• Review “Gastrointestinal Disorders” of the Burns et al. text.
• Review the provided case studies. Analyze the patient information.
• Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient.
• Think about a treatment and management plan for the patient. Be sure to consider appropriate dosages for any recommended pharmacologic and/or non-pharmacologic treatments.
• Consider strategies for educating patients and families on the treatment and management of the gastrointestinal disorder.
Post on or before Day 3 an explanation of the differential diagnosis for the patient in the case study you selected. Explain which is the most likely diagnosis for the patient and why. Include an explanation of unique characteristics of the disorder you identified as the primary diagnosis. Then, explain a treatment and management plan for the patient, including appropriate dosages for any recommended treatments. Finally, explain strategies for educating patients and families on the treatment and management of the gastrointestinal disorder.
Case Study 2:
Victoria is a 15-year-old who complains of chronic sore throat and bad taste in her mouth. Her height and weight are appropriate for age and she remains on the same growth trajectory since infancy. Abdominal examination and chest examination are negative. History reveals frequent burping and occasional feelings of regurgitating food. Diet history reveals she eats a balanced diet, but her primary sources of fluids are coffee, tea, and carbonated drinks.
SAMPLE ANSWER
GASTROINTESTINAL DISORDERS
GASTROESOPHAGEAL REFLUX DISEASE
A female adolescent reports chronic sore throat accompanied by bad taste in her mouth. Her growth trajectory has been consistent since birth and the body mass index is normal. Both abdominal and chest examinations are normal. History taking reveals frequent burping and regurgitating of food reported to be occasional. On further history taking, she reports that she takes a balanced diet, but her common sources of fluids are coffee, tea and carbonated drinks.
The diagnosis for this patient is gastroesophageal reflux disease (GERD). This is characterized by symptoms such as heartburn, regurgitating of food, sore throat that doesn’t go away for a while and bad taste in the mouth among other signs (TeensHealth, 2015). Although occasional regurgitation of food may be common to everyone, it is a classic sign of GERD especially when it is not associated with nausea. WebMD (2015) defines gastroesophageal reflux as “the return of the stomach’s contents back up into the esophagus”. WebMD further suggests carrying out a special x-ray test known as barium-swallow radiograph that would help rule out other possible problems.
Treatment and management
If GERD is left untreated, serious pathologic changes in the esophageal lining may occur which may develop into more complicated disorders. For this mild case, early treatment would be appropriate which would include Proton pump inhibitor (PPI) such as Omeprazole 20mg once a day before meals for four weeks (PDRHealth, 2015) This would provide a more rapid symptom control and better healing. The chronic sore throat and bad taste in her mouth would be addressed by educating the patient some diet and lifestyle changes such as reducing or avoiding fluids and foods containing caffeine and nicotine and carbonated snacks, taking smaller but frequent meals and eating two to three hours before bedtime.
Differential diagnosis
A patient presenting with the above symptoms would also be suffering from stomach ulcers which would be due to bacteria H.Pylori. The bacteria increase the acid content in the stomach, therefore presenting similar symptoms as GERD.
Inked item M6A3: Pain Management for the Obstetric Patient Paper
Helping a woman manage discomfort and pain associated with pregnancy, labor, birth and recovery from birth is an essential role of the registered professional nurse.
Using APA format, write a six (6) to ten (10) page paper (excludes cover and reference page) that addresses the comfort and pain relief needs of the antepartum, intrapartum and postpartum patient.
A minimum of three (3) current professional references must be provided. Current references include professional publications or valid and current websites dated within five (5) years. Additionally, a textbook that is no more than one (1) edition old may be used.
The paper consists of two (2) parts and must be submitted by the close of week six.
Part one (1) looks at the causes and management interventions of discomfort and pain during pregnancy, labor, birth and recovery from birth. Part two (2) is a component of a teaching plan the registered nurse would use to assist an antenatal patient make an informed decision regarding pain relief measures to be used during labor and birth.
Part 1
A. Identify and explain two (2) sources of pain for the antepartum patient, intrapartum patient, and postpartum patient during an uncomplicated pregnancy, labor, and recovery from the birthing process.
B. Identify one (1) pharmacologic and two (2) non pharmacologic pain management measures for the intrapartum patient. Explain the benefits and risks of each of these pain management measures.
Part 2
In order for the woman to make an informed decision regarding pain relief measures to be used in the intrapartum period, the information needs to be provided in the antepartum period.
Before finalizing a teaching plan for the pregnant woman, her history needs to be assessed to determine any variables that may affect the content of the teaching plan. For example, are there any language variables/barriers that will affect care provided during labor and birth?
A. Identify three (3) variables unique to the pregnant patient that need to be considered when developing a patient specific pain management teaching plan for the antepartal patient preparing for labor and birth. Provide an explanation why each of these three (3) variables needs to be considered when developing a teaching plan for an obstetric patient.
B. Select two (2) non-pharmacologic pain relief options used in the intrapartum period. For each option, explain three (3) specific points of information related to this pain relief option that needs to be taught to the patient. Include rationales for each piece of content regarding why you would need to incorporate this information.
Compose your work using a word processor (or other software as appropriate) and save it frequently to your computer. Use a 12 font size, double space your work and use APA format for citations, references, and overall format.
