What are the benefits of evaluating the role of outcomes in practice change through research? Discuss how you would evaluate the roles of outcomes through a change proposed from research findings.
Expectations
Initial Post:
keep all posts you win on bids in US sources
Peer Responses:
Chamberlain
Week 6
Midweek Comprehension Questions
Discussion
Purpose
As mentioned in this lesson, numerous telecommunications-ready tools are already available to assist nurses in delivering care and improving patients' health outcomes. New and innovative tools are rapidly making it to the marketplace, making current tools dated and sometimes obsolete. Continue to reflect upon the point-of-care tools you may be familiar with using in your role as a Registered Nurse and how your responsibilities will change with your future role as an APN. How will you stay current?
Provide a brief response (100 words or less)
FLU, COVID AND RSV VACCINE. please see attached file.
Each week you will take a few minutes and ask 2 people about their personal coping mechanisms for dealing with the stress of working in healthcare during this unique time of Covid. Stress can be physical, emotional, spiritual, or any combination of triggers. Ask a diverse variety of people, don’t forget those in other departs at different points of hierarchy. For example, ask your unit manager, environmental services, volunteers, patients, fellow nurses, etc. Write 2-3 paragraphs on your findings and impressions while respecting the person’s identity.
Dr Burke TED talk about ACESLinks to an external site.
One in six adults report having an average of 4 adverse childhood experiences according to the CDC.
Discuss why it is important to know our patient’s history of ACEs?
Also, what is one fact you could share with your patients and their families regarding the importance of ACES?
2
PICOT Question for Preventing Childhood Obesity
Tahimi Salfran Mesa
Florida National University
Professor: Yesenia Osle
September 15, 2023
PICOT Question for Preventing Childhood Obesity
Obesity is a pressing public health issue with serious long-term consequences. Obesity is a chronic medical condition characterized by excessive body fat. A body mass index (BMI) of 25 or above is considered overweight, and a BMI of 30 or higher is considered obese (WHO, 2021). Obesity has witnessed a global upswing, with a particularly alarming impact on children, sparking significant public health apprehension. Childhood obesity has become a pressing global concern, transcending the confines of adulthood. The alarming trend exposes children to immediate obesity-related health risks and casts a shadow over their future. Children are categorized as overweight or obese based on their BMI exceeding age and gender-specific thresholds. Precise height and weight assessments form a crucial aspect of routine physical examinations. Childhood obesity sets the stage for a lifelong battle, predisposing youngsters to adult obesity and a spectrum of non-communicable diseases like diabetes mellitus, hypertension, and osteoarthritis in adulthood.
Childhood obesity is driven by complex interplay of genetic, environmental, and behavioral factors. Genetic predisposition increases child's susceptibility to obesity. Environmental factors entail easy access to high-calorie, low-nutrient foods, and sedentary lifestyles influenced by modern technology and urbanization (Lister et al., 2023). Lower-income families may have limited access to fresh, nutritious foods and safe places for physical activity. Advertising of unhealthy foods and beverages targeted at children further exacerbates the problem. Behavioral factors are the psychological factors driving stress and emotional eating that hinder healthy habits. Addressing this burgeoning crisis demands urgent, comprehensive action to safeguard the well-being of our youngest generation and mitigate the far-reaching health consequences they face in adulthood. This paper explores the problem of obesity and identifies effective prevention strategies are essential to mitigate the growing concern using the PICOT framework.
Problem Statement
Childhood obesity rates have been steadily increasing worldwide. The global prevalence of overweight and obese children has risen dramatically in recent years. The World Health Organization (2021) reports that in 2020, 39 million children under five were overweight or obese. Over the past four decades, the global count of school-age children and adolescents grappling with obesity has skyrocketed by over tenfold, surging from 11 million to a staggering 124 million by 2016. Additional 216 million fell into the category of being overweight but not yet classified as obese in 2016. The numbers are projected to substantially increase by 2030.
The primary driver of obesity and overweight issues worldwide stems from a crucial energy imbalance: consuming calories exceeding those expended. The global challenge is exacerbated by an alarming surge in the consumption of energy-dense foods rich in fats and sugars and rise in physical inactivity (Fox et al., 2019). The latter can be attributed to the increasingly sedentary nature of many job roles, shifts in transportation methods, and the expanding urban landscape. These dietary habits and activity levels shifts often result from broader environmental and societal changes linked to development.
