Monday, May 25, 2020

The social determinants of health for Aboriginal and Torres Strait Islander mothers - Free Essay Example

Sample details Pages: 11 Words: 3155 Downloads: 8 Date added: 2017/06/26 Category Medicine Essay Type Analytical essay Did you like this example? Aboriginal and Torres Strait Islander people, referred to as Indigenous Australians, experience significantly poorer health outcomes than non-Indigenous Australians. This is particularly true for Indigenous women. The difference in life expectancy between Indigenous and non-Indigenous women is some 9.5 years, and Indigenous mothers are three times as likely as non-Indigenous mothers to die during childbirth (AIHW, 2014a; AIHW, 2014b). Don’t waste time! Our writers will create an original "The social determinants of health for Aboriginal and Torres Strait Islander mothers" essay for you Create order There are many complex, interrelated social factors which impact the health of Indigenous people. This paper provides a critical analysis of the social determinants of health for Indigenous mothers in particular. Education is one of the most fundamental social determinants of health, and this is particularly true for Indigenous Australians. Education enables Indigenous women to access and interpret health-related information to prevent ill health, and it also improves their capacity to engage effectively with the health care system when necessary (Jones et al., 2014). In Indigenous women, higher levels of education are directly linked with positive health outcomes; for example, an Indigenous woman is less likely to smoke if she completes secondary schooling (Australian Government Department of Health Ageing, 2012; Biddle Cameron, 2012). However, Indigenous women have poor rates of formal education attainment; just 29% of Indigenous people complete Year 12 compared with a nationa l average of 73% (ABS, 2012). Indigenous women with a lower standard of education are more likely to bear a child in their adolescent years, a particular problem for Indigenous women generally, and are also more likely to have a child with a low birthweight (Comino et al., 2009; Osborne et al., 2013). Additionally, Indigenous mothers with lower standards of education are more likely to children with poor educational outcomes; this highlights the significant problems associated with the intergenerational transfer of health and social risk in Indigenous communities (Benzies et al., 2011). Education is related directly to an Indigenous womans level of economic participation à ¢Ã¢â€š ¬Ã¢â‚¬Å" specifically, her ability to gain employment and earn an adequate income, both of which are key predictors of health (Osborne et al., 2013). Research suggests that an Indigenous persons chance of gaining employment increases by 40% if they complete Year 10 and by 53% if they complete Year 12 (N ew South Wales Government Department of Education Training, 2004). However, as with low education, low employment is a significant problem for Indigenous women; indeed, rates of unemployment for Indigenous women are above 16%, compared with a national average of just 4% (ABS, 2013). Economic disadvantage resulting from unemployment is a significant predictor of poor health. Booth and Carrol (2008) suggest that economic variables can explain up to 50% of the disparity in health between Indigenous and non-Indigenous Australians. Additionally, and demonstrating the cyclical nature of socioeconomic disadvantage and poor health in Indigenous communities, research also suggests that poor health may explain 60% of the disparity in employment participation between Indigenous and non-Indigenous women (Kalb et al., 2011). Unemployment and socioeconomic disadvantage may affect the health of Indigenous women in a range of ways. Primarily, limited disposable income à ¢Ã¢â€š ¬Ã¢â‚¬Å" in comb ination with a lack of food storage and cooking facilities within households and, particularly within remote communities, lack of access to fresh food itself à ¢Ã¢â€š ¬Ã¢â‚¬Å" means indigenous women have reduced access to nutritionally-appropriate foods and lower food security (Osborne et al., 2013; Browne et al., 2014). Indeed, the diets of Indigenous people in many regions are characterised by a high intake of saturated fats, refined carbohydrates and salt, and little to no intake of fresh fibre-rich foods (ABS, 2006). In Indigenous women, as in all women, nutrition is fundamental to health in the ante-, intra- and post-partum periods (Browne et al., 2014). Poor dietary intake leads to high rates of gestational diabetes mellitus among Indigenous mothers à ¢Ã¢â€š ¬Ã¢â‚¬Å" 5.1%, compared with a national average of 4.5% (2000-2009 estimate) (Chamberlain et al., 2014). Poor nutritional status also underpins the burden of chronic disease evident in Indigenous women and particularly c hronic diseases related to obesity, which are a significant problem in Indigenous communities (Liaw et al., 2011). Around 60% of Indigenous women aged 25-55 years have a body mass index which indicates they are obese (ABS, 2006). Because of the risks posed by chronic disease, Indigenous mothers are significantly more likely than non-Indigenous mothers to require antenatal hospital admission (Badgery-Parker et al., 2012). Additionally, maternal chronic disease means that around 11% of indigenous neonates have a low birthweight (ABS, 2014). This is an important marker for increased risk of chronic disease, again demonstrating the cyclical nature of socioeconomic disadvantage and poor health outcomes in Indigenous communities. Socioeconomic disadvantage has a variety of other impacts on Indigenous mothers. For example, lack of employment and poverty mean that many Indigenous women have reduced access to appropriate housing. Up to 28% of Indigenous people live in housing which is sev erely overcrowded and where basic facilities à ¢Ã¢â€š ¬Ã¢â‚¬Å" including showers, toilets and stoves à ¢Ã¢â€š ¬Ã¢â‚¬Å" are not available or do not work (Osborne et al., 2013). Compounding the issue of poor housing is the fact that Indigenous Australians, and particularly those living in regional and remote communities, have disproportionate access to essential health infrastructure such as safe drinking water, rubbish collection services, sewerage systems and a reliable supply of power (Australian Human Rights Commission, 2007; Osborne et al., 2013). Indeed, lower standards of