Sexual Health In Aboriginal Teenagers In The Rural Areas Of Australia Essay

Sexual Health In Aboriginal Teenagers In The Rural Areas Of Australia Essay

Most people would normally think that nurses only play a critical role in the actual practice of patient care. While this may be true up to a certain extent, the idea that nursing practice and patient care itself is a continuously evolving practice cannot be ignored. The roles of nurses are continuously expanding and becoming more specific. There are for example, nurses these days who call themselves sexual health nurses. These are typically the nurses who are responsible of administering drug injections and other primary and secondary nursing care practices to patients who have sexually related cases such as gonorrhea and hepatitis B for example .
It is common among community nurses, even for those who are assigned to monitor and manage the health and wellness of people in rural villages, particularly in the rural villages of Australia, to focus on sexual health and sexual education programs in a bid to decrease the booming prevalence rates of sexually transmitted diseases. Most teenagers and young adults in these areas are poorly educated about the possible negative health implications of unprotected sex and as someone who is knowledgeable in sexual education; a community nurse can do a good job of spreading the word and warning the residents about the major drawbacks of unprotected sex.
This would seem to be an effective enough strategy to combat the booming prevalence rates of sexually transmitted diseases—considering the fact that the only reason behind such boom is lack of education and not pure stubbornness which is out of the scope of this paper, but it really is not. Nurses being assigned in the rural areas of Australia are particularly limited considering the patient to nurse ratio in metropolitan areas of the country. Thus, the impact of nurses in this great inequality can be rebalanced by significantly increasing the volume of nurses who get rotated in the rural areas of Australia. That way, the government and the public can be sure that more and more people will be educated not only in the sexual aspect of health but in all areas of it .

Jackson, V. (2011). What is the role of the school nurse in sexual health education. NASH Sch Nurse Journal, 146-147.
O’Keefe, E. (2005). The Evolution of Sexual Health Nursing in Australia: A Literature Review. Journal of Sexual Health, 33-37.


Women And Midwifery In Early America Research Papers Example

Women And Midwifery In Early America Research Papers Example

History I Section 263
The practices of childbirth and delivery have changed drastically throughout history. With the advances in science and technology and growing knowledge over the years, America has been delivering healthier babies than ever. But unlike now, in early America midwives played a large role in child delivery and child care, “When the English settled in America they brought the traditional English customs and practices of childbirth to the New World.” Midwives were more than just someone who delivered a baby; they also acted as the nurse and were a friend to the pregnant woman throughout her labor. Midwives felt a lot of responsibility for their patients, which can be seen though their stories. Their stories and evidence not only show their successes, troubles, but also the history of diseases prevalent in early America.
Midwives were a necessity in early American society, whether it was for emotional or physical help. “The women of this era shared a special bond when it came to dealing with problems specific to women. The midwife was all the more important as she assisted in childbirth which was considered a life-changing event.” This was true when slavery was in existence too and black women who were midwives were given special privileges. They were not made to work in the plantation but were given chores like cooking and cleaning in the houses of their masters. The pension files from early America have stories and first person narratives of midwives and the role they played in the American society. In addition to government archives and pension files, information about midwives during those time scan also is found in the form of journals or diaries that they had kept. One such instance is the diary of Martha Bullard, a midwife in the mid eighteenth century who kept a careful account of her life and her practice as a midwife. Her diary was unearthed and later transcribed in the form of a book by Ulrich.
When describing the role of a midwife in the life of a woman and during the pregnancy and birth of her kid, Bullard says that “A woman liked having a midwife around in such times as she would not only ease her pains during childbirth but will also comfort her in cases of still birth.” Through her accounts the reader gets to know about the multitude of tasks a midwife did in those days. Most tasks are medically related such as delivering babies, checking to see if a woman had gone into labor or if it was a false alarm, preparing the burial for still born babies or the woman who died in childbirth, making other medical calls, giving pills to the sick as well as looking for herbs that could cure some sicknesses. The tale of the midwife also is a rich source of information on the medical practices in the 18th century America such as the interest in homeopathic remedies and how the trained doctors and local healers interacted with one another. The importance of household work in the life of a midwife, the division of work according to gender and the female sub-economic system are other facts that we know about from her accounts. Martha’s account also lets us know that during those times a midwife should be summoned by the parents of the unborn child to be present at the birth. She herself says that she would not be present in the birth of a stranger’s kid. Also the midwives reputation spread by word of mouth and the good ones were recommended to others.
Although midwives were in great demand in the early days of America, their presence and necessity soon came under threat with the advance in modern medicine and science. Richard and Dorothy Wertz give an account of the history of midwives in America in their book, ‘Lying-in: A history of Childbirth in America’. In the book the readers are shown the importance that is given to the midwife as childbirth was more of a social event than anything else. Midwives were revered and their practices were not questioned. After their gradual demise over the centuries, they have now since come back to prominence with people trying out alternate practices of childbirth. “Very soon Americans will face the problems of excessive medical intervention during childbirth. Someday they might have to understand the problems of too much scientific advancement in childbirth.” The authors here talk about the resurgence of the midwives and how it is essential to bring back the age old traditions. The very fact that they successfully delivered thousand if not more number of babies without any formal training itself is a testament to their skills. The role of the midwife also started declining with the invention of the obstetric forceps. With this invention and a few more advances men believed that women could no longer learn these new techniques and slowly midwives disappeared for a while until their resurgence in this century.
Midwifery in the colonial times actually started with three births in the Mayflower in 1620. Bridget lee Fuller was the woman who acted as the midwife during these births ad she continued doing this even after setting foot in the New World. She went to deliver more babies and was a midwife for 44 years. The midwife not only had a respected position in American during these times but she also was a de facto physician. She not only offered her services during childbirth but also helped women with other gynecological problems. “During this period, the midwives were trained as apprentices by other midwives, were middle aged or slightly older. They also had kids of their own on top of running their houses. The midwife could also mix the medicines herself and take care of the sick.” Since the men of the household or any other man was not allowed inside the birth chambers during childbirth, the midwives had monopoly in matters of women’s health and childbirth. The matter of issuing a license to a midwife started in New York in the eighteenth century. Getting a license meant that the midwife was the servant of the state and had duties such as the keeper of civil and social order. This was equivalent to a registered nurse or a civil official. They had not only more duties but also more power. It also meant that their jobs were guaranteed by the state ad safe. The protestant church was also supportive to the midwives as they were alarmed at high level of infant mortality in some places. In such cases the midwives came under the control of the bishop.
Although accurate records of births and deaths were not kept, on historian made a note that the birth rate was successful for 95% of the time. Men did not attend childbirth during colonial times as it was considered indecent and also a woman’s affair. The less number of doctors present also ensured that midwives were popular. Not all midwives were famous or highly looked upon by members of the colonial society. Midwives who were present during the delivery of deformed or still born children were normally accused of witchcraft. The women who often went to midwives or the people who went to midwives were usually people from the lower classes or people who could not afford doctors. This was after the profession was taken over by men. When these people started going to midwives and healers instead of going to established physicians, the male doctors went against them. It was not only the men who were against these women but the church was not also favorable towards the midwives.
The importance given to women and their knowledge did not sit well with the established patriarchy and they were soon labeled as witches. “No one does more harm to the Catholic Church than midwives,” wrote witch-hunters Kramer and Sprenger. The reason why doctors were against midwives was because for every patient who saw a midwife there was a loss of a potential research subject for them. The loss of the privileges for the midwives and the eventual disappearance of women from this field meant that this trend continued on for a long time. The earlier privileged position they enjoyed were no longer available as they were seen as being ignorant. The midwives lost their position as favored medical practitioners thanks to a sustained effort by male doctors as well as the church. Religious beliefs along with the growth in medicine were responsible for the decline in midwifery. Where earlier there were no books, advancement in the field of medicine saw more books and the increase in number of qualified doctors.
Women have long been associated with medicine and childbirth. Although they had no degrees they went from home to home and town to town dispensing their medicinal knowledge and childbirth skills. Until this profession was taken over by men, midwives played an important role in the health of the women in early American society. Midwives were different from doctors in the sense that their job did not end with the birth of the child. They stayed with the mothers as long as they were needed and as the mother could raise her kids on her own. An example of how the medical profession was taken over by men can be seen in the book, ‘Outlines of the Theory and Practice of Midwifery’ by Alexander Hamilton. This book written by a man and details the intimate nature of a woman’s body and her reproductive organs. Although it is a medical book, the fact that it was written by a man and not a woman shows the decline of women in the field of childbirth. There are also instances where the doctor speaks disparagingly of the midwife and throughout the book the midwife is seen as a help and not as the chief player she once was. Hamilton describes a pregnancy, a rather difficult one in his book and says the following. “The midwife mistook the presenting part for the breech, and the pains after a few hours became strong and painful.” Although this is a description of just one pregnancy it is symptomatic of the position that midwives now enjoyed. It was that of an aide and not of a person who could conduct delivery of her own.
“The midwife was an accoucher and a general healer than a nurse. Sent for a woman who entered labor, she stayed trough the delivery and perhaps another day.” She was often seen as an herbalist and and all round healer. The quotes from the book, ‘Ordered to Care: The Dilemma of American Nursing, 1850-1945 by Susan Reverby again shows the nature of the midwife in the mid 19th century. She no longer stays with the new mother for as long as she is needed but she is slowly being used less. She is asked to come just for the delivery and asked to leave after that. A nurse or a wet nurse takes over the process after that. Any study about the midwives in early American history would be incomplete without the role played by the Native American midwives before the European arrival. “Early Native American women sought the assistance of midwives for prenatal and postnatal care before European contact in the fifteenth century. Midwives knew much about herb lore and attended to everyday healing. They were also skilled at delivering babies and performed a bloodletting technique called “lancing” among other forms of surgery.” As healers and teachers, midwives are often called the special people, women who are considered intermediaries between Mother Earth and the harmony and rhythm of the seasons, the bringers of life and continuity of the Native community and its culture.”
Thus from early native American society where midwives were treated as special women to early colonial history where they still had an important place to finally losing their position of importance after the advent of modern medicine and male doctors the history of midwives in Early American history has been chequered. Their stories and history has also served to inform readers about the history of modern medicine and medical practices. Except in Native American society midwives are no longer considered important in America. They still make an appearance but people would prefer to have their babied delivered by a doctor than by a midwife. However, all hope is not lost for the midwife as home births and water births are making a comeback. In the case of home birth, the woman can give birth with a licensed midwife attending to her. Midwives thus have had an eventful role to play in early American lives.

