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Gestational Diabetes and African-American Women
Comment by Sabina:
Gestational Diabetes is a diagnosis of diabetes during pregnancy. This diagnosis is usually obtained about the 24th week of pregnancy after taking a blood glucose test. A diagnosis of gestational diabetes does not mean the individual is going to become diabetic after pregnancy or was diabetic prior to pregnancy. Gestational diabetes is usually caused by the imbalance of hormones during pregnancy, along with other biological factors such as a decrease in pancreatic production of insulin. I will discuss how the diagnosis is obtained, how it is treated, medication that can be used, ethical and cultural affiliation with gestational diabetes. Finally I will also discuss some controversies surrounding this disease and how it impacts African-American females.
What is Gestational Diabetes?
According to American Diabetic Association (ADA, 2011) gestational diabetes affects about 4% of all pregnant women in the United States, about 135,000 women…
ADA (2011). What is Gestational Diabetes? American Diabetes Association. Retrieved from http://www.diabetes.org/diabetes-basics/gestational/what-is-gestational-diabetes.html
Anderwald et. al. (2011). Glucose absorption in gestational diabetes mellitus during an oral glucose tolerance test. Diabetes Care. 34 (7) 1475-1480
Bowers et. al. (2011). A prospective study of prepregnancy dietary iron and risk for gestational diabetes mellitus. Diabetic Care. 34 (7) 1557-1563
Costan, D.R. (2007). Pharmacological Management of Gestational Diabetes. Diabetic Care. 30 (2) 206-208
Gestational iabetes Mellitus: Implications for Pre-Screening and Type II
Gestational iabetes Mellitus
Implications for Pre-Screening in Type II
Screening of patients for the condition of "gestational diabetes mellitus" is considered to be an extravagance from the perspective of Lepercq (2004) who considered Universal Screening to be "contentious." However due to the 6.4% mortality rate due to untreated diabetes mellitus as well as the know birth defects and maternal health effects there are those who consider pre-screening for GM to be vital in terms of the health of the expected mother and expected child. There exist implications for the lack of prescreening in terms of ethical responsibility as well as in terms of costs realized in universal screening. Systemic study of this subject is necessary in understanding what the best practice in pre-screening actually is.
Gestational iabetes Mellitus
Implications for Pre-Screening in Type II
- Type 1 and Type 2…
Diagnosis of diabetes mellitus identifies those at risk of developing type 2 diabetes. "The uncertainty surrounding the level of glucose intolerance that should be treated as gestational diabetes is highlighted." McElduff (2003) A study conducted in relation to newly diagnosed diabetes mellitus and the symptoms or conditions to watch for states that: "Screening for diabetes makes good sense in particular in patients with overweight, hypertension ....For Type 2 diabetes is often not recognized until sequelae have put in appearance." Palitzsch (2004)
It is apparent that further study is needed in this area of pre- and peri-natal health care in order to provide the most ethical and superior care for expectant parents and expected children.
In a study entitled "Epidemiology of gestation diabetes mellitus and its Association with Type 2 Diabetes" states that in reality GDM or "Gestational
Gestational Diabetes Case Study
State the patient's chief complaint, reason for visit and/or the problem for which you are providing follow-up.
The client is a 30-year-old 27 weeks pregnant Hispanic-American woman in her third pregnancy. The client is married and has two children living at home and no history of miscarriage.
All symptoms related to the problem are described using the following cue descriptive categories:
Precipitating/alleviating factors (including prescribed and/or self-remedies and their effect on the problem).
The client denies any attempted self-remedies for her gestational diabetes mellitus (GDM), which is defined as experiencing intolerance to glucose that is initially identified during pregnancy (Jafari-Shobeiri & Ghojazadeh, 2015).
2) Associated symptoms
The client reports frequent urination and being thirsty much of the time which are both consistent with a diagnosis of GDM (Mcgill, 2015).
3) Quality of all reported symptoms including the effect on the patient's lifestyle
The client reports…
Jafari-Shobeiri, M. & Ghojazadeh, M. (2015, August). Prevalence and risk factors of gestational diabetes in Iran: A systematic review and meta-analysis. Iranian Journal of Public Health, 44(8), 1036-1041.
Liberatore, S. (2009, September). Q: What causes diabetes, and how does it affect a person's health? The Science Teacher, 76(6), 68.
Malmqvist, E. & Jakobsson, K. (2013, April). Gestational diabetes and preeclampsia in association with air pollution at levels below current air quality guidelines. Environmental Health Perspectives, 121(4), 488-491.
McGill, N. (2015, March). Gestational diabetes: A risk during pregnancy. The Nation's Health, 45(2), 20.
Gestational Diabetes Amongst North American Pregnant Mothers: esponses
Crowther, Hiller, Moss et al. (2005) show that "treatment of gestational diabetes reduces serious perinatal morbidity" -- more so than simple routine care, so that was an interesting discovery based on the questions posed by Nelson and isa. The fact that gestational diabetes does affect both the mother and the embryo/fetus is indeed troubling -- and it got me thinking about how the interventions impacted both. After reviewing the study by Crowther, Hiller Moss et al. (2005), however, I was interested in seeing what other studies showed about the relationship between gestational diabetes, fetal growth, and treatment.
The study by Catalano, Kirwan, Mouzon and King (2003) confirmed the assertion of Nelson and isa that there is increased risk for the offspring, especially if there is evidence of pregestational diabetes. What was one consolation however was the finding within the same study that…
Catalano, P, Kirwan, J., Mouzon, S., King, J. (2003). Gestational diabetes and insulin resistance: Role in short- and long- term implications for mother and fetus. The Journal of Nutrition, 133(5): 16745-16835.
Crowther, C., Hiller, J., Moss, J. et al. (2005). Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. The New England Journal of Medicine, 352: 2477-2486.
Reece, A. (2010). The fetal and maternal consequences of gestational diabetes mellitus.
The Journal of Maternal-Fetal & Neonatal Medicine, 23(3): 199-203.
Another author notes, "African-American women are at an increased risk for developing gestational diabetes, experts say. Much like other forms of diabetes, gestational diabetes affects the way your body uses blood sugar (glucose). In the case of gestational diabetes, your blood-sugar level is too high" ("Exercise & pregnancy," 2006). Women suffering from gestational diabetes are also more prone to suffer from toxemia, as well. Another writer states, "Compared with women who don't have diabetes, women with diabetes are up to five times more likely to develop toxemia, a disorder marked by hypertension, protein in the urine, swelling, headache, and visual disturbances" (Meadows, 2001, p. 7). Exercise has proven to help remove the risk of gestational diabetes in some women, especially those who are overweight when they become pregnant.
Fortunately, for the women who find themselves suffering from gestational diabetes, there are ways to control or manage the disease. Gestational diabetes…
Exercise & pregnancy: Staying fit through the nine months. (2006, May). Ebony, 61, 100+.
Gestational diabetes. (2007). Retrieved 19 Nov. 2007 from the American Diabetes Association Web site: http://www.diabetes.org/gestational-diabetes.jsp .
Lewis, C. (2002, January/February). Diabetes: A growing public health concern. FDA Consumer, 36, 26+.
Meadows, M. (2001, November/December). Encouraging women to take charge of diabetes: About 8.1 million women in the United States have diabetes, and one-third of them don't know it. FDA Consumer, 35, 7.
Screening for Gestational Diabetes
Gestational diabetes mellitus (GDM) is caused by the development of glucose intolerance during pregnancy (National Institutes of Health 2013). In the United States the National Institutes of Health (2013), U.S. Preventive Services Task Force (2008), and the American Diabetes Association (2013) are just a few agencies and organizations who have weighed in on this topic. Elsewhere, the Cochrane Systematic eviews (Tieu et al. 2010) and the World Health Organization (WHO 2013a) have also published their recommendations. Despite the overwhelming number of recommendations concerning GDM, the best GDM screening protocols, diagnostic methods, and treatment approaches remain controversial.
To better understand recommended best practices for GDM care this proposal will first examine what is known about this disease and then review the evidence-based rationales underlying current recommendations. Particular attention will be paid to the health care challenges facing emerging developed nations, in particular Saudi Arabia.
