This randomized controlled trial investigated the effectiveness of pulsatile dry cupping therapy compared to no intervention for knee osteoarthritis. 40 patients were randomly assigned to receive either 8 cupping sessions over 4 weeks or no treatment. Outcome measures including pain, stiffness, physical function, and quality of life were assessed at 4 and 12 weeks. At 4 weeks, cupping resulted in significantly greater improvements in pain, physical function, and quality of life scores compared to the control group. Many benefits were still present at 12 weeks, though some scores were no longer significantly different. The study provides preliminary evidence that cupping may be an effective treatment for relieving symptoms of knee osteoarthritis.
Pregabalin is an effective and safe adjuvant for reducing chronic
post-thoracotomy pain, without significant side effects, in all age
groups and either gender. The pain relief becomes statistically
significant after three weeks of treatment and it continues till six
months. However, larger randomized and placebo-controlled trials
of longer durations are required to further validate these findings.
Effects of cold application on pain & anxiety during chest tube removal among...iosrjce
IOSR Journal of Nursing and health Science is ambitious to disseminate information and experience in education, practice and investigation between medicine, nursing and all the sciences involved in health care. Nursing & Health Sciences focuses on the international exchange of knowledge in nursing and health sciences. The journal publishes peer-reviewed papers on original research, education and clinical practice.
By encouraging scholars from around the world to share their knowledge and expertise, the journal aims to provide the reader with a deeper understanding of the lived experience of nursing and health sciences and the opportunity to enrich their own area of practice. The journal publishes original papers, reviews, special and general articles, case management etc.
This document describes a research study protocol to evaluate the efficacy of intrathecal dexmedetomidine as an adjuvant to levobupivacaine spinal anesthesia for abdominal hysterectomy. The study will randomly assign 104 patients to receive either levobupivacaine with normal saline or levobupivacaine with 10 μg dexmedetomidine intrathecally. The primary outcomes will be postoperative analgesia duration measured by VAS scores and time to first rescue analgesic. Secondary outcomes include sensory and motor block durations and any intraoperative hemodynamic changes or side effects. Standard protocols will be followed for preoperative, intraoperative and postoperative care.
This document provides an overview of regional anesthesia techniques for total joint arthroplasty (TJA), including total hip arthroplasty (THA) and total knee arthroplasty (TKA). It discusses the evidence regarding general versus regional anesthesia, as well as various regional techniques for intraoperative anesthesia and postoperative analgesia. While regional anesthesia is associated with improvements in some outcomes like pain control and reduced side effects, the evidence on other outcomes like infection rates and length of stay is mixed compared to general anesthesia. A variety of regional techniques can provide effective analgesia after TJA, including neuraxial blocks, peripheral nerve blocks, and extended-release epidural morphine, but they each have specific risks and benefits to consider.
Cryotherapy involves applying cold to the body for therapeutic purposes. It can be used to reduce inflammation, edema, pain, and muscle spasms. Various cryotherapy techniques are discussed in the document, including ice packs, ice massage, cold whirlpools, vapocoolant sprays, cryotherapy with compression, whole-body cryostimulation, and the use of cryogenic liquids like liquid nitrogen or carbon dioxide. Contraindications and factors affecting an individual's response to cold are also reviewed.
Gabapentin reduced acute pain after mastectomy and decreased the incidence of chronic pain in two studies. A single dose of gabapentin was ineffective for reducing thoracotomy pain when an epidural was also used. Regional anesthesia and intravenous lidocaine reduced chronic pain incidence after mastectomy or thoracotomy in several studies. Ketamine and intercostal cryoanalgesia did not reduce chronic pain. Total intravenous anesthesia may reduce post-thoracotomy pain in one study.
This randomized controlled trial investigated the effectiveness of pulsatile dry cupping therapy compared to no intervention for knee osteoarthritis. 40 patients were randomly assigned to receive either 8 cupping sessions over 4 weeks or no treatment. Outcome measures including pain, stiffness, physical function, and quality of life were assessed at 4 and 12 weeks. At 4 weeks, cupping resulted in significantly greater improvements in pain, physical function, and quality of life scores compared to the control group. Many benefits were still present at 12 weeks, though some scores were no longer significantly different. The study provides preliminary evidence that cupping may be an effective treatment for relieving symptoms of knee osteoarthritis.
Pregabalin is an effective and safe adjuvant for reducing chronic
post-thoracotomy pain, without significant side effects, in all age
groups and either gender. The pain relief becomes statistically
significant after three weeks of treatment and it continues till six
months. However, larger randomized and placebo-controlled trials
of longer durations are required to further validate these findings.
Effects of cold application on pain & anxiety during chest tube removal among...iosrjce
IOSR Journal of Nursing and health Science is ambitious to disseminate information and experience in education, practice and investigation between medicine, nursing and all the sciences involved in health care. Nursing & Health Sciences focuses on the international exchange of knowledge in nursing and health sciences. The journal publishes peer-reviewed papers on original research, education and clinical practice.
By encouraging scholars from around the world to share their knowledge and expertise, the journal aims to provide the reader with a deeper understanding of the lived experience of nursing and health sciences and the opportunity to enrich their own area of practice. The journal publishes original papers, reviews, special and general articles, case management etc.
This document describes a research study protocol to evaluate the efficacy of intrathecal dexmedetomidine as an adjuvant to levobupivacaine spinal anesthesia for abdominal hysterectomy. The study will randomly assign 104 patients to receive either levobupivacaine with normal saline or levobupivacaine with 10 μg dexmedetomidine intrathecally. The primary outcomes will be postoperative analgesia duration measured by VAS scores and time to first rescue analgesic. Secondary outcomes include sensory and motor block durations and any intraoperative hemodynamic changes or side effects. Standard protocols will be followed for preoperative, intraoperative and postoperative care.
This document provides an overview of regional anesthesia techniques for total joint arthroplasty (TJA), including total hip arthroplasty (THA) and total knee arthroplasty (TKA). It discusses the evidence regarding general versus regional anesthesia, as well as various regional techniques for intraoperative anesthesia and postoperative analgesia. While regional anesthesia is associated with improvements in some outcomes like pain control and reduced side effects, the evidence on other outcomes like infection rates and length of stay is mixed compared to general anesthesia. A variety of regional techniques can provide effective analgesia after TJA, including neuraxial blocks, peripheral nerve blocks, and extended-release epidural morphine, but they each have specific risks and benefits to consider.
Cryotherapy involves applying cold to the body for therapeutic purposes. It can be used to reduce inflammation, edema, pain, and muscle spasms. Various cryotherapy techniques are discussed in the document, including ice packs, ice massage, cold whirlpools, vapocoolant sprays, cryotherapy with compression, whole-body cryostimulation, and the use of cryogenic liquids like liquid nitrogen or carbon dioxide. Contraindications and factors affecting an individual's response to cold are also reviewed.
Gabapentin reduced acute pain after mastectomy and decreased the incidence of chronic pain in two studies. A single dose of gabapentin was ineffective for reducing thoracotomy pain when an epidural was also used. Regional anesthesia and intravenous lidocaine reduced chronic pain incidence after mastectomy or thoracotomy in several studies. Ketamine and intercostal cryoanalgesia did not reduce chronic pain. Total intravenous anesthesia may reduce post-thoracotomy pain in one study.
Austin Journal of Musculoskeletal Disorders is a peer-reviewed, open access journal published by Austin Publishers. It provides easy access to high quality Manuscripts in all related aspects of diseases and disorders that may adversely affect the function and overall effectiveness of the musculoskeletal system. The Journal focuses upon all the related aspects of musculoskeletal system disorders and the new advancements in the related treatments including Complex issues and injuries involving the musculoskeletal system and surgeries.
Austin Publishing Group is a successful host of more than hundred peer reviewed, open access journals in various fields of science and technology with intent to bridge the gap between academia and research access.
Austin Journal of Musculoskeletal Disorders accepts original research articles, review articles, case reports, mini reviews, rapid communication, opinions and editorials on all related aspects of diseases and disorders that may adversely affect the function and overall effectiveness of the musculoskeletal system.