1. Richard Wertz and Dorothy Wertz, Lying-in: A History of Childbirth in America (Yale university press, 1989), 1.
2. Noralee, Frankel. “From Slave Women to Free Women:The National Archives and Black Women’s History in the Civil War Era,” Federal Records and African American History, 29, no.4 (1997).
3. Laurel Thatcher Ulrich, A Midwife’s Tale: The Life of Martha Ballard, Based on Her Diary, 1785-1812, (New York: Knopf, 1990).
4. Richard Wertz and Dorothy Wertz, Lying-in: A History of Childbirth in America (Yale university press, 1989), 9.
5. Heather, Whaley. “Colonial Midwifery”. (Accessed November 31, 2014).
6. Barbara, Ehrenreich, and Deirdre English. Witches, Midwives, and Nurses: A History of Women Healers. 2nd ed. Old Westbury, N.Y.: Feminist Press, 1973.
7. Richard Wertz and Dorothy Wertz, Lying-in: A History of Childbirth in America (Yale university press, 1989), 9.
8. Barbara, Ehrenreich, and Deirdre English. Witches, Midwives, and Nurses: A History of Women Healers. 2nd ed. Old Westbury, N.Y.: Feminist Press, 1973.
9. Hamilton, Alexander. Outlines of the Theory and Practice of Midwifery. A ed.Philadelphia: Printed by Thomas Dobson, Bookseller and Stationer, at the Stone House in Second Street., 1790.
10. Colonial midwifery. (Accessed November 31, 2014).
11. Hamilton, Alexander. Outlines of the Theory and Practice of Midwifery. A ed.Philadelphia: Printed by Thomas Dobson, Bookseller and Stationer, at the Stone House in Second Street., 1790.
12. Ibid
13. Susan, Reverby. Ordered to Care: The Dilemma of American Nursing, 1850-1945. Cambridge [Cambridgeshire: Cambridge University Press, 1987. 13-14,101-283.
14. Ibid
15. Elizabeth Gifford. The Importance of Midwives and Healers, From Martha Ballard to Mary Peterson: An Examination of the History and Cultural Significance of Midwifery and Healing in Native, European and American Societies.(Western Oregon University, 2003)
16. Ibid

Primary Sources
Ehrenreich, Barbara, and Deirdre English. Witches, Midwives, and Nurses: A History of Women
Healers. 2nd ed. Old Westbury, N.Y.: Feminist Press, 1973.
Hamilton, Alexander. Outlines of the Theory and Practice of Midwifery. A New ed.Philadelphia:
Printed by Thomas Dobson, Bookseller and Stationer, at the Stone House in Second
Street., 1790.
Ulrich, Laurel Thatcher. A Midwife’s Tale: The Life of Martha Ballard, Based on Her Diary,
1785-1812. New York: Knopf :, 1990.
Frankel, Noralee. “From Slave Women to Free Women:The National Archives and Black Women’s History in the Civil War Era,” Federal Records and African American History, 29, no.4 (1997).
Secondary Sources
Mays, Dorothy A. Women in Early America Struggle, Survival, and Freedom in a New World.
Santa Barbara, Calif.: ABC-CLIO, 2004.
Reverby, Susan. Ordered to Care: The Dilemma of American Nursing, 1850-1945. Cambridge
[Cambridgeshire: Cambridge University Press, 1987. 13-14,101-283.
Wertz, Richard W., and Dorothy C. Wertz. Lying-in: A History of Childbirth in America.
Expanded ed. New Haven: Yale University Press, 1989.
Colonial Midwifery. Retrieved from
Whaley, Heather. Colonial Midwifery. Retrieved from


Free Nutrition: Focusing On Children And Obesity Argumentative Essay Sample

We have all heard about the growing epidemic of obesity from our parents, teachers, and even our government. According to a recent study, about a quarter of two to five year olds and one-third of children are overweight or obese in the U.S. (Ogden et al., 2014). There is a wide array of factors which play a role in children becoming overweight or obese. Genetics, along with behavioral, social, cultural, environmental influences, can create an environment conducive for obesity. Environmental factors include great amount of exposure to advertising that encourages food consumption and promotes unhealthy foods, technological advances or increase in media use, limited access to safe recreational facilities, limited time for recess or physical activity in schools, and limited time for activity during the workday (FRAC, 2010). The socioeconomic status of families also plays a part in the obesity epidemic. According to one study, about thirty percent of low-income preschoolers are overweight or obese (Centers for Disease Control and Prevention, 2011). In accordance with the influences previously mentioned, the current high rates of children being obese or overweight are largely caused by behaviors made by the individual, along with environmental factors, that lead to a surplus of caloric intake and a poor amount of physical activity.
An increase in caloric intake can include over snacking, over indulging in sugary beverages, larger portions given by parents or restaurants, eating meals out instead of in the home, and the lower cost given to fast food chains making it more convenient for lower income families to purchase. Portion size has had a tremendous impact on obesity due to it drastically increasing within the past twenty years. For instance, years ago a 3-inch bagel was the average bagel size at 140 calories, and today a regular bagel is 6-inches and 350 calories (We Can! 2013). Recently, Michelle Obama attempted to create healthier plates, but her plan backfired and led to more than 1 million children declining to eat it, according to a recent report (Harrington, E. 2014). This new plan made things complicated; they included calorie ranges for each age group, sodium limits, zero trans-fats, and specific ounce amounts for meats and grains. The pros to this plan led to a withdrawal of unhealthy foods, such as pudding cups and potato chips. But with these new food options, combined with a lack of appeal, it led to kids taking the food but not eating it.However, what this report said was that, “Although school lunch participation has declined, it is likely that participation will improve over time as students adjust to the lunch changes” (Harrington, E. 2014).This report proved to be more of a trial and error than one of success. Even though it seemed like Michelle’s plan didn’t work out, there is something being done about the lunches in schools and advocators who will continue to try. Hopefully parents and children will come to understand that in order to be healthy, good nutrition must be woven into all expanses of one’s life, including school.

Negative Outcomes of Obesity
Being overweight or obese can be very dangerous and can have serious physiological, psychological and social concerns. Some of the most common physiological consequences of obesity are diabetes, high blood pressure, asthma, and iron deficiency; they all lead to a shorter life span for the affected person (FRAC, 2011).Of these physiological consequences diabetes is one of the most common and there are short and long-term complications associated with it. The short term consequences are hypoglycemia, ketoacidosis, and hyperosmolar hyperglycemic state (HHS) (, 2014). The long term consequences are being at risk for coronary heart disease, strokes, kidney disease, and diabetes also affects the eyes, digestion, skin, and the nerves of the body (, 2014). Having high blood pressure can quietly damage your body for years before symptoms develop. Left uncontrolled, you may wind up with a disability, a poor quality of life, or even a fatal heart attack (Staff, M. 2014). Complications with high blood pressure include; damage to your arteries, heart, brain, kidneys, and eyes, sexual dysfunction, bone loss, and trouble sleeping (Staff, M. 2014). With asthma, most people can have a normal life but will have to live and deal with the consequences paired with it. Asthmatics will have to carry around their inhaler, take a controller medicine each day, develop anxiety, stomach trouble, and may develop lung scarring (Bottrell, J. 2013). Iron deficiency can delay normal infant motor function or mental function, during pregnancy it can increase the risk of prematurity, and also iron deviancy can cause fatigue in adults and mental or memory function in teens (Stoppler, M. 2014).
With psychological concerns, some of the most common are depression, anxiety, low self-esteem, body dissatisfaction, and even substance abuse (FRAC, 2011). Depression can lead to a lot of different frightening side effects; suicide, addiction, self-injury, reckless behavior, relationship problems, health concerns, and even poor school performance (U Lifeline, 2014). Concurrently, anxiety causes all kinds of problems such as, panic attacks, heart disease, and gastrointestinal disorders (Health Harvard, 2008). When someone has low self-esteem, negative outcomes come easily create anxiety, stress, loneliness, relationship problems, job problems, and even increases the vulnerability to abuse or use drugs or alcohol (Self Esteem, 2013).Body dissatisfaction encompassesindividual factors including negative moods, dieting, and social withdrawal, body mass and pubertal status (Presnell, K. 2007). Lastly, substance abuse, which is considered a form of disease, has physical effects which consist of organ damage, hormone imbalance, cancer, pre-natal and fertility issues, gastrointestinal disease, and HIV/AIDS. These consequences can lead to long term neurological impairment and emotional effects (Summit Helps, 2014).
All of these physiological and psychological consequences are extremely serious and should not have to be dealt with at any age, but especially as a child. This is why it is so important to start teaching children to eat a balanced diet and give them the nutrients they need to live a long and healthy life. By giving them the tools they need to do so, these kids will have the knowledge for a lifetime and be able to grow and teach their kids and so forth. Being healthy does not have to be as difficult as some are making it out to be, and there are plenty of opportunities to achieve this.