housing health infrastructure in Australian communities contribute directly to the high rates of parasitic and bacterial infection and increased rates of physical injury à ¢Ã¢â€š ¬Ã¢â‚¬Å" for example, from house fires à ¢Ã¢â€š ¬Ã¢â‚¬Å" among Indigenous women (Bailie Wayte, 2006). Inappropriate, overcrowded housing has had other impacts on Indigenous mothers. Specifically, it has led to breakdowns in tr aditional, complex social structures, norms and spiritual practices in Indigenous communities (Osborne et al., 2013). This has resulted in increases in the rates violence, including domestic violence, perpetrated against Indigenous women; indeed, Indigenous women are 40 times more likely than non-Indigenous women to experience violence, and are 35 times more likely to experience intra-familial violence which results in hospitalisation (Osborne et al., 2013). Indigenous people are also significantly more likely than non-Indigenous people to experience sexual assault (Phillips Park, 2006; ABS, 2009). The Australian Human Rights Commission (2007) notes that a combination of unemployment, the receipt of welfare payments and a lower standard of education also predispose Indigenous women to an increased risk of poor health outcomes due to violence. In Indigenous women in particular, social capital à ¢Ã¢â€š ¬Ã¢â‚¬Å" including a connection with community, country and culture, is positi vely correlated with wellbeing (Brough et al., 2004; Biddle, 2012; Osborne et al., 2013). The relationship between social capital and mental wellbeing, particularly in Indigenous people, is well-established, however the correlation between social capital and physical wellbeing is now also acknowledged. For example, a number of Australian studies have demonstrated that Indigenous people who are connected to their community, country and culture are less likely to be diagnosed with a range of chronic health conditions including obesity, diabetes mellitus, hypertension and renal disease (Burgess et al., 2009; Campbell et al., 2011). Where there are declines in social capital, therefore, the mental and physical health of Indigenous women also decline. Shepherd et al. (2012) report on the growing body of knowledge which suggests that Indigenous peoples social environment may significantly affect their mental health. Rates of mental illness among Indigenous women are high; indeed, Indig enous women are 2.6 times as likely as non-Indigenous women to report experiencing psychological distress and are also more likely to engage in self-harm and / or suicide (Australian Human Rights Commission, 2007; Burns et al. 2015, np). Mental illness is also strongly correlated with poverty; for example, Australian research suggests that people in poverty lack a sense of control over their lives and so experience higher levels of psychological stress (Australian Human Rights Commission, 2007). In addition to poor mental health, psychological stress can also lead to poor physical health outcomes à ¢Ã¢â€š ¬Ã¢â‚¬Å" specifically, via negative effects on the immune and cardiovascular systems and metabolic function (Australian Human Rights Commission, 2007; Shepherd et al., 2012). Mental illness is not only underpinned by social health determinants, it is also problematic in terms of modifying the social factors which underpin poor health outcomes in Indigenous communities. For example , Marmot (2011) suggests that, in Indigenous communities, marginalisation results in disempowerment which in turn leads many Indigenous women to perceive little value in efforts to make health-related changes. Social dysfunction and high rates of mental illness in Indigenous communities is driven by à ¢Ã¢â€š ¬Ã¢â‚¬Å" and, indeed, drives à ¢Ã¢â€š ¬Ã¢â‚¬Å" the high rate of substance abuse in these communities (Osborne et al., 2013).   Indigenous women are twice as likely as non-Indigenous women to smoke on a daily basis, and three times as likely to smoke during pregnancy (Osborne et al., 2013; Passey et al., 2013). Approximately 50% of Indigenous people report consuming alcohol at least once per week, 28% report current regular use of illicit substances including cannabis and other drugs, and 15% engage in risky behaviours related to substance use (ABS, 2006). Substance abuse is an important social determinant of health; the correlation between substance use and poor outc omes in terms of both physical and mental health in adults is well-established. Whilst the prevalence of Indigenous mothers who use alcohol and illicit substances is unknown, rates of fetal alcohol spectrum disorder and neonatal abstinence syndrome are high among Indigenous neonates (AIHW, 2015). Additionally, Indigenous mothers who abuse substances are at greater risk of losing custody of their children; because of the relationship between social capital and health in Indigenous communities, this can itself be perceived as a poor health outcome (Australian Human Rights Commission, 2007; Osborne et al., 2013). As noted by the Australian Government Department of Health and Ageing (2013), poverty limits the access of many Indigenous people to health care services. This is particularly true in regional and remote communities à ¢Ã¢â€š ¬Ã¢â‚¬Å" and approximately 46% of Indigenous women live in an area classified as regional or remote (ABS, 2010). Though many regional and remote Indig enous communities are supported by fly-in fly-out health services, research suggests that fragmented services and discontinuity of care can contribute to poor health outcomes for Indigenous women (Bar-Zeev et al., 2012). Many communities have no health services at all, and to receive medical attention Indigenous women are often required to travel long distances to regional centres. Although the federal government subsidises the transport and accommodation expenses associated with such trips, general living costs borne by Indigenous women are often significant (Kildea et al., 2010). Additionally, the costs for those accompanying a woman are often not subsidised, so women may be required to travel without support (Kildea et al., 2010). These issues affect Indigenous mothers disproportionately; for example, in comparison to non-Indigenous women, Indigenous women tend to access antenatal care both less frequently and later in their pregnancy, and this is underpinned by lack of access to care (Osborne et al., 2013). Further complicating these issues is the fact