Discuss the nature of management, financing, and quality issues related to integration and cooperation in the facilities

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Discuss the nature of management, financing, and quality issues related to integration and cooperation in the facilities.

Choose two long-term care facilities—one from nursing facilities, assisted living, or subacute care and another from adult day care, home health care, or hospice care—on which you would want to base your research work. Research Internet to read about your chosen long-term care facilities.

Assume you are responsible for the management and administration of the two facilities. You have to orient the newly appointed manager by providing an overview on managing long-term care. You also need to discuss the programs of the two facilities. From this perspective and based on your research about the facilities, prepare a Microsoft PowerPoint presentation of 10–15 slides including the following:

What are the various multidisciplinary departments (teams) included in your facilities?

Who comprise the target population being served by the various programs provided by your chosen facilities?

What are the major staffing and human resource issues faced by your chosen facilities?

What are the significant trends in long-term care likely to impact the operation of the various programs provided by your chosen facilities, and what is your plan of action to overcome them?

What are the various forms of cooperation and integration existing in your chosen facilities? Discuss the nature of management, financing, and quality issues related to integration and cooperation in the facilities?

localization global standardization transnational strategy

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Please answer the following questions:

In what kind of industries does a localization strategy make sense? Why? When does a global standardization strategy make the most sense? Why?

What do you see as the main organizational problems that are likely to be associated with the implementation of a transnational strategy? Explain.

What is the most appropriate organizational architecture for a firm that is competing in an industry where a global strategy is most appropriate?

Discuss the differences between preventive and corrective discipline.

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Discuss the differences between preventive and corrective discipline.

Paper instructions:
1. Discuss the differences between preventive and corrective discipline. Do you favour one form of discipline over the other? Identify the contexts in which each is most appropriate.

2. Explain the difference between “equal pay for equal work” and “equal pay for work of equal value,” and elucidate the differences in implications for a human resources manager.

These two questions needs to be answered. Page and a half for each question. This is regarding human resources management in health care organization.

Health Essays – Childhood Obesity Overweight

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Childhood Obesity Overweight

Introduction

Childhood obesity in the United States is proving to be a topic of major concern. Throughout the past decades, this issue has been overlooked and simply unattended to. Other health issues such as second-hand smoke and cancer have indeed been the more popular topics addressed. However, people are starting to notice a change in the leaders of tomorrow. Quite frankly, these children are becoming extremely unhealthy and overweight. In the past, it was out of the ordinary to see a child that was obese.

However, overweight children in the United States are actually starting to become a norm (Koplan, Liverman & Kraak, 2005). This is where the problem begins to unfold. Parents are becoming increasingly concerned about their children’s health due to the fact that obesity hinders a wide range of factors. Imagine a child that cannot participate in any extracurricular activities such as baseball, soccer, or basketball due to his or her weight.

Then, try to explain to that child that due to being overweight, he or she might have an increased chance of heart disease, strokes, and high blood pressure (Vessey & MacKenzie, 2000). Above all, imagine being a child and learning that one of their peers has just died due to the fact that he or she was obese. One must begin to realize that the lives of children in the United States are at stake.

Science in the past has told the public that each generation is living longer than its precedent. The tide has turned sadly enough as scientists are predicting that this verity is now untrue (Kimm & Obarzanek, 2002). With that being said, if lives are beginning to shorten, one might conclude that it is now time to take some action.

In an attempt to explore the idea of childhood obesity one must result to an interdisciplinary analysis. The topic involves a wide range of disciplines such as biology, sociology, psychology, and business, which should all be taken into consideration to avoid an oversimplification. There is not one single discipline that can fully address the entire scope of childhood obesity (Repko, 2005). By narrowing down the research, a large amount of data will be looked at using numerous perspectives to try to avoid a biased outcome.

The extent of obesity in children is an extremely multifaceted topic and desperately needs to be approached this way to fully grasp and comprehend the issue. Also, for a complete understanding and resolution to be formulated, every discipline needed to investigate the issue must be used. Childhood obesity contains a vast range of disciplines to help in its characterization. With that being said, these disciplines tend to all be interlocked with one another.

Looking at childhood obesity through the discipline of biology for instance would constantly be leading the researcher to a psychological standpoint every time a page is turned. Simply ignoring certain disciplines would be an extreme mistake in trying to come to a conclusive solution of the issue addressed and would most likely lead to a biased opinion.

Disciplines

The following is a compilation of all the disciplines used along with each of their contributions in the process of addressing the issue of childhood obesity. There is indeed a vast range of disciplines that are included. Chemistry, economics, law, and history all bring important insights to the table when addressing childhood obesity. Chemistry will look at various experimental data to try to assess the various structures of fats and sugars that are involved in a child’s diet.