The main findings of upper endoscopy in 133 patients with laryngopharyngeal reflux were:
1. Gastritis was found in 77% of patients, esophagitis in 59%, and hypofunction of the cardia in 40%.
2. Hiatal hernia was identified in 32% of patients.
3. Barrett's esophagus and neoplasms were found in 9% and 2.2% of patients respectively.
4. Only 12% of patients had a normal endoscopy.
5. Helicobacter pylori was positive in 30% of patients.
The dry needling of myofascial pain syndrome trigger points provided pain relief compared to sham needling.
This document contains summaries of 4 research studies:
1. A randomized controlled trial that found suprascapular nerve blocks were no more effective than saline injections for treating subacute adhesive capsulitis.
2. A study that found intra-articular injections of hyaluronic acid plus dextrose for knee osteoarthritis resulted in greater improvements in physical function and pain reduction compared to hyaluronic acid plus saline.
3. A randomized controlled trial that demonstrated alendronate effectively prevented bone loss in the hip in men during the first year after a traumatic spinal cord injury.
4. A study that found patients with acquired brain injuries who had contractures required more intensive rehabilitation therapy, longer
1. This document provides summaries of 4 recent studies related to chiropractic care, beginning with a major study published in Annals of Internal Medicine that found spinal manipulative therapy and home exercises were superior to medication for neck pain.
2. The second study summarized was the first randomized controlled trial to examine chiropractic management for patients with chest pain, finding that chiropractic patients improved significantly more than those receiving self-management.
3. References and appendices are provided for each study summarized. The document concludes by commenting on how chiropractic addresses the mechanical cause of problems rather than just symptoms.
- More than 230 million people undergo surgery each year worldwide, and postoperative pain is common, causing patient suffering. Chronic pain after surgery can lead to sleep issues, depression, and disability.
- Healthcare providers need to design "comfort contracts" for managing postsurgical pain in patients at home after discharge, since most do not stay in the hospital long enough to fully recover from pain. These contracts provide adherence and follow-up plans.
- Inadequate treatment of acute postoperative pain has been linked to development of chronic pain. Improving communication between doctors and patients and increasing professional education on pain management can help address this issue.
This document presents the 2018 consensus statement of the Section of Regional Anaesthesia and Pain Therapy of the Polish Society of Anaesthesiology and Intensive Therapy on postoperative pain management. It provides guidelines and recommendations based on a review of the latest scientific evidence published since 2014. The guidelines cover appropriate use of opioids and other drugs for postoperative pain relief, and emphasize the importance of multimodal analgesia and the need to individualize treatment to the patient and surgery. Pethidine is not recommended due to concerns about its efficacy and safety profile compared to other opioids.
EFFICACY OF TRANSDERMAL PATCHES IN THE MANAGEMENT OF POSTOPERATIVE PAIN: AN O...DrHeena tiwari
This study compared the efficacy of a single 100mg transdermal diclofenac patch to a single 75mg intramuscular diclofenac injection for managing postoperative pain in 30 patients who underwent maxillofacial surgery. Patients were randomly assigned to receive either the patch or injection. Pain levels were assessed at various timepoints using a visual analogue scale. The results found that the patch provided longer lasting analgesia (15 hours on average) compared to the injection (9 hours), and fewer patients in the patch group required rescue pain medication. No local complications occurred with the patch. The study concluded that a single diclofenac patch was more effective than intramuscular diclofenac for managing immediate postoperative pain
This document reviews current treatment strategies for spinal compression fractures and potential future directions. The major current treatment strategies are conservative pain management and vertebral augmentation procedures like vertebroplasty and kyphoplasty. However, there is a lack of consensus on the optimal treatment approach. Prospective clinical trials with new biomarkers are needed to better assess treatment efficacy and develop clearer guidelines. The document provides an overview of common pain management strategies like NSAIDs, opioids, and bisphosphonates as well as vertebral augmentation procedures and calls for future research to establish standardized treatment pathways.
Extracorporeal shockwave therapy (ESWT) has analgesic and anti-inflammatory effects. With the evolu- tion and comprehension of its biological and physical mechanisms, the application of ESWT on other pathologies has also been studied, especially in musculoskeletal diseases. Recently, studies on animal models have shown its angiogenic capacity and a higher rate of local re-epithelization. These small stud- ies led to few trials using low-energy, radial ESWT to treat problematic chronic skin ulcers. Skin ulcers have diverse etiologies, ranging from pressure ulcers, burns, venous or arterial ulcers, and even diabetic ulcers. Their treatment is usually a challenge, due to the long-term treatment and high costs.
Artigo - Acupuncture and physiotherapy for painful shoulderRenato Almeida
This randomized controlled trial evaluated the efficacy of single-point acupuncture combined with physiotherapy compared to physiotherapy alone for the treatment of painful shoulder. 425 patients with subacromial syndrome received 15 sessions of physiotherapy over 3 weeks along with either weekly acupuncture at point ST38 or sham TENS. Patients receiving acupuncture showed significantly greater improvement in shoulder function scores and reported less analgesic use compared to the control group receiving only physiotherapy. The study demonstrates that adding acupuncture to physiotherapy can more effectively treat painful shoulder conditions.
This randomized controlled trial compared the effectiveness of spinal manipulation therapy (SMT), medication, and home exercise with advice (HEA) for acute and subacute neck pain. The trial found that:
1) SMT had a statistically significant advantage over medication in reducing pain up to 1 year after treatment based on participant-reported pain levels.
2) HEA was as effective as SMT, with no important differences in pain reduction between the two treatments at any time point.
3) Both SMT and HEA were more effective for reducing neck pain than medication in both the short and long term.
Pilot Study of Massage in Veterans with Knee OsteoarthritisMichael Juberg
This pilot study assessed the feasibility and preliminary efficacy of Swedish massage therapy for 25 veterans with knee osteoarthritis. The study found high retention and adherence rates, suggesting massage was feasible and acceptable for veterans. Veterans receiving 8 weekly one-hour massage sessions experienced statistically significant improvements in self-reported knee pain, stiffness, function, and quality of life, as well as trends toward improved range of motion. The results support further study of massage as a treatment approach for knee osteoarthritis in veterans.
Total knee replacement (TKR) is one of the most commonly done surgical procedures, with over 150,000 total knee replacements and THR performed annually in England and Wales in the National Health Service (NHS). In India although clear-cut data is not available but the incidence is increasing. In the US, 431,000 TKRs are performed yearly and the utilization of TKR has increased over the last two decades, especially among younger patients .TKR may be associated with severe post-operative pain. The International Association for the Study of Pain (IASP) has defined pain as “an unpleasant sensory or emotional experience associated with actual or potential tissue damage, or described in terms of such damage”. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has made adequate pain management a priority and has deemed monitoring pain as the “fifth” vital sign.
This study compared the effectiveness of hydroplasty versus intra-articular steroid injection for the treatment of idiopathic frozen shoulder. The study included 50 patients divided into two groups. The hydroplasty group showed significantly greater improvement in pain, shoulder function and range of motion compared to the steroid injection group at the 1 month and 3 month follow ups. Hydroplasty was found to be a more effective treatment for idiopathic frozen shoulder than intra-articular steroid injection alone.
The document summarizes a systematic review that analyzed 15 randomized controlled trials on the use of acupuncture and related techniques for postoperative pain management. The review found that acupuncture was associated with significant reductions in postoperative opioid consumption, pain intensity, and opioid-related side effects such as nausea, dizziness, and sedation, compared to sham controls. Specifically, acupuncture reduced opioid use by 23-29 mg at 8-72 hours postoperatively and decreased pain scores at 8 and 72 hours. The studies involved a variety of surgeries and acupuncture methods.
A single blind RCT to evaluate the effect of intraoperative bupivacaine infilteration fro post operative pain relief was conducted. Observations based on the VAS and mean duration for requirement of 1st analgesic dose post operatively. Results compared with other similar studies and found that the there is significant reduction in the VAS of post operative pain and increase in the duration for requirement for the 1st dose of the analgesic postoperatively
More harm than benefit of perioperative dexamethasone on recovery following ...Dibya Falgoon Sarkar
1. A prospective double-blind randomized trial found that perioperative dexamethasone provided minor pain relief but significantly increased insulin requirements and risk of infections in patients undergoing reconstructive head and neck cancer surgery.