Nutrition- What is it?
Hippocrates once said, “Let food be your medicine and medicine be your food” in regards to the significance of nutrition has on one’s overall health (Ladau, 2010). Nutrition is defined as “the study of food at work in our bodies, our source for energy, and the medium for which our nutrients can function” (Ladau, 2010). Nutrition has a huge influence on one’s life, making a lack of proper nutrition detrimental for people of all ages. Through receiving and applying accurate nutritional knowledge, one can achieve a positive health state. Ladau theorizes that health education and promotion may “be a key to avoiding obesity, illness and many of today’s most prevalent chronic diseases” (Ladau, 2010). From the beginning to the end of life, a proper balance of nutrients is crucial. Today, many parents struggle with what is nutritious for their children; as such, this lack of parental education regarding nutrition is leading to earlier illnesses in adolescents and teens.

Nutrition: What To Aim For
The essential macronutrients for life include carbohydrates, proteins, and lipids. Fiber, vitamins, minerals, and other micronutrients are also vital for development. Most importantly, adequate amounts of water must be present in the body, as it is the solvent for all soluble ingredients in the blood and cells (Ladau, 2010). Children lack both the access and the means of providing their own food, making it the parent’s responsibility to provide their child with a balanced diet. Below is a table that indicates the balance that needs to be used daily for childrenage’s two to three retrieved from the Nutrition Guide from Toddlers.
No matter what age, child or adolescent, there are five strategies parents can follow that will more than likely result in a nutritious diet. These five strategies for parents include “having regular family meals, serving a variety of healthy food and snacks, being a role model by eating healthy themselves, avoiding battles over food, and involving kids in the process” (Healthy Eating, 2014). Caretakers also need to understand the needs of the child, as the child’s needs are likely to be very different than their own. According to the Nutrition Guide above,toddlers, who are categorized as 9-12 months old to 4 years old, only need about 1,000-1,400 calories per day (Healthy Eating, 2014). Adults on the other hand typically need around 2,000 calories; maybe more depending on how active they are.

Diabetes Due to High Sugar Intake
We touched slightly on diabetes when we talked about the negative outcomes of obesity, but a problem of this severity must be further addressed. The WHO Global Strategy for the Prevention and Control of No communicable Diseases recognizes diabetes as one of its priority conditions. In a direct effort to understand diabetes in children, an examination of the link between nutrition in kids and diabetes is essential. Although the consumption of sugar is typically associated with diabetes, this is not necessarily the case. In fact, Type I diabetes is primarily genetic and caused by a few other factors that are not yet known (Sugars & Desserts, 2014). Type 2 diabetes is associated with being overweight; however, the American Diabetes Association supports research findings that have revealed an extremely strong correlation between excess sugar intake and diabetes (Sugars & Desserts, 2014).

Children with diabetes, or at risk for diabetes, must not only monitor their nutrition, but also face the challenging task of developing and sticking with healthy eating habits (Dowshen, 2013). Assessing the two main forms of carbohydrates (sugars and starches) play an essentialrole in understanding the nutrition in children with diabetes (Dowshen, 2013). According to KidsHealth, “the body breaks down or converts most carbs into glucose, which is absorbed by the bloodstream.” As a result, the glucose level increases in the blood, causing the pancreas to release a hormone called insulin; insulin is responsible for transferring glucose from the blood to the cells so it can be utilized as an energy source (Dowshen, 2013). Children with diabetes must follow a nutritional regimen that balances carbohydrates and other nutrients, while maintaining a high level of physical activity to aid in controlling blood sugar levels (Dowshen, 2013).
Overall, creating and maintaining a balanced healthy diet and lifestyle is not as difficult as some make it out to be. If the education is delivered and creativity is added, the only other piece left to add is consistency. There has been intense studies shown that too much sodium, sugar, or just eating the wrong foods and too much of them, can cause negative outcomes. Maladaptive nutrition triggers immense harm to our wallets and bodies. Obesity, heart disease, diabetes, and premature death among infants are only few of the many possible consequences. People must adapt to practicing healthier lifestyles, as it will allow them to live long, happy and healthy lives.

Health Care Costs
According to the World Health Organization, the United States spent 17.9% of their gross domestic product (GDP) on health care during the year of 2012. This worked out to be around 2.7 trillion dollars or 8,680 dollars for every person in the population (“Health Expenditures”, 2014). The majority of this money is going toward necessary, unpreventable health outcomes such as nursing homes, retirement homes, and hospital costs. However, there is a large chunk of the United States’ health care expenditure going towards conditions that are easily preventable by proper nutrition and exercise. Every person can justify the use of health care dollars on legitimate illnesses, but is it fair to have to step up and pay for people’s conditions that have developed because a lack of good care and/or education? The health care dollars going in to treat these diseases could better be used to promote and education of healthy behaviors.
Some may wonder how a child’s health behaviors play a role in this, for they have not developed these diseases yet. Many parents write off healthy eating for their children because they are facing many barriers such as resistance from the children, availability of healthy food, a busy lifestyle, and the influence of food advertising(Slater et. al, 2009). Children developtheir eating habits early on, making childhood a window of opportunity to instill healthy lifestyle values at a young age. Contrastingly, if negative eating habits are enforced during the childhood years, they typically continue on into adulthood. When this occurs on a large scale, you end up with a consistently large population of obese adults, which costs the health care system billions of dollars, not to mention all of the overweight adults being at high risk for early mortality and other serious diseases. These serious diseases also cost the health care system billions due to medication, hospital, and physician or clinical service costs. Components making up these costs involve things such as morbidity treatments, loss of productivity, and premature mortality (Colditz, 1999).

Potential Avenues for Intervention
Sugar-Sweetened Beverages
One of the largest culprits in childhood obesity is the overconsumption of sugar-sweetened beverages (SSB). A systematic review went so far as to conclude that SSB’s may in fact be the primary contributor to the childhood obesity epidemic (Malik, Schulze, & Fu, 2006). Over the last twenty years, Americans have substantially increased their carbohydrate consumption. The extra carbohydrates being consumed are largely in the form of added sugars (Malik et al., 2006). Fruit juices, carbonated beverages, sweet tea, specialty coffees, and vitamin water drinks are all considered to be sugar sweetened beverages, as they all contain unnatural amounts of added sugar. SSBs typically do not contain any nutrients that are beneficial for the body. In March 2010, the CDC released a report highlighting that 80% of America’s youth consumes SSBs on a daily basis and it is collectively accounting for 11% of their total daily caloric intake (CDC, 2010). This creates an array of problems, as SSBs have been linked to causing diabetes, dental problems, cardiovascular disease, and a numerous amount of other health issues. Most significantly, endless studies have proved that SSBs have a strong causal link to obesity, especially among children between the ages of 12 and 19 (CDC, 2010). As obesity rates increase among this sector of the population, interventions must be implemented to attack and decrease the consumption of SSBs.

Our Target: Parents
Children’s nutrition is heavily affected by their parents own nutrition habits, knowledge, decisions, and overall lifestyle (Oliveria et. al., 1992). A child’s nutrition is an important and multifaceted factor in improving his or her health. When analyzing the nutrition of a child, it is important to also look at the diet of the parents, as this has an effect on children. This is because they are the decision makers and the purchasers: what they say goes. Slater concurrently stated that, “parents are likely to be the most important influence in determining children’s nutrition and activity environment and habits” (Slater et. al., 2009). If the parents of the household lack the necessary awareness of what makes for a healthy lifestyle, then their children’s lifestyle will also reflect unhealthy behaviors, eventually leading to serious health problems.
In a study by Oliveria and colleagues, an associated link between nutrition of the parents and children is described with the following, “In this study, when both parents consumed a diet high in saturated fatty acids or dietary cholesterol their children were much more likely to consume such a diet” (Oliveria et al., 2013). Parents and their choice of a healthy or unhealthy lifestyle affects children through the repeated exposure to foods the parents promote. “Parents who promote foods with high nutritional value such as fruits and vegetables, are more likely for their children to accept these healthy foods influencing the children’s nutrition” (Lindsay, Sussner, Kim, &Gortmaker 2006 p. 173).
The two most important reasons why parents need to be targeted is because parents have the greatest influence on their children, and evidence regarding parents’ knowledge of nutrition has shown noticeable deficits. Throughout the remainder of the paper, the two greatest reasons why parents need to be targeted will be discussed, along with strategies to attain these health behavior changes among children. In the end, it will be evident the reason we have ranked parents as high as we have and how big of a role they play in their child’s lives.

