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  • Health Policy Values Sample Essay

    Write a Health Policy Values Sample Essay paper of 750-1,000 words examining your personal values and beliefs. Include the following:

    1. Describe your personal values and spiritual beliefs.

    2. Using the elements of cost, quality, and social issues to frame your description, differentiate your beliefs and opinions about health care policy. Give examples of relevant ethical principles, supported by your values.

    3. Analyze how factors such as your upbringing, spiritual or religious beliefs/doctrine, personal and professional experiences, and political ideology affect your current perspective on health care policy Health Policy Values Sample Essay.

    4. Examine any inconsistencies you discovered relative to the alignment of your personal values and beliefs with those concerning health policy. Discuss what insights this has given you.

    Health Policy Values

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    Personal values and Spiritual beliefs

    Spiritual beliefs and personal values play a significant role in the nursing profession. In particular, spirituality forms part of the holistic care when attending to mental, physical, emotional and spiritual needs of a patient. I acquired my religious beliefs from the Catholic family which mentored me through teaching me the traditions of the faith. Personal values are comprehensive and are essential trusting in one’s capability and self-determination to demonstrate who they are without impacting negatively on others. With attention to this, accountability is critical to me. The value teaches me to be responsible for my behavior which makes the patients and my colleagues develop trust in me. By the same token, authenticity and being genuine helps me show my true self and restricts me from compromising my values for reception of others. Additionally, I am self-reliable hence making me not to lean on others for my success. Reliability makes patients develop trust and also count on me. Health Policy Values Sample Essay.

    Differentiate your beliefs and opinions about health care policy using the elements of cost, quality, and social issues

    Boessel argues that the cost of health care in the United States is astronomical since it has treated a significant number of patients with multiple co-morbidities (2016). The patients can request the care which comforts them as they pay bills basing on how happy the patient is with the services  Health Policy Values Sample Essay. However, United States spends billion dollars on health problems such as cardiovascular disease, stroke and diabetes which could have been prevented if individuals lived a healthy lifestyle with regular exercises.

    A survey of Kaiser Family Foundation of 2015 on employer health benefit revealed that the cost of healthcare premium rose by four percent between 2014 and 2015 whereas the wages only increased by one point nine percent (Boessel, 2016). Equally important, other than raising the premiums, the employers were subject to reaching deductibles before taking over any coverage hence leaving a lot of out-of-pocket expenses unaccounted for (Dimick & Ryan, 2014). Health Policy Values Sample Essay. Correspondingly, the mortality rate for infants in the United States is alarming, the chronic conditions of patients are controlled poorly, and the mistakes in the health care are four percent above the average of other countries. In my opinion, these elements discourage my dependence on our health care giving me a feeling that I can trust only my individual care. My inside skills of health care systems give me the privilege to make educated decisions on where I can seek health care.

    There exist ethical and social issues which relate to the delivery of fair health care to all citizens. My opinion as a practicing nurse is that health upkeep is a mandatory and a right to all individuals irrespective of the republic of their origin or race. Identically, the cost of the healthcare in the United States will decrease if there will be annual checkups, diagnostic testing and also preventive screening which improves health care (Glen, 2013). The patients should be given the autonomy to decline or accept the service care provided to them Health Policy Values Sample Essay.

    How does your religious, spiritual, personal /professional experience affect your current health care policy?

    Taking care of patients and attending to family illness issues gave me the experience to develop a new perspective on life. The experience has made me more considerate to patients and their relatives when I consider the extent of my profession. Moreover, the experience has taught me how to communicate effectively as most of the families and patients are often scared of the outcome of the illness hence proper communication erases any fear. Not to mention, I have learnt not to be judgmental while giving care to patients with diverse religious and spiritual beliefs than my own. My professional experience has given me an opportunity to interconnect efficiently with patients irrespective of their dialectal since I am capable of delivering assurance using non-verbal cues, and being therapeutic to patients undergoing anxiety caused by their illness. The idea of thinking about appropriate health care for all regardless of their wages is essential.

    Inconsistencies in Healthcare Policy and my insight

    Even though America gives her citizens free press and freedom of speech, however, the country lacks health care for all Health Policy Values Sample Essay. Health care is a human right which should, therefore, be made available to all people. In contrast, there are inconsistencies in health care policies. For instance, Medicare is only available for persons with over sixty years old and the disabled individuals whereas Medicaid is only offered to low salaried individuals and those living in dearth. Such inconsistencies make me fail to understand whether health care in the United States is a privilege or a right. High premiums discourage middle class and low class families to take health insurance since they find it unaffordable. My insight is that the lawmakers, insurance, and pharmaceutical companies should make it easier for health professionals to keep their values. The healthcare policies must undergo revision and access to health care granted to all people regardless of who they are. Such measures will improve the quality of healthcare in the United States.

     

    Reference

    Boessel, B. (2016). The Cost of Healthcare in America. Small Business Employee Benefits and HR Blog. Retrieved from http://Small Business Employee Benefits and HR Blog 97-236.

    Dimick, J. B., & Ryan, A. M. (2014). Methods for evaluating changes in health care policy: the difference-in-differences approach. 
    Jama
    , 
    312
    (22), 2401-2402.

    Glen, P. (2013). Health care and the illegal immigrant. 
    Health Matrix (Cleveland, Ohio
    : 1991), 23(1), 1 Health Policy Values Sample Essay.

  • Geriatric Care Teams Sample Essay

    Geriatric Care Teams Sample Essay

    NURS 6540: ADVANCED PRACTICE CARE OF FRAIL ELDERS

    Week 3

    Introduction Resources Discussion Assignment Week in Review Looking Ahead

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    NURS 6540: ADVANCED PRACTICE CARE OF FRAIL ELDERS

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    Introduction Resources Discussion Assignment Week in Review Looking Ahead Geriatric Care Teams Sample Essay

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    NURS 6540: Advanced Practice Care of Frail Elders

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    Syllabus

    Course Calendar

    Course Overview

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    Resource List

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    A female caretaker assisting senior women in knitting while man reading book in background at nursing home.

    Week 3: Geriatric Care Teams Geriatric Care Teams Sample Essay

    Interdisciplinary geriatric care teams are a critical component of geriatrics, and I truly believe that geriatrics really does interdisciplinary care probably better than most other areas of health care because we have to—because we need to. Older adults have care needs that require the expertise of a community. No single provider can do it all well. The needs are just so vast.

    —Dr. Barbara Resnick, CRNP, FAAN, FAANP, AGSF, President of the American Geriatrics Society

    Dr. Resnick emphasizes the importance of interdisciplinary geriatric care teams, as geriatric patients often have complex health needs Geriatric Care Teams Sample Essay. This was the case for 90-year-old Gus Snare. A diagnosis of bile duct cancer resulted in the need for surgery to remove parts of his stomach, duodenum, pancreas, bile duct, and gallbladder. Snare’s care team included a geriatrician, surgical oncologist, and a team of nurses, including an advanced practice nurse. Together, they determined his eligibility for surgery, performed the surgery, and developed a treatment and management plan post-surgery (The University of Chicago Medicine, 2011). As an advanced practice nurse, you must identify your role within care teams for patients like Snare to ensure patients receive comprehensive care.

    This week you explore models of interdisciplinary geriatric care teams and compare the roles of advanced practice nurses at various sites of care. Then, as you complete your first SOAP Note, you examine the assessment, diagnosis, and treatment of a geriatric patient from your practicum site Geriatric Care Teams Sample Essay.

    Learning Objectives

    By the end of this week, students will:

    Compare models of interdisciplinary geriatric care teams

    Analyze models of interdisciplinary geriatric care teams used in various sites

    Analyze the roles of advanced practice nurses in different clinical sites

    Evaluate diagnoses for patients*

    Evaluate treatment and management plans*

    *These Learning Objectives support assignments that are assigned this week, but due in Week 4.

    Photo Credit: Maskot/ Maskot/Getty Images

    Learning Resources

    Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus. Geriatric Care Teams Sample Essay.

    Required Readings

    Resnick, B. (Ed.). (2016). Geriatric nursing review syllabus: A core curriculum in advanced practice geriatric nursing (5th ed.). New York, NY: American Geriatrics Society.

    Chapter 18, “Hospital Care” (pp. 134-145)

    This chapter explores systems of care for assessing and managing hospitalized older patients. It also examines alternatives to hospital care and transitions from hospital care.

    Chapter 20, “Rehabilitation” (pp. 152-166)

    This chapter describes essential components of geriatric rehabilitation, including sites of rehabilitation, roles of core health care providers on rehabilitation teams, and disease-specific care plans for older adults. It also explores mobility aids, orthotics, adaptive methods, and environmental modifications for older adults with disabilities Geriatric Care Teams Sample Essay..

    Chapter 21, “Nursing-Home Care” (pp. 167-174)

    This chapter identifies the demographic and functional characteristics of older adults living in nursing homes as well as the availability of nursing homes in the United States. It also describes staffing patterns, quality issues, and legislation related to nursing home care.

    Chapter 22, “Community-Based Care” (pp. 175-180)

    This chapter explores characteristics of care in communities, including home care, community-based services not requiring a change in residence, and community-based services requiring a change in residence Geriatric Care Teams Sample Essay. It examines older adult populations, health care issues, and the primary provider’s role in these sites of care.

