Glycemic Control Essays (Examples)

Acceptable Recruitment Methods

Acceptable Method of Selection of Controls

Minimization of Bias

Were the Confounders Accounted for in the Study Design

Are the Results Believable

Are They Applicable to Other Populations (Generalizable)

Do the Results Fit with Available Evidence

Jorde & Figenschau, 2009

Yes, as reflected from the title: Supplementation with cholecalciferol does not improve glycaemic control in diabetic subjects with normal serum 25- hydroxyvitamin D levels

Yes, because patients with poor glycemic control were randomly assigned to control and case group. Also appropriate dosages of Vit. D was used

Place of recruitment was not specified.

Patients were randomly assigned to both groups.

Variables were clearly defined.

Yes, the control group was randomly selected from the actual population

No blinding method used. Compliance was assessed by asking patients to return unused capsules.

Yes, they were: BMI, smoking status, waist to hip ratio, blood pressure, serum calcium, creatinine, lipid profile and…

Diabetes and Vitamin D Studies

Evaluation Table

Clearly Focused Issue

Appropriate Method to Answer the Research Question

Acceptable Recruitment Methods

Acceptable Method of Selection of Controls

Minimization of Bias

Were the Confounders Accounted for in the Study Design

Are the Results Believable

Are They Applicable to Other Populations (Generalizable)

Do the Results Fit with Available Evidence

Witham et al., 2010

This is a follow-up study. The issue is whether patients with a vitamin D level of higher than 250 HD will gain a benefit from vitamin D supplementation.

A positive result is defined by reaching a level of 75 nmol or above. This is considered the level for optimum health.

Patients for the study were selected from general practice and diabetes specialty offices based on a positive type 2 diabetes mellitus diagnosis in accordance with the requirement set forth by the World Health Organization.

The group was divided into three…

Diabetes Intervention

As a complex metabolic disease, diabetes does not lend itself to a wide variety of interventions and concurring the disease does not appear to be an event that medicine will see in the near horizon. For these reasons, and because diabetes can be such a devastating disease, research that shows promise of positively impacting the course of the disease is greeted with enthusiasm by the medical community and the public.

Blood glucose levels must be strictly regulated in order to avoid the complications that diabetes can create. A substantive stumbling block is the difficulty of achieving consistent glycemic control without occurrences of hypoglycemia. Indeed, this factor is a primary obstacle to obtaining regulatory approval of an artificial pancreas. Earlier research has focused on automatic systems that monitor the levels of glucose and stop insulin flow when the blood glucose drops too low. While this is a viable approach,…

Intervention for the Improvement of Hypoglycemic Control

Diabetes complication is one of the top health problems in the United States, and the ADA (American Diabetes Association) recommends that people suffering from diabetes should control their hypoglycemic and maintain A1C to < 7% to avoid diabetes complications. To achieve this objective, the "diabetes self-management education (DSME)"(Ni coll, aiser, Campbell, ET AL. 2014 p 207) is an effective tool to enhance hypoglycemic control and improve patients' outcomes. The DSME is an on-going educational process to facilitate the skill, knowledge, and ability of patients to carry out a diabetes self-care. I am a diabetic educator working in the diabetic outpatient clinical setting. My experience has made to understand that patients struggle to manage and control their diabetes after being educated because patients are not allowed to set their goals in order to manage their diabetes. (American Diabetes Association; 2013).

Objective of this paper…

The CDC has provided almost $7 million in funding to establish DPPs for research purposes, which means the number of pre-diabetes individuals helped by these programs will be very limited (CDC, 2012). While these programs will probably provide free or nearly-free diabetes preventive services to a large number of individuals, most underserved patients will not benefit from these programs.

S. 452 is worded in such a way that establishing DPPs under Medicaid will be optional for states (Sebelius, 2010). As of 2010, 43 states covered the expense of screening Medicaid patients for diabetes, but only 13 states provided reimbursement for obesity preventive services. This suggests that states are willing to pay for screening, but not preventive services like lifestyle interventions; however, if only a few states implement DPPs for Medicaid recipients, this will provide a proof-of-principle experiment in a real-world setting and establish the overall healthcare savings such programs can…

incidence of diabetic nephropathy, its etiology, its comorbidities, and how to control it. The best type of 'cure' is, as always, prevention, and close regulation of the disease which is particularly important since diabetic nephropathy can be fatal.

Diabetic nephropathy is the primary etiology of chronic kidney disease and kidney failure. Unfortunately, type 2 diabetes mellitus is skyrocketing in the United States alone to over 21 million cases, it is imperative for health care professionals to understand the mechanisms of diabetic nephropathy. This is particularly so since early recognition and prevention of the disease as well as tight serum glucose control can help prevent diabetic nephropathy from occurring thereby leading to potentially longer life for its carriers.