Economics could be used to try to understand the possible effects that production and distribution of certain foods has when placed in front of children. Why are these extremely unhealthy foods being put on the shelf for kids to buy? Economics would try to investigate this issue and bring forth a decisive explanation. In addition, law would be utilized to help to understand what governmental efforts have been made towards the issue of childhood obesity.

Are the steps being taken by are government in the right direction or are they simply dancing around the heart of the issue? Finally, history is a very helpful discipline in referencing statistical data taken about obese children. Has this problem always been around or is it just now becoming an issue? History with the help of statistics will also illustrate past successes and failures of strategies that were put in action to help to aid the issue being discussed.

Throughout the course of the investigation of childhood obesity all the preceding disciplines listed will be taken into consideration. However, biology, sociology, and business will be most relevant and crucial to the process of defining the issue at hand.

Biology

Biology will be used to try to understand the needs of the human body to progress and function. Each person has a minimum amount of calories that must be consumed to properly run its processes. Likewise, each person has a unique rate of consuming these calories and converting them to energy. The researcher can use biology to place an actually measurement of health of an individual.

Attaining a proper measurement or gauge of health has proven to be a very difficult task. Height, sex, genetics, bone structure, and even ethnicity are all very important factors that determine a child’s proper weight. Biology will help to place a gauge on each of these factors and formulate a proper medium for each person. This discipline will be examined first in the following writing because one needs to understand what obesity is before he or she can begin to examine the problem. Biology will basically lay a foundation for the rest of the disciplines as to how they are to be used to assess obesity in children.

Sociology

Next, a viewpoint based on sociology must be addressed. Demographics of families, along with their ethnicities will be looked at to try to explain the effects of obesity on certain specific populations. Society will be investigated to try to expose the viewpoints of obese children and their parents. Does society really understand the issue? Do children place any concern with health and fitness? These are both very important questions that sociology will help to address through the aid of statistical data.

Also, every child does have the right to choose what he or she consumes on a day-to-day basis. Hence, each child must face all of the problems that arise if he or she becomes obese. Obesity is not purely a biological problem. If the previous statement was true, a child could then simply consume less calories and loose weight. However, a child has to make cognitive choices and observations about what is acceptable.

Sociology will step in and try to uncover any problems that may be resulting in a population of obese children that simply are misguided by the viewpoints of society. This discipline will be used after biology in hopes to build upon the new understanding of the problem. Once a person understands the physical aspects of childhood obesity using biology, then he or she can delve into the societal traits.

Business

Finally, obesity has become such a large issue that it has effectively created an entire new industry to take care of itself. Business is a discipline that will be used to help explain the way industries portray children and how they affect what populations recognize and understand. Business will try to assess ethical issues as to whether the food industry for example is making an effort to help.

There are obviously many businesses in the United States that are trying to educate children about obesity. However, for every positive product formed, there is another marketing scheme that is made to try to take advantage of a very helpless situation. As a result, the structure and function of the food industry needs to be addressed and scanned for possible pitfalls and shortcomings.

Lastly, the discipline of business will be used in the final part of this paper in hopes to illustrate how it relates back to the obese children. The reader will then furthermore understand the extremity of this issue and how it is rooted in almost every aspect of life.

In summation, childhood obesity is an extremely sophisticated problem involving the ethics and morals or our society. Children cannot be expected to solve their own problem and desperately need help from all ends of the spectrum. The purpose of this paper is to lay the foundation for a better understanding and new perspective of childhood obesity.

This perspective will hopefully stem new possible outcomes that are constructed by the synthesis of each of the discipline’s contributions. Furthermore, the following writing will attempt to educate society of the dangers of childhood obesity and show that this is not a problem caused by one situation. Hopefully the reader will realize that through an interdisciplinary understanding, bringing an end to obesity in children is not an unattainable goal.

Background

How is childhood obesity defined? Has this issue been around for a long time or is it merely just beginning to cause trouble for the United States? These are two very important questions that every individual needs to be aware of. One cannot expect to be able to successfully tackle an issue without knowing its history beforehand.

First, childhood obesity is basically defined as a person that has a body mass index that is above the 95

th

percentile. That is, the individual exceeds his or her natural weight by approximately 20%. Body mass index is the most widely accepted procedure for sampling obesity in large populations.

Basically, it is a numerical measurement composed of a person’s height and weight. Although this particular test does not take a persons bone structure into consideration, the average of an overall population remains very accurate (Vessey & MacKenzie, 2000).