    Chapter 23, “Outpatient Care Systems” (pp. 181-185)

    This chapter describes current approaches that maximize patient outcomes in geriatric outpatient care systems. It also examines new approaches that may benefit older adults in outpatient care systems.

    Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2011). Mosby’s guide to physical examination (7th ed.). St. Louis, MO: Mosby.

    Chapter 26, “Recording Information” (pp. 792–813)

    This chapter outlines the components of SOAP notes and provides guidelines for writing SOAP notes after patient examinations.

    Note: You should have this textbook in your personal library, as it was the required text in NURS 6512: Advanced Health Assessment and Diagnostic Reasoning. Geriatric Care Teams Sample Essay

    Arbaje, A., Maron, D., Yu, Q., Wendel, V., Tanner, E., Boult, C., & … Durso, S. (2010). The geriatric floating interdisciplinary transition team. Journal of the American Geriatrics Society, 58(2), 364–370.

    This article examines the Geriatric Floating Interdisciplinary Transition Team, a geriatric transitional care model. It describes the roles of health care providers on this care team and identifies potential benefits of this model Geriatric Care Teams Sample Essay.

    The geriatric floating interdisciplinary transition team. Journal of the American Geriatrics Society, 58(2), by Arbaje, A., Maron, D., Yu, Q., Wendel, V., Tanner, E., Boult, C., & … Durso, S. Copyright 2010 by John Wiley& Sons, Inc. Journals. Reprinted by permission John Wiley & Sons, Inc. Journals via the Copyright Clearance Center.

    Gagan, M. (2009). The SOAP format enhances communication. Nursing New Zealand, 15(5), 15.

    Note: Retrieved from the Walden Library databases.

    This article outlines the four parts of SOAP notes and examines the importance and effectiveness of SOAP notes in clinical settings. Geriatric Care Teams Sample Essay.

    American Geriatrics Society. (2011). The principles of geriatric care. Retrieved from http://www.americangeriatrics.org/files/documents/Adv_Resources/PayReform_fact3.pdf

    This article identifies the principles of geriatric care, focusing on the geriatric care team, geriatric assessment, and care coordination. It also presents three models of care that encompass geriatric assessment and care coordination: the GRACE (Geriatric Resources for Assessment and Care of Elders) model, PACE (Program of All-inclusive Care for the Elderly) model, and the Guided Care model.

    American Geriatrics Society. (2012). American Geriatrics Society updated Beers Criteria for potentially inappropriate medication use in older adults. Retrieved from http://www.guideline.gov/content.aspx?id=49933

    This article examines three categories of medications that impact older adults: those that are potentially inappropriate and must be avoided, those that are potentially inappropriate and must be avoided in older adults with certain diseases, and those that must be used with caution.

    Document: Geriatric Care Teams Sample Essay Comprehensive SOAP Note Template (Word document)

    Required Media

    Laureate Education (Producer). (2013b). Care team models [Video file]. Baltimore, MD: Author.

    Note: The approximate length of this media piece is 16:29 minutes.

    In this video program, Dr. Kristen Mauk and Dr. Barbara Resnick discuss the importance of interdisciplinary geriatric care teams, as well as the role of the advanced practice nurse within these teams.

    Accessible player

    Discussion: Models of Interdisciplinary Geriatric Care Teams

    With the growing population of frail elders, there is an increase of geriatric patients requiring ongoing care for multiple medical conditions. This creates the need for interdisciplinary geriatric care teams. Often, the dynamics and culture of these teams differ across various sites of care, such as assisted living, home care, hospitals, long-term care, and rehabilitation facilities. As an advanced practice nurse, it is important to understand your role in the care team as well as your potential impact on patient care Geriatric Care Teams Sample Essay. In this Discussion, you explore models of interdisciplinary geriatric care teams for different sites of care and the varying roles of the advanced practice nurse.

    Consider the following three case studies:

    Case Study 1

    Mrs. Martinez is an 83-year-old Mexican American widow who lives in her own home and is cared for by her adult daughter. Mrs. Martinez owns the home, and her daughter lives with her and provides the care. Her daughter brought her mother to the clinic today to ask to speak to the social worker. She requests that her mother be placed in a nursing home. The daughter states that her mother has nothing to do during the day. The television is on The Weather Channel most of the day because Mrs. Martinez has limited English capability and is unable to read closed-captioning. Mrs. Martinez also has two sons who do not live in the local area, but they do call regularly and check in with their mother and sister. Geriatric Care Teams Sample Essay. The two sons are opposed to moving their mother to a nursing home because they had promised her that they would “never put her away.”

    Case Study 2

    Mr. Williams, a 79-year-old African American widower, resides in a foster care home. He has lived there for 4 years since his wife died. He is a former minister. His medical history includes long-term diabetes, high blood pressure, and benign prostatic hypertrophy. The home care provider has requested a home visit to evaluate Mr. Williams’s ability to remain in the home. The provider states that because Mr. Williams’s vision is seriously compromised (he is nearly blind), and because he has been unable to get to the toilet as quickly as necessary (he is very unsteady on his feet), his care is becoming burdensome Geriatric Care Teams Sample Essay. According to the home care provider, for safety reasons, Mr. Williams may not fit the criteria for remaining in the foster care home.

    Case Study 3

    Mrs. Randall is a 77-year-old female who resides in a long-term care facility. She has a history of frequent falls and is severely cognitively impaired. The nursing staff at the long-term care facility called the nurse practitioner at the medical home office to report the recent development of productive cough and high fever. There have been cases of flu in the facility; however, Mrs. Randall has had a flu shot. The nurse practitioner in the office requests a chest x-ray in the long-term care facility. The nurse on duty in the facility states that there is no portable chest x-ray equipment available. She further requests that Mrs. Randall be transferred to the emergency room of the local hospital. Mrs. Randall’s daughter has durable power of attorney for health care decisions for her mother. The long-term care facility has notified the daughter of the change in her mother’s condition. The daughter says whatever the nursing home wants is fine with her Geriatric Care Teams Sample Essay.

    To prepare:

    Review this week’s media presentation, as well as the American Geriatrics Society and Arbaje et al. articles in the Learning Resources.

    Research models of interdisciplinary geriatric care teams that are used at various sites, such as assisted living, home care, hospitals, long-term care, and rehabilitation facilities.

    Consider the model used for the interdisciplinary geriatric care teams at your current practicum site. Geriatric Care Teams Sample Essay Compare this model to models used at other sites.

    Reflect on how the role of the advanced practice nurse differs according to the site of care.

    Select one of the three case studies. Consider how care should be facilitated for the patient in the case you selected based on the model used for the interdisciplinary geriatric care teams at your practicum site Geriatric Care Teams Sample Essay.

    By Day 3

    Post a comparison of the model used for the interdisciplinary geriatric teams at your current practicum site to models used at other sites. Then, explain how the role of the advanced practice nurse differs according to the site of care. Finally, explain how care should be facilitated for the patient in the case you selected based on the model used for the interdisciplinary geriatric teams at your practicum site.

    Geriatrics Care Team

    Post a comparison of the model used for the interdisciplinary geriatric teams at your current practicum site to models used at other sites.

    My facility applies the co-managed model and this will be compared to the orthopedic model. The co-managed model entails having a geriatrician-led medical team attending to the patients and taking care of all management issues. On the other hand, the orthopedic model entails engaging an orthopedic surgical team to assume responsibility for the patients’ surgical and medical care and using referral support from the acute care team. Although the two models are intended to take care of the medical needs of geriatrics, they produce comparable results. Firstly, the co-managed model results in shorter length of stay in the facility when compared to the orthopedic model. That is because the co-managed model includes a wider range of medical professions such as sub-acute and rehabilitative services that allow patients to recover faster and in the right way (Coventry, Nguyen & Karahalios, 2017). Geriatric Care Teams Sample Essay. Secondly, the co-managed model presented more comprehensive medical care since input was from a wider range of medical professions as opposed to the orthopedic model that engages the surgical team to provide primary care and only uses other professions in the acute care team for referrals. Thirdly, the co-managed model offers care recommendations at a faster speed. For instance, patients are reviewed and scheduled for surgery earlier than when the orthopedic model is used. That is because co-managed model engages different medical professions who offer continuous high level medical care that includes ongoing access to consultants so that the correct care decision is arrived at much faster. Finally, the orthopedic model appears unreliable since it will typically continue the care plan recommended by the patient’s local doctor without consideration of its appropriateness or effectiveness. On the other hand, the geriatric model makes use of its capacity to evaluate the patient’s biochemical workup thus allowing the team to recommend the more appropriate and effective care plan (Coventry, Nguyen & Karahalios, 2017). This means that the co-managed model is optimized for patient care irrespective of when the patient visits the facility. Geriatric Care Teams Sample Essay.

    Then, explain how the role of the advanced practice nurse differs according to the site of care.

    Advanced practice nurses are in prime position to meet the needs of the society they serve through clinical inquiry and by bridging scientific information to clinical practice. Today’s advanced practice nurses are capable of integrating knowledge from diverse sources and across disciplines, by cultivating the spirit of inquiry, formulate a clinical question in PICOT format, explore and amass the more pertinent proof, critically review the proof, assimilate the proof into clinical practice for change, and appraise the results while creating opportunities for future research (Catalano, 2015). Advanced practice nurses, irrespective of their role as direct or indirect care providers, have seven principal competencies Firstly, they direct medical services delivery to include public forums and health discussions. Secondly, offering mentoring, education, and coaching services for other medical personnel and patients. Thirdly, consultants who use their extensive expertise and experience Geriatric Care Teams Sample Essay. Fourthly, conducting research and applying evidence-based practice. Fifthly, contribute to decision-making as leaders and influence clinical care systems. Finally, facilitate collaborations within the care team (Harrington & Terry, 2013; Thomas et al., 2014). As such, advanced practice nurses will apply the competency that best serves their particular environment.