ACOG (2013) 'Practice Bulletin No. 137: Gestational Diabetes Mellitus'. Obstetrics and Gynecology 122(2), 406-16
Al-Daghri, N.M., Al-Attas, O.S., Alokail, M.S., Alkharfy, K.M., Yousef, M., Sabico, S.L., and Chrousos, G.P. (2011) 'Diabetes mellitus type 2 and other chronic non-communicable diseases in the central region, Saudi Arabia (Riyadh cohort 2): A decade of an epidemic'. BMC Medicine 9(1), 1-6
Alto, W.A. (2005) 'No need for glycosuria/proteinuria screen in pregnant women'. Journal of Family Practice 54(11), 978-83
American Diabetes Association (2013) 'Standards of Medical Care in Diabetes -- 2013'. Diabetes Care 36(suppl. 1), S11-66
Gestational diabetes mellitus (GDM), glucose intolerance recognized during pregnancy, affects approximately 7% of all pregnancies in the United States. GDM, diagnosed by an abnormal oral glucose tolerance test (OGTT) done during the second trimester. Women diagnosed with GDM are at a high risk of developing type 2 diabetes, cardiovascular disease, and hypertension. With this prevalence, the American Diabetes Association (ADA) has recommended screening women with GDM 6-12 weeks after delivery, which roughly coincides with the timing of their first postpartum visit. For almost 90% of women diagnosed with GDM, glucose intolerance will resolve immediately after delivery, but their risk of developing type 2 diabetes mellitus is 35% to 60%. There is also a likelihood of the woman adversely affecting their future offspring when they become pregnant again with undiagnosed type 2 diabetes mellitus or they experience recurrent GDM. There is a need to analyze the factors contributing to and…
Bandyopadhyay, M., Small, R., & Davey, M.-A. (2015). Attendance for postpartum glucose tolerance testing following gestational diabetes among South Asian women in Australia: A qualitative study. J Womens Health Issues Care, 4(1), 1-8.
Carson, M. P., Morgan, B., Gussman, D., Brown, M., Rothenberg, K., & Wisner, T. A. (2015). SUGAR: spotting undiagnosed glucose abnormal results—a new protocol to increase postpartum testing among women with gestational diabetes mellitus. American journal of perinatology, 32(03), 299-306.
Carter, E. B., Martin, S., Temming, L., Colditz, G., Macones, G. A., & Tuuli, M. G. (2018). Early versus 6–12 week postpartum glucose tolerance testing for women with gestational diabetes. Journal of Perinatology, 38(2), 118-121.
Cho, G. J., An, J.-J., Choi, S.-J., Oh, S.-y., Kwon, H.-S., Hong, S.-C., & Kwon, J.-Y. (2015). Postpartum glucose testing rates following gestational diabetes mellitus and factors affecting testing non-compliance from four tertiary centers in Korea. Journal of Korean medical science, 30(12), 1841-1846.
Korpi-Hyövälti, E., Laaksonen, D. E., Schwab, U., Heinonen, S., & Niskanen, L. (2012). How can we increase postpartum glucose screening in women at high risk for gestational diabetes mellitus? International journal of endocrinology, 2012.
Man, B. (2016). Diabetes Screening in US Women with a History of Gestational Diabetes. Division of Epidemiology and Biostatistics Michelle A. Kominiarek ….
Rosenbloom, J. I., & Blanchard, M. H. (2018). Compliance with postpartum diabetes screening recommendations for patients with gestational diabetes. Journal of women\\'s health, 27(4), 498-502.
Shah, B., Lipscombe, L., Feig, D., & Lowe, J. (2011). Missed opportunities for type 2 diabetes testing following gestational diabetes: a population?based cohort study. BJOG: An International Journal of Obstetrics & Gynaecology, 118(12), 1484-1490.
Diabetes in Australia
The Australian government and the relevant Health agencies have for many years strived to put the diabetes menace under close observation and management. There have been massive researches and huge sums directed towards good management and possible elimination of diabetes at the national levels. This commitment is exhibited by the specialized funds and efforts like the Juvenile Diabetes esearch Fund (JDF) that has been committed to striving to mitigate the effects of diabetes from the render age of the Australians.
Since diabetes is such a big challenge to Australia as a whole, diabetes mellitus was declared a National Health Priority Area in 1996 during the Australian Health Minister's Conference and this was as recognition to the high levels of diabetes prevalence within Australia, the mortality rates that were due to it, the impact it had on morbidity and the possibility of the health improvements that can be…
American Diabetes Association, (2013). Kidney Disease (Nephropathy). Retrieved May 13, 2013 from http://www.diabetes.org/living-with-diabetes/complications/kidney-disease-nephropathy.html
Australian Government, Department of Health and Ageing, (2012). Diabetes. Retrieved May 13, 2013 from http://www.health .gov.au/internet/main/publishing.nsf/Content/pq-diabetes
Australian Institute of Health and Welfare, (2011). Diabetes Prevalence in Australia Detailed estimates for 2007 -- 08. Retrieved May 13, 2013 from http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=10737419307
Baker IDI, Heart & Diabetes Institute (2013). Diabetes: The Silent Pandemic and its Impact on Australia. Retrieved May 13, 2013 from http://www.diabetesaustralia.com.au/Documents/DA/What%27s%20New/12.03.14%20Diabetes%20management%20booklet%20FINAL.pdf
However, advancements in pharmacogenetics promises new and better ways of managing diabetes. Studies have shown that Lisofylline, an anti-inflammatory compound is very effective in suppressing the autoimmune activity and in improving the islet secretion of insulin. Mice studies showed significant difference (25% vs. 91.6%) in the onset of diabetes among Lisofylline treated mice compared to placebo mice. Reduction of inflammatory cytokines IFN-? And TNF-? levels correlated with reduction in ss cell apoptosis. [Yang et.al, 2003] Recent study by Lipsett et.al (2007) has shown that Islet Neogenesis-Associated Protein (INGAP) is useful as a pancreatic regeneration agent. Successful tests in mice and regeneration of cultured human pancreatic cells have encouraged the researchers to seriously consider INGAP as an effective agent for improving insulin synthesis. [Lipsett et.al, (2007)]
A recent Cornell University study focused on an entirely different approach to diabetes management. The researchers examined the possibility of recombinant Commensal bacteria engineered to…
1) George S. Eisenbarth, (2007) 'Update in Type 1 Diabetes', The Journal of Clinical Endocrinology & Metabolism Vol. 92, No.7. http://jcem.endojournals.org/cgi/content/full/92/7/2403
2) McGill University, 'Deficient Regulators in the Immune System Responsible for Type 1 Diabetes', Updated 25 Jan 2008, Available at, http://www.sciencecentric.com/news/article.php?q=08012539
3) Kent SC, Chen Y, & Bregoli L. et.al (2005) 'Expanded T cells from pancreatic lymph nodes of type 1 diabetic subjects recognize an insulin epitope'. Nature 435:224 -- 228
4) Mathieu C, Gysemans C. et.al (Jul 2005), 'Vitamin D and Diabetes', Diabetologia. 48(7):1247-57
What is Diabetes?
Clinical Practice ecommendations
Diabetes is considered to be a chronic disease which really needs some kind of long-term nursing and medical intermediations. esearch shows that patients likewise need to take a part that is active in their own treatment and management, and the alter their lifestyles in order to keep their metabolic state at a level that is normal (Sperl-Hillen, 2010). One of the transformations in education is recognized as being electronic learning. This technique is interesting because it has all of these unique features which users are interested in using, and has made it possible to learn anywhere. It facilitates individual as well as group learning, and makes it conceivable to familiarize the material as stated by the users' needs. However, in the last 10 years, it has been very obvious that the Internet has turned out…
EIJJ, V. (2009). Interventions for improving adherence to treatment recommendations in people with type 2 diabetes mellitus. The Cochrane Library, 44(8), 1-44.
Marjatta Kelo, M.M. (2011). Self-care of school-age children with diabetes: an integrative review. JOURNAL OF ADVANCED NURSING, 2096-2105.
Marzieh Moattari, M.H. (2012). The impact of electronic education on metabolic control indicators in patients with diabetes who need insulin: a randomised clinical control. Journal of Clinical Nursing, 22, 32 -- 38.
Sperl-Hillen, J. (2010). Are benefits from Diabetes Self-Management education Sustained? American Journal of Managed Care is the property of Intellisphere, 104-113.
Untreated diabetes can result in serious deterioration of the circulatory system as a consequence of long-term exposure to elevated blood glucose levels (NIDDKD, 2006). By monitoring blood glucose levels and administering insulin to reduce glucose concentration in the blood, many patients can carry on with their lives without significant effects of the disease (ADA, 2009).
However, undiagnosed or untreated diabetes can have very serious effects on the body and consequences for the patient. Among those effects and consequences are kidney damage, cardiac and circulatory system damage, as well as vision problems leading to increasing blindness (ADA, 2007; ADA, 2009). Because untreated or insufficiently managed diabetes often results in decreased circulation to the extremities, diabetes is also associated with the significant risk of losing fingers, toes, and even arms or legs. Once circulation is reduced below the minimum level required to oxygenate tissues enough to sustain them, the patient is at…
American Diabetes Association. (2007). "Diabetes and women's sexual health"
Retrieved July 31, 2009, from: http://www.diabetes.org/type-1-diabetes/women-sexual-health.jsp .
