Education (1213)
Alcoholism During Pregnancy And Current Responsibilities Of Professional Nurses
WRITTEN_BY AdministratorAlcoholism During Pregnancy And Current Responsibilities Of Professional Nurses
Definition
Today, the government advices that pregnant women should, altogether, avoid alcohol. Some women are used to taking alcohol in their daily lives. As a result, they end up intentionally or unintentionally taking alcohol during their pregnancy months. For women who cannot do without alcohol, it had been advised that a unit or two per week were alright for the pregnant alcoholic mothers. This advice has also been extended to women with the trying to conceive. During conception and during pregnancy, women should not only avoid heavy drinking of alcohol but should avoid drinking alcohol altogether to avoid harmful conditions on the baby.
Brief history
Alcoholism in women is found throughout history (Ornoy, and Ergaz, 2010). Today women account for about one third of all Americans with disorders related to alcohol dependence or alcohol use. However, there has been a major issue related to alcohol and women which is alcohol during pregnancy.. Sir Francis Bacon, in the 17th Century warned women not to take alcohol during pregnancy. Since the 17th century, there has been increased knowledge on alcohol and pregnancy. In the 18th century, the British Government recognized the impact of alcohol on the outcomes of pregnancy and took necessary measures to counterattack such deadly trends. In the 19th century, the British House of Commons reported starvation and imperfect look as observed in infants of alcoholic mothers. By the end of the 19th century and researchers began examining alcohol effects on fetus (Ornoy, and Ergaz, 2010). Originally, it was believed that genetic shock and not exposure to alcohol resulted to birth defects in children of alcoholic mothers. However, from reliable research carried out in Germany, Sweden, and France, pattern of malformations, defects of the central nervous system, and growth deficiencies were found in children of alcoholic mothers.
Effects upon maternal-child health
The dependence of fetus on the mother to feed means, when mother takes alcohol during pregnancy, so does the baby. This also implies that the alcohol level in the mother’s blood is the same level in the baby’s blood. The only difference in the two blood alcohol levels is that the baby has very small liver that cannot regulate the alcohol blood levels thereby ends up being hurt during development (Ornoy, and Ergaz, 2010). This results FASD or fetal alcohol spectrum disorder. Alcohol can also result to birth defects, preterm birth, low birth weight, hearing or vision problems, disabilities in learning, delayed speech and language, sleeping and suckling problems, and behavior problems.
Related elements
The total amount of money estimated to treating birth defects by 1985 was estimated more than $1.3 billion. Other related elements include FAS in adolescence, and adulthood. FAS are also associated with women of low social economic status especially amongst African American an native Americans. Both Hispanics and whites have lower FAS incidence rates compared to African Americans, Hispanic Americans, and Alaskan native groups.
Professional disciplines involved in managing alcoholism during pregnancy
The professional involved is maternal-child health.
Health care responses
Women are always warned to stay away from alcohol to avoid such harmful FAS conditions. Occasional drinkers will be required to have regular prenatal care and communication of any concerns, or contact with alcohol treatment program.
Nursing participation, actions, and interventions
Major nursing intervention to reduce alcohol-exposed pregnancy is motivational intervention coupled with brief motivational information to pregnant women. Introduction of alcohol educational programs in schools is also an effective intervention measure. For the children born with FAS conditions, creation of diagnostic centers for consultation and treatment is an essential way to guide alcoholics on how to deal with their children. Again, nursing can also establish programs to educate and train professionals on significant information that needs to be known. Information campaigns also play an important role in addressing future mothers and society while new interview models will be used in identifying dangerous alcohol consumption patterns.
Nursing interventions
Nursing interventions are intended at providing significant information on alcoholism and pregnancy to children, vulnerable women, and childbearing women. Child bearing women are vulnerable to ineffective use of birth control especially if alcoholic. In addition, binge drinking among these women is worse than just low level daily drinking. Advising such women on alcohol intake at pregnancy and the use of effective birth control will play a major role in reducing alcohol exposure pregnancy. By maintaining routine health maintenance, child bearing women are informed about safe sex, use of alcohol, and contraception. For the pregnant women, intervention information should require them to stop usage and screening used during prenatal care visit. While dealing with heavy drinkers, brief intervention will include provision of advice, obtaining feedback, setting goals, and additional contacts. Brief intervention could be very brief-five minute session-, brief- up to 15 minutes, and multicontact brief session 15 minutes initial session with successive visit taking lesser time (Mengel et al. 2006).
Evolution of nursing roles and responsibilities
The role of nursing in healthcare is to provide preventative and curative care to patients. During pregnancy, alcoholism has deleterious effects on the Central Nervous System as well as other embryonic and fetus organs. The impact of alcohol on embryo and fetus is dependent on duration, dose, and developmental stage. The role and responsibility of nursing evolved with the aim of reducing alcohol consumption during pregnancy to as low as possible. However, the definition of minimal pregnancy alcohol consumption is difficult which is why nursing is advocating for cessation in alcohol consumption for those trying to conceive as well as for the pregnant women. Since alcohol is a toxin associated with numerous children abnormalities, nursing intervention has become handy in the assessment, education, and intervention.
Future nursing solutions
For a brighter future on nursing responsibilities in preventing FAS, Family physicians’ clinical practice should integrate screening, assessment, education, and brief intervention to be part of their practice (Mengel, 2006). This is important especially for alcoholic women who do not make it to the health care institutions. Educating healthcare professionals is not a sufficient measure in ensuring that the attained skills are integrated into practice. As a result, nursing responsibilities in preventing FAS should include support systems to facilitate educational intervention (Mengel, 2006). Some women tend to deny the existence of alcoholism problem. As a result, they end up being at high risk and later delivering babies with FAS. For such women, overlapping reinforcement levels of education and persuasion, incentives, and intervention will work well in ensuring women remain truthful. After admission of alcohol use, the healthcare professionals can now use gained knowledge to understand the probable contributing factors and focus on root cause elimination other that curing the symptoms (Mengel, 2006).