2. Dexamethasone did not accelerate recovery or shorten hospital stay and its use in head and neck cancer reconstruction provided no clear clinical benefits while increasing complications.
3. A randomized controlled trial of corticosteroids after transoral robotic surgery found extended perioperative dexamethasone was safe and may allow for earlier improvement in diet consistency and decreased hospital stay, though it minimally affected postoperative pain.
Application of Pstim in Clinical Practice MaxiMedRx
The P-Stim and ANSiStim™ miniaturized device is designed to administer auricular point stimulation treatment over several days. The ear provides numerous points for stimulation within a small area. Stimulation is performed by electrical pulses emitted through strategically positioned needles. The ANSiscope device monitors the pain condition of the patient before, during and after the treatment.
The P-Stim and ANSiStim™ point stimulation therapy is mainly used to treat pain. Use of the device is recommended for pre-operative, intra-operative and post-operative pain therapy as well as for the treatment of chronic pain. DyAnsys is researching the possibilities of using this concept for the treatment of depression, addiction and allergy.
P-Stim and ANSiStim™ therapy allows continuous point stimulation over a period of several days while offering the patient a high degree of comfort and mobility. Use of the P-Stim and ANSiStim™ therapy provides advantages over drug therapy by minimizing possible side-effects caused by pain medications (i.e. opioid). In most cases, the patient continues to lead a normal life without side effects or any loss of quality of life.
This randomized controlled trial evaluated the effectiveness of low-level laser therapy (LLT) for treating chronic knee pain. 126 patients with knee osteoarthritis were randomly assigned to receive either active laser treatment or sham laser treatment over 12 sessions within 4 weeks. The primary outcome was pain level measured using a visual analog scale (VAS) from 0-10. Results showed that the active laser treatment provided significant pain relief and osteoarthritic improvements compared to the sham laser, with statistical significance of p<0.01 in reduced VAS scores from baseline to 30-day follow-up. The laser treatment was thus found to be an effective adjunctive therapy for chronic knee pain.
Constructivism and Self-Directed Learning in Adult learners An.docxmelvinjrobinson2199
Constructivism and Self-Directed Learning in Adult learners
Analyzes assessment methodologies for adult learners, and identifies roadblocks for implementing assessment methodologies.
please use information attached below to help with the assignment:
3-4 pages
APA format
.
Construction Management Jump StartChapter 5Project Sta.docxmelvinjrobinson2199
Construction Management Jump Start
Chapter 5
Project Stages
Chapter 5
Project StagesThis chapter introduces you to the people, activities, and requirements that must be coordinated to execute the construction project. This chapter focuses on the stages of the design and construction process.
The Design and Construction Process
The design and construction of buildings, bridges, and roadways follow a consistent linear path from initial concept to occupancy.
The Design StageProgramming and feasibilityDone prior to design and engages the owner to clarify needs.Schematic designFirst step of the creative process consisting of sketches that identify preliminary design characteristics. Design development (DD)Detail work of the design occurs here. Selection of material, equipment and systems to go into the building.Contract documents (CDs)Final detailed drawings known working drawings and the project specifications are known as the CD’s
Codes and Compliance IssuesThe major goal of the design team is to make the building compliant with various statutory regulationsThe duration of this process varies. It can take weeks, months, or even years.The success of the project depends on the successful execution of this stages
The Bidding StagePlans and Specifications produced for biddersThis stage is traditionally coordinated by the architect to assist the owner in contractor selectionNotice to Proceed with construction is issued to the winning contractor.
Pre-construction StageProject manager plays the lead role in assembling and orchestrating the team that will complete the job.Detailed planning is invaluable at the this stageOne of the hardest stages of the job to manageAssigning the team is dependent on the size and complexity of the job. Usually there is…
Assigning the Project Team
Team Roles Project manager (PM)Captain of the team, usually with extensive experience in construction and management. Contract administratorAssists the PM and Super with the details of the contract.SuperintendentCoordinates all of the on-site construction activities. He/she is the daily point contact for the owner other representatives.Field EngineerEntry level position that is the first step in progressing through the ranks of project management. Primarily handle paperwork such as requests for information (RFI), submittals, and shop drawings
Due DiligenceSite InvestigationLooking for hidden geological problems, hazardous material, or historical remnants that may delay or alter the job.Soil testing and engineeringShould be provided by owner, reviewed by architect for design, and used by the contractor to price and conduct work
The process of identifying any problems or areas of concern that exist and addressing them during the preconstruction phase
Value EngineeringThe point when this occurs depends on the selected delivery method.Field personnel are underutilized and can provide valuable information during this process.
T.
Austin Journal of Musculoskeletal Disorders is a peer-reviewed, open access journal published by Austin Publishers. It provides easy access to high quality Manuscripts in all related aspects of diseases and disorders that may adversely affect the function and overall effectiveness of the musculoskeletal system. The Journal focuses upon all the related aspects of musculoskeletal system disorders and the new advancements in the related treatments including Complex issues and injuries involving the musculoskeletal system and surgeries.
Austin Publishing Group is a successful host of more than hundred peer reviewed, open access journals in various fields of science and technology with intent to bridge the gap between academia and research access.
Austin Journal of Musculoskeletal Disorders accepts original research articles, review articles, case reports, mini reviews, rapid communication, opinions and editorials on all related aspects of diseases and disorders that may adversely affect the function and overall effectiveness of the musculoskeletal system.
The main findings of upper endoscopy in 133 patients with laryngopharyngeal reflux were:
1. Gastritis was found in 77% of patients, esophagitis in 59%, and hypofunction of the cardia in 40%.
2. Hiatal hernia was identified in 32% of patients.
3. Barrett's esophagus and neoplasms were found in 9% and 2.2% of patients respectively.
4. Only 12% of patients had a normal endoscopy.
5. Helicobacter pylori was positive in 30% of patients.
The dry needling of myofascial pain syndrome trigger points provided pain relief compared to sham needling.
This document contains summaries of 4 research studies:
1. A randomized controlled trial that found suprascapular nerve blocks were no more effective than saline injections for treating subacute adhesive capsulitis.
2. A study that found intra-articular injections of hyaluronic acid plus dextrose for knee osteoarthritis resulted in greater improvements in physical function and pain reduction compared to hyaluronic acid plus saline.
3. A randomized controlled trial that demonstrated alendronate effectively prevented bone loss in the hip in men during the first year after a traumatic spinal cord injury.
4. A study that found patients with acquired brain injuries who had contractures required more intensive rehabilitation therapy, longer
1. This document provides summaries of 4 recent studies related to chiropractic care, beginning with a major study published in Annals of Internal Medicine that found spinal manipulative therapy and home exercises were superior to medication for neck pain.
2. The second study summarized was the first randomized controlled trial to examine chiropractic management for patients with chest pain, finding that chiropractic patients improved significantly more than those receiving self-management.
3. References and appendices are provided for each study summarized. The document concludes by commenting on how chiropractic addresses the mechanical cause of problems rather than just symptoms.
- More than 230 million people undergo surgery each year worldwide, and postoperative pain is common, causing patient suffering. Chronic pain after surgery can lead to sleep issues, depression, and disability.
- Healthcare providers need to design "comfort contracts" for managing postsurgical pain in patients at home after discharge, since most do not stay in the hospital long enough to fully recover from pain. These contracts provide adherence and follow-up plans.
- Inadequate treatment of acute postoperative pain has been linked to development of chronic pain. Improving communication between doctors and patients and increasing professional education on pain management can help address this issue.
This document presents the 2018 consensus statement of the Section of Regional Anaesthesia and Pain Therapy of the Polish Society of Anaesthesiology and Intensive Therapy on postoperative pain management. It provides guidelines and recommendations based on a review of the latest scientific evidence published since 2014. The guidelines cover appropriate use of opioids and other drugs for postoperative pain relief, and emphasize the importance of multimodal analgesia and the need to individualize treatment to the patient and surgery. Pethidine is not recommended due to concerns about its efficacy and safety profile compared to other opioids.