    Finally, explain how care should be facilitated for the patient in the case you selected based on the model used for the interdisciplinary geriatric teams at your practicum site

    Care should be facilitated for the patient by adopting a patient-centered care approach. This would entail informing, educating and consulting the patient at every step of the care process. At its core is the need for medical personnel to be responsive to and respectful of the values, needs and preferences expressed by the patient so that the patient’s values help guide medical decisions (Catalano, 2015). In this respect, applying a patient-centered approach to care would allow for the care to be facilitated for the patient. Geriatric Care Teams Sample Essay.

    References

    Catalano, J. (2015).
    Nursing Now! Today’s issues, tomorrow’s trends
    . (7
    th
    ed.). Philadelphia, PA: FA Davis Company.

    Coventry, L., Nguyen, A. & Karahalios, A. (2017). Comparison of 3 Different Perioperative Care Models for Patients With Hip Fractures Within 1 Health Service.
    Geriatric Orthopaedic Surgery & Rehabilitation
    , 8(2), 87-93. Geriatric Care Teams Sample Essay.

    Harrington, N. & Terry, C. (2013).
    LPN to RN Transitions: Achieving success in your new role
    . (4
    th
    ed.). Philadelphia, PA: Lippincott Williams & Wilkins.

    Thomas, A., Crabtree, K., Delaney, K., Dumas, M., Kleinpell, R. … & Wolf, A. (2014).
    Nurse Practitioner Core Competencies Content: A delineation of suggested content specific to the NP core competencies
    . Retrieved from http://c.ymcdn.com/sites/nonpf.site-ym.com/resource/resmgr/Competencies/NPCoreCompsContentFinalNov20.pdf Geriatric Care Teams Sample Essay.

  • Application: Planned Change in a Department or Unit

    For this Application: Planned Change in a Department or Unit Assignment, you propose a change at the department or unit level and develop a plan for guiding the change effort.

    To prepare:

    Review Chapter 8 in the course text. Focus on Kurt Lewin’s change theory, and contrast it with other classic change models and strategies.

    Reflect on problems, inefficiencies, and critical issues within a specific department, unit, or area in your organization or one with which you are familiar. Select one issue as a focal point for this assignment, and consider a change that could be made to address the issue Application: Planned Change in a Department or Unit.

    Think about how the change would align with the organization’s mission, vision, and values as well as relevant professional standards.

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    Using one of the change models or strategies discussed in Chapter 8, begin formulating a plan for implementing the change within the department/unit. Outline the steps that you and/or others should follow to facilitate the change effort. Align these steps to the change model or strategy you selected.

    Determine who should be involved in initiating and managing the change. Consider the skills and characteristics that are necessary to facilitate this change effort.

    Write a 3 page paper page count does not include title and reference page that addresses the following:

    Identify a problem, inefficiency, or issue within a specific department/unit.

    Describe a specific, realistic change that could be made to address the issue.

    Summarize how the change would align with the organization’s mission, vision, and values as well as relevant professional standards. Application: Planned Change in a Department or Unit.

    Identify a change model or strategy to guide your planning for implementing the change. Provide a rationale for your selection.

    Outline the steps that you and/or others would follow to facilitate the change. Align these steps to your selected change model or strategy.

    Explain who would be involved in initiating and managing this change. Describe the skills and characteristics that would be necessary to facilitate the change effort Application: Planned Change in a Department or Unit.

  • Complete Health History Sample Essay

    Complete Health History Sample Essay

    Write-up complete health history on a selected person of your choice, citations in the diagnoses section and the treatment plan section.

    Use the history components of the SOAP note to guide you.

    I’d like the hypothetical person to be a 32-year-old male, no past medical history, only complaint constipation.

    Complete Medical History

    Patient’s ID:
    Mr. A

    Physical and History conducted by:
    Dr. P

    Physical and History conducted on:
    March 10, 2018

    Chief Complaint:
    “I am okay most days, except that I have regular constipation that is very irritating and for which I have to take laxatives.”

    Past Medical History:
    No past medical history.

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    HPI:
    32-year-old male. He has been treating his constipation using over the counter laxatives without a prescription. His follow up in the clinic has been occasioned by the on and off constipation that is not solved by over the counter laxatives Complete Health History Sample Essay.

    Review of Systems:

    General: No night sweats or fever.

    Skin: Normal baldness pattern due to aging with no changes to the skin.

    Head: No history of seizures, dizziness, trauma, headaches, or trauma.

    Eyes: No field or vision changes, or glaucoma diagnosis.

    Ears: No vertigo or tinnitus.

    Nose: No running nose, facture history or epistaxis.

    Mouth and Throat: No pain or sores.

    Neck: No pain, goiter or masses.

    Respiratory: No hemoptysis, sputum, wheezing, or cough.

    Gatrointenstinal: No black stools, diarrhea, vomiting or nausea. Persistent constipation that occurs at least once weekly for which he takes over the counter laxatives. The constipation is accompanied by abdominal pain. Complete Health History Sample Essay.

    Genitourinary: No urination urgency or frequency, or dysuria.

    Neurologic: No paresthesia, tingling or numbness.

    Musculoskeletal: Occasional abdominal pain but no joint or muscle pain.

    Hematologic: No history of transfusion, anemia or bleeding disorder.

    Emotional: N history of abnormal adjustments, depression, or psychiatric problems.

    Family History:

    Father 82, Obesity, Hypertension

    Mother 76, Rheumatoid arthritis

    Sister 42, History of breast cancer

    Physical Examination:

    General Appearance:
    Oriented and alert 32-year-old male in no acute distress.

    Vital Signs:
    BP 127/77 HR 70 RR 15 Weight 174lbs Height 6’1/4” Temp not measured

    Skin:
    No abnormal lesions or moles noted.

    Neck:
    No masses.

    Cardiovascular:
    Regular rhythm and rate, no gallops, rubs or murmurs.

    Lungs:
    No crackles or wheezes.

    Abdominal:
    Abdominal pain, soft and no striations, scars or distensions. No pulsatile masses. Liver and spleen are not palpable. Complete Health History Sample Essay Murphy’s sign is negative with no guarding or reflex tenderness.

    Rectal:
    Negative hemoccult.

    Problem list:
    Persistent constipation.

    Differential diagnosis:

    Constipation, abdominal obstruction

    Discussion:

    Mr. A reports constipation with all other signs being normal.  As such, there is a need to recommend medication for constipation.

    In addition, intestinal obstruction should be considered. That is because it can add to the persistent constipation to cause the abdominal pain (Tham, Collins & Soetikno, 2016).

    Diagnostic plan:
    Abdominal tests to check for obstructions that could cause the constipation.

    Therapeutic plan:

    Complete Health History Sample Essay The constipation should be treated by prescribing docusate sodium BID (a laxative).

    Patient Education:
    Mr. A should be educated on the need for proper diets, rich in fiber, and exercise.

     

    References

    Tham, T., Collins, J. & Soetikno, R. (2016).
    Gastrointestinal Emergencies
    (3
    rd
    ed.). Hoboken, NJ: John Wiley & Sons Complete Health History Sample Essay.

  • Cognitive behavioral therapy vs emotional behavioral therapy sample essay

    Cognitive behavioral therapy vs emotional behavioral therapy sample essay

    Cognitive Behavioral Theory (CBT) Versus Rational Emotive Behavioral Theory (REBT)

    While cognitive behavioral therapy (CBT) and rational emotive behavioral therapy (REBT) have many similarities, they are distinctly different therapeutic approaches. When assessing clients and selecting one of these therapies, you must recognize the importance of not only selecting the one that is best for the client, but also the approach that most aligns to your own skill set. For this Assignment, as you examine the similarities and differences between CBT and REBT, consider which therapeutic approach you might use with your clients.

    Rational Emotive Behavioral Theory (REBT) Learning Objectives

    Students will:

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    Compare cognitive behavioral therapy and rational emotive behavioral therapy

    Recommend cognitive behavioral therapies for clients Cognitive behavioral therapy vs emotional behavioral therapy sample essay.

    To prepare:

    Review the media in this week’s Learning Resources.

    Reflect on the various forms of cognitive behavioral therapy.

    The Assignment

    In a 1- to 2-page Cognitive Behavioral Theory (CBT) Versus Rational Emotive Behavioral Theory (REBT) paper, address the following:

    Briefly describe how cognitive behavioral therapy (CBT) and rational emotive behavioral therapy (REBT) are similar.

    Explain at least three differences between CBT and Rational Emotive Behavioral Theory (REBT). Include how these differences might impact your practice as a mental health counselor.

    Explain which version of cognitive behavioral therapy you might use with clients and why. Support your approach with evidence-based literature. Cognitive behavioral therapy vs emotional behavioral therapy sample essay.

    Note: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at http://writingcenter.waldenu.edu/57.htm). All papers submitted must use this formatting.

