and helping physicians in therapy. Thus, the process enhances the quality of life of patients. This paper will discuss neurodiagnostic technology importance in medicine today and different services of neurodiagnostic technologists that they offer in medicine today.

Neurodiagnostic technology is cutting edge technology in today medicine that uses specialized equipment for ascertaining normal and abnormal electrical activity in the central nervous, autonomic as well as in peripheral nervous systems. For instance, there can be ambulatory monitoring, brain mapping, long-term epilepsy monitoring, and nerve conduction studies. Before sending results of different tests to physicians, neurodiagnostic technologists will analyze and edit them. This practice assists the physician in interpreting the results ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"t23tZzop","properties":{"formattedCitation":"(Tatum et al., 2018)","plainCitation":"(Tatum et al., 2018)","noteIndex":0},"citationItems":[{"id":35,"uris":["http://zotero.org/users/local/CNBGYtRv/items/URXX6MWD"],"uri":["http://zotero.org/users/local/CNBGYtRv/items/URXX6MWD"],"itemData":{"id":35,"type":"article-journal","title":"Clinical utility of EEG in diagnosing and monitoring epilepsy in adults","container-title":"Clinical Neurophysiology","page":"1056-1082","volume":"129","issue":"5","author":[{"family":"Tatum","given":"W. O."},{"family":"Rubboli","given":"G."},{"family":"Kaplan","given":"Peter W."},{"family":"Mirsatari","given":"S. M."},{"family":"Radhakrishnan","given":"K."},{"family":"Gloss","given":"D."},{"family":"Caboclo","given":"L. O."},{"family":"Drislane","given":"F. W."},{"family":"Koutroumanidis","given":"M."},{"family":"Schomer","given":"D. L."}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Tatum et al., 2018).

 Neurodiagnostic technologists have the required knowledge as well as skills to interpret records of patients' nervous system function. This interpretation helps in diagnosis of surgery and therapy for different conditions. For example, when a surgeon is treating the issue related to the spinal cord, by moving, opening or correcting it. During this procedure, neurodiagnostic technologists observe the pathways and if there is any change in nerve responses of patients, they inform surgeon so there may not be damaged at or near the surgical site ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"Ff5Lzkjn","properties":{"formattedCitation":"(Tatum et al., 2018)","plainCitation":"(Tatum et al., 2018)","noteIndex":0},"citationItems":[{"id":35,"uris":["http://zotero.org/users/local/CNBGYtRv/items/URXX6MWD"],"uri":["http://zotero.org/users/local/CNBGYtRv/items/URXX6MWD"],"itemData":{"id":35,"type":"article-journal","title":"Clinical utility of EEG in diagnosing and monitoring epilepsy in adults","container-title":"Clinical Neurophysiology","page":"1056-1082","volume":"129","issue":"5","author":[{"family":"Tatum","given":"W. O."},{"family":"Rubboli","given":"G."},{"family":"Kaplan","given":"Peter W."},{"family":"Mirsatari","given":"S. M."},{"family":"Radhakrishnan","given":"K."},{"family":"Gloss","given":"D."},{"family":"Caboclo","given":"L. O."},{"family":"Drislane","given":"F. W."},{"family":"Koutroumanidis","given":"M."},{"family":"Schomer","given":"D. L."}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Tatum et al., 2018). In the absence of these technologies, it is not possible to detect these kinds of damages by surgeons with the naked eye.

Moreover, neurodiagnostic technology is also important in the intensive care unit. Patients with seizures are evaluated for probable surgery ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"XaBNW9Lf","properties":{"formattedCitation":"(Osman, Friedman, & Hirsch, 2017)","plainCitation":"(Osman, Friedman, & Hirsch, 2017)","noteIndex":0},"citationItems":[{"id":34,"uris":["http://zotero.org/users/local/CNBGYtRv/items/M2SKTTE9"],"uri":["http://zotero.org/users/local/CNBGYtRv/items/M2SKTTE9"],"itemData":{"id":34,"type":"chapter","title":"Diagnosing and Monitoring Seizures in the ICU: The Role of Continuous EEG for Detection and Management of Seizures in Critically Ill Patients, Including the Ictal-Interictal Continuum","container-title":"Seizures in Critical Care","publisher":"Springer","page":"31-49","author":[{"family":"Osman","given":"Gamaleldin"},{"family":"Friedman","given":"Daniel"},{"family":"Hirsch","given":"Lawrence J."}],"issued":{"date-parts":[["2017"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Osman, Friedman, & Hirsch, 2017). neurodiagnostic tech run EEG tests on patients and detect various disorders and diseases such as epilepsy, brain tumors as well as sleep disorders. Additionally, apart from hospitals neurodiagnostic technologists also work in specialized sleep and epilepsy labs; independent clinics; educational institutions as well as in research facilities.

References

ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Osman, G., Friedman, D., & Hirsch, L. J. (2017). Diagnosing and Monitoring Seizures in the ICU: The Role of Continuous EEG for Detection and Management of Seizures in Critically Ill Patients, Including the Ictal-Interictal Continuum. In Seizures in Critical Care (pp. 31–49). Springer.

Tatum, W. O., Rubboli, G., Kaplan, P. W., Mirsatari, S. M., Radhakrishnan, K., Gloss, D., … Schomer, D. L. (2018). Clinical utility of EEG in diagnosing and monitoring epilepsy in adults. Clinical Neurophysiology, 129(5), 1056–1082.

Why Pain Management Is Needed Across The Ages.

Why Pain Management Is Needed Across the Ages

Name

Affiliations with Institutes

Why Pain Management Is Needed Across the Ages

Pain is one of the most common problems in hospitalized patients and is associated with many adverse consequences if not properly managed. The adverse consequences include decreased moving ability, increase hospital stay, and pulmonary complications. In this article, three articles are reviewed to determine the effectiveness of evidence-based interventions for the management of pain.

The first study included in this article was conducted with the main aim to determine the effectiveness of the implementation of evidence-based guidelines for pain management in hospitalized patients. It was a cross-sectional study that was conducted in two hospitals in Sweden between 2009 and 2010. The sample size of this study comprises of 306 patients. The patients were asked about pain intensity while moving and rest and the effect of pain on their sleep. Clinical and demographic data such as diagnosis, age, and sex were obtained from the review of the medical record. The validated verbal Descriptor Scale and Numerical Rating Scale were used for the self-rating of the intensity of pain. Interventions based on evidence-based guidelines such as education of staff and assigning of responsibility of pain management to nurses were implemented. In 2012, a follow-up survey was conducted in which some questions were answered by patients. In a follow-up survey, 293 patients took part. As compared to the baseline survey, the follow-up survey showed significant differences in the prescription of more analgesics and the use of validated instruments for a rating of pain. In a follow-up survey, a significant increase was seen in the prescription of paracetamol. Paracetamol was prescribed to 56% of the patient regularly as compared to 42% at baseline. The results of this study also showed a significant increase in strong opioid use (38% at baseline and 55% at follow-up). In this study, 29% of the patients at baseline reported severe pain at rest and this figure decreases to 24% at follow-up. In both the baseline and follow-up survey, 41% of the patients showed severe pain during movement. Approximately 39% of the patient showed disturbed sleep at baseline and follow-up surveys ADDIN EN.CITE <EndNote><Cite><Author>Andersson</Author><Year>2017</Year><RecNum>380</RecNum><DisplayText>(Andersson et al., 2017)</DisplayText><record><rec-number>380</rec-number><foreign-keys><key app="EN" db-id="2s2s0zrapsf0pbe5efuvv20f9rszvx0sd2fe" timestamp="1578899252">380</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Andersson, Viveka</author><author>Bergman, Stefan</author><author>Henoch, Ingela</author><author>Ene, Kerstin Wickström</author><author>Otterström-Rydberg, Eva</author><author>Simonsson, Hanna</author><author>Ahlberg, Karin</author></authors></contributors><titles><title>Pain and pain management in hospitalized patients before and after an intervention</title><secondary-title>Scandinavian journal of pain</secondary-title></titles><periodical><full-title>Scandinavian journal of pain</full-title></periodical><pages>22-29</pages><volume>15</volume><number>1</number><dates><year>2017</year></dates><isbn>1877-8879</isbn><urls></urls></record></Cite></EndNote>(Andersson et al., 2017).

The purpose of the second article chosen for this study was to increase the knowledge of nurses concerning the complications, intervention, and manifestation related to unmanaged pain and to develop, evaluate and implement evidence-based algorithms to improve the satisfaction of pain with pain. This study also evaluates the satisfaction of nurses regarding pain management using the scores of HCAHPS before and after the algorithm and education program implementation. This study utilizes a prospective pre-post algorithm and survey design. The scores of pre and posttest were analyzed by using an independent t-test. The sample size consists of 23 nurses who participated in pre and post educational surveys. In the second posttest, 11 nurses have participated. Results have shown that the use of non-pharmacological pain intervention increased sleep time from 57% to 64% and the use of earplugs from 65% to 70%. The HCAHPS pain scores significantly increased after the implementation of the pain management algorithm and education program with an average of 62% ADDIN EN.CITE <EndNote><Cite><Author>DeVore</Author><Year>2017</Year><RecNum>382</RecNum><DisplayText>(DeVore, Clontz, Ren, Cairns, &amp; Beach, 2017)</DisplayText><record><rec-number>382</rec-number><foreign-keys><key app="EN" db-id="2s2s0zrapsf0pbe5efuvv20f9rszvx0sd2fe" timestamp="1578899331">382</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>DeVore, Jennifer</author><author>Clontz, Amy</author><author>Ren, Dianxu</author><author>Cairns, Leslie</author><author>Beach, Michael</author></authors></contributors><titles><title>Improving patient satisfaction with better pain management in hospitalized patients</title><secondary-title>The Journal for Nurse Practitioners</secondary-title></titles><periodical><full-title>The Journal for Nurse Practitioners</full-title></periodical><pages>e23-e27</pages><volume>13</volume><number>1</number><dates><year>2017</year></dates><isbn>1555-4155</isbn><urls></urls></record></Cite></EndNote>(DeVore, Clontz, Ren, Cairns, & Beach, 2017).