References
Mengel, M., Searight, H., and Cook, K., (2006). Preventing alcohol exposed pregnancies. The Journal of American board of family medicine. Vol. 19. Iss. 5. P. 494-505. http://www.jabfm.org/content/19/5/494.full
Ornoy, A., and Ergaz, Z., (2010). Alcohol abuse in pregnant women effects on the fetus and newborns, mode of action and maternal treatment. International Journal of environmental research and public health. Vol. 7. Iss. 2. P. 364-379. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2872283/
The Lemon Tree by Sandy Tolan
Migration of Jewish Bulgarians
Bulgaria aligned itself with the Axis powers and Germany during the build-up to World War II1. These countries perceived the Jews as anticommunists. Approximately 50 000 Jews lived in Bulgaria at the time the Holocaust started. Bulgarian had signed a pact with Nazi Germany that would allow the handover for annihilation of Bulgarian Jews. Bulgaria subjected the Jews to discrimination and so in 1943 it began to prepare them for mass deportation to the German authorities in Treblinka, where they would be put to death. However, resistance from Bulgarian parliamentarians, the orthodox clergy, and intellectuals prevented the government from deporting the Jews. This paved way for the migration of the Jews to Israel in 1948.
Glossary
King Abdullah of Transjordan: Abdullah is the former King of Transjordan, the modern-day Jordan 2 He annexed the Palestinian territory of West Bank in 1947 and under his reign, Ramla, modern-day Ramallah, which falls within West Bank, became Jordanian-controlled. During the reign of King Abdullah’s, Ramallah became a cardinal transport hub and communications center of the territory of West Bank. It is a center of conflict between Israel and Palestine and, hence was a crucial military base for the King. In 1948, King Abdullah led the Arab Legion (Jordanian Army) into war with Israel 3. He transformed Transjordan into Jordan. A Palestinian nationalist assassinated him in 1951 due to his collaboration with Zionists (Israel) against the creation of the state of Palestine.
Notes
- Sofia University. “Soviet and East European Jews during World War II”. Conference
Paper. International Academic Conference, November 2-4, 2012. Sofia University
- Tolan, S. “The Lemon Tree”. London: Transworld, 2008
- Kashgari, T. “Transjordan and Israel: Examining the Foundations of the Special
Relationship”. Student Pulse, 3, 3 (2011): 2
Bioethics
Future Goals and Vision
As a PhD student in the bioethics program, I have several main goals for the future. Firstly, I intend to help in training upcoming health care practitioners. As a result of the knowledge gained in this program, I am equipped to guide the upcoming health care practitioners towards the right direction in terms of career. I also have the goal of establishing a research center specializing in bioethics. Research serves as an important aspect of health care. Through the research center, it will be possible to enhance the quality of health services offered to the population. In the future, I intend to work on a publication on bioethics. Through this publication, I will share my insights with other professionals and also enlighten upcoming practitioners. The publication will emphasize on the importance of bioethics and what should be done to enhance bioethics standards in health care.
Lessons Learnt
Throughout the program, I have gained a lot in terms of knowledge. Whereas most of the lessons learnt are theoretical in nature, they will be beneficial when it comes to actual application. Firstly, I have grasped the various concepts that govern bioethics in health care. Informed consent serves as an essential principle that governs bioethics in all parts of the world. The participants should not be forced to take part in any experiment or trials. The participation of all individuals should be voluntary in order to maintain the highest standards of human dignity. Apart from informed consent, bioethics is also governed by the principle of respect for autonomy. Individuals should be allowed to make independent decisions free of any form of influence.
Throughout this program, I have also gained the knowledge to solve problems depending on the prevailing conditions. These lessons will come in very handy for my future career. This is because I will have the relevant knowledge of addressing different types of issues in bioethics.
Importance of Bioethics
As mentioned earlier, bioethics serves a crucial role in medicine. Essentially, it provides an excellent framework for establishing a regulatory mechanism. In academic institutions, bioethics also serves different types of roles. Firstly, it helps in averting dangerous medical surveys. (Johnstone, 2008)
In all academic institutions, the fulfillment of the fundamental principles of bioethics is a mandatory requirement. Medical surveys are disapproved if they do not conform to the basic principles of bioethics. Bioethics also helps in establishing an appropriate framework for distributing the gains derived from the survey. Essentially, bioethics also helps in preparing the students for future careers in medicine or health care. This is because they are provided with adequate exposure.
Ethics Consultations
Within a hospital setting, ethics consultations may be handled in numerous ways. Firstly, it is essential to ensure that all health care practitioners in the hospital are familiar with the fundamental principles of bioethics. Through such an approach, it is possible to minimize errors. Minimization of errors within the health care organization helps in enhancing the standards of patient safety. (Johnstone, 2008) Additionally, it is also crucial to adjust the hospital’s policies in accordance to the various principles of bioethics. As a result of this approach, the quality of decision making in the hospital is enhanced. When the hospital’s entire structure conforms to the various provisions of bioethics, it is easier to facilitate ethics consultations. Additionally, this approach helps in averting potential conflicts.
Reference
Johnstone, M. J. (2008). Bioethics: A nursing perspective, Elsevier Health Sciences
Misconducts Within Animal And Human Subject Research
WRITTEN_BY AdministratorMisconducts Within Animal And Human Subject Research
Introduction
Animals and humans have been the center for medical research for a long period of time. Clinical as well as other researchers have continued to use animals and humans for experimental purposes. Over time, there have, however, been misconducts that have been conducted by researchers in their process of research. Such misconduct has been conducted mostly on animals as they do not have to provide consent for them to be used in research. This has resulted to researchers violating animal rights with impunity for years. It is such violations and misconducts that have resulted to formation of animal rights organizations. Such organizations are geared towards ensuring that researchers who use animals for research do not engage in any misconduct. In the recent past, human beings have also been the subject of research by scientists. There are various issues that have risen with regard to use of humans for research purposes. This has resulted to a debate on whether the wide use of person subjects in study is in itself misconduct. Paul M. (1993).
Misconduct in animal research
Animal rights activists have been opposed to the use of animals for purposes of medial research. They have had this stand with views that human beings do not have the mandate to use animals. With extremely little exceptions, experiments are not carried out on human subjects without seeking for their consent. Animals activists have made claims that it would, therefore, be gross misconduct to carry out experiments on non- human animals. Animals do not contain the capacity to provide informed consent and it is on this basis that it would misconduct to use the animals for experiments.
Another misconduct that is carried out on animals is the degree and extent of experiments that are conducted on animals in research. Researchers have often conducted experiments on animals that involve procedures that are detrimental. Such procedures involve practices that jeopardize the physical condition and lives of the animals. The procedures are injurious and invasive on the animals and it results to them being prone to immense pain. Given the extent of the procedures it is with no doubt that human beings can not allow such practices to be conducted on them. It is, therefore, can be considered as misconduct that scientists and other researchers have continuously performed such procedures on the animals. The experiments that are conducted on animals sometimes are so extreme and dangerous that the lead to the death of those animals. Kevin D. (2002).