Reasons to Target Parents

Free Nutrition: Focusing On Children And Obesity Argumentative Essay Sample

Low Knowledge
The largest and most apparent reason children’s nutrition is lacking is due to their low knowledge of nutrition, and this comes from their parent’s lack of nutrition knowledge.Therefore, in order to increase children’s good nutritional habits, we must take a look at how well parents are informed and how much they know about nutrition.There have been a small number of studies conducted to figure out how much parents know and why they do not know very much about nutrition. The two biggest reasons parents are lacking in this division is their socio-economic status (SES) and their education levels.
As teachers does not only work as an educators, but some of them also have children that makes it important for them to the values of high nutrition knowledge in order to pass down to their own children and the ones who sit in their classrooms each day.
In one study, performed by DorotaZarnowiecki and others, children were given a healthy food knowledge activity and parents completed questionnaires (Zarnowiecki, 2011). In their study of 192 children ages 5-6 years old and their parents, they found was that “Nutrition education for parents, targeted at low-SES areas at higher risk for obesity, may contribute to the development of healthy food knowledge in young children” (Zarnowiecki, 2011). These findings suggest that raising the awareness and understanding of nutrition values in low-SES populations and areas where parents are lacking high education will lead to a rise in nutrition knowledge. Therefore,by putting together effective behavioral advertising and having advocates check back to make sure progress is continuing and to push encouragement, their knowledge will continue to spread all over and obesity and other health issues won’t become such an issue in the years to come.
Stated perfectly from the article written by Zarnowiecki, along with others, is “Of the many factors that can influence eating behaviors, a lack of nutrition knowledge is one of the most amenable to change, and improving nutrition knowledge through nutrition education is a common component of obesity interventions” (Zarnowiecki, 2011). This quote can sum up the importance of why parents should be informed frequently and in depth about their knowledge about nutrition, along with increasing their children’s knowledge in order for their children and their selves to live a long, happy, and healthy life.

How to Target
As stated earlier that it is important for the parents to provide their children with proper nutrition, therefore it is important for them to target them. The parents can be targeted in different ways by using different means of media, i.e., television ads, magazine ads and health awareness through social media marketing, social organizations and other educational programs by schools. The use of these different means of advertisements will help to inform parents and educators regarding the nutrition diet and other health alarming factors that can affect the children.

Previous Researches
Several researches have shown the growing importance of nutritional education for the parents especially for the females who take better care of their children. According to Ira Wolinsky and Judy A. Driskell (2000), the parents must be informed through Nutrition and Education training programs, head start, and Special Supplemental Food Program for Women, Infants and Children, and National Institute of Health as these programs have proved to give more better education to the parents about the nutritional food for children that has also showed positive outcomes (Wolinsky and Driskell, 2000). According to a research by Bobbie Berkowitz and Marleyse Borchard (2009), has emphasized on the prevention strategies for obesity that include utilization of social learning theory that partners with the parents to inform them in engaging their small children to play different physical activities, assess the acceptance of the parents to achieve the change in life styles and parenting style that is important for obesity prevention, and use different counseling techniques which connects parents in a discussion regarding the behaviors which helps to prevent obesity, inform them regarding the strategies and opportunities for prevention, advise them different measures, develop an action plan, listen to the response of the parent and reflect the related challenges and outcomes (Berkowitz and Borchard, 2009). Similarly, a research by W. Douglas Evans, Katherine K. Christoffel, Jonathan W. Necheles and Adam B. Becker (2012) have emphasized on the use of online marketing mediums to inform target, i.e., parents regarding the reasons and poor dietary factors behind obesity in children. According to them, Social marketing is mainly used in the framework of obesity prevention measures that are community-based that helps to encourage behaviors like more child-parent communication which also contributes to improved family health. In addition, the research has also stated that the different social marketing efforts have also showed positive outcomes such as physical activity and nutrition messages marketed by the one percent milk campaign in the California, activities by the Centers for Disease Control and Prevention (CDC), “5-4-3-2-1 Go! Campaign” and “It’s What You Do campaign” etc have targeted parents (Evans, Christoffel, Necheles and Becker, 2012). Thus, different means are used to increase awareness regarding nutrition food to prevent obesity.

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Example Of Research Paper On Myths And Misinformation In Human Health And Disease

Example Of Research Paper On Myths And Misinformation In Human Health And Disease

Autism, Aspergers’s syndrome, and pervasive development disorders are conditions which affect children during their early childhood (Scahill & Bearss, 2009). These disorders are characterized by deficits in socialization and communication as well as unusual interests and repetitive behaviours (Scahill & Bearss, 2009). The aetiology of the diseases is yet to be fully elucidated and is the subject of myths, conjecture, and wide ranging debate. A debate about a possible link between autism and vaccines in a prime-time TV show and government settlements under the vaccine protection program are some of the recent events in relation to the issue (Scahill & Bearss, 2009). This paper will provide an overview of the issue and its relevance to the course. It will also describe the different perspectives to the debate and discuss my personal views on the issue.

Overview of the Issue and its Relevance to the Course
Currently, the prevalence of Autism is estimated to be 20 per 10 000 children. This prevalence rate is significantly higher to the pre-1980 rate which was only 4 cases per 10 000 children (Scahill & Bearss, 2009). The combined prevalence of Autism, Asperger’s syndrome, and pervasive development disorder (60 to 65 children per 10,000 children) is also much higher than previously recorded (Scahill & Bearss, 2009).
The debate about a link between vaccines and Autism is based on two contentions. The first proposal is based on the toxic effects of thimerosal which contains an ethyl mercury preservative. The second argument is hinged on the potential adverse effects of the mumps, measles, and rubella (MMR) vaccine (Scahill & Bearss, 2009). The vaccine and autism debate is about two decades old. By late 1996, the Autism epidemic had attracted the notice of many parents in the UK (Rimland, 2000). At that time, 150 families believed that the cause of Autism in their children was the MMR vaccine which was being given as a single shot as opposed to three separate vaccines (Rimland, 2000). Currently, a significant number of people still believe that vaccines cause autism. This is in spite of the fact that there is no scientific evidence on a relationship between Autism and vaccines (Woo et al., 2004). For example, only 15% of parents believe that vaccines are important (Woo et al., 2004).

The view that Vaccinations Cause Autism
Thimerosal, which is used to prevent bacterial contamination, is a mercury based preservative (“Study finds,” 2004). Mercury is known for its toxicity on the brains and nervous systems of fetuses and young children (“Study finds,” 2004). Thimerosal was, however, not an issue of safety previously because the amount in each vaccine was insignificant (“Study finds,” 2004). These days though thimerosal is an issue because the mercury administered to infants in their first months of life has tripled (“Study finds,” 2004). The increase in the mercury content of thimerosal has strengthened the belief that Autism is caused by this mercury (“Study finds,” 2004). This notion seems to be supported by statistics that indicate that the prevalence rate of autism during the 1980’s and early 1990’s was ten times less current figures (“Study finds,” 2004).

The View that Vaccinations do not Cause Autism
Findings from current studies suggest that Autism has a large hereditary component (Recame, 2012). Further, numerous studies have indicated that there is no link between vaccines and serious diseases (Recame, 2012). Shan (2011) also noted that there is no epidemiological study which supports the idea of an association between autism and MMR (Shan, 2011). There are, however, scientific studies which show no relationship between Autism and MMR triple vaccine. For example, a study in Japan showed that Autism rates are constantly increasing in spite of a decreased uptake of the MMR vaccine (Shan, 2011). Similarly in the USA, it has been seven years since thimerosal was removed from all vaccines other than the flu vaccine but the prevalence of Autism is still increasing (Gorski, 2007). Gorski (2007) also contended that the incident of Autism is higher in children born after 1992 who did not get the MMR vaccine than in children born before 1992 who got the MMR vaccine. McGuinness & Lewis (2010) attribute the increase in the number of Autism cases to heightened awareness on the disorder, availability of more treatment options, and reclassification of disorders.

Discussion on the Importance of Vaccines
Vaccines have saved millions of life in the world (McGuinness & Lewis, 2010). Because of them, the life expectancy of the society has increased and a huge burden of suffering and disability around the world eliminated (McGuinness & Lewis, 2010). Gorski (2007, p. 125). asserts that “vaccination is the most effective public health intervention ever developed.” He further contends that compared to the diseases that vaccines prevent, the risks due to vaccines are much lower (Gorski, 2007).Vaccines prevent health complications of diseases such as measles which causes encephalitis and seizures, mumps which causes testicular problems, and rubella which can result in birth defects including mental retardation (McGuinness & Lewis, 2010). Martin (2013) also noted that measles can cause pneumonia, meningitis, serious eye disorders, and even death. He further warns that if vaccinations are stopped, the diseases which are prevented by these vaccines will increase. Unvaccinated persons are at a high risk for contracting the measles virus which causes respiratory diseases, miscarriage, and even death (Recame, 2012). For instance, an estimated 200 000 people die from measles every year worldwide. Notably, postponement or avoidance of immunizations puts children as well as communities in danger of possible outbreaks (Recame, 2012).

There is no published evidence supporting a link between Autism and vaccines. In spite of this, many parents still believe vaccines can cause immune dysfunction, attention deficit disorder, and autism. Therefore, psychiatric nurses should educate parents with young children who have questions about autism and MMR vaccine and place emphasis on the importance of vaccination. Health care providers are in a position to provide appropriate information to parents who believe vaccinations can lead to autism.