The main purpose of the third study included in this article was to determine the impact of therapeutic virtual reality for pain management in hospitalized patients. This study comprises of a randomized, prospective trial in patients. In the experimental group, patients were given a library of 21 experiences of virtual reality experiences. In the control, group patients were allowed to viewed specialized television training programs to promote wellness and health. The pre and post pain scores were immediately compared after the initial intervention, after 48 hours and after 72 hours. The sample size consists of 120 participants (61 virtual reality and 59 control). Descriptive statistics for clinical and demographic characteristics such as sex, age, ethnicity, baseline pain score and reason for hospitalization were determined. Bivariate analysis was carried out to determine the significant difference between the experimental and control groups. Chi test for categorical variables and t-test for continuous variables were used. The results showed that patients in the virtual reality group were more satisfied and contended with their experience of audiovisual as compare to the patient in the control group. No significant difference was found in opioid quantity consumed between the group in pre and post-intervention. Virtual reality intervention significantly reduces pain in the experimental group and reported as the most effective intervention for the management of severe pain ADDIN EN.CITE <EndNote><Cite><Author>Spiegel</Author><Year>2019</Year><RecNum>383</RecNum><DisplayText>(Spiegel et al., 2019)</DisplayText><record><rec-number>383</rec-number><foreign-keys><key app="EN" db-id="2s2s0zrapsf0pbe5efuvv20f9rszvx0sd2fe" timestamp="1578899432">383</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Spiegel, Brennan</author><author>Fuller, Garth</author><author>Lopez, Mayra</author><author>Dupuy, Taylor</author><author>Noah, Benjamin</author><author>Howard, Amber</author><author>Albert, Michael</author><author>Tashjian, Vartan</author><author>Lam, Richard</author><author>Ahn, Joseph</author></authors></contributors><titles><title>Virtual reality for management of pain in hospitalized patients: A randomized comparative effectiveness trial</title><secondary-title>PloS one</secondary-title></titles><periodical><full-title>PloS one</full-title></periodical><volume>14</volume><number>8</number><dates><year>2019</year></dates><urls></urls></record></Cite></EndNote>(Spiegel et al., 2019).

Conclusion

This article has determined the different evidence-based interventions in the management of pain in hospitalized patients. The results of three different studies showed that evidence-based intervention programs are important in pain management in hospitalized patients.

References

ADDIN EN.REFLIST Andersson, V., Bergman, S., Henoch, I., Ene, K. W., Otterström-Rydberg, E., Simonsson, H., & Ahlberg, K. (2017). Pain and pain management in hospitalized patients before and after an intervention. Scandinavian journal of pain, 15(1), 22-29.

DeVore, J., Clontz, A., Ren, D., Cairns, L., & Beach, M. (2017). Improving patient satisfaction with better pain management in hospitalized patients. The Journal for Nurse Practitioners, 13(1), e23-e27.

Spiegel, B., Fuller, G., Lopez, M., Dupuy, T., Noah, B., Howard, A., . . . Ahn, J. (2019). Virtual reality for management of pain in hospitalized patients: A randomized comparative effectiveness trial. PloS one, 14(8).

Wicked Problems



Full Title of Your Paper Here

Your Name (First M. Last)

School or Institution Name (University at Place or Town, State)

Wicked Problem

Wicked problems are the most contentious and critical, especially in the paradigm of healthcare. In the United States of America (USA), a wide range of stakeholders presents contrasting views on the manifestations of the problem and its nature. The solutions to severe wicked problems are not always right or wrong. Instead, it assimilates the nature of the problem as the best or worst case solution. One of the common wicked problems witnessed in the healthcare paradigm in America is that there is a stopping rule for the patients. For instance, they recover and go home and then transfer to other system and in the end, face death. It sounds a natural system but in essence, it requires a critical approach to examine the wickedness of the problem.

Moreover, how the choice of the patient should be encouraged? The school of thoughts proposes to treat them near home or far away from home based on expert healthcare services. The patients were faced by the wicked problem of not being able to afford the quality healthcare services which is generally not restricted to the specific organization. Almost each healthcare organization in America faces a similar challenge. The prospects of Medicare and Medicaid have struggled to confront these wicked problems in true letter and spirits. The primary onus of the impediment lies on the stakeholders of the healthcare organizations. Irrefutably, they possess the key to formulate the financial structure of the organization and thus they can advance to resolve the wicked problem. Nevertheless, the nature of the wicked problem is complex. These stakeholders will have to rebuild the policies, financial assessment and the operational structure of the organization to meet the challenges.

Windshield Survey

Population and Its Primary Health Concern.

Students' Name

Institution affiliation

Date

Windshield survey

When living in a country as large as the United States, it is a given that there are going to be people from different ethnicities. Living in the 21st century, discrimination based on race should be put behind, but unfortunately, it is still present in many areas. People are denied their right based on being from a different race; being a minority just adds to their hardships and makes them more vulnerable. In order to provide effective health to the community, the healthcare provider needs to fully understand the demographics, cultural beliefs, economy, behaviors and needs of the consumer in the community. The paper gives a report of Windshield survey addressing the issue of health disparities for people living in Brooklyn Center.

Overview of Brooklyn Center zip; code 55429, 55430

It should be understood that America is a country with diverse culture, religions, beliefs, and people with different values. The nurses who are in distinct places, meet new people from various ethnicities every day. People who are generally part of a diverse culture are said to be vulnerable. These people suffer from disparities of health when they are put in comparison with the dominant population; this issue makes them vulnerable. Disparities generally exist in a high amount in the US; nurses need to make a targeted effort in order to bring a difference. Areas like Mississippi, Michigan, and Miami are the cities which face such issues. A lot of African Americans and Hispanics reside in these areas. In general, I would like to add that these are the areas with abundant population, but I have witnessed that where the diverse group is in the minority, the issues faced by them to access healthcare is higher. Brooklyn Center is one of the cities in Hennepin County located in the State of Minnesota, United States. It is on the west bank of the River Mississippi and borders Minneapolis to the northwest border.

Demographics

According to the most recent census estimate of 2017, the area has a population of 31006. Whites made about 46.6 % of the racial makeup, 27.8 % comprises of the African American, the Asian made 16.6 %, Native American was 0.8% while 0.1% Pacific Islander. People from other races make 4.4 % of the population. Hispanic or Latino were 9.6% of the population. The city's average age is 32.1years. 27.6% of inhabitants were children under the age of 18; 60.2 % were adults between the ages of 18 to 64; while the old aged 65 or older made 12.2% of the population. 48.3% were male and 51.6% female by the gender makeup.

Surveillance survey of Brooklyn Center

The survey will give a detailed overview of people living in Brooklyn Center. The areas of interest will be education, economy, households, lifestyle, pollution, and culture. As per Bailey, D. N. (2010), Vulnerable groups in the population and health disparities will be based on age, wealth and level of education among the different races. Majority of the people who are not whites lack health insurance. If the health insurance issue can be solved for blacks, Asians, Hispanics, and other minorities, the things would become a whole lot better for them. According to the survey, it was suggested that the people living in the area lacked health insurance. If that was not enough, it was found out that the way they were treated by the nurses was not how a regular white was treated. It is safe to say that discrimination is present in the Healthcare sector. I will be focusing on the African American community and how a big chunk of them suffer from being overweight. It was seen in the area that their willingness to shed weight was quite less as opposed to white people.

Education

About 10% of the population has achieved less than 9th grade and similar group less than 12th grade. A larger population of about 30% are high school graduates, 21% have gone to college while 11% are degree associates. This might be the case as they might not be well aware of what consequences can they suffer from. If they were more aware of what results can being overweight for a longer period of time bring, they would be a lot more interested in trying to make an effort to reduce it.

Economy

The economy of Brooklyn Center has a labor of up to 15000 people. Most of them specialized in Management, Manufacturing, and healthcare Social Assistance. The average income per household is $50,618. The overall poverty rate in Brooklyn is 18.2%. The back race and the uneducated group is more vulnerable to poverty with about 30% and 27% of them living below the poverty line respectively. Sometimes, people refuse to go to the clinic based on their wages. They cannot afford it; a lot of these people opt for online help or home remedies. There are usually a few elders of the community who help relieve pain with home remedies. Further, they do not pay much attention to someone being obese or overweight. In the black community, there are still thoughts that having extra kilograms is a good thing. Another thing that needs to be kept in mind is the fact that when one is living in poverty, they accept the majority of the food that they get in any situation or gathering. This obviously means that they will gain weight.

Lifestyle and Housing

Brooklyn Center features a life of urban to the suburban regime. The environment has miles of trails, sidewalks, numerous parks and river access which offers an active way of life. There are roughly 11 000 households in the city. More than 60% had an owner-occupied housing unit rate with a median value of 151,500 $, 0.6 times smaller than the national average. If awareness can be created, then there can be a difference made. The nurses that are recruited in these areas need to make the people more aware. In my opinion, health caregivers need to be given awareness when it comes to diversity. They need to know how to deal with people from different ethnicities so when they deal with people who are from different cultural backgrounds they would know how to deal with them. A lot of people do not understand the fact that people of a different race at times do not go to clinics just because of the fear that they have of how they will be treated.

Pollution

One of the main problem facing the people of Brooklyn Center is access to clean water. The city waters are impaired to the pollutants such as bacteria, turbidity, nutrients, and industrial effluents. This is also a cause that the areas go through various health issues. Now when it comes to being overweight, imagine the number of processed foods present in the market. People do not have the awareness and nor the guidance to opt for a healthier lifestyle. It is pretty simple; the thought of organic food just makes people think of the price tag. An overall difference needs to be made so people can make healthier choices on a budget.

Culture and diversity.

Brooklyn Center is a multicultural community with diverse cultural and religious ethnicities. There are Christians making the largest proportion of the community, Jews, Muslims, and other religious expressions. 90% 0f the population is an American resident. Spanish forms most of the foreign language with about 25000 speakers, African Languages with 1200 speakers and 300 Latino’s speakers. Language can be a barrier to effective healthcare in a community. It is a fact that because the health caregivers not being well aware there is a barrier to getting proper healthcare. There are going to be people who will not be able to communicate what the actually want. So, as I mentioned above, I will mention this here as well that the nurses need to be given diversity education.

