External drainage was used in cases of misdiagnosis, high risk of anastomotic dehiscence due to infected pseudocyst, or when the wall is immature. It was considered inferior to internal drainage in that external drainage can cause hemorrhage due to mechanical abrasion by the drainage tube, frequent occurrence of secondary infection, persistent pancreatic fistura, which was 10% of all cases, disease rate at 18% and a high 10% mortality. The study revealed a 9% mortality rate for external drainage, often due in turn to the poor condition of the patient.
This last study pointed to internal drainage as the preferable surgical procedure for all uncomplicated cases of pseudocysts (Govil et al. 2004). Cystogastrostomy is the option for cysts, which densely attach to the posterior stomach walls, while cystoduodenostomy should be for pseudocysts in the head and the uncinate process of the pancreas. The authors found that cystojejunestomy would be appropriate for…...

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Bibliography

Andersson, R and W. Cwikiel. Percutaneous Cystogastrostomy in Patients with Pancreatic Pseudocysts, European Journal of Surgery, vol 168 (6) September 1, 2002. Taylor and Francis Ltd.  http://ingentaconnect.com/connect/tandf/ssur/2002/00000/68/00000006/art00005 

Cantasdemic, M, et al. Percutaneous Drainage for the Treatment of Infected Pancreatic Pseudocysts. Southern Medical Journal, vol 96 (2): 136-1-40, February 2003. http://smalljournalonline.com/pt.re/smi/searchplusresults.htm:jsessionid=CruAvbls0tN28va87ouAqSGITNtLFRuDWtzElV5D

Cutress, Golash. Laparaoscopic Cytogastrostomy for a Giant Pseudocyst of Pancreas, a case report. Department of Surgery: Sultan Qaboos Hospital. The Surgeon, vol 03 (1), February 2005. http://icsed.ac.uk/journal/svol3_1/3010008.html

Govil D. et al. Surgery for Complicated Pancreatic Pseudocysts. Indian Journal of Gastroenterology, vol 23 (1), pp 33-34. (  (article.asp?)issn=0254-8860,year=2004,volume=23,issue=1,spage=33,epage=34,aulast=Govilhttp://www.indianjgastro.com 

Article Summary: A Randomized, Controlled Trial of Total Knee Replacement In this study, the authors conduct an assessment of two approaches for addressing moderate-to-severe knee osteoarthritis. The said approaches are; total knee replacement followed by a nonsurgical program, and the adoption of nonsurgical interventions. It is, however, important to note that as the authors point out, both approaches lead to improvements that are deemed clinically relevant. More specifically, the authors of this particular study present their findings on the efficacy rate of the fusion of both surgical treatment and nonsurgical treatment, with the nonsurgical treatment program coming after the surgical intervention. The nonsurgical treatment program was implemented for a total of 12 weeks and it included pain medications, utilization of insoles, advice on diet, education, and exercise. The patient I took care of during my clinical rotation has knee pain and is scheduled for total knee replacement. On the strength of…...

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References

Skou, S.T., Roos, E.M., Laursen, M.B., Rathleff, M.S., Nielsen, L.A., Simonsen, O. & Rasmussen, S. (2015). A Randomized, Controlled Trial of Total Knee Replacement. The New England Journal of Medicine, 373(17), 1597 – 1606.

When one looks at the occurrence of recidivism in offenders who have partaken in treatment programs varying from organic programs to those geared to more social and emotional support programs, it becomes clear that recidivism of sexual re-offense is relatively low, compared to those who undergo no treatment program. However, there is still an issue with non-sexual re-offense. In addition, there is evidence that the contributing factors for adult and juvenile offenders are different.
As such, it is suggested that not all offenders should receive the same treatment. Correctional literature indicates that high-risk offender require the greatest use of resource, while lower risk offenders require the lowest level of resources (Andrews & Bonta, 2003).

As such, blanket policies that deem all offenders as 'high risk' are neither effective nor efficient. In addition, it may take away resources from those who truly need it, such as juvenile offenders who require longterm treatment.

eferences

Abracen,…...

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References

Abracen, J., Looman, J., DiFazio, R., Kelly, T., & Stirpe, T. (Mar 2006). Patterns of attachment and alcohol abuse in sexual and violent non-sexual offenders. Journal of Sexual Aggression, 12(1). Retrieved December 17, 2007, from Academic Search Premier database.

Andrews, D. & Bonta, J. (2003). The psychology of criminal conduct. Cincinnati, OH: Anderson Publishing.