The people involved in this issue are individuals between the ages of 6 and 17. Male and female children including every ethnicity that resides in the United States are included in this problem. Although obesity rates are increasing almost exponentially in all age groups, children seem to be of the most concern to health experts today. These children are in the most important stage of their growth. An overweight child is putting his or her entire lifespan in jeopardy (Green & Reese, 2006).

Adolescent obesity has not been around as long as other problems such as cancer, leukemia, or the flu. Yet, it is unique due to the fact that childhood obesity is growing at such an alarming rate. The first signs of childhood obesity began to appear in the 1960’s (Schwartz & Puhl, 2003). What caused this sudden weight gain in children during this time? There are several possible explanations however there does not seem to be one clearly defined culprit.

The fast food industry is just one of the possible causes that is often looked at. Critics believe that during the 1960’s fast food was starting to embed in American culture. McDonalds restaurants were popping up all around the United States offering a quick and effortless meal. Before fast food, most families were dependant upon time consuming home cooked meals. However, for the first time, people were starting to realize that a ready-to-eat meal was just a few dollars away. Consequently, people started putting the healthy meal aside and began to grab a quick sandwich from a fast food restaurant.

Hence, in the 1960’s children’s calorie intake began to rise as their eating habits were basically being altered by society. Statistics showed during this time that the percentage of obese children was approximately 4.5%. As calorie intake began to rise, physical activities began to decrease. Approximately 33% of students in high school do not expose themselves to any strenuous physical activity.

Present day schools are so involved in standardized testing that extracurricular activities have been in some ways taken out of the daily lesson plan. Even technology, which usually always aids in the advancement of society, has played a role in increasing rates of childhood obesity. Computer based games, and highly sophisticated cell phones are a few examples that have placed negative outcomes on beneficial cardiovascular events (Harper, 2006).

Heath experts began to see a problem by the 1970’s. The National Health and Nutrition Examination Survey was one of the first efforts in addressing the issue of childhood obesity. A study was done in three parts during a 25-year span starting in the late 1960’s. The test studied the body mass index of children and adjusted the results as age, sex, and ethnicity of the population of children changed through time.

The results were anything but subtle. There was a 40% increase of overweight children in the ten-year span of the first and second studies. No other illness at this time was even close to growing at such an astounding rate (Rosenbaum & Leibel, 1998). With that being said, the third study that was completed in 1994 delivered a divesting knockout punch. The National Health and Nutrition Survey revealed that the number of obese children in the United States had grown a monstrous 100% in the past 10 years (Dietz & Gortmaker, 2001).

Obesity in children was now considered an epidemic. In the past decade, the percentage of obese adolescents in the 95

th

percentile has once again doubled. Obese children between the ages of 6 and 11 seemed to have the highest grow rates of any other subgroup. Estimates were now showing that almost 15% of the children in the United States are obese or extremely overweight. Obesity does not seem to be biased towards any particular age, race, or gender. However, African American girls, Hispanics, and American Indians were shown to have the largest overweight populations (Koplan, Liverman & Kraak, 2005).

Why are obese children the population that is drawing the most attention? First, biologists studying this epidemic have noted that fact that the gene pool in the United States has basically remained the same over the past 15 years. This tends to rule out any possible explanations dealing with actual evolutionary changes or modifications in the human body. As a result, scientists tend to believe that the causes of the increase in children’s weight are a product of environmental effects on metabolism.

At any rate, it is shown that individuals who are obese as children are most likely beginning a lifelong fight (Dietz & Gortmaker, 2001). Present studies have shown that approximately 95% of obese individuals who succeed in loosing weight tend to gain almost all of it back over time (Koplan, Liverman & Kraak, 2005). This statement is supported by our ever-increasing percentage of obese adults. In 2001, statistics show that there were 29 states containing a percentage of obese adults of 20% or greater.

Hence, prevention at the earliest possible age is said to be the only hope for success in stopping this seemingly out of control problem. It is shown that the younger the child is, the less likely he or she will have developed bad eating habits. Also, younger children tend to be much easier to work with as oppose to stubborn teenagers who may not accept parental influence.

All in all, childhood obesity tends to result in numerous mental, physical and social health disorders for the growing individual. Without immediate intervention at a young age, obesity in children may continue to grow (Kimm & Obarzanek, 2002).

The following writing will continue to decipher the issue of adolescent obesity and will expose crucial concepts, theories and assumptions dealing with each discipline involved. Biology will first be discussed with the goal of further defining the physical and biological effects of childhood obesity. One must understand how the child physically becomes obese and what biological factors are involved.