SAMPLE ANSWER
Part 1a; sources of pain in antepartum, intrapartum and postpartum
The period between when a child is conceived and the period a child is born is referred to antepartum. During this period, the expectant mother undergoes numerous morphological as well as physical changes as the child develops. This is why it is important to attend prenatal clinics so that the nurses can assess these morphological changes to determine if they are normal of putting the expectant mother at risk. Patient should be taught on ways to maintain physical activeness and appropriate nutrition. Most health complications experienced by the antepartum patient is attributable to changes in body hormones, including progesterone levels, estrogen, gonadotrophin and lactogen. The two main sources of pain are abdominal pain and pelvic pain. The abdominal pain is due to the stretching of the uterine muscles and expansion of the ligaments to accommodate the growing fetus. This process is often accompanied by other physiological disturbances such as nausea and fatigue. The pelvic pain also occurs due to the enlargement of the abdomen area which causes the pelvic bones adjust accordingly to support the increase of the growing abdomen (Sandra, Judith, & Jean, 2015).
Intrapartum occurs when one is undergoing labor. This natural process comprises the expulsion of the fetus, the placenta, and membranes. Sources of pain during this time arise due to the uterine contractions. The contractions are progressive with the cervix dilation. Picotin and prostaglandin hormones normally stimulate the pains. The uterine contraction pain and intensity increases as the baby is about to be expelled. The contractions increase with activities that increase myometrial such as walking. Initially, the pain occurs in the form of cramping just like when one is undergoing menstruation and increases with time. The first hours of labor, the expectant mother is able to control the pains, as they are usually mild. The intrapartum patient can be taught on effective strategies to manage the pain (Demirel et al., 2013).
Postpartum refers to the period just after birth, mainly the first four hours following birth. This period is described by excitement and joy, but also pain due to the hemorrhages that may have occurred during the birth. The main sources of pain are lacerations that could have occurred during giving birth process. In some cases, the uterine cramping can continue and pain in the lochia rubra. Pain management during this stage is controlled using narcotics, anti-inflammatory analgesics that are non-steroidal and where necessary, topical antiseptics could be applied (Chaillte et al., 2014).
Part 1b; pain management for intrapartum
The pain management in intrapartum can be controlled following pharmacological and non-pharmacological interventions. Following pharmacological approaches, the nurses can provide the patient with sedatives to help the patient relax. However, these medications should be used with caution because the sedative often present adverse effects to the baby and the mother. In many cases, the use of sedatives makes the mother relax, and feel drowsy. This could present difficulties in concentrating especially when pushing the baby. The cardiovascular effects are also associated with alteration of the cardiovascular system. This includes lowering of the heart rate, which is often linked with difficulties in child’s breathing and even reflexes after birth. These medications must be avoided and should only be given when necessary and in small dosages. Additionally, these medications must never be administered to a patient who is about to deliver (Sandra, Judith, & Jean, 2015).
In the late stage of intrapartum, the best intervention is non-pharmacological intervention. The nurses must provide the patient with techniques that will enable them cope with pain, fear, and anxiety that results. One of the techniques that can be applied is controlled breathing technique. This intervention is important because it relaxes the muscles, which are often tensed. Anxiety induces endocrinal system, which produces hormones that cause the muscles to become tense. Tense muscles cause interference with the contractions of the uterine wall, leading to a complication during delivery. Counseling intervention has also been associated with increased relaxation of the uterine muscles (Green, 2011).
Nurses should constantly encourage the expectant mother by constantly verbalizing the patient ability to cope with the pain and the delivery process. If available, the patient can be encouraged to participate in activities that divert their focus form pain. These include activities such as walking, massage and the use of the birth ball. The patient should be well educated on about the gestation period and what to expect during the labor process. This way, the expectant mother becomes psychologically prepared about the process. Thus, it can face the whole process with confident. Anxiety is believed to stimulate the endocrinal system where the brain stimulates the production of the adrenal corticoid hormones, which is often associated with the reduction of blood flow to important body structures such as the fetus and the placenta. Evidence based research indicates that an informed patient has less tension which increases blood flow to the fetus and to the muscles during the uterine contraction process and during delivery (Chaillte et al., 2014).
Part 2a; variables considered when designing a teaching plan
Nurses are mandated in empowering patients so that they can case manage their healthcare complications. The process of case management and teaching is challenged by various factors, including cultural barriers, patient literacy and linguistic barriers are some of the barriers that affect a successful outcome of a teaching plan. The first key variable that should be assessed is cultural values and respects. This is because cultural values determine if the patient will follow the set interventions or cultural aspects interfere with the established interventions. For instance, in some cultures, the patient is not allowed to take some types of food during pregnancy or even to carry out vital activities during pregnancy period (Green, 2011).
The patient medical history is important. This is especially valuable in order to understand previous consumption of medication to avoid adverse interactions. In some cases, the expectant women can be consuming harmful drugs such as opiods, smoking, and heroin. These drugs are associated with adverse effects such as Fetal Alcohol Spectrum Disorders, which associated with numerous neuropathologies. Patients who are addicted should be treated using diazepam and other necessary support (Sandra, Judith, & Jean, 2015).