The authors describe the characteristics and etiology of diabetic nephropathy explaining how and why it can result in kidney disease and kidney failure.

Understanding these mechanisms can help us prevent kidney failure from…

Problem Statement and Purpose of Study Self-care regimens that require a lot of input are necessary in making the study of diabetes effective. A lot of people with diabetes undergo distress. The diabetes distress is commonly described as the distress that arises from the effect of the diabetes symptoms, regimens for self management, the fear that there would be complications and functionality failure. The diabetes stress stabilizes after some time. It has been found that about a third of all diabetes type 2 patients are prone to diabetes stress regarded as clinically significant. Diabetes distress severely affects adult diabetic patients with a poor diabetes management plan. Such patients stand a high risk of diabetes-related complications. These developments are linked to poor glycemic control and self-management (Leeet al, 2018). The current research seeks to establish whether autonomy support by the health supporters of patients such as the members of their family…

Glycogen Storage and Use

Exercise and diabetes: Beneficial effects

Diabetes is increasing in the United States and throughout the world due to the ever-growing adoption of an unhealthy lifestyle, including poor diet and lack of physical activity. Obesity is a characteristic often present in individuals with diabetes, and in order for the occurrences of diabetes to be reduced and the effects of diabetes to be minimized, efforts must be put in place to encourage weight loss and the maintenance of a healthy weight. It is expected that obesity and diabetes will reach epidemic proportions unless prompt action is taken to counteract these conditions (Albu & aja-Khan, 2003).

Lifestyle factors have been identified that are associated with glycemic control and body mass in individuals with diabetes. Grylls et al. (2003) found that reducing dietary saturated fat and excess body weight may be useful for improving glycemic control in older adults with…

Improving Provider-Patient Communication Among LEP Patients
Abstract
Elderly Hispanic patients experience numerous challenges when seeking for healthcare services since they are only eloquent in their native language and are classified as Limited English Proficient (LEP) patients. Language barriers contribute to poor provider-patient communication and necessitate the integration of third parties in the care delivery process. This paper whether the use of professional interpreters improves patient-provider communication and results in better health outcomes. Through a study that was carried out a sample of 40 elderly Hispanic diabetic patients at a Wellness Center in Los Angeles, using a professional interpreter improves provider-patient communication. The use of professional interpreters and language concordance is associated with improved provider-patient interactions, enhanced interpersonal care, and better medication adherence within three months.
Keywords: elderly Hispanics, patients, medication adherence, bilingual interpreters, treatment, patient-provider communication, healthcare providers.
Overview
Provider-patient communication is an important factor in enhancing patient outcomes in…

Diabetes Management

Early Detection and Management of Diabetic Neuropathy in a Clinical and Homecare Setting

The objective of this study is to examine early detection and management of diabetic neuropathy in a clinical and homecare setting and specifically through examination of articles published after 2002. The information from each source will be summarized listing the strengths and weaknesses of each article in separate paragraphs. As well, this work will utilize table or graphs to present the findings.

O'eilly, Caryl Ann (2005) Managing the Care of Patients with Diabetes in the Home Care Setting, Diabetes Spectrum, July 2005. Vol. 18. No. 3. etrieved from: http://spectrum.diabetesjournals.org/content/18/3/162.full

The work of O'eilly (2005) reports that more patients than ever before are released earlier from hospitals and rehabilitation center and that those with diabetes are included in this trend. Diabetes is reported to be ranked second following congestive heart failure as the primary diagnosis at…

Drugs thought to enhance serotonin-mediated neurotransmission have been shown to diminish appetite for carbohydrates. In a study done by Heraief, Burckhardt, Wurtman and Wurtman, (1985), they examined the ability of tryptophan (TP), serotonin's amino acid precursor, or a placebo to influence weight loss among 62 obese Swiss outpatients who were on a reducing diet known as the Protein-Sparing Modified Fast (PSMF) Diet which is often associated with severe carbohydrate craving. This diet provided relatively large amounts of protein but little carbohydrates, thus stimulating ketone body production. Its consumption also reduced the ratio of plasma TP to the summed concentrations of the other large neutral amino acids, thereby probably diminishing brain TP and serotonin levels. It was found that among moderately obese patients the TP significantly enhanced weight loss, especially during the first treatment month but also during the total. The TP didn't modify the reported adherence to the PSMF diet.…

The structure of yetta is similar to that of GLP-1 and performs the same functions. oth promote decreased appetite (Wilson).