American Diabetes Association. (2009). "Standards of medical care in diabetes"
Retrieved July 31, 2009, from:
NR 601 Week 5 Case StudyNR 601 Week 5 Case StudyThe World Health Organization (WHO) defines diabetes as a disease that affects the bodys ability to prepare or produce the hormone insulin, resulting in abnormal metabolism of blood glucose and elevated levels of the same in the blood (WHO, 2021). When an individual has diabetes, their body either does not make sufficient insulin or fails to make use of insulin as it should, causing elevated levels of blood sugar in the bloodstream. There are three types of diabetes: Type 1 diabetes, Type 2 diabetes, and Gestational Diabetes (CDC, 2020). The Center for Diseases Prevention and Control (CDC) estimates that 34 million (representing 1 in every 10) Americans have diabetes, and 90-95 percent of these patients have Type 2 diabetes (CDC, 2020). The high prevalence of diabetes calls for adequate understanding on the part of healthcare providers to ensure effective diagnosis…
ReferencesADA Standards of Medical Care (2021). Standards of Medical Care in Diabetes 2021 Abridged for Primary Care Providers. American Diabetes Association. Retrieved from https://clinical.diabetesjournals.org/content/diaclin/early/2020/12/02/cd21-as01.full.pdfBibiloni, M., Salas, R., Garza, Y., Villareal, J., Sureda, A., & Tur, J.(2016). Serum Lipid Profile, Prevalence of Dyslipidemia and Associated Risk Factors among Northern Mexican Adolescents. Journal of Pediatric Gastroenterology and Nutrition, 63(5), 544-49.Bigelow, A., & Freeland, B. (2017). Type II Diabetes Care in the Elderly. The Journal for Nurse Practitioners, 13(3), 181-86.CDC (2021). Diabetes Symptoms. Center for Diseases Prevention and Control (CDC). Retrieved from https://www.cdc.gov/diabetes/basics/symptoms.htmlCDC (2020). What is Diabetes? Center for Diseases Prevention and Control (CDC). Retrieved from https://www.cdc.gov/diabetes/basics/diabetes.htmlFDA (2017). Glucophage. Food and Drug Administration (FDA). Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/020357s037s039,021202s021s023lbl.pdfGalicia-Garcia , U., Benito-Vicente, A., Jebari, S., Larrea-Sebal, A., Siddiqi, H., Uribe, K., Ostolaza, H., & Martin, C. (2020). Pathophysiology of Type II Diabetes Mellitus. International Journal of Molecular Sciences, 21(17), 6275-81.Hill, M., & Bordoni, B. (2021). Hyperlipidemia. Treasure Island, FL: Statpearls PublishingHuang, W., Xu, W., Zhu, P., Yang, H., Su, L., & Tang, H.(2017). Analysis of Blood Glucose Distribution Characteristics in a Health Examination Population in Chengdu (2007-2015). Medicine, 96(49), Doi: 1097/MD.0000000000008765Molugulu, N., Yee, L., Ye, Y., Khee, T., Nie, L., Yee, N., Yee, T., Liang, T., & Kesharwani, P. (2017). Systematic Review of Metformin Monotherapy and Dual Therapy with Sodium Glucose Co-Transporter 2 Inhibitor (SGLT-2) in Treatment of Type II Diabetes Mellitus. Diabetes Research and Clinical Practice, 132(1), 157-68.NIH (2021). Diabetes Tests and Diagnoses. National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved from https://www.niddk.nih.gov/health-information/diabetes/overview/tests-diagnosis#whichtestsPiva , S., Susko, A., Khoja, S., Josbeno, D., Fitzgerald, G., & Toledo, F. (2015). Links between Osteoarthritis and Diabetes: Implications for a Physical Activity Perspective. Clinical Journal of Geriatric Medicine, 31(1), 67-87.Storey, H. L., Pelt, M., Bun, S., Daily, F., Neogi, T., Thompson, M., McGuire, H., & Weigl, B. (2017). Diabetes and Endocrinology, 8(3), 1-8.WHO (2021). Diabetes. World Health Organization (WHO). Retrieved from https://www.who.int/health-topics/diabetes#tab=tab_1
Diabetes and Thyroid
What is the mechanism of action of insulin and what are the differences in insulin therapy for Type I and Type II diabetes mellitus?
The pancreas secretes insulin, and it is used for the regulation of glucose from the blood into the cells. Insulin assists in lowering blood glucose by causing peripheral glucose uptake by skeletal muscle cells. The breakdown of fat, proteins, and manufacture of glucose is inhibited by insulin. Insulin will also increase protein synthesis and the conversion of excess glucose to fat. Patients suffering from diabetes are not able to produce enough insulin, and this leads to hyperglycemia. Insulin therapy for type I diabetes mellitus is aimed at increasing or providing insulin in the patient's body (Trauner, ichert, & Luddeke, 2013). For type II diabetes, insulin therapy is aimed at controlling blood sugar, increasing insulin levels, and lowering the patient's resistance to insulin.…
Kahn, S.E. (2013). Incretin therapy and islet pathology: a time for caution. Diabetes, 62(7), 2178-2180.
Reinehr, T. (2010). Obesity and thyroid function. Molecular and cellular endocrinology, 316(2), 165-171.
Stohl, H.E., Ouzounian, J., Rick, A.-M., Hueppchen, N.A., & Bienstock, J.L. (2013). Thyroid disease and gestational diabetes mellitus (GDM): is there a connection? The Journal of Maternal-Fetal & Neonatal Medicine, 26(11), 1139-1142.
Trauner, A., Richert, K., & Luddeke, H.-J. (2013). Start of an insulin therapy in type 1 diabetes patients. Diabetes aktuell fur die Hausarztpraxis, 11(06), 248-252.
Diabetes and Drug Treatments
TYPE II DIABETES AND DUG TEATMENTS
Type I Diabetes
Diabetes mellitus type 1 result from autoimmune destruction of insulin-producing beta cells within the pancreas. Subsequent shortage of insulin translates to increased urine and blood glucose. The developed world is associated with increasingly variant type I diabetes with a large cause of kidney failure and non-traumatic blindness. The link is based on an increased dementia and cognitive dysfunction risk through disease processes of vascular dementia and Alzheimer's disease. The complications are inclusive of sexual dysfunction, acanthosis nigricans, and frequent infections (Jones, et al., 2012).
Type II Diabetes
The classic diabetes symptoms include polyuria (frequent urination), increased thirst, increased hunger (polyphagia), and weight loss. Alternative symptoms commonly presented in the diagnosis include histories of blurred vision, fatigue, recurrent vaginal infections, peripheral neuropathy, and itchiness (Barnett, 2012). However, many people lack symptoms in the initial years and while…
Barnett, A. (2012). Type II Diabetes. New York: OUP Oxford.
Ezrin, C. & Kowalski, R. (2011). The Type 2 Diabetes Diet Book, Fourth Edition. McGraw Hill Professional
Jones, R. M. et al., (2012). New Therapeutic Strategies for Type 2 Diabetes: Small Molecule Approaches. New York: Royal Society of Chemistry
Pereira, M. A. (2013). Nutrition and Type II Diabetes: Etiology and Prevention. New York: CRC Press.
In many clinical practice situations, research and use of current evidence is neither prized nor supported as part of the nursing culture. One of the earliest and best-known nursing research utilization activities was the Conduct and Utilization esearch in Nursing project, awarded to the Michigan Nurses' Association by the Division of Nursing in the 1970s for a five-year study. The major objective of the project was to increase the use of research findings in the daily practice of registered nurses by disseminating research findings, facilitating organizational changes needed to implement innovations and encouraging collaborative clinical research (Polit, 2004, p. 676).
Many models for nursing research utilization have emerged since the 1970s. These various models developed from efforts to use or disseminate nursing research and ultimately improve patient outcomes. The first research utilization model was developed in the 1970s with the Western Interstate Commission for Higher Education in Nursing egional Program…
Cormack, D. (2006) Research Process in Nursing. New York: Blackwell
Ervin, N.E. (2002). Evidence-based nursing practice: Are we there yet? The Journal of the New York State Nurses' Association, 33(2), 11-16.
Fitzpatrick, J. (Editor) (2005) Encyclopedia of Nursing Research. New York: Springer
Burden of disease: disability/morbidity
The word 'pre-diabetes' applies to persons highly susceptible to contracting diabetes mellitus (type 2). Those diagnosed as pre-diabetic have sustained, higher-than-normal blood glucose levels; however, these levels are not sufficiently high to be characterized as diabetes. Pre-diabetics suffer from either IGT (impaired glucose tolerance), or IFG (impaired fasting glucose), or both. The former denotes a condition wherein glucose tolerance levels of individuals after two hours of glucose consumption lie between 140 and 199 milligrams/deciliter whereas the latter refers to a condition wherein fasting blood glucose levels lie between 100 and 125 milligrams/deciliter (when nothing has been consumed throughout the night) (Thomaskutty & Dwivedi, 2011).