EFFICACY OF TRANSDERMAL PATCHES IN THE MANAGEMENT OF POSTOPERATIVE PAIN: AN O...DrHeena tiwari
This study compared the efficacy of a single 100mg transdermal diclofenac patch to a single 75mg intramuscular diclofenac injection for managing postoperative pain in 30 patients who underwent maxillofacial surgery. Patients were randomly assigned to receive either the patch or injection. Pain levels were assessed at various timepoints using a visual analogue scale. The results found that the patch provided longer lasting analgesia (15 hours on average) compared to the injection (9 hours), and fewer patients in the patch group required rescue pain medication. No local complications occurred with the patch. The study concluded that a single diclofenac patch was more effective than intramuscular diclofenac for managing immediate postoperative pain
This document reviews current treatment strategies for spinal compression fractures and potential future directions. The major current treatment strategies are conservative pain management and vertebral augmentation procedures like vertebroplasty and kyphoplasty. However, there is a lack of consensus on the optimal treatment approach. Prospective clinical trials with new biomarkers are needed to better assess treatment efficacy and develop clearer guidelines. The document provides an overview of common pain management strategies like NSAIDs, opioids, and bisphosphonates as well as vertebral augmentation procedures and calls for future research to establish standardized treatment pathways.
Extracorporeal shockwave therapy (ESWT) has analgesic and anti-inflammatory effects. With the evolu- tion and comprehension of its biological and physical mechanisms, the application of ESWT on other pathologies has also been studied, especially in musculoskeletal diseases. Recently, studies on animal models have shown its angiogenic capacity and a higher rate of local re-epithelization. These small stud- ies led to few trials using low-energy, radial ESWT to treat problematic chronic skin ulcers. Skin ulcers have diverse etiologies, ranging from pressure ulcers, burns, venous or arterial ulcers, and even diabetic ulcers. Their treatment is usually a challenge, due to the long-term treatment and high costs.
Artigo - Acupuncture and physiotherapy for painful shoulderRenato Almeida
This randomized controlled trial evaluated the efficacy of single-point acupuncture combined with physiotherapy compared to physiotherapy alone for the treatment of painful shoulder. 425 patients with subacromial syndrome received 15 sessions of physiotherapy over 3 weeks along with either weekly acupuncture at point ST38 or sham TENS. Patients receiving acupuncture showed significantly greater improvement in shoulder function scores and reported less analgesic use compared to the control group receiving only physiotherapy. The study demonstrates that adding acupuncture to physiotherapy can more effectively treat painful shoulder conditions.
This randomized controlled trial compared the effectiveness of spinal manipulation therapy (SMT), medication, and home exercise with advice (HEA) for acute and subacute neck pain. The trial found that:
1) SMT had a statistically significant advantage over medication in reducing pain up to 1 year after treatment based on participant-reported pain levels.
2) HEA was as effective as SMT, with no important differences in pain reduction between the two treatments at any time point.
3) Both SMT and HEA were more effective for reducing neck pain than medication in both the short and long term.
Pilot Study of Massage in Veterans with Knee OsteoarthritisMichael Juberg
This pilot study assessed the feasibility and preliminary efficacy of Swedish massage therapy for 25 veterans with knee osteoarthritis. The study found high retention and adherence rates, suggesting massage was feasible and acceptable for veterans. Veterans receiving 8 weekly one-hour massage sessions experienced statistically significant improvements in self-reported knee pain, stiffness, function, and quality of life, as well as trends toward improved range of motion. The results support further study of massage as a treatment approach for knee osteoarthritis in veterans.
Total knee replacement (TKR) is one of the most commonly done surgical procedures, with over 150,000 total knee replacements and THR performed annually in England and Wales in the National Health Service (NHS). In India although clear-cut data is not available but the incidence is increasing. In the US, 431,000 TKRs are performed yearly and the utilization of TKR has increased over the last two decades, especially among younger patients .TKR may be associated with severe post-operative pain. The International Association for the Study of Pain (IASP) has defined pain as “an unpleasant sensory or emotional experience associated with actual or potential tissue damage, or described in terms of such damage”. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has made adequate pain management a priority and has deemed monitoring pain as the “fifth” vital sign.
This study compared the effectiveness of hydroplasty versus intra-articular steroid injection for the treatment of idiopathic frozen shoulder. The study included 50 patients divided into two groups. The hydroplasty group showed significantly greater improvement in pain, shoulder function and range of motion compared to the steroid injection group at the 1 month and 3 month follow ups. Hydroplasty was found to be a more effective treatment for idiopathic frozen shoulder than intra-articular steroid injection alone.
The document summarizes a systematic review that analyzed 15 randomized controlled trials on the use of acupuncture and related techniques for postoperative pain management. The review found that acupuncture was associated with significant reductions in postoperative opioid consumption, pain intensity, and opioid-related side effects such as nausea, dizziness, and sedation, compared to sham controls. Specifically, acupuncture reduced opioid use by 23-29 mg at 8-72 hours postoperatively and decreased pain scores at 8 and 72 hours. The studies involved a variety of surgeries and acupuncture methods.
A single blind RCT to evaluate the effect of intraoperative bupivacaine infilteration fro post operative pain relief was conducted. Observations based on the VAS and mean duration for requirement of 1st analgesic dose post operatively. Results compared with other similar studies and found that the there is significant reduction in the VAS of post operative pain and increase in the duration for requirement for the 1st dose of the analgesic postoperatively
More harm than benefit of perioperative dexamethasone on recovery following ...Dibya Falgoon Sarkar
1. A prospective double-blind randomized trial found that perioperative dexamethasone provided minor pain relief but significantly increased insulin requirements and risk of infections in patients undergoing reconstructive head and neck cancer surgery.
2. Dexamethasone did not accelerate recovery or shorten hospital stay and its use in head and neck cancer reconstruction provided no clear clinical benefits while increasing complications.
3. A randomized controlled trial of corticosteroids after transoral robotic surgery found extended perioperative dexamethasone was safe and may allow for earlier improvement in diet consistency and decreased hospital stay, though it minimally affected postoperative pain.
Application of Pstim in Clinical Practice MaxiMedRx
The P-Stim and ANSiStim™ miniaturized device is designed to administer auricular point stimulation treatment over several days. The ear provides numerous points for stimulation within a small area. Stimulation is performed by electrical pulses emitted through strategically positioned needles. The ANSiscope device monitors the pain condition of the patient before, during and after the treatment.
The P-Stim and ANSiStim™ point stimulation therapy is mainly used to treat pain. Use of the device is recommended for pre-operative, intra-operative and post-operative pain therapy as well as for the treatment of chronic pain. DyAnsys is researching the possibilities of using this concept for the treatment of depression, addiction and allergy.
P-Stim and ANSiStim™ therapy allows continuous point stimulation over a period of several days while offering the patient a high degree of comfort and mobility. Use of the P-Stim and ANSiStim™ therapy provides advantages over drug therapy by minimizing possible side-effects caused by pain medications (i.e. opioid). In most cases, the patient continues to lead a normal life without side effects or any loss of quality of life.
This randomized controlled trial evaluated the effectiveness of low-level laser therapy (LLT) for treating chronic knee pain. 126 patients with knee osteoarthritis were randomly assigned to receive either active laser treatment or sham laser treatment over 12 sessions within 4 weeks. The primary outcome was pain level measured using a visual analog scale (VAS) from 0-10. Results showed that the active laser treatment provided significant pain relief and osteoarthritic improvements compared to the sham laser, with statistical significance of p<0.01 in reduced VAS scores from baseline to 30-day follow-up. The laser treatment was thus found to be an effective adjunctive therapy for chronic knee pain.
Constructivism and Self-Directed Learning in Adult learners An.docxmelvinjrobinson2199
Constructivism and Self-Directed Learning in Adult learners
Analyzes assessment methodologies for adult learners, and identifies roadblocks for implementing assessment methodologies.
please use information attached below to help with the assignment:
3-4 pages
APA format
.