Since those animals do not have the ability to advocate for their rights, researchers have continued to practice the experiments on the animals. Just as unethical experimentation on certain humans can not be justified by a benefit to humanity at large, the same ought to be true for animal experimentation. Just as humans have consciousness as well as interests in their own lives and freedom animals too have similar interests. The only different is that when animals’ interests are violated, they can not be able to forward their concerns. Treating animals differently and try and justify experimentation without consent on them but not on humans would be termed as some level of misconduct.
The misconduct on animals and violations against them has resulted to animals’ rights activists standing up for the animals. The activists have provided evidence of medical advancements that were discovered without the use of animals. Such include the cure for scurvy which did not involve animals, but studies were carried out on human subjects who already had scurvy. The first vaccine was invented in the eighteenth century and it did not involve animal experimentation. This was when people were immunized with cowpox so as to be able to build on their resistance to smallpox. Other medicines such as penicillin were also discovered without using animals to conduct research. In the recent past Heimlich maneuver was crated without vivisection and has resulted to saving of numerous lives. Some of the researchers have studied human populations and this has lead to significant medical discoveries. Part of this has included the link between cardiovascular ailment and cholesterol as well as the connection between smoking and cancer. Daniel W. (2001).
Legislation against misconduct in animal research
Various measures have been taken with the aim of reducing the misconduct against animals during scientific and other research. In the United States of America, the animal welfare act has looked to set various minimum requirements. These requirements are related to the humane treatment of animals that are used for research purposes in laboratories and other settings. The animal welfare act requires organizations that carry out vivisection to have institutional animal care. They are required to use committees that have the mandate of overseeing and approving the proposed used of animals in research. The measures that have been taken, however, appear to have certain levels of ineffectiveness. For instance, the animal welfare act has in its provisions explicitly excluded from protection all rats and mice. This is with concern as rats and mice make up approximately 95% of the animals that are used in laboratories. Furthermore, the act does not consider it illegal for researchers to practice invasive practices or the demise of the animals after experiments have been concluded.
Misconduct in use of humans in research
Humans although not as widely as animals have also been used in scientific as well as other research. This has also seen instances when misconduct has occurred when humans are being used for research. Though scientists are required to get consent from individuals prior to using them for research, this does not always happen. Some of the scientists in organizations have violated human rights and have used them for research without accessing their consent. This usually happens when individuals have been diagnosed with various ailments. This results to them being admitted in medical facilities so as to get treatment. It is during this time when they are under anesthesia that medical practitioners take advantage of the situation. They in some instances get some body samples from the patients and are used for research purposes that are not related to the ailment of the patient. Jonsen A. (1982).
Some of the researchers have also used young children with no family backgrounds and have carried out research on them. They sue such individuals as the children do not have anybody under their care hence the scientists would not be answerable to anyone. Some of the medical practices and research that are carried out on human beings end up being detrimental to the individuals. They usually result to various complications that may have an eternal outcome on the lives of the victims. In instances when the research practices are extreme, they can even result to death of the victims. This usually occurs when the researchers carry out scientific or other research on human beings that they do not know of the effects.
Another major concern that has resulted to claims that it is misconduct is the practice of cloning. Scientists have claimed that there is not anything incorrect with cloning and that it ought to be conducted. They have added that cloning of human beings would result to individuals who are more resistant to diseases and can live longer. The claims from scientists have resulted to great uproar from various quarters. This has included religious leaders as well as other leaders who claim that this is gross misconduct as no man has the power and authority to create another. The concerns have been immense and this has resulted to placing of a ban that makes cloning of human beings to be illegal. Legislation has been put in place that has made it illegal for scientists to use human beings to create other ‘human beings’. Jay (1987).
Conclusion
Scientific and other research ought to be encouraged as long as it does not violate animal as well as human rights. When researchers make a decision that thy have to use animals, they should make sure that the procedures are not dangerous. Animals ought not to be subjected to pain and injury when they are being used by scientists and other researchers. When it comes to use of human beings for research, human rights should not be taken for granted. Children who have no family background ought to be protected by government from having their rights violated.
Reference:
Paul M. (1993) The ethics and politics of human experimentation: New York.
Daniel W. (2001) Laying ethical foundations for clinical research, Public Health Classics, Bulletin of the World Health Organization.
Kevin D. (2002) Ethics of health care: an introductory textbook, Georgetown University Press.
Jay Katz (1987) The Regulation of Human Experimentation in the United States: A Personal Odyssey, IRB: Ethics and Human Research.
Jonsen A. (1982). "The Evolution of Regulatory Influences on Research with Human Subjects". New York.
Restricting Health Care Delivery System
The restructuring of the health care delivery system result on great emphasis on measures for cutting cost, which will lead to a reduction of nurses who provide direct patient care. Accountable care organizations are integrated groups of physicians, hospitals, and other providers who are responsible for the need of health service in a defined population of patients (Goldsteen, K et al 2012). Accountable care organizations offer a pathway for controlling cost through the payment reform. It establishes collaboration of providers who enter into an agreement with payers so as to be financially accountable of the provision of the health care services to the defined population. Through the collaboration, the providers will be able to build an existing local relationship among themselves. The method of payment will include a variety of the provider incentives that will meet the cost targets including the shared risks, the shared savings, partial capitation, and beneficiary incentives like different co pays. The Accountable care organization will depend on several organizational and structural features so that to be able to meet their quality and cost targets.
The coordination and care management adopted by ACO will require a nurse workforce that is linked to the patient. The nurse who will be employed by Accountable care organizations will be responsible of management of care to the most complexly ill patients in the group, and also for the transition of their care. The transition that the nurse will be responsible will include from home to hospital, hospital to home, or from primary care to intensive outpatient secondary care. When restructuring the health care delivery system, the demand to build primary care nursing work force for nurses will grow. The demand will grow as the accessibility to service setting, coverage, and services will be increasing. The nursing jobs will increase with a large number because of the increase in the demand for primary care services. The demand for primary care services will be because of the expansion in the health coverage.