The patient medical history is also very important. This involves the history of relatives. This is because some health complications are inherited and genetic. Other relevant information includes number abortions, the number sexually transmitted infections (STIs). The number of previous pregnancies, existing children, and their health status of the children must be recorded. In the first and the second trimester, pain is an indication of an issue with the physiological process, and if the pain is very severe, the physician should be consulted. In the last trimester, pain is an indication of labor. Labor pain varies from person to person and is unique. Mother’s reaction to pain differs according to the patient physiological preparedness. Patient should be empowered effectively to ensure that they could manage the disease comfortably and with ease (MartÃnez et al., 2012).
The common factors during this process are fear and anxiety experienced by the patients. The emotional status of the parent determines their ability to cope with anxiety the first time mothers because of the fear of unknown as well as cultural belief. It is important to understand these variables because they facilitate in designing of the patient education plan. Additionally, different stages of labor will require different approach to manage pain. For instance, the first trimester time pain can be manageable, but in the last trimester, the dilation of the cervix and contractions of the uterine walls could require non-pharmacological intervention such as breath relation technique or massage (Demirel et al., 2013).
Part 2b Non-pharmacological pain management
Evidence based research indicates that the best intervention to manage anxiety is through breath relaxation. Anxiety arises when the patient is inadequately informed about the processes and physiological activities during the gestation period. Anxiety can also arise due to mixed emotions of excitement and fear. The interventions should ensure that patient integrity is sustained; this can be done by drawing curtains when attending to an expectant woman to ensure that privacy is maintained. The reduction of exposure indicates respect and promotes the patient relationship with the staff (Chaillte et al., 2014). This mutual relationship makes the patient feel more comfortable and more relaxed, reducing the rate of anxiety. It is also important to value cultural beliefs and values give the patient sense of belonging, which empowers the patient to manage pain. The breath relaxation technique enables the patient cope with anxiety, which helps in managing pain because it helps relax muscles. This is because tense muscles cause interference of fetal descent, which is often associated with increased fatigue. The fatigue increases pain perception negatively affecting patient ability to cope. It also increases mother’s confidence improving their ability to cope with pains (Demirel et al., 2013).
The use of massage enables pain relief especially during the initial stage of labor. The source of pain during this stage is due to dilation of the cervix caused by the hypoxia or the contractions of the uterine muscles. The aim of this intervention is to ensure that patient verbalizes pain relief indicating that the patient is coping with uterine contractions. It also facilitates the process of voiding. Full bladder increases pain intensity and discomfort. The massage enables pain distraction, and can be coupled with other destruction activities such as watching TV, music, or talking (Chaillte et al., 2014).
Demirel, I., Ozer, A., Atilgan, R., Kavak, B., Unlu, S., Bayar, M., & Sapmaz, E. (2013). Comparison of patient-controlled analgesia versus continuous infusion of tramadol in post-cesarean section pain management. J Obstet Gynaecol Res, 40(2), 392-398. doi:10.1111/jog.12205
Green, C.J. (2011). Maternal newborn: Nursing care plans. Jones and Bartlett Learning. Burlington
MartÃnez, B., Canser, E., Gredilla, E., Alonso, E., & Gilsanz, F. (2012). Management of Patients with Chronic Pelvic Pain Associated with Endometriosis Refractory to Conventional Treatment. Pain Practice, 13(1), 53-58. https://www.doi:10.1111/j.1533-2500.2012.00559.x
Sandra, M., Judith A, D., & Jean, W. (2015). CNE SERIES. Pain Management in the Post-Operative Pediatric Urologic Patient. Urologic Nursing, 35(2).
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Need to analyse How Quirky used IT to develop a competitive advantage (both techniques and applications)
First, Identification and Discussion of Information Technology (IT) techniques and how it gave them competitive advantage. How it works and how the
information technology help business improve the process or something.
Second, applications implementations and how it gave them competitive advantage.
Please answer the questions separately by making the necessary references.
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As an intern at the Career Development Centre of the University of Westminster you have been asked to write a formal report called “Acquiring Business
Communication Skills Necessary for Business Graduates”. This report is intended to explore and emphasise the value of business communication skills that the
students of the Westminster Business School (WBS) will need to develop before they graduate in order to increase their career opportunities. This report is
prepared primarily for the students of WBS, and also for the Career Development Centre advisers and for members of staff.
To prepare this report you are required to focus on the following:
• Identify and evaluate types of general communication skills
• Identify and evaluate types (or categories) of business communication skills
• Give examples of how communication skills can be used in business environment with references to reliable and relevant sources
• Give recommendations to the undergraduate students of WBS on how they can develop different business communication skills whilst they are studying
different modules of their course
You are required to use the following sources of information:
Conrad, D. and Newberry, R. (2012). Identification and Instruction of Communication Skills for Graduate Business Education. Journal of Education for
Business. Vol. 87, Issue 2, 2012.
Gallagher, K. (2013). Skills Development for Business and Management Students. Study and Employability. Chapter 4. Oxford: Oxford University Press.
In addition to a minimum of the above mentioned literature sources it is expected that students will also consult other reliable sources resulting in at
least five different academic sources (e.g. academic journal articles and books) for their work. A minimum of eight relevant academic sources is expected to
be referenced in the report for any coursework with a first grade mark.