After pre-diabetes sets in, beta cells lose their function progressively, resulting in the onset of diabetes. Type 2 diabetics characteristically have by high blood sugar levels, a condition that, with time, damages blood vessels and nerves, thereby giving rise to…
Quality Improvement Project
Diabetes -- Chronic Condition Background
Type 1 and Type 2 Diabetes
isk factors for type 1 diabetes
isk factors for prediabetes and type 2 diabetes
isk factors for gestational diabetes
The ationale for Selection
The Target Population
It has been estimated that in New York there is roughly two million people, or over twelve percent of the population, that have diabetes; furthermore, of this population, over half a million people have the condition but are not aware that they have it (American Diabetes Association, N.d.). It is further estimated that nearly five and a half million people, or over a third of the population, have prediabetes. Diabetes and diabetes-associated cardiovascular diseases have become the leading cause of death in the region accounting for roughly two-thirds of the deaths and the rates of diabetes has lead this trend to be referred to as the…
American Diabetes Association. (N.d.). Health Disparities. Retrieved from American Diabetes Association: http://www.diabetes.org/advocacy/advocacy-priorities/health-disparities.html
American Diabetes Association. (N.d.). New York, New York. Retrieved from American Diabetes Association: http://www.diabetes.org/in-my-community/local-offices/new-york-new-york/
CDC. (2013). Diagnosed Diabetes, Age Adjusted Rate (per 100) Adults - Total 2013. Retrieved from Center for Disease Control: http://gis.cdc.gov/grasp/diabetes/DiabetesAtlas.html
Department of Health. (N.d.). Diabetes. Retrieved from New York State: https://www.health.ny.gov/diseases/conditions/diabetes/
There are various types of diabetes, including type 1, type 2, gestational, and juvenile diabetes. Type 1 diabetes occurs when the body fails to produce adequate amounts of insulin. It most often is found in children and young adults which is why it is now referred to as juvenile diabetes. Type 2 diabetes occurs when cells fail to respond to insulin. This subtle distinction makes a great deal of difference in terms of treating the two types of diabetes (Arcangelo & Peterson, 2006). It is also worth noting that type 2 diabetes tends to set in later in life, typically around middle age, though it can occur earlier. Moreover, 90% of all diabetes cases are type 2 diabetes. Gestational diabetes occurs in pregnant women who have never had diabetes but who have high blood sugar levels during pregnancy. Nearly one in ten women is at risk of developing gestational diabetes.…
Aligning Diabetes Care with the DSIP Program Using Social Media
A title for the campaign that concisely communicates the objective:
"Aligning Diabetes Care with the Delivery System eform Incentive Payment (DSIP) Program Using Social Media"
A policy brief:
Approximately half of all New York residents suffer from at least one chronic health disease, including conditions such as obesity, cardiovascular disorders, and diabetes, and these healthcare consumers need ongoing assistance in helping them prevent and better managing these diseases, particularly as treatment regimens and healthcare technologies become increasingly complex (Long, 2016). This is especially true when it comes to adult diabetes which represents a serious public health threat to the citizens of New York State (NYS) (uberto & Brissett, 2012). Indeed, the NYS Department of Health emphasizes that, "Diabetes has become an epidemic that affects one out of every 10 adult New Yorkers. It has become an epidemic that affects one…
Curran, J. M. & Lennon, R. (2011, September). Participating in the conversation: Exploring usage of social media networking sites. Academy of Marketing Studies Journal, 15(51), 21-25.
Diabetes. (2016). New York State Department of Health. Retrieved from http://www.health . ny.gov/diseases/conditions/diabetes/.
King, D. L. (2015, January). Chapter 1: Why use social media? Library Technology Reports, 51(1), 6-9.
Long, T. (2016, February). Coaching patients to better health. American Nurse Today, 11(2), 37.
2012, 1.5 million lives were lost to diabetes globally. It ranked eighth among the causes of deaths across both sexes and fifth among women (WHO, 2016). Higher than optimal glucose levels, even those that fall below diabetes diagnostic threshold, is one of the major causes of morbidity and mortality. Diabetes' diagnostic criterion is fasting plasma glucose ≥ 7.0 mmol/L which is a diagnostic point chosen because of micro-vascular issues such as diabetes retinotherapy. The likelihood of having a macro-vascular disease such as stroke or a heart attack begins to increase even before this point is reached (ellamy, Casas, Hingorani & Williams, 2009). To comprehend the impact blood glucose levels can have on mortality, one ought to view blood glucose related mortality as a risk factor. The total lives that were lost to high blood glucose levels in 2012 have been estimated to be about 3.7 million. The number includes those…
ADA. (n.d.). Statistics About Diabetes. Retrieved from American Diabetes Association: http://www.diabetes.org/diabetes-basics/statistics/?referrer=https://www.google.com.pk/
Bellamy L, Casas JP, Hingorani AD, Williams D. Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis. Lancet. 2009; 373:1773 -- 1779.
CDC. (n.d.). What Is the National DPP? Retrieved from Centers for Disease Control and Prevention: https://www.cdc.gov/diabetes/prevention/about/index.html
CDPH. (n.d.). Race/Ethnic Group Differences. California Department of Public Health. Retrieved from: http://www.cdph.ca.gov/programs/ohir/Pages/Diabetes2008Race.aspx
Persons with diabetes are at risk for complications such as amputations, heart attacks, strokes, blindness, kidney failure and gum disease (Arizona Department of Health Services, 2006). The Arizona Department of Health (2006) notes several activities that the individual and their family can follow to manage and prevent diabetes. For example, practicing a basic health regimen can reduce the risk of developing diabetes as well as preventing the complications once the disease is present. Family members should note that eating regular healthy meals is necessary, and complications can be prevented by recording blood sugar levels daily, exercise, and taking medication as prescribed.
Social and Economic Implications of Diabetes
There are many social and economic implications of diabetes in the Phoenix, Arizona population. The Centers for Disease Control and Prevention is currently working with the Arizona Diabetes Prevention and Control Program to assist with the prevention of diabetes and develop the state's…
Arizona Department of Health Services. (2006). AZ Diabetes Prevention and Control
Program. Retrieved February 23, 2007, at http://www.azdhs.gov/phs/oncdps/diabetes/igns.htm
Centers for Disease Control and Prevention. (1997). National Diabetes Fact Sheet:
National estimates and general information on diabetes in the United States. Atlanta,
Type 2 Diabetes (T2D) in the U.S.
The development of Type 2 Diabetes (T2D) in the U.S. And developing countries
Type 2 diabetes was known previously as non-insulin-dependent diabetes. Unlike an individual with type 1 diabetes, a person with type 2 diabetic issues continues to produce insulin, but the individual's body fails to respond to it in a normal manner. Glucose cannot penetrate the cells and supply the required energy (it has been commonly referred to as insulin resistance). Eventually, the blood sugar levels rise and make the pancreas produce additional blood vessels insulin. In the end, the pancreas wears out because of overworking to generate surplus insulin and eventually becomes unable to generate adequate insulin to keep blood vessels sugar levels normal. Individuals with insulin resistance may or may not develop type 2 diabetic issues (Atta-ur-ahman, eitz & Choudhary, 2010). This is independent of the pancreas' ability to generate…
Atta-ur-Rahman, Reitz, A.B., & Choudhary, M.I. (2010). Frontiers in Medicinal Chemistry Volume 1. Sharjah: Bentham Science Publishers.
Ginsburg, G.S., & Willard, H.F. (2013). Genomic and personalized medicine. London: Academic.
Kalhan, S.C., Prentice, A. & Yajnik, C.S. (2009). Emerging societies: Coexistence of childhood malnutrition and obesity. Basel, Switzerland: Karger.
Kumar, D. (2012). Genomics and health in the developing world. Oxford: Oxford University Press.
diet and diabetes.
Review 2-3 sources of information on diet and its effects on diabetes.
Diet and diabetes are closely linked and very often this diet can be diet controlled.
Diabetes is a disease that makes it hard for the body to control the level of glucose (the main form of sugar in the body) in the blood. There are three main types of diabetes: Type 1 which is insulin-dependent, Type 2 which is the most common and is not insulin-dependent and Gestational which occurs during pregnancy and goes away when the baby is born.
Diet is an integral part of managing diabetes and is based on the treatment goals and a nutritional assessment that will take into account blood lipids, caloric needs and prevention of diabetes related complications.
Because the body's ability to make and use insulin is compromised, the body can't regulate glucose and therefore, the diabetic has…
Diet for Diabetes." Kimberly Tessmer, RD, LD. http://www.health .discovery.com.2001
Diabetes and Diet. Http://www.diabetes-and-diet.com.2003.
Diabetes and Self-Care Initiative Among High School Students
The onset of modernization, coupled with the globalization process over the last 50 years has seen not just the spread of positive cultures and influences to different parts of the world but also the propagation of some negative health related conditions among them being diabetes. The importation of the western cultures to other regions including remote islands saw the carrying of the Western diets and ways of life some of which have had negative impacts. The fast foods, docile lifestyle perpetuated by the inactive entertainment from electronics have been a major cause of diabetes among the cultures that have adopted the Western cultures. The staggering number of new cases of diabetes among men and women who traditionally did not have such high numbers of diabetes is a cause of alarm. Worse still is the ever increasing number of children with type 1…
Ajala, O., English, P., Pinkney, J. (2013). Systemic review and meta-analysis of different dietary approaches to the management of type 2 diabetes. American Journal of Clinical Nutrition, 97(3): 505-516.