Baker, J. (2008). Mercury, vaccines, and autism: One controversy, three histories. American
Gorski, D. (2007). Mercury in vaccines as a cause of autism and Autism Spectrum Disorders
(ASDS): A failed hypothesis. Scientific Review of Alternative Medicine,1123-1128.
Martin, J. (2013). Believe It. Practice Nursing, 24(5), 213.
McGuinness, T., & Lewis, S. (2010). Update on autism and vaccines. Journal of Psychosocial
Nursing & Mental Health Services, 48(6), 15-18. doi:10.3928/02793695-20100506-02
Recame, M. A. (2012). The Immunization- Autism Myth Debunked. International Journal of
Childbirth Education, 27(4), 76-78.
Rimland, B. (2000). The autism epidemic, vaccinations, and mercury including commentary by
Downing D. Journal of Nutritional & Environmental Medicine, 10(4), 261-269.
Scahill, L., & Bearss, K. (2009). The rise in autism and the mercury myth. Journal of Child &
Adolescent Psychiatric Nursing, 22(1), 51-53. doi:10.1111/j.1744-6171.2008.00152.x.
Shan, Y. (2011). Strategies to improve vaccination uptake rates. Primary Health Care, 21(2), 16-
Study finds no autism link to mercury in childhood vaccinations — findings are challenged.
(2004). HealthFacts, 29(1), 5-6.
Woo, E., Ball, R., Bostrom, A., Shadomy, S., Ball, L., Evans, G., & Braun, M. (2004). Vaccine
risk perception among reporters of autism after vaccination: Vaccine adverse event
reporting system 1990-2001. American Journal of Public Health, 94(6), 990-995.


Critical Thinking On Patient-Centered Model Medical Model Versus

Critical Thinking On Patient-Centered Model Medical Model Versus

Health care system remains an integral component in the society as it contributes in national development. It is within the facet of an effective health care system that a nation can realize its potential in production, technology advancement, trade and other economic sectors. It is clear that a healthy nation is more productive, innovative, and creative than unhealthy one because the former ensures that all citizens have access to quality, affordable, and reliable medical services. In order to achieve this goal, the federal governments has established more health care facilities and nursing homes, hired qualified and trained medical practitioners, and introduced technology. This move aims at reforming the health care system and ensuring that no patient dies from lack of quality medical services.
Over the years, people have had the notion that patients suffering from chronic and terminal illness should stay in nursing homes awaiting their death because they are considered useless and a burden to their families. Based on this aspect, many families have abandoned their patients in nursing homes and ignored the responsibility of taking care and supporting them morally. The act of abandoning the patient in long- term care facilities worsens the patient’s condition and affects the way a patient responds to treatment. On this premises, the government has reformed health care system by introducing patient-centered model in long- term care facilities so that to improve medical services (Brush, 2009). Patient centered model also known as medical home model provide patients with a home like environment, orient medical practitioners to patient’s needs, facilitate coordination of health care system and promote accessibility of medical care services.
In the last few years, long-term care facilities have been under intense pressure to change the traditional approaches, which employ medical care model, and instead employ patient –centered model that is more efficiency and cost effective. The federal government introduced Patient-centered model in 2007 and has continued to gain momentum in the last five years. Patient-centered model and medical care model differ in certain aspects, but they share similar constructs.

Patient-centered models is a medical approach that aims at providing comprehensive, coordinated, quality and continuous medical services to all patients and improve the outcome of the health care system. This infers that patient-centered model ensure that all patients have access to quality, reliable and affordable medical care services and orient doctors to the needs of the patients. Patient-centered model advocate that doctors rely on team-based perspective and involve medical practitioners with diverse and unique skills and knowledge in their respective profession (Earp, French, & Gilkey, 2008). This move aim at personalizing medical care services so that they meet the needs of the patient. On the other hand, medical model care advocates that a patient has no option of choosing a primary care giver, and instead should accept the one assigned by the hospital management. In other words, a patient has a designated health care provide who has been assigned the responsibility of coordinating, monitoring, and evaluating patient’s medical needs and treatment progress.
Patient-centered model provides comprehensive, coordinated, and continuous medical care services and serves patients of all ages. It is applicable to all people suffering from different illnesses and of different age. On the other hand, medical model care in long-term care facilities provide quality, affordable and reliable medical care services, but to patients suffering from either two or more chronic diseases or at a higher risk of developing chronic and terminal illness (Miller, 2010). It is also applicable to patients suffering from mental illnesses, and because of their medical condition requires intensive and coordinated care.
Patient-centered model employs medical practices, which are physician-based, and are offered by either a doctor or a qualified, trained and registered nurse. On the other hand, medical care model mainly integrate other practices such as community based health organization, counselors, addict service providers and other federal health agencies.

Both models have a common goal of maximizing the outcome of medical care services, and ensure that patients have access to quality, affordable and accessible medical services. Patient-centered model provide comprehensive primary care to all patients and has introduced the use of technology so that to attain this goal. In the same breath, medical care model articulate that all patients suffering from terminal and chronic illnesses have right for quality, accessible and affordable medical care services.
Both models employ medical practices, which are offered by qualified, trained, and accredited medical practitioners and health agencies. Patient-centered model is physician based as it involves nurses and doctors, and the same aspect applies in medical care model.


Acute Lymphoblastic Leukemia Treatment And Psychosocial Support Case Study Examples

Acute Lymphoblastic Leukemia Treatment And Psychosocial Support Case Study Examples