Bates, a., Saunders, R., & Wilson, C. (Spring 2007). Doing something about it: A follow-up study of sex offenders participating in Thames Valley Circles of Support and Accountability. British Journal of Community Justice, 5(1). Retrieved December 17, 2007, from SocINDEX database.

Calley, N. (Spring 2007). Integrating theory and research: The development of a research-based treatment program for juvenile male sex offenders. Counseling & Development, 85(2). Retrieved December 17, 2007, from Academic Search Premier database.

The facility should strive to bring the SSI rate down below the expected level for the types of patients and surgeries that the facility has.
Plan of Action

In order to achieve better-than-average results in the SSI rates for our facility, there are a number of tactics that can be used. The first is that the culture of the organization needs to emphasize safety to a degree greater than the current degree. As of now, there is no particular focus on SSIs, and this contributes to a culture where there is little accountability with respect to the SSI rates, or to individual SSI cases. The organization must improve the accountability, so that staff members are specifically held accountable for the mistakes that they make that result in an SSI.

Beyond culture, there are specific things that the organization can do to promote an improved rate of SSI. The first is that the…...

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Works Cited:

Anderson, D. (2009). Surgical site infections. Division of Infectious Diseases, Duke University Medical Center. Retrieved September 29, 2012 from http://www.hapmd.com/home/hapmdcom/public_html/wp-content/uploads/2009/03/cirugia/bibliografica-cx/20110504_articulo_2.pdf

Barie, P. & Eachempati, S. (2005). Surgical site infections. The Surgical Clinics of North America. Vol. 85 (6) 1115-35.

Harbarth, S., Samore, M., Lichtenberg, D. & Carmeli, Y. (2000). Prolonged antibiotic prophylaxis after cardiovascular surgery and its effect on surgical site infections and antimicrobial resistance. Circulation. Vol. 101 (2000) 2916-2921.

Lauwers, S. & de Smet, F. (1998). Surgical site infections. Acta Clin Belg. Vol 53 (5) 303-310.

ole of Antibiotic Therapy in the Treatment of Periodontal Disease?
The objective of this work is to examine the role of antibiotic therapy in the treatment of periodontal disease. Also examined will be the delivery system, the type of antibiotics and efficacy as an adjunct to mechanical therapy in the management of periodontal disease. Toward this end, this work will examine the literature in this area of study including literature located in professional and academic journal and publications.

Sub-Antimicrobial Dose Doxycycline

The work of Preshaw, et al. (2005) entitled "Long-Term Treatment with Sub-Antimicrobial Dose Doxycycline Has No Antibacterial Effect on Intestinal Flora" reports a study that sought to determine if a nine-month regimen of subantimicrobial doxycycline (20 mg. bid) had an effect on either the intestinal or the vaginal microflora. The study involved 69 individuals with periodontal disease who were randomized to receive drug or placebo control for a nine-month period. It…...

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References

American Academy of Periodontology. (2000) Parameter on "refractory" periodontitis. J Periodontol 2000;71:859-860.

Andrian E, Grenier D, Rouabhia M. (2004) In vitro models of tissue penetration and destruction by Porphyromonas gingivalis. Infect Immun. 2004;72: 4689 -- 98.

Chen C, Slots J. (1993) The current status and future prospects of altering the pathogenic microflora of periodontal disease. Curr Opin Periodontol 1993;71-77.

Chen C, Slots J. (2000) Microbiological tests for Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis. Periodontol 2000-1999;20:53-64.

Endovascular Laser and Microphlebectomy for Treatment of Varicose Vein
Venous insufficiency is a condition that affects hundreds and thousands of individuals each year, particularly women. Venous insufficiency often results in varicose veins, phlebitis and similar physiological conditions. In general these abnormalities are thought to result from a combination of gender and heredity among other things. Historically treatment for venous insufficiencies involved very aggressive and invasive surgery which stripped veins; this process resulted in a removal of the offending veins. Often the recovery time was in excess of two weeks, with patients often only minimally mobile.

Advances in technology and procedure however have resulted in a new minimally invasive procedure that combines the use of endovascular laser surgery and microphlebectomy to remove varicosities that occur below the knee (Pearce, 2003). The use of endovascular laser is limited primarily to the greater and minor saphenous veins, which are often implicated in venous disorders.…...

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Bibliography/References

Aetna. "Varicose Veins." Aetna. {Online} Retrieved April 11, 2004, Available: http://www.aetna.com/cpb/data/CPBA0050.html

Anwar, S, Shrivastava, V, Welch M, al-Khaffaf H. Subfascial endoscopic perforator surgery: A review. Hosp Med. 2003; 64(8): 479-483

Arnoldi CC. The aetiology of primary varicose veins. Dan Med Bull 1957; 4: 102-107.