Dr. Wysham was an observer at a study conducted on 20 Rockwood diabetic patients who were taking conventional diabetic medication for their uncontrolled blood sugar (Wilson 2005). She was not informed about their glucose levels for several months after the tests began. About two-thirds of the respondents were given different injectible doses of yetta to incorporate into their medication plan, while the rest were given placebos. All of them were instructed and trained to do the injections at certain times twice daily for a month. Then they were subjected to a physical exam. Dr. Wysham closely monitored their liver, kidney, blood counts, and other functions. She observed that the patients consistently lose weight while taking yetta. The average respondent-patient lost 15 pounds in the duration of the study, 5 lost…

However, what was once a slow journey has recently gathered momentum with the introduction of "more flexible immunosuppression protocols, the ability to individualize surgical options to patient needs, and the dramatic improvement of isolated islet transplantation results." (Allen, p. 3485) esearchers use pancreas transplant options and advanced surgical techniques, but the donor pancreas and surgical complications, as well as the type of immunosuppression affect the outcome of islet transplantation.

The immunosuppressive drugs have significant side effects and long-term effects are still not known. Known side effects of immunosuppressive drugs include mouth sores and gastrointestinal problems, such as stomach upset or diarrhea. Patients also have experienced increased blood cholesterol levels, decreased white blood cell counts, decreased kidney function, and increased susceptibility to bacterial and viral infections. Taking immunosuppressive drugs increases the risk of tumors and cancer as well.

Progress on whole pancreas and beta cell transplantation has been hampered by the…

Diabetes

According to Waryasz & McDermott (2009), the global prevalence of diabetes among people aged between 20 and 79 rose to 6.4% affecting 285 million people in 2010 and the rate will rise to 7.7% affecting 439 million people by 2030. Amid 2010 and 2030, the rate of individuals with diabetes will increase by 69% in developing nations, and a twenty percent rate in developed nations. In 2011, the number rose to 366 and it is expected to rise to 552 by 2030. The pervasiveness of diabetes is advanced in males compared to females, yet the number of women with diabetes is more compared to that of men.

Diabetes affects any part of the human body and people with diabetes are likely to die of heart-related problems or stroke. Seventy-percent of individuals with diabetes show signs of high blood pressure which a risk factor for heart-related diseases. The majority of…

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…

Beneficial effects of the Mediterranean Diet on Type 2 Diabetic Patients in the United Kingdom.

The beneficial effects of the Mediterranean Diet on Type 2 Diabetic Patients in the UK

Science of the problem

Type II diabetes progresses through two stages. The initial stage is referred to as insulin resistance. During this stage, the pancreas produces enough insulin, but the body's cell are unable to respond to insulin. The pancreas increases the production of insulin in the body to compensate for the resistance. The body cells absorb more and more insulin resulting in the pancreas continuously increasing its insulin production. Eventually, the pancreas will shut down the production of insulin because it is unable to keep up with the demand, which results in type II diabetes. The lack of sugar for conversion to energy results in the starvation of cells and there is a buildup of glucose levels in the…

eferences

Acheson, K.J. (2012). Diets for body weight control and health: the potential of changing the macronutrient composition. European Journal of Clinical Nutrition. etrieved from PubMed: doi: 10.1038/ejcn.2012.194.

Austin et al. (2011). Trends in carbohydrate, fat, and protein intakes and association with energy intake in normal-weight, overweight, and obese individuals:

1971 -- 2006. American Journal of Clinical Nutrition. etrieved:

http://ajcn.nutrition.org/content/early/2011/02/09/ajcn.110.000141.full.pdf+html

Barnard, Neal 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.

American Journal of Clinical Nutrition, 89(5): 1588S -- 1596S. etrieved from Pub Med:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2677007/

Davis, N., Forbes, B., & Wylie-osett, J. (2009). Nutritional Strategies in Type 2 Diabetes.

Mount Sinai Journal of Medicine, 76(3), 257-268. etrieved from EBSCOhost

doi:10.1002/msj.20118

Foster, G.D., Wyatt, H.., Hill, J.O., Makris, a.P., osenbaum, D.L., Brill, C., & ... Klein, S.