Next, sociology will be addressed with the goal of educating the reader of the impacts that society has on obese children. Are there any direct causes of obesity that society may have initiated? Finally, business will be mined for possible ways that large companies and organizations have affected the issue. Are these interventions effective or are they merely ways to mask the problem?

In conclusion, each discipline involved offers its own understanding of childhood obesity. One must take each possible approach into consideration in hopes of forming a new more comprehensive explanation. An interdisciplinary approach is used in this situation to help organize the inputs of the disciplines and then synthesize them into a new holistic picture. This process helps to avoid a biased opinion, which is likely formed by increasing specialization of the disciplines. Furthermore it attacks the issue from every angle within the reach of the disciplines used (Repko, 2005).

References

Biology

Dietz, W., & Gortmaker, S. (2001). PREVENTING OBESITY IN CHILDREN AND

ADOLESCENTS.

Annual Review of Public Health

,

22

(1), 337. Retrieved

February 29, 2008, from Academic Search Complete database.

Kimm, S., & Obarzanek, E. (2002, November). Childhood Obesity: A New Pandemic of

the New Millennium.

Pediatrics

,

110

(5), 1003. Retrieved February 8, 2008, from

Academic Search Complete database.

Rosenbaum, M., & Leibel, R. (1998, March). The physiology of body weight regulation:

Relevance to the…

Pediatrics

,

101

(3), 525. Retrieved February 29, 2008, from

Academic Search Complete database.

Vessey, J., & MacKenzie, N. (2000, September). Childhood Obesity: Strategies for

Prevention.

Pediatric Nursing

,

26

(5), 527. Retrieved February 8, 2008, from

Academic Search Complete database.

Sociology

Green, G., & Reese, S. (2006, Fall). CHILDHOOD OBESITY: A GROWING

PHENOMENON FOR PHYSICAL EDUCATORS.

Education

,

127

(1), 121-124.

Retrieved February 29, 2008, from Academic Search Complete database.

Koplan, J., Liverman, C., & Kraak, V. (2005, Spring). Preventing Childhood Obesity.


Issues in Science & Technology

,

21

(3), 57-64. Retrieved February 4, 2008, from

Academic Search Complete database.

Schwartz, M., & Puhl, R. (2003, February). Childhood obesity: a societal problem to

solve.

Obesity Reviews

,

4

(1), 57-71. Retrieved February 29, 2008, from

Academic Search Complete database.

Business

Harper, M. (2006, October). Childhood Obesity.

Family & Community Health

,

29

(4),

288-298. Retrieved February 29, 2008, from Academic Search Complete

database.

Other disciplines

Repko, A (2005).

Interdisciplinary practice a student guide to research and writing

.

Boston, MA: Pearson Custom Publishing.

Advantages and disadvantages of qualitative and qualitative methods in nursing

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Advantages and disadvantages of qualitative and qualitative methods in nursing

The theoretical foundations of qualitative and quantitative methods are very different, but many researchers believe both methods should be used in the research study to increase validity and reliability.

What advantages or disadvantages do you see in using both types of methods in a nursing study? Support your answer with current evidence-based literature.

Analyze the flow of data and information among disparate health information systems to support internal and external business processes

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Analyze the flow of data and information among disparate health information systems to support internal and external business processes

Case Study, Stage 2: Data Flow Among Health Care Systems

Before you begin this assignment, be sure you have read the “UMUC Family Clinic Case Study”, the course readings assigned to date, and feedback on your graded Stage 1 assignment.

Purpose of this Assignment

This assignment specifically addresses the following course outcomes to enable you to:

Analyze the flow of data and information among disparate health information systems to support internal and external business processes
Examine the implications of ethical, legal, and regulatory policy issues on health care information systems

UMUC Family Clinic Medical Practice

In your Stage 1 assignment, you created process models for the patient visit process in the UMUC Family Clinic. For the Stage 3 assignment, you will identify an Electronic Health Records System that will address the process problems at the Clinic. The EHR system you identify will initially be implemented at the UMUC Family Clinic, but will soon need to be able to connect and communicate with external systems. As part of analyzing the requirements for the new system, one step is to consider how that system will enable the UMUC Family Clinic to exchange electronic data with other health organizations – such as other providers, pharmacies, insurance companies, and even patients themselves. The case study mentions several of these. For this assignment you will select two types of external organizations and describe what kind of data would flow between the UMUC Family Clinic and those organizations and how that can be done effectively.