Jasmine is diagnosed with acute lymphoblastic leukemia (ALL), which is the most common form of pediatric cancers. It is caused by malignant transformations that occur in hematopoietic stem cells, making them undifferentiated cells with increased longevity. In ALL, those cells are called lymphoid cells, and their rate of proliferation causes fast growth and destruction of healthy bone marrow. Because of Jasmine’s age, the chances for an initial remission can be estimated at 95 percent (Rytting, 2012). However, achieving a complete cure is not a likely outcome, and an open and honest communication with Jasmine and her parents about her condition is required to prepare them for palliative and end-of-life care.
Even though the prognosis may appear favorable and the initial remission can alleviate the symptoms significantly, subsequent remissions are difficult to achieve and symptoms are reduced only for brief periods (Rytting, 2012). That means Jasmine’s treatment may be successful in the beginning, but the life-threatening nature of ALL indicates that her treatment can only be used to maintain her condition for up to three or five years (Rytting, 2012). With that in mind, it is also important to provide full psychological support to both Jasmine and her parents and prepare them for end-of-life care.
Jasmine will require palliative care, meaning the goal of the treatment is to alleviate symptoms and reduce suffering. The first step in planning palliative care is to assign a multidisciplinary team according to the requirements of Jasmine’s condition. Multidisciplinary teams in palliative care can consist of doctors, nurses, pharmacists, dietitians, psychologists, social workers, and chaplains (National Cancer Institute [NCI], 2012b).
In Jasmine’s case, doctors and nurses are required to manage the disorder by conducting assessments and interventions to maintain her physical quality of life as much as possible. However, psychosocial support in nursing interventions can also be beneficial when required by the patient or the patient’s family.
Grieving is the first diagnosis that can be established. Everybody experiences the stages of grief upon experiencing loss or expecting a loss, and the goal of the intervention is to allow the family to express their grief and share it together. The nursing intervention should educate the parents to participate in care, help them set realistic goals, and encourage them to accept individual reactions to their impending loss. That approach will maintain the psychological integrity of the family by increasing understanding among themselves and promoting acceptance of the situation. The evaluation of the intervention needs to be conducted by assessing the length of denial and depression stages before and after treatment.
The second diagnosis in Jasmine’s case is social isolation. With her condition, she will most likely experience feeling useless, have concerns for survival, and perhaps feel the desire for more social contact with her peers. The goal of the intervention is to identify ways she can improve her relationship with peers and find appropriate activities for entertainment. The intervention needs to identify Jasmine’s likes, hobbies, assist her in finding activities to feel fulfilled, and find ways to increase social relationships. By identifying those factors and strategies, Jasmine’s parents can help her work with specific goals to avoid social isolation or feeling useless. An evaluation can be made by talking to Jasmine about her feelings of uselessness and isolation and comparing her answers to the initial assessment.
The third diagnosis is depression. While depression is a part of grieving, it is also a specific stage because it can occur throughout the entire end-of-life care process. Some common characteristics of depression include anxiety, worry, guilt, and feeling worthless. The goal of the treatment is to improve the patient’s mood and prevent self-destructive behaviors. The intervention needs to accept the reality of the situation, but it also needs to include some cognitive-behavioral therapy (CBT) techniques. Because depression can induce self-destructive behavior, CBT needs to be used to avoid negative consequences and improve Jasmine’s mood. The evaluation of the treatment can be done by assessing the patient with standardized questionnaires.
One of the potential diagnoses is spiritual distress. After the initial stages of denial, the patient and her family may begin to question the credibility of their belief system and experience significant disturbances in their interpretation of the belief system. The goals of the intervention are to restore Jasmine’s and her parents’ original belief system to decrease their guilt and improve spiritual satisfaction. The nursing interventions should include the assessment of the family’s spiritual state and offer an open discussion on how stress can challenge personal values and beliefs. By discussing the topic with the patient and her family, they have the opportunity to maintain their spiritual values and beliefs, which can be useful when dealing with personal loss. Evaluation can be done with patient interviews before and after treatment.
Another potential diagnosis is powerlessness. Powerlessness can develop as the disease progresses. Jasmine’s parents will most likely face that problem as they realize how little control they have over the situation. Other signs of powerlessness may include apathy, resignation, anxiety, depression, or anger. The goal of treating powerlessness is to help her parents identify factors they can control and encourage them to make the decisions related to Jasmine’s treatment. The intervention should consist of enabling the parents to participate in care decision-making, allow Jasmine to express her needs, and establishing a care plan that takes in account the family’s values and psychosocial needs. The intervention is designed to promote synergy among family members because resignation of a single member can lead to lack of support and further issues. The evaluation can be done by interviews or standardized questionnaires for anxiety, depression, or hopelessness.
Psychologists and chaplains can be a part of the multidisciplinary team to provide emotional and spiritual support to the patient and her family. A chaplain can help people explore their beliefs and values or help them find meaning in life and help them understand the situation they are in (NCI, 2012b).
The pharmacologist needs to be a on the multidisciplinary team because Jasmine will receive several types of medication, and her medication intake needs to be monitored properly. In the late stages of palliative care, when death is near, the role of pharmacological interventions is to alleviate the symptoms and conditions that may arise. For example, acute uncontrolled pain and dyspnea can be treated with morphine or diamorphine while nausea or vomiting can be treated with cyclizine (Marie Curie Palliative Care Institute Liverpool [MCPCIL], 2012). In most cases, a pre-authorized care plan is used to allow the staff to administer subcutaneous injections because that approach ensures quick interventions to address symptoms and alleviate suffering as soon as possible (MCPCIL, 2012).
The psychologist working on the multidisciplinary team has to fulfill two roles. First, the parents will require support. Caring for family members is difficult, and without adequate social support, emotions such as worry and fear can induce high stress levels and various psychological challenges that undermine their own health (NCI, 2012b). Second, the parents need assistance in coping with the stages of grief. The psychologist needs to guide the parents through the stages of grief. If the psychologist can help them reach acceptance as soon as possible, they will be able to enjoy the rest of their time with Jasmine better. Jasmine also needs to be included in psychological support sessions because children can go through stages of grief like adults, and keeping her in ignorance about her condition will not enable her to accept the reality of her situation.
According to Kavanaugh (1974, p. 107), there are seven stages of grief, and each stage is characterized by distinct feelings and reactions to those feelings. In each stage, a person needs help to cope with a different type of emotion. The seven stages of grief include shock or disbelief, denial, bargaining, guilt, anger, depression, and acceptance.
Initial shock is the most common reaction to losing loved ones. For Jasmine’s parents, the shock stage has started from the moment they received the news about her condition. While in shock, people do not completely understand the situation and maintain a certain psychological distance from facts. They are most likely going to look for evidence that the information provided is not correct, attempt to undermine the diagnosis of ALL, or look for alternative solutions in finding a cure. However, open and honest communication with patients and their families is critical at this stage because discussing care options and realistic prognosis decreases stress and improves the patient’s ability to cope with the condition (NCI, 2012a). With an honest approach and support in palliative care, this stage can be overcome quickly.
The second stage of grief is denial. After the initial shock and disbelief, people are most likely going to have a hard time accepting reality. Another possibility is that they will refuse to address the situation. It is usually a short stage, but people who are in denial need appropriate support to help them overcome psychological defensive mechanisms. Otherwise, they will not overcome the denial stage and consciously resolve the underlying anger that is responsible for their reasoning. If people remain in the denial stage, they will be at risk for developing various psychological disorders, such as depression or posttraumatic stress disorder (Dryden-Edwards, 2012).
Guilt can sometimes overlap with denial, but it is categorized as a distinct stage of grief because the patients and their family respond differently to the situation. For example, Jasmine’s parents may experience guilt because they will consider themselves responsible for Jasmine’s condition. Jasmine can also experience guilt because she can observe the situation as her own fault. She can consider that she is being punished for something she had done. During this stage, psychosocial support is necessary to provide an alternative viewpoint to patients and their family. Psychosocial and spiritual support can help them understand that there is no correlation between Jasmine’s disease and their sense of guilt.
Bargaining follows guilt, and it is the last stage in which emotions connected to grief are dormant. Making peace with the reality of the situation is still not an option, and they will still desire control over the situation to change the outcome. Jasmine and her parents will most likely need spiritual support because of the correlation between dying and religion. Jasmine’s parents may bargain with God to exchange their own lives in exchange for her life. Jasmine can also resort to bargaining by promising to live a fulfilling and productive life in exchange for an extending her life. Resorting to prayer for finding peace and spiritual consultation for understanding the situation from a religious perspective may be a suitable role for the chaplain in the multidisciplinary approach.
Until a person reaches the fifth stage, the emotions are mainly an internal affair because the conflict among accepting reality, denial, and bargaining is taking place. In the anger stage, the emotions are no longer directed towards blaming oneself or suppressed. When people express their anger, the grieving process becomes an emotional manifestation. During this stage, people’s needs have to be acknowledged, and they should be encouraged to express their feelings. At the same time, they need to be aware of their anger and manage it properly because it should not become a destructive and chronic behavioral pattern. At this stage, it is dangerous to suppress anger because understanding it is required for transcending into the next stage.
Depression is rarely a separate stage because it can frequently manifest throughout the entire grieving process. Because it is a recurring process, it can be beneficial to address it at every stage. However, when observed as a separate stage, depression can be the consequence of anger. When the anger caused by loss is expressed and managed, depression becomes a dominant state. In a way, people accept that they are helpless, but they also fail to find meaning and purpose when observing their situation. Social isolation is a common occurrence in this stage, but mental disorder experts need to prevent that condition because it can lead to self-punishment and similar forms of behavior. Psychological and spiritual support can help people find meaning and achieve self-preservation in this stage.
Finally, when people reach the acceptance stage, they can accept the situation as it is. When they understand that the loss is beyond their control, they are able to recollect themselves and plan ahead in life. They are also no longer at risk of developing psychological disorders because of suppressed anger or depression. Even though Jasmine is still alive, she and her parents are already going through the grieving process because they understand the outcome of her disorder. Attending to their needs is required because it will help them improve the quality of the remaining time they have as a family.
After death, follow-up support is required because Jasmine’s parents may relapse into the initial stages of the grieving process, even if they have accepted the situation while Jasmine was receiving care. Psychosocial and spiritual support activities remain equally valuable after death as they are while coping with the dying process because they can protect the parent’s physical and psychological health. Going through the stages once again with expert guidance will help them cope with their loss, express their emotions, and reach acceptance.

Dryden-Edwards, R. (2012). Loss, grief, and bereavement. Medicine Net. Retrieved from
Kavanaugh, R. (1974). Facing death. New York, NY: Penguin Books.
Rytting, M. E. (2012). Acute leukemia. The Merck Manual. Retrieved from acute_leukemia.html
Marie Curie Palliative Care Institute Liverpool. (2012, October). Best care for the dying: Liverpool care pathway for the dying patient: Supporting care in the last hours of life. Retrieved from LCP%20Core%20Documentation.pdf
National Cancer Institute. (2012a). End-of-life care for people who have cancer. Retrieved from
National Cancer Institute. (2012b). Palliative care in cancer. Retrieved from
Törnebohm, E., Blombäck, M., Lockner, D., Egberg, N., & Paul, C. (1992). Bleeding complications and coagulopathy in acute leukaemia. Leukemia Research, 16(10), 1041-1048.


Example Of Research Paper On Nursing: Current Rural Health Issues In Florida

Example Of Research Paper On Nursing: Current Rural Health Issues In Florida

Part 1:
– Introduction

Part 11:
– Body

Part 111
– Conclusion

Leadership in nursing includes both formal and informal roles. Demonstrating nursing leadership includes initiating change to improve the health and wellness of a community. It does not entail being in a managerial position to effect change. As such, this presentation will encompass an evaluation of a community problem in Florida and presentation of a plan to address the issue.

Part 1: Introduction
Opa Locka is a rural community situated in Miami Dade country. It has a population of approximately 15,219 people according to the 2010 census bureau figures. There are 5, 207 housing units. 69.4% of the population is African Americans; 28.5% Hispanic; 22.8% white; 0.35% Native Americans and 0.21 Asians. A negligible percentage of 3.6 are of other unclassified ethnic orientation. Males have a media income of approximately $22, 347 annually while women annual median income is $19,270. Importantly, the dominant language spoken in this community is English accounting for 68%; next is Spanish 28.2%, French creole 2% and French 0.47% (US Census Bureau, 2010).
Significantly 32% of the population is below the standard poverty line. Of this amount 42% are under the age of 18 and 40% over age 65. Consequently, a 2013 Miami Times relating the crime rate in Opa Locka described the phenomenon as a plague, which is skinning the environment. Citizens are blaming the decline in police vigilance of the Opa Locka as being responsible (Godfrey, 2008).
Hence, escalating crime rate and poverty are the two major public health issues in this community. These insidiously contribute towards large populations of uninsured/underinsured persons in this rural landscape. It obviously exceeds the proportions observed in urban locations. In concluding my assessment using data derived from United States Census Bureau the visible problem was identified as poverty and crime which have a direct relationship to an uninsured status. Supporting data revealed that 42% of children in the community were below the poverty line and 40% age 65and over were experiencing the identical socio-economic difficulty. Opa Locka is the listed as 7th community with the highest rate of property crime in the country (Godfrey, 2008).

Part 11: Body
Paragraph 1
America’s healthcare system is one in which a citizen or resident must have health insurance to access healthcare. Due to unreasonable cost of health insurance some 60% of Americans are uninsured because they cannot afford to pay for health insurance. As such, in situations where poverty and crime intermingle it becomes even more difficult to find money for health insurance. Anthony R. Eves and Keith Mueller (2013) researched ‘State Health Insurance Exchanges: Assessing Rural Implications of Statutes.’ The researchers analyzed ‘how five characteristics of health insurance exchanges might address particular rural concerns’ (Eves & Muller, 2013, p.1). Five key characteristics identified, which could hinder insurance coverage of residents living in rural areas such as Opa Locka were market function; governance; enrollment; access standards and certifying qualified health plans (Eves & Muller, 2013). While these may appear remote to the real problem of predisposition of poverty and crime combination the usefulness lay in discerning that with poverty and crime people seldom gravitate towards providing for themselves in this way. It is striving for survival perhaps coping with incidences of jail terms and lack of eligibility to work legally. Therefore, making health insurance accessible to their needs is important. The truth is that health insurance plans are very expensive for the poor.