that the risk-prevention paradigm evident in many medicalised health services is incompatible with the holistic perception of health held by many Indigenous women (Ireland et al., 2011). Additionally, historic protectionist and paternalist attitudes directed towards Indigenous people continue to pervade many medicalised health services in Australia. Durey and Thompson (2012) suggest that racism, both covert and overt, towards Indigenous women in Australian health services remains a significant problem; indeed, the Australian Human Rights Commission (2007) notes that systematic discrimination is a key factor underpinning the lack of opportunity for Indigenous Australians achieve a health status equitable to that of non-Indigenous Australians. These issues associated with culturally-safe service provision often culminate in Indigenous mothers disengaging from medicalised health services. This is a significa nt problem considering a lack of antenatal and intrapartum care in particular, and health care in general, is fundamental to the high maternal morbidity and mortality rates in Indigenous communities (AIHW, 2014a). This paper has provided a critical analysis of the many social determinants of health for Australias Aboriginal and Torres Strait Islander peoples à ¢Ã¢â€š ¬Ã¢â‚¬Å" and, particularly, Indigenous mothers. It has demonstrated that social factors underpin the health of Indigenous mothers in both the physical and mental domains. It has also provided evidence for the complex relationship between health and social determinants in Indigenous mothers. 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Bar-Zeev, SJ, Barclay, L, Farrington, C Kildea, S 2012, From hospital to home: The quality and safety of a postnatal discharge system used for remote-dwelling Aboriginal mothers and infants in the Top End of Australia, Midwifery, vol. 21, no. 3, pp. 366-373. Benzies, K, Tough, S, Edwards, N, Mychasiuk, R Donnelly, C 2011, Aboriginal children and their caregivers living with low income: Outcomes from a two-generation preschool program, Journal of Child Family Studies, vol. 20, no. 3, p. 311-3 18. Biddle, N 2012, Measures of Indigenous social capital and their relationship with well-being, Australian Journal of Rural Health, vol. 20, no. 6, pp. 298-304. Biddle, N Cameron, T 2012, The benefits of Indigenous education: Data findings and data gaps, Australian National University, viewed 26 September 2015, https://press.anu.edu.au/wp-content/uploads/2012/11/ch071.pdf Booth, AL Carrol, N 2008, Economic status and the Indigenous / non-Indigenous health gap. Economics Letters, vol. 99, no. 3, pp. 604-606. Brough, M, Bone C Hunt, J 2004, Strong in the city: Towards a strength-based approach in Indigenous health promotion, Health Promotion Journal of Australia, vol. 15, no. 3, pp. 215-220. Browne, J, Hayes, R Gleeson, D 2014, Aboriginal health policy: Is nutrition the gap in Closing the Gap?, Australian New Zealand Journal of Public Health, vol. 38, no. 4, pp. 362-369. Burgess, CP, Johnston, FH, Berry, ML, McDonnell, J, Yibarbuk, D, Gunabarra, C, Mileran, A Bailie, RS 2009, Healthy country, healthy people: The relationship between Indigenous health status and caring for country, Medical Journal of Australia, vol. 190, no. 10, pp. 567-572., viewed 26 September 2015, https://www.mja.com.au/journal/2009/190/10/healthy-country-healthy-people-relationship-between-indigenous-health-status-and Burns, J, MacRae, A, Thomson, N, Anomie, M, Gray, C, Levitan, L, McLoughlin, N, Potter, C, Ride, K, Stumpers, S, Trzesinki, A Urquhart, B 2013, Summary of Indigenous womens health, viewed 26 September 2015, https://www.healthinfonet.ecu.edu.au/population-groups/women/reviews/our-review Campbell, D, Burgess, CP, Garnett, ST Wakerman, J 2011, Potential primary health care savings for chronic disease care associated with Australian Aboriginal involvement in land management, Health Policy, vol. 99, no. 1, pp. 83-89. Chamberlain, C, Banks, E, Joshy, G, Diouf, I, Oats, JJ, Gubhaiu, L Eades, S 2014, Prevalence of gestational diabetes mellitus amon g Indigenous women and comparison with non-Indigenous Australian women: 1990-2009, Australian New Zealand Journal of Obstetrics Gynaecology, vol. 54, no. 5, pp. 433-440. Comino, E, Knight, J, Webster, V, Jackson-Pulver, L, Jalaludin, B, Harris, E, Craig, P, McDermott, D, , Henry, R Harris, M 2012, Risk and protective factors for pregnancy outcomes for urban Aboriginal and non-Aboriginal mothers and infants: The gudaga cohort, Maternal Child Health Journal, vol. 16, no. 3, pp. 569-578. Durey, A Thompson, SC 2012, Reducing the health disparities of Indigenous Australians: Time to change focus, BMC Health Services Research, vol. 12, no. 1, pp. 151-161. Ireland, S, Wulili, N, Concepta, B Kildea, S 2011, Niyith nniyith watman (the quiet story): Exploring the experiences of Aboriginal women who give birth in their remote community, Midwifery, vol. 27, no. 5, pp. 634-641. Jones, K, Parker, EJ Jamieson, LM 2014, Access, literacy and behavioural correlates of poor self-rat ed oral health amongst an Indigenous South Australian population, Community Dental Health, vol. 31, no. 3, pp. 167-171. Kalb, G, Le, T Leung, F 2011, Decomposing differences in labour force status between Indigenous and non-Indigenous Australians, Melbourne Institute of Applied Economic and Social Research, viewed 25 September 2015, https://ftp.iza.org/dp6808.pdf Kildea, S, Kruske, S, Barclay, L Tracy, S 2010, Closing the gap: How maternity services can contribute to reducing poor maternal / infant health outcomes for Aboriginal and Torres Strait Islander women, Rural Remote Health, vol. 10, no. 3, pp. 1-18. Liaw, ST, Lau, P, Pyett, P, Furler, J, Burchill, M, Rowley, K Kelaher, M 2011, Successful chronic disease care for Aboriginal Australians requires cultural competence, Australian New Zealand Journal of Public Health, vol. 35, no. 3, pp. 238-248. Marmot, M 2011, Social determinants and the health of Indigenous Australians, Aboriginal Islander Health Worker Journ al, vol. 35, no. 3, pp. 21-22. New South Wales Government Department of Education and Training 2004, The Report of the Review of Aboriginal Education, viewed 26 September 2015, https://www.det.nsw.edu.au/media/downloads/reviews/aboriginaledu/report/aer2003_04.pdf Osborne, K, Baum, F Brown, L 2013, What works? 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Thursday, May 14, 2020

