Diagnosis and Management of Acute Otitis Media

The article under consideration is titled Diagnosis and Management of Acute Otitis Media and it is written by the American Academy of Pediatrics (AAP) and American Academy of Family Physicians (AAFP) (2004).Advertising We will write a custom essay sample on Diagnosis and Management of Acute Otitis Media specifically for you for only $16.05 $11/page Learn More The article â€Å"provides guidelines for primary care clinicians in managing children with uncomplicated acute otitis media (AOM) who are aged between two months and twelve years,† (American Academy of Pediatrics and American Academy of Family Physicians, 2004, p. 1451). This paper is a critical analysis and evaluation of the article. Sources of Evidence The study makes use of a wide range of sources of evidence. The types of source of evidence, classification of source and the appropriateness of the sources are illustrated in the table below. Table showing the sources of evidence and their characteristics Source Type of resource Appropriateness/ inappropriateness of the resource Classification of source of evidence 1. American Academy of Pediatrics and American Academy of Family Physicians. Clinical practice guideline: Diagnosis and management of acute otitis media Filtered resource: this resource provides general recommendations for the diagnosis and management of AOM that are based on evidence from other research studies. It is therefore considered to be a filtered resource. Appropriate: this resource is appropriate because it provides evidence-based recommendations on the ways through which AOM can be diagnosed and managed. Evidence-based guideline 2. Causative pathogens, antibiotic resistance and therapeutic considerations in acute otitis media. Pediatric Infections Disease Journal. Unfiltered resource: this is an unfiltered resource because it is a primary research study that was conducted by the researchers. Appropriate: this resource is appropriate becau se it provides evidence as to the pathogens that cause AOM and factors that need to be taken into consideration for effective management of AOM. Primary research evidence 3. Ear, nose, and throat. Current Pediatric Diagnosis and Treatment. Filtered resource: this is a filtered resource because it provides information on the current techniques used to diagnose and treat ENT problems among children. The information is based on prior primary research studies conducted by other researchers. Appropriate: this resource is appropriate because it provides further information regarding the current practices in diagnosing and managing AOM. Evidence summary 4. â€Å"Treatment of acute otitis media in an era of increasing microbial resistance,† (McCracken, 1998, p. 576). Pediatric Infectious Disease Journal. Unfiltered resource: this is an unfiltered resource because it is a primary research study that was conducted by the researcher to determine how AOM can be treated in case of mic robial resistance. Appropriate: this resource is appropriate because it also provides further evidence of more effective ways of treating AOM to avoid microbial resistance. Primary research evidence 5. Results from interviews with parents who have brought their children into the clinic for acute otitis media. Unfiltered resource: the results from the interview can be classified as an unfiltered resource because they provide information for a primary research study that was conducted by the researcher to determine the opinions of parents with children suffering from AOM. Appropriate: the resource is appropriate because the interviews help to identify the risk factors of AOM for instance, the length of time an infant breastfed among other factors. Primary research evidence Watchful Waiting The article provides credible and well-supported discussion of whether watchful waiting is an appropriate approach for treating children with acute otitis media based on the evidence that it pr esents (Brown, 2009). The term watchful waiting is specified as the observation option. This is presented by a definition, the basis upon which the decision is made as well as the initial requirements and the systems expected to be in place for its recommended usage. Speziale and Carpenter (2007) suggest that there must be support of evidences, application and summary of the recommendation which the authors of the article have provided. Application of the Findings to Nursing Practice The article provides a logical discussion of how to apply the findings of the article to improve nursing practice in the clinic. This is done by presenting a framework for helping primary care clinicians make effective decisions in dealing with AOM (Speziale Carpenter, 2007).Advertising Looking for essay on health medicine? Let's see if we can help you! Get your first paper with 15% OFF Learn More This is further presented through diagrammatic recommendations, tables and flow charts for simplification purposes (Brown, 2009). The issue of non-conventional ways of treating AOM using complementary and alternative medicine is identified. The changing clinical guideline practices are identified based on the evidence-based research with recommendations made for further studies that provide a guideline for the conclusive nature of research. Ethical and Other Issues The article does not include issues of confidentiality and informed consent (Speziale Carpenter, 2007). However, emphasis is placed on the roles of the parents and guardians especially in the initial examination and follow-up with no evidence of children giving their views. The role of the parents and guardians in studies involving children is important because children are a vulnerable population and need to be protected from any harm that may arise from such studies. The article therefore presents credible and well-supported discussion of the ethical issues presented in the research. Reference List American Academy of Pediatrics and American Academy of Family Physicians. (2004). Diagnosis and management of acute otitis media. American Academy of Pediatrics, 113(5), 1451-1463. Brown, S. (2009). Evidence-based nursing: the research practice connection. Boston: Jones Bartlett Learning. McCracken, G.H. (1998). Treatment of acute otitis media in an era of increasing microbial resistance. Pediatric Infectious Disease Journal, 17(6), 576-579. Speziale, H., Carpenter, D. (2007). Qualitative research in nursing: advancing the humanistic imperative. Philadelphia, PA: Lippincott Williams Wilkins.Advertising We will write a custom essay sample on Diagnosis and Management of Acute Otitis Media specifically for you for only $16.05 $11/page Learn More This essay on Diagnosis and Management of Acute Otitis Media was written and submitted by user Zariah W. to help you with your own studies. You are free to use it for research and reference purposes in order to write your own paper; however, you must cite it accordingly. You can donate your paper here.