Construction Management Jump StartChapter 5Project Sta.docxmelvinjrobinson2199
Construction Management Jump Start
Chapter 5
Project Stages
Chapter 5
Project StagesThis chapter introduces you to the people, activities, and requirements that must be coordinated to execute the construction project. This chapter focuses on the stages of the design and construction process.
The Design and Construction Process
The design and construction of buildings, bridges, and roadways follow a consistent linear path from initial concept to occupancy.
The Design StageProgramming and feasibilityDone prior to design and engages the owner to clarify needs.Schematic designFirst step of the creative process consisting of sketches that identify preliminary design characteristics. Design development (DD)Detail work of the design occurs here. Selection of material, equipment and systems to go into the building.Contract documents (CDs)Final detailed drawings known working drawings and the project specifications are known as the CD’s
Codes and Compliance IssuesThe major goal of the design team is to make the building compliant with various statutory regulationsThe duration of this process varies. It can take weeks, months, or even years.The success of the project depends on the successful execution of this stages
The Bidding StagePlans and Specifications produced for biddersThis stage is traditionally coordinated by the architect to assist the owner in contractor selectionNotice to Proceed with construction is issued to the winning contractor.
Pre-construction StageProject manager plays the lead role in assembling and orchestrating the team that will complete the job.Detailed planning is invaluable at the this stageOne of the hardest stages of the job to manageAssigning the team is dependent on the size and complexity of the job. Usually there is…
Assigning the Project Team
Team Roles Project manager (PM)Captain of the team, usually with extensive experience in construction and management. Contract administratorAssists the PM and Super with the details of the contract.SuperintendentCoordinates all of the on-site construction activities. He/she is the daily point contact for the owner other representatives.Field EngineerEntry level position that is the first step in progressing through the ranks of project management. Primarily handle paperwork such as requests for information (RFI), submittals, and shop drawings
Due DiligenceSite InvestigationLooking for hidden geological problems, hazardous material, or historical remnants that may delay or alter the job.Soil testing and engineeringShould be provided by owner, reviewed by architect for design, and used by the contractor to price and conduct work
The process of identifying any problems or areas of concern that exist and addressing them during the preconstruction phase
Value EngineeringThe point when this occurs depends on the selected delivery method.Field personnel are underutilized and can provide valuable information during this process.
T.
Create a 10- to 12-slide presentation in which you Compare .docxmelvinjrobinson2199
Create
a 10- to 12-slide presentation in which you:
Compare health systems of various countries.
Describe approaches to connecting public health and the health care system.
Describe lessons learned from past issues.
Identify future trends in public health.
Include
at least 3 references.
USE THESE COUNTRIES: France, Italy, Iran, US, & Indonesia.
no speaker notes required. Use pictures
.
Create a 10-12-slide presentation about the role of scientist-pr.docxmelvinjrobinson2199
Create a 10-12-slide presentation about the role of scientist-practitioners. Include the following in your presentation:
A title page
A description of the key knowledge, skills, and abilities of an effective scientist-practitioner
A description of how research reports are an essential component for the scientist-practitioner
A description of why data management and presentation are key components of research reports
A reference page
At least three scholarly sources
Detailed speaker notes that represent what would be said if giving the presentation in person
.
Create a 1-page (front and back) information fact sheet on postpartu.docxmelvinjrobinson2199
Create a 1-page (front and back) information fact sheet on postpartum depression that will help to educate the vulnerable population on the disease or condition. The fact sheet should address prevention, detection, and treatment.
**Will provide more detailed instructions for the accepted bid**
.
Create a 1-2-page resource that will describe databases that are.docxmelvinjrobinson2199
Create a 1-2-page resource that will describe databases that are relevant to EBP around a diagnosis you chose and could be used to help a new hire nurse better engage in EBP.
Evidence-based practice (EBP) integrates the best evidence available to guide optimal nursing care, with a goal to enhance safety and quality. EBP is crucial to nursing practice because it incorporates the best evidence from current literature, along with the expertise of the practicing nurse. The concern for quality care that flows from EBP generates a desired outcome. Without these factors, a nurse cannot be an effective leader. It is important to lead not only from this position but from knowledge and expertise. To gain the knowledge, you require a good understanding of how to search for scholarly resources, as well as identify which databases and websites are credible for the purposes of implementing evidence-based changes in practice.
Demonstration of Proficiency
By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:
Competency 1: Interpret findings from scholarly quantitative, qualitative, and outcomes research articles and studies.
Explain why the sources selected should provide the best evidence for the chosen diagnosis.
Competency 2: Analyze the relevance and potential effectiveness of evidence when making a decision.
Describe the best places to complete research and what types of resources one would want to access to find pertinent information for the diagnosis within the context of a specific health care setting.
Competency 4: Plan care based on the best available evidence.
Identify five sources of online information (medical journal databases, websites, hospital policy databases, et cetera) that could be used to locate evidence for a clinical diagnosis.
Competency 5: Apply professional, scholarly communication strategies to lead practice changes based on evidence.
Describe communication strategies to encourage nurses to research the diagnosis, as well as strategies to collaborate with the nurses to access resources.
Communicate using writing that is clear, logical, and professional with correct grammar and spelling using current APA style.
Professional Context
As a baccalaureate-prepared nurse, you will be responsible for providing patient-centered, competent care based on current evidence-based best practices. You will be required to do research, analysis, and dissemination of best evidence to stay abreast of these best practices. Understanding where to go to find credible sources and locate evidence, as well as which search terms to use, is the foundation of incorporation of best practices.
Scenario
You are supervising three nurses working on the medical-surgical floor of a local teaching hospital. This hospital is nationally recognized as a leader in education and has a computer lab with an online libr.
Create a 1-2 page single-spaced Analysis of Research abstract pu.docxmelvinjrobinson2199
Create a 1-2 page single-spaced Analysis of Research abstract published scholarly articles related to a topic you selected in 2.2. (topic cybersecurity)
Brevity and being concise are important as this analysis is intended to be a brief summation of the research.
Each abstract must therefore consist of the following in this order:
1. Bibliographic Citation – use the correctly formatted APA style citation for the work as the title of your abstract, displaying the full citation in bold font.
2. Author Qualifications – name and qualification of each author conducting the research
3. Research Concern – one paragraph summary of the reason for the overall research topic
4. Research Purpose Statement AND Research Questions or Hypotheses – specific focus of the research
5. Precedent Literature – key literature used in proposing the needed research (not the full bibliography or reference list)
6. Research Methodology – description of the population, sample, and data gathering techniques used in the research
7. Instrumentation – description of the tools used to gather data (surveys, tests,interviews, etc.)
8. Findings – summation of what the research discovered and the types of analysis that were used to describe the findings (tables, figures, and statistical measures)
Additional information on writing scholarly abstracts can be found via this
link
See completed example
.
Cover/Title Page
Abstract
Body of Paper
10-12 pages words long
Introduction
Explanation of the research topic
How the topic fits into Emergency Management
How the Emergency Management cycle applies to your chosen topic
Conclusion
References Page
Format of Paper
Times New Roman font ONLY
12 point font
1 inch margins (you will have to change your margins if using Word 2003 or earlier)
Double Spaced
.
Cover LetterA significant part of a registered nurse’s job i.docxmelvinjrobinson2199
Cover Letter
A significant part of a registered nurse’s job involves communicating with patients and providing emotional support. A successful cover letter should emphasize examples of your bedside manner and empathy as well as your emotional stability and composure in difficult situations.
Follow these steps to create your customized entry-level, registered nurse cover letter:
You are applying for a job at Kindred Hospital in South Florida. Research the unique needs, characteristics, and culture of the hospital.
1. Specify how you're a good fit for the position. (10 points)
2. Highlight your specialties and skills which set you apart from other nurses, paying particular attention to those that required additional training. (10 points)
3. Don't neglect soft skills that are highly relevant to a position as a registered nurse, such as problem solving, teamwork, communication, and leadership. (5 points)
4. Carefully proofread your cover letter before submitting to make sure all contact information is correct and that there are no misspellings.(5 points)
.