Books Like The Harry Potter Series, Go Ask Alice, Or The...

One can only imagine what a banned book consist of, is it drugs, sex, racial issues, or witchcraft? The answer is it could be all of the above. Chances are, you have once read and maybe even declared a banned book your favorite book. Books like the Harry Potter series, Go Ask Alice, or The Hunger Games series are all on the banned book list. These books are often removed from schools or public library shelves. â€Å"For many years, American schools have been pressured to restrict or deny students access to books or periodicals deemed objectionable by some individual or group on moral, political, religious, ethnic, racial, or philosophical grounds.† (The Students 1) The pressure of removing said controversial books comes from concerned parents or administrators that feel the book’s content is too overwhelming for their children or students. According to Butler University, over 2500 of the 3500 challenged books came from concerned parents between 2000 and 2009 (LibGuides 3) Banning these books places an authoritarian outlook on our school systems and freedom to read in America. An authoritarian government places restrictions on citizen’s freedoms in return for power over their country. By restricting children’s right to read, one is also restricting their First Amendment rights. The First Amendment states that Congress shall not restrict one’s freedom of speech and press. The author of the publication and the readers are getting their rights torn out from under them as if theShow MoreRelatedLogical Reasoning189930 Words   |  760 PagesDowden This book Logical Reasoning by Bradley H. Dowden is licensed under a Creative Commons AttributionNonCommercial-NoDerivs 3.0 Unported License. That is, you are free to share, copy, distribute, store, and transmit all or any part of the work under the following conditions: (1) Attribution You must attribute the work in the manner specified by the author, namely by citing his name, the book title, and the relevant page numbers (but not in any way that suggests that the book Logical ReasoningRead MoreStephen P. Robbins Timothy A. Judge (2011) Organizational Behaviour 15th Edition New Jersey: Prentice Hall393164 Words   |  1573 PagesOne Lake Street, Upper Saddle River, New Jersey 07458, or you may fax your request to 201-236-3290. Many of the designations by manufacturers and sellers to distinguish their products are claimed as trademarks. Where those designations appear in this book, and the publisher was aware of a trademark claim, the designations have been printed in initial caps or all caps. Library of Congress Cataloging-in-Publication Data Robbins, Stephen P. Organizational behavior / Stephen P. Robbins, Timothy A. Judge

Wednesday, May 6, 2020

Christianity And The Biblical Scriptures Essay - 1759 Words

In regards to Judaeo Christian religion, for many years’ people believed that the creation of the earth had taken place in 4004BC. Nigel Scotland, a senior lecturer in The Faculty of Arts in St. Paul and St. Mary, Cheltenham College wrote in his article, Darwin and Doubt and the Response of the Victorian Churches, â€Å"Up until the late eighteenth and early nineteenth century, the church held the Bible to speak authoritatively on all matters in which determined the relationship between God and man† and how man was to deal with all living things on the earth (Scotland 1). Also, â€Å"the bible remarks all that takes place on the earth was a result, in God’s divine powers† (Scotland 1), without providing proper explanations for all that has happened; However, all that started to change during the Victorian Era, as many people began to doubt Christianity and the Biblical scriptures (Scotland 1). One of the main reasons for this doubt to burst to the surfac e was because of new scientific discoveries. In particular, in1859, during the time Charles Darwin published his book â€Å"The Origin Of Species by Means of Natural Selection Of the Preservation Of Favored Races In the Struggle For Life.† Charles Darwin’s book caused a mass evolution in scientific theory. His theories challenged long held religious teachings and beliefs, which caused a major backlash from the Victorian churches and religious believers (Scotland 3). The three main theories Darwin argued here that the earth existed longShow MoreRelatedPaper 2 - the Rise of Fundamentalism1726 Words   |  7 Pagesassociated with the concepts of biblical fundamentalism. The modern day controversies that have challenged the integrity of God’s Word have necessitated the question of whether fundamentalism was ever sanctioned and orchestrated by God. 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Tuesday, May 5, 2020