How demographics have changed.

According to the 2010 census the area had a population of 30,104. This is about 3% increases for the last 7years and by0.33% between .2015 and 2016. Whites racial makeup reduced by about 4% while African American and Asian make up increased. According to Lindeke, B. (2014). Over the last decade, Brooklyn and Minnesota in large have been evaded by fast-changing sub-urban tension of poverty. Since the last census, Brooklyn Center's Poverty rose from 4.8-11.4%. According to Dilworth‐Anderson. (2012). World Health Organization’s list poverty is one of leading the determinants of health, and the trend is worrying.

Prevalent health risks statistics and Health Care in Brooklyn Center.

The most dominant diseases in Brooklyn Center High blood pressure and being overweight with 25%. Prevalence next is asthma with 20% preference followed by diabetes at 15%. Hearing and vision problems are also common at 15% according to Dartmouth Atlas healthcare 2017; Heart failure is low with about 377 patients, Myocardial acute infection with 220 patients and pneumonia with about 340 patients. Diabetes Medicare enrolls 611black enrolled, and 2941 non-black enrolls for treatments related to diabetes and is aged between 65-75. There are 117 primary physicians, 91 dentists, 312 mental profession s and 141 0ther providers for every 100,000 people. Due to a lack of health insurance for most of the vulnerable group, they cannot go to more than half of these clinics. The African American community has been around for so long, yet, they still do not have the same rights as most of the whites. White privilege is an issue, and it needs to be dealt with on a higher level in the hierarchy to make a difference further.

Health Disparities and Social Determinants.

Culture is an intrinsic element in the community of Brooklyn that has its own impact on health. Religious affiliation has a high correlation to health hence an impact on stress, diabetes, and high blood pressure diseases. Some cultural beliefs refrain one from seeking medication or using some products. Research shows that patient’s satisfaction is meant if the spiritual beliefs and practices are meant. There are going to be people with different mindsets, be it African American, Asian or Muslim. They will not go for healthcare thinking that medication is not good for the health. At times one's own culture can become a hurdle in getting healthcare. Awareness for such patients also needs to be created that how at times things can spiral out of control leading to a near-death experience if medication is not taken on time.

Since 2017 the members of Brooklyn Center have been complaining about the icky odor and taste of tap water provided. The city is blaming the cause of this awful water to the debris of the new treatment work. The rich have shunned the water leaving the poor in the risk of contradicting water-borne diseases arising from drinking the unsafe water. The rich have easier access to better health services compared to the poor. (DeNavas-Walt, C. 2010). It is not just the fact that rich people get what they want; it is more like a community as a whole kind of scenario. Everyone needs to be held accountable for their actions from the rich to the poor. This will bring a change to a higher level.

The educated have better knowledge in solving physiological problems. Among the adolescent, there is anxiety, depression, self-esteem, gambling, and drug abuse. Among the old, there are cardiovascular diseases, schizophrenia, obesity, and other dementia problems, the educated among these vulnerable groups have higher chances of awareness, diagnosis, and treatment of underlying conditions (Sorensen et al. 2012). Further, the reason why obesity and overweight is such a common thing in the black community is because they do what they saw their elders doing. Awareness needs to be brought not in just the system but the families as well.

Conclusion

Brooklyn Center is known to be one of the culturally diverse counties in Minnesota. The diversity also prevailing in levels of education, culture and wealth distribution has formed to be major disparities affecting health in the community. Social equality needs to prevail among all classes of lifestyle in order to achieve superb healthcare to each and every resident of Brooklyn.

References

Bailey, D. N. (2010). Healthcare of vulnerable populations: Through the lens of Halldorsdottir’s theory. International Journal of Human Caring, 14(3), 53-59.

DeNavas-Walt, C. (2010). Income, poverty, and health insurance coverage in the United States (2005). Diane Publishing.

Dilworth‐Anderson, P., Pierre, G., & Hilliard, T. S. (2012). Social justice, health disparities, and culture in the care of the elderly. The Journal of Law, Medicine & Ethics, 40(1), 26-32.

Hennepin County, MN/2017Data USA Dartmouth Atlas of Health Care retrieved from https://datausa.io/profile/geo/hennepin-county-mn/

Johnson, K. S. (2013). Racial and ethnic disparities in palliative care. Journal of Palliative Medicine, 16(11), 1329– 1334. Denton,

Lindeke, B. (2014). Minneapolis’ fast-changing suburbs deal with unique challenges. MinnPost. com.

Satcher, D. (2010). Include social determinants of health approach to reduce health inequities. Public Health Reports, 125(4_suppl), 6-7.

Sørensen, K., Van den Broucke, S., Fullam, J., Doyle, G., Pelikan, J., Slonska, Z., & Brand, H. (2012). Health literacy and public health: a systematic review and integration of definitions and models. BMC public health, 12(1), 80.

Windshield Survey/Community Assessment

Windshield Survey/Community Assessment

Your Name (First M. Last)

School or Institution Name (University at Place or Town, State)

Windshield Survey/Community Assessment

Topic Selected:

Obesity among the Hampton Roads Population

Introduction:

Community-selected for windshield survey was Hampton roads community. It is situated in Virginia at northern Carolina. It has an estimated population of 597.72/sq. mi. It was originally named as Hampton Roads Coliseum. Hampton was established in 1609 as the country’s first unceasingly occupied English speaking settlement. Unfortunately, obesity cases in the Hampton Roads are on the rise. The obesity epidemic has increased at a fast speed that is alarming. Children, young and adult all are suffering from obesity. According to statistics ore then 34% of the population is obese which has become a serious cause of other types of health problems ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"Gi2JRVKz","properties":{"formattedCitation":"(Mokdad et al., 2003)","plainCitation":"(Mokdad et al., 2003)","noteIndex":0},"citationItems":[{"id":1350,"uris":["http://zotero.org/users/local/KZl8ZL3A/items/ZA94MEPC"],"uri":["http://zotero.org/users/local/KZl8ZL3A/items/ZA94MEPC"],"itemData":{"id":1350,"type":"article-journal","title":"Prevalence of Obesity, Diabetes, and Obesity-Related Health Risk Factors, 2001","container-title":"JAMA","page":"76-79","volume":"289","issue":"1","source":"jamanetwork.com","abstract":"ContextObesity and diabetes are increasing in the United States.ObjectiveTo estimate the prevalence of obesity and diabetes among US adults in 2001.Design, Setting, and ParticipantsRandom-digit telephone survey of 195 005 adults aged 18 years or older residing in all states participating in the Behavioral Risk Factor Surveillance System in 2001.Main Outcome MeasuresBody mass index, based on self-reported weight and height and self-reported diabetes.ResultsIn 2001 the prevalence of obesity (BMI ≥30) was 20.9% vs 19.8% in 2000, an increase of 5.6%. The prevalence of diabetes increased to 7.9% vs 7.3% in 2000, an increase of 8.2%. The prevalence of BMI of 40 or higher in 2001 was 2.3%. Overweight and obesity were significantly associated with diabetes, high blood pressure, high cholesterol, asthma, arthritis, and poor health status. Compared with adults with normal weight, adults with a BMI of 40 or higher had an odds ratio (OR) of 7.37 (95% confidence interval [CI], 6.39-8.50) for diagnosed diabetes, 6.38 (95% CI, 5.67-7.17) for high blood pressure, 1.88 (95% CI,1.67-2.13) for high cholesterol levels, 2.72 (95% CI, 2.38-3.12) for asthma, 4.41 (95% CI, 3.91-4.97) for arthritis, and 4.19 (95% CI, 3.68-4.76) for fair or poor health.ConclusionsIncreases in obesity and diabetes among US adults continue in both sexes, all ages, all races, all educational levels, and all smoking levels. Obesity is strongly associated with several major health risk factors.","DOI":"10.1001/jama.289.1.76","ISSN":"0098-7484","journalAbbreviation":"JAMA","language":"en","author":[{"family":"Mokdad","given":"Ali H."},{"family":"Ford","given":"Earl S."},{"family":"Bowman","given":"Barbara A."},{"family":"Dietz","given":"William H."},{"family":"Vinicor","given":"Frank"},{"family":"Bales","given":"Virginia S."},{"family":"Marks","given":"James S."}],"issued":{"date-parts":[["2003",1,1]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Mokdad et al., 2003).

Windshield survey:

For windshield survey I visited the poor, working class and the elite population areas, to observe and analyze the Hampton roads culture, habit, and lifestyle of its citizens. Initially, I visited the Phoebus area, which is an old fashion area, packed with vintage shops and wide roads. Then I visited the Fox hill North Kind St. All these areas have different concentration of population. Poor neighborhoods were thickly populated, and the posh regions were less crowded. You rarely will see any humans walking around. From the noisiest to the parks, one thing that caught my attention was the food eating habit. I visited the local parks of the neighborhood, where I have seen that young children and teenagers were constantly eating. The body structures also looked heavy. Rarely have I seen children with fit body structure. Majority of them were more or less overweight and lazy. In the parks, kids of age less than nine were having a hard time playing and moving. But it seemed like a norm. Strangely in the parks, I rarely saw any adult or old person walking, rarely. The concentration of adults was also low in the open places. And the ones I saw were extremely overweight to the point that they had a hard time breathing and talking. Majority of adults and old people were using sticks for walking. During my survey, the most crowded areas that I observed were the hotels and restaurants. I also visited the nearby hospital to find evidence of obesity in the population.

Demographics and Statistics

Hampton Roads is the place where the trend of the weight loss clinics is on the rise. According to the Virginia Department of Health, 550,000 people in the South of Hampton roads are overweight and obese which makes them 62 percent. According to the general assembly 2010, around $ 1 million is spent on the obesity control initiatives.