    The Cognitive Behavioral Theory (CBT) Versus Rational Emotive Behavioral Theory (REBT) Assignment

    In a 1- to 2-page Cognitive Behavioral Theory (CBT) Versus Rational Emotive Behavioral Theory (REBT) paper, address the following:

    Briefly describe how cognitive behavioral therapy (CBT) and rational emotive behavioral therapy (REBT) are similar. Cognitive behavioral therapy vs emotional behavioral therapy sample essay.

    Explain at least three differences between CBT and REBT. Include how these differences might impact your practice as a mental health counselor.

    Explain which version of cognitive behavioral therapy you might use with clients and why. Support your approach with evidence-based literature. (Please use APA formanting Introduction, summary References, ) Cognitive Behavioral Theory (CBT) Versus Rational Emotive Behavioral Theory (REBT).

    Psychologists employ an array of methods when handling clients with mental disabilities. The methodologies used vary according to the problem under study. Besides, psychiatrists ensure that they incorporate strategies that aim at both healing the patient and ensuring the longevity of their mental stability.  Among the many approaches available, psychologists use cognitive behavioral therapy (CBT) and rational emotive behavior therapy when handling clients with mental instabilities. Cognitive behavioral therapy vs emotional behavioral therapy sample essay.

    CBT and REBT

    Cognitive behavioral therapy (CBT) entails one -on-one interaction with clients. Psychiatrists analyze patients’ views and advise them to change their way of thinking in order to achieve stable mental states (Fairburn et al., 2015). Besides, rational emotive behavioral therapy (REBT) entails convincing clients to identify, evaluate, dispute and act against his/her beliefs which bring about disturbances (David, D. (2015). CBT and REBT are useful approaches with similar and dissimilar provisions.

    Similarities

    CBT and REBT are similar in that they require the client to identify the cause of their problems and situations. Patients need to ascertain the root of their depressions and work towards correcting the situations Cognitive behavioral therapy vs emotional behavioral therapy sample essay. Loerinc et al. (2015) state the two theories are instruction-based, since psychologists advise the clients on refraining from certain behaviors or models of thinking.  The approaches are time-limited and directive, as the psychiatrists advise on strategies that would guarantee outcomes if implemented effectively.

    Differences

    CBT approaches are mind-oriented, since they only direct the client to modify their thinking criterion on a limited basis. REBT aims at identifying the root cause that leads to decision making, and advises on an in depth critical evaluation of situations before deriving a decision (Şoflău, & David, 2017). It teaches individuals on effective assertiveness and the ability to solve problems.  Besides, Tulbure et al. (2015) state that the CBT approach aims at bolstering a client’s mental stability by reinforcing their positive qualities. The REBT approach teaches clients on accepting difficult situations and developing newer behaviors to ensure mental stability.

    Opinion

    In my opinion, I would employ the REBT approach, since it aims at identifying the root cause of discomfort and mental problems in a client. This way, one can recommend on insightful thinking before making a decision. In the long run, the client is guaranteed of a table mental state. Cognitive behavioral therapy vs emotional behavioral therapy sample essay.

    References

    David, D. (2015). Rational emotive behavior therapy (REBT).
    The Encyclopedia of Clinical Psychology
    .

    doi: 10.1002/9781118625392.wbecp077

    Fairburn, C. G., Bailey-Straebler, S., Basden, S., Doll, H. A., Jones, R., Murphy, R., … Cooper, Z. (2015). A transdiagnostic comparison of enhanced cognitive behaviour therapy (CBT-E) and interpersonal psychotherapy in the treatment of eating disorders.
    Behaviour research and therapy
    ,
    70
    , 64-71.

    https://doi.org/10.1016/j.brat.2015.04.010

    Loerinc, A. G., Meuret, A. E., Twohig, M. P., Rosenfield, D., Bluett, E. J., & Craske, M. G. (2015). Response rates for CBT for anxiety disorders: Need for standardized criteria.
    Clinical psychology review
    ,
    42
    , 72-82 Cognitive behavioral therapy vs emotional behavioral therapy sample essay.

    https://doi.org/10.1016/j.cpr.2015.08.004

    Şoflău, R., & David, D. O. (2017). A Meta-analytical approach of the relationships between the irrationality of beliefs and the functionality of automatic thoughts.
    Cognitive Therapy and Research
    ,
    41
    (2), 178-192.

    Retrieved from https://link.springer.com/article/10.1007/s10608-016-9812-y

    Tulbure, B. T., Szentagotai, A., David, O., Ștefan, S., Månsson, K. N., David, D., & Andersson, G. (2015). Internet-delivered cognitive-behavioral therapy for social anxiety disorder in Romania: A randomized controlled trial.
    PLoS One
    ,
    10
    (5), e0123997.

    https://doi.org/10.1371/journal.pone.0123997 Cognitive behavioral therapy vs emotional behavioral therapy sample essay

  • Super sized kids Sample Article Critique Essay

    Super sized kids Sample Article Critique Essay

    Journal Article Critiques

    Instructions:

    These critiques should be between 1.5 and 2 pages, double-spaced, in Times New Roman (12 point) font, and with 1” margins on all sides. Please include and APA style cover page, page numbers and headers/sub headers, in text citations, and works cited page.

    Summary: The summary should be between 1 and 2 paragraphs. This should briefly explain the authors’ purpose(s), method, and results (main findings in your own words. No numbers.) Keep the summary informative, but concise (less than a page).

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    Critique: You should critique the articles based on the following criteria. Be sure to completely and concisely address each point. Remember this should be a critical assessment or the study (objective). DO NOT INCLUDE YOUR OPINION. Paraphrase , no direct quotes Super sized kids Sample Article Critique Essay.

    1. Purpose/Research Question: Determine the authors’ purpose of the research and state it in your own words. Comment on how clearly this was presented in the article.

    2. Method: Comment on how appropriate the method used was for addressing the purpose. State if the method was employed effectively.

    3. Evidence of Support: Examine the method and results of the article and determine if they helped the authors effectively address the purpose presented. Also discuss the strengths and weaknesses of the evidence and the study as a whole. Super sized kids Sample Article Critique Essay.

    4. Real World Application: After reading the discussion section summarize any real world implications the authors suggest. Also give your own suggestions for the real world application of the study and its’ findings.

    5. Recommendations: Determine who might benefit from the article, what the benefit may be, and the importance of the benefit. Here you may summarize your subjective judgments of the work and suggestions on how to improve or extend the work Super sized kids Sample Article Critique Essay.

    Super-Sized Kids

    Morbid obesity is a serious condition that exists in many populations. Patel (2005) explains that close to 60% of the American population is overweight, with a majority of them being children. In fact, close to 5.3 million youngsters in the U.S are obese,  accounting for 30% of all the American children (Patel, 2005). Morbid obese children display a BMI measurement that is higher than 30. The higher the BMI figure, the most likely the child would contract ailments related to obesity. The author sought to elaborate the main causes of morbid obesity amongst children. He employed a quantitative analysis method to scrutinize several case studies on American families.  He established that morbid obesity was mainly caused by family neglect, unhealthy eating habits, and lack of enough physical exercising. A combination of these factors ultimately leads to accumulation of body fat. The researcher recommended the need for education amongst families on controlling diet through government-initiated programs, and engaging children in more physical exercises. Super sized kids Sample Article Critique Essay.

    Purpose of Research

    Patel (2005) purposed to determine the causes of morbid obesity amongst children. The author presented his views about morbid children in children concisely, by offering valid evidence, specifically amongst kids in the U.S. He explains the eating trends amongst the population, noting an increase of sugar intake from 24 ounces to 48 ounces for the past 15 years amongst American families. The author succeeds in formulating the basis of his question by stating that genetic patterns in families play a crucial role in a child’s weight. Super sized kids Sample Article Critique Essay.

    Method

    The researcher analyzed a number of case studies of families whose children experienced complications related to morbid obesity in the U.S. The studies covered a variety of families across the country, notably the state of Iowa, Indiana, California, New Mexico, Pennsylvania and Texas. Since the cases under study were from different states, the research attained diversity. The author eradicated any chances of errors that would arise from bias on one region. The study results would therefore display the true picture of obesity in children living in the country. This way, the researcher was guaranteed of accurate results Super sized kids Sample Article Critique Essay.

    Evidence of Support

    The researcher derived that many cases of child obesity were as a result of family negligence, which led to sedentary behavior and unhealthy eating. Specifically, one household in California experienced the death of their child due to inattention.  The mother gave consent for the child to abandon school, so as to give her maximum care. However, the child resorted to watching television and uncontrolled eating. Besides, the mother was also obese, therefore, could not offer adequate care Super sized kids Sample Article Critique Essay. The child was later found dead in the sitting room.  The evidence was relevant enough to ascertain that neglect is the main cause of child obesity in the U.S. However, the indication failed to reveal whether there were other family members responsible for care, since the mother was also obese, a factor that could hinder provision of maximum care.

    Real World Application

    The article is educative, since it highlights the plights faced by families with histories of obesity.  The author suggests that it is vital for the society to ensure the safety and wellness of families suffering from health related problems, especially obesity. Since obesity may be acquired through genetics, teachers in the community can identify overweight families through observing children in schools. Super sized kids Sample Article Critique Essay This way, they can incorporate strategies that ensure proper practices in the child and the family in general. In the long run, the family benefits in engaging in proper practices that guarantee healthier lives.