A GROUP OF MEDICAL RESEARCHERS INVESTIGATED THE EFFECTS OF DRUG X ON LOWERING CHOLESTEROL LEVELS IN A GROUP OF MEN BETWEEN THE AGES OF 50 AND 70 YEARS OLD.

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A GROUP OF MEDICAL RESEARCHERS INVESTIGATED THE EFFECTS OF DRUG X ON LOWERING CHOLESTEROL LEVELS IN A GROUP OF MEN BETWEEN THE AGES OF 50 AND 70 YEARS OLD.

THE RESEARCHERS DID THE FOLLOWING EXPERIMENT AND OBTAINED THE INDICATED RESULTS: ONE GROUP OF 150 MEN TOOK A TABLET CONTAINING DRUG X FOR 3 WEEKS – 95 OF THESE MEN DECREASED THEIR CHOLESTEROL LEVELS BY AT LEAST 10% (THREE MEN FROM THIS GROUP DROPPED OUT OF THE STUDY).

1. What is the correct sequence of steps in the scientific method?

Make observations and ask a question
Analyze the data
Develop a hypothesis
Share the results with other scientists
Design and perform an experiment to test the hypothesis

a) I>II > III > IV > V

b) III > I > V > II > IV

c) V> IV > III > II > I

d) I> III > V >II > IV

e) V > II > I > III > IV

2. You have formulated a hypothesis: “Apples contain more vitamin C than oranges.”

To test your hypothesis you measure vitamin C levels in 20 oranges and 20 apples from trees that were grown in the same orchard under the same environmental conditions (temperature, rain, sunlight). This experiment was conducted twice. The control in the experiment is__________________________________.

a) type of soil, temperature, amount of rain and sunlight in the orchard

b) vitamin C levels

c) oranges

d) apples

e) a large sample size and repeated experiment

***Use the following information to answer questions 3, 4,5 & 6 below***:

A group of medical researchers investigated the effects of Drug X on lowering cholesterol levels in a group of men between the ages of 50 and 70 years old. The researchers did the following experiment and obtained the indicated results: One group of 150 men took a tablet containing Drug X for 3 weeks – 95 of these men decreased their cholesterol levels by at least 10% (three men from this group dropped out of the study). Another group of 150 men was given a tablet with no added Drug X for 3 weeks – 10 of these men decreased their cholesterol levels by at least 10% (two men from this group dropped out of the study).

3. Which of the following is the best hypothesis for this experiment?

a) Will drug X lower cholesterol levels in men between the age of 50 and 70 years?

b) Drug X will lower cholesterol levels in men.

c) Since high cholesterol levels significantly increases several health risks for men, drug X is most likely beneficial.

d) Men between the age of 50 and 70 years will have reduced cholesterol levels if they take drug X over a 3 week period.

e) There is no significant difference in cholesterol levels between men that take drug X and those that don’t take it.

4. Which of the following was the control group in this experiment?

a) The amount of Drug X contained in the tablet

b) The number of participants in each group at the end of the experiment

c) The group of participants that received tablets containing Drug X

d) The group of participants that received tablets that did not contain Drug X

e) The number of participants in each group at the beginning of the experiment

5. Which of the following is a dependent variable in this experiment?

Prevention interventions to address the opioid crisis | nursing | Chamberlain College of Nursing

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The alarming opioid crisis, with its staggering death rates, is affecting the life expectancy rates of Americans. Select one of the populations on the map and address the following:

I selected Florida:

Opioid-Related Overdose Death Rates (per 100,000 people) (2016): 14.40

Opioid Pain Reliever Prescriptions (per 100 persons) (2015): 62.80

1-Compare the opioid-related overdose death rates of the selected population to national opioid-related overdose death rates.

2-Identify one primary, one secondary, and one tertiary prevention intervention to reduce the misuse of opioids in the selected population.

3-Describe one evidence-based strategy to address provider opioid prescription rates.

4-Identify the stakeholders charged with addressing the opioid crisis in your community.

5-Share your professional experience related to the topic. (i work in hospice and we use a lot of opiod)

Please answer each question separated and use at least 3 sources no later than 5 years.

The impact the identified issue has on healthcare in an Australian and/or global context

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The impact the identified issue has on healthcare in an Australian and/or global context

disscussion paper Research Paper

The purpose of this discussion paper is to enable transition students to acquire insight into the contemporary issues in nursing at a national and international level and to demonstrate effective consolidation of nursing theory and practice, in preparation for transition into the professional nursing workforce. Document Preview:

Assessment 5: Professional Nursing Issue Discussion Paper Length: 1200 words Weighting: 50% Due Date: Week 15, Saturday 3rd November 1700hrs Overview The purpose of this discussion paper is to enable transition students to acquire insight into the contemporary issues in nursing at a national and international level and to demonstrate effective consolidation of nursing theory and practice, in preparation for transition into the professional nursing workforce. Details Students are required to identify and critically analyse one contemporary nursing issue impacting on the profession as highlighted in the current nursing literature.