Barnard, N., Cohen, J., Jenkins, D. et al. (2009). A low-fat vegan diet and a conventional diabetes diet in the treatment of type 2 diabetes: a randomized, controlled, 74-wk clinical trial. The American Journal of Clinical Nutrition, 89(suppl): IS-9S.
Cunningham-Myrie, C., Theall, K., Yonger, N., et al. (2015). Associations between neighborhood effects and physical activity, obesity, and diabetes: The Jamaica Health and Lifestyle Survey, 2008. Journal of Clinical Epidemiology, 68(9): 970-978.
Reece, A. (2010). The fetal and maternal consequences of gestational diabetes mellitus.
There are remedies (albeit not easy ones for the individuals involved), as suggested by the research. However, and this is very important, the current public health approaches that the Saudi government has taken, as Mabrey et al. (2010) note, have focused fairly narrowly on medical approaches. This focus includes research that has been conducted on metabolic syndrome (which is caused primarily by being overweight). This is caused by clear-cut factors and has a number of possible poor consequences.
Mabrey et al. (2010) note that metabolic syndrome is on average 10 to 15% higher in the GCC states than in the rest of world and that females are disproportionately affected by metabolic syndrome. These researchers are among those who note that a strictly medical approach to such medical problems is far from sufficient. For while metabolic syndrome itself can be identified and described in purely medical terms, such an approach does…
Abraham, S. & Nordsieck, M. (1960). Relationship of excess weight in children and adults. Public Health 75: 263-273.
Alghamdi, K.M. (2010). The use of topical bleaching agents among women: A cross-sectional study of knowledge, attitude and practices. Journal of the European Academy of Dermatology and Venereology, 24(10): 1214-1219.
Al-Qahtani, D.A., Imtiaz, M.L., Saad, O.S., & Hussein, N.M. (2006). A comparison of the prevalence of metabolic syndrome in Saudi adult females using two definitions. Metabolic Syndrome and Related Disorders, 4(3): 204-214.
Al Qauhiz, N.M. (2010). Obesity among Saudi Female University Students: Dietary Habits and Health Behaviors. Journal of the Egyptian Public Health Association 85(1-2):45-59.
Counterbalance of Sugar and Fat Content between Insulin and Glucagon
Physical survival depends on the sustained availability and use of energy in the form of adenosine triphosphate or ATP from sufficient levels of a substance, called glucose (owen, 2001). The use of energy depends on the varying levels of activity. Hence, the amount of glucose needed for activity likewise varies each day. Too much or too little glucose is damaging to the body, hence the need for some system to regulate the availability of glucose. It must be present at the precise time and amount that it is needed in order to maintain what is called glucose homeostasis. Homeostasis is the tendency of the body to maintain internal stability and balance through the coordinated responses of body parts to stimuli or conditions (owen).
Insulin and Glucagon
The regulation of glucose availability begins with the pancreas, primarily by…
Biomed (2002). Insulin/glucagons. Brown University. Retrieved on November 25, 2013
Bowen, R.A. (2001). Hormones, receptors and control systems. University of Colorado.
Retrieved on November 25, 2013 from http://arbl.cvmbs.colostate.edu/hbooks/pathphys/endocrine/basics/index.html
HHS Prevention strategies that is of interest to you and relevant to advance practice nursing
I CHOSE DIAETES PREVENTION
Diabetes disease management in the setting of a clinic is a multicomponent, proactive and organized approach in order to deliver healthcare to every member of the society who has diabetes. Every aspect of the healthcare delivery system is embraced by the management with care focusing on the entire range of the disease along with its complications and preventions. The main goal of this prevention program is to improve the long and short-term economic or health outcomes among the diabetic population. The main elements of a disease management are: to identify the population of individuals with diabetes; using performance standards or guidelines to manage the people identified with diabetes; an information system to monitor and track the interventions and results; management and measurement of population and patient outcome. Other than that, the…
Chou, C. H., Burnet, D., Meltzer, D., & Huang, E. (2015). The effectiveness of Diabetes Prevention Programs in Community Settings. NYS Health Foundation.
Diabetes. (2014). Retrieved from Healthypeople.gov: http://www.health ypeople.gov/2020/topics-objectives/topic/diabetes
NIH. (2013). Diabetes Prevention Program. National Institute of Diabetes and Digestive and Kidney Diseases.
Sepah, C., Jiang, L., & Peters, A. (2015). Long-Term Outcomes of a Web-Based Diabetes Prevention Program: 2-Year Results of a Single-Arm Longitudinal Study. JMIR Publications.
Doctors use a fasting plasma glucose test to confirm a diagnosis of type-two diabetes. A patient must fast for 8 hours prior to giving a blood sample (http://diabetes.webmd.com/guide/diagnosing-type-2-diabetes). If it is determine that the patient has diabetes, the doctor will prescribe diet management and exercise. In some cases, insulin shots or pills may also be prescribed.
Unlike type-one diabetes, type-two develops because of lifestyle choices. If you are overweight and get little or no exercise, you have a greater chance of developing type-two diabetes. Other un-controllable factors known to contribute to type-two diabetes include: family history, age, race, ethnicity and a low body weight at birth (https://members.kaiserpermanente.org/kpweb/healthency.do?hwid=hw135189§ionId=ur1000&contextId=hw135189).
COMPLICATIONS AND EFFECTS OF DIABETES
There are many long-term health issues are associated with diabetes. If a patient fails to be diagnosis or a patient does not maintain their insulin schedule, complications may occur. Diabetics have a higher likelihood of developing eye problems…
www.webmd.com www.diabetes.org www.kaiserpermanente.org
Bakalar, N. "Diabetes: A state-by-State Breakdown," New York Times, October 12, 2009.
Type I diabetes is usually diagnosed in children and young adults and results from the body's failure to produce insulin. Type 1 account for 5% to 10% of all diagnosed cases of diabetes (Centers for Disease Control, National Diabetes Fact Sheet, www.cdc.gov/diabetes/pubs/pdf/ndfs_2003.pdf). The most common form of diabetes is Type II, which accounts for about 90 to 95% of all diagnosed cases of diabetes (Centers for Disease Control, National Diabetes Fact Sheet, www.cdc.gov/diabetes/pubs/pdf/ndfs_2003.pdf). Pre- diabetes is a condition often present prior to the development of Type II diabetes. In pre-diabetes, blood glucose levels are higher than normal, but not high enough to be considered diabetic.
Pre-diabetes does not have to lead to the development of diabetes if a person diagnosed with this condition: Patients who work to control their weight and increase their physical activity can often prevent or delay the onset of diabetes. There are 41 million Americans…
American Diabetics Association. Retrieved 22 March 2010 from http://www.diabetes.org/diabetes-basics/diabetes-statistics/
Centers for Disease Control, National Diabetes Fact Sheet.Retrieved 18 March 2010 from www.cdc.gov/diabetes/pubs/pdf/ndfs_2003.pdf
Five thousand flyers will be distributed to local synagogues and churches. Another major distribution channel is through the public education system, Brooklyn College is located within the Midwood community, it has now become a strong community meeting point for both students and adults. Pamphlets distributed through the school will be able to attract large audiences. ADA provides a series of seminar and workshops called the "Diabetes Awareness Program." Using the DAP as the basis for creating local interest; this series will be launched through the community as a public forum for understanding diabetes. Such a forum will be targeted to two distinct audiences. The first will be public speaking engagements for local health care professionals to increase their awareness of diabetes within their community and prepare for the flood of questions to come. Information sessions for the general public will take the form of public rallies or seminars staged through…
Diabetic Vascular Disease state caused by the deficiency of a chemical in the body called insulin which is a hormone is called Diabetes. There are two forms of diabetes. In the type-one diabetes no insulin is formed and people require insulin injections for existence. This was once thought it would affect only children, but now it can occur at any age. The type2 diabetes is due to the resistance of the body towards the effects of insulin. This also includes insulin which is insufficient. ut in this type there is some amount of insulin produced. In both the types the blood glucose levels is increased. When compared to people without diabetes, people with diabetes are prone to certain problems. These problems occur in the nerves (neuropathy), kidney (nephropathy) and eye (retinopathy). These people are prone to early heart attacks and stroked due to the hardening of the arteries (arteriosclerosis). With…
Diabetes Basics-About Diabetics," Retrieved from www.orthop.washington.edu/faculty/Hirsch/diabetesAccessed on March 3, 2004
Diabetes & Vascular Disease Research" retrieved from www.medstv.unimelb.edu.au/Research/DCVDR/. Accessed on March 3, 2004
Haptoglobin: A major susceptibility gene for diabetic vascular complications," retrieved from www.pulsus.com/europe/07_02/szaf_ed.htm. Accessed on March 3, 2004
Pathophysiology of Diabetes" retrieved at http://www.dhss.state.mo.us/diabetes/manual/DMOverview.pdf. Accessed on March 3, 2004
Organ transplant recipients are more susceptible to cancer due to oncogenic viral infections and immunosuppression. What is the overall pattern of cancer following an organ transplantation?