    Recommendations

    The article is beneficial to families that have histories with obesity. It helps them understand the prevalence of obesity and therefore, engage in practices that ensure better health. Besides, obese children can gain extensively from this research, and refrain from unhealthier practices like poor eating habits and sedentary behaviors. This way, the community is guaranteed of a healthy and competent young generation.  Additionally, government officials can learn on the causes of morbid obesity in children. Since it may be difficult to reach all families to educate on interventions, federal officials can collaborate with learning institutions to implement   strategies that deter behaviors promoting obesity. For instance, they can enact feeding packages that exclude fatty foods and enforce mandatory physical education programs to ensure all children are active. This way, the government is guaranteed of a healthy population.

    Reference

    Patel, D. (2005). Super‐sized kids.
    Family Court Review
    ,
    43
    (1), 164-177.

    doi:10.1111/j.1744-1617.2005.00015.x Super sized kids Sample Article Critique Essay.

  • Catheter Associated Urinary Tract Infections Essay

    Catheter Associated Urinary Tract Infections Essay

    Following an operation, Catheter urinary may be inserted, for a short time, into the patient’s bladder to assist in emptying the bladder. Nevertheless, certain compelling medical circumstances may dictate long-term insertion of the Catheter Urinary to continue draining the bladder. These ways applied in Catheter Urinary maintenance are what turns to be referred to as ‘health care policies’. Lately, cases of Catheter Urinary overuse have been on the rise, despite the fact that the Indwelling Urinary Catheter (IUC), as it is also referred to, is designed for the purposes of effecting healing and diagnosis of the patient. The failure of executing a timely termination of IUC usage is chiefly attributed to the inability of the patient to move, nurses’ workload that hinders prioritization, urinary incontinence as well as limited knowledge regarding IUC risks. This has many at times, resulted in development of other Urinary Tract Infections which are commonly known as Catheter Associated Urinary Tract Infections (CAUTI).

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    From literature, a considerable amount of evidence on the CAUTIs prevention is made available with main best recommendations for practice as follows: various coatings, including silver alloy, prevention of unnecessary insertions, and perineal hygiene is highly recommended for patients.

    Focus plan for the nursing care in regards to UTI, is aimed at increasing knowledge on knowledge of prevention, compilations’ absence, regimen treatment and reducing both pain and discomfort. This will involve acute pain, hyperthermia, infection, deficient knowledge, uneasy sleep pattern and compromised urinary elimination Catheter Associated Urinary Tract Infections Essay.

    Change Model Overview

    The ACE star model of knowledge transformation facilitates quick and easy comprehension of the nature, sequences and knowledge characteristics applied in various elements of Evidence-Based Practice (EBP). Where knowledge transformation implies adapting findings of the research to influence health care upshots in a manner anchored in evidence oriented care Catheter Associated Urinary Tract Infections Essay. It portrays different stages that knowledge is transformed through to the stage where it is integrated into practice. The model generally has five broad phases namely, discovery research, evidence summary, translation to guidelines, integration into practice and lastly process and outcome evaluation by design.

    With the EBP at the core of this model, nurses are encouraged to adopt this model as a guide to facilitate change. EBP is rapidly gaining momentum in the nursing practice. EBP emphasizes on more practice-related research, modifications in student education and handier working interactions between researchers and clinicians. Simply put, the application of evidence in defining best practices instead of supporting the current practices ensures nursing care remains updated with the modern advances in technology as well as ensuring nursing capitalizes on new knowledge improvements Catheter Associated Urinary Tract Infections Essay.

    Define the Scope of the EBP

    Cases of Catheter Urinary over use have been on the rise, despite the fact that the Indwelling Urinary Catheter (IUC), as it is also referred to, is designed for the purposes of effecting healing and diagnosis of the patient. The failure of executing timely termination of IUC usage has resulted into many IUC risks such as CAUTIs Catheter Associated Urinary Tract Infections Essay.

    Based on the first stage of the ACE star model that encompasses the discovery research, a single study to investigate policies guiding replacement of long term IUC will be conducted among adult patients (Stevens, 2004). Catheter Associated Urinary Tract Infections Essay From the randomized control trials involving 107 participants conducted in three separate healthcare locations namely Israel’s geriatric center, Hong Kong nursing service for the army and the nursing home administration for the USA veterans as recorded in the Cochrane Collaboration, the following comparison pre-stated data was found. Different catheter replacement time intervals were evaluated by Priefer and colleagues (n= 17); different antibiotic prophylaxis replacement times were evaluated by Firestein and colleagues (n= 70); and different cleaning solution types were compared by Cheung and colleagues.

    Generally, adoption of use or non- use of policy in the prevention of CAUTIs has a significant impact on the quality improvement in the care adults with IUC receive.

    Stakeholders

               
    The research will involve the following; the Infection Prevention specialists, Urology Specialists, Ward Managers/ Matrons and The entire Healthcare Staff Catheter Associated Urinary Tract Infections Essay.

    Determine Responsibility of Team Members

    The research members will perform their tasks respectively as follows; Urologists will offer competent training on current care as well as removal and    insertion. The Infection prevention specialists will have roles ranging from auditing and inspecting use of catheter, CAUTI and dwell time. Ward Managers/ Matrons will be tasked with ensuring proper evidence-based training is given to all healthcare personnel dealing with catheter insertion, current care giving and removal. The responsibility of entire Healthcare Staff will be to set out learning as well as development needs besides taking accountability for the delegated tasks to non-registered member of staff.

                    

    Evidence

    A thorough search for evidence in this proposal yielded Clinical Practice Guides, EBP guidelines, and Quality improvement data besides the Evidence summary Catheter Associated Urinary Tract Infections Essay. Very small methodological errors existed in all the three trials. Thus, new trials are required to so that they can answer research questions precisely.

    Summarize the Evidence

    The following three are some few evidence-based interventions discovered in the summary evidence that could become handy in the carrying out the project in future as suggested by (Faikh M G, et al., 2014) .

    Various coatings, including silver alloy, and constituent materials of catheters have been undertaken through numerous changes to boost comfort and prevent infection. In the Journal of Clinical Nursing, a review was conducted systematically and showed that silver alloy utilization in IUC reduced CAUITs. Most indwelling catheter kits were designed by hospitals with silver alloy coating as the main components (Lederer J W. Jarvis W R. Thomas L, et al., 2014).

    Prevention of unnecessary insertions of IUC as the practice was found by (Anema, C., Schalich, C., Skewis, L., et al, 2014), to be taking place in emergency departments without orders of the physician. Life-threatening complications such as urethral strictures, hematuria, urosepsis, and urethritis and bladder perforations occurred even after a short duration of use.

    Perineal hygiene is highly recommended for patients with indwelling catheters because the direct exposure they have towards microorganisms makes them highly vulnerable to CAUTIs. This can be achieved through daily cleaning of insertion points with water and soap during bathing or showering (Barsuk JH, Cohen ER, Pots S, et al., 2014) Catheter Associated Urinary Tract Infections Essay.

    Develop Recommendations for Change Based on Evidence

    It is recommended that the nursing healthcare personnel handling IUC cases to effect quality improvement that is based on evidence as well as ensure there is knowledge transformation in the practice Catheter Associated Urinary Tract Infections Essay. Care is supposed to be redesigned to ensure it becomes safe, effective and efficient. Nurses are expected to launch initiatives like training and curricular modifications, development of models and theories, participate in new fields of scientific research and develop a network of research nationally to promote improvement.

    Translation

    Action Plan

    The plan to implement this project will involve working systematically through steps of infrastructural preparation, project stakeholders’ coordination and eventually monitoring the implementation outcome. Catheter Associated Urinary Tract Infections Essay The outcome evaluation plan will entail engaging stakeholders, program description, evaluation design focus, justification of conclusions and using and sharing lessons learned among the nursing staffs.

    Process, Outcomes Evaluation and Reporting

    The anticipated outcomes of this research are to encourage the use of evidence-based healthcare practice policies and procedures that will result into the overall improvement in the prevention of Catheter Associated Urinary Tract Infections. Patient satisfaction is also expected to rise as in correspondence to the quality care they receive. The outcome of this research will be communicated through written reports such as fact sheets, newsletters, annual reports, empirical publications and abstract and briefing. Reports prepared visually or orally will also become handy when it comes to communication of outcomes to stakeholders.

    Identify Next Steps

    There is relatively low morbidity and mortality resulting from CAUTIs as compared to other Healthcare Associated Infections. But occurrence of urinary catheters still high and could turn in the long run to be infectious or fatal Catheter Associated Urinary Tract Infections Essay. Therefore, the use of Urinary Catheter Protocol (UCP) is necessary though there is need to determine barriers hindering implementation of UCP so as to minimize catheter use and eventually eliminate CAUTIs.

    To ensure implementation plans of CAUTIs prevention remain permanent, the healthcare personnel should be encouraged to embrace the change and apply it in their care plan. The staff resisting change should be reported to relevant departments for further education on the same.

    Disseminate Findings

    The research findings will be communicated internally through use of newsletters, meetings, and town hall. Externally, communication of the findings will entail use of posters, publications and conferences bringing together other personnel in the nursing profession.