Paragraph 11
Erika C. Ziller, Jennifer D. Lenardson and Andrew F. Coburn(2011) highlighted some interventions which have been enacted to address this problem and presented them in a documentation entitled ‘Health Care Access and Use Among the Rural Uninsured’ (Ziller, 2011). Researchers admitted that being uninsured denotes poor access to healthcare. More importantly, access to quality health care is denied since Medicaid offers minimal access. Adults over 65 who have only Medicare part A and B without accompanying HMO coverage are at a greater disadvantage. Subsequently, researchers recommended that the Affordable Care Act (ACA) designate a further $8M towards resolving this issue (Ziller, 2011). Similarly, Jennifer King and George M. Holmes (2011) in their research highlighted ‘Recent Changes in Health Insurance Coverage in Rural and Urban Areas.’ These processes and polices have become ineffective since the unemployment escalating rates in America has pushed 5.6 million more people into becoming uninsured during 2007-2009. Therefore, uninsured in rural communities has reached epidemic proportions. In response there have been significant increases in coverage for children with Medicaid. Rural residents 65 years and older have been educated towards open enrolment periods when they can access supplemental coverage through HMOs (King & Holmes, 2011).

Paragraph 111
Ultimately, in discussing my analysis of this issue from the viewpoint of a nurse leader in the community with the aim of developing possible solutions is to first devise strategies for assisting Opa Locka residents find alternative employment beside crime. When residents are convicted of a crime they are denied access to employment. Therefore, upon release from prison they cannot function within the society in any other way but to pursue a crime career. The dilemma is poverty, crime, unemployment, crime, poverty. It is a misery go-round-cycle for this community. In taking steps to resolve the poverty/crime syndrome and consequences of being uninsured is accessing stake holder participation by approaching the mayor of Opa Locka with suggestions for. The psychology of crime and recidivism is not secret to the average American politicians. Perhaps, this is why more money is expended on building larger prison since once they keep doing the same thing the identical results will come forth. The only way to expect change is to change. People who are released from state prisons must be offered opportunities to positively synchronize with their communities. Depending on how long they are incarcerated when inmates leave the prison they learn skills, but few opportunities are thee to practice them. Therefore, the mayor must take personal interest in reforming Opa Locka by positively intervening in this dysfunction in an effort to resolve the issue.

Paragraph 1V
After addressing the poverty/crime abnormality, Keith J. Mueller, Andrew F. Coburn, Jennifer P. Lundblad, A. Clinton MacKinney, Timothy D. McBride, and Sidney D. Watson (2011) outlined ‘The High Performance Rural Health Care System of the Future.’ My leadership and management skills as a nurse could be employed to effect change in this situation by adapting their guidelines. These researchers identified affordability, accessibility, community focus, high quality, and patient centeredness as being the foundation of resolving uninsured issues within rural communities. As such, linking forces with community groups I would lead the way in designing projects where Opa Locka residents could be educated about affordable health insurance coverage; access to it their community bringing the services to them in their homes through a door to door intervention passing out pamphlets.
Part 111

Poverty and crime have been identified as being positively related in assessing uninsured status of Opa Locka residents. Research has revealed that even though residents have Medicaid and Medicare coverage lack of education on how they are applied to health care availability has limited access to quality care. Strategies to relive poverty and crime syndrome within the society have been advanced. Ultimately, as nurse leader in the community, I would design programs to educate resides pertaining to the availability of insurance service, which are accessible to them

Eves, A., Mueller, A. (2013). State Health Insurance Exchanges: Assessing Rural Implications
of Statutes. Rural Health Research and Policy Centers.
Godfrey, C. (January 30th 2008). Opa-locka Boots the Boss. Miami New Times.
King, J., & Holmes, G. (2011). Recent Changes in Health Insurance Coverage in Rural and
Urban Areas. North Carolina Rural Health Research & Policy Analysis Center
Mueller, K. Coburn, A. Lundblad, J. MacKinney, C. McBride, T., & Watson, S (2011).
The High Performance Rural Health Care System of the Future. Robert Wood
Foundation. Rural Policy Research Institute.
Ziller, E. Lenardson, J., & Coburn, A. (2011).Health Care Access and Use Among the
Rural Uninsured. Maine Rural Health Research Center


Nursing Research Document Epidemiology Of Asthma Research Paper Examples

Nursing Research Document Epidemiology Of Asthma Research Paper Examples

This research presentation consists of an in-depth study into a community public health problem derived from two separate epidemiological approaches. It is also written in two parts; namely Part I and I1.The goal, primarily, is to demonstrate the fundamental community health nursing skills involved in describing a population’s health problem using appropriate descriptive epidemiological straxtegies. Secondly, it encompasses applying statistical interpretations and Healthy People 2020 objectives. Thirdly it embraces analyzing the development of health problems integrating epidemiology and theoretical models for explanations. Fourthly, it affords community health practitioners the opportunity to identify levels of prevention when applied to the chosen health problem. Asthma has been the topic of choice for discussion in this research and will be thoroughly addressed based on the foregoing requirements.

Descriptive Epidemiology: Epidemiological Description of the Problem
Theoretical epidemiological approaches towards interpreting disease conditions occurring within communities fall into seven distinct phases; namely diagnostic, descriptive, investigative; experimental, analytical, interventive and decision making. (Putt et. al, 2008). Each has its unique relevance towards outcomes of the process.

Part 1 of this study on Asthma the writer will adopt the descriptive epidemiological approach into investigating the condition for the purpose of public health scrutiny. There are also three main types of studies into which these theoretical concepts can be integrated. Precisely, they are prospective, retrospective and cross-sectional. (Putt et. al, 2008).

For this descriptive analysis of Asthma, the author will adapt the theoretical cross-section model in accounting for the incidence and prevalence as it pertains to person, place and time. Supporting details will be cited from reliable sources in projecting the condition as not only a social problem, but more importantly a grave public health concern.

Identification and Description of Asthma as a Public Health Concern
Asthma has been described as a chronic inflammatory disorder affecting the respiratory tract and organs. It is characterized by hyper-responsiveness to stimuli and restriction of membranes and blood vessels within the system. It often manifests as wheezing, tightness of the chest, shortness of breath and a dry cough (Lyon-Callo et. al, 2000).

Figures derived from a study conducted in Michigan USA (Place) between 1990-1997(time) revealed that Asthma accounted for 10, 854 hospitalizations yearly, people ranging from the ages between 1-44. 56% of that population were whites (People). Further figures were indicative of a low mortality rate, generally, but even though more whites were affected, death rates among blacks were higher. Precisely, during this eight year investigation there were 47 children deaths between the ages of 1-14 and 323 adults between the ages of 15-44. ((Lyon-Callo et. al, 2000).

Globally, however, the incidence and prevalence of Asthma in relation to people place and time vary based on cultural adaptations. Dr’s Padmaja Subbarao, Piush J. Mandhane and Malcolm R. Sears (2009) of the Canadian Medical Association conducted cross- sectional studies to describe contemporary trends in the evolution of Asthma world wide. (Subbarao, 2009)

With regards to time, place and people as it relates to incidence and prevalence, these researchers discovered that the prevalence varies around the world largely due to environmental factors. This was shown to be occurring in many industrialized societies/ countries. However, higher mortality rates world wide were found among poorer countries. Importantly, the rising incidence among pregnant women and children presented great concerns. In 2005, 6 million children in United States alone were affected. (Subbarao, 2009).

Precisely, the problem is escalating among children who develop this symptoms from smoking mothers. According to Dr Subbarao (2009) ‘ the allergic sensitization, environmental tobacco smoke, exposure to animals, breastfeeding, decreased lung function in infancy, family size and structure, socio-economic status, antibiotics and infections, and sex and gender.’ (Subbarao, 2009) are all contributory factors which need to be considered.

Healthy People 2020 objective
The healthy people 2020 objectives embrace a number of guidelines applicable to controlling Asthma globally. Its intervention is expected to forge a better quality of life so that people could live longer through the implementation of public health policies that offer equal opportunities to every citizen on earth in accessing quality health care and emotional support.

Globally, as any other public health concern children mortality is of paramount public health significance since they are the population of tomorrow and valuable human resources. Therefore, when Healthy People Objectives are applied Public Health control of asthma, it is imperative that a holistic approach be tendered in lieu of isolated methods of intervention

Lyon-Callo S, Reeves M, Wahi R, Hogan J (2008) Epidemiology of Asthma Fact Sheet. Bureau
Of Epidemiology, Michigan Department of Community Health
Putt S, Shaw A, Woods A, Tyler L, James A. (2008) Veterinary Epidemiology and Economics
Research Unit. Department of Agriculture. Berkshire. University of Reading.
Subbarao P, Mandhane P, Sears M. (2009). Asthma: epidemiology, etiology and risk factors.
CMAJ. 181(9) E180-191

Analytic Epidemiology and Levels of Prevention
Analytical approaches to interpreting disease conditions occurring within communities are among seven other distinct theoretical concepts; namely diagnostic, descriptive, investigative; experimental, interventive and decision making. (Putt et. al, 2008). Each paradigm is important for adequate evaluation of any public health concern. However, for the purposes of this Part 11 segment of the research presentation, emphasis would be placed on analytic epidemiological theory perspective of Asthma

Application of statistical interpretations
Statistics have shown where in 2009, 300 million people were affected by Asthma internationally, with a subsequent mortality rate of 250,000 annually. Approximately 7% of the US population has developed the dysfunction according to 2009 statistics. In 2005, 22 million people were hospitalized with asthma.. Since then it has been accounting for more than 4,000 deaths annually. (Fanta, 2009).
Comparatively, in the United Kingdom 5% of its population are Asthmatics. From 2005 statistical knowledge some 261, 400 were newly diagnosed and a total 5.7 million people treated with 32 million prescriptions. (Simpson & Sheikh, 2010).