Childhood obesity elevates the risk of numerous health issues, encompassing asthma, sleep apnea, bone and joint problems, type 2 diabetes, and precursors to heart disease like high blood pressure. It also exerts substantial impact on healthcare costs. In adulthood, individuals grappling with obesity face increased susceptibility to stroke, various cancers, heart disease, type 2 diabetes, premature mortality, and mental health conditions such as clinical depression and anxiety. Therefore, childhood obesity carried over to adulthood will expose them to these problems. The problem affects both developed and developing nations. However, gender disparities are relatively minimal. Addressing the escalating obesity epidemic necessitates a comprehensive approach considering genetic predispositions and environments that encourage unhealthy behaviors. However, identifying the most effective strategies and interventions for specific populations is crucial.
PICOT Question
In school-aged children (P), does a comprehensive school-based nutrition and physical activity program (I) compared pharmacological interventions (C) reduce prevalence of obesity over 12-month period?
Explanation of PICOT Components
Population of Interest (P)
The population of interest for this PICOT question is school-aged children, typically ranging from 5 to 18 years old. The age group is particularly susceptible to obesity due to dietary habits, physical activity levels, and environmental influences. Childhood often emerges as a pivotal phase in development. It is increasingly acknowledged as a critical period influencing an individual's susceptibility to obesity in later life (Smith et al., 2020). During this window, taste preferences, dietary patterns, and lifestyle behaviors take shape and have a lasting impact. Interventions implemented during these early years possess the potential to redirect this trajectory, reshaping a child's preferences and habits before they solidify, offering a vital opportunity to mitigate the risk of obesity in the future.
Intervention of Interest (I)
The intervention of interest is a comprehensive school-based nutrition, behavioral therapy, and physical activity program. School-based nutrition interventions are strategies enacted within school environments to cultivate positive nutritional attitudes, knowledge, and behaviors in school-aged children and adolescents (O’Brien et al., 2021). These initiatives encompass various facets, including food policies, environmental enhancements, and nutrition education. Their recipients may range from school administrators, food service personnel, and teachers to parents and students. Conventional classroom educators or specialized program instructors can carry out implementation.
Physical activities are bodily engagements that require energy expenditure. They encompass exercises, sports, recreational pursuits, and daily tasks like walking or climbing stairs. Encouraging regular exercise helps children achieve and maintain a healthy weight while promoting overall well-being. Activities should be age-appropriate, enjoyable, and integrated into daily life. School-aged children and adolescents should engage in minimum of 60 minutes of daily physical activity, with at least 30 minutes devoted to structured activities like sports and supervised exercises, aligning with recommendations by the American Academy of Pediatrics (van Sluijs et al., 2021). Behavioral therapy focuses on modifying unhealthy behaviors and promoting positive lifestyle changes. It encourages self-monitoring, where children track their eating habits, physical activity, and food-related emotions. Second, the education encourages setting specific, achievable goals for healthier eating and increased physical activity tailored to their age and abilities.
Comparison of Interest (C)
The comparison of interest in this PICOT question is pharmacological intervention. Pharmacological intervention encompasses using pharmaceutical agents or drugs to manage obesity in children. These interventions include prescription medications like orlistat for reducing fat absorption in the digestive tract or metformin to regulate blood sugar levels and treat obesity-related insulin resistance (Florencia et al., 2022). Other weight management medications may also be considered, although their use in pediatric populations is generally more limited and carefully monitored due to potential side effects. Comparing the effectiveness of these pharmacological interventions with comprehensive school-based nutrition and physical activity programs is essential to determine the most appropriate and beneficial approach to address childhood obesity.
Outcome of Interest (O)
The primary outcome of interest is the body mass index (BMI) percentile reduction. BMI percentile is a commonly used metric to assess and monitor children's weight status. Decrease in BMI percentile indicates positive change in weight status and reflect progress in preventing childhood obesity.
Timeframe (T)
The proposed timeframe for implementing and evaluating the comprehensive school-based program's impact on BMI percentile is 12 months. The duration ensures comprehensive assessment of intervention's effectiveness over reasonable period.
Conclusion
Childhood obesity is a growing public health concern with far-reaching consequences. It stems from energy imbalance and has intensified due to increased consumption of energy-dense foods and reduced physical activity, driven by societal changes. Childhood obesity exposes children to immediate health risks and sets foundation fo lifelong battle with obesity-related diseases in adulthood. Interventions for combating childhood obesity should consider the complex interplay of genetic, environmental, and behavioral factors. Addressing childhood obesity requires comprehensive strategies illustrated through the PICOT framework. The outlined PICOT question focuses on school-aged children and impact of comprehensive school-based nutrition and physical activity program on BMI percentile reduction over 12 months. The question is designed to guide research and evaluation efforts in determining effectiveness of such interventions in preventing childhood obesity. Comparing the approach with pharmacological interventions is critical in determining appropriate effective path forward.
References
CDC. (2022, August 29).
