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Among Patients with A Dual Diagnosis of Schizophrenia and Substance Use Disorder What Current Treatments Provide Optimal Outcomes?
Get PDFIntroduction: This research was conducted on the topic of dual diagnosis (DD) patients with co-occurring schizophrenia (SZ) and substance use disorder (SUD). The research question posed for this topic: among patients with a DD of SZ and SUD what current treatments offer optimal outcomes?
Methods: The research for this paper was predominantly a literature review. Forty-five sources were utilized in its construction. The majority of sources were peer-reviewed studies obtained from an online service via the Lindell Library at Augsburg University. Three textbooks were utilized. One expert interview was conducted.
Results: Three key findings within the research identified first, SUD rates were shown to be higher among patients with SZ than the general population (47-70% vs. 6%). The second finding suggests that Long-acting injectable (LAI) medications have shown promise in offering optimal outcomes due to fewer opportunities for missed doses. Third, according to a U.S. prison study and two leading mental health organizations, 26.1% and 3% of inmates had documented SUDs or SZ diagnosis respectively compared to 6% and 0.25-0.64% in the general population.
Discussion: In this essay I will discuss the issue of this patient population disproportionately overlapping with the CJS and the demand for policy change and societal accountability. More resources will need to be dedicated to this patient population in order to move towards optimal outcomes. Patients with SZ and SUD have complex needs and require an interdisciplinarian mental health team to achieve the best outcomes
Environmental Influences on Pediatric Asthma: The Role of Social Determinants of Health in Costa Rica
Get PDFPediatric asthma is one of the leading causes of morbidity and mortality among children worldwide. In Costa Rica, rates of childhood asthma are among the highest in the world. Many factors contribute to the rising prevalence of asthma, including increasing urbanization and westernization, indoor and outdoor air pollution, diet, and lifestyle. According to the WHO, air quality in Costa Rica is considered moderately unsafe, with a disproportionate exposure to air pollution in low-income urban areas. Social inequalities further contribute to the development and progression of asthma in Costa Rica. Children living in low socioeconomic neighborhoods have greater exposures to air pollution through higher traffic density and proximity to landfills and powerplants. Increasing rates of obesity and limited access to antioxidant-rich fresh produce also contribute to asthma presence and severity. While Costa Rica has implemented a National Asthma Program, much of its efforts have been focused on optimizing asthma treatment, rather than reducing occurrence. Addressing the social determinants of health within the country, by specifically focusing on living conditions and equitable access to clean air, water, and fresh produce, will help to improve the overall health of Costa Ricans and reduce the socioeconomic burden of childhood asthma
On James Sterba’s refutation of theistic arguments to justify suffering
Get PDFIn his recent book Is a Good God Logically Possible? and article by the same name, James Sterba argued that the existence of significant and horrendous evils, both moral and natural, is incompatible with the existence of God. He advances the discussion by invoking three moral requirements and by creating an analogy with how the just state would address such evils, while protecting significant freedoms and rights to which all are entitled. I respond that his argument has important ambiguities and that consistent application of his moral principles will require that God remove all moral and natural evils. This would deleteriously restrict not only human moral decision making, but also the knowledge necessary to make moral judgments. He replies to this critique by appealing to the possibility of limited divine intervention, to which I rejoin with reasons why his middle ground is not viable
Nurse Practitioners and Community Health Workers Improve Community Health
Get PDFAddressing health disparities in primary care is essential for the advanced practice nurse practitioner(NP). Recent research demonstrates that the United States spends more money on health care than any other country of equal income but has worse outcomes, including lower life expectancy, higher infant mortality rates, and more stratified health inequities (Papanicolas, Woskie, & Jha, 2018). The NP has many opportunities to improve healthcare by partnering with diverse voices that seek to change the healthcare system. To better address health disparities among marginalized people in Minnesota, this scholarly project will determine best practices for the development and incorporation of community health workers (CHWs) into clinical practice. This scholarly project will identify barriers to practice, identify systems processes of improvement, and partner with a local clinic to determine the impact of the NP and CHW on patient health
Pediatric Obesity: Prevention, Assessment and Treatment in Primary Care
Get PDFPeople of all ages deserve care for the disease of obesity. Pediatric obesity affects one in three children in the United States, and the number of obese children has tripled since the 1970s (Centers for Disease Control and Prevention (CDC), 2018a). High blood pressure, high cholesterol, type 2 diabetes, and sleep apnea are complications that pediatric patients now face, and these diseases are well known to worsen quality of, and potentially shorten life. This scholarly project addresses the question: How can family nurse practitioners effectively address pediatric obesity in the primary care setting? Interventions early in life, perhaps even pre-conception, aim to avoid development of severe health issues and diseases that are related to obesity. It is the role of the primary care provider to help families understand the impact of excess weight on health, to assess young patients for weight concerns, to promote positive behaviors and initiate effective treatment options. This scholarly project will examine nurse practitioner knowledge of pediatric obesity prevention, assessment, and treatment. Further, it will explore current approach to care delivery by nurse practitioners in a primary care practice setting. This scholarly project will demonstrate that one must be empowered with the education on best practice to most effectively engage in pediatric obesity care delivery
Mindfulness Meditation in Nursing Practice: an Educational Module to Assist With Decreasing Stress in Nursing
No full textThe demands of nursing can be challenging both personally and professionally. Nurses often place the needs of the patient, the patient’s families, and the organization above their own. Consistent care of others without proper attention and care to one’s own needs can lead to increased stress and possible burnout of the nurse. It is important for nurse leaders to promote self-care to nurses so they can provide excellent compassionate patient care from the heart. Nurses working in a fast-paced ambulatory clinic at a Midwest teaching institution were identified as having stressful days, often without times for breaks. An educational module and a 30-day pilot utilizing mindfulness meditation during a daily workday huddle was developed to help keep nurses grounded and present in the moment. A survey will be used to evaluate the educational session and the 30-day pilot of daily mindfulness meditation in the practice. Watson’s Theory of Human Caring guided the development of the mindfulness meditation education and the content of the educational module. A tree as a metaphor is a pictorial representation to explain how Watson’s theory and mindfulness meditation can help nurses to provide heart centered care
What Treatment and Prevention Options are the Most Effective for Elbow, Knee, and Plantar Tendinopathies?