Statistical interpretation is highly suggestive of marked increases in the incidence and prevalence of asthma overtime within various sections of the world’s population among diverse groups of people. Precise analysis points to United States of America as having the most people affected. This has increased tremendously within the past two-three decades 1960-2008. (Fanta, 2009).

What does this mean to public health intervention? Is it that industalization has a negative impact on the health of people living in those societies. Another marked concern is that even when pollution of modern technology does not affect the comunity enough to create mortality from asthma attacks, people in poorer countries are still more likely to die from the condition compared to ones living in developed societies. These are the two pertinent issues facing public health practice as a discussion on levels of prevention is entertained.

Asthma: Control measures
With reference to Subbarao and others( 2009) ‘allergic sensitization, environmental tobacco smoke, exposure to animals, breastfeeding, decreased lung function in infancy, family size and structure, socio-economic status, antibiotics and infections, and sex and gender’ (Subbarao, 2009) were all contributory factors which need to be considered. These are very sensitive issues, which must be addressed at each level of intervention.

Theories pertaining to health promotion posit that the primary level from a community perspective focuses on prophylactic measures. This includes vaccination, healthy sanitation practices and environmental safety. So far there is no vaccine for asthma. Therefore, at this preventative stage the two other techniques to be employed are healthy sanitation practices and environmental safety.

From a secondary perspective education during prenatal management regarding smoking must be emphasized as community wide sensitization. If mothers do not smoke they should avoid being in the company of smokers too. Early screening, detection and treatment of the condition throughout all age groups is advocated.

At the tertiary level, hospitalization becomes inevitable and support measures must be available to guide asthma suffers into overcoming the condition and lead a normal life. Heartening reports are, despite the severity of the infection, children usually overcome this dysfunction by adulthood, once they survive. Most likely, adults who frequent hospitals have developed the chronic phase with associating Chronic Obstructive Pulmonary Disease (COPD) pathology. After hospital or nursing home discharge, emotional support becomes extremely necessary.

Statistically asthma can be considered to be moving towards pandemic proportions. Developed countries are most affect due to the impacts of industrialization. Poorer countries, however, tend to suffer from non-recovery due to, perhaps, poor sanitation, socio-economic issues; along with environmental pollutants. This is a public health concern requiring immediate intervention.

Fanta, C (March 2009). “Asthma.” New England Journal of Medicine 360 (10): 1002–14.
Putt S, Shaw A, Woods A, Tyler L, James A. (2008) Veterinary Epidemiology and Economics
Research Unit. Department of Agriculture. Berkshire. University of Reading.
Subbarao P, Mandhane P, Sears M. (2009). “Asthma: epidemiology, etiology and risk factors.”
CMAJ. 181(9) E180-191
Simpson C, Sheikh A (2010). “Trends in the epidemiology of asthma in England: a national study of 333,294 patients”. J R Soc Med 103 (3): 98–106


Sample Essay On Health Informatics

Sample Essay On Health Informatics


For a long time, stress management has not been considered a serious issue in health care. Much has not been done to help those who are affected by stress. In fact, these people have been subjected to theoretical counseling techniques that mostly do not offer the necessary solutions to stress management. However, this should be the right time that researchers and technology experts collaborated to come up with systems and equipments that offer the much needed relieve and solutions for stress patients. Nurses have for a long time borne the blunt of poor training and lack of enough equipment for handling these cases. (Jack Needleman, &, 2002)
Electronic biofeedback stress management systems should be incorporated with evidence based practices to ensure that patients receive up to date health care in this sector. Currently, stress has been treated by focusing on cognitive representations and habit memory systems which have proven hard when it comes following up on patient progress after treatment.
Combining biofeedback systems with evidenced-based practices, means that innovations will come up with a device that will be capable of regulating and reducing stress while relying on previous techniques that have proven to be successful. (Ann Hendrich, A., Marilyn P Chow, & Boguslaw A Skierczynski 2008) The device should not only offer real time up date of an individual’s stress levels but should also be able to relay the data it gathers about an individual to a healthcare institution information system where the patient receives regular health checkups. Once this information about an individual is relayed by the biofeedback device into the system, the system should be able to compare the information with other previous cases available.
Once this comparison has been done, the system should analyze the information and relay solutions to the patients through a notification on the device. If the system indicates the patients’ situation as critical, it should be able to notify the emergency department within the healthcare facility to immediately reach the patient and offer emergency treatment. This would be very effective especially for patients who suffer chronic stress. The device would provide them with information that would prevent severe medical complications as it will monitor the current body conditions and provide accurate information as to the most probable reaction by the body in the near future.
The device should automatically check for the patient’s body conditions after a reasonable amount of time say five minutes and use the data to determine what probable measures the patient should take. By using previous proven records of data, the chances of accuracy are high especially since most of the times the patient will be expected to offer self treatment as per the instructions relayed by the device.
This technology would reduce the burden placed on nurses to treat and advice stress patients as these techniques fail to address real time solutions for patients.

Ann Hendrich, A., Marilyn P Chow, & Boguslaw A Skierczynski (2008). A 36-Hospital Time and Motion Study: How Do Medical-Surgical Nurses Spend Their Time? Retrieved from
Jack Needleman, &, (2002, May 30). Nurse-Staffing Levels and the Quality of Care in Hospitals. Retrieved from
Haux, R. (2006). Health Information Systems – Past, Present, Future☆. International Journal of Medical Informatics, 75(3-4), 268-281.


Example Of Essay On Functional Health Assessment Pattern

Example Of Essay On Functional Health Assessment Pattern

In contemporary healthcare management, medical fraternity is using effective techniques of diagnosing and treating patients. One of such effective technique used in patient management is Functional Health Patterns Assessment sheet. This sheet aims at obtaining detailed and relevant information from patients themselves. In practice, assessment is carried out by focusing on specific aspects like patient’s metabolism, nutrition and psychological well being. Such specific aspects enable nurses to develop a comprehensive understanding of a patient in relationship to both the internal and external environment. With respect to nursing ethics, it is worth acknowledging the fact that information obtained from assessment of patients is restricted and confidential. Merva (2005) states that upon completion of these exercises, nurses will use information gathered in ascertaining both the short term and long term health problems faced by a given patient. Consequently, nurses will develop customized intervention measures aimed at remedying the patient from an underlying clinical condition.
In this paper, we will create a simulated functional health pattern assessment sheet in order to illustrate its purpose in analyzing patients. Based on the sheet’s technical outlook, we will explore both the actual and potential health problems associated with children during their development. The exercise will be a combination of the assessment sheet and Erikson’s concepts of human developmental stages. According to Moyet and Juall (2008), integration of the two aspects of health will facilitate development of a more comprehensive essay concerned with children’s general health patterns. Upon its completion, one can relate between age and potential health issues related to human development. In case there is a conspicuous pattern, we can consider proposing any potential remedies that will save children from health complications as a result of problems identified. In addition, thorough analysis of children in aspects of psychology and physiology will enhance further understanding of nutrition and exercise in individual health.

Children’s Functional Health Pattern Assessment
Short Answer Questions
Similarities and Difference in Assessment Outcomes
With respect to early stages of development, all children experience varied clinical problems resulting from fungal, bacterial or viral infections. Findings from the pattern of health perception and health management indicate that both pre-school aged and school aged children experience respiratory complications. In this context, the developing immune system in children below 12 years of age cannot fully defend minors from respiratory infections in cold weather. However, assessment on other aspects like cognitive development and self-perception yielded different outcomes. Erikson (2013) says that while toddlers are learning to develop self-esteem through pride, school-aged children are achieving their goals through already developed confidence. In this regard, assessment across the different stages of childhood development indicates certain similarities and differences in health issues. Differences in assessment outcomes signify that a child’s age acts as a pre-disposing factor to certain health problems. On the contrary, similarities show that the young immune system in minors suffers constant disturbances from disease causing microorganisms.

Children versus Adults in Medical Examinations
Pediatric nursing is totally distinct from adult nursing because of ethics related to cultural considerations. Rivera (2012) acknowledges that in most cases, children cannot make informed consent in medical examinations and education. Therefore, a nurse will have to approach medical communication with a child from a parental perspective. However, adults can be made to understand information that would be otherwise offensive to children, especially those of explicit nature. In this case, a nurse will strive to acquire a lot of information from an adult, as compared to that sourced from a child. This difference in quantity of information is attributed to the fact that adults can objectively speak for themselves, whereas children cannot fully represent themselves in medical procedures.

Erikson, E. (2013). Stages of social-emotional development-Erik Erikson. Retrieved from
Merva, K. (2005). The clinical and medical assessment. New York: Cengage Learning Publishers
Moyet, C. & Juall, L. (2008). Nursing Diagnosis: Application to clinical practice. Berlin: Lippincott Williams & Wilkins Publishing.
Rivera, T. W. (2012). Child and adolescent health and healthcare quality: Measuring what matters. Washington DC. National Academic Press.