Preventing Childhood Obesity: 4 Things Families Can Do. Centers for Disease Control and Prevention. https://www.cdc.gov/nccdphp/dnpao/features/childhood-obesity/index.html
Florencia, M., Gonzalez, C., Hirschler, V., & Guillermo Di Girolamo. (2022). Pharmacotherapeutic options in pediatric obesity: an urgent call for further research.
Expert Opinion on Pharmacotherapy,
23(8), 869–872. https://doi.org/10.1080/14656566.2022.2050212
Fox, A., Feng, W., & Asal, V. (2019). What is driving global obesity trends? Globalization or “modernization”?
Globalization and Health,
15(1). https://doi.org/10.1186/s12992-019-0457-y
Lister, N. B., Baur, L. A., Felix, J. F., Hill, A. J., Marcus, C., Reinehr, T., Summerbell, C., & Wabitsch, M. (2023). Child and adolescent obesity.
Nature Reviews Disease Primers,
9(1), 1–19. https://doi.org/10.1038/s41572-023-00435-4
O’Brien, K. M., Barnes, C., Yoong, S., Campbell, E., Wyse, R., Delaney, T., Brown, A., Stacey, F., Davies, L., Lorien, S., & Hodder, R. K. (2021). School-Based Nutrition Interventions in Children Aged 6 to 18 Years: An Umbrella Review of Systematic Reviews.
Nutrients,
13(11), 4113. https://doi.org/10.3390/nu13114113
Smith, J. D., Fu, E., & Kobayashi, M. A. (2020). Prevention and Management of Childhood Obesity and Its Psychological and Health Comorbidities.
Annual Review of Clinical Psychology,
16(1), 351–378. https://doi.org/10.1146/annurev-clinpsy-100219-060201
van Sluijs, E. M. F., Ekelund, U., Crochemore-Silva, I., Guthold, R., Ha, A., Lubans, D., Oyeyemi, A. L., Ding, D., & Katzmarzyk, P. T. (2021). Physical activity behaviours in adolescence: current evidence and opportunities for intervention.
The Lancet,
398(10298). https://doi.org/10.1016/s0140-6736(21)01259-9
World Health Organization. (2021, June 9).
Obesity and Overweight. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
TO PREPARE
· Review this week’s Learning Resources and consider the insights they provide on assessing, diagnosing, and treating personality and paraphilic disorders.
· Select a specific personality or paraphilic disorder from the
DSM-5-TR to use for this Assignment.
· Use the Walden Library to investigate your chosen disorder further, including controversial aspects of the disorder, maintaining the therapeutic relationship, and ethical and legal considerations.
THE ASSIGNMENT
In 2–3 pages:
· Explain the controversy that surrounds your selected disorder.
· Explain your professional beliefs about this disorder, supporting your rationale with at least three scholarly references from the literature.
· Explain strategies for maintaining the therapeutic relationship with a patient that may present with this disorder.
· Finally, explain ethical and legal considerations related to this disorder that you need to bring to your practice and why they are important.
Write a detailed, 2-page description of an appropriate literature search strategy and execute that strategy by locating a minimum of 20 scholarly publications. Then, analyze each source and identify main themes. Also, complete steps 2 and 3
Step 1: Develop and Execute an Appropriate Search Strategy.
Write a detailed, 2-page description of an appropriate literature search strategy. Then, use that strategy to locate a minimum of 20 scholarly sources, published within the last five years (unless seminal, practice guideline, or consensus statement), addressing your PICOT question. You may need to find additional sources if you do not have at least two sources that address the same main theme (see Step 3).
Step 2: Document and Analyze the Evidence.
Analyzing the evidence you have gathered in a literature search is necessary to develop a coherent synthesis of your findings. Use the
Evidence Table [XLSX]
Download Evidence Table [XLSX]
template to help you document and analyze the source materials you have located for this assessment.
Step 3: Identify Main Themes in the Literature.
Organizing your evidence by main themes or ideas addressed in each source will help you identify commonalities and differences in research questions, methodologies, and findings, and gaps in the research. Sort your evidence using the
Main Themes Table [XLSX]
Download Main Themes Table [XLSX]
and locate additional sources if you do not have at least two sources that address the same main theme.
Please replies to these two work with 200 words each one with a reflection of their response
FIRST-Screening, a fundamental component of nursing practice, entails administering measures or tests to differentiate individuals who may have a particular condition from those who probably do not. This pivotal healthcare tool offers a multitude of advantages while also presenting some notable disadvantages, requiring nurses to navigate the complexities of its implementation carefully.
One of the most significant advantages of screening in nursing is its potential for early disease detection. This advantage is crucial for conditions like cancer, where earlier identification can significantly improve treatment outcomes (Crosby et al., 2022). By regularly administering screening tests, nurses can identify health issues in their nascent stages, enabling prompt intervention and increasing the likelihood of successful treatment.