The discussion should also include the impact the identified issue has on healthcare in an Australian and/or global context. The essay must be supported by at least 5 peer reviewed journal articles relevant to the identified nursing issue. The essay must be submitted through Turnitin as per School policy (refer to Submission Requirements section of this Learning Guide). A hard copy of your essay will then be submitted into your tutors designated assessment box on your home campus, along with a copy of the complete Turnitin Report and marking criteria. Resources i. Annotated examples will be available on the vUWS site. ii.

There are a number of textbooks available through the UWS Library that will assist you to identify a nursing issue. However, please ensure that your critical analysis of your identified issue is contextualised to a global and/or Australian perspective. That is, your discussion should not focus on another country. Marking criteria and standards (over page) 7 400764 T R A N S I T I O N T O G R A D U A T E P R A C T I C E CRITERIA The introduction clearly states the MARK S P R I N G Assessment Item 5: Professional Nursing Issue Discussion Paper Marking Criteria and Standards Guide HIGH DISTINCTION DISTINCTION CREDIT PASS 5-4 3.5 3 2.5 Introduction is clear and Attachments: assesment.docx

Roles and Duties Adult and Learning Disability Nursing

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District nurses work within the primary health care team. They support patients at home or in residential care. They also provide a teaching role by enabling patients to care for themselves or by helping family members learn to care for their relatives. (NHS, 2011)

Nurse consultants spend at least of 50% of their time working in direct contacts with patients. They are highly trained and are responsible for developing personal practice. They are involved in research, development and teaching. (NHS, 2011)

Specialist nurses are also known as clinical nurse specialists. They specialise in a specific area of nursing, for example, patients suffering from diseases such as cancer, diabetes or viruses. . Some clinical nurse specialists also have a teaching and advisory role. They may also be involved in advising medical and nursing staff about caring for patients with particular conditions and/or in teaching nurses and other professionals. (NHS, 2011)

Practice nurses work in a GP surgery and are part of a primary healthcare team, which involves other health professionals such as doctors and dieticians. In larger practices, there may be several practice nurses sharing duties and responsibilities but in smaller ones, you’d be working on your own, taking on many roles (NHS, 2011).

Asthma is a long-term condition that can cause a cough, wheezing and breathlessness. Asthma can be well controlled in most people most of the time. When a person with asthma comes into contact with something that irritates their airways (an asthma trigger), the muscles around the walls of the airways tighten so that the airways become narrower and the lining of the airways becomes inflamed and starts to swell. Sometimes sticky mucus or phlegm builds up which can further narrow the airways (NHS, 2011). Salbutamol is a beta 2 agonist. Salbutamol works by acting on receptors in the lungs called beta 2 receptors. When salbutamol stimulates these receptors it causes the muscles in the airways to relax. This allows the airways to open. Side effects of these types of medication can include nervousness, tremor and headache. (BNF, 2011)

Angina describes the pain and chest tightness – and sometimes breathlessness or choking feeling – caused when blood flow in the arteries that supply the heart is restricted (BUPA, 2011). Glycerol Trinitrate can be helpful in reducing angina attacks, rather than reversing angina started, by supplementing blood concentrations of nitric oxide. Side effects from Glycerol Trinitrate include, headache, dizziness, and diarrhoea, feeling sick and flushing (BNF, 2011).

Congestive cardiac failure is something that happens when a heart does not have enough strength to pump blood around the body properly; this leads to fluid collecting inside the lungs and body tissue, which then leads to congestion. It tends to affect older people. It is a long term condition and can be managed with medication and changes in lifestyle. One of the treatments available for use in congestive heart failure is Furosemide, which is a diuretic. Diuretics get rid of excess fluid and salt from a patient’s body, but in turn the body produces extra urine. They reduce swelling in ankles, make breathing easier and potentially increase life expectancy.

Cerebrovascular accident is the medical term for a stroke. The World Health Organisation (WHO) states that: ‘A stroke is caused by the interruption of the blood supply to the brain, usually because a blood vessel bursts or is blocked by a clot. This cuts off the supply of oxygen and nutrients, causing damage to the brain tissue.’ Aspirin is used in both the treatment and in the prevention of strokes. It works by thinning the blood, therefore reducing the risk of clots. Common side effects include stomach problems such as vomiting and pain. Long term effects can be serious and include a small risk of internal haemorrhage, which could lead to death.