Prostate Cancer essays

Prostate Cancer essays The prostate is a gland that is located just underneath the bladder. It surrounds the urethra through which a man urinates. The prostate gland is therefore vital to proper bladder control and urine flow-rate. The prostate is also essential for normal sexual function. It is the gland of ejaculation, supplying 95% of the seminal fluid and the power to push it through the urethra and out of the penis. The normal prostate in an adult man is about the size of a walnut. Its size often increases over time, however, particularly once a man gets beyond age 40. Because the urethra runs right through the middle of it, a growth spurt of the prostate will squeeze the urethra and begin to choke off the urinary flow. This can effect the ability to urinate and perform sexually. Prostate cancer occurs when some of the cells that make up the prostate gland escape from the normal controls on their growth and start to divide, grow and spread in an uncontolled manner. At first the growth of the cancer occurs very slowly and is usually limited within the prostate gland. Later on in the course of the illness, the prostate gland cells can spread around the body, particulary to the bones where they can paues pain and disability. Estimates show that the cancer may have been growing in some men for up to 10 yearsbefore it causes symptoms and is diagnosed. Some men develop symptoms whereas others do not. In those who that do, the following symptoms are commonly found: Need to urinate frequently, especially at night Sudden, incontrolable urges to urinate A burning sensation or pain when urinating Continuing pain in lower back, pelvis, or upper thighs There appears to be several forms of prostate cancer. Some men ...

Recreational Drug Use Negatively Affects Society Research Paper

Recreational Drug Use Negatively Affects Society - Research Paper Example From the report it is clear that recreational drugs include many kinds of drugs which can be legal or illegal. The use of recreational drugs in a society can cause several economic effects as people commonly start spending about one-fourth of their income in drugs, and utilize their savings, thus lowering their standards of living. In recent years, the overall economy of the American society has tremendously lowered as there is an increase in the usage of recreational drugs. The drugs industry is making high profits and it surely benefits their market as some drugs are highly expensive and once people are addicted to them, they buy them excessively to fulfill their needs. The more profits the drugs industry makes, the more risks of drugs smuggling, illegal selling and possession of drugs, and access use of controlled drugs will increase causing social, economic, and psychological problems. This paper highlights that people often start taking recreational drugs to divert their minds from their life problems or to gain some pleasure. Drugs are often successful in providing peace to the disturbed person and allowing him to forget all his worries for a while. This attracts people to use them more often, hence creating an addiction. Most people first get addicted to this feeling, then physically addicted, as it becomes a need for the body to calm down and feel good. Drug addicts are fifty percent more likely to commit crimes such as robbery and stealing, only for the purpose of buying more drugs.