Belcaro, G., Nicolaides, AN, Ricci A, et. al. Foam scleropathy, surgery, sclerotherapy and combined treatment for varicose veins: A 10-year, prospective, randomized, controlled trial (VEDICO Trial). Angiology. 2003; 54 (3): 307-315

Presbyopia is a disorder, where the lens of the eye loses its capacity to focus. This incapacity makes it hard to see items up close. Some scholars have suggested that presbyopia means "age of sight." Presbyopia is not similar to farsightedness because it involves the loss of accommodation and ability for the eye to correct to enhance clarity at various distances. In this context, the young eye requires to change its interval or shape to focus on close objects. The capability of the lens to change shape gives the lens elasticity, which when lost results to presbyopia. When people grow old, they tend to lose this elasticity, and this explains why the eye gradually loses its capacity to focus on close objects (ennett, 2008).
How Presbyopia Occurs

Presbyopia happens when the cornea and lens refract light so that the light appears behind the retina



People realize they have this condition when they are…...

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Bibliography

Adnan, A.A. et al. (2013). Prevalence of refractive errors of the eye among adults in Iraq. Journal of natural sciences research, 3(4), pp. 117-124.

Bennett, M.Q. (2008). New thoughts on the correction of presbyopia drivers.Diving and hyperbaric medicine, 38(3), pp. 163-164.

Brahma, A., & McGhee, C.N. (2000).Surgical Correction of refractive errors (Review).J Royal

Soc Medicine, 93 (3):118-23

Speech Problems and Psychological Damage From Cleft Lips and Cleft Palates
Cleft lips and cleft palates are among the most common of birth defects and if left untreated can lead to serious speech problems as well as psychological damage that can result both from those speech and communication problems as well as from the ostracism that a child with a facial deformity must endure.

However, while the consequences of cleft lips and palates can be severe and long-lasting, these can be averted by medical intervention, especially if it is done as early as possible. This paper explores the various options for surgical and medical management of cleft lips and palates and the ways in which these interventions can help children with these particular birth defects.

We should begin this discussion of treatment of cleft lips and palates by establishing what exactly is meant in medical terms by these two terms. A cleft palate…...

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References

Bebout, L., & Arthur, B. (1992). Cross-cultural attitudes toward speech disorders. Journal of Speech and Hearing Disorders, 35, 45-52.

Bernthal, J.E., & Bankson, N.W. (1993). Articulation and phonological disorders (3rd ed.). Englewood Cliffs, NJ: Prentice Hall.

Broen, P.A., Strange, W., Doyle, S.S., & Heller, J.H. (1983). Perception and production of approximant consonants by normal and articulation- delayed preschool children. Journal of Speech and Hearing Research, 26, 601-608.

Catts, H.W. (1993). The relationship between speech-language impairments and reading disabilities. Journal of Speech and Hearing Research, 36, 948-958.

Interstitial lung disease is a blanket term for a big group of disorders categorized by progressive scarring of both the lung tissue supporting and between the air sacs. This tissue is called the interstitium. The interstitium consists of the region between the alveolar space and the capillaries. The scarring causes inflammation and damage in the lung tissue followed by lung stiffness, meaning the air sacs cannot expand as much as before. Lung stiffness makes it harder to breathe. People affected by the condition are not able to get enough oxygen from the lungs into their bloodstream.
Although some potential causes have been researched, there may be no underlying cause for development of interstitial lung disease. If there is no known cause, it is called idiopathic interstitial lung disease. IPF or idiopathic pulmonary fibrosis remains the most common type of this illness. Of the causes most widely recognized, cigarette smoking is said…...

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References

Fischer, A. & du Bois, R. (2012). Interstitial lung disease in connective tissue disorders. The Lancet,380(9842), 689-698.  http://dx.doi.org/10.1016/s0140-6736 (12)61079-4

Maher, T. (2014). Current and Emerging Treatment Options in Interstitial Lung Disease. Pulmonary Manifestations Of Rheumatic Disease, 193-216.  http://dx.doi.org/10.1007/978-1-4939-0770-0_14 

Moazedi-Fuerst, F., Kielhauser, S., Brickmann, K., Tripolt, N., Meilinger, M., Lufti, A., & Graninger, W. (2015). Sonographic assessment of interstitial lung disease in patients with rheumatoid arthritis, systemic sclerosis and systemic lupus erythematosus. Clinical And Experimental Rheumatology,33(4 Suppl 91), S87-91. Retrieved from  http://europepmc.org/abstract/med/25665185