Nursing Case study Medical

Questions: I: Mrs Joan McNeil is a 64-year-old widower who currently lives with her daughter due to a recent fall and DVT in her left calf.S: She has presented to your hospital with a DKA after having nausea and vomiting for the past 3 days which she was unable to tolerate anything oral and is dehydrated.B: Joan has been a type 2 Diabetic on Metformin for 30 years. Recently her GP started her on insulin a.c and nocte. Joan weighs 115 kg and suffers from Osteoarthritis and finds it difficult to mobilise. She also has hypertension in which she is medicated for.A: After spending the night in ED receiving IV fluids and an insulin infusion, she has been admitted to your ward with uncontrolled Type 2 Diabetes needing re-assessment and management. Joan currently has an intravenous infusion in progress and has a sliding scale, requiring 2/24 BSLs and additional insulin pre meals.R: Refer to the mediation charts.Question 1:a) Explain the aetiology and pathophysiology of Type 1 Diabetes and Type 2 Diabet es.In your answer compare the differences between Type 1 and Type 2 diabetes. Include: characteristics and treatment.b) Explain what a DKA is and possible reasons from the history why this would have occurred?Question 2:Joan has been a Type 2 Diabetic for 30 years. She has now been commenced on Insulin.a) Is she now considered a Type 1 diabetic? Explain your answer.b) Why would Joans GP have commenced her on Insulin a.c and nocte? Give a detailed explanation.Question 3:a) What are the symptoms of Hypoglycaemia?b) What is the treatment for Hypoglycaemia?Question 4:Mrs McNeils Blood Glucose levels for the past 12 hours are as follows:0600: 13.5mmol/l; 0800: 14.5mmol/l; 1000: 9.9mmol/l; 1200: 15.0mmol/L; 1400: 7.7mmol/l; 1600: 6.8mmol/l; 1800: 3.2mmol/l; 1900: 10.6 mmol/l; 2100: 16mmol/l;a) Document these on the attached BGE (Blood Glucose Form).b) At 1200hrs you documented the BSL as 15.0. What would you do?Question 5:Identify 5 other conditions related to diabetes that Joan is at ris k of? Choose 1 and explain this in detail including pathophysiology, aetiology, signs and symptoms, medications and treatment options.Question 6:On arrival to the ward Joan gives you a bag containing her medications. This bag includes: Metformin, Actrapid, Protaphane, Digoxin, Ventolin Puffer, Coloxyl with Senna, Atenolol.For each of these medications please explain: The pharmacodynamics (how they work) on Mrs McNeils body. Why Joan would be taking these medications Trade names Dosage parameters Adverse reactions Nursing Considerations Patient educationQuestion 7:Mrs McNeil was commenced on IV fluids due to dehydrationa) What clinical manifestations would Mrs McNeil exhibited on admission for the Doctor to diagnose this.b) Outline in detail the Enrolled Nurses role in relation to managing Joans IVT.c) Identify and explain in detail at least 4 possible complications of having an IV Infusion.You have just completed a set of observations. These are as follows:BP: 160/96HR: 98R: 26O2 sa ts: 86%Joan is having difficulty responding to your questions in full sentences.d) What is Joan most likely suffering from?e) What could have caused this and why?Question 8:As part of the admission process you complete a patient medical history check. You identify that the patient has had a recent DVT in her left calf.a) After identifying this, what medication is used in hospital to prevent this from reoccurring?b) How does this medication work?c) Outline how you would administer this medication (please include equipment, process and safety precautions)d) Please sign the medication chart to indicate you have given the morning medications.Question 9:You assist Joan to the toilet, on returning to the chair Joan appears to be short of breath and complains of a squeezing sensation (heaviness) in her chest. Please explain your immediate actions in order of priority and provide a rationale for each.Question 10:Continuing on from above, you have just completed a set of observations. These are as follows:BP: 86/38HR: 46R: 24O2 sats: 80%Joan is sweating profuselyBased on the observations you decide to leave the patient to make a MET call.a) What is the criteria for making a MET call?Question 11:The Doctor diagnosed acute Myocardial Infarction as the troponin level was 0.9.a) What is the normal range for a troponin level?The following day, you are doing a ward round. You notice Mrs McNeil walking to the toilet on her own. You ask if she is ok and she responds yes. You continue your round. 20 minutes later you walk past Mrs McNeils room and notice she has not returned from the toilet. As you walk closer you see Mrs McNeil collapsed on the floor in the doorway of the toilet.b) What is your next response?c) Joan has No Pulse and is not breathing. You know you need to commence CPR, what does this involve. Give a detailed explanation of the resuscitation process. Ratio, depth of compression, frequency, checking of pulse, timing of interventions, other assistance etc.d) What medications are used in the management of a cardiac arrest. Explain the pharmacodynamics, dosage parameters and timing for these medicationsQuestion 12:After a long stay in hospital recovering from her MI, Joan is finally ready for discharge to a rehabilitation facility.a) Develop a discharge plan and a written handover to the facility. Using the ISBAR handover format ensure you include all information, events and medication pertaining to Joans stay hospital. Answers: 1. a) Type I Diabetes: in this condition the immune system of the body that fights against viruses and bacteria incorrectly demolishes the islet cells within the pancreas. Pathophysiology of this condition includes beta cells destruction within the pancreas in spite of which causative agent or risk factors are present (Schatz, Haller and Atkinson, 2010). Risk factors include autoimmune response towards the beta cells within the pancreas, consisting expansion of autoantibody-generating beta cells, CD8+ T cells, CD4+ T helper cells and innate immune system activation. Type II Diabetes: in this condition human system becomes insulin resistant or the pancreas may stop producing adequate amount of insulin. Insulin resistance that is the cell inability to respond properly to normal insulin levels takes place initially within fat tissue, muscles and liver (Taylor, 2012). Type I Diabetes Type II Diabetes Characteristics beta cells destruction within the pancreas in spite of any causative agent or risk factors In case of insulin resistance, liver inadequately releases proper amount of glucose in the blood stream Treatment Immunosupressive drugs: Cyclosporine A. Proper nutrition, regular exercise, lifestyle modification (Karlsen and Bru, 2000). b) DKA is considered as a life threatening illness among the sufferers of diabetes mellitus. This takes place mainly with those who are suffering from type I diabetes. It results from insulin shortage, and because of insulin insufficiency body switches to burn fatty acids and generates acidic ketone bodies which cause mainly the complications and symptoms (Egred, 2005). In this case study Mrs. Joan is a diabetic patient and suffering from this condition since last 30years. DKA most often takes place in those patients who previously have diabetes. Apart from that she is obese. From various researches it is seen that DKA may takes place among those who have features of diabetes type II and features include obesity and family history. 2. a) No, she is not considered as Type I diabetic. This is because both features of these conditions are entirely different. Type II diabetes is characterized by increased glucose levels within the blood stream but in type I diabetes immune system destroy s the production of insulin by the pancreatic cells (Hassanein, Ewins and Worth, 2000). In this case body generates insulin but is not capable to identify and utilize it appropriately and that is why insulin therapy is given to the patient to control her blood sugar level. Her immune system does not destroy the insulin producing beta cells within the pancreas. b) Joans GP have commenced her on insulin dosages because Type II diabetes is completely curable and preventable. The recommendation is justified as Joan is diabetic for last 30years and consuming Protaphane and Metformin (Drugbank.ca, 2015). Yet her blood sugar level is not under control. Therefore commencement of insulin therapy prior meal and during the night time will help Joan to control her elevated blood sugar level. 3. a) The symptoms of hypoglycemia includes fatigue, pale skin, heart palpitations, anxiety, shakiness, hunger, irritability, sweating, blurry vision, nervousness, mood swing, sleeping difficulty, skin ting ling, loss of alertness, trouble in concentrating (Park et al., 2010). b) The treatment of hypoglycemia includes drinking juice or consuming glucose tablets or chewing sugary food (Bellenir, 2008). GP can also give a glucagon shot as for immediate purpose, because this raises the level of blood sugar.4. a) Blood Glucose Form: TIME BSL 0600 13.5mmol/l 0800 14.5mmol/l 1000 9.9mmol/l 1200 15.0mmol/l 1400 7.7mmol/l 1600 6.8mmol/l 1800 3.2mmol/l 1900 10.6mmol/l 2100 16mmol/l b) When it is documented that the BSL is 15.0 at 1200hrs, the responsible care provider should focus on her hyperglycemia treatment. It is also mentioned in this case study that she has diabetic keto acidosis, so taking care of this factor is of utmost important. Joan weighs 115kg so she should be administered with 6units of insulin. 