Cold War and American Contribution Essay Example | Topics and Well Written Essays - 1250 words

Cold War and American Contribution - Essay Example The war had come just as the US was facing one of the greatest economic challenges ever. It had come from a great recession. The conflict that resulted spurred some economic growth. In retrospect, it led to new opportunities. The economy of the US bounced back. In addition, the country received immigrants from other nations. This was the period that saw the passing of the employment of the employment act. This was under the leadership of Truman. However, an economic uncertainty was to follow after the boom. This was expected since the economy during the cold war had not been based on the fundamentals aspects but sentimental factors. This was one of the effects of the Second World War. It divided East Germany and Berlin from the West of Berlin. Basically, the East part of German fronted different ideologies from the West in terms of political governance. The West divide was accused of harboring Nazi-like ideologies. The East fronted what was perceived to communism. The west fronted li beralism. This conflict led the east to construct the wall around Berlin. They even had watchtowers around it. The wall was later to be brought down after the collapse of communism. The war in Korea had a direct relevance to the cold war. It pitted communism against democracy. Communist thoughts were propagated by USSR together with China. Democracy was an idea of the US. South Korea adopted democracy. However, the north was a communist state which was an ally of the USSR and China. The political rift between the two neighboring states almost led to war. The tensions have been imminent even in recent times. The nuclear and arms threat at the time of the cold war led to exclusion of the North from world trades. The South prospered so much due to its open policy and promotion of liberalism. It has been argued that the period of the cold war affected North Korea the most. The country is yet to recover from the effects of the war. Question 2 Three essay questions What were the consequences of the cold war on the economic prospects of the world? What led to the end of the world cold war? Did the cold war influence the current political alignment in the world? The consequences of the Cold War on the economics prospects of the world The period of the cold war was characterized by imminent economic implications. The trade sanctions that were part of the war had dire consequences on selected economies. At the time, there are

Agenda Setting Essay Example | Topics and Well Written Essays - 4250 words

Agenda Setting - Essay Example Social problems are issues that negatively affect the state of being of individuals in the society. A social problem has two elements that include subjective concerns and objective condition of the problem. An objective condition of a social problem includes all the aspects the problem that can be viewed without any biasness. Subjective concerns are issues that are affect and individual based on their biasness to particular points of view. Subjective concerns create differences with solving problems in the society. The formation opposing groups in a society is due to the subjective concerns of individuals.Objective conditions have enlightened people in societies such that they have reformulated human conditions. Through intelligence by humankind, complex problems that seemed unsolvable are solved in the modern societies. Social reformers developed empirical analysis that has formed the basis for political science and social science. Positivists were empowered by the strength of facts . For instance, Florence Nightingale and William Beveridge believed that use of scientific researches was essential in solving social problems in our societies. Nightingale was convinced that doctrines are not very important as facts are. Facts do not hold uncertainties that make the process of making decisions harder.The other view of positivists in regard to problems is by perceiving social problems as dysfunctions. Other people against the views of the society define things as acceptable or unacceptable.