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    Conclusion

    The exercise of simple nursing care in nursing and patient advocacy can, in the long run, lead to constructive change in patient results. There is need to revise policy as well as procedures within the institutional and the present-day evidence-based research. This can assist in developing an instrument that will help nurses adhere to proper insertion and maintenance of catheters. The nursing personnel will be required to undergo continuous education and training on appropriate maintenance of IUC and Chlorohexidine Gluconate (CHG) bathing to bring about efficient change in this project. Catheter Associated Urinary Tract Infections Essay. The ACE star model for knowledge transformation will be incorporated to help implement, reinforce, and preserve changes of this project. All ACE star model processes as mentioned in the foregoing such as summary evidence, translation into practice guidelines and practice integration as well as process outcome evaluation will be applied. When this project will be successfully completed, the results will not just be limited to prevention of CAUTIs, other areas like duration of stay, fall, and cost will reduce as well as delirium will decline too (Frampton G. K.,Harris P., Cooper K., et al, 2014)

    References

    Anema, C., Schalich, C., Skewis, L., et al. (2014). Best evidence of suprapubic catheter and exchange.
    The Nursing Voice
    , 6.

    Barsuk JH, Cohen ER, Pots S, et al. (2014). Dissemination of a simulation-based mastery learning intervention reduces central line-associated bloodstream infections.
    BMJ Qual Saf.
    , 47-52.

    Beattie M. and Taylor J. (2011). Silver alloy vs. uncoated catheters: A systematic review of literature.
    Journal Clinical Nursing
    , 20(15-16) Catheter Associated Urinary Tract Infections Essay.

    Faikh M G, et al. (2014).
    Avoiding potentialharm by improving appropriateness of urinary catheter use in 18 emergency departments.
    , 761-8.e1.

    Frampton G. K.,Harris P., Cooper K., et al. (2014). Educational interventions for preventing vascular catheter bloodstream infections in critical care evidence map, systematic review and economic evaluation.
    Health Technological Assessment.
    , 1-365.

    Godfrey H, Fraczyk L. (2004). Preventing and managing catheter-associated urinary tract infections.
    British Journal Community Nursing
    , 205-212.

    Gokula et al. (2007). Emergency room staff education and use of urinary catheter indication sheet improves use of Foley catheters.
    American Journal Infection Control.
    , 589-593.

    Lederer J W. Jarvis W R. Thomas L, et al. (2014). Multicenter Cohort Study to Assess the Impact os a Silver-Alloy and Hydrogel Coated Urinary Catheter on Symptomatic Catheter Associated Urinary Tract Infections.
    Wound Ostomy Continence Nursing
    .

    Stevens, K. R. (2004).
    ACE Star Model of EBP: Knowledge Transformation.
    Retrieved from Academic Center for Evidence-Based Practice: http://www.acestar.uthscsa.edu.com

    Wilson M, Wilde M, Webb L, et al. (2009). Nursing intervention to reduce the risk of catheter-associated urinary tract infection.
    Wound Ostomy Continence
    , 137-154 Catheter Associated Urinary Tract Infections Essay.

  • Research priority for transforming nurse leadership:Identification of the influence of nursing on important health care decisions at all levels.

    Research priority for transforming nurse leadership:Identification of the influence of nursing on important health care decisions at all levels.

    Reflect on how the research findings for your area of priority impact nurses as leaders in organizations and health care reform. Why is research on this priority important?

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    Post a description of the Identification of the influence of nursing on important health care decisions at all levels. the benefits and challenges of further researching this area. Provide an overview of the articles you found (using appropriate APA citations not older than 5 yrs) relating to Identification of the influence of nursing on important health care decisions at all levels. highlight any key findings. Explain how continued research in this area could strengthen the ability of nurses to lead in both individual organizations and as advocates of health care reform. Research priority for transforming nurse leadership:Identification of the influence of nursing on important health care decisions at all levels.

  • Pathophysiology sample essay

    Pathophysiology sample essay

    Ann is a 32-year-old married female who presents to her nurse practitioner reporting lower abdominal pain, cramping, slight fever, and dysuria of 3 days duration.

    History includes:

    LMP 2 weeks ago (regular)

    Reports oral contraceptive use

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    Reports pain in lower abdomen with cramping and pain on urination for 3 days

    Denies any GI problems, reports regular bowel movements.

    Denies vaginal discharge

    Ann is married and in a monogamous relationship. Has one child age 2

    Reports no use of condoms/sexual intercourse 2-3 times per week

    Denies any history of STDs

    Physical Exam reveals:

    Temp 100. 6, P 80 BP 100/62 Wt. 125 Ht. 5’3’’

    HEENT WNL

    No CVA tenderness

    Pain in lower quadrants with light palpation.

    Positive inguinal lymphadenopathy

    External genitalia without lesions or discharge Pelvic exam reveals minimal cervical mucopus Bimanual exam reveals uterine and adnexal tenderness and cervical motion pain.

    Uterus anterior, midline, smooth, not enlarged

    1. Based on the above case what is your diagnosis and what is an appropriate CDC-recommended therapeutic regimen for this patient? Pathophysiology sample essay.

  • A literature review analyzes on Obesity based on PICOT Statement Paper and Literature Evaluation Table

    A literature review analyzes on Obesity based on PICOT Statement Paper and Literature Evaluation Table

    While the implementation plan prepares students to apply their research to the problem or issue they have identified for their capstone change proposal project, the literature review enables students to map out and move into the active planning and development stages of the project.

    A literature review analyzes how current research supports the PICOT, as well as identifies what is known and what is not known in the evidence A literature review analyzes on Obesity based on PICOT Statement Paper and Literature Evaluation Table. Students will use the information from the earlier PICOT Statement Paper and Literature Evaluation Table assignments to develop a 750-1,000 word review that includes the following sections:

    1.Title page

    2.Introduction section

    3.A comparison of research questions

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    4.A comparison of sample populations

    5.A comparison of the limitations of the study

    6.A conclusion section, incorporating recommendations for further research

    Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

    This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

    Literature Evaluation Table

    Obesity

    Student Name:

    Change Topic (2-3 sentences):

     

    Criteria

    Article 1

    Article 2

    Author, Journal (Peer-Reviewed), and Permalink or Working Link to Access Article

     

    Cochrane, A.J., Dick, B., King, N.A., Hills, A.P. & Kavanagh, D.J. BMC Public health. Retrieved from: https://doi.org/10.1186/s12889-017-4834-2

    Foster, C., Moore, J.B., Singletary, C.R. and Skelton, J.A. Wiley Online Library. Retrieved from: http://onlinelibrary.wiley.com /doi/10.1111/cob.12230/full#publication-history

     

    Article Title and Year Published

     

    Developing dimensions for a multicomponent multidisciplinary approach to obesity management. Published in 2017

     

    Clinicalobesity. Physical activity and family-based obesity treatment. Published in 2017

    Research Questions (Qualitative)/Hypothesis(Quantitative), and Purposes/Aim of Study

    The specific aims of this research were to operationalize a MCMD approach for obesity management and to develop a theoretical model that could guide the approach.

     

    Identify family-centered strategies to be implemented by clinicians providing care for children and adolescents with obesity.

    Design (Type of Quantitative, or Type of Qualitative)

     

    Qualitative study.

    Used a computerized qualitative data management system, nVivo (QSR, N8, 2010), to construct conceptual frameworks from the large volume of data generated by the convergent interviews.

     

    Employed both qualitative and quantitative studies.

     

    Setting/Sample

     

    The stakeholders involved in the study are patients, practitioners, educators, and researchers.

     

    Children and adolescents with obesity.

    Methods: Intervention/Instruments

     

    We used qualitative action research methods, including convergent interviewing and observation, to assist the process of inquiry.

     

    Methods utilized here are statements, summations and recommendations from professional organizations involved in child and adolescent physical activity, exercise and health.

     

    Analysis

     

    A preliminary step in the research analysis was to determine whether or not stakeholders believed that current obesity approaches have not been effective. A second step was to identify whether stakeholders endorsed the development of a multicomponent multidisciplinary (MCMD) approach for obesity management as recommended by position papers.

     

    The analysis of this review has focused on exercise and activity as a component of family-based obesity interventions, which also support the guidelines detailed here, including: encouraging and promoting increased physical and decreased sedentary activity; sports and organized/structured exercise programs; play and family activities; and high level of parent involvement.

    Key Findings

     

    The key finding of this research was to source problems and solutions reported by researchers, educators, policy influencers, practitioners and patients, to coproduce a MCMD approach to obesity management that addressed a number of practice issues or thematic concerns.

     

    The key finds have been summarized guidelines by domains of: aerobic activity, muscle strengthening, bone strengthening, child developmental status and age, clinical settings, inclusion of family and recommendations for those with overweight and obesity.

     

    Recommendations

     

    Endorsed the development of a multicomponent multidisciplinary (MCMD) approach for obesity management as recommended by position papers.

     

    60 min of PA a day for children/teens.

    Most of the 60 min should be either moderate- or vigorous intensity aerobic PA.

    Muscle-strengthening PA three times a week.

    Bone-strengthening PA at least three times a week.

    Families need to set a positive example by leading an active lifestyle. Make PA part of your family’s daily routine by taking family walks or playing active games together, make PA fun etc.

     

     

    Explanation of How the Article Supports EBP/Capstone Project

     

     

    This article seeks to explain the multidisciplinary approaches used in the EBP examination of skills, knowledge, beliefs, and recommendations by the stakeholders in managing obesity.