According to statistics around 30.1% of the adults are obese, which includes 17.7% of the age group 18-25, 30.3 % in age group 26-44, 35.6% in age group 45-64, and 28.2 % in the adults of above 65 years. Of the total adult obesity rate, 31.6% of women are obese, and adult men make 31.6% of the total adult population ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"etE1bW7Q","properties":{"formattedCitation":"(\\uc0\\u8220{}State Briefs,\\uc0\\u8221{} n.d.)","plainCitation":"(“State Briefs,” n.d.)","noteIndex":0},"citationItems":[{"id":1353,"uris":["http://zotero.org/users/local/KZl8ZL3A/items/KVK8J63I"],"uri":["http://zotero.org/users/local/KZl8ZL3A/items/KVK8J63I"],"itemData":{"id":1353,"type":"post-weblog","title":"State Briefs","container-title":"The State of Obesity","URL":"https://www.stateofobesity.org/states/","language":"en-US","accessed":{"date-parts":[["2019",3,6]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (“State Briefs,” n.d.).

Similarly, the obesity rate in young children between a 2-4 years of age is 20.0%, in 10-17 years of age is 13.2 % and high school students have an obesity rate of 12.7 %.

Causes of the obesity epidemic

Multiple factors contribute to the obesity epidemic. All the cases revolve around the poor lifestyle choices and genetic issues. Children with one obese parent are already at risk of obesity before their birth. Increased screen time in children, overeating, and lack of physical activity are the causes of obesity in the children. Parents are often responsible for obesity in children as they overfed them with high-fat food that is unhealthy for them ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"8hjvTZeQ","properties":{"formattedCitation":"(Rolls, 2003)","plainCitation":"(Rolls, 2003)","noteIndex":0},"citationItems":[{"id":1348,"uris":["http://zotero.org/users/local/KZl8ZL3A/items/C9AZICMC"],"uri":["http://zotero.org/users/local/KZl8ZL3A/items/C9AZICMC"],"itemData":{"id":1348,"type":"article-journal","title":"The Supersizing of America: Portion Size and the Obesity Epidemic","container-title":"Nutrition Today","page":"42","volume":"38","issue":"2","source":"journals.lww.com","abstract":"Although we are just beginning to understand how environmental factors such as portion size affect eating behavior, the available data suggest that large portions of energy-dense foods are contributing to the obesity epidemic. Several possible strategies for adjusting portions to bring intake back in line with energy requirements are discussed. The continuing rise in the rates of obesity calls for urgent action.","ISSN":"0029-666X","shortTitle":"The Supersizing of America","language":"en-US","author":[{"family":"Rolls","given":"Barbara J."}],"issued":{"date-parts":[["2003",4]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Rolls, 2003).

In adults one of the leading cause of stationary lifestyle and overeating. In Hampton, the majority of the population belongs to the working class, despite their wages. They tend to eat the already cooked food. That is the leading cause of their weight gain.

Another primary reason for weight gain is the lack of insurance, poverty and socioeconomic conditions that become the cause of lack of excess to quality healthcare, which results in obesity and lack of dietary knowledge. This poor population is at highest risk of the increase in obesity and other health-related problems ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"5ATmZVPC","properties":{"formattedCitation":"(Marik & Chen, 2016)","plainCitation":"(Marik & Chen, 2016)","noteIndex":0},"citationItems":[{"id":1345,"uris":["http://zotero.org/users/local/KZl8ZL3A/items/NB6C3U9Z"],"uri":["http://zotero.org/users/local/KZl8ZL3A/items/NB6C3U9Z"],"itemData":{"id":1345,"type":"article-journal","title":"The clinical characteristics and hospital and post-hospital survival of patients with the obesity hypoventilation syndrome: analysis of a large cohort","container-title":"Obesity Science & Practice","page":"40-47","volume":"2","issue":"1","source":"Wiley Online Library","abstract":"Objective The worldwide prevalence of obesity has reached epidemic proportions. Obesity hypoventilation syndrome (OHS) is a common yet largely undiagnosed and mistreated condition that likely carries a high mortality. The aim of this study was to determine the clinical characteristics, hospital outcome, outcome following hospital discharge and predictors of death in a large cohort of patients hospitalized with OHS. OHS is an important condition as many patients with this syndrome are misdiagnosed and receive inappropriate treatment. Methods We reviewed the electronic medical records of patients with unequivocal OHS admitted to a 525-bed tertiary-care teaching hospital over a 5-year period. Demographic and clinical data as well as hospital disposition were recorded. In order to determine the patients' post-discharge status, we linked our database to the database of death certificates of the State Registrar of Vital Records. Results We identified 600 patients who met the inclusion criteria for this study. The patients' mean age was 58 ± 15 years with a mean body mass index of 48.2 ± 8.3 kg m−2; 64% were women. Thirty-seven percent had a history of diabetes and 43% had been misdiagnosed as having chronic obstructive pulmonary disease, while none had been previously diagnosed with OHS. The most common admission diagnoses were respiratory failure, heart failure and sepsis. Ninety (15%) patients died during the index hospitalization. The patients' age, S-creatinine, respiratory failure, sepsis and admission to the ICU were independent predictors of hospital mortality. The hospital survivors were followed for a mean of 1,174 ± 501 d (3.2 ± 1.3 years) from the index hospitalization. On follow-up, 98 of the 510 (19%) hospital survivors died, with an overall cumulative mortality of 31.3%. The patients' age, S-creatinine and admission to the ICU were independent predictors of post-hospital mortality. Conclusion Obesity hypoventilation syndrome is a common disease that is frequently misdiagnosed and mistreated and carries a 3-year morality, which is significantly worse than that for most cancers combined. Considering the high mortality of this disease, all patients with a body mass index > 35 kg m−2 should be screened for OHS; those patients with both early and established OHS should be referred to a pulmonary and/or sleep specialist for evaluation for non-invasive positive pressure ventilation, to a dietician for dietary counseling and lifestyle modification and to a bariatric surgeon for evaluation for bariatric surgery.","DOI":"10.1002/osp4.27","ISSN":"2055-2238","shortTitle":"The clinical characteristics and hospital and post-hospital survival of patients with the obesity hypoventilation syndrome","language":"en","author":[{"family":"Marik","given":"P. E."},{"family":"Chen","given":"C."}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Marik & Chen, 2016).

Effects of the obesity epidemic

Obesity epidemic effects the overall health of a persona and results in the high cholesterol levels, insulin disorder, diabetes, hypertension, colon cancer, liver diseases, joint pain, arthritis, gastrointestinal problem and asthma ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"6luvkOa6","properties":{"formattedCitation":"(Preston, Morales, & Plunk, 2016)","plainCitation":"(Preston, Morales, & Plunk, 2016)","noteIndex":0},"citationItems":[{"id":1332,"uris":["http://zotero.org/users/local/KZl8ZL3A/items/GLLC8SW9"],"uri":["http://zotero.org/users/local/KZl8ZL3A/items/GLLC8SW9"],"itemData":{"id":1332,"type":"article-journal","title":"O022 The relationship between asthma and food deserts in the hampton roads area","container-title":"Annals of Allergy, Asthma & Immunology","page":"S8","volume":"117","issue":"5","source":"www.annallergy.org","abstract":"Our goal was to compare the prevalence of pediatric asthma between groups of patients\nby food desert status, while controlling for allergic rhinitis and overweight/obesity.\nWe hypothesized that the prevalence of asthma will be higher in food deserts.","DOI":"10.1016/j.anai.2016.09.382","ISSN":"1081-1206, 1534-4436","journalAbbreviation":"Annals of Allergy, Asthma & Immunology","language":"English","author":[{"family":"Preston","given":"D."},{"family":"Morales","given":"M."},{"family":"Plunk","given":"A."}],"issued":{"date-parts":[["2016",11,1]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Preston, Morales, & Plunk, 2016).

Nursing Assessment and Conclusion

I have realized that one of the primary reason for weight gain in the Hampton Roads community is the lifestyle issue. Despite the socioeconomic backgrounds, all the population eats the unhealthiest kind of food that is usually made of multiple readymade ingredients that don't contain the actual nutrition information ion the labels.

Unhealthy eating habits have a severe influence on the dietary habits of children and teenagers. Majority of the diseases that are prevailing in the community can be avoided through controlling the weight ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"Wn4RKQ5J","properties":{"formattedCitation":"(N\\uc0\\u250{}\\uc0\\u241{}ez et al., 2007)","plainCitation":"(Núñez et al., 2007)","noteIndex":0},"citationItems":[{"id":1342,"uris":["http://zotero.org/users/local/KZl8ZL3A/items/28BRREJW"],"uri":["http://zotero.org/users/local/KZl8ZL3A/items/28BRREJW"],"itemData":{"id":1342,"type":"article-journal","title":"Extreme Obesity Reduces Bone Mineral Density: Complementary Evidence from Mice and Women","container-title":"Obesity","page":"1980-1987","volume":"15","issue":"8","source":"Wiley Online Library","abstract":"Objective: To evaluate the effects of body adiposity on bone mineral density in the presence and absence of ovarian hormones in female mice and postmenopausal women. Research Methods and Procedures: We assessed percentage body fat, serum leptin levels, and bone mineral density in ovariectomized and non-ovariectomized C57BL/6 female mice that had been fed various calorically dense diets to induce body weight profiles ranging from lean to very obese. Additionally, we assessed percentage body fat and whole body bone mineral density in 37 overweight and extremely obese postmenopausal women from the Women's Contraceptive and Reproductive Experiences study. Results: In mice, higher levels of body adiposity (>40% body fat) were associated with lower bone mineral density in ovariectomized C57BL/6 female mice. A similar trend was observed in a small sample of postmenopausal women. Discussion: The complementary studies in mice and women suggest that extreme obesity in postmenopausal women may be associated with reduced bone mineral density. Thus, extreme obesity (BMI > 40 kg/m2) may increase the risk for osteopenia and osteoporosis. Given the obesity epidemic in the U.S. and in many other countries, and, in particular, the rising number of extremely obese adult women, increased attention should be drawn to the significant and interrelated public health issues of obesity and osteoporosis.","DOI":"10.1038/oby.2007.236","ISSN":"1930-739X","shortTitle":"Extreme Obesity Reduces Bone Mineral Density","language":"en","author":[{"family":"Núñez","given":"Nomelí P."},{"family":"Carpenter","given":"Catherine L."},{"family":"Perkins","given":"Susan N."},{"family":"Berrigan","given":"David"},{"family":"Jaque","given":"S. Victoria"},{"family":"Ingles","given":"Sue Ann"},{"family":"Bernstein","given":"Leslie"},{"family":"Forman","given":"Michele R."},{"family":"Barrett","given":"J. Carl"},{"family":"Hursting","given":"Stephen D."}],"issued":{"date-parts":[["2007"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Núñez et al., 2007).