Cancer is a major adverse outcome of solid organ transplantation.2 Previous studies have demonstrated an overall 2- to 4-fold elevated risk of cancer.3- 11 Excess risk is largely due to immunosuppression, with a spectrum of cancer resembling that seen with human immunodeficiency virus (HIV) infection, another immunosuppressing condition.11 isks are especially high for malignancies caused by viral infections, including non-Hodgkin lymphoma and Hodgkin lymphoma (both due to Epstein-Barr virus [EBV]), Kaposi sarcoma (human herpesvirus 8), anogenital cancers (human papillomavirus), and liver cancer (hepatitis C and B viruses). Certain other malignancies such as cancers of the lung, kidney, skin, and thyroid also are increased in transplant recipients. Linkage of population-based transplant and cancer registries from the same geographic region can allow for systematic ascertainment of…
Engels, E.A., Pfeiffer, R.M., Fraumeni, J.F., Kasiske, B.L., Israni, A.K., & Snyder, J.J. (2011). Spectrum of Cancer Risk among U.S. Solid Organ Transplant Recipients. JAMA, 306(17), 1891-1901. doi:10.1001/jama.2011.1592
Saaristo, T., Moilanen, L., Korpi-Hyovalti, E., Vanhala, M., Saltevo, J., Niskanen, L. . . . Keinanen-Kiukaanniemi, S. (2010). Lifestyle intervention for prevention of type 2 diabetes in primary health care: one-year follow-up of the Finnish national diabetes prevention program (FIND2D). Diabetes Care, 33(10), 2146-2151. Doi:10.2337/dc10-0410
Sperling, R.A., Aisen, P.S., Beckett, L.A., Bennett, D.A., Craft, S., Fagan, A.M., . . . Phelps, C.H. (2011). Toward defining the preclinical stages of Alzheimer's disease: Recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimer's & Dementia,7(3), 280 -- 292. doi:10.1016/j.jalz.2011.03.003
Exercise and Pregnancy
"How much, and how intensively, nurse, should I exercise over the course of my pregnancy?' A seemingly simple question -- and one a gynecological or obstetrical nurse must be prepared to answer, given that many newly pregnant women may feel more comfortable directing such queries to a nursing staff health care provider, rather than a physician. This may be particularly the case if the attending physician is male, and the woman has concerns germane to the 'female' experience of pregnancy and exercise, such as weight control or temporary pregnancy-specific problems related to exercise such as bladder or back pain or incontinence. ut as nursing strives to teach and treat the whole individual undergoing a pregnancy, all nurses must be prepared to answer such crucial questions as to how much, when, and how a pregnant woman should exercise.
Article 1: 1998 Overview from the American Family Physician
Note: All articles from the peer-reviewed journal available on the EBSCO list of ejournals at http://ejournals.ebsco.com/info/EJSTitles.asp?PageNo=1
Miller, Karl E. (1 Sept 2004) "Exercise in patients with gestational diabetes."American Family Physician. Retrived 1 Jul 2005 at http://www.findarticles.com/p/articles/mi_m3225/is_5_70/ai_n6182511
Walling, Anne D. (15 May 2005) "Exercise During Pregnancy Is Associated with Thinner Babies." American Family Physician. Retrived 1 Jul 2005 at http://www.findarticles.com/p/articles/mi_m3225/is_10_65/ai_85615776
Wang, Thomas W. & Barbara S. Apagar. (15 Apr 1998)"Exercise during pregnancy." American Family Physician. Retrived 1 Jul 2005 at http://www.findarticles.com/p/articles/mi_m3225/is_n8_v57/ai_20570146/pg_2
recoding a pregnant mother-Based case study. thai primegravida multpara.
This essay is about a process recording for a pregnant mother. Process recording is a written record of an interaction with a client. Pregnant mothers are in danger of any disease but there most alarming gestational diseases; these include hypertension, cardiac disease, anemia, diabetes, hyperemis gravidarum and many more. In this essay am only going to dwell in gestational hypertension.
This is a process recording of a case study of a pregnant mother. Mrs. B is a 16 years old primigravida at 30 weeks gestation and has attended the antenatal clinic three times. All finding were within the normal range until her last visit 1 week ago when her blood pressure was 130/90mmHg.On urinalysis there was no proteinuria. The fetal heart sounds were normal, the fetus was active and uterine size was consistent with dates. She has come to clinic today,…
American Association of Clinical Endocrinologists medical guidelines for clinical practice for the diagnosis and treatment of hypertension. National Guideline Clearinghouse. Available at http://www.guideline.gov/summary/summary.aspx?doc_id=9338 . Retrieved on 11/02/2011
Benson M.D.( 1989) Obstetrician Pearls,.Philadelphia:F.A Davis.
[Best Evidence] Hedderson MM, Ferrara A (.2008) High blood pressure before and during early pregnancy is associated with an increased risk of gestational diabetes mellitus. Diabetes Care. Dec 31(12)
Chobanian AV, Bakris GL, Black HR, et al. (.2003) The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 289(19):2560-72.
Moreover, some genetic testing is inaccurate, creating the possibility of false positives and false negatives.
The second problem with genetic testing is that it can provide information about diseases where there is no treatment or intervention. This is the case for Tay-Sachs. There is no way to prevent the disease, which is fatal in children. However, unlike some other genetic disorders, the baby is born healthy and begins to deteriorate sometime after birth. Does knowing that the child will develop the disorder help the family, when prenatal screening does nothing to help treat the child?
The third problem with genetic testing is that it may lead people to make undesired choices. Abortion rates for children with genetic diseases are higher than those rates for children without those diseases. Abortion is a major moral issue in the United States. Does a process that might increase the likelihood that a mother will…
National Institute of Neurological Disorder and Stroke (2007, Feb. 14). NINDS Tay-Sachs
Disease Information Page. Retrieved from http://www.ninds.nih.gov/disorders/taysachs/taysachs.htm
National Tay-Sachs & Allied Diseases. (2011). Tay Sachs Disease. Retrieved from http://www.ntsad.org /index.php/tay-sachs
Sheth, K. (2010, Nov. 17). Tay-Sachs disease. Retrieved August 13, 2011, from PubMed
Their heritage is important because certain ethnic groups are more likely to be carriers of Tay-Sachs. "The incidence of Tay-Sachs is particularly high among people of Eastern European and Ashkenazi Jewish descent. Patients and carriers of Tay-Sachs disease can be identified by a simple blood test that measures beta-hexosaminidase a activity." (NINDS, 2011). Because the Trosacks have a fetus with Tay-Sachs, it is not necessary to test their blood and examine the beta-hexosaminidase a activity of either of the parents. However, doing so may help Peter transition out of denial and understand the reality of the diagnosis.
Tay-Sachs impacts a person by interfering with genetic lipid storage. An insufficiency of the enzyme beta-hexosaminidase a, which is responsible for biodegrading gangliosides, leads to a buildup of the ganglioside GM2 in tissues and nerve cells in the brain (NINDS, 2011). Because gangliosides develop, and normally degrade, rapidly in infancy, the disease progresses…
A.D.A.M. Medical Encyclopedia. (2010 November 17). Tay-Sachs disease. Retrieved November 11, 2012 from PubMed website: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002390/
American Pregnancy Association. (2006). Chorionic villus sampling: CVS. Retrieved
November 11, 2012 from http://www.americanpregnancy.org/prenataltesting/cvs.html
Genetic Alliance. (2012). Home. Retrieved November 11, 2012 from http://www.geneticalliance.org /
Further, Robinson and Sirard posit that applying a "Litmus Test" helps to identify the specific research questions, study designs, and methods that will most likely contribute to improving individual and overall population health (198). The researchers suggest that a study should only be performed if the researcher(s) knows what the conclusion from each possible result (negative, null, positive) will be, and how the result will incline intervention to address policy, clinical or a public health problem like childhood obesity. If research is conducted as suggested, the authors maintain that studies with a greater possibility of advancing science and directly, not suggestively, improving well being and health, would be the result. Therefore, greater assurance that will be provided that ethical responsibilities of not devaluing the contributions of research participants, and responsibly responding to the need for useful research to the public, particularly if public funds are used for the project,…
Allison, D.B., Pietrobell, A., Faith, M.S., Fontaine, K.R., Gropp, E., & Fernandez, J.R.
(2003). Genetic influences on obesity. In Eckel, R. (ed). Obesity: Mechanisms
and Clinical Management. Elsevier: New York, pp. 1-74.
Ballard, M.B., & Alessi, H.D. (2004). The impact of childhood obesity upon academic.