Restructuring the health care delivery system will change how the nursing practice performs their responsibility. The way the nurses plan, document, deliver, and review clinical care will change. The process of reviewing and obtaining diagnostic information, communicating with the patients, carrying out clinical interventions, and making clinical decisions will radically change from how the activities have been performed. The time that most of the nurses take when performing their tasks will change. The restructuring will change all facets of care, which will be mediated by digital workflow, decision support, and computerized knowledge management. The introduction of electronic health records will make it easy in caring for patients as medication, diagnostic tests, and some therapies will be will be managed and directed by support from the computer (Kongstvedt, P 2007).
With the introduction of electronic health record, the cost of services will be lower, and the quality of care will improve as measured by the achievements and outcomes of the other end points. With the restructuring of health care delivery systems, the demand for nurses will increase. Training and education for nurses will also be improved where the education sector will be able to produce nurses who are prepared and ready to deliver acute care services in acute care settings. Health care institutions will have no shortage of nurses, which will help in improving the care provided to patients.
Reference
Pozgar, G (2007). Legal aspects of health care administration Jones & Bartlett Publishers
Kongstvedt, P (2007). Essentials of managed health care Jones & Bartlett Publishers
Jonas, S Goldsteen, R & Goldsteen, K (2012). Jona’s Introduction to the US Health care system Springer Publishing Company
Who Attends Clinical Supervision? The Uptake Of Clinical Supervision By Hospital Nurses
WRITTEN_BY AdministratorWho Attends Clinical Supervision? The Uptake Of Clinical Supervision By Hospital Nurses
In this study, the researchers sought to establish the efficacy of clinical supervision and the number of nurses who attend such programs. The study was in Kuopio university hospital, in Finland. The participants of the study were two hundred and fifty seven registered nurses and ninety six assistant nurses. The study found out that few registered nurses attend the programs as compared to the assistant nurses. Nurses who attend the programs expressed more motivation to work; they expressed a positive attitude to work as opposed to those who did not involve in clinical supervision. Clinical supervision was a paramount tool to nursing. It reduces burnout at work. Nurses who do not subscribe to CS expressed low self-confidence at work, less empowerment and low, work orientation. The researchers recommended for clinical staff to ensure nurses attend the services through the creation of time and opportunity for them, Saarinen, Hyrkas & Koivu (2011).
The benefit to the participants of the study was the understanding which was to be derived on the relevance of clinical supervision. The respondents would get a better understanding of CS at the end of the study and would, therefore, be motivated to participate in such programs. There was no risk of participation identified. There were no risks involved in the research. There was participants’ consent prior to their inclusion in the sample. There was notification of the hospital management about the undertaking before the study, and participants’ consent obtained. There was voluntary participation of the respondents to the study as there was no risk of participation. There was approval from the management staff before the study. Confidentiality of the participants was also through anonymity of the participants. Return of questionnaires indicated consent by the participants.
The major variables for the study were job demands, social interactions and perception of mastery. Job demands refers to the demands of the workplace that prevent nurses from attending the clinical supervision programs. The researchers found out that some nurses involuntarily failed to attend the programs due to high demands of the workplace. There was time constraint that prevented the nurses from attending the programs. Social interaction refers to the benefits that participants to the programs obtained. The interactions during the programs made work more interested and developed the self-confidence of the nurses. Perception of mastery refers to how the nurses responded to the benefits that are to be derived from the programs.
Questionnaires were the method of data collection used. The nurses provided their responses on their opinions of the CS programs. They also stated whether they had at any one time attended such programs. The author used this data collection because the interview questions were not complex to respond to, the participants would effortlessly fill the questionnaires by themselves. The use of questionnaires was also due to the large number of participants in the study. This would reduce time wastage. The study was in three days. However, there were follow up studies whose time frame is unknown. The sequence of data collection events for the participants was the reception of the questionnaires, filling them and then returning the filled questionnaires to the researchers. There was limited interaction between researchers and respondents in this study.
Data management and analysis was through use windows SSPS program. There was also transforming of data collected was into an electronic form and storage into computers. This was to ensure that it could not be lost. The researchers also kept paper trail of the questionnaires for reference whenever there was any conflict with the findings. Rigor was through the use of SSPS software for data management and analysis. There was also paper trail for the findings in case any discrepancies arose during the data analysis. The elimination of bias was through ensuring representativeness of the selected sample. The sample was not at the discretion of the researchers but on the basis of its representativeness of the target population.
The researchers interpret the findings on the impact of their efficacy to nursing. Nurses who attend the clinical supervision were more efficient at work than those who did not. The findings are accurate and reflective of reality. Nurses who attend to CS program have the opportunity to better their profession through interaction. It also reduces burnout, Burns & Grove (2011). The researchers identified the inaccuracy of some of instruments such as the QPSNordic scale as one of the limitations to the study. There was coherent logic in the presentation; the presentation of data in tables made it easier for researchers to analyze. The researchers found out that clinical supervision improved the nursing practice. This presents an opportunity for nurses to better their carriers. Medical institutions should also ensure that clinical supervision programs are available in their institutions and provide opportunities for nurses to enroll. No recommendation for future research in the article.
References
Burns, N., & Grove, S. (2011). Understanding Nursing Research (5th Ed.). Elsevier. ISBN-13: 9781437707502
Saarinen, I. P., Hyrkas K. & Koivu, A. (2011). Who attends clinical supervision? The uptake of clinical supervision by hospital nurses. Journal of nursing management, 19: 69-79. DOI: https://ehis.ebscohost.com/eds/pdfviewer/pdfviewer?vid=2&hid=120&sid=9b7c1399-5e56-4f26-a748-c2f9ff542adf%40sessionmgr111
Combining Qualitative and Quantitative Methods
While conducting any research study there are two main categories of research methods that can be used: qualitative and quantitative. Studies have indicated that researchers should use both quantitative and qualitative research methods so as to properly tackle a research study. Quantitative and qualitative methodologies are not different; in fact they focus on the same phenomenon but use different approaches. Combining qualitative and quantitative methods enable the two methods to corroborate each other through triangulation (Borkan, 2004). If one method fails to attain a certain goal, it is attained by the other.
Quantitative data can for instance be used to find a reliable sample for qualitative study. Similarly, qualitative data can help a quantitative research to develop an effective research design and instrumentation. Used of both methods also enables researchers to provider finer details into their research study. In nursing for instance, the research would be more reliable as all possible loop holes will have been covered by either of the methodologies used (Borkan, 2004). Use of both methodologies encourages researchers in nursing to conjure up new lines of thinking that had not been considered before.