5. 5 other conditions related to diabetes are: amputation, vision loss, nerve damage; kidney disease and stroke and heart complication. Amputation: the main two reasons associated with amputations of legs or feet include narrowing down of blood vessels, obstruction in adequate amount of blood circulation to the lower body portion. Sores or cuts in the legs or feet take time to heal properly and can get bad instead of getting healed. If a problem of damaged nerve is also present then the patient might not feel the ache because of foot problem (Healey and Healey, 2007). Sores if left untreated or ignored then the sores can become rapidly infected that leads to an emergency for amputation (Akram, Kerr and Mclennan, 2008). Treatment includes proper foot care, inspection of sores; avoid wearing badly fitting shocks and proper follow up with doctors. 6. DRUGS PHARMACODYNAMICS REASON TRADE NAMES DOSAGE PARAMETERS ADVERSE REACTIONS NURSING CONSIDERATION PATIENT EDUCATION Metformin Improves glucose tolerance, lowers basal and postprandial plasma glucose She is hyperglycemic Glucophage 1gm, twice Daily Stomach discomfort, lower back pain, cough, decreased appetite History of allergy and physical assessment like: skin color, lesions, liver evaluation Avoid alcohol consumption while administering with this drug Actrapid Helps glucose to enter the body cells from blood To manage the condition of diabetes Actrapid 4units/8hrs Excessive reduction all of blood glucose level sudenly Correct dosage should be prepared Education need to be given on lifestyle modification, proper diet Protaphane Helps glucose to enter the body cells from blood To control elevated level of blood sugar Protaphane 14units Excessive reduction all of a blood glucose level sddenly Correct dosage should be prepared Education need to be given on lifestyle modification, proper diet Digoxin A cardiac glycoside, treat congestive cardiac complication and arrhythmias because of reentry mechanism Control the rate of ventriculation in atrial fibrillation, manage congestive cardiac failure Digacin 62.5mcg/day Fainting, dizziness Need to be administered undiluted Patient should complain if any adverse effect initiates Ventolin Puffer A bronchodilator to control the condition of asthma To treat asthma or COPD Asthavent 2mg 3-4times/day Headache, flushing, hypokalaemia Assess lung sound, observe fore paradoxical spasm Patient should complain if any adverse effect initiates (Nhs.uk, 2015) Coloxyl with Senna Sennosides which are obtained from senna leaves, irritates bowel lining causing laxative effect Recommended for constipation Coloxyl II daily Weight loss, stomach pain As digoxin, blood thinner and diuretic tablets can affect Coloxyl, nurses should monitor if any adverse reaction arise Patient should complain if any adverse effect initiates (Aspenpharma.com.au, 2015) Atenolol It has lowest solubility in lipid and does not have membrane stabilizing activity She is hypertensive, so it is used to control her hypertension Normiten Daily Cold hand, feet, confusion History of sinus bradycardia and physical assessment: urine glucose, blood glucose, cholesterol CConsume drug with food id gastrointestinal upset takes place (Mayoclinic.org, 2015) 7. a) The clinical manifestations include extreme thrust, confusion, dry skin, mucous membranes, mouth, no urination and sunken eyes (Simmons, 2010). b) Nurses should have a good amount of knowledge about intra venous therapy. Many technical modifications are now in place those are time saving and innovative. This increases the therapy efficacy. The nurses need to be well equipped with these techniques.c) The complications may include hematoma infiltration, air embolism and phlebitis (Wittstock, Benecke and Zettl, 2003). d) Her blood pressure is at higher side, her heart rate is also increased and from her oxygen saturation measurement it is clearly understood that she is suffering from hypoxia. e) She could have suffering from loss of consciousness and increased palpitation because of dehydrated condition. 8. a) Heparin is used to prevent this from reoccurring.b) Heparin binds to antithrombin III and leads to instant inactivation of factors Xa and IIa. This heparin bound complex can inactivate plasmin (Drugbank.ca, 2015). Heparins antithrombotic effect is related well with the factor Xa inhibition. Heparin prevents formation of existing clots by diminishing further clotting and not a thombolytic agent.9. Immediate actions: support with oxygen mask as she is suffering from breathing shortness. The squeezing pain in the heart might represent a change of heart attack, so Digoxin can be administered or any other sublingual tablets can be immediately placed. 10. a) The criteria here that can be considered to give a MET call includes her sudden chest pain and raised heart rate and elevated blood pressure that indicate her chance to get a heart attack. 11. a) Normal range of troponin: 0-0.2ng/ml.b) The next response is a call to the medical emergency team.c) Turn patient onto her back, open airway using chin lift and head lift, keeping this passage open the personnel should look, feel, and listen to identify whether the patient is normally breathing and should take l ess than 10seconds. Listen at patients mouth for breathing sounds, look or movement of chest, feel for air on cheek. Chest decompression can be given and 2ventilations. d) ACE inhibitors can be used in this condition. Generic name: benazepril; Trade name: LotensinThis drug inhibits ACE in human (Nlm.nih.gov, 2015). This enzyme catalyzes conversion of angeotensin I to vasoconstrictor substance. Dosage: 20mg/day. 12. Joans discharge plan should be focused on her physiological conditions: DVT, DKA, diabetes and dehydrated condition. As the doctor has started insulin therapy, the patient should be educated properly regarding insulin administration. If help is required the hospital should arranged for nurse aide along with her. She should be provided with a template mentioning dos and donts, so that she can follow proper medication and its timing. References Akram, A., Kerr, R. and Mclennan, A. (2008). Amputation of lower left lip following dental local anaesthetic.Oral Surgery, 1(2), pp.111-113. Aspenpharma.com.au, (2015).Coloxyl - docusate | Aspen Pharmacare Australia. [online] Available at: https://www.aspenpharma.com.au/products/details/index/id/448/product/Coloxyl [Accessed 19 Feb. 2015]. Bellenir, K. (2008).Diabetes sourcebook. Detroit, MI: Omnigraphics. Drugbank.ca, (2015).DrugBank: Heparin (DB01109). [online] Available at: https://www.drugbank.ca/drugs/DB01109 [Accessed 19 Feb. 2015]. Drugbank.ca, (2015).DrugBank: Heparin (DB01109). [online] Available at: https://www.drugbank.ca/drugs/DB01109 [Accessed 19 Feb. 2015]. Drugbank.ca, (2015).DrugBank: Metformin (DB00331). [online] Available at: https://www.drugbank.ca/drugs/db00331 [Accessed 19 Feb. 2015]. Egred, M. (2005). Diabetic keto-acidosis and hyperkalaemia induced pseudo-myocardial infarction.Heart, 91(9), pp.1180-1180. Hassanein, M., Ewins, D. and Worth, R. (2000). Case presentation: An unusual cause of severe peripartum hypoglycaemia in type I diabetes.Diabetes Research and Clinical Practice, 50, p.215. Healey, J. and Healey, J. (2007).Diabetes. Thirroul, N.S.W.: Spinney Press. Karlsen, B. and Bru, E. (2000). Coping among adults with type I and type II diabetes.Diabetes Research and Clinical Practice, 50, p.231. Mayoclinic.org, (2015).Atenolol (Oral Route) Description and Brand Names - Drugs and Supplements - Mayo Clinic. [online] Available at: https://www.mayoclinic.org/drugs-supplements/atenolol-oral-route/description/drg-20071070 [Accessed 19 Feb. 2015]. Nhs.uk, (2015).Ventolin - Asthma medicines and drugs - NHS Choices. [online] Available at: https://www.nhs.uk/Conditions/Asthma/Pages/MedicineOverview.aspx?condition=Asthmamedicine=Ventolin [Accessed 19 Feb. 2015]. Nlm.nih.gov, (2015).Benazepril: MedlinePlus Drug Information. [online] Available at: https://www.nlm.nih.gov/medlineplus/druginfo/meds/a692011.html [Accessed 19 Feb. 2015]. Park, M., Freund, G., Donovan, S., Freund, G., Johnson, R. and Woods, J. (2010).Neuroendocrine mechanisms of behavioral changes induced by hypoglycemia. Urbana, IL.: University of Illinois. Schatz, D., Haller, M. and Atkinson, M. (2010).Type I Diabetes. Philadelphia: Saunders. Simmons, S. (2010). Acute dehydration.Nursing, 40(1), p.72. Taylor, R. (2012). Insulin Resistance and Type 2 Diabetes.Diabetes, 61(4), pp.778-779. Wittstock, M., Benecke, R. and Zettl, U. (2003). Therapy with Intravenous Immunoglobulins: Complications and Side-Effects.Eur Neurol, 50(3), pp.172-175.