Childhood Obesity and Interventions
There is a strong relationship between childhood obesity and exposure to environmental factors -- most notably socio-economic status. There are exposures that trigger both positive and negative outcomes, and these have to be discussed along with the possible interventions that can be undertaken. Low socio-economic status (E) has been associated with a large number of problematic outcomes where health is concerned, including obesity and related issues in childhood (Kallem, et al., 2013). Despite this correlation, though, there are plenty of children with low E who grow up slim and apparently health, so it is clear that environment is not the only factor (Kallem, et al., 2013). The objective of the study by Kallem, et al. (2013) was to examine the "shift-and-persist" strategy and how (or if) it was what was protecting low E children from obesity in some cases. This strategy involves how a person deals…
Studies have found that racial and ethnic disparities can be just as significant as SES, diet, and exercise issues -- largely because SES and related concerns are often tied to specific racial and ethnic groups more than others (Carroll-Scott, et al., 2013). Preschool age children who are in minority racial and ethnic categories have a statistically higher prevalence of obesity when all other variables have been controlled for by researchers (Carroll-Scott, et al., 2013). That is a serious indication that there is more at play in the overall environment, and that study of all factors that could contribute to obesity is needed. That would include analyzing a larger area of environmental factors, because there are many causes for the tripling of obese children and adolescents throughout the last three decades (Dixon, et al., 2012). That much of a change in that short of a time period is a significant problem for society, and can raise the rates of health care for everyone.
If the obesity epidemic in children is not dealt with now, society can expect to see increases in the rates of many chronic diseases, and these diseases will be particularly obvious in populations that already have a disparity in their health (Dixon, et al., 2012). In the study conducted by Dixon, et al. (2012), the associations between SES and social characteristics of the residential environment were considered. Then, these were looked at as compared to diet, physical activity, and BMI (Dixon, et al., 2012). The participants consisted of students in the fifth and sixth grade at a school in New Haven, Connecticut (Dixon, et al., 2012). That was done to narrow down a population in order to determine the environmental factors associated with it (Dixon, et al., 2012). Multilevel modeling was used in order to collect information on the area and the students (Dixon, et al., 2012).
It was discovered that students living within a close walking distance of fast food outlets had higher BMI numbers than those who lived farther away (Dixon, et al., 2012). Additionally, high fast food outlet densities were linked to higher BMIs and more unhealthy eating (Dixon, et al., 2012). When students had close access to gyms, parks, and playgrounds, though, they were more likely to get exercise, helping to offset some of the unhealthy eating patterns (Dixon, et al., 2012). More affluent neighborhoods were also linked to healthier eating behaviors and better exercise regimens, where students who were on the low end of the SES scale ate poorly and got little exercise (Dixon, et al., 2012). One of the ways to help lessen the problems with childhood obesity could be to provide more parks, playgrounds, and other areas where students could get good exercise, and to lower the number of fast food establishments in residential areas.
And for good reason: it's still one of the most effective, affordable and trusted products in agriculture today.
The company points out that this herbicide is 'safe' and that it is essential for increased crop production at a time of critical demand in the United States and the world. Syngenta also refers to the fact that in 2006 the U.S. Environmental Protection Agency "…re-registered atrazine in 2006, based on the overwhelming evidence of safety from nearly 6,000 studies" (Syngenta).
While the main reason for the EU ban on this product was the indication of contaminated drinking water supplies, Syngenta denies this claim. It supports this view by referring to a 2008 study in which 122 Community Water Systems monitored in 10 states were monitored. This study found that the federal standards set for Atrazine were not exceeded in any of the states.
One should however bear in mind that…
Ackerman F. ( 2007)the Economics of Atrazin. Retrieved from http://ase.tufts.edu/gdae/Pubs/rp/EconAtrazine.pdf
Ackerman F. ( 2010) With weed killer atrazine, the benefits are small, the risks are huge. Retrieved from http://www.kansascity.com/2010/09/14/2224213/with-weed-killer-atrazine-the.html
A Field of Nightmares Updated: Atrazine, Corn, and Frogs. Retrieved from http://frogsaregreen.com/tag/effect-of-atrazine-on-frogs/
Atrazine. Retrieved from http://www.pan-uk.org/pestnews/Actives/atrazine.htm
So, in those regards the curriculum is slowly catching up with the times. Personally, I would like to see additions such as a playing of the movie, "The Business of Being Born" at one of the sessions or as homework.
The second way that the curriculum should change within the next three years is to begin allowing more nurses to become certified teachers. Currently, it is easier for a parent to become a coach than it is for a nurse. The reason, according to Bradley, is that the parents have direct experience, whereas nurses only have book-related experience. In fact, Bradley does offer the option for nurses to become a teacher, but additional reading and exam requirements must be met.
Personally, I find it to be in the best interest of Bradley to offer their curriculum with open arms to nurses for one simple reason: the more nurses who know…
Halfon, Saul (2010). Encountering Birth: Negotiating Expertise, Networks, and My STS Self. Science as Culture, 19(1), 61-77.
Hathaway, Marjie; et al. (2007). The Bradley Method Student Workbook. American Academy of Husband Coached Childbirth.
Lake, Rikki (2008). The Business of Being Born. Barranca Productions.
Lieberman, Adrienne (1992). Easing Labor Pain: The Complete Guide to a More Comfortable and Rewarding Birth. The Harvard Common Press, Boston.
Business of Being Born
The movie The Business of Being Born delves into the industry of birth in the United States. The movie seeks to tackle two basic angles regarding the nature of birth and whether it should be treated as a natural and normal process or as a medical emergency requiring intense intervention.
The documentary, produced by famous TV talk show host Ricki Lake and Abby Epstein, investigates how the landscape of birth is changing as the social climate has evolved; the view of birth has become clouded by forces of fear, money, overreliance on doctors and an eagerness to treat the birthing process as a medical condition.
The film offers sobering statistics on how the U.S. has one of the highest maternal mortality rates in the developed world along with second-worst newborn death rate of any industrialized nation. While midwives are commonplace in Japan and Europe, only 8%…
Obesity is a serious social problem in America. The effects of obesity in childhood are well documented in both the social science literature and medical journals. During the last 30 years, the percentage of obese children between the ages of 6 and 11 has risen 200% while the percentage of obese children between 12 and 19 has tripled (CDC, Preventing Childhood Obesity, 2010). Obesity in the nited States has increased among all cohorts and ethnicities, spans across generations, and is not limited to income or educational levels. However, the incidence of obesity among African-American women is of particular concern given the prevalence and severity of the issue in America.
Public health issue
More than two-thirds of Americans are now obese or overweight (Ogden et al., 2010).
Rates of adult obesity now exceed 20% in 49 states and D.C and 25% in 40 states. By way of comparison, in 1991, rates…
U.S. Centers for Disease Control and Prevention (2011). Morbidity and Mortality Weekly Report. Vital Signs: Prevalence, Treatment, and Control of Hypertension -- United States, 1999 -- 2002 and 2005 -- 2008
Ward, S., Gray, A., Paranjape, A. (2008). African-Americans' perceptions of physician attempts to address obesity in the primary care setting. The Journal of General Internal Medicine, 24(5), 579-584.
Coenen, K.R., Hasty, A.H. (2007). Obesity potentiates development of fatty liver and insulin resistance, but not atherosclerosis, in high-fat diet-fed agouti LDLR-deficient mice. Retrieved from: http://ajpendo.physiology.org/content/293/2/E492.short
The program includes five components namely 'Family Support', 'Maternal Interview', 'Records review', 'case review' and 'Community action'. (FIMR, 2010)
The FIMR Process
FIMR Informed of Fetal/Infant Death
Data Collection/Record Review
Improved Maternal & Infant Health
Fetal origins of health and disease has developed into a new medical frontier for researchers. The growing body of research evidence has affirmed positive associations between the gestational environment and the development of various physical and mental disorders in the infant, adolescent and the adult population. The new knowledge that even gestational diet composition has the ability to alter the human epigenome resulting in the expression of undesirable genes and the onset of obesity, diabetes, cancer and other chronic health conditions, is convincing scientific evidence for pregnant women to be careful and cautious in their diet choices. Results from the studies on maternal…
1) Annie Murphy Paul, (Nov 4-2010), "How the First Nine Months Shape the Rest of Your Life," TIME, retrieved Dec 3rd 2010, from, http://www.time.com/time/health/article/0,8599,2020815-1,00.html
2) Barry E. Levin. (July 2006) " Metabolic Imprinting: Critical Impact of the perinatal environment on the regulation of energy homeostasis," Biol Sci. 29; 361(1471)
3) Irwing B. wiener & Richard M. Lerner et.al (2003), "Handbook of Psychology: Developmental Psychology," John Wiley & Sons
4) Kjersti M. Aagaard-Tillery, Kevin Grove, & Jacalyn Bishop et.al (Aug 2008), "Developmental Origins of Diseases and Determinants of chromatin Structure: Maternal diet modifies the Primate fetal epigenome," J. Mol Endocrinol 41 (20) 91 -- 102
Having a baby is a dream that many families have. Women in particular are associated with the idea and "dream" of having a child but men are pretty excited about it to when it comes, albeit also nervous. However, there is a danger when it comes to waiting too long before starting a family in terms of age. Whether it is career concerns, finding the right, the delaying of the marriage or what have you, there are multiple reasons that are common in today's society whereby women put off having families. An unfortunate byproduct of this pattern is that the risk of birth defects is much higher with children born of women over the age of 35. This report shall explore the precise and specific reasons that these birth defects why it is more common for women beyond the line stated in this proposal. Even with the increasing…
The authors state, "underlying mechanism through which exposure to childhood abuse is associated with increased risk of panic cannot be determined based on these data alone" (p. 888). They offer several possible explanations. Exposure to abuse as a child may result in an extreme and realistic fear of threat to survival. This may be how panic disorder starts. Later, it may persist, or recur spontaneously, even without abusive conditions. In the face of a real life threat, panic is not pathological, but in childhood panic may make the child more vulnerable to panic later. Exposure to abuse may lead to biochemical changes that increase the risk of a disorder. Because the study was based on interviews with 18 to 21-year-olds, who were asked to recall past experiences, the findings could be contaminated by recall bias in which young people with mental instability might be more likely to report abuse in…
Bandelow, B., Sojka, F. et al. (2006). Panic disorder during pregnancy and postpartum period. European Psychiatry, 21, 495-500.