The main disadvantage of using quantitative and qualitative approaches to data collection is the cost and time used. Integration of the concepts of qualitative and qualitative data into one research study takes more time than if one methodology was adopted. The second disadvantage is the risk of loss of flexibility and depth of qualitative data that has been quantified. Data acquired qualitative is multidimensional while quantitative data is one dimensional (Borkan, 2004). A researcher should be skilled enough so that he has the expertise needed not to quantify qualitative data. This makes the process time-consuming and very expensive.
Reference
Borkan, J. (2004). Mixed Methods Studies. Journal of Annual family medicine. Vol. 2(1); 4-6.
Retrieved from
Nutrition Paper On Eating Disorders
Introduction
Eating disorder is one where a person takes up abnormal eating habits. The abnormality can be insufficient or excessive intake of food which thereby affects an individual’s emotional and physical health. Eating disorders can be as a result complex and partially understood causes with majority of the patients being women. In the US alone, there are about 5-10 million female and 1 million males who are estimated to be affected by eating disorders. These eating disorders are not classified but the most common eating disorder is Binge which affects 3.5% of females and 2% males (NEDA, n.p). These statistics are according to Harvard affiliated Mclean Hospital which also revealed that bulimia Nervosa took second position while Anorexia nervosa was third. Traditionally, anorexia nervosa has been associated with teenage girls. However, time has revealed that even older women have increasing numbers of involvement in anorexia nervosa. In this paper, the discussion focuses on defining eating disorders, their effects on the society and people, statistics and how people die or suffer from it.
What is eating disorder?
Eating disorders are a set of health conditions that are associated with anomalous eating habits. A person is said to have eating disorders when they are caught up in excessive food intake or insufficient food intake. Either way, an individual’s physical and mental health is affected. In the United States and the United Kingdom, the most common forms of eating disorders are Bulimia nervosa, binge eating disorder and anorexia nervosa. Although eating habits tend to affect both women and men in the western world, it is women who are at the highest risk of developing these disorders. Westernization is said to be the leading factor responsible for most women being at higher risk than men. In the United States, approximately half of the population is aware of at least one person who has an eating disorder. Today, there has been increased need to understand the central processes of appetite since Leptin was discovered. This study has been coupled with the study of the brain functioning as well.
There are many causes of eating disorders. This could be biological, psychological or environmental. These factors can exist individually or as combination. Biological factors responsible for eating disorders include genetic, epigenetic, biochemical, infection, lesions, tumors, brain calcification, and somatosensory homunculus. Psychological factors include depression, anxiety disorders, obsessive compulsive disorder, and ADHD among others. Environmental factors associated with eating disorders include child ill-treatment, social segregation, parental, peer, and culture pressure.
Although eating disorders have been associated with women, eating disorders also affect men. Among men, eating disorders are higher in bisexual and gay communities. Eating disorders also affect people from heterosexual communities. Eating disorders in men also high profile male celebrities who have published their struggles with eating disorders. Some of these celebrities are required to lose weight to fit into characters in movies among other job descriptions.
Effect on people and the society
Majority of the adolescents and teenagers are very much anxious regarding how they seem to be. This results to, the feeling of self consciousness about their bodies (New, n.p.) . For most adolescents, puberty comes along with dramatic physical changes and the adolescent has to face new social pressures. Although it is not wrong to feel this way, some adolescents become so concerned about themselves to the extent that they become obsessed resulting to an eating disorder. In most cases, the adolescent is not happy about their size and want to dramatically lose weight. As a result, they become anorexic or bulimic which then becomes part of their daily life and affect their normal lives. With time, this becomes permanently affect their health.
The best way to deal with the development of eating disorders among adolescents is through assistants by parents. At this young age, parent play an important role in ensuring that children build their self esteem and encourage healthy attitudes on appearance and nutrition (New, n.p.). Proper medical care can also play an important role in ensuring that adolescents are advised on how to eliminate negative feelings and thoughts concerning their food and body weight. Timely advice is essential given that it works well in ensuring that children do not get involved in eating habits that disrupt their daily activities and daily functions.
To the society, anorexic people tend to have an extreme fear of gaining weight given their distorted view of their body size and shape (New, n.p.). Such people tend to eat as little as possible and engage in excessive exercise. As a result, anorexic persons tend to be underweight and are usually very thin. Like other eating disorders, Anorexia a is a very serious clinical problem that calls for professional treatment by therapists, doctors, and nutritionists. To the children, eating disorders are a source of low self-esteem, serious mental and behavioral health conditions like trauma; heart problems, or kidney failure.
Statistics
According to the National Institute of Mental Health, NIMH (2012), eating disorders appear frequently during the teen years or during young adulthood. This does not mean that eating disorders are not developed during childhood and adulthood as well. During teenage and young adulthood, most females are concerned about how they look and develop eating disorders including those called eating disorders not otherwise specified or EDNOS like Binge. Although many people believe eating disorders are not real, these disorders are real and curable. In addition these disorders coexist together with other disorders like anxiety, substance abuse, and depression.
Today, eating disorders are very common in the US (Medical news, 2012). There are about 5-10 million females and one million males. The leading eating disorder is Binge which affects about 3.5% of females and 2% males (NEDA, n.p). The other two include bulimia nervosa and anorexia nervosa respectively. Anorexia nervosa (AN) has a remission rate of between 75%-83%. Most experts of AN however approximate the recovery potential rate to be 70% (NEDA, n.p). Bulimia Nervosa or BN is estimated to have a remission rate of 75% and the full recovery rate for BN was estimated to be 74% with about 99% of patients gaining partial recovery (Medical news, 2012). Binge eating disorder or BED had a reduction eating episode of 88.3%.
In the US, 1 or 2 children in every 100 struggle with one of the most common eating disorders since majority of them hide their eating habits from their parents. At alarmingly tender age, evidence is present revealing that 42% of first to third grade girls want to be thinner while 81% of 10-year-olds are afraid of being fat. Basically, at the age of 11 and 13, most children have already begun experiencing eating disorders (New, n.p.).