As a nurse, I think the nursing community can play their roles in educating the public. Nurses should educate their patients about food and nutrition and encourage them to incorporate exercise. Also, small workshops should be arranged in the schools to help children control weight at a younger age. Government officials in the community should declare the health emergency and treat this as global health warming.

References

ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Marik, P. E., & Chen, C. (2016). The clinical characteristics and hospital and post-hospital survival of patients with the obesity hypoventilation syndrome: analysis of a large cohort. Obesity Science & Practice, 2(1), 40–47. https://doi.org/10.1002/osp4.27

Mokdad, A. H., Ford, E. S., Bowman, B. A., Dietz, W. H., Vinicor, F., Bales, V. S., & Marks, J. S. (2003). Prevalence of Obesity, Diabetes, and Obesity-Related Health Risk Factors, 2001. JAMA, 289(1), 76–79. https://doi.org/10.1001/jama.289.1.76

Núñez, N. P., Carpenter, C. L., Perkins, S. N., Berrigan, D., Jaque, S. V., Ingles, S. A., … Hursting, S. D. (2007). Extreme Obesity Reduces Bone Mineral Density: Complementary Evidence from Mice and Women. Obesity, 15(8), 1980–1987. https://doi.org/10.1038/oby.2007.236

Preston, D., Morales, M., & Plunk, A. (2016). O022 The relationship between asthma and food deserts in the hampton roads area. Annals of Allergy, Asthma & Immunology, 117(5), S8. https://doi.org/10.1016/j.anai.2016.09.382

Rolls, B. J. (2003). The Supersizing of America: Portion Size and the Obesity Epidemic. Nutrition Today, 38(2), 42.

State Briefs. (n.d.). Retrieved March 6, 2019, from https://www.stateofobesity.org/states/

WK 4 EHR Database And Data Management

EHR for Obesity Management

Introduction

Obesity is a critical clinical and general medical issues. More than 35 percent of U.S. grown-ups are obese. Obese is related with numerous genuine wellbeing conditions, including type 2 diabetes, cardiovascular ailment, and a few diseases. Clinical practice rules encourage suppliers to screen for these issues and prescribe fitting treatment alternatives, as even little measures of weight misfortune can prompt huge medical advantages. However, primary consideration suppliers regularly neglect to do as such.

Electronic wellbeing records (EHRs) can possibly improve the board and treatment of obesity by primary consideration clinicians, however few instruments have been created or assessed for this reason. The goals of this exploration consider were to create and assess EHR-based apparatuses, for example, updates and clinical choice help for distinguishing proof, conclusion, and treatment of obese and obese patients.

The particular points of the undertaking were as per the following:

Develop EHR-based apparatuses to help primary consideration clinicians distinguish, assess, and treat patients who are obese or obese.

Conduct a bunch randomized controlled preliminary to survey the adequacy of EHR-based apparatuses for the recognizable proof, assessment, and treatment of obese and obesity in primary consideration.

Structured and Unstructured Data

For the given database, the structured data will be:

First and last name

Gender

Date of birth

Ethnicity

Demography

Medical History

For the EHR,the unstructured data will be

BMI

Medication history

Recreational drug use

Name, amount and frequency

Smoking history

Family History of Obesite

Cardiac health history

Cholesterol

Diabetes

AF

Discussion and Conclusion

The electronic health record system is a longitudinal electronic record of patient wellbeing information created by clinical experiences in an assortment of consideration conveyance settings and incorporates understanding socioeconomics, advance notes, issue records, meds, fundamental signs, past medicinal history, vaccinations, research facility data, and radiology reports. Electronic health record systems utilize social database structures and utilities to access and show data that facilitate medicinal consideration and clinical basic leadership, substituting for conventional paper-based "graphs". Electronic health record systems may likewise help address the long-standing issue of the long slack time that exists before proof based therapeutic learning is utilized in clinical consideration (Wood et al. 2012). What's more, the electronic health record system is a strong wellspring of data that can be abused for research. It gives a way to describe patients through misusing existing clinical data, instead of re-surrendering such data by means of research exercises.

In research conventions, physical estimates, for example, height and weight are commonly gathered by research colleagues prepared in explicit conventions. The apparatuses for those estimations are commonly adjusted instruments to lessen blunder. In contrast, clinical estimations that are recorded in the electronic health record system might be taken by an assortment of social insurance experts whose methodology might be less stringent, and with hardware that may vary by area. For instance, weights might be completely dressed or gowned; heights might be with shoes or without. A portion of this sort of blunder can be moderated by substantial example sizes, yet some methodical mistakes can't. In the event that, for instance, most of heights are estimated with shoes, bmi computations will be deliberately one-sided downwards. In this examination, key height and weight data were extricated from the electronic health record system from estimations got in the weight management center in which an exploration like institutionalized procedure utilizing aligned instruments was performed via prepared work force in a similar facility. This institutionalization likewise improves the rate of estimation of height, which is estimated less much of the time than the estimation of weight in electronic health record systems (Bronder et al. 2015).

Data taking drugs use and co-morbidities may likewise introduce potential issues while separating from electronic health record systems. We utilized medicine reconciliation and not doctor drug orders, at times utilized as an intermediary for prescription utilization. However, not every single filled remedy will be utilized by patients. International classification of diseases, ninth modification, (icd-9) codes, which are utilized for charging, protection, and documentation in electronic health record systems, just as for arrangement of clinical measurements and quality investigations, were utilized as surrogates for the nearness of co-horrible conditions. We didn't endeavor to record the precision of individual icd-9 codes utilizing supporting data, for example, research facility results or medicine orders. However, the rates of patients relegated explicit icd-9 codes was like the level of patients endorsed comparing meds for various significant scatters including diabetes and biguanides, dejection and ssris, and osteoarthosis and nsaids. Less firmly related were hypertension and hypertension meds likely due to the utilization of custom fitted polypharmacy to treat singular patients. Furthermore, the level of patients endorsed proton siphon inhibitors was higher than the number with gerd likely in view of recommending for other gastrointestinal scatters.

Research center data are among the most strong data accessible from electronic health record systems. We were ready to extricate a substantial number of research center factors on generally patients. Two noteworthy explanations behind why patients needed data were that the tests were either never requested or were acquired at an outside research center and the outcomes transmitted in non-electronic structure, for example paper or filtered compact report design duplicate. This contrasts with review data in which studies were offered by suppliers to every patient, regardless of whether in readable paper design or through on-line get to. Since they were not "endorsed" through formal doctor request section, the general rate of return of this data was not exactly different kinds of data areas. All things considered, significant quantities of a few study instruments were gotten.

Notwithstanding the nearness of clinical data in electronic health record systems that are promptly gotten to by suppliers on individual patients, such data can be strategically hard to separate for research use. Some examination bunches have been creating common language handling ways to deal with obesity-related electronic health record system data (Baer et al. 2013). We utilized a data warehouse that reflected the electronic health record system and enormously facilitated commonsense access to data. Other obesity explore studies have used data warehouses (Mandl & Kohane, 2012). The facility stores height and weight estimations that have been gone into the electronic health record system in the national corporate data warehouse. Like the data warehouse, the database was created to enable access to data and apparatuses for a few purposes including research. In spite of the fact that weight, height and other data are stored at regular intervals, the database does not yet contain data on lab measures, strategies, and judgments.

Conclusion

Electronic health record system data can be a profitable wellspring of data for obesity explore, in spite of the fact that the accessibility and integrity of various data types can shift generously. Access to a data warehouse can incredibly upgrade the productivity of data gathering over direct extraction from the electronic health record system. Electronic health record system inferred data can be utilized for an assortment of research and clinical uses, for example, for deciding length of development.

References

Wood, G. C., Chu, X., Manney, C., Strodel, W., Petrick, A., Gabrielsen, J., ... & Still, C. D. (2012). An electronic health record-enabled obesity database. BMC medical informatics and decision making, 12(1), 45.

Bronder, K. L., Dooyema, C. A., Onufrak, S. J., & Foltz, J. L. (2015). Electronic health records to support obesity-related patient care: Results from a survey of United States physicians. Preventive medicine, 77, 41-47.

Baer, H. J., Karson, A. S., Soukup, J. R., Williams, D. H., & Bates, D. W. (2013). Documentation and diagnosis of overweight and obesity in electronic health records of adult primary care patients. JAMA internal medicine, 173(17), 1648-1652.

Mandl, K. D., & Kohane, I. S. (2012). Escaping the EHR trap—the future of health IT. New England Journal of Medicine, 366(24), 2240-2242.

Bailey, L. C., Milov, D. E., Kelleher, K., Kahn, M. G., Del Beccaro, M., Yu, F., ... & Forrest, C. B. (2013). Multi-institutional sharing of electronic health record data to assess childhood obesity. PLoS One, 8(6), e66192.

WK 5 Annotated Bibliography

In an Obese Diabetic Adult Patient (P) Will a StructuredExercise Regimen and Diet Plan Versus No Structured Exercise Or DietPlan (C) Reduce HAIC (O) Within 12 Weeks Or 24 Weeks (T).

[Name of the Writer]

[Name of the Institution]

Taheri, S., Chagoury, O., Zaghloul, H., Elhadad, S., Ahmed, S. H., Omar, O., & El Nahas, K. (2018). Diabetes Intervention Accentuating Diet and Enhancing Metabolism (DIADEM-I): a randomized controlled trial to examine the impact of an intensive lifestyle intervention consisting of a low-energy diet and physical activity on body weight and metabolism in early type 2 diabetes mellitus: study protocol for a randomized controlled trial. Trials, 19(1), 284.