Get PDFObjective: Tendinopathies of the upper and lower extremity are one of the most common injuries in athletes and non-athletes in the United States. This literature review aimed to determine the most effective preventions and treatments for patients with tendinopathies.
Methods: A literature search was conducted primarily through Google Scholar and PubMed, for articles related to effective preventions and treatments for tendinopathies.
Discussion: Based on the literature review, there were multiple effective treatments and preventative measures for tendinopathies in the upper and lower extremity. The most effective preventative measures consisted of risk factors, dynamic warmups, and prevention programs. Treatments were broken down into three categories: elbow, patella, and plantar tendinopathies. The diamond tape job and counterforce brace improved symptoms in patients with elbow tendinopathies, and improved function throughout the body. Corticosteroids improved symptoms short term in the UE and LE, while PRP improved symptoms and promoted long term tissue healing. Physical therapy (eccentric exercises) appeared to show abundant benefit on tendinopathies regardless of the location.
Conclusion: For tendinopathies that fail conservative treatments, preventative measures can help avert tendinopathies. Corticosteroids, PRP, and physical therapy can be used for treatment. Specific prevention programs can inhibit elbow tendinopathies and improve function throughout the whole body, while a reduction in risk factors could prevent elbow, patella, and plantar tendinopathies. Regarding the elbow and plantar fascia, the best long-term results were PRP or physical therapy (eccentric exercises). For the knee, eccentric exercises were the most effective treatment, while PRP had mixed results. Despite an increase in research on these topics, more RCT’s are needed in upper/lower tendinopathies, and standard protocols for PRP
In Patients With a Ruptured Anterior Cruciate Ligament, Does an Autograft Versus Allograft Reconstruction Provide Superior Post- Operative Outcomes?
Get PDFBackground: The literature surrounding anterior cruciate ligament (ACL) reconstruction (ACLR) exhibits the most commonly used grafts for a ruptured ACL are bone-patellar tendon-bone (BPTB) autografts, quadriceps tendon (QT) autografts, hamstring tendon (HT) autografts, and allografts. This paper was designed to compare the postoperative outcomes between autografts and allografts to determine which graft is superior.
Methods: A literature review of studies were searched and selected based on inclusion and exclusion criteria using Augsburg University Interlibrary loan system, PubMed, and Elsivier.
Results: The research demonstrates superior outcomes for autografts compared to allografts. Additionally, the research delineates outcomes based on the type of autograft used in ACLR. The literature describes BPTB autografts as having decreased laxity and failure rates compared to other autografts. The literature also suggests specific indications for autografts and allografts. Autografts have demonstrated decreased rates of graft failure and laxity, and are associated with better postoperative functional outcomes. Autografts are the graft of choice for younger, more active patients, but have been associated with increased donor-site morbidity including hamstring weakness, anterior knee pain, and hypoesthesia. Allografts are associated with increased laxity and graft failure, but are noted to have better subjective outcomes based on less donor-site morbidity.
Conclusion: Overall, autografts have been validated to be the superior graft choice when it comes to laxity and failure rates for younger and more active patients, but allografts have their own indications for older, less active patients looking to maintain knee function without risking the complications associated with autograft harvest
Compositional Methods in Music Therapy
No full textSelecting and designing appropriate and effective music therapy experiences involves a critical thought process that considers multiple aspects of the client and their personal, interpersonal, and therapeutic contexts, as well as the nature of the four music therapy methods. Compositional Methods in Music Therapy focuses specifically on procedural guidelines for the compositional method-variations. Case illustrations examine the thought process leading to clinical decisions about the selection of music experiences that are based on the needs of clients and the affordances inherent in music composition. General guidelines for planning and implementing are provided in the form of questions that encourage critical thinking and creativity and which allow understanding of the client to be incorporated into the music therapist’s preparation for sessions. Approaching music therapy planning in this manner provides the foundation for practice that is based in music engagement and makes full use of the potential of music to be transformational in people’s health and well-being. This book is intended for use by pre-internship music therapy students and by professionals who have never approached music therapy planning and implementation from the perspective of the four methods. It is designed to be used either in whole from front to back or in parts in any order in relation to a course or to an individual’s learning needs. Illustrative material is provided to solidify understanding, as well as to connect readers with other resources they can seek out on their own.https://idun.augsburg.edu/monographs/1082/thumbnail.jp