     

     

    This article supports and explains how obesity can be prevented by providing guidance for the amount of physical activity that children should acquire and how many days a week aerobics, bone strengthening and muscle strengthening activities should occur.

     

     

     

    Criteria

    Article 3

    Article 4

    Author, Journal (Peer-Reviewed), and

    Permalink or Working Link to Access Article

     

    Carayol. J., Chabert, C., Di Cara, A., Armensie, C., Vlasesia, A. & Haper. J. Nature Communications Article. Retrieved from: https://www.nature. com/articles/s41467-017-02182-z#Abs1

    Martin, A., Booth, J.N., Laird, Y., Sproule, J., Reilly, J.J. & Saunders, D.H. Cochrane Database. Retrieved from: ttp://onlinelibrary.wiley.com/doi/ 10.1002/14651858.CD009728.

    pub3/full

     

     

    Article Title and Year Published

     

    Protein quantitative trait locus study in obesity during weight-loss identifies a leptin regulator. Published in 2017

    Physical activity, diet and other behavioural interventions for improving cognition and school achievement in children and adolescents with obesity or overweight. Published in 2018

     

    Research Questions (Qualitative)/Hypothesis (Quantitative), and Purposes/Aim of Study

     

    How can proteome analysis provide new insights into the molecular mechanisms of complex traits like obesity?

    Healthy weight interventions for improving thinking skills and school performance in children and teenagers with obesity? The aim of this Cochrane Review was to find out if healthy weight interventions can improve thinking skills and school performance in children and teenagers with obesity.

     

    Design (Type of Quantitative, or Type of Qualitative)

     

    Evidence based quantitative study. protein quantitative trait locus (pQTL) analysis.

     

    Evidence based randomized and quasi-randomized controlled trials (RCTs) of behavioural interventions for weight management in children and adolescents with obesity or overweight.

     

    Setting/Sample

     

    932 Caucasian overweight or obese subjects were recruited in clinical centers from eight European countries. Participants followed an initial 8 weeks weight loss intervention on a low-calorie formula diet (LCD 3300 kJ/day, ca. 800 kcal) The mean weight loss during LCD was 10.3 kg.

    Sample included 18 studies (59 records) of 2384 children and adolescents with obesity or overweight. Eight studies delivered physical activity interventions, seven studies combined physical activity programmes with healthy lifestyle education, and three studies delivered dietary interventions. The studies took place in 10 different countries. Two were carried out in children attending preschool, 11 were conducted in primary/elementary school-aged children, four studies were aimed at adolescents attending secondary/high school and one study included primary/elementary and secondary/high school-aged children.

    Methods: Intervention/Instruments

     

    This study is part of the Diet, Obesity, and Genes (DIOGenes) intervention study. The method used here is a two-step pQTL-mapping strategy combined with eQTL mapping to limit the multiple testing burden and gain greater insight in the mechanism underlying the GWAS signal.

     

    Did randomized and quasi-randomized controlled trials (RCTs) of behavioural interventions for weight management in children and adolescents with obesity or overweight.  Used CENTRAL, MEDLINE and 15 other databases.

    Analysis

     

    To address the issue of obesity, they design a large-scale protein quantitative trait locus (pQTL) analysis based on a set of 1129 proteins from 494 obese subjects before and after a weight loss intervention.

    Physical activity and healthy eating benefit a healthy body weight and improve thinking skills and school performance in children with a healthy weight. Studies found that healthy-weight interventions can reduce obesity in children and teenagers, but it is unknown if and how well healthy-weight interventions can improve thinking skills and school performance in children and teenagers with obesity.

     

    Key Findings

     

    Using data from a dietary intervention study in obese patients this study has identified multiple 
    cis-
    pQTL and 
    trans
    -pQTL signals associated with BMI at baseline and after the intervention.

    The findings indicate that changing knowledge about nutrition, and changing the food offered in schools can lead to moderate improvements in general school achievement of teenagers with obesity, when compared to standard school practice. However, we need more high-quality healthy-weight interventions that test thinking skills and school performance, as well as health outcomes.

     

    Recommendations

     

    No specific recommendations are found in the study.

     

    Future obesity treatment and prevention studies in clinical, school and community settings should consider assessing academic and cognitive as well as physical outcomes.

     

    Explanation of How the Article Supports EBP/Capstone

     

    The study has revealed that proteome analysis can provide new insights into the molecular mechanisms of complex traits like obesity.

    This article may support my project to explain the importance of changing knowledge about nutrition, and changing the food offered compared to standard practice.

     

     

    Criteria

    Article 5

    Article 6

    Author, Journal (Peer-Reviewed), and

    Permalink or Working Link to Access Article

     

    Torti, J., Liug, T., Borowitz, M., Johnson, JA., Sharma, AM., & Cambell-Shere, DL. BMC Family Practice. Retrieved from: https://link.springer.com/article/10.1186/s12875-017-0596-2

     

    Ogden, C. L., Carroll, M. D., Kit, B. K., & Flegal, K. M.  Jama Network Journals. Retrieved from: https://jamanetwork.com

    /journals/jama/fullarticle/1832542

     

    Article Title and Year Published

     

    The 5As team patient study: patient perspectives on the role of primary care in obesity management. Published in 2017

     

    Prevalence of Childhood and Adult Obesity in the United States. Published in 2014

     

    Research Questions (Qualitative)/Hypothesis (Quantitative), and Purposes/Aim of Study

    To assess whether lifestyle interventions to improve school achievement, cognitive function and/or future success in children and adolescents with obesity or overweight.

     

    The aim of this article is to provide the most recent national estimates of childhood obesity, analyze trends in childhood obesity between 2003 and 2012, and provide detailed obesity trend analyses among adults.

     

    Design (Type of Quantitative, or Type of Qualitative)

     

    Qualitative research employing semi-structured interviews and thematic analysis.

     

    National Health and Nutrition Examination Survey (NHANES 2011-2012) includes Data Source and Methods: Personal interviews, physical examinations, laboratory tests, nutritional assessment and DNA repository.

     

    Setting/Sample

     

     

    Sample of 28 patients from a cohort of 255 patients living with obesity and receiving care to support their weight management in a large Primary Care Network of family practices.

     

    Weight and height or recumbent length were measured in 9120 participants in the 2011-2012 nationally representative National Health and Nutrition Examination Survey.

     

    Methods: Intervention/Instruments

     

    The 5As Team intervention study (5AsT) is a longitudinal randomized control trial with convergent mixed-methods evaluation. A literature review analyzes on Obesity based on PICOT Statement Paper and Literature Evaluation Table

     

    The intervention method used is approved by NHANES physical examination which is approve by National Center for Health Statistics Research Ethics Review Board, weight and height were measured in a standardized fashion. For children younger than 2 years, recumbent length was measured instead of standing height. In 2011-2012, 1.5% (141) of examined participants were missing weight and height or length measurements.

     

    Analysis

     

     

    The patient-physician relationship plays an important role in the adequacy of obesity management. Patients have clear expectations of substantive conversations with their primary care team. Complex conditions affect weight and patients require assistance tailored to individual obesity drivers. Current services provide support in important ways but are not yet meeting patient needs for individual plans, advanced education, and follow-up opportunities.

     

    Analyses of trends in obesity prevalence among middle and high school students have shown mixed results. Data from many countries have shown a decline or stabilization of obesity levels, especially in children. Analysis of time trends depends on what is chosen as the initial point of examination.

     

     

    Key Findings

     

    This study helped understanding of patients’ perception of if, when, and how primary care clinicians and resources can support weight management.

     

    Overall, there have been no significant changes in obesity prevalence in youth or adults between 2003-2004 and 2011-2012.

    Recommendations

     

    Patients expressed the need for weight management that is tailored to their individual set of comorbidities and provides strategies that are realistic and sustainable under their personal circumstances.

     

    Obesity prevalence remains high and thus it is important to continue surveillance.

    Explanation of How the Article Supports EBP/Capstone Project

     

    This article highlights the importance of family based health programs and patients’ perspectives on the role of primary care in obesity management and their experience with existing resources, with a view to develop an improved understanding of this perspective, and more effective management strategies.

     

    This article advocates the importance of continuous monitoring or surveillance of factors affecting obesity in US that enforces the need to implement and practice evidence based practices to curtail obesity in US

     

    Criteria

    Article 7

    Article 8

    Author, Journal (Peer-Reviewed), and

    Permalink or Working Link to Access Article

     

    Swift, D. L., Johannsen, N. M., Lavie, C. J., Earnest, C. P., & Church, T. S. ELSEVIER Publication. Retrieved from: http://www.online pcd.com/article/S0033-0620(13)00165-5/fulltext

     

    Skinner, A. C. & Skelton, J. A. The JAMA Network Journals. Retrieved from: https://jamanetwork.com/journals/jamapediatrics /article-abstract/1856480

    Article Title and Year Published

     

    The role of exercise and physical activity in weight loss and maintenance. Published in 2014

    Prevalence and trends in obesity and severe obesity among children in the United States. Published in 2014

     

    Research Questions (Qualitative)/Hypothesis (Quantitative), and Purposes/Aim of Study

     

    What are the roles of Physical Activity(PA) and Exercise Training (ET) in the prevention of weight gain, initial weight loss, weight maintenance, and the obesity paradox?