Coventry University 385ACC (Part-time) Advanced Study fo.docxmelvinjrobinson2199
Coventry University
385ACC (Part-time)
Advanced Study for Accounting and Finance
ASSIGNMENT 2019
Coursework Submission
Coursework should be submitted on given dateline in electronic format, via Turnitin and a hard
copy submitted to the Lecturer for second-marking.
Coursework Assignment
This is an Individual written assignment. Prepare a report for about 7,000 words (+/- 10%)
Learning Outcomes Assessed
The intended learning outcomes are that on completion of this project the student should be able
to:
1) Work independently, but with tutor guidance, on a project of their choice.
2) Synthesise a wide range of academic literature in order to evaluate critically current
research and contemporary issues in accounting or finance.
3) Utilise and apply relevant accounting and finance models, theories and concepts in order
to produce a properly researched written report.
4) Gather and organise evidence and draw appropriate conclusions based on a sound
understanding of the models, concepts and theories utilised.
5) Produce clear and coherent written work, supported by appropriate references to the
sources used (using the Coventry Harvard method of referencing).
Other Information:
• Assignments should not exceed 7,000 words. Please include a word count at very end of the
assignment.
• Title page, TOC, bibliography and further appropriate and relevant appendices do not count
towards the word limit. A 10% deduction (pro-rata) will be made from your mark for every
1,000 words over this limit (i.e. 1% if 100 words over limit etc).
• Coursework assignments should not be copied in part or in whole from any other source,
except for any clearly marked up quotations. Students found copying from internet or other
sources will get zero marks and may be excluded from the university.
• You can refer to the attached marking scheme to understand the criteria for the marking of
your courework.
385ACC - Assessment Criteria
Guidelines for what would be expected from a project at each particular level.
Note that not every criterion phrase need apply. Your mark will be a matter of balance.
1ST
70 - 100
The project is well structured and communicated. It is coherent and shows an
excellent level of synthesis and/or evaluation with clear signs of originality and
insight. Has read beyond the immediately relevant reading.
2:1
60 – 69
The project has worthwhile aims and objectives clearly expressed and an
appropriate methodology. Clear evidence of independent inquiry and critical
judgement in selecting, ordering, analysing and synthesising. Has read the
immediately relevant literature and, to a limited extent, beyond.
2:2
50 – 59
Aims and objectives clearly expressed. Some appropriate theory plus an attempt at
analysis but with only basic linkages made between theory and analysis. Has read
enough of the immediately relevant literature to be credible.
3RD
40 – 49
Makes on.
COV-19 -Corona Virus -- What a past week in our country and globally.docxmelvinjrobinson2199
COV-19 -Corona Virus -- What a past week in our country and globally ! Tremendous changes with compulsory disorganization and vigilance everywhere in our great country and throughout our world ! The news seems to captivate with an approach of sensitivity to the economical impacts each American as well as every nation on our planet is facing dealing with this emergency management (EM) disaster/pandemic event. Our governments national grip and charge for social distancing with the mandatory closing of non-essential businesses has reach a crucial point in every persons desire to see this horrible virus erracticated. We are all eager to resume our life's, go back to work and make sure we remain and stay healthy and safe as we move forward and into the future. However, will life as Americans ever be the same again for this country and every person in it ? Are face masks the new norm? What about social distancing ? (SD) ? Is SD also a new norm?
Today April 15th is the 6th of 7th classes in this EMA 205 class/course. I was looking forward to enjoying a class room environment with each and all the students enrolled in this EMA 205 course. I enjoy and believe social interaction and amalgamation where we would be able to interact, share, discuss and learn about the many accountable responsibilities in the profession of emergency management could have provided a more balanced understanding of EM. Unfortunately, we were unable to congregate as a group and this is where I find a topic of interest for your next assignment:
The corona virus and COVID-19, the illness it causes, are spreading among communities in the United States and other countries, phrases such as “social distancing,” “self-quarantine” and “flattening the curve” are showing up in the media. What do these terms mean? how do these terms apply to you, your family, your work place, your friends and your community? Have you seen --"Please limit the spread of infection and this diseases and be sure to follow public health guidance programs as the situation develops". What are the public health guidance programs?
Emergency vs. Disaster : An emergency is defined as an unforeseen combination of circumstances, resulting in a state that calls for immediate action or an urgent need for assistance or relief. Large-scale emergencies are usually considered disasters. An emergency can be a temporary disruption of services due to a short power outage, a longer-term situation causing an organization to relocate due to substantial building damage or even a larger scale, city-wide or regional emergency. Depending on the magnitude of the event, services may be provided as usual, services may need to be altered temporarily or, in extreme situations, services may be re-located or even discontinued. In any type of event, the goal is to have plans in place that will: • minimize damage • ensure the safety of staff and clients • protect vital records/assets • allow for self-sufficiency for at least 72 hours .
Course ScenarioReynolds Tool & Die
Reynolds Mission Statement
“We are committed to providing our customers quality products with the highest engineering standards.”
Reynolds Vision Statement
“We are committed to achieving our goal of being a market leader for engineering solutions and will investment in technical innovation. Our desire is to continue to expand our markets, our technical competence, and our intellectual curiosity to serve our customers.”
Additional Information
Reynolds Tool & Die is an automotive component manufacturer supplying suspension pieces and technology to both other suppliers and major U.S. and foreign manufacturers. Annual revenue is around $50 million, and the company is profitable.
Reynolds has production facilities at their headquarters in Akron, OH; in Bloomington, IN; and in Memphis, TN. Approximately 300 people work for Reynolds, including 7 in IT. The IT staff is broken down as follows:
· IT Director
· 2 Help Desk personnel
· 3 Network Engineers
· 1 Software Engineer, primarily supporting the company’s ERP system
One network engineer works in Bloomington, one in Memphis, and the rest of the IT staff is located in Akron.
The three sites are networked via an MPLS circuit. In addition to SAP® software, the company uses Microsoft® Office 2010 for administrative work along with several specialized CAD programs for design. The SAP software is two versions behind, but not at end of its life. A data center is in Akron, while the other two sites have smaller hardware footprints consisting of Microsoft Exchange servers for email, a small file and print server, and redundant Active Directory servers. EMC Storage Area Network (SAN) devices are at each site. Redundant backup appliances are in Akron and Bloomington, and data can be cycled among the SANS for further redundancy. While some server virtualization has been achieved, only about 20 percent of all servers have been virtualized with the help of VMWare. All sites use Cisco® switches, routers, and firewalls. Servers, desktops, laptops and printers are all HP®, and are between 3 and 5 years old and the desktops and Laptops use Windows® 7 as the operating system. All servers are on Microsoft Server 2012.
There are no cloud applications. There has been a demand by administrative personnel and engineers for integrating mobile devices with Microsoft Exchange and other apps but to date the company has not implemented a BYOD (Bring Your Own Device) or a MDM (Mobile Device Management) solution.
The IT budget typically is between $1.2 and $1.5 million annually, depending on capital expense. Note that this budget ONLY covers hardware, software, services, and licensing. Personnel costs are not included, nor do you need to include them for the Week 4 budget assignment.
This year the company is embarking on significant expansion. A joint venture has been signed with a firm from Mexico Peraltada LLC in order to gain access to a new supplier market. Both companies will remain in.
COURSE REFLECTIONJune 11, 2020How has this course helped you.docxmelvinjrobinson2199
COURSE REFLECTION
June 11, 2020
How has this course helped you be more prepared for successful leadership?
This course has helped prepare me for successful leadership. It has enlightened me about various rights regarding the treatment of students. The learning standards in the course have been helpful. Through the learning standards, knowledge of the freedom of religion and expression was gained. As a successful educational leader understanding that the students have the freedom of religion. Also understanding that students who come from minority groups are likely to be discriminated against or denied their rights. Therefore, advocates for equity in the course of educational leadership and honors diverse views. However, being a successful educational leader understands that children have different learning needs, and this makes them strive to create a strong educational opportunity and provide adequate learning resources.