As an intern at the Career Development Centre of the University of Westminster you have been asked to write a formal report called “Acquiring Business
Communication Skills Necessary for Business Graduates”. This report is intended to explore and emphasise the value of business communication skills that the
students of the Westminster Business School (WBS) will need to develop before they graduate in order to increase their career opportunities. This report is
prepared primarily for the students of WBS, and also for the Career Development Centre advisers and for members of staff.
To prepare this report you are required to focus on the following:
• Identify and evaluate types of general communication skills
• Identify and evaluate types (or categories) of business communication skills
• Give examples of how communication skills can be used in business environment with references to reliable and relevant sources
• Give recommendations to the undergraduate students of WBS on how they can develop different business communication skills whilst they are studying
different modules of their course
You are required to use the following sources of information:
Conrad, D. and Newberry, R. (2012). Identification and Instruction of Communication Skills for Graduate Business Education. Journal of Education for
Business. Vol. 87, Issue 2, 2012.
Gallagher, K. (2013). Skills Development for Business and Management Students. Study and Employability. Chapter 4. Oxford: Oxford University Press.
In addition to a minimum of the above mentioned literature sources it is expected that students will also consult other reliable sources resulting in at
least five different academic sources (e.g. academic journal articles and books) for their work. A minimum of eight relevant academic sources is expected to
be referenced in the report for any coursework with a first grade mark.
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The case is about Mondetta Everywear, a clothing company located in Winnipeg in Canada. The company is owned by four individuals also brothers (Laughren, 2013). The case therefore provides an in-depth analysis about the company that gives insights on the operation and best growth strategy for the company. The company has sound financial resources that have contributed to its expansion. Through licensing, the company has also managed to ensure that they preserve their copyrights (Laughren, 2013). There is also a fit between personal and corporate objectives since the four owners have resolved to work hard to ensure that the business to whom they have shares succeeds.
SWOT analysis as well provides insights about the company. Internal issues of the company are understood through the strengths and weaknesses. Strength includes, lean management structure and stable finances (Laughren, 2013). Weakness includes stiff competition. Opportunities include ready market in some of the foreign countries such as USA. Threats includes, different trade dynamics in part of the markets, and changes in fashion trends
Segment 1
Segment 2
Segment 3
Who
Young people
Adults
Young and adults
What
Jeans
Sweatshirts
t-shirts, swimming costumes
When
Throughout the years
Throughout the years
Throughout the years
Where
Canada
USA
Western Europe
Why
Usually clothing
How
Press exposure
Word of mouth, trade shows
Graphic appeal of clothing, display on transit shelters
Market size
Small
Larger
Larger
Implications:
Segment 1
Segment 2
Segment 3
Product
Variety of products to get wider customer base
Different designs increased customer base
Products came in various designs and this increased profitability
Price
Prices were competitive aimed to attract more customers and increase sales
Prices were competitive aimed to attract more customers and increase sales
Prices were competitive aimed to attract more customers and increase sales
Place
The markets varied and included Canada market which was potential
Extending in USA increased sales but was met with competition
Widened market to Europe and this impacted on sales volume
Promotion
Media helped to expose the company products
Use of word of mouth as well increased awareness
Use of graphics as well as word of mouth increased the level of sensitivity increasing sales volume
The products are distributed using independent stores and chain stores (Laughren, 2013). The company uses these distribution channels sparingly and decisively to ensure that the customers get access to their products. For instance, chain stores are preferred in USA as opposed to Canada markets hence, this ensures that more customers access to their products. Competitors in the market are many such as Passport International that contributes to stiffer competition in the market. They have reduced market share and as well leading to reduction in prices of the products.
The company is as well affected by various external factors such as social, economic, technological and politics. The environment of operation is stable hence, the company has confident in the markets. The economic situation is also stable. The advancement of technology requires the company to embrace innovation to remain competitive. Cultures vary and this should be considered in the designs of their clothing.
Corporate capabilities as well affect the business. The company uses various marketing strategies such as word of mouth which has enabled it to get more customers. This form of advertisement however takes long period for many customers to know about the products. Financial manages is good. The company employs competent employees that have enabled it to succeed in their initiatives. The company has as well managed to maintain its fixed costs as well as variable costs hence achieved a breakeven point.
I recommend the company to survey other potential markets that are yet to be explored and take the opportunity. They should as well change their distribution strategy, consider using technology to market, and sell its clothes to reach wider customer bas
Reference
Laughren, T. (2013). Management of Organizations COM 1007, Laurentian University; Ivey Publishers.
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This assignment will give you an opportunity to complete the outline used in the pre-writing technique as part of creating an academic paper.
Objective:
Demonstrate the process of creating an outline prior to creating a draft of an academic paper.
Assignment Requirements:
Complete an outline for the academic paper that is the final written assignment in this course. The outline body must have the following sections:
1.A definition of a good decision
2.Examples of a good decision
3.Synthesis of the previous research on good decisions that results in a general definition of good decision making
SAMPLE ANSWER
Decision-Making
Introduction
Whether decisions are good or bad, their makers should be accountable for them.
Making the right conclusions should be a decision maker’s priority (Karelaia, 2014). Whether the results are bad or good, decision-makers have to face the consequences of their choices (The Marketing Society, 2015). There are always hindrances to making right decisions (Pillay, 2014).