History of Autism Identification

History of Autism Identification Natures Smudged Lines When Kanner published his autism paper in 1943, he felt it was premature at that point to propose a set of criteria for diagnosing the condition he described. To make the pattern visible to his peers, he proposed two essential common characteristics shared by all children with this syndrome. The first was a will to self-isolation, present from birth. The second was a fear of change and surprise. These two characteristics became the diagnostic basis known as classic autism, or Kanners syndrome. In 1961, a British psychiatrist named Mildred Creak led a working party that established a nine-point criteria for the diagnosis of autism, based in part on studies of 100 children she herself had collected. The nine points were: Sustained impairment of interpersonal relationships Unawareness of personal identity Preoccupation with particular objects Striving to maintain sameness Acute anxiety produced by change Abnormal perceptual experience (hearing and vision) Failure to develop speech beyond a limited level Distortion of movement Some learning difficulty, but some islets of particular skills or abilities or knowledge These criteria represented the first set of standardized criteria for the diagnosis of autism, which she called schizophrenic syndrome in childhood. They differed significantly from Kanners two-point criteria and were more difficult to apply in practice. *** In the late 1960s, a young British psychiatrist name Lorna Wing set out to help her husband, John, a schizophrenia researcher at the University of London, compile a database of case records in Camberwell to determine if the National Health Service was providing the families of cognitively disabled children with adequate resources. John and Lorna had a daughter Susie, who was diagnosed with autism when she was three years old in 1959. It didnt take long for John and Lorna to figure out that there were almost no resources in place to support the families of children like their daughter. But fortunately they could send Susie to Sybil Elgars school. Sybil Elgar was a school secretary who was taking a correspondence course to become a Montessori teacher. After visiting an institution for severely and emotionally disturbed children in London in 1958, she started teaching classes for a small group of autistic children in the basement of her house in London. Susie Wing became one of her early students. In 1962, a group of parents from the National Autistic Society converted an old railway hostel in Ealing into the Sybil Elgar School using the money they raised. The Beatles visited the school one afternoon, and John Lennon became one of the schools first major donors and attracted other celebrities to the cause. In the late 1960s, when the Medical Research Council (MRC) asked John Wing to examine the prevalence of autism, he put a graduate student named Victor Lotter on the case. They sent out thousands of questionnaires to schoolteachers, training center supervisors, nurses, and parents in Middlesex and screened the entire population of eight- to ten-year-olds. Basing his selection criteria for autism on Creaks Nine Points, Lotter calculated a prevalence estimate of 4.5 cases of autism in 10,000. A closer look at the numbers reveals several problems. They found that several children had been screened out because they didnt fit Kanners criteria. Suspicious of the validity of Kanners criteria, Lorna Wing took a different approach in analyzing the data. Rather than using a top-down method as Lotter had done, she employed a bottom-up approach, searching for aspects of autistic behavior among children in Camberwell who were already identified as cognitively disabled. She and another MRC researcher named Judith Gould reached out to everyone whose job might bring them in contact with a child with special needs. Just as the Middlesex study predicted, they found only a handful of children in Camberwell 4.9 in 10,000 who met Kanners criteria. But Lorna and Judith didnt stop there. As they made their rounds of the neighborhood, they noticed a much larger group of children who had signs of his syndrome, but were not eligible for a diagnosis under his guidelines. While Lorna was trying to make sense of what she was seeing, she came across a paper by Dirk Arn Can Krevelen arguing that Kanners autism and Asperger syndrome were distinct conditions. After John (who can speak German) translated Aspergers paper for her, she realized that Asperger had seen the same thing in Vienna that she was seeing in Camberwell. Lorne began a quiet but determined campaign to expand the concept of autism to include people who had been excluded from Kanners. To replace Kanners unified syndrome, she proposed the term the autistic continuum. While there were clearly many shades and hues along this continuum, all autistic people seemed to benefit from the same highly structured and supportive educational approaches, just as Asperger predicted. It was apparent that a person could occupy one point on the continuum at a given point in their lives and another point later. Some children, like Susie, would remain disabled into middle age and beyond. But others blossomed in unexpected ways when given an accommodating environment and special consideration by their teachers. In 1981, Lorna codified the condition for Asperger syndrome by writing a case series of her own called Aspergers Syndrome: A Clinical Account. Over time, Lorna would lose her taste for the word continuum and adopted the term autism spectrum.