How do you see yourself using the information in this course to support your leadership goals?
The course enabled me to learn about how to handle student records. As an educational leader, I am in a better position to safeguard the records of students. Upon completion of the course, one understands how to communicate with parents about the progress of children and their rights. I learned that I should ensure that student records are accessed only for educational legitimate reasons. Researchers are likely to ask for students' records, and this means an educational leader must have a proper understanding of privacy laws. The knowledge acquired about the safety of students was important. It was useful to know that teachers are responsible for the safety of students as they must care for them when they are at school or during school-related events. Regarding school attire, it was good to know that one must create opportunities for open discussion with parents and teachers and even community members to decide on the appropriate attire for students.
The information gained in this course will be used to create safe learning environments for children in the future. Students will be protected from harassment, discrimination, and other potential dangers they could face at school. The information will also be used to create adequate policies about various issues such as school uniforms and the level of expression. It will also help to find learning resources for students, especially from the community members. While creating policies regarding various school issues such as student privacy and search, I will use the information acquired from this course. For students with disabilities, adequate learning aids will be provided and they will be treated fairly. Positive relationships will be developed with families and caregivers of the children. There will also be a high level of collaboration and supervision of instruction.
How might the information in this course change or add to your own personal definition of leadership (Especially .
Course Reflection GuidelinesPurposeThe purpose of this assignmen.docxmelvinjrobinson2199
Course Reflection GuidelinesPurpose
The purpose of this assignment is to provide the student an opportunity to reflect on selected RN-BSN competencies acquired through the NUR3165 course. Course Outcomes
This assignment provides documentation of student ability to meet the following course outcomes:
· The student will be able to produce a complete research paper.
· The student will identify the research methods, sources and application in nursing practice.
Points
This assignment is worth a total of 100 points (10%).
Due Date
Submit your completed assignment under the Assignment tab by Sunday 11:59 p.m. EST of Week 15 as directed.Requirements
1. The Course Reflection is worth 100 points (10%) and will be graded on quality of self-assessment, use of citations, use of Standard English grammar, sentence structure, and overall organization based on the required components as summarized in the directions and grading criteria/rubric.
2. Follow the directions and grading criteria closely. Any questions about your essay may be posted under the Q & A forum under the Discussions tab.
3. The length of the reflection is to be within three to six pages excluding title page and reference pages.
4. APA format is required with both a title page and reference page. Use the required components of the review as Level 1 headers (upper and lower case, centered):
Note: Introduction – Write an introduction but do not use “Introduction” as a heading in accordance with the rules put forth in the Publication manual of the American Psychological Association (2010, p. 63).
a. Course Reflection
b. ConclusionPreparing Your Reflection
The BSN Essentials (AACN, 2008) outline a number of healthcare policy and advocacy competencies for the BSN-prepared nurse. Reflect on the NUR3165 course readings, discussion threads, and applications you have completed across this course and write a reflective essay regarding the extent to which you feel you are now prepared to:
1. “Explain the interrelationships among theory, practice, and research.
2. Demonstrate an understanding of the basic elements of the research process and models for applying evidence to clinical practice.
3. Advocate for the protection of human subjects in the conduct of research.
4. Evaluate the credibility of sources of information, including but not limited to databases and Internet resources.
5. Participate in the process of retrieval, appraisal, and synthesis of evidence in collaboration with other members of the healthcare team to improve patient outcomes.
6. Integrate evidence, clinical judgment, interprofessional perspectives, and patient preferences in planning, implementing, and evaluating outcomes of care.
7. Collaborate in the collection, documentation, and dissemination of evidence.
8. Acquire an understanding of the process for how nursing and related healthcare quality and safety measures are developed, validated, and endorsed.
9. Describe mechanisms to resolve identified practice discrepancies .
Course ProjectExamine the statement of cash flows for the compan.docxmelvinjrobinson2199
Course Project
Examine the statement of cash flows for the companies you selected in
Week 1
for the most recent year.
Tasks:
Summarize your course project to this point. What have you learned about your companies?
What are the two largest investing activities and financing activities for each firm?
Compare and contrast the investing and financing activities of the two companies.
Evaluate the investing and financing strategies of the two firms? Provide a rationale for your opinion as to the effectiveness of each of the strategies.
Submission Details:
Submit a 3-4 page Microsoft Word document, using APA style.
Name your file: SU_FIN4060_W3_CP_LastName_FirstInitial.doc
Submit your assignment to the
Submissions Area
by
the due date assigned.
.
Course PHYSICAL SECURITYDiscussion Question – Primary post du.docxmelvinjrobinson2199
Course: PHYSICAL SECURITY
Discussion Question – Primary post due Wednesday by 11:55 pm EST
"There are many different types of physical barriers, internal and external to an organization or facility.How can physical aid in the protection of high dollar assets that an organization wants to protect?"
"APA Format"
"NO PLAGIARISM"
Plagiarism includes copying and pasting material from the internet into assignments without properly citing the source of the material.
.
Course Project Layers of Me” My Humanitarian Professional Pro.docxmelvinjrobinson2199
Course Project: “Layers of Me”: My Humanitarian Professional Profile
It is a best practice to create a professional development plan as part of a professional journey. Plans can be quite extensive, detailing everything you need to do in order to complete a degree and engage in the profession. For this Assignment, you are expected to consider one element of a professional development plan which is reflective of your self-assessment. What skills and abilities, characteristics do you possess that will make you an effective leader? In addition, how do your cultural identity and personal values fit in your aspirations to engage in this type of work?
To prepare for this Assignment:
Complete the interactive media, “Layers of Me: Skills and Abilities.”
Using a scale of 1–10 (1 being the lowest rating and 10 being the highest), assign yourself a score for each of the following questions:
How would you rate your leadership skills?
How would you rate your interpersonal skills (e.g., empathy, listening, sharing, caring)?
How would you rate your oral and written communication skills?
How would you rate your collaboration skills? (Do you work well with others? Are you a team player?)
How would you rate your stress-management skills?
How would you rate your level of perseverance?
How well do you respond to disappointment and frustration?
How would you rate your optimism?
How would you rate your negotiation skills?
After you have completed your self-assessment, review your blog posts throughout the course. Combine your assessment information to create your own professional profile. This is only the start in developing this profile; however, it will give you a better understanding of who you are as a humanitarian professional, what you hope to do within this field of work, and how you will affect social change.
To complete the Assignment:
Create a 4- to 5-page paper assembling all the assessment data you gathered throughout the course. Summarize the data and describe yourself as a humanitarian professional. Include the following:
The skills and characteristics you possess that will allow you to be effective in your role
An explanation of the role your cultural identity will play in your success as a humanitarian professional and your ability to demonstrate cultural competence
How your ethics and values will guide you in your future work
How your profile fits in with your professional goals
.
Course ObjectivesCLO #1 Assess elements of contemporary le.docxmelvinjrobinson2199
Course Objectives:
CLO #1: Assess elements of contemporary leadership theories and models.
CLO #2: Analyze qualities and skills of a highly effective, ethical leader.
Assignment Prompt:
Take both the American College of Healthcare Executives (ACHE)
Ethics Self Assessment
and the Project Management Institute (PMI)
Ethics Self-Assessment
.
Watch the MindTools video on
Values
.
Instructions:
Conduct an analysis of your personal ethical beliefs and values. Use the ethics self-assessments to help determine your strengths, weaknesses, and opportunities. Develop a
3-4 page
essay that discusses the results of those assessments, your personal ethical beliefs and values, and your own personal philosophy of ethical leadership. Your essay must be supported by at least
2-3 scholarly sources
.
.
Course Name Intro to big data.Assignment Big data and CO.docxmelvinjrobinson2199
Course Name: Intro to big data.
Assignment: Big data and COVID -19
1-How is Big Data used in the fight against COVID-19?
2. How can we extend these applications to the marketing field after the crisis is under control?
3. What are the ethical concerns from the use of Big Data? Use COVID-19 as an example
.