People suffering or died from eating disorders
Children may have intense fear of gaining weight than they actually look. For sports persons, like gymnastics, ice skating and wrestling, and children are subjected to eating classes that put them at risk of eating disorders. Media images contribute to a large extent the rise in incidents of eating disorders. This occurs through advertisements, sports and TV programs, and movies where celebrities remain very thin resulting to girls believing that beauty is in extreme thinness. Boys on the other hand tend to emulate compulsive exercising that encourages them to build muscle mass.
According to North Carolina Department of Mental health, eating disorders have the highest mortality rates amongst all mental disorders. Within ten years of contracting anorexia, about 5-10 % of the reported anorexic cases die. After 20 years, 18-20% of anorexics die while only 30-40 % make full recovery. For females 15-24 years , death cases resulting from anorexia are highest of all other causes.
Works cited
Medical news. What is eating disorder? 2012. 10 Sep. 2012. http://www.news-medical.net/health/What-is-an-Eating-Disorder.aspx
National Eating Disorders Association. Statistics: eating disorders and their precursors.
National Institute of Mental Health. Eating disorders. 2012. 10 Sep 2012. http://www.nimh.nih.gov/health/publications/eating-disorders/complete-index.shtml
New, M. eating disorders. 2011. 10 Sep 2012. http://kidshealth.org/parent/emotions/feelings/eating_disorders.html#
South Carolina Department of Mental Health. Eating disorder statistics. 2012. 10 Sep 2012. http://www.state.sc.us/dmh/anorexia/statistics.htm
Use Of Animals And Human Subjects
Introduction
Use of animals and human subjects in research has been practiced by scientists over long periods of time. Scientists and researchers who carry out research with animal and human participants are required to protect their interests. The interest of research subjects ought to be protected by ensuring that there is compliance with local, state and federal legislation.
Regulations are formulated to make certain that there are nominal risks to human and animal subjects. The regulations also serve to ensure that risks are reasonable when compared with the expected benefits. Legislation makes sure that participants or their authorized representatives avail informed consent of their use in research. The researcher is also required to provide the participants with the key elements of the study protocol. The privacy of participants and the confidentiality of data should also be maintained by the researcher. Katz (1972).
The Common Rule lay out which is a U.S. federal regulation has requirements that ought to be met by researchers who use human participants. The regulation specifies the types of research that fall under its jurisdiction as well as the provisions of acquiring informed consent. There are also procedures that are required in order to get approval of conducting a particular project. The Common Rule also specifies the level of training that a researcher ought to undergo in order to use human participants in research.
Research that is federally funded and involves use of human subjects should be reviewed and approved by independent committees. These committees are known as Institutional Review Boards that are required to approve all research that is covered under the Common Rule. The committees are also required to conduct regular research reviews and approve changes that are proposed in ongoing research. Institutional Review Boards have the mandate to monitor informed consent procedures as well as gathering information on adverse events. It is also upon the Institutional Review Boards to examine cases where they reckon that there may be conflict of interest. These requirements are generally observed for both non-federally funded and federally funded research.
Involvement of human participants in research
The involvement of human participants in research has raised challenging and difficult aspects and questions. One of the aspects is whether people should be asked to participate in studies, some of which may be of some risk to them. This with regard to consideration that the studies may have no direct benefits to the human participants. Another significant aspect is the manner in which consent provisions should be modified for certain groups of individuals. Such people include: prisoners, children, the mentally ill as well as other populations that may be vulnerable.
Questions as to whether similar provisions should apply to all research that is carried out all over the world also arise. There has been concern as to whether standards of using human subjects should be modified so that they can reflect local conditions. When it comes to bioethics, there should be formal training so as to analyze the complex moral issues that are raised by human participants in research. It is expected that any researcher who engages in research that involves human subjects should be aware of all pertinent regulations and undergo effective training. Varga (1984).
All research projects that have been proposed and involve human subjects are required to be reviewed so as to establish the risk. There are various aspects that denote human subject involvement. Such include the use of human derived data or cultures of human cells that are personally identifiable. Projects where the investigator is the only subject, information acquired indirectly are other aspects of human subject involvement.
Information that is acquired directly through an interview and physical participation in a research are also termed to be scenarios of human subject involvement. Donations of organs, tissues, fluids and other bodily material are considered to be human subject involvement. Generally, human subject involvement is where there are collaborative studies where information or material is collected from individuals and used by researchers.
In situations where human subject involvement has met and satisfied various criteria, it may be exempt from extra review. This, however, does not mean that the research project should not be reviewed. Research that involves human subject involvement should be documented and grant application. Review of research projects that involve humans must be conducted even when the project appears to be similar to one that has been approved in the past. Research that involves subjects that are vulnerable always requires a full review.
Human subject research should have review which should be followed by a formal approval by an institutional review board. The essence of conducting reviews is to establish whether the subjects face any risk during from the research. Risk is clear where there is exposure to the likelihood of harm whether, psychological, physical or sociological to a participant in research. Human involvement research calls for special care in design and review. Reviews also seek to determine whether the expected benefits of the research outweigh the risk. Another function of carrying out reviews is to establish whether there has been acquisition of consent for the participants. It is only in extraordinary cases where the researcher is not required to obtain informed consent of a subject so as to participate in research. Studies projects that engage human subjects ought not to be initiated until appropriate approval is received. Moreno (1999).
Agencies that fund research that involves human subjects requires that certification of human subjects approval are provided with the grant proposal. The National Institutes of Health provide a sixty days grace period after the proposal submission date. There should be request for human subjects review during preparation of a research proposal. This is attributed to the possibility of having delays before granting of final approval. For continuing projects, annual reviews are required.
Research that is not conducted under expected standards, conditions and requirements should be terminated. This is because such research is associated with gross harm to human subjects. In situations where there has been suspension of research, the research activities ought not to continue. This is until there is sufficient assurance that the required corrections have been implemented. The terminating authorities are required to communicate to the researcher indicating the reason for termination. There are various reporting requirements for concerns and issues that might be associated with termination or suspension. There must be reporting of information that is concerned with noncompliance by the researchers. Reporting must also be done to the necessary authorities regarding injuries that might have been caused on human subjects.
Misconduct in use of humans in research
There are various issues that have risen with regard to use of humans for research purposes. This has resulted to a debate on whether the wide use of person subjects in study is in itself misconduct. Paul M. (1993).