Quantitative esearch Critique and Ethical Considerations Part IIMy PICOT question focuses on hospitalized patients suffering from surgical site infections and generating a comparison of different interventions (including training and reducing stressors upon staff) to reduce the likelihood of such infections occurring post-surgery. This paper reviews the previous literature on attempts to better understand why such preventable infections occur and how to address their root causes.Background of StudyThe study of Teshager, Engada, & Worku (2015) focuses on human-related factors associated with increased risks of surgical infection in Amhara, Ethiopia. The study focused on nursing personnel specifically. Associated demographic factors with lower risk included greater knowledge of preventative factors, increased age of the nurse, increased practice experience, male gender, past training, and higher education level. The study encompassed 423 nurses, and more experienced male nurses with higher levels of training and education had the greatest knowledge of infection preventative practices. Male nurses…...

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ReferencesAwoke, N., Arba, A., & Girma, (2019). Magnitude of surgical site infection and its associated factors among patients who underwent a surgical procedure at Wolaita Sodo university teaching and referral hospital, south Ethiopia. PLos ONE, 14(12), e0226140.   C., Bensimon, C.M., Hales, B., Laflamme, C., Fenech, D., & Smith, A. (2012, December). Surgical site infection prevention: a qualitative analysis of an individualized audit and feedback model. Journal of the American College of Surgeons, 215(6), 850-857.  https://doi-org.lopes.idm.oclc.org/10.1016/j.jamcollsurg.2012.08.007 Teshager, F.A., Engada, E.H., & Worku, W.Z. (2015). Knowledge, practice, and associated factors towards prevention of surgical site infections among nurses working in Amhara regional state referral hospitals, northwest Ethiopia. Surgery, Research and Practice, 2015.  https://doi-org.lopes.idm.oclc.org/10.1155/2015/736175  https://doi-org.lopes.idm.oclc.org/10.1371/journal.pone.0226140 Nessim,

Case Study: KBPatient Information: KB, 36, Female, BlackS.CC (chief complaint): \\\"My mother took my blood pressure and it was a little higher than it should be\\\"HPI: KB is a 36-year-old black female, who is 30 5/7 weeks pregnant. She presents with a complaint of high blood pressure noted by her mother. She also reports recent headaches but no other symptoms such as epigastric pain, vision changes, or nausea. She has noticed slight swelling and weight gain of 17 lbs to date. Fetal movement has been normal and she denies any leaking fluid, vaginal bleeding, or contractions. Prior to her pregnancy, she was on hctz for borderline BP but stopped it when she underwent IVF. Her blood pressure has since remained \\\"pretty normal\\\". Her current BP is 162/90 with a pulse of 82, respirations 16, and temperature 98.2 orally.Current Medications: Prenatal vitaminsAllergies: None reportedPMHx: Borderline hypertension. No history of major illnesses.…...

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ReferencesMruma, H. A., McQuillan, R., & Norrie, J. (2020). The association of malaria infection and gestational hypertension in Africa: systematic review and meta-analysis. Journal of Global Health, 10(2).   Tanner, M. S., Davey, M. A., Mol, B. W., & Rolnik, D. L. (2022). The evolution of the diagnostic criteria of preeclampsia-eclampsia. American Journal of Obstetrics and Gynecology, 226(2), S835-S843.  https://doi.org/10.1016/j.ajog.2021.11.1371  Thomas, C. A., Anderson, R. J., Condon, D. F., & de Jesus Perez, V. A. (2020). Diagnosis and management of pulmonary hypertension in the modern era: insights from the 6th world symposium. Pulmonary therapy, 6, 9-22.  https://link.springer.com/article/10.1007/s41030-019-00105-5  https://doi.org/10.7189%2Fjogh.10.020417 

Routine Shaving of the Surgical Site
Select a preoperative procedure (e.g., routine shaving of the surgical site) that you would commonly find on a surgical floor.

Describe the process or procedure you have chosen and why you think it needs change.

The process which I have chosen for surgical floor is routine shaving of the surgical site and I think it needs change because patients going through surgery are required to remove hair from the site of the cut. This is considered to reduce the chance of the surgical site becoming infected (National Collaborating Centre for omen's and Children's Health, 2008). Shaving, clipping the hair and using a cream which dissolves the hair are some of the different methods available to remove hair. And these are important because clinically, care plans offer a way to plan and communicate appropriate patient care.

A2. Based on your initial investigation of the situation, do the following:

Explain who…...