     

    To examine the prevalence of obesity and severe obesity over time for 14 years of the continuous National Health and Nutrition Examination Survey, 1999 to 2012, and to examine differences in the trends by age, race/ethnicity, and sex.

    Design (Type of Quantitative, or Type of Qualitative)

     

    Evidence based qualitative review on weight loss from different modalities of exercise training and physical activities.

    Evidence based qualitative case studies taken from National Health and Nutrition Examination Survey includes Data Source and Methods.

    Setting/Sample

     

    This article settings shows the amounts of physical activity based on goals for maintaining health, prevention of weight gain, promoting clinically significant weight loss, and prevention of weight gain after successful weight loss based on the American College of Sports Medicine position stand of Appropriate Physical Activity Intervention Strategies for Weight Loss and Prevention of Weight Regain for Adults.

     

    A literature review analyzes on Obesity based on PICOT Statement Paper and Literature Evaluation Table Representative sample (N = 26 690) of children in the United States, ages 2 to 19 years, in repeated cross-sections of the National Health and Nutrition Examination Survey, 1999 to 2012.

    Methods: Intervention/Instruments

     

    STRRIDE; Studies of a Targeted Risk Reduction Intervention through Defined Exercise. DREW; Diabetes Aerobic and Resistance Exercise.  PA; Physical activity and ET; exercise training are the methods employed in this study.

     

    In this study, data came from the repeated cross-sections of the NHANES, 1999 to 2012. The NHANES is a stratified, multistage probability sample of the civilian, noninstitutionalized population of the United States. It includes an in-home questionnaire on a variety of demographic and health-related topics, a computer-assisted interview, and an examination component consisting of a thorough physical examination including measured height and weight.

     

    Analysis

     

    The weight loss from ET programs without caloric restriction are very heterogeneous, based on the present literature patients who engage in a PA program may experience modest weight loss.

     

    Nationally representative data do not show any significant changes in obesity prevalence in the most recently available years. But trends across 1999 to 2012 are positive overall and within certain subgroups. Prevalence rates for all categories of obesity increased among most groups from 2009 to 2010 and 2011 to 2012, although these differences are not statistically significant.

    Key Findings

     

    Exercise training, regardless of weight loss, provides numerous health benefits especially for overweight and obese individuals at risk for CV diseases or with current CV conditions.

     

    The findings reflect those of earlier work using the NHANES where younger children and nonwhite participants were at greater risk for obesity and severe obesity.  The greater prevalence rates of class 2 and class 3 obesity are particularly notable in adolescents and non-Hispanic black individuals. Additionally, overweight and obesity at all levels of severity are increasing significantly among Hispanic girls and non-Hispanic black boys.

     

    Recommendations

     

    Clinicians should attempt to encourage participants to adhere to ET programs over the long-term regardless of the amount of weight loss achieved, as CV benefits are readily achieved in the absence of weight loss. Clinicians can also advocate the use of caloric restriction in weight management plans. Importantly, PA contributes to the negative energy balance seen with caloric restriction

     

    Although our results suggest that the prevalence of obesity is continuing to level off, research is needed to determine which, if any, public health interventions can be credited with this stability.

     

    Explanation of How the Article Supports EBP/Capstone

     

    Throughout this literature review, from various ways, it reveals need for intervention, like that found in this EBP project, to combat rising levels of Obesity.

     

    This article is very important to demonstrate because the high prevalence and upward trend of more severe forms of obesity will likely require more intensive interventions than can be done through widespread public health efforts.

     

    Introduction

    Obesity is a weight related condition that is described as BMI value exceeding 30. It is caused by physical activity and dietary changes linked with societal and environmental factors that act in concert with inadequate supportive education, distribution, marketing, environmental, food processing, transport, urban planning, agriculture, and health policies. Perhaps the most significant aspect of obesity is that it is a health risk factor that predisposes individuals to non-communicable chronic ailments such as stroke and apnea (Ogden et al., 2014; Skinner & Skelton, 2014; Swift et al., 2014). Based on this awareness, there is a need to adopt a preventive strategy when addressing obesity, with the focus being on children since they are at a young age when the condition is easily managed.

    A comparison of research questions

    The eight research articles answered a range of questions in a bid to improve awareness of the nature of obesity. Cochrane et al. (2017) asked two questions. The first question is: Can a MCMD approach be operationalized for obesity management? The second question is: Is it possible to develop a theoretical approach to guide the operationalization? A literature review analyzes on Obesity based on PICOT Statement Paper and Literature Evaluation Table. Foster et al. (2017) asked the question: Do family-centered strategies exist that can be implemented by clinicians providing care for children and adolescents with obesity? Carayol et al. (2017) asked the question: How can proteome analysis provide new insights into the molecular mechanisms of complex traits like obesity? Martin et al. (2018) asked the question: Can healthy weight intervention improve thinking skills and school performance in children and teenagers with obesity? Torti et al. (2017) asked the question: Can lifestyle intervention improve school achievement, cognition and/or future success in children and adolescents with obesity or overweight? Ogden et al. (2014) asked two questions. The first question is: What is the national of childhood obesity? The second question is: What are the childhood obesity trends between 2003 and 2012? Swift et al. (2014) asked the question: What are the roles of Physical Activity (PA) and Exercise Training (ET) in the prevention of weight gain, initial weight loss, weight maintenance, and the obesity paradox? Skinner and Skelton (2014) asked two questions. The first question is: What is the prevalence of obesity and severe obesity over time for 14 years of the continuous National Health and Nutrition Examination Survey, 1999 to 2012? The second question is: Are there differences in differences in the obesity trends by age, race/ethnicity, and sex? The research questions from the eight selected journal articles are all concerned with obesity management, with the focus being on its occurrence among children. There relevance to the current research is highlighted by the fact that they all address the same topic (obesity) for the same population (children).

    A comparison of sample populations

    Cochrane et al. (2017) applied a qualitative research approach that recruited patients, researchers, educators, and practitioners who were identified as stakeholders. Although the exact number of participants is not mentioned, the research concedes that a large volume of data was generated from interviews and observations.  Foster et al. (2017) applied a mixed methodology approach that included elements of both qualitative and quantitative research in which children and adolescents with diabetes were recruited as the study participants. Carayol et al. (2017) applied a quantitative approach in which932 Caucasian overweight or obese subjects were recruited in clinical centers from eight European countries A literature review analyzes on Obesity based on PICOT Statement Paper and Literature Evaluation Table. Martin et al. (2018) applied a literature review approached in which 18 studies applying evidence-based randomized and quasi-randomized controlled trials on children and adolescents with obesity or overweight were evaluated. Torti et al. (2017) applied a qualitative research approach that employed semi-structured interviews and thematic analysis on 28 patients from a cohort of 255 patients living with obesity and receiving care to support their weight management. Ogden et al. (2014) relied on data from National Health and Nutrition Examination Survey for 2011-2012 in which 9120 participants were recruited. Swift et al. (2014) relied on evidence-based qualitative review on weight loss from different modalities of exercise training and physical activities. Skinner and Skelton (2014) evaluated evidence-based qualitative case studies that had recruited 26,690 US children aged 2 to 19 years from 1999 to 2012. The present study will make use of these aspects by focusing on recruiting the participants from the population of interest (children with diabetes).

    A comparison of the limitations of the study

    The eight articles do not mention their limitations. Still, a notable limitation in the qualitative studies is that they recruited a small number of participants. Recruiting a large sample of participants will improve the results generalizability. Another limitation on the studies is that they did not focus on the children with obesity. Instead, they focused on mixed populations that included a range of age groups from children to adults. The present research will address the two limitations by recruiting a large sample of participants and focusing on children as a sample since the study population is children with obesity A literature review analyzes on Obesity based on PICOT Statement Paper and Literature Evaluation Table.

    Conclusion (with recommendations)

    One must accept that obesity is a source of concern since it presents a high risk factor for other to non-communicable chronic ailments. In addition, one must acknowledge that the best strategy for addressing obesity is to focus on children, ensuring that they develop into healthy adults. Eight research studies have been present that contribute to the current research topic, but their results are limited by their focus on mixed populations and small sample recruited for qualitative studies. The present research will address the limitations by recruiting a large sample of participants to improve results generalizability, and focusing on children with obesity as the population sample. The intention is to present evidence that supports an efficient and effective strategy for improving obesity management results among children A literature review analyzes on Obesity based on PICOT Statement Paper and Literature Evaluation Table.

    .

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    Carayol. J., Chabert, C., Di Cara, A., Armensie, C., Vlasesia, A. & Haper. J. (2017). Protein quantitative trait locus study in obesity during weight-loss identifies a leptin regulator.
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    Cochrane, A. J., Dick, B., King, N. A., Hills, A. P. & Kavanagh, D. J. (2017). Developing dimensions for a multicomponent multidisciplinary approach to obesity management.
    BMC Public Health
    , 17, 814. Retrieved from https://doi.org/10.1186/s12889-017-4834-2

    Foster, C., Moore, J. B., Singletary, C. R. and Skelton, J. A. (2017). Clinicalobesity. Physical activity and family-based obesity treatment.
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    Ogden, C. L., Carroll, M. D., Kit, B. K., & Flegal, K. M. (2014). Prevalence of Childhood and Adult Obesity in the United States.
    Jama Network Journals
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    Skinner, A. C. & Skelton, J. A. (2014). Prevalence and trends in obesity and severe obesity among children in the United States.
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