Biederman, J., Petty, C., Faraone, S.V. et al. (2006). Effects of parental anxiety disorders in children at high risk for panic disorder: A controlled study. Journal of Affective Disorders, 94, 191-197.
Goodwin, R.D., Fergusson, D.M. And Horwood, L.J. (2004). Childhood abuse and familial violence and the risk of panic attacks and panic disorder in young adulthood. Psychological Medicine, 35, 881-890.
Warren, S.L., Racu, C., Gregg, V. And Simmens, S.J. (2006). Maternal panic disorder: Infant prematurity and low birth weight. Anxiety Disorders, 20, 342-352.
In light of the evidence in this literature review then it is of great import that monitoring of the health of pregnant women is vital in reference to LW infants not only in the sense of present terms but as well to lifelong health considerations for the LW infant which is probably why stated further is: "Given the relative neglect that mothers and newborns have suffered, their centrality to the Millennium Development Goals, and the cost-effectiveness of maternal and newborn health interventions, a greater emphasis on safe motherhood and newborn health is clearly needed within many health sectors." (JHPIEGO, 2003)
Stated in the publication "Shaping Policy for Maternal and Newborn Health: A Compendium of Case Studies (2003) is that: "The health of a newborn is inextricably linked to the health of the mother; the majority of newborn deaths are caused by the poor health of the mother during…
Krieger N. & Smith, G.(2004) Bodies County and body counts: Epidemiology and embodying inequality. Epidemiological Review Journal 200:26:92-103
Coker, AL et al. (2004) Partner Violence During Pregnancy and Risk of Adverse Pregnancy Outcomes. Pediatrics Perinatal Epidemiology 2004 Jul; 18 (4): 260-9. University of Texas School of Public Health.
Bohn, D.K. et al. (2004) Influences of Income, Education, Age, and Ethnicity on Physical Abuse before and During Pregnancy. Journal Obstetrics Gynecology Neonatal Nursing 2004 Sep-Oct; 33(5): 561-71.
Salihu, Boy a. (2004) Intimate Partner Violence and Birth Outcomes: A Systematic Review International Journal of Fertility Women's Medicine 2004 Jul-Aug; 49(4): 159-64. Department of Maternal and Child Health, School of Public Health, University of Alabama at Birmingham, Alabama.
Good nutrition and healthy lifestyle are important to a better quality of life, but both can be crucial during pregnancy. Inspection of the research indicates that sound nutritional practices during pregnancy have always been considered important in the development of the unborn child Allen, 2005). However, good maternal nutrition may also be an important factor in the development of the fetus before the mother becomes pregnant and the effects of maternal nutrition on the fetus may extend well beyond childhood into adulthood (Barker, 1992).
Obviously the use of alcohol and certain drugs is not recommended during pregnancy. The consequences of alcohol and drug use during pregnancy have been well-documented and need not be discussed here (e.g., Streissguth, Barr, & Martin, 1984). With respect to pre-pregnancy plans, the National Institute of Health suggests three things that should be undertaken before a woman becomes pregnant: (1) both prospective parents should have physical…
Allen, L.H. (2005). Multiple micronutrients in pregnancy and lactation: An overview. American Journal of Clinical Nutrition, 81(supplement), 1206S-1212S.
Barker, D.J.P., (Ed.) (1992). Fetal and infant origins of adult disease. London: British Medical Journal Books.
Godfrey, K.M & Barker, D.J.P. (2000). Fetal nutrition and adult disease. American Journal of Clinical Nutrition, 71 (5), 1344-1352.
Institute of Medicine. (1990) Nutrition during pregnancy. Washington DC: National
Analysis of the Issues: The ethical concern for the rights and welfare of viable infants is certainly a legitimate concern, but the central ethical analysis that pertains to stem cell research revolves around the issue of defining human life appropriately. Objective criteria like anatomical development, cognitive awareness, and above all, sentience of any degree and in any form are all legitimate bases for the definition of life and for identifying the period of gestation corresponding to the earliest conceivable safeguards necessary to prevent suffering.
On the other hand, purely subjective doctrinal claims without objective criteria of any kind are wholly inappropriate bases for defining scientific concepts like when life begins. The fact that human development varies among individuals and that it may be impossible to know exactly where sentience and other elements of "humanness" first begin in the fetus does not mean that it is impossible to identify periods of…
Dershowitz, a.(2002) Shouting Fire: Civil Liberties in a Turbulent Age.
Boston: Little Brown, 2002
Healy, B. On Health: The Other Stem Cells; U.S. News & World Report (Jun. 14/04), p. 77.
Hellemans, a., Bunch, B. (1998) the Timetables of Science. New York: Simon & Schuster.
There are many positive effects of exercise during pregnancy. It can decrease the time it takes to get back into shape after giving birth. It may also decrease the amount of time spent in the hospital. In addition, it can increase Apgar scores and birth weight, as well as decrease discomfort during pregnancy. Women who exercise during pregnancy also find that they have less difficulty and length of labor. Research shows that exercise has many benefits for pregnant women.
However, as both exercise and pregnancy exert stresses on the body, the cumulative effects must be taken into consideration when analyzing the relationship between exercise and pregnancy. In general, research about this topic is sparse, and animal studies have presented conflicting findings. Chronic disorders such as diabetes, hypertension, and heart disease are the most obvious reasons to discourage persons at risk from intense rehabilitative exercising while pregnant. In addition, small…
Araujo, David. (April, 1997). Expecting Questions About Exercise and Pregnancy? The Physician and Sports Medicine, Vol. 25, No. 4, pp. 67-69.
Kramer MS. (February 12, 2002). Aerobic exercise for women during pregnancy (Cochrane Review). In: The Cochrane Library, Issue 1. Oxford: Update Software.
Smith, James. (1998). Exercise During Pregnancy. The American College of Obstetricians and Gynecologists.
South-Paul, J. Rajagopo, K. Tenholder, M. (1988). Exercise and Pregnancy. Obstet Gynecol: 71:175-179.
Define the term Teratology
Teratology refers to the study of abnormal fetal growth. Teratogenic prenatal exposures arise from: infectious agents, chemical and drug agents, metabolic or maternal causes (such as phenylketonuria and diabetes), and physical agents (such as heat, ionizing radiation, and mechanical factors) (Jelinek, 2005). Inbred abnormalities occur commonly, with 2-3% babies, both live and stillborn, as well as aborted fetuses having structural abnormalities. Furthermore, about 10% of infants have internal functional deficits or anomalies which might not be perceptible at birth, and may only surface later on in life. Congenital abnormalities can be categorized into: (1) Malformations, which denote changes in normal growth transpiring from an inherent development-process abnormality; (2) Deformations, which arise due to an irregular mechanical force upon a fetus which is otherwise normal (e.g., clubfoot in an environment of oligohydramnios); and (3) Disruptions, occurring because of disturbance in normal process of growth (for instance,…
Adam, M.P., Polifka, J.E. & Friedman, J.M. (2011). Evolving knowledge of the teratogenicity of medications in human pregnancy. Am J Med Genet C Semin Med Genet. 157C:175.
Finnell, R.H. (1999). Teratology: General considerations and principles. J Allergy ClinImmunol.Vol. 103, No. 2. S337-s342
Jelinek, R. (2005). The Contribution of New Findings and Ideas to the Old Principles of Teratology. Reproductive Toxicology 20: 295-300.
Jones, K.L. (August 17, 2005). Smith's Recognizable Patterns of Human Malformation, Sixth edition Saunders.