(2010). Weight and metabolic outcomes after 2…

Interdisciplinary Care Providers
CABG or coronary artery bypass graft surgery is advised for individuals suffering from CHD (coronary heart disease), for alleviating symptoms, prolonging lifespan, and improving QOL (quality of life) (Bayoumi, 2015). Improvements in mechanical ventilation-supported cardiac operation patient management continues to be a major focus area for better optimizing clinical results. The FTE (fast-track extubation) theory applied in case of cardiac operation patients is growing in popularity, in a bid to offer more economical and superior-quality healthcare. A large number of research works have established that prompt extubation (i.e., between 6 and 8 hours after surgery) may be a safe step, whilst decreasing admission and resource use expenses (Cheng, Karski & Peniston, 1996). In spite of the aforementioned advantages, prompt extubation is not consistently performed, underscoring the need to adopt a protocolized strategy for decreasing setbacks and variations and linked to weaning mechanical ventilation. Time-guided extubation protocols’ benefits have been…

This means these children have a much higher chance of developing other diabetes related illnesses as they grow older, including serious damage to the eyes, nerves, heart, kidneys, and blood vessels (Bren, 2004). If they do not learn how to self-manage the disease when they are children, they will have more serious side effects as they grow older, and they will be a drain on the healthcare and insurance areas, as well.

One way to prevent diabetes is to treat the underlying causes, such as poor nutrition, lack of education, and obesity. This education should start in childhood, and the population should have resources available to help them deal with and self-treat the disease. Perhaps "diabetes centers" could open in inner city neighborhoods, that provided treatment kits, education, and even cooking and nutrition classes to help with patients cope with their disease.

In conclusion, Type 2 diabetes hits minority victims…

Health Disparity

Health disparities refer to a certain kind of health-related difference closely tied to economic or social disadvantage. They negatively impact groups of individuals systematically subject to greater economic and social barriers to a hygienic environment and health, on the basis of their ethnic or racial group, age, gender, religion, mental health, socioeconomic standing, geographic location, gender identity or sexual orientation, physical, cognitive, or sensory disability, or any other characteristics that are associated historically with marginalization or discrimination (Department of Health & Human Services, 2011b).

Of all industrialized countries, the U.S. expends maximum resources on the area of healthcare; despite this, millions of U.S. citizens do not enjoy a chance to live a healthful life. Overall population health in the U.S. has witnessed improvements over time, but health disparities for underserved, racial minority and ethnic minority communities continue. Vulnerable population clusters such as ethnic and racial minorities, disabled individuals,…

Self-Help Group Observation

The purpose of the group (diabetic group) is basically to educate patients on how to sustain a healthy lifestyle in case they are diabetic. The main aim for patient education is for individuals suffering from diabetes to enhance their knowledge, confidence and skills, allowing them to have increased control of their condition and incorporate effectual self-management into their day-to-day lives. High quality structured education could have an intense impact on health outcomes and considerably enhance the quality of life (Tidy, 2014). Some of the potential benefits that patient education could have on individuals suffering from diabetes are:

Enhancing health, knowledge, beliefs, and lifestyle changes

Enhancing patient outcomes, for instance, smoking, weight, and psychosocial changes like depression levels and quality of life

Enhancing physical activity levels

Minimizing the need for, and potentially better targeting of drugs together with other items like blood testing strips.

Educational events, like community…

Diabetes

The pathophysiology of Type 2 diabetes is found in the way the body's relationship with insulin. Either the body produces too little of it to meet the body's own needs or else there is a resistance to the insulin that the body has developed (which makes the insulin unable to do what it should -- thus there could be enough insulin in the body, it is just that cells in the body do not respond to it). The cause is due to "a combination of genetic factors related to impaired insulin secretion and insulin resistance" and impacts from external factors "such as obesity," inadequate exercise, aging, etc. (Kaku, 2010, p. 41).

Wilmot and Idris (2014) show that there is an age continuum risk associated with separating Type 2 diabetes diagnosis onsets into two separate categories -- pediatric (under 20 years of age) and adult (over 20). They assert that…

Long-Term Management for Diabetic Patients Under the Home Setting

Aubert .E., et.al, (1998).Nurse case Management to Improve Glycemic Control in Diabetic Patients in a Health Maintenance Organization. A randomized, controlled trial. https://www.ncbi.nlm.nih.gov/pubmed/9786807

This is a report on the research on the comparison of diabetes control in patients receiving nurse case management and patients receiving usual care. The research took a randomized controlled trial model. The research was conducted in primary care clinics in a group model health maintenance organization. It involved 121 patients with type 2 diabetes mellitus and 17 patients with type 1 diabetes mellitus. The intervention that was used in this case study was that the nurse case manager followed the written management algorithm with the direction of the family physician and an endocrinologist. If there were any changes then they would be communicated to the primary care physician. The patients received ongoing care through their primary care…

Diabetes Intervention

The author of this report has been asked to find, analyze and assess a study that is related to a diabetes intervention. The study found needs to be recent and will be described in terms of the major aspects and traits of the study. Precisely such a study was found and it involves the review of the effects of food label use on diet quality when it comes to Latinos that are type II diabetics but are getting assistance from community health workers. The article actually came out this month in a prominent academic public health journal and is very illuminating. While food labels are only so effective as they have to be consulted and used, the concurrent use of community health workers to coach and assist type II diabetics in the study seems to show some promise.