Friday, April 10, 2020

Calculating Real GDP

Calculating Real GDP of an economy entails a general summation of the total output produced in an economy. The two main approaches for calculating this output are the Expenditure Approach and the Income approach. TheAdvertising We will write a custom essay sample on Calculating Real GDP specifically for you for only $16.05 $11/page Learn More Income approach focuses on the incomes which accrue from the totality of economic activities carried out within the economy. The expenditure approach on the other hand focuses on the values of total expenditure in the economy as per the different economic units in the country. This paper gives a mathematical representation of the expenditure approach to calculate the level of GDP and also assesses the effect of changes in some of the variables on the GDP. Generally, GDP=Consumption + Investment + Government Expenditure + Net Exports This can be summarized as Y= C + I + G + NX HoweverAdvertising Looking for essa y on business economics? Let's see if we can help you! Get your first paper with 15% OFF Learn More C=C0 + c1Yd Where Co is the autonomous level of consumption and C1 is the marginal propensity to consume. Yd is defined as (Y-T) and is called disposable income I=Io+I1Y Where Io is the autonomous level of investment and I1 the marginal propensity to invest. G=Go Where Go is the level of government expenditure determined outside the model. NX = X-M Where X is the level of exports and M the level of imports M=Mo+m1Y where Mo is autonomous level of exports and m1 the marginal propensity to import T=Tp where Tp are taxes as determined by government.Advertising We will write a custom essay sample on Calculating Real GDP specifically for you for only $16.05 $11/page Learn More Combining the equation gives Y=co+c1(Y-Tp) +Io+i1Y+Go+ (Xo-(mo+m1Y)) Hence Y= co+Io+Go+Xo-mo – c1Tp/ 1-c1-i1=m1 1-c1-i1=m1 Given that Autonomous consumption (Co) = 200 a utonomous investment (I0) = 200Advertising Looking for essay on business economics? Let's see if we can help you! Get your first paper with 15% OFF Learn More government spending = 100 export spending (X0) = 100 autonomous import spending (M0) = 100 taxes (Tp) = 0 marginal propensity to consume (c1) = 0.8 marginal propensity to invest (i1) = 0.1 marginal propensity to import (m1) = 0.15 Then Y= (200+200+100+100-100)/ (1-0.8-0.1+0.15) = 500/0.25=1,600 Exchange rates have significant effects on international trade. This is because they determine how much the local currency is valued in the international markets. Consequently, they affect the levels of imports and exports from the economy. Appreciation of the exchange rate has the effect of making imports cheaper in the domestic market while exports get expensive in the international markets. Depreciation of exchange rates on the other hand makes imports expensive in the local market while exports get cheaper in the international markets. In a case where the exchange rates cause autonomous imports to rise from 100 to 200 the GDP changes as shown below. The new level of Y is Y= (200+200+100+1 00-200)/ (1-0.8-0.1+0.15) = 400/0.25=1600 In the initial state the GDP level is 2000 a figure which is 400 higher than after the change in exchange rate. As mentioned above, the exchange rate is a conversion factor or a price relating local currency to international currency. This being the case, a rise in the autonomous imports would only result from an appreciation of the exchange rate. This is due to the fact that an appreciation in the exchange rate causes imports to be cheaper hence the same amounts used to purchase the autonomous imports can now purchase much more than before. It should be noted that the change in the GDP occasioned by the change in autonomous imports is much higher than the actual change in autonomous imports. This is due to the multiplier effect on the economy. In conclusion, exchange rate is an important component in the determination of the growth of GDP especially in economies where international trade contributes to a large portion of the GDP. It is alwa ys best to achieve stability of the exchange rates to avoid the scenario described above This essay on Calculating Real GDP was written and submitted by user Anaya Tate to help you with your own studies. You are free to use it for research and reference purposes in order to write your own paper; however, you must cite it accordingly. You can donate your paper here.