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Works Cited

Collins, A.S. (n.d.). Preventing Health Care - Associated Infections. Retrieved October 30, 2012, from National Center for Biotechnology:  http://www.ncbi.nlm.nih.gov/books/NBK2683/ 

Graham, I.D., RN, J.L., Harrison, M.B., Straus, S.E., Tetroe, J., RN, W.C., et al. (2006). Lost in knowledge translation: Time for a map? Journal of Continuing Education in the Health Professions, 13-24.

Green, L.A., & Seifert, C.M. (2005). Translation of Reserch into Practice: Why we can't "Just Do It." PubMed, 541-545.

National Collaborating Centre for Women's and Children's Health. (2008, October). Surgical Site Infection: Prevention and Treatment of Surgical Site Infection. Retrieved October 29, 2012, from Nice.org.uk:  http://www.nice.org.uk/nicemedia/pdf/CG74FullGuideline.pdf

As Pressman states, "Given what has later become known about the delicacies of brain function and the complexities of psychiatric illness, it strains credulity that such a crude procedure as the original lobotomies might truly have yielded therapeutic benefits for a great many patients." (Pressman1998, 195) This also refers to the fact that some medical theories are favored at certain times and not others. This suggests the relativity rather than the certainty of the scientific -- rational worldview.
The above brings us to the views put forward by Freeman and others concerning the technological fix. This in turn relates to other questions; such as why a method like lobotomy should have been seen to be effective in the past but not today. This leads to the view that political and social factors influence medicine and especially the success once attributed to a technology like lobotomy. For example, Pressman refers to…...

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Bibliography

Freeman, Walter and Watts, W. 1942. Psychosurgery, Intelligence, Emotion and Social

Behavior Following Prefrontal Lobotomy for Mental Disorders. Springfield:Baltimore.

Freeman, Walter and Watts, W. 1937. "Subcortical Prefrontal Lobotomy in the Treatment

of Certain Psychoses." Archives of Neurology and Psychiatry 38: 225-229

Varied Perspectives on Non-Surgical Sterilization Methods:

There have been varied perspectives on the use of non-surgical sterilization of the dog since these products do not entirely solve the problem of the overpopulation of dogs and cats. Additionally, the varied perspectives and arguments on the use of these methods have also been due to the fact that some people don't care since they want to breed their animals. Given that there is no secure and effective non-surgical sterilization method of the dog that has been identified and announced, the varied perspectives have continued to increase. However, there have been various approaches to identify non-surgical products though none of the products have shown tremendous results to be widely adopted and implemented (Bowen, 2006).

One of the major perspectives has been against the non-surgical sterilization of the dog since the methods that have been explored have not only been ineffective but have also proven to…...

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References:

Bowen, R. (2006, April 25). Nonsurgical Sterilization of Dogs and Cats. Retrieved Colorado

State University website:  http://www.vivo.colostate.edu/hbooks/pathphys/reprod/petpop/nonsurg.html 

Singer, J. (2010, January 13). Non-Surgical Pet Population Control: A Godsend or Nightmare.

Retrieved November 16, 2010, from  http://www.petside.com/petsideblog/2010/01/non-surgical-pet-population-co.php

The nurse must 'read' the patient's personality, and know whether acting firm or sensitive is the best way to deal with the individual. A nurse must always comport herself in a professional manner, but needs to take a different tone with a child vs. An adult; a person in a dissociated state vs. A man experiencing chest pains. Communications decisions, much like medical decisions, must often be undertaken in a split second. The first few minutes of the encounter can set the tone of the entire client-nurse interaction, even the tone of the patient's entire experience on the unit.
Effective communication is also required with other healthcare professionals on the unit, including but not limited to doctors, other nurses, and physician's assistants. 'Triage' -- deciding what patients and procedures are of highest priority, establishing standard operating procedures to deal with being short-staffed, and using time and resources in an effective…...

Topic 1: Scoliosis: An Overview

Definition and prevalence of scoliosis
Types of scoliosis: idiopathic, congenital, neuromuscular
Risk factors and contributing factors
Symptoms and signs of scoliosis

Topic 2: Diagnosis and Treatment of Scoliosis

Diagnostic techniques: physical examination, X-rays, MRI
Non-surgical treatments: bracing, physical therapy, exercise
Surgical treatments: spinal fusion, instrumentation
Management and monitoring of scoliosis progression

Topic 3: The Impact of Scoliosis on Health and Well-being

Physical implications: pain, deformity, impaired mobility
Psychological and social consequences: body image issues, anxiety, depression
Respiratory and cardiovascular complications
Long-term effects of untreated or inadequately treated scoliosis

Topic 4: Advancements in Scoliosis Treatment

Minimally invasive surgical techniques:....