Analysis

Brief Summary of Disease

Type II diabetes, unlike its…

"Hyperkalemia is a potentially life-threatening metabolic problem caused by inability of the kidneys to excrete potassium, impairment of the mechanisms that move potassium from the circulation into the cells, or a combination of these factors "FN12. The article states that acute episodes of hyperkalemia are commonly triggered by the introduction of a medication affecting potassium, and that illnesses and dehydration can also be factors. The physician must also be aware therefore that a common positive response by patients in these circumstances was to a sodium bicarbonate supplementation.

Another bit of information that might be important to the diagnosing physician would be that "elevated serum aldosterone causes the renal cortical collecting ducts to excrete potassium and retain sodium, further lowering serum potassium" FN13. Potassium levels should be monitored in an ongoing fashion to determine whether they are stable or not. Additional monitoring should take place for hypertension since twenty to sixty…

Expressive functioning is related to communication such as emotional, verbal, and nonverbal communication, problem solving and roles within the family. Beliefs within the family are also a part of expressive functioning.

For the purpose of the Calgary Family Assessment Model, a family is defined as who they say they are. It is very important that the clinician performing the assessment not assign their own beliefs upon what he or she believes a family is, and take into account what the patient feels about family as to the patient is may mean not only the people who actually live within the household but can also address past, present and future emotional attachments.

Calgary Family Intervention Model:

The immediate family is composed of Mr. Herbert Schelley (the patient), Mrs. Annette Schelley (his wife), and their son Thomas Schelley. The extended family consists of the Schelley's two married daughters, their husbands and their…

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…

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

Intervention Plans

Target Goals

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…

Evidence-Based Practice, or EVB, is a strategy that uses research, quality control measures, and other forms of evaluation data in order to improve practice methods within the healthcare setting.

EVB utilizes innovative clinical research study findings, survey results from both patients and healthcare providers, expert opinions, and quality improvement data to demonstrate a need for change and generate the most potentially successful strategy to improve the quality of care.

The procedures used within any application of EVB practices are guided by a clear mission and vision statement that directly reflect a need for improvement or other problem area.

Teams within the healthcare setting must be willing to search for and use evidence to help facilitate change.

Slide

Today, there are more Americans living with and at risk for diabetes than ever before in this nation's history.

Over 29 million Americans deal with diabetes on a daily basis. Many might think…

ole of Omega-3 Fatty Acids on Endothelial Functions

ole of fatty acid on endothelial functions

Antioxidants and Marine N-3 Fatty Acids Improves Endothelial Function in Hypercholesterolemic People

The hypercholesterolemic people refer to the individuals who suffer from the high concentration of cholesterol in their bodies. These hypercholesterolemic people normally needs the improvement of their endothelial functions in order accommodate the high levels of cholesterol in their bodies. The individuals normally witness a change in their aortic consequently altering their endothelial functions. Hypercholesterolemia is responsible for alteration of dilatation function of the endothelium in the small blood vessels. Further, the alteration of the aortic functioning also makes the patients be susceptible to higher blood pressure. Studies show that the patients normally witness abnormality in the endothelium-dependent dilator function in the human circulation (Goodfellow et al., 2002). The extent of impairment (endothelium-dependent dilator) depends on the level of hypercholesterolemia. From this, it…

eadmission of patients with diabetes is a problem that warrants consideration of the contributing factors. eadmission of patients within 30 days of discharge is considered to be an indicator of healthcare quality -- along with other circumstances, such as patient lifestyle -- that needs to be addressed from a patient care perspective and from a cost of care perspective (Dungan, 2012). A dismal statistic starkly represents the problem: oughly 8% of the U.S. population is represented by patients with diabetes, yet this group accounts for 23% of the hospitalizations in the nation (Dungan, 2012). On top of this figure, between 14.4% to 21% of diabetic patients are readmitted, compared to 8.5% and 13.5% of U.S. hospital patients overall (Dungan, 2012). The problem is exacerbated by the rise in national rates of diabetes means that more patients will present from the general population and, accordingly, more patients with diabetes will experience…

Diabetes Management

Describe the background of the problem

Diabetes is considered to be one of most manageable and frequent problems impacting a large number of Americans. As someone becomes older, they are more likely to develop the condition from poor lifestyle choices, diet, the lack of exercise and genetics. According to the Centers for Disease Control (CDC), there are a total of 29 million Americans who are impacted every single year. Out of this, number 17.7 million are between the ages of 40 to 60 years old. In many cases, learning to manage their diabetes and making healthy choices are critical for avoiding other complications. The most notable include: heart disease, stroke, blindness and the loss of limbs. This issue deserves attention as the inability to live with and manage the condition will result in premature death and the inability to function normally on a daily basis. ("National Diabetes Statistics…

By educating patients on early warning signs of hepatotoxicity, this rare but potentially fatal consequence could be detected early to allow appropriate intervention." (Wright and Vandenberg, 2007) it is extremely critical to understand the nature of psychiatric nursing in today's clinical environment.