While comparing the adult regime exercises and diet plan with a structured workout that reduce HAIC in 12-24 weeks, these scholars research on the impact of LED-based ILI (Intensive lifestyle intervention) on body weight and diabetes remission in 18-50 years old individuals. An outcome of their study incorporates the quality of life, mental health, physical activity, cardiovascular health and complications of diabetes. Remissions of type 2 diabetes mellitus can be achieved with a significant loss in weight among those who are younger and required fewer medications. Low energy diet has substantial impacts on healthcare services across the world. The meal replacement approach along with physical activity is positively integrated for the promotion of younger individual health in the early stages of type 2 diabetes.

Sloan, R. P., Shapiro, P. A., McKinley, P. S., Bartels, M., Shimbo, D., Lauriola, V., & Scodes, J. M. (2018). Aerobic Exercise Training and Inducible Inflammation: Results of a Randomized Controlled Trial in Healthy, Young Adults. Journal of the American Heart Association, 7(17), e010201.

The authors in their randomized control trial, reflect the inflammation and training exercises for individual facing type 2 diabetes. The exercise contains time for 12 weeks and a wait-list control by four weeks of sedentary deconditioning. The capacity by cardiopulmonary exercise was measured by the study entry (T1). There were no changes occur in inflammatory markers, and further analysis unfolded that the activity is affected by lipopolysaccharide level. The condition training exercise has anti-inflammatory effects. However, scholars have commented that aerobic exercise is progressive for properties of health promotion. During the weeks of research, they fail to support the primary hypothesis regarding the promotional aspects of exercise on the pro-inflammatory response. For healthy subjects and patients, the training and conditioning have specific effects of cardio protective. Aerobic capacity is enhanced through the twelve weeks of exercise.

Van Den Hoek, D. J., Miller, C. T., Fraser, S. F., Selig, S. E., & Dixon, J. B. (2017). Does exercise training augment improvements in quality of life induced by energy restriction for obese populations? A systematic review. Quality of Life Research, 26(10), 2593-2605.

Since there is a significant difference between the structured and non-structured exercises, the authors in their systematic review raise the question that training improves the quality of life or not. They concerned about the energy restrictions faced by obese population. Type 2 diabetes and obesity have a close link with each other. The outcome of the study provided that after assessing nine hundred and fifty-two papers, four studies supported the health effects of exercise. It also contains the energy restriction and health-related quality of life among adults with diabetes.

Due to substantial heterogeneity, the finding of this study is limited. However, one thing is very much clear that improvement in the capacity of exercise play a progressive role for facilitating more significant improvement in health and diet. For the obese adult, the existing study illustrates that exercise is not feasible unless the body is regularized through specific and other measures. Comparable readings should be utilized in the future research for sufficient health-related quality of life assessment.

Duscha, B. D., Piner, L. W., Patel, M. P., Craig, K. P., Brady, M., McGarrah III, R. W., ... & Kraus, W. E. (2018). Effects of a 12-week health program on peak VO2 and physical activity patterns after completing cardiac rehabilitation: A randomized controlled trial. American heart journal, 199, 105-114.

Exercise, education, and motivation are essential for patients of diabetes and HAIC, and these patients are also influenced by cardiac health. According to the randomized control trial the authors asses the effects of a 12-week health program. They incorporate cardiac rehabilitation through activity patterns and supervised exercise. By using the physical activity trackers and health coaching the program was implemented through the participation of twenty-five patients which were randomized in moderate health or usual care after completing heart rehabilitation.

The program as mentioned by the scholars is effective and can sustain the gains in physical activity by site-based rehabilitation of heart disease. A significant purpose of this study was to assess the health program which can maintain the well-being of the patient through physical activity with increasing levels that are attained after the exercise. Divergent changes between the health and usual care resulted in creating differences among various groups.

Thind, H., Fava, J. L., Guthrie, K. M., Stroud, L., Gopalakrishnan, G., Sillice, M., & Bock, B. C. (2018). Yoga as a Complementary Therapy for Adults with Type 2 Diabetes: Design and Rationale of the Healthy, Active, and Control (HA1C) Study. International journal of yoga therapy, 28(1), 123-132.

The researcher in this study used yoga as therapy for adults with type 2 diabetes through HAIC research. The prevalence of diabetes in well-known fact in the United States and the scholars provide that medication is not enough to achieve glycemic control. They paid significant attention to the issues of stress management, regular exercise, and a sustainable diet. Yoga in this regard is a mindful practice which is examined under the healthy, active and in control study design. The 12-week yoga exercise incorporates stationery cycling and walking. With 3 to 6-months post-intervention, the activity was conducted at the end of 12 weeks of treatment with a particular focus on acceptability and feasibility.

The HAIC research reflects the satisfaction, retention, and attendance of glycemic outcomes like the blood glucose, fasting blood glucose and HbA1c. The changes in the physiological and behavioral factors are related to the intervention of type 2 diabetes. At the end of the response, the study showed for the exploration of participants’ views for the program and their potential for the utility of yoga in managing diabetes.

Kim, K. T., Cho, D. C., Sung, J. K., Kim, C. H., Kang, H., & Kim, D. H. (2017). Changes in HbA1c levels and body mass index after successful decompression surgery in patients with type 2 diabetes mellitus and lumbar spinal stenosis: results of a 2-year follow-up study. The Spine Journal, 17(2), 203-210.

The prospective longitudinal and observational study was conducted to examine the changes in HbA1c level and body mass index after the decompression surgery in patients of diabetes. According to the authors diabetic and LSS patients (Lumbar Spinal Stenosis), a successful operation can facilitate glycemic control. It can increase the physical activity or training capacity of the patient to reduce the weight of the body. Without systematic resolution of the surgery or medical intervention, LSS can hinder the exercise of individual along with impairment of glucose tolerance and regulation of body weight. It is crucial for the patients of diabetes to improve leg and back pain. Comparison of two groups was considered in the research, and it was found that after the surgery sugar and overweight become regulated. After the second year of surgery, significant BMI reduction was estimated by the researchers.

References

Duscha, B. D., Piner, L. W., Patel, M. P., Craig, K. P., Brady, M., McGarrah III, R. W., ... & Kraus, W. E. (2018). Effects of a 12-week health program on peak VO2 and physical activity patterns after completing cardiac rehabilitation: A randomized controlled trial. American heart journal, 199, 105-114.

Kim, K. T., Cho, D. C., Sung, J. K., Kim, C. H., Kang, H., & Kim, D. H. (2017). Changes in HbA1c levels and body mass index after successful decompression surgery in patients with type 2 diabetes mellitus and lumbar spinal stenosis: results of a 2-year follow-up study. The Spine Journal, 17(2), 203-210.

Sloan, R. P., Shapiro, P. A., McKinley, P. S., Bartels, M., Shimbo, D., Lauriola, V., & Scodes, J. M. (2018). Aerobic Exercise Training and Inducible Inflammation: Results of a Randomized Controlled Trial in Healthy, Young Adults. Journal of the American Heart Association, 7(17), e010201.

Taheri, S., Chagoury, O., Zaghloul, H., Elhadad, S., Ahmed, S. H., Omar, O., & El Nahas, K. (2018). Diabetes Intervention Accentuating Diet and Enhancing Metabolism (DIADEM-I): a randomized controlled trial to examine the impact of an intensive lifestyle intervention consisting of a low-energy diet and physical activity on body weight and metabolism in early type 2 diabetes mellitus: study protocol for a randomized controlled trial. Trials, 19(1), 284.

Thind, H., Fava, J. L., Guthrie, K. M., Stroud, L., Gopalakrishnan, G., Sillice, M., & Bock, B. C. (2018). Yoga as a Complementary Therapy for Adults with Type 2 Diabetes: Design and Rationale of the Healthy, Active, and Control (HA1C) Study. International journal of yoga therapy, 28(1), 123-132.

Van Den Hoek, D. J., Miller, C. T., Fraser, S. F., Selig, S. E., & Dixon, J. B. (2017). Does exercise training augment improvements in quality of life induced by energy restriction for obese populations? A systematic review. Quality of Life Research, 26(10), 2593-2605.

WK 7 RESEARCH PAPER WITH 5 ANNOTATED BIBLIOGRAPHY

PICOT: In an obese diabetic adult patients (P) will a structured exercise regimen and diet plan (I) Versus no structured exercise or diet plan (C) reduce HAIC (O) within 12 weeks or 24 weeks (T)

Literature Review

Obesity is high across the nation pervasiveness, are related with expanding human services costs, and negatively affect personal satisfaction (Tuomilehto et al. 2001). A decade back, the national commonness of obesity was less than 30% (Tuomilehto et al. 2001). The Behavioral Risk Factor System Surveillance information show self-announced obesity predominance was at an average of 26%, a range that both includes and outperforms the national normal of almost 27% (Tuomilehto et al. 2001). Obesity is additionally an exorbitant condition with an expected yearly expense of seventy five billion dollars in medicinal costs (Tuomilehto et al. 2001). Obesity is a reason for expanded mortality just as an expanded hazard factor for some ailments from cardiovascular sickness and diabetes to discouragement (Tuomilehto et al. 2001).

Obesity is a hazard factor of the improvement of diabetic patients that is set apart by abnormal amounts of blood glucose and raised HAIC. In 2010, more than eight percent of the US populace was influenced by diabetes, with more than eighteen million people living with analyzed diabetes and an expected seven million living with undiscovered diabetes (Lindstrom et al. 2006). The concurrence of diabetic and obese patients is settled. Further, it is set up that way of life adjustment, explicitly diet and exercise prompting weight loss, is a first line of treatment for new conclusions of diabetic patients and for those in danger of obesity (Lindstrom et al. 2006). In any case, the definite impact which any subsequent weight loss from way of life alterations has upon FBG isn't too settled.

The American Diabetes Association recommended that an HAIC of 6.5% belittles the predominance of prediabetes and diabetes in obese kids and youths. Given the low affectability and particularity, the utilization of HAIC independent from anyone else speaks to a poor demonstrative apparatus for prediabetes and type 2 diabetes in obese youngsters and youths.