Body
A good decision is usually the right answer to a particular question (Fox, 2014).
Decisions must not only be the right answers, but they should also be specific to the questions they answer. Decisions are the driving power in organizations and managers cannot avoid them (Mandelberg, 2015). Being at an informed position facilitates the making of a good decision.
Examples of Good Decisions
Infosys’s decision in 1999 to let its local competitors excel is an example of a good decision. It was hard for the company to determine the appropriateness of the move, but with time, the decision made the Indian IT market competitive (Kaipa & Radjou, 2013).
Wendy Kopp’s decision to allow other people to run Teach for America initiative in 1999 serves as an example of a good decision. It was only after the founder had sacrificed his role that the company realized its current economic status (Kaipa & Radjou, 2013).
Research Synthesis:
Carrying out decision-making on the basis of credible and nonbiased information leads to the right decisions. The credibility of sources entails the truthfulness of the information they provide (Myatt, 2012). For instance, people would make bad decisions if they face limitations such as being under pressure (Zenger & Folkman, 2014).
In most cases, the effectiveness of the processes involved in decision making determine the achievement of either good or bad decisions (McKinsey & Company, 2009). The outcomes of decisions are vital to the determination of the appropriateness of choices. For instance, right decisions in healthcare result in desirable patient outcomes (Lee & Emanuel, 2013).
Conclusion
Decisions are good if they are the right answers to the particular question. The ultimate goal of decision-makers is to realize benefits regardless of periods they may take. At firsts, decisions may appear what they are not. Decision-makers should be accountable for the consequences of their decisions.
References
Fox, J. (2014, November 21). How to tell if you’ve made a good decision. Harvard Business School Publishing. Retrieved from https://hbr.org/2014/11/how-to-tell-if-youve-made-a-good-decision
Kaipa P. & Radjou, N. (2013, April 14). 7 business decisions that looked bad but turned good. CNBC. Retrieved from http://www.cnbc.com/id/100634625
Pillay, S. (2014, March 31). How to improve your decision-making skills. Harvard Business School Publishing. Retrieved from https://hbr.org/2014/03/how-to-improve-your-decision-making-skills
The Marketing Society. (2015, May 16). Decision-making and accountability. Retrieved from https://www.marketingsociety.com/the-gym/decision-making-and-accountability
Zenger, J. & Folkman, J. (2014, September 1). 9 habits that lead to terrible decisions. Harvard Business School Publishing. Retrieved from https://hbr.org/2014/09/9-habits-that-lead-to-terrible-decisions
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Should parents discipline their children by using corporal punishment techniques, such as spanking? Or is a nonphysical approach more conducive to raising mentally and emotionally healthy children?
Complete a 5-6 page argumentative topic written in
an informational essay style research paper for class. This paper will address a debatable topic which focuses on an academic topic of social, political or culture relevance. You will be providing both sides to the debatable topic, but will NOT be providing your opinion or side. Each side will be neutrally presented allowing your audience to make their own decision as to which side to take.
Length: 5-6 pages excluding cover page, abstract, and references
Purpose: Argument—addresses a debatable topic on an academic topic of social, political, or cultural relevance.
Audience: General, college level, academic (third person only!)
Organization: Topical
Sources: Minimum of 11; minimum of 5 academic.
Format: APA 6th Edition
Please stick to the topic and follow all parts of the Instructions.
If you may have any questions or any problems during the time period please contact me as soon as possible.
If possible, please send me and outline or first draft to be reviewed.
As you know this paper should be in third person only. please let me know to whom this paper would be viewed by such as students, parents, doctors, nurses, regular people, etc
And please inform me in a message what type of sources you are planning on using.
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Among the commonest devices that hospitalized patients need are the peripheral intravenous catheters (The Royal Children’s Hospital Melbourne, 2015). The devices mainly find use in the administration of medications and fluids. It is also common for clinicians to use the catheters to collect blood samples. As such, the instruments are indispensable in in-patient environments, and there would be a need to maintain the best possible practice with them (Food and Drug Administration, 2010) Ricard, Webster, Wallis, Marsh, McGrail, French, and Whitby (2012) are some of researchers who have explored the use of the devices in clinical care. The researchers conducted a randomized trial with the aim of establishing that clinically indicated catheter devices served the same purpose and effectiveness as the routine replacement ones. This paper aims at appraising their work. The paper puts emphasis on the methodology, findings, implication to practice, as well as the prospective that the research makes for future studies.
The motivating factor for the researchers was the observation that the routine replacement type of catheters failed constantly during treatment provision to patients. The scientists felt that the replacement procedures involved with catheters had little effect in minimizing chances of the contraction of infections and phlebitis (Ricard, 2012, Pg. 1066). The long title they had for their research is one of the basic structural shortcomings. Usually, long titles do not attract readers as the short ones do (Paiva, Lima, & Paiva, 2012, Pg. 509). People tend to refer more to articles with short titles (Habibzadeh, & Yadollahie, 2010, Pg. 165)
An Appraisal of the Method
The researchers’ description of their theoretical framework was inadequate. They only mentioned that clinically indicated catheters were better than the cultural replacement ones. The researchers ought to have made their framework comprehensive by indicating the benefits and shortcomings of each method. Failure to establish a strong framework compromises the necessity of the study (Statistics Solutions, 2015). Also, the absence of sufficient scientific background makes research works to have a weak rationale. Again, their framework was weak as they only mentioned that their proposed method was cheap, but they did not give financial estimations of the savings that the advocated technique would earn institutions. The researchers identified their design as multicenter and randomized. The researchers also used a non-blinded method, which is justifiable owing to the nature of the variables. They further used manual selection of participants, and they were able to determine patients who would fit for the study. The exclusion of patients from emergency room was necessary, but the move created a bias. Patients from emergency rooms are likely to have unpredictable use of the catheters unlike their counterparts in other areas. The predictable nature of the use of the catheters in a particular group is a source of bias.