IV. ROLE of NURSE PRACIIONER in RANSIION

Specifically stated in the work of Kathryn R. Puskar entitled; "he Nurse Practitioner Role in Psychiatric Nursing" published in the Online Journal of Issues in Nursing is: "Commercialization of psychiatric care is underway. Psychiatric inpatient admissions have decreased, admissions to general hospitals have decreased, while outpatient admissions are increasing. Academic centers are purchasing smaller hospitals as affiliates; satellite clinics and networks of services are being established. Physicians in solo practice are merging into group practices. New health care professional roles must be restructured and "cross trained" to maintain competitiveness by offering flexible, cost-saving effective care. his is the background environment in…

thirds of the global population lives within the Asia Pacific area where pervasiveness of diabetes has reached rampant proportion. With India and China being the most densely inhabited countries in the world, it is thought that over one hundred and fifty million diabetes cases reside in the area with more than a staggering 95% being of T2DM or type 2 diabetes mellitus. Additionally, other Pacific islands within the area have high rates of T2DM. These islands include Tonga, Nauru, French Polynesia, and Fiji.

The latter possesses the highest occurrence of T2DM per populace in the globe. Over the past twenty, New Zealand and Australia, the incidence of T2DM has actually doubled, largely midst the Torres Strait Islander and Aboriginal and Maori peoples correspondingly. With the snowballing frequency of diabetes within the Asia Pacific area coupled with the inadequate number of resources, use of a consistent and efficient mode of diagnosis…

Healthy People 2020 and Diabetes

Diabetes is a community health problem that is also a Healthy People 2020 priority area. abish (2007) has cited it as a growing epidemic occurring all over the world. Because diabetes has been linked to obesity, poor diet and lack of exercise, it is reasonable to arrive at the conclusion that if people ate better and exercised more the rising spread of diabetes could be reversed. his is the contention of researchers such as Davis (2008) and Cunninghamm-Myrie, heall, Younger et al. (2015). In short, diabetes is impacting everyone. All who consume "fast food" type of diets are at risk of developing diabetes according to these studies.

he public health leadership problem related to this health issue is that public health leaders appear all too willing to simply treat the symptoms of diabetes instead of attacking the causes of the disease. Better leadership in this…

Clinical Problem: Diabetes Mellitus in Rural Settings

Mid-range nursing theories can be extremely useful in understanding specific clinical issues. These theories are less broad and all-encompassing than so-called grand theories of nursing such as Jean Watson’s Theory of Human Caring and seek to offer a more technical and practical approach to applying theory in daily practice (Alligood, 2018). This paper will specifically examine the application of Kristen Swanson’s Theory of Caring to the treatment of patients suffering from diabetes mellitus living in rural settings without adequate access to healthcare. Virtually all nursing theories are composed of four essential core definitions, that of person, environment, health, and nursing itself. Swanson’s theory, however, specifically focuses on nursing, which Swanson defines as a very specific type of caring.

Clinical Issue

Although obesity is increasing across the nation, obesity is often particularly rife in rural settings with limited access to healthcare and healthy foods.…

Multiple studies support the use of cognitive behavioral approaches in individual therapy combined with group therapy sessions to support self-care behavior, self-efficacy and positive patient outcomes (Van der Ven, et. al, 2005; Bernard & Goodyear, 1002; Alterkruse & ay, 2000). Altekruse & ay (2000) also support the notion that group therapy may be interchangeable with individual therapy to promote positive outcomes among patients.

Conclusions

esults of the studies reviewed suggest a new approach to group therapy should include individual and group sessions that encourage patients to focus on their successes rather than failures. At this time the evidence supporting group therapy over individual therapy is conflicting. Much of the research suggests that both approaches may be equally effective. egardless many therapists still advocate group therapy as a primary modality for overcoming patient issues.

Pre-group training sessions may help members of the group adopt a new attitudes toward therapy that enables…

Walker and Avant (2010) as a technique of describing real phenomena in the realms of nursing practice. Concept analysis is noted by Walker & Avant (2005, pg. 63) to "allows the theorist, researcher, or clinician to come to grips with the various possibilities within the concept of interest." Walker and Avant (2010) developed a special eight step process to be employed in content analysis. These eight steps are what we employ in this paper in the investigation of the assumption of self-care by adolescents suffering from Type 1 diabetes Mellitus.