Following quite a while of discussion, the American Diabetes Association (ADA) distributed updated proposals to utilize HAIC to analyze diabetes and to recognize subjects in danger for creating diabetes later on (Tuomilehto et al. 2001). The choice depends on various cross-sectional and longitudinal investigations demonstrating the relationship among's HAIC and diabetes at pattern or long haul relationship among HAIC and danger of diabetes and diabetes-related comorbidities 1. Extra factors impacting this choice were as per the following: HAIC does not require a fasting state, mirrors the typical 3– 4 months before glycemia, has low intraindividual inconstancy, and is a decent indicator of diabetes-related difficulties. It ought to be noticed that this choice was made just on studies performed in grown-ups. Little is thought about the utilization of the HAIC test for the conclusion of sort 2 diabetes and prediabetes in youth and pre-adulthood. In perspective on the way that both prediabetes and, progressively vital, type 2 diabetes have as of late risen as early complexities of youth obesity, it is of basic significance to analyze these types of dysglycemia right off the bat in their improvement. In this manner, the point of this examination was to evaluate the demonstrative utility of HAIC for the conclusion of prediabetes and type 2 diabetes in obese youngsters and teenagers. We in this manner directed this investigation to assess the accompanying: 1) the dissemination of HAIC levels in a multiethnic associate of obese kids and young people without known diabetes and 2) the affectability and explicitness of HAIC for sort 2 diabetes and prediabetes determined contrasted with have the present oral glucose resilience test (OGTT) best quality level.

Structured exercise and diet plan in a therapeutically supervised weight loss program can be compelling in actuating weight loss, diminishing FBG levels in either types of patients, and diminishing the HAIC in diabetics. Moreover, the finding of weight loss after the eating regimen and exercise intercession is reliable with othersimilar ponders (Lindstrom et al. 2006).

Fasting blood glucose diminished for patients with and without diabetes. This reduction in fasting blood glucose after eating regimen and exercise is predictable with earlier investigations in different populaces (Anderson et al. 2004). We found no huge distinction among diabetics and non-diabetics in the level of diminishing in fasting blood sugars.

The Look AHEAD preliminary confirms the discoveries of the present investigation, recommending that structure diet and exercise plan can result in a clinically noteworthy decline in HAIC in diabetics of Type II (Anderson et al. 2004). For non-diabetic patients who are in danger for creating diabetes, discoveries of the Diabetes Prevention Program additionally propose that way of life mediation as eating routine and exercise is powerful in counteracting improvement of hyperglycem.

The lessening in HAIC is of clinical significance in the finding of diabetes just as in the potential for improvement of entanglements from the sickness. New ADA rules have included that a HAIC of six percent or more prominent is demonstrative of diabetes (Anderson et al. 2004). It is also proposed that a lessening in HAIC of one percent had critical dreariness and mortality benefits (Anderson et al. 2004). Less cardiovascular occasions, diminished requirement for retinal photocoagulation, and less progression to end organize renal infection in diabetic patients whose HAIC diminished less than one percent when treated with oral hypoglycemic meds (Anderson et al. 2004).

The abatement in HAIC is of clinical significance in emphatically influencing the administration of diabetes just as in lessening the potential for improvement of difficulties from the infection. One investigation detailed that of fifteen members tried out a comparative HMR based therapeutically supervised weight loss program eleven had the capacity to stop their diabetes drugs (Anderson et al. 2004). These medications accompany a budgetary expense just as potential reactions. The decrease in HAIC created by the restoratively supervised program in this investigation might be a successful option in contrast to the expense and reactions of diabetic meds (Anderson et al. 2004).

Factor which adds to the advancement of Obesity is a low dimension of physical wellness. The significance of physical wellness is all around archived, and numerous examinations have detailed the significance of keeping up certain dimension of physical wellness to counteract endless sicknesses, for example, type 2 diabetes and cardiovascular illness (Franz et al. 2007). Obese individuals with low dimensions of cardiopulmonary wellness have a higher death rate than obese individuals who have larger amounts of cardiopulmonary wellness (Franz et al. 2007). Actually, an individual with low cardiopulmonary wellness has a death rate 2.1 occasions higher than an individual with high cardiopulmonary wellness, which plainly demonstrates that high cardiopulmonary wellness is related with diminished death rate (Franz et al. 2007). Another examination analyzing the relationship between obesity, physical wellness and constant malady mortality with 21,925 individuals announced that individuals who were lean and poor physical wellness (2.91 occasions), and obese and poor physical wellness (4.08 occasions) had higher death rate when contrasted with lean and great physical wellness (Franz et al. 2007). Results from the above examinations demonstrate that type 2 diabetes and cardiovascular infection ought to be dealt with and counteracted through treatment and destruction of obesity, yet in addition by the expanded condition of physical wellness with investment of customary physical movement. What's more, keeping up certain dimension of solid perseverance additionally helps keeping up lower dimensions of blood glucose and HAIC (HbHAIC) (Franz et al. 2007).

Despite the fact that the significance of both largeness and cardiopulmonary readiness for the counteractive action and treatment of Obesity and other endless sicknesses has been examined, the impacts of solid perseverance or joined impacts of both cardiopulmonary and strong wellness on Obesity are not completely comprehended (Riddle et al. 2006). In this way, the reason for the present examination is to research the relationship of obesity level, cardiopulmonary wellness and solid continuance with HbHAIC level and Obesity hazard factors (Riddle et al. 2006).

Overview

Diet and structured exercise is compelling in lessening HAIC in diabetics and decreasing fasting blood sugars in patients with or without diabetes. Furthermore, future research is expected to evaluate the impact of hypoglycemic medicine changes in medicinally supervised weight loss programs. Evaluation of the advantages of diminished need and cost for medicine could give an incredible spark to patients to take an interest in a restoratively supervised eating routine and exercise program (Riddle et al. 2006). The improvement in HAIC found in this examination proposes that a therapeutically supervised weight loss program has potential for obese people to decrease the bleakness and cost related with elevated blood sugars.

References

Tuomilehto, J., Lindström, J., Eriksson, J. G., Valle, T. T., Hämäläinen, H., Ilanne-Parikka, P., ... & Salminen, V. (2001). Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. New England Journal of Medicine, 344(18), 1343-1350.

Lindström, J., Ilanne-Parikka, P., Peltonen, M., Aunola, S., Eriksson, J. G., Hemiö, K., ... & Louheranta, A. (2006). Sustained reduction in the incidence of type 2 diabetes by lifestyle intervention: follow-up of the Finnish Diabetes Prevention Study. The Lancet, 368(9548), 1673-1679.

Anderson, J. W., Randles, K. M., Kendall, C. W., & Jenkins, D. J. (2004). Carbohydrate and fiber recommendations for individuals with diabetes: a quantitative assessment and meta-analysis of the evidence. Journal of the American College of Nutrition, 23(1), 5-17.

Franz, M. J., VanWormer, J. J., Crain, A. L., Boucher, J. L., Histon, T., Caplan, W., ... & Pronk, N. P. (2007). Weight-loss outcomes: a systematic review and meta-analysis of weight-loss clinical trials with a minimum 1-year follow-up. Journal of the American Dietetic Association, 107(10), 1755-1767.

Riddle, M. C., Henry, R. R., Poon, T. H., Zhang, B., Mac, S. M., Holcombe, J. H., ... & Maggs, D. G. (2006). Exenatide elicits sustained glycaemic control and progressive reduction of body weight in patients with type 2 diabetes inadequately controlled by sulphonylureas with or without metformin. Diabetes/metabolism research and reviews, 22(6), 483-491.

Wk 8 Cumulative Of Case 1, 2 And 3 Paper

Case Report Down’s syndrome

Name

Institution

Down’s syndrome

As mentioned earlier, Down’s syndrome is a genetic impairment resulting from abnormal chromosomal attachments. This condition is hard to be treated and can only be managed as the affected individual requires full fledge assistance in daily living under the influence of physical, psychological, social and neurological impairments (Carothers et. al., 2018). Being a genetic condition, Down’s syndrome gives rise to some ethical considerations as well such as communication of just information regarding its treatment and its prenatal screening. This paper will examine the ethical considerations regarding Down’s syndrome screening during prenatal period. How this screening becomes an ethical consideration? This question would be embraced thorough explanation in the next section.

Prenatal Screening as an ethical consideration in Down’s syndrome

Contemplating through the lens of history, we come to know that screening for the Down’s syndrome was first executed in the last 1960s through the process of fetal karyotyping and amniocentesis. During the first half of 20th century, children diagnosed with Down’s syndrome during prenatal period were placed in specialized institutions for care right after birth (Fortier & Wanlass, 1984). At that time, most of the doctors told parents that they could be unable to nurture the specialized needs of their affected children and hence require separate living with particular professional care.

With the passing time, the prenatal testing for Down syndrome continued to become advanced. The American College of Obstetricians and Gynecologists (ACOG) emphasizes the execution of screening tests for Down syndrome to the mothers prior to childbirth. The process of screening encapsulates two levels; prenatal screening and prenatal diagnosis. Prenatal screening encompasses ultrasound and blood test during the first and second trimester of pregnancy that is usually done to indentify the risk of child being born with Down syndrome (Bull et. al., 2011). Approximately 80% of the fetuses can be predicted accurately being born with problem condition.

Numerous ethical and legal concerns are brought by advancements in the prenatal diagnosis of the chromosomal and genetic disorders. Literature is enriched with many instances where selective abortion and prenatal diagnosis was supported by many proponents saying that such procedure link directly to the benefit of both society and the family acting as an excellent constituent of preventive medications (Girdler et. al., 2012). On the other hand, those who consider all forms of life valuable and precious; put strong arguments against aborting affected fetuses. In their view, intellectual and physical impairments are the part of life and do not provide a solid ground to terminate pregnancy.

Ethical Concerns about Screening and Testing of Down syndrome

Some people are in view that prenatal testing for chromosomal and genetic defects such as Down syndrome is a source of immense discrimination against people with such disabilities. They propound that discriminatory attitudes are indicated by selective abortion and a question arises that how the coexistence of the idea—goal of the society is to include individuals with intellectual and physical abilities—with the desire to abort the individuals and prevent the births of those who have the potential to be born with disabilities is possible? Certainly, no one can deny the fact that it is impossible; screening and aborting such individuals before even being born opposes the societal values and threatens the dignity of those who are different from the majority (Carothers et. al., 2018).