Monday, March 9, 2020

Free Essays on Dark Matter

There is perhaps no current problem of greater importance to astrophysics and cosmology than that of "dark matter". The controversy, as the name implies, is centered on the notion that there may exist an enormous amount of matter in the Universe that cannot be detected from the light that it emits. The evidence of dark matter is from the motions of astronomical objects, specifically stellar, galactic, and galaxy cluster/super cluster observations. The basic argument is that if we measure velocities in some region, then there has to be enough mass there for gravity to stop all the objects from flying apart. When such velocity measurements are done on large scales, it turns out that the amount of inferred mass is much more than can be explained by the luminous mass. Hence we infer that there is non-luminous matter in the Universe, i.e. there is dark matter. Dark matter has important consequences for the evolution of the Universe. According to standard cosmological theory, the Universe must conform to one of three possible types: open, flat, or closed. A parameter known as the "mass density" - that is, how much matter per unit volume is contained in the Universe - determines which of the three possibilities applies to the Universe. In the case of an open Universe, the mass density is less than unity, and the Universe is predicted to expand forever. If the Universe is closed the Universe will eventually stop its expansion and re-collapse back upon itself. For the case where the universe is exactly equal to one, the Universe is delicately balanced between the two states, and is said to be "flat". Dark matter candidates are usually split into two broad categories, with the second category being further sub-divided: baryonic and bon-baryonic. Then, under non-baryonic, hot dark matter (HDM) and cold dark matter (CDM) are its types. Depending on their respective masses and speeds, CDM candidates have relatively large mass and travel at ... Free Essays on Dark Matter Free Essays on Dark Matter There is perhaps no current problem of greater importance to astrophysics and cosmology than that of "dark matter". The controversy, as the name implies, is centered on the notion that there may exist an enormous amount of matter in the Universe that cannot be detected from the light that it emits. The evidence of dark matter is from the motions of astronomical objects, specifically stellar, galactic, and galaxy cluster/super cluster observations. The basic argument is that if we measure velocities in some region, then there has to be enough mass there for gravity to stop all the objects from flying apart. When such velocity measurements are done on large scales, it turns out that the amount of inferred mass is much more than can be explained by the luminous mass. Hence we infer that there is non-luminous matter in the Universe, i.e. there is dark matter. Dark matter has important consequences for the evolution of the Universe. According to standard cosmological theory, the Universe must conform to one of three possible types: open, flat, or closed. A parameter known as the "mass density" - that is, how much matter per unit volume is contained in the Universe - determines which of the three possibilities applies to the Universe. In the case of an open Universe, the mass density is less than unity, and the Universe is predicted to expand forever. If the Universe is closed the Universe will eventually stop its expansion and re-collapse back upon itself. For the case where the universe is exactly equal to one, the Universe is delicately balanced between the two states, and is said to be "flat". Dark matter candidates are usually split into two broad categories, with the second category being further sub-divided: baryonic and bon-baryonic. Then, under non-baryonic, hot dark matter (HDM) and cold dark matter (CDM) are its types. Depending on their respective masses and speeds, CDM candidates have relatively large mass and travel at ...

Saturday, February 22, 2020

Oh What a Lovely War Movie Review Example | Topics and Well Written Essays - 250 words

Oh What a Lovely War - Movie Review Example The stage production and the film differ from each other in many ways. The stage adaptation of the World War was more lighthearted and funny. It had a backdrop on which were projected harsh images of the war, but in sharp contrast the action on the stage was more comic in nature. Attenborough’s film however, had huge sequences of the war interspersed with motifs from the stage production. The stage play made use of Pierrot costumes, but the film did not make use of them. However, what was used in the film was the ‘cricket scoreboards’ that were used in the play, depicting the number of deaths that took place. The songs in the film are filled with dark comedy depicting the madness of the war. E.g. ‘When this Lousy war is over’ and Good-bye-ee.’ The songs though highly patriotic were masked by irony that hides the hideousness and carnage of the war. One of the most memorable scenes shot by Attenborough for the film was a crane shot of the final s equence showing hundreds of graves, on a large expanse of land. This scene is highly charged with emotion and is sure to bring tears to ones