The aim of this specific concept analysis is to examine the concept of assumption of self-care by adolescents suffering from Type 1 diabetes Mellitus. Walker and Avant's (2010) methodology of concept analysis was employed in the identification of the antecedents, the defining attributes, the consequences, the empirical referents as well as the cases that are associated with the concept.

Purpose…

Teenagers in Conflict ith Their Environment

At the time of the stories

Teenagers are often in conflict with their environment. hat some call the "rebellious" years are at times just periods in a person's life where he or she may feel confused, lost, and alone. Three stories by Oates, Boyle, and Gilman highlight the lives of teenagers and their conflicts within their worlds. Each character will show how teenagers may act; the paths they choose along with the reasons.

HERE ARE YOU GOING, HERE HAVE YOU BEEN by Joyce Carol Oates is a novel that describes the life of a teenage girl named Connie. Connie is one of the main characters and the protagonist of the story. Oates paints her as a beautiful and self-absorbed 15-year-old who argues with her mom. Although her mother was once beautiful like Connie, she has aged. Her sister, older and more homely, provides a…

Health Maintenance Issues

Mrs. Gray is an 86-year-old woman who has been diagnosed with Type Two Diabetes. She has lived with the disease for three years. Mrs. Gray is single and lives in the area in a naturally occurring retirement community. Mrs. Gray, though 86, appears much younger than her stated age, which can be largely attributed to her active physical nature. Mrs. Gray boasts an exceedingly active social life, meeting her friends for lunch several times a week, and she strives to keep herself in good physical condition by going to the gym an average of four times a week. Mrs. Gray is further involved in the community through significant work in her church and as a member of the Senior Friends Program, which allows volunteers to interact with shut-ins by visiting with them and bringing them dinner once a week. Mrs. Gray's last A1C was 6.1%.

Health Maintenance…

Homeostasis Defined
Homeostasis, according to Nirmalan and Nirmalan (2017), is the propensity for living organisms to maintain relative stability in the internal environment. Homeostasis is made possible through the cooperation of several regulatory mechanisms and separate sub-systems which make up the normal physiology of a living organism (Nirmalan & Nirmalan, 2017). During critical illnesses internal or external stress can make an attempt at interfering with the self-regulation systems beyond what is considered as normal range in physiology. According to Palaparthi and Med (2017), the word homeostasis is derived from two Greek words i.e. ‘homeo’ (stands for similar) and ‘stasis’ (standing for stable). Homeostasis is the balance, equilibrium and the stability of the body or of the cell (Palaparthi & Med, 2017). Living organisms exhibit this character. The process of maintaining stability in the internal environment necessitates occasional internal adjustments as the environmental conditions continue to change outside and inside the…

Medical Conditions -- There are a number of factors that can increase the likelyhood of type-2 diabetes: hypertension, eleveted cholesterol, and a condition called Symdrome X, or metabolic syndrome (combination of obesity, high cholesterol, sedentary lifestyle, stress, and poor diet). Cushing's syndrome, cortisol excess and testosterone deficiency are also associated with the disease. Often, it is a number of co-dependent conditions that seem to give rise to diabetes (Jack & Boseman, 2004).

Genetics -- There is ample evidence that there is a strong inheritable genetic condition in type-2 diabetes. In addition, there is a genetic mutation to the Islet Amyloid Polypeptide gene that results in early onset diabetes (Lee & Hasim, 2001). There is a stronger inheritance pattern for type-2 diabetes with a significant association between family members. Typically, this is excacerbated by cultural and lifestyle factors that, while not inherited, are culturally shared. Gene expression promoted by a diet…

Dieting Factors

Americans spend billions of dollars on weight-loss products and programs every year. Despite this, most people do not lose the amount they would like or, if they do, regain the weight after a short period of time. The problem lies with following specific fads that emphasize one type of eating pattern. The low-carbohydrate diet, which has been popular off-and-on-again since the mid-1800s, exemplifies such a diet program. Studies do show that the low-carbohydrate diet can offer some benefits, but over the long-term does not offer any more advantages than any other diet. Other factors, such as adherence to the diet and lifestyle are more important to the equation.