Grapes Of Wrath - Characterization :: John Steinbeck and Robert Demott

Evidence/ Quotations from the Text: "Winfield was breathless in his telling. 'So then they fit, an' that big girl hit Ruthie a good one, an' Ruthie said her brother'd kill that big girl's brother. An' then- an' then, Ruthie said our brother already kil't two fellas. An'- an' that big girl said, 'Oh yeah! You're jus' a litlle smarty liar.' An' Ruthie said, 'Oh yeah? Well, our brother's a- hiding right now from killin' a fella, an' he can kill that big girl's brother too" (456). "Muley continued, 'Well, sir, it's a funny thing. Somepin went an' happened to me when they tol' me I had to get off the place. .. Then all my folks all went away out west. An' I got wanderin' aroun'. Jus' walkin' aroun'. Never went far. Slep' where I was... I'd tell myself, 'I'm lookin' after things so when all the folks come back it'll be all right.' But I knowed that wan't true. There ain't nothin' to look after. The folks ain't never comin' back. I'm jus' wanderin' aroun' like a damn ol' graveyard ghos" (54). Analysis/ Commentary: At the camp, Ruthie becomes engaged in an argument that leads to serious consequences. In an effort to preserve her Cracker Jacks, she threatens to call upon her brother, who has killed two men and is now in hiding. Ruthie's revelation endangers Tom and forces him to abandon both his hideout and family. Ma, whose primary goal has been to keep the family together, must bid another painful farewell. Through his speech, Muley reveals that he is stubborn and refuses to accept the fact that things have changed. His home has been seized, and his family migrated to California, but he refuses to leave the land. Muley roams the countryside alone, sleeping and eating like a wild animal. Evidence/ Quotations from the Text "John shook his head. "No. Go on. Ain't goin'. Gonna res' here. No good goin' back. No good to nobody-jus' a draggin' my sins like dirty drawers 'mongst nice folks. No. Ain't goin'....Go ri' 'long. I ain't no good. I ain't no good. Jus' a-draggin' my sins, a-dirtyin' ever'body." (305). "For a minute Rose of Sharon sat still in the whispering barn. Then she hoisted her tired body up and drew the comfort about her. She moved slowly to the corner and stood looking down at the wasted face, into the wide, frightened eyes. Then slowly she lay down beside him. Grapes Of Wrath - Characterization :: John Steinbeck and Robert Demott Evidence/ Quotations from the Text: "Winfield was breathless in his telling. 'So then they fit, an' that big girl hit Ruthie a good one, an' Ruthie said her brother'd kill that big girl's brother. An' then- an' then, Ruthie said our brother already kil't two fellas. An'- an' that big girl said, 'Oh yeah! You're jus' a litlle smarty liar.' An' Ruthie said, 'Oh yeah? Well, our brother's a- hiding right now from killin' a fella, an' he can kill that big girl's brother too" (456). "Muley continued, 'Well, sir, it's a funny thing. Somepin went an' happened to me when they tol' me I had to get off the place. .. Then all my folks all went away out west. An' I got wanderin' aroun'. Jus' walkin' aroun'. Never went far. Slep' where I was... I'd tell myself, 'I'm lookin' after things so when all the folks come back it'll be all right.' But I knowed that wan't true. There ain't nothin' to look after. The folks ain't never comin' back. I'm jus' wanderin' aroun' like a damn ol' graveyard ghos" (54). Analysis/ Commentary: At the camp, Ruthie becomes engaged in an argument that leads to serious consequences. In an effort to preserve her Cracker Jacks, she threatens to call upon her brother, who has killed two men and is now in hiding. Ruthie's revelation endangers Tom and forces him to abandon both his hideout and family. Ma, whose primary goal has been to keep the family together, must bid another painful farewell. Through his speech, Muley reveals that he is stubborn and refuses to accept the fact that things have changed. His home has been seized, and his family migrated to California, but he refuses to leave the land. Muley roams the countryside alone, sleeping and eating like a wild animal. Evidence/ Quotations from the Text "John shook his head. "No. Go on. Ain't goin'. Gonna res' here. No good goin' back. No good to nobody-jus' a draggin' my sins like dirty drawers 'mongst nice folks. No. Ain't goin'....Go ri' 'long. I ain't no good. I ain't no good. Jus' a-draggin' my sins, a-dirtyin' ever'body." (305). "For a minute Rose of Sharon sat still in the whispering barn. Then she hoisted her tired body up and drew the comfort about her. She moved slowly to the corner and stood looking down at the wasted face, into the wide, frightened eyes. Then slowly she lay down beside him.