The researchers followed the necessary guidelines when they sought validation from the regulatory institutions. Also, the researchers indicated that participants’ consent was in writing. Such a move is encouraging in terms of ethics of practice and participants had the right of having all the necessary information. So as to avoid inconveniences in the hospitals, the researchers also needed consent from the hospital administration. The scientist needed to guarantee that their activities would not interfere with the appropriate clinical service to the participants. The team needed expressing its willingness to minimize interference with the care of the patients who participated in the study. The research missed out important details in patients’ participation such as methodologies that ensured minimal bias (Sackett, 2011, Pg. 351).
The researchers did not give a detailed description of philosophical underpinnings necessary for research, and neither did they pose research questions. Usually, philosophical underpinnings and research questions facilitate subsequent processes of research including data collection and analysis (Jeanfreau, & Jack, 2010, Pg. 615). In addition, the methods increase the rationale for research. The strategies direct procedures to a particular direction hence expressing their necessity clearly and enabling researchers to evaluate the outcomes of research. Research works should develop in a way that they answer research questions in a stepwise manner. The extent to which studies offer solutions to issues appropriately measures their success. Also, study questions must come in the early parts the study especially in the description of methodology. In addition, research questions should exhibit consistency and the solution of earlier issues should facilitate the answering of subsequent concerns (Riva, Malik, Burnie, Endicott, & Busse, 2012, Pg. 169)
Notable strengths in methodology that the research include the inclusion and involvement of a large sample size. Response from participants was high and it rendered credibility and reliability to the findings. The high response depicts the researchers’ ability to manage their sample for optimal evaluation and assessment. Again, there was minimal bias in selection of the sample, an occurrence that further demonstrates the competence of the investigators in handling their study. Also, the research used a broad variety of patients from different hospital settings. The insertion of catheters to patients by medical and nursing staff only also enhanced the accuracy of findings. The practice decreased the occurrence of errors and enhanced the standardization of services and so the reliability of findings (Study Data Tabulation Model, 2011).
Remarkable drawbacks in the design of the research included the non-blinded nature. However, the limitation is understandable as catheters were devices that everybody could witness their application. As such, the non-blind nature was a source of bias that could have been challenging to overcome. Also, the design involved a total of five items in a list to rate the occurrence of phlebitis. However, only one of the five involved patient ratings making it impossible to establish a diagnostic rating. Again, the methodology of the research was limited in not all catheter tips were cultured following budgetary constraints in the laboratory department and the hospital.
An Appraisal of the Results
The results of the study were from a well-conducted investigation. They were therefore reliable and valid for application (Castro, Bevans, Miller-Davis, Cusack, Loscalzo, Matlock, & Hastings, 2011, Pg. 76). Expert stastisticians analyzed the collected data and generated comprehensive figures and other forms of data expression. Accessibility of data to all authors was an essential fulfillment of the requirements of scientific studies (Archives of Internal Medicine, 2011). It was after the interpretation of the analysis that the researchers offered their results and conclusions. The results were also free form the influence of the agency funding the research (Rickard et al., 2012, Pg. 1072). Had there been influence from the funding body, the results of the research would have been biased. It is most likely that the research would have arrived to conclusions that favor the financing agency. Therefore, it was necessary to reassure the public and users of the data that the outcomes did not bear external influence (Jack, Hayes, Scharalda, Stetson, Jones-Jack, Valliere, LeBlanc, 2010, Pg. 163).
The number of patients involved in the study was large enough to validate the research. In addition, the total number of catheters and days that the research involved was satisfactory to validate the findings. Also, there was a high adherence of the participants to the protocol and procedures. However, though the mean figures obtained from the calculation of the number of days that the patients remained on catheters were reasonable, the range of hours was too large. As such, the researchers could have sought other methodologies of expressing the same information. Basing findings on the mean of data that had a broad range was inappropriate for the research. The large variation of data could have prompted the researchers to exclude extreme values in the calculation of the mean. However, such an action would have amounted to data manipulation and would have created a bias (Lu & Su, 2010, Pg. 96). Therefore, the researchers only had the option of applying other statistical techniques that would have reconciled the gap in the range of results.