Another concern that opponents of abortion possess is the biased education of parents regarding screening and testing and their prospective results. For example, parents who are undergoing screening for the genetic disorders if debriefed about the negative consequences of having a child with Down syndrome may develop strong tendency towards abortion upon getting positive screening tests (Bull et. al., 2011). Inadequate education and misinformation both lead the parents making wrong decisions for their child.

Prospective parents require just and accurate information to ensure better decision making regarding screening and testing of the results. After receiving test results, some parents are left helpless without providing any direction about future that what would be the quality of life of the child after birth and what are the both positive and negative aspects of giving birth to a disabled child. They are not provided with sufficient professional guidance and assistance that supports their decision making ability particularly when they do not know any person with the similar disability and are entirely alien to that term.

Estimations indicate that over 90% of the pregnant women in the United States who are diagnosed to have a baby with Down syndrome through prenatal screening tests select abortion as a preventive measure (Carothers et. al., 2018). Columnist George Will regards prenatal genetic testing as a “search and destroy mission” rather than a method of testing and informing parents about prospective disability (Magyar et. al., 2014). On the other hand, some parents choose to abort their affected child in response to the fear of his dark and discrimination-rich future that may cause irreparable damage to his sense of self. The true problem arises when more and more parents abort their children and create a spell of isolation for the remaining ones. Hence, genetic testing and screening acts as a serious ethical dilemma in the healthcare field.

How genetics can improve care with reference to cost effective practices

As mentioned earlier, genetic testing and screening enables the patients to gain a profound insight about the actual prenatal and potential post natal conditions of their fetus. This screening helps the patient to make rational and careful decisions about their future; either abortion or admission to specialized institutions for afterbirth care (Carothers et. al., 2018). Researchers suggested that individuals with Down syndrome are more likely to have feeding difficulties, dental problems, congenital cataracts, thyroid disease, Leukemoid reactions, otitis media, respiratory infections, immunization problems, motor, language, social and psychological problems. Genetic testing allows the parents to monitor their affected children from the very beginning so that their management skills could be improved (Martin et. al., 2018). Hence, genetics reduce the costs of other preventive and management interventions through testing prior to birth.

Changes in approaches to care when new options warrant for improved outcomes

When prenatal screening is done, parents and medical professionals come to know about the disability from the very beginning and attempt to develop multifaceted intervention strategies just after childbirth (Carothers et. al., 2018). In order to accelerate the development of child at the initial stages of development, speech, physical, occupational and psychological therapies render immensely effective (Magyar et. al., 2014). In other words, diagnosing at early stages enable the parents to learn effective management techniques that best synchronize with the specialized needs of their children and start providing such interventions at appropriate ages. In this way, genetic information helps elevating the quality of life in time- effective manner.

Plan to educate colleagues and patients of Down’s syndrome

In this era of technological advancements, social media is the most groundbreaking and effective platform for carrying educational programs and spreading awareness in the desired audience—parents, researchers and medical professionals (Plough, 2015). Realizing the significance of social media, I would design a campaign in form of awareness groups where more and more targeted audience would be invited to participate in discussions and sharing their experiences with the affected children. These groups would allow medical professionals to convey affective management techniques in form of video lectures to newly diagnosed parents whereas experienced parents would share their experiences with the new ones so that they could make careful decisions accordingly. Researchers would gather data for exploring the evidence-based practices and other issues related to Down syndrome. In this way, social media platform would be used for educating the desired audience.

References

Carothers, A. D., Hecht, C. A., Hook, E. B. (2018). International variation in reported live birth prevalence rates of Down syndrome, adjusted for maternal age. J Med Genet., 36, 386–93.

Magyar, C. I., Roizen, N. J., Kuschner, E. S., Sulkes, S. B., Druschel, C., van Wijngaarden, E. et al. (2014). A community cross-sectional survey of medical problems in 440 children with Down syndrome in New York State. J Pediatr., 164, 871–875

Martin, T., Smith, A., Breatnach, C., Kent, E., Shanahan, I., Boyle, M. et al. (2018). Infants born with down syndrome: burden of disease in the early neonatal period. J Pediatr. 193, 21–26

Bull, M. J. & Committee on G. (2011). Health supervision for children with Down syndrome. Pediatrics., 128, 393–406

Girdler, S., Pillay, D., Collins, M., et al. (2012) ‘It’s not what you were expecting, but it’s still a beautiful journey’: the experience of mothers of children with Down syndrome. Disability and Rehabilitation, 341(18), 1501–1510.

Fortier, L. M., Wanlass, R. L. (1984) Family crisis following the diagnosis of a handicapped child. Family Relations, 33, 13–24.

Plough, A. L. (2015). Building a culture of health: a critical role for public health services and systems research. Am J Public Health., 105 (2), S150–2. doi: 10.2105/AJPH.2014.302410

WK3 Applying An Ethical Decision-Making Model

WK3 Applying an Ethical Decision-Making Model

[Author Name(s), First M. Last, Omit Titles and Degrees]

[Institutional Affiliation(s)]

WK3 Applying an Ethical Decision-Making Model

Introduction

The wellbeing of a patient is in the hands of a healthcare professional, whether they are physician/doctors, nurses or paramedical staff. This wellbeing is hugely dependent on the ethics of these professionals, and their ethical decision-making. Hence, the interests of a patient's wellbeing are directly linked to the ethical or standardized practice and a decision made by healthcare professionals. In their daily routine, nurses and patients go through various ethical issues faced which are linked to the ethical decision-making issues. One such issue is the collision of the nurse's rights with that of the patient's beliefs. Therefore, an explicit model or systematic method for making an ethical decision is highly prioritized by the healthcare professionals and nurses for solving such ethical decision-making matters. This paper will explore the solution by applying a six-step integrated model of ethical decision-making for nurses as proposed by Eun-Jun Park in his article published in the journal of nursing ethics.

Discussion

Integrated Model of Decision-Making

The model proposed by Park included six steps as follows:

Recognition of an ethical issue

Gathering additional information for identifying the issue and then developing solutions

Advancement of options for examination and evaluation

Choosing the best option and validation for it

Expansion of varied, realistic ways of implementing the ethical actions and decisions

Estimation of effects and improvement in the strategies for preventing the issue from reoccurring

The ethical issue related to the rights of the patient is that nurses have since long struggled with challenging situations, where their rights or beliefs collided with that of the patients. A moral issue can happen in any healthcare services circumstance where ethical decision-making is necessitated due to the "wrongness" or "rightness" concerning the proficient leadership of nurses and the useful consideration of patients (Park, 2012). For instance, the nurses on critical care duty often come across the situations where the presence of an ethical issue regarding the beliefs of the patient and their right to know is in contradiction with the nurse’s nature of duty. Justifiably, all the nurse or healthcare professionals are influenced by the choices lead by ethics, so it is difficult for these nurses to go through such an intense situation. In such scenarios where there is a contradiction in the ethical decision making between the nurses and their patients, nurses often come up with the model of ethical decision making as the solution for such issues.

Application of the Model

The foremost step in Park’s ethical decision-making model is to identify the ethical issue; hence it has been identified as the contradiction among patient’s beliefs and rights with the nurses’ (Park, 2012). The additional information in this regard would be the specification of the issues, whether it is related to the end-of-life decision or issue of consent, or the cultural safety of the patient. The difference in ethics and standards of nurses' with the patients is the sole reason for the occurrence of such problems in nursing (Kulju et al., 2016).

Regarding the ethical issue of patient’s rights and its contradiction with nurse’s practice or rights, the next step is to identify the options for evaluation and examination of possible solutions and their options (Kangasniemi, Pakkanen, & Korhonen, 2015). So the significant solution to this issue is providing proper training to the nurses regarding cultural safety and effective communication with the patients with diverse or unified cultures. The violation of patient's rights and beliefs should not be considered any lesser than a serious violation because it is the rightful duty of a healthcare practitioner to provide a secure and accurate treatment to the patient with absolute righteousness. It is one of the best options for nurses to deal with the patients with complete information and compliance to their cultural safety and this will bring productivity in the patient-nurse relationship making them understand the rights and beliefs of each other and this will thus lead to the better outcome of patient quality care. By creating a safe patient experience it enhances the healthcare service to unbound heights and it serves the purpose of the society.

Moreover, the second last step of Park’s model is the most important step as it ensures the integration of the varied, realistic ways of implementing ethical actions and decisions. Therefore, the proper ways and manners of implementing the solutions provided above for the proposed issue are by ensuring the learning of nurses and healthcare professionals regarding the ethics and morals of nursing, which they are taught in nursing or medical school. The last step is to assess the implemented solutions, and the easy way to do it by carrying out the surveys or interviews, or the screening of nurses can be done regarding the learning of ethics (Park, 2012).

Conclusion

The above-mentioned model devised by Park is effective in its own way as it provides the solution in a step-by-step manner for the ethical issues in nursing. The nursing field is full of excessive challenges as they are the sole protectors of patient’s wellbeing and is they do neglected duty or misjudge their intentions for the cause it will heavily endure penalty to the patient’s outcomes and wellbeing. In certain scenarios where there is a disagreement in the ethical decision making between the nurses and their patients, nurses often come up with the model of ethical decision making as the solution for such issues. Hence, this paper explored the possible solution by applying a six-step integrated model of ethical decision-making for nurses as proposed by Eun-Jun Park in his article published in the journal of nursing ethics.

References

Kangasniemi, M., Pakkanen, P., & Korhonen, A. (2015). Professional ethics in nursing: an integrative review. Journal of advanced nursing, 71(8), 1744-1757.

Kulju, K., Stolt, M., Suhonen, R., & Leino-Kilpi, H. (2016). Ethical competence: A concept analysis. Nursing Ethics, 23(4), 401-412.

Park, E. J. (2012). An integrated ethical decision-making model for nurses. Nursing Ethics, 19(1), 139-159.