Diabetes is a condition in which the body produces too much glucose as a result of a decrease in the amount of insulin that is present in the body. In a healthy individual the pancreas produces insulin which helps to regulate the amount of sugar that remains in the blood stream. In the body of someone with diabetes there is not enough insulin in the blood stream to break down glucose and create energy. There are two types of Diabetes known simply as Type 1 and Type 2. In Type 1 diabetes the body is unable to create insulin on its own and is diagnosed generally during youth mainly during the teenage years. It is very uncommon as it is an inherited trait and only 5-10% of all people who suffer from diabetes fall into the Type 1 category. With type 2 diabetes, the illness and symptoms tend to develop gradually. This is because in type 2 diabetes you still make insulin (unlike type 1 diabetes). However, you develop diabetes because: you do not make enough insulin for your body’s needs, or the cells in your body do not use insulin properly. This is called ‘insulin resistance’. The cells in your body become resistant to normal levels of insulin. This means that you need more insulin than you normally make to keep the blood glucose level down, or a combination of the above two reasons. Diabetes is associated with short term problems such as hypoglycaemia which can lead to death and many long term health issues which can develop as a result of the illness. The risk of these potential health problems can be reduced through lifestyle and diet management. Synthetic Insulin is used in the treatment of type 1diabetes in a carefully planned insulin therapy programme to replace the insulin that has not been produced by the pancreas. The longer a person has type 2 diabetes the greater the risk that they will have to start insulin therapy at some point throughout their lives.

Appendectomy – Removal of Appendix in cases of acute appendicitis.

Total Knee Replacement – Replacement of the whole knee joint. Used to treat severe knee pain, trauma, long term arthritis and mobility problems.

Coronary Artery Bypass Graft – A surgical procedure used to treat coronary heart disease. It diverts blood around narrowed or clogged parts of the major arteries, to improve blood flow and oxygen supply to the heart.

Total Mastectomy – A total mastectomy is also known as a simple mastectomy. It is a procedure that removes all of the breast tissue of an affected breast. The most common form of the surgery, referred to as traditional total mastectomy, includes the removal of the areola and nipple. However, the surgery can be performed using skin and nipple sparing techniques. It also leaves the muscle under the breast left intact.

Prostatectomy – A prostatectomy is the surgical removal of all or part of the prostate gland. Blockages like tumors of the prostate can affect the normal flow of urine in the urethra. A prostatectomy can help with this.

Laparoscopy – A laparoscopy is a surgical procedure that is carried out using a laparoscope which is a small, flexible tube with a camera on it. Using a laparoscope means that a surgeon can access the inside of the abdomen and the pelvis without the procedure being invasive because large cuts are not needed; Sometimes known as keyhole surgery.

According to The department of Health (2005) MRSA stands for Meticillin Resistant Staphylococcus Aureus. It is a very contagious strain of the Staphylococcus type of bacteria. It can cause many different infections and some of these can be very serious. About 3% of the population are known carriers of MRSA and it can be transmitted by a carrier to another person or themselves through an open wound or into the blood steam. In order to reduce the risk of infection of MRSA healthcare workers can practice proper hand hygiene and they can encourage patients to wash their hands after going to the toilet. Gloves can also be used with known carriers.

The Department of Health (2007) explains that Clostridium Difficile is a bacterium which is the major cause of antibiotic-associated diarrhoea and colitis, an infection of the intestines. It most commonly affects elderly patients with other underlying diseases. It is present in a small proportion of the population but is usually kept in check by the good bacteria. When this good bacteria is not present illness develops. People who have been treated with antibiotics are most at risk. The disease can be spread by healthcare workers, therefore washing hands after contact with a patient can help prevent the spread and reducing the use of antibiotics can help reduce the harm that the bacterium can cause.

Adult nurses work with old and young adults with a variety of health problems, chronic and acute. They are involved in many roles including caring, counselling, managing and teaching to improve the quality of a patient’s life, often in challenging situations. Adult nurses can hold positions at most levels of the NHS career framework. Adult nurses work at the centre of a multi professional team that can include doctors, physiotherapists, occupational therapists, pharmacists, radiographers, healthcare assistants and others workers. They assess, plan, implement and evaluate care for individual patients. Adult nurses can work in both hospital and community settings.