The researchers also expressed their findings of participation in a flow chart to enhance the understanding of data. Such a tool made it easy for the users of the information to understand and apply it in their works (University of Washington, 2011). The chart indicated clearly the number of eligible participants and further categorized them into their specific tests. From the expression, users of the information could establish that the difference between analyzed participants for the different studies was barely a hundred, a figure that translates to a reasonable percentage. The researchers expressed patient characteristics and demographics in the form of a table, which was an appropriate tool (Rodriguez, 2013). The three column table allowed for quick comparison of outcomes so that users of the information could establish a clear picture of the outcomes. The table allowed concurrent expression of multiple parameters hence making the data readily exploitable. Among the parameters that users could compare form the table include the catheter dwell time, the type of admissions, and the occurrence of various comorbidities. The researchers also utilized tables to express data concerning the properties of the catheters they used, study outcomes from the various groups, and clinical microbiological information of the positive cultures. Such a methodology of expressing findings was excellent as it made information handy for users. The researchers later elaborated their data as they had presented it in table. From the information, it was possible to establish that the inter-rater reliability testing for phlebitis across hospitals had an agreement close to a 100%, and its Cohen constant value was 0.03. Also, it was possible to establish from comparison that 7% of patients from either group had phlebitis, and that the absolute risk difference was 0.41%, and that the value was within the margin of 3% that had been predefined (Rickard et al. 2012, Pg. 1070). The researchers also applied the per-protocol power method to measure the degree of equivalence. It was possible to establish from the findings that the study hypothesis was upheld. Treatment of data and the results led to the conclusion that both routine replacement and clinically indicated catheter techniques were of equal value.
Though the findings led to a conclusion that upheld the hypothesis, the investigators failed to indicate methods that they used to guarantee the validity of their data (Code of Federal Regulations, 2011). The scientists only gave the limitations of their study, but they did not explain how rigorous their findings were. It is also notable that the investigators did not describe the transferability and dependability of their outcomes as it would have been expected of the type of their study. As such, it would be difficult for users of the information to determine the appropriateness of the findings for reference in other works (Krishnankutty, Bellary, Kumar, & Moodahadu, 2012).
An Appraisal of the Implications of the Study to Clinical Practice
Though the researchers did not address the implications that their study would have on clinical practice per se, it is evident that the findings would influence the application of catheters in patient care. The findings suggested that clinically indicated catheters were not associated with any increased risk to blood stream infections. The researchers also suggested that blood stream infections that occur with the use of catheters are mostly as a result of unhygienic practices (Rickard et al., 2012, Pg. 1072). As such, clinicians would seek to maintain proper sanitation practices such as hand washing when using catheters for their patients. Maintaining hygiene would decrease the occurrence of such types of infections, and it would eventually improve patient outcomes. The researchers also indicated that routine replacement of catheters had a theoretical basis of reducing infections, but, in practice, the methodology only exposed patients to other infections (Rickard et al., 2012, Pg.1072). Such strong assertions could influence clinicians to consider clinically indicated catheters at the expense of the routine replacement types. The researchers argued that there were already cases where the catheters were used for longer hours than they were meant for, and so failure to replace them routinely would not be such a risky approach. Clinicians would consider the argument and adopt clinically indicated catheters.
An Appraisal of the Implication of the Study to Future Research
The researchers did not directly indicate the impact that their study would have on future research. However, there are several mentions of potential routes for research. For instance, the researchers suggested that the understanding of their findings would be better if there were more knowledge on the pathogenesis of blood stream infections associated with the use of catheters. There are suggestions that hygiene would be the best approach to avoiding the infections. However, there could be other potential interventions to avoiding the occurrence. For instance, research may reveal the best antiseptics to employ when using catheters in patients. Also, the researchers suggested a need to develop molecular-based diagnostic techniques to improve the understanding of the association between catheter use and blood stream infections. The indication would motivate future researchers to take the route. In addition, the scientists observed gaps in some policies governing catheter use. They argued that clinicians leave catheters in place for periods that exceed the recommended time. The practice amounts to policy violation, and there would be a need to adjust the policies. Stakeholders and researchers might take the approach and investigate the strategies of handling such situations. There are possibilities that research findings would propose a modification of the policies.
Conclusion
Catheter use remains a primary practice in hospitals, especially among in-patients. Clinicians should offer high quality services by employing the most appropriate techniques of catheter use (International Association of Clinical Research Nurses, 2010). The discussed research offers substantial insight regarding catheter use. The study had both strengths as well as shortcomings. As such, there could be considerations for the application of the findings it generated. However, such considerations would be limited in the view that the researchers failed to offer crucial basics of research such as data validation (Kuchinke, Ohmann, Yang, Salas, Lauritsen, Gueyffier, & Lejeune, 2010). Researchers might find it hard to rely on the findings without a guarantee that the methods used and the data obtained was valid and of high standard. Nevertheless, the research would propel both clinical practice and future studies.
References
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The assignment is annotated bibliography (find seven articles then summarize each article and with APA citation in half page)
1- Please try to use simple English as you can
2- My general topic is about Arab Spring
3- I need one article background about Arab’s culture
4- One article about Arab political at this certain time
5- One article about the freedom of speech in w Middle East.
6- One article regarding the law of speech in Arab world
7- One article about the use of social Media in Arab world
8- Two articles about the rule of social Media in Arab Spring
9- In the flyer the instruction of the assignment and some sample, so you have to follow it.
10- You should cite each article in the same the articles’ sample citation.
11- You have to write just the important information from each article.
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In contrast to ethical philosophies that focus on moral obligations, pleasure, or utility, Aristotle’s ethics centers on his unique understanding of the good life, which aims at happiness or “flourishing” (eudaimonia) by means of the habitual cultivation of virtue (areté).