Humans although not as widely as animals have also been used in scientific as well as other research. This has also seen instances when misconduct has occurred when humans are being used for research. Though scientists are required to get consent from individuals prior to using them for research, this does not always happen. Some of the scientists in organizations have violated human rights and have used them for research without accessing their consent. This usually happens when individuals have been diagnosed with various ailments. This results to them being admitted in medical facilities so as to get treatment. It is during this time when they are under anesthesia that medical practitioners take advantage of the situation. They in some instances get body samples from the patients and are used for research purposes that are not related to the ailment of the patient. Jonsen A. (1982).
Some of the researchers have also used young children with no family backgrounds and have carried out research on them. They sue such individuals as the children do not have anybody under their care hence the scientists would not be answerable to anyone. Some of the medical practices and research that are carried out on human beings end up being detrimental to the individuals. They usually result to various complications that may have an eternal outcome on the lives of the victims. In instances when the research practices are extreme, they can even result to death of the victims. This usually occurs when the researchers carry out scientific or other research on human beings that they do not know of the effects.
Another major concern that has resulted to claims that it is misconduct is the practice of cloning. Scientists have claimed that there is not anything incorrect with cloning and that it ought to be conducted. They have added that cloning of human beings would result to individuals who are more resistant to diseases and can live longer. The claims from scientists have resulted to great uproar from various quarters. This has included religious leaders as well as other leaders who claim that this is gross misconduct as no man has the power and authority to create another. The concerns have been immense and this has resulted to placing of a ban that makes cloning of human beings to be illegal. Legislation has been put in place that has made it illegal for scientists to use human beings to create other ‘human beings’. Jay (1987).
Use of animals in research
Animals have also been widely used in research. Researchers who use animals in projects are required to comply with the Animal Welfare Act. They are also expected to comply with other regulations that relate to animals and federal statutes. When using animals for research, it is required that such research should be in accordance with the public health service guide for care and use of laboratory animals. There should be maintenance of complete certification of laboratory animal care. There also ought to be an official assurance of compliance with public health service policy on human care and use of laboratory animals. This should be with the office for protection of study hazards of the National Institutes of Health. Mark (1993).
Research practitioners are responsible for adhering to procedures that are provided in the approved animal use protocol. This is accompanied by taking appropriate care of animals that are used in laboratory experiments. The researchers are required to ensure that all students, staff and visitors under their guidance, follow and approved protocol. The staff should be properly trained so as to be able to carry out procedures that are involved. The researchers are required to practice extreme care in maintaining the letter and spirit of assurance.
While carrying out research projects that involve live vertebrate animals, there ought to be prior review and official approval from the relevant authorities. Practitioners are responsible for providing a full animal use protocol for experiments that will use live vertebrate animals. Authorities that supervise use of animals in research are responsible for determining whether the research project is in compliance with various requirements.
Procedures that entail live animals are required to ensure that there is minimal distress, discomfort and pain to the animals. This should be consistent with sound research design. There are procedures that are likely to cause distress or pain to the animal. When carrying out search procedures, appropriate analgesia, sedation or anesthesia ought to be applied. Unless there is approved justification for scientific reasons, these procedures should not be omitted.
In case there is justification for omission, the researcher is required to put the justification in writing. There should be inclusion of the sources that are used to determine there are no existing alternatives to the procedure. There may be circumstances where certain animals may experience extreme or chronic distress or pain and cannot be relived. Such animals should be painlessly euthanized during the procedure or at the end of the procedure. Swarez J. (2008).
While using animals, researchers are obligated to explain the essence of the research and the significance of using animals. They should explain why using mails would lead to achievement of the mentioned research goals in terms comprehendible to a nonscientist. There should not be duplication of existing data by the proposed research. There should be justification on the number of animals used in an experiment based on a sound research design. While using animals for research, there should be provision of living conditions that are appropriate for specific species of animals being used.
Researchers should ensure that the living conditions add to the physical condition and calm of the animals. The feeding, housing and care of the animals should be conducted by a professional. This may be a veterinarian or a scientist that is trained and experienced. This should be a professional who is effective and efficient in handling and proper care and use of the animals that are being studied. All conditions are required to be in accordance with specifications of the guide for the care and use of laboratory animals.
With regard to medical care, there should always be a qualified veterinarian who is available whenever needed during procedures. Other personnel that are involved in carrying out procedures on the animals should be qualified and trained in the specific procedures. The knowledge and awareness of protocol procedures, laboratory measures and guidelines should be documented on a protocol personnel form.
The methods of euthanasia that are used ought to be consistent with the recommendations of the euthanasia review panel of the American veterinary medical association. These methods should never be omitted unless there is justification based on scientific reasons. In order to get approval of projects, researchers are required to submit requests four weeks prior to the proposed used of the animals.
Funding agencies have it as a requirement that there should be submission of approval from relevant authorities. National Institutes of Health provides a grace period of sixty days after the proposal submission date. It is essential to ensure that official recognition of animal use protocol approval is acquired by the time a proposal is provided to the sponsoring agency. This is to guard against any delays in grant proposal review and funding. Research that deals with animals should never be initiated until when the suitable animal use protocol has received approval from the relevant bodies.
Authority to suspend or terminate approval of research
Under the assurance to the National Institutes of Health, overseeing research bodies have the authority and responsibility to suspend or terminate research. This is with regard to research that is not being carried out in accordance to the expected standards, conditions and requirements. Furthermore, United States Department of Agriculture has regulations that require research activities to be suspended. This is when such research does not meet the standards of animal welfare housing and care, or mitigation of distress and pain. In circumstances where research has been suspended, it should not resume until there is sufficient assurance that right corrections have been made.
Misconduct in animal research
Over time, there have, however, been misconducts that have been conducted by researchers in their process of research. Such misconduct has been conducted mostly on animals as they do not have to provide consent for them to be used in research. This has resulted to researchers violating animal rights with impunity for years. It is such violations and misconducts that have resulted to formation of animal rights organizations. Such organizations are geared towards ensuring that researchers who use animals for research do not engage in any misconduct.
Animal rights activists have been opposed to the use of animals for purposes of medical research. They have had this stand with views that human beings do not have the mandate to use animals. With extremely little exceptions, experiments are not carried out on human subjects without seeking for their consent. Animals activists have made claims that it would, therefore, be gross misconduct to carry out experiments on non- human animals. Animals do not contain the capacity to provide informed consent and it is on this basis that it would misconduct to use the animals for experiments.