Americans spent approximately $60 billion in 2009 on weight loss products and programs, including so-called "special" diet foods, appetite suppressants, diet books, exercise memberships, workout videos, and stomach-clamping surgery (World Health Organization, 2010). Yet obesity, especially among children and youth,…

Patient, Mr. D., is a 74-year-old male Caucasian, married and retired. Mr. D. complains of dizziness and weakness. Type-2 diabetes was diagnosed in 1994, hypertension in 2002, and arthritis in 2007. Mr. D. is currently taking 20mg Lipitor/daily; 81 mg Aspirin/daily; 333mg Calcium/daily; 5mg zinc/daily, and 500mg Vitamin C/3X day. He denies any drug or herbal use, and uses 650 mg of Tylenol for pain as needed. He has no known food allergies, does not use tobacco or illicit drugs, but has a family history of diabetes and heart disease with both mother and father. His general health acuity is strong (bowels, urinary, etc.), but has occasional slurred speech, weakness in right lower limb, syncope, vertigo, and vision fluctuations. Mr. D. reports that his wife complains he asks the same question repeatedly within a short time period.

Areas for Focused Assessment- The combination of syncope, vertigo, vision, and memory issues…

Nutrigenomics is an important field of study. It finds in roots in modern times, because of the direct relation to advances in science and technology. Nutrigenomics also straddles the nature vs. nurture divide. The publication of the relatively preliminary results of the Human Genome has given greater impetus to the idea of Nutrigenomics. One might assuredly say that the publication of the Human Genome is preliminary because the current versions of the genome are merely representatives of a very select group of individuals. (Lander et al., 2001; Venter et al., 2001) What makes individuals unique of course is the presence of single nucleotide polymorphisms or SNPs. It is these SNPs that give each of us our individuality. Hence each individual's genome is his or her genotype. A genotype is an individual's genome -- the genetic coding that identifies the character traits that govern existence. In the context of Nutrigenomics, a…

Organizational Case Study -- Nutri Systems

Company Background - Nutrisystem is an American company that provides weightloss products and services. Originally, the company's sales and marketing model focused on Brick and Mortar stores, in-person counseling and exercise sessions, and the sale of prepackaged supplements and food products retail. In 1999, however, largely due to the number of diets on the market and exhaustive competiton, Nutrisystem began selling online with support through 800#s and email. The company expanded to QVC in 2001 and Costco since 2009 (www.nutrisystem.com).

The foundation of the organization is portion-control and a diet that has a low glycemic index. Separate plans are offered for men and women that support a 1-2#/week loss. All plans have love sugar, cholesterol and sodium and cost from $280-400/week. Users must also purchase additional fresh items locally, but 2009 clinical trials showed that persons with Type-2 diabetes consistently lost more weight and…

Stevia

Underlying the Sweetness: An Analysis via Mass Spectrometry of the Diterpene Glycosides Occurring in Stevia Leaves

A large part of the nutritional and dietary social and technological revolution that has been occurring since the middle of the twentieth century has focused on the issue of sugar and other sweeteners, and the various health problems that these can cause -- especially when consumed in abundance. The caloric content of sugar and most other naturally derived sweeteners has caused worries concerning the growing obesity epidemic in the Western world, and the United States especially, but many zero-calorie artificial sweeteners that have been developed have been shown to be carcinogenic. It is for this reason that naturally-derived yet zero-calorie sweeteners have been sought as dietary alternatives.

The leaves of the Stevia plant have been known to be naturally sweet by certain peoples for quite some time, and recently this plant and its…

Hypoglycemia

How to deal with hypoglycemia:

What is hypoglycemia?

Hypoglycemia is a condition that occurs when a patient's blood sugar (glucose) is too low. Quite often, the patient will be aware of this condition through symptoms such as feeling faint, agitation or anxiety, sweating, weakness, or headache. Confusion and double vision may also manifest themselves. Technically, any blood sugar below 70 mg/dL is considered low (Topiwala 2012). Common causes of hypoglycemia include too much insulin is released into the bloodstream when the patient is an insulin-dependent diabetic.

People with diabetes often suffer hypoglycemia when their condition is not being treated properly, such as when they inject themselves with too much insulin. "Hypoglycemia may also result if, after taking your diabetes medication, you don't eat as much as usual (ingesting less glucose) or you exercise more (using up more glucose) than you normally would" (Hypoglycemia, 2012, Mayo Clinic). Other causes include…

Business Case Quality for Athens Medical Center

A cost reduction, and high quality healthcare delivery are paramount to the values of a healthcare organization. Typically, a cost reduction is driven by operational quality, and clinical improvement leading to removal of harm, variation and waste. The objective of this paper is to present a business case to achieve quality improvement for Athens Medical Center to deliver optimal quality improve patients outcomes. Moreover, the business case develops the implementation plan to enhance the quality of healthcare delivery for our Medical Center. The implementation plan will focus on health education for diabetes patients. After 6 months of the plan implementation, the paper previews that 50% of diabetes patients who receive the health education will record a lower HA1C by 1 point. At least, 25% of the patients will be able to lower their HA1C by 2 points. (Homer et al., 2004, Swensen et…