For this assignment, please write a short paper that examines the role of virtue in the good life by carefully comparing Aristotle’s account, given in Books 1-3 of his Nicomachean Ethics (Marino, 43
-84) with another text that describes moral virtue.
N.T. Wright, “What Am I Here For?” (Blackboard). N.T. Wright is a New Testament scholar who has written numerous books on Jesus Christ, the Apostle Paul, and the early church. This essay is from his recent book After You Believe: Why Christian Faith Matters (2012). He notes that while Christian ministers, pastors, and priests often focus on getting people to believe in Christianity, or to join the church, they are rarely able to describe how life is supposed to be different after someone believes. To address this challenge, he considers the moral teaching of the New Testament according to the category of “character,” which he believes to be synonymous with “virtue.”
Writing Instructions
This essay requires careful reading of Aristotle’s text, which is complex and often difficult to summarize. In order to make sense of Aristotle’s views, it will be important to show the connection between his main ideas, such as: happiness/flourishing (eudaimonia), virtue, habit, and the doctrine of the mean or
intermediate. This summary of Aristotle is a central part of your paper, and you should strive to write it concisely and accurately.
In writing about your comparison text, your essay should clearly explain how it relates to Aristotle’s conception of ethics. In developing this section, you
may want to consider the following questions:
What insights does this text provide for ethics?
How does this text compare to Aristotle’s understanding of virtue?
Does this text largely agree with Aristotle and so provide additional support for his ideas, or does it offer a criticism or an opposing position?
Suggestions for Writing a Successful Paper:
You should compose your paper as if writing for a general audience, made up of persons who are intelligent but unfamiliar with the authors or texts you are discussing.
Your introductory paragraph should clearly communicate both the topic and the thesis of your essay. The function of this introduction is to orient the reader to what you are writing about and to the position you are arguing in the paper. Your paper should also include an appropriate conclusion paragraph that sums up your argument and restates your overall position.
Although this paper is short and focuses on interpretation, it still requires that you identify and defend a clear thesis. This means that your paper should not merely be a collection of general statements or assertions about a text, nor should you simply give your opinion without offering adequate support.
Instead, you should back up your explanation with examples or evidence from the texts. In other words, you should give your readers reasons for thinking that what you are saying is accurate.
It is important to recognize the difference between thesis statements and themes/topics. A theme or topic simply names the issue under discussion in the
paper, while a thesis statement makes a claim about that issue. For example, this sentence names a theme/topic: “In this paper I will talk about Aristotle,
the New Testament, and virtue.” By contrast, this thesis statement makes a particular claim about that topic: “In contrast to Aristotle’s description of
moral virtue as cultivated by natural habit and upbringing, the New Testament presents genuine virtue as a gift of the Spirit.” For more information on thesis statements, see http://www.unc.edu/depts/wcweb/handouts/thesis.html.
Your sentences and paragraphs should clearly communicate what you are trying to say, and you should organize these in such a way that readers can easily see how your individual points relate to the paper’s overall argument. Avoid excessively informal language, contractions, sentence fragments, and run-on sentences. Also, take care to structure each paragraph around a unified and coherent theme that relates to your thesis. (For more information on writing clear and effective paragraphs, see http://www.unc.edu/depts/wcweb/handouts/paragraphs.html.
Writing a strong and successful paper requires backing up your claims with fitting quotations. There is no specific number of quotations that you should use, but in general it is better to use several brief quotations rather than a few long ones. When including a quotation, make sure that it fits in with what you are writing in a way that will be clear to your readers. In some cases, you may need to provide additional information to clarify the meaning of the
quotation.
This assignment does not require any additional research beyond the texts mentioned. However, you are welcome to use additional sources for help, provided that you cite them. You may want to consult the following online source on Aristotle: http://plato.stanford.edu/entries/aristotle-ethics/. If you are writing on Aristotle and Augustine, you may also find this page helpful (especially section four, “Ontology and Eudaimonism”) http://plato.stanford.edu/entries/augustine/. If you consult these sources, be sure to list them (along with any other sources) in a bibliography or works
cited page, even if you did not quote them in the paper.
Formatting Guidelines
Please give your paper an appropriate title. (You do not need a separate title page). Include your name and the date on the first page of the paper, either
on the top left corner or the top right corner.
The paper should be 3-4 pages, in 12 point Times New Roman font, with 1” margins.
The paper should be formatted according to the Chicago Manual of Style. (For more information on this style, see http://www.chicagomanualofstyle.org/tools_citationguide.html.) However, for the sake of simplicity, you may cite the texts parenthetically with the author’s name followed by the page number, as “(Aristotle, 25)” or “(Wright, 10).” You can also cite the additional chapters from Augustine’s City of God, Book XIX (on Blackboard) as “(Augustine, Ch. 25).” If you are choosing your own text, you may also cite it in parentheses with the author’s name and page number, but be sure to include the full information in the bibliography.
Bibliographic entries in Chicago style should be formatted as followed (this is the entry for the Wright text):
Wright, N.T., “What Am I Here For?” in After You Believe: Why Christian Character Matters (New York: HarperOne, 2016), pp. 1-26.
Your bibliography should include a citation from every source that you consulted for the paper. The bibliography will not count as one of your pages.
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