Additionally, screening equips nurses to provide preventative care effectively. Healthcare professionals can use screening to find people more likely to develop a specific condition and then take preventative measures to lower that risk. This can entail suggesting dietary adjustments, physical activity, and providing immunizations to lower the chance of contracting an illness. Preventive measures can lower the incidence of various diseases, which can significantly positively impact public health overall.
The potential long-term cost-effectiveness of screening is another benefit. While the initial costs of screening programs might seem high, compared to managing advanced-stage illnesses, early disease detection and treatment frequently necessitate less intensive interventions and resources (van der Aalst et al., 2021). Therefore, early detection and intervention can lead to significant cost savings for patients and healthcare systems, consistent with providing healthcare at a reasonable cost.
Nonetheless, there are some disadvantages to screening in nursing practice. The possibility of false-positive and false-negative results is one major worry. Erroneous results from screening tests can have serious repercussions because they are not perfect (Wikramaratn et al., 2020). False positive results can cause patients to experience needless worry, more diagnostic testing, and higher medical expenses. On the other hand, false negative results may give rise to a false sense of security, postponing required medical intervention and possibly allowing the illness to worsen unchecked.
Another notable disadvantage of screening is the phenomenon of overdiagnosis. Some screening tests may identify conditions that would never have caused harm or required treatment in an individual’s lifetime. This situation can lead to overtreatment, expose patients to unnecessary risks, and escalate healthcare costs. Overdiagnosis underscores the importance of carefully weighing the benefits and harms of screening.
Ethical considerations also loom large in the world of screening. Deciding who should be screened, at what age, and how frequently can be ethically challenging. It involves a delicate balance between potential benefits and harms. In some instances, individuals may feel coerced into screening, infringing on their autonomy and raising ethical dilemmas regarding informed consent.
In conclusion, screening in nursing practice is a powerful tool with a multifaceted impact. Nurses must meticulously evaluate the advantages and disadvantages when implementing screening programs and communicate effectively with patients to make informed decisions. While early disease detection and prevention benefits are undeniable, nurses must also remain cognizant of potential drawbacks to ensure the highest patient care and ethical practice standards.
SECOND-In modern healthcare, health promotion and disease prevention are highly emphasized instead of treatment. The premise is that with prevention, healthcare professionals can detect an individual’s disease risk or identify any healthcare concerns early enough to initiate effective treatment protocols. Screening tests are part of the prevention strategies, and they come with some advantages and disadvantages:
The most common advantage of screening tests is that they can be used to identify disease at its early stages. Screening tests are usually done on patients who do not feel sick. Such patients may have hidden illnesses developing. However, if the illness is identified, it may be treated early to avoid further complications. For example, cancer may be identified at an early stage before it spreads out to vital organs. Treatment at this stage may have a higher likelihood of better patient outcomes.
Also, screening tests can be used to detect a disease risk, such as the risk of lung cancer in people who smoke (Krist et al., 2021). If found at risk, the patient may be asked to initiate effective lifestyle changes that protect them from developing the disease. In another example, a blood sample may be used to screen for a patient’s cholesterol levels. If the patient is found with abnormal cholesterol levels, they may be rendered at high risk of heart disease (Mortensen et al., 2023). The healthcare professional may recommend a reduction of cholesterol in the diet to prevent the disease. This suggests that screening tests are quite helpful in detecting disease risks.
However, screening tests may come with certain disadvantages. For example, specific screening tools may expose patients to harmful health effects. Such tools include X-rays, which may emit high radiation levels and increase the risk of radiation poisoning (Jaglan et al., 2019).
Another con is that screening tests may not be entirely reliable. This is because there are several cases of false positives or false negatives, which may lead to unnecessary treatments or unmet healthcare needs and additional hefty medical costs. Also, screening tests may expose the healthcare system to poor resource management or allocation, especially if the tests are publicly administered but with less health impact on the participants. The premise of this point is that healthcare systems have limited resources and must make decisions based on opportunity costs. If such decisions are not effective, the health system may be deemed inefficient. Therefore, public health decision-makers need to compare the advantages and disadvantages plus costs before making such decisions.
Answer the questions below based on the following case study.
A 41-year-old man presents to his PCP with feelings of hopelessness, sadness, and helplessness. He says that he cries for no reason, and has difficulty sleeping. He noticed that the problems began about 6 weeks before, and he did not feel able to shrug them off. He has been drinking more alcohol than usual and has stopped going to work. When on his own, he admitted that he had thought of driving his car into the nearest canal.
Submission Instructions:
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