Learning Disability Nursing

The World Health Organisation defines learning disabilities or LD as: “a state of arrested or incomplete development of mind”. Learning disabilities is an umbrella term encompassing a range of disorders and deficits that create problems for an individual in relation to learning. People with LD often have physical problems that go hand in hand.

Learning disabilities are often diagnosed by psychologists, through a combination of intelligence testing, academic achievement testing, classroom performance, and social interaction and aptitude. Other areas of assessment may include perception, cognition, memory, attention, and language abilities.

IQ or Intelligence Quotient is an attempt to measure intelligence using standardized tests. According to the British Institute of Learning Disabilities (2006) it is often used to classify the level of intellectual impairment in someone with learning disabilities. Below 20 would be classed as a profound learning disability; 25 to 35, Severe; 35 to 50, Moderate and 55 to 70, Mild.

Errors in fetal development. Problems during pregnancy. Toxins in the child’s environment. Tobacco, alcohol and other drug use. Genetic factors.

According to the British Institute of Learning Disabilities (2006), between 1 and 2 percent of the UK population have a learning disability.

According to Autism.org.uk, autism is a developmental disability that lasts for a lifetime. It affects how they make sense of the world around them and how they communicate and relate to other people. It is a spectrum condition so even though people with autism share difficulties, their condition will be personal to them and will affect them in different ways. People with autism sometimes experience over- or under-sensitivity to sounds, touch, tastes, smells, light or colours.

According to the NHS (2010) Epilepsy affects the brain and can cause repeated seizures, also known as fits. Epilepsy usually begins early in someone’s life, although it can potentially start at any age. The severity of the seizures can vary in different people. Some may experience a ‘trance-like’ state for a short time, while some others lose consciousness completely and have convulsions where they shake uncontrollably.

Down’s syndrome is a genetic condition where a person inherits an extra copy of one chromosome. This additional genetic material can result in characteristic physical features such as a flatter than normal face and also intellectual features which can vary from moderate to severe LD.

Cerebral palsy is not a learning disability, but is common to have a LD if you also have cerebral palsy. It is a physical condition that affects the movement and control of a body. It is caused by a lack of development in part of the brain during pregnancy or childhood. The severities of problems are dependent on which part of the brain is affected (Mencap, 2010).

When talking about people with LD, dual diagnosis refers to the comorbidity of learning disabilities and mental health problems. People with LD often suffer with depression or anxiety.

It is important for nurses to be aware of the common conditions in LD because they can easily be missed if they are not actively looked for. It can be much more difficult for someone with LD to communicate a problem with their health and also, symptoms can be missed due to diagnostic overshadowing which means that secondary illnesses are missed because the symptoms are mistaken to be related to the primary disorder.

Most people with LD live at home with help from families and day care services.

Care for people with LD is often provided by family members with support from a range of healthcare workers and professionals such as nurses, psychologists, speech therapists, physiotherapists and specialist behavioral therapists; healthcare assistants and day workers.

Direct payments are made by councils to people receiving social care services, instead of the council providing the service directly (direct.gov.uk).

LD nurses work in a variety of setting which include the home, family, adult education, education for young people and community/residential settings (NHS Careers Website).

Social Role Valorisation is the name given to a concept formulated by Wolf Wolfensberger, Ph.D in 1983 which follows the principle of normalisation. Normalisation is a set of principles that underlie the idea that people with a learning disability should live in ordinary places, doing ordinary things, with ordinary people: essentially experiencing the ‘normal’ patterns of everyday life.

The five service accomplishments identified by O’Brien and Tyne (1981) were: Community presence; Relationships; Choice; Competence; Respect.

Person Cantered Planning is way of seeing and working with all people with disabilities. It helps people with disabilities plan and organise their future in a more ordinary way. Fundamentally the person is at the centre and family members and friends are made full partners in the plan. The plan should reflect what is important to the person and the capacities that they have. It should also help a person to make a valued contribution to society.

People with learning LD have been referred to as patients, clients and service users. Service user is the current term used within healthcare but the term client is still used by some and probably depends on who you are talking to.

The four principles of the 2001 white paper ‘valuing people’ are: right, independence, choice and inclusion. Right means that people with learning disabilities should have the same rights and choices as everybody else. Independence means the people with LD should be helped to live lives that are as independent as possible. Choice means that people with LD should be empowered to have choice in the treatment they receive and the lives that they lead. Inclusion means that people with LD should be included in society, have access to services and helped to gain valued social roles within society.

One of the issues with LD nursing is mental health. People with LD often also suffer with mental health problems. There is a distinct difference between a person having a mental illness and a learning disability,