Another misconduct that is carried out on animals is the degree and extent of experiments that are conducted on animals in research. Researchers have often conducted experiments on animals that involve procedures that are detrimental. Such procedures involve practices that jeopardize the physical condition and lives of the animals. The procedures are injurious and invasive on the animals and it results to them being prone to immense pain.
Given the extent of the procedures it is with no doubt that human beings cannot allow such practices to be conducted on them. It is, therefore, can be considered as misconduct that scientists and other researchers have continuously performed such procedures on the animals. The experiments that are conducted on animals sometimes are so extreme and dangerous that the lead to the death of those animals. Kevin D. (2002).
Since those animals do not have the ability to advocate for their rights, researchers have continued to practice the experiments on the animals. Just as unethical experimentation on certain humans cannot be justified by a benefit to humanity at large, the same ought to be true for animal experimentation. Just as humans have consciousness as well as interests in their own lives and freedom animals too have similar interests. The only different is that when animals’ interests are violated, they cannot be able to forward their concerns. Treating animals differently and try and justify experimentation without consent on them but not on humans would be termed as some level of misconduct.
The misconduct on animals and violations against them has resulted to animals’ rights activists standing up for the animals. The activists have provided evidence of medical advancements that were discovered without the use of animals. Such include the cure for scurvy which did not involve animals, but studies were carried out on human subjects who already had scurvy. The first vaccine was invented in the eighteenth century and it did not involve animal experimentation. This was when people were immunized with cowpox so as to be able to build on their resistance to smallpox.
Other medicines such as penicillin were also discovered without using animals to conduct research. In the recent past Heimlich maneuver was crated without vivisection and has resulted to saving of numerous lives. Some of the researchers have studied human populations and this has lead to significant medical discoveries. Part of this has included the link between cardiovascular ailment and cholesterol as well as the connection between smoking and cancer. Daniel W. (2001).
Legislation on animal use in research
Various measures have been taken with the aim of reducing the misconduct against animals during scientific and other research. In the United States of America, the animal welfare act has looked to set various minimum requirements. These requirements are related to the humane treatment of animals that are used for research purposes in laboratories and other settings. The animal welfare act requires organizations that carry out vivisection to have institutional animal care. They are required to use committees that have the mandate of overseeing and approving the proposed used of animals in research. The measures that have been taken, however, appear to have certain levels of ineffectiveness.
The use of animals in research as well as research training is under regulations and codes that are professional. The federal animal welfare act is aimed at ensuring animals that are to be used for research are availed with human treatment and care. The U.S. public health service’s policy on the humane care and use of laboratory animals is for all animal research that is supported by the NIH.
It requires organizations to develop and maintain appropriate measures that ensure the proper care and use of all animals. Such are animals that are used in research, research training and biological testing. The policy stipulates that there should be adherence with the guide for the care and use of laboratory animals and the animal welfare act. The guide for the care and use of laboratory animals is a document that is created and often updated by committees which are under the National Research Council.
Direction for researchers who make use of animals has recommendations that practitioners should consider certain aspects of animal testing alternatives. There should be a reduction in the quantity of animals that are used, review and update of techniques and procedures meant to reduce distress and pain. There should also be replacement of animals that have higher conscious living with insentient material. Researchers who intend to use animals in research or training are required to be verse with the appropriate regulations.
The animal welfare act and the policy on humane care and use of laboratory animals have requirements for institutions. Organizations are required to have institutional animal care and should use committees that have experts in the care of animals. The committees are obligated to evaluate and endorse research proposals that use animals. The committees are also obligated to oversee animal care facilities and programs and give response to concerns regarding use of animals in research. Private institutions such as American association for the accreditation of laboratory animal care provide endorsements. They do so to organizations by making use of existing regulations and guide as standards.
Conclusion
Researchers who use human and animal subjects in their practice ought to ensure that they do so as they consider the well being of the subjects. Legislation and regulations that have been put in place should be adhered to when using animals and humans for research purposes. Researchers found in contradiction of provided regulations should be suspended or terminated from practice depending on the degree of violation.
Reference:
Moreno, Jonathan (1999) Undue Risk: Experiments on Humans: New York
Katz, Jay. (1972)Experimentation with Human Beings,New York: Russell Sage.
Mark Livermore (1993) Guide to the Care and Use of Experimental Animals: Ontario.
Swarez J. (2008) Anesthesia and Paralysis in Experimental Animals. 1 (4): 421-6.
Varga, Andrew (1984) The Main Issue in Bioethics Revised Edition. New York: Paulist Press.
Paul M. (1993) The ethics and politics of human experimentation: New York.
Daniel W. (2001) Laying ethical foundations for clinical research, Public Health Classics, Bulletin of the World Health Organization.
Kevin D. (2002) Ethics of health care: an introductory textbook, Georgetown University Press.
Jay Katz (1987) The Regulation of Human Experimentation in the United States: A Personal Odyssey, IRB: Ethics and Human Research.
Jonsen A. (1982). "The Evolution of Regulatory Influences on Research with Human Subjects". New York.
Qualitative Data Collection
Saturation refers to a point in data collection where there has been hearing of similar responses in prior interviews. The participants keep on providing similar responses to the focused interview questions. This is essential in qualitative research. The data collected should be as wide as possible contrary to the quantitative technique. In the quantitative technique, the aim of the data collected is to prove a hypothesis. Hypothesis formulation, which is usually at the start of the study, once there is adequate collection of data for valid approval of the hypothesis, there is no more data collection. In the qualitative technique on the other end, the inclination of data collected is not to hypothesis testing. There is no formulation of the hypothesis at the inception; it may be formulated during the course of the study which necessitates the collection of substantial data.
Qualitative data also relies on descriptive data rather than statistical, numerical data. This calls for data collection until saturation because descriptive data can not be measured for accuracy. This is the reason why qualitative researchers modify the research interview questions periodically in order to obtain exhaustive data from the participants. It is also the reason why qualitative research is on a sample selected according to the discretion of the researcher rather tan the representativeness of the sample. In Pelto & Pelto (1997), the researchers describe data saturation of data as that point that the data collected is similar. In their study, the researchers collected data from as many respondents as possible to ensure that there is data saturation. Saturation is the only sure means of ascertaining the accuracy in qualitative studies. When responses from participants interviewed personally are similar, there is a substantial degree of confidence in the findings.
Reference
Pelto P, Pelto G, (1997). Studying knowledge, culture and behavior in applied medical anthropology. Med Anthropol, 11(2):147-63.