COURSE MGT211Using the Internet, and credible electronic se.docxmelvinjrobinson2199
COURSE: MGT211
Using the Internet, and credible electronic search tools, research various options for delivering worker performance training programs in this 21st century. Select a minimum of three training methods (e.g., classroom, directed study, video conferencing, self-paced, computer-mediated, manual, etc.). Using the aforementioned “Guidelines for Writing Papers”,
write a 4-5 academic paper
that describes a minimum of three methods of today’s training options. Include a minimum of two credible references that were used in your research.
Guidelines for Writing Papers
Your papers should be:
word-processed using Microsoft’s Word (extension .doc or .docx)
double-spaced
Your papers should have:
one-inch margins
a font size of 12
a cover page that includes your paper’s title, your name, the date, and the course identification
an introduction that states the purpose of the paper, and provides a roadmap of the paper’s contents
paragraphs that develop and support your ideas
section titles or headings, that help to organize your presentation
a conclusion that summarizes the paper
a logical flow
smooth transitions between ideas
in-text citations and a reference (bibliography) page using APA style (no footnotes)
No grammatical, punctuation, or spelling errors
.
Beyond Degrees - Empowering the Workforce in the Context of Skills-First.pptxEduSkills OECD
Iván Bornacelly, Policy Analyst at the OECD Centre for Skills, OECD, presents at the webinar 'Tackling job market gaps with a skills-first approach' on 12 June 2024
Andreas Schleicher presents PISA 2022 Volume III - Creative Thinking - 18 Jun...EduSkills OECD
Andreas Schleicher, Director of Education and Skills at the OECD presents at the launch of PISA 2022 Volume III - Creative Minds, Creative Schools on 18 June 2024.
How Barcodes Can Be Leveraged Within Odoo 17Celine George
In this presentation, we will explore how barcodes can be leveraged within Odoo 17 to streamline our manufacturing processes. We will cover the configuration steps, how to utilize barcodes in different manufacturing scenarios, and the overall benefits of implementing this technology.
A Visual Guide to 1 Samuel | A Tale of Two HeartsSteve Thomason
These slides walk through the story of 1 Samuel. Samuel is the last judge of Israel. The people reject God and want a king. Saul is anointed as the first king, but he is not a good king. David, the shepherd boy is anointed and Saul is envious of him. David shows honor while Saul continues to self destruct.
Gender and Mental Health - Counselling and Family Therapy Applications and In...PsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
2. therapy in the spine surgery setting.
METHODS: Researchers used a two-group randomized
control design to evaluate the effects of local cold therapy
on postoperative pain and analgesia use after lumbar spinal
fusion surgery. The primary outcome was postoperative
pain. Secondary outcomes included analgesia use and per-
ceived benefit of cold therapy.
RESULTS: The intervention (cold) group had a marginally
greater reduction in mean Numerical Rating Scale score
across all 12 pain checks (M ± SD = −1.1 ± 0.8 points
reduction vs. −1.0 ± 0.8 points reduction, p = .589). On
average, the intervention group used less morphine equiva-
lents (M ± SD = 12.6 ± 31.5 vs. 23.7 ± 40.0) than the
control group across pain checks seven to 12 (p = .042).
CONCLUSIONS: This study provides additional evidence to
support the use of cold therapy as an adjuvant pain man-
agement strategy to optimize pain control and reduce opi-
oid consumption following spine fusion surgical procedures.
Effects of Localized Cold Therapy on Pain
in Postoperative Spinal Fusion Patients
A Randomized Control Trial
Patricia Quinlan ▼ Jack Davis ▼ Kara Fields ▼ Pia Madamba
▼ Lisa Colman ▼
Daniela Tinca ▼ Regina Cannon Drake
Patricia Quinlan, PhD, MPA, RN, CPHQ, AVP Nursing
Excellence,
Department of Nursing, Hospital for Special Surgery, New
York, NY.
Jack Davis, MSN, RN, ONC, Manager, Patient Education
Programs and
Research, Department of Nursing, Hospital for Special Surgery,
New
3. York, NY.
Kara Fields, MS, Statistical Analyst, Healthcare Research
Institute,
Hospital for Special Surgery, New York, NY.
Pia Madamba, BSN, RN, ONC, Patient Care Director,
Department of
Nursing, Hospital for Special Surgery, New York, NY.
Lisa Colman, RN, ONC, Clinical Nurse, Department of Nursing,
Hospital
for Special Surgery, New York, NY.
Daniela Tinca, BSN, RN, ONC, Clinical Nurse, Department of
Nursing,
Hospital for Special Surgery, New York, NY.
Regina Cannon Drake, MA, RN, ONC, Patient Educator,
Department of
Nursing, Hospital for Special Surgery, New York, NY.
The authors have disclosed no conflicts of interest.
DOI: 10.1097/NOR.0000000000000382
et al., 2003; Konrath, Lock, & Goitz, 1996; Wahern,
Torebjork, & Jorum, 1989). Cold therapy is used in sports
and rehabilitation settings to treat tissue injuries and has
been found to be effective in reducing pain and swelling
after arthroscopy and arthroplasty surgery (Aide, Kwan,
Naylor, Harris, & Mittal, 2012; Bleakley, et al., 2004;
Kullenberg, Ylipaa, Soderlund, & Resch, 2006; Lessard,
Scudds, Amedola, & Vaz, 1997). Cold therapy with com-
pression has been shown to have additive benefits of re-
duced swelling, but findings from the studies also sug-
5. operative therapy with a cooling device used 49% less
patient-controlled analgesia (PCA) than the control
group patients who did not receive cold therapy
(Stephee, Booher, & Biscup, 1996). In addition, those
who received cold treatment reported an eight out of 10
satisfaction score with the intervention.
Findings across the limited number of studies using
cold therapies to manage the care of postoperative spine
patients suggest benefits to decreasing narcotic con-
sumption. Narcotics, specifically opiates, often require
additional care management strategies to address ad-
verse side effects including nausea, vomiting, constipa-
tion, sedation, dizziness and the potential for tolerance,
physical dependence, addiction, abuse, and diversion
(Benyamin et al., 2008).
The purpose of this study was to determine the ef-
fects of the application of cold (ice pack) on postopera-
tive spine pain fusion patients and add to the body of
knowledge specific to practical application in the spinal
fusion surgical setting. Given limited clinical evidence,
this study should inform practitioners on the benefits of
using cold therapy as an adjuvant therapy to reduce
pain and narcotic consumption in the management of
the postoperative spine patient population.
Methods
Design
Researchers used a two-group randomized control de-
sign to evaluate the effects of local cold therapy on post-
operative pain and analgesia use after lumbar spinal fu-
sion surgery. The primary outcome was postoperative
pain. Secondary outcomes included analgesia use and
perceived benefit of cold therapy. Participants were ran-
domly assigned to two strata: (a) lumbar spine fusion
6. patients with repositioning and application of cold ther-
apy and (b) lumbar spine fusion patients with reposi-
tioning and no application of cold therapy. Concealed
randomization schedule was generated by the biostatis-
tics department at the study organization, with rand-
omization lists provided to investigators after consent
and prior to treatment. Participants were assigned to
either the control or intervention group by the random
generator, and his/her treatment arm assignment was
placed in a concealed envelope. There was no blinding
of participants because it was obvious who received
cold therapy and who did not. The study was approved
by the organization’s institutional review board.
setting anD sample selection
Subjects were recruited from July 11, 2013, through
February 13, 2015, in their surgeons’ offices or the
preoperative holding center of an urban, acute care fa-
cility specializing in the treatment of musculoskeletal
diseases.
Participants were a convenience sample of adults
who underwent postoperative lumbar spinal fusion sur-
gery from one to four levels and were admitted to a spe-
cific inpatient surgical unit within 12 hours after sur-
gery. Preoperative inclusion criteria included (a) English
speaking and (b) 18 years or older. Exclusion criteria
included (a) non-English speaking, (b) intolerance to
cold, (c) medical history of rheumatoid arthritis, sclero-
derma, dermatological conditions, Reynaud’s phenom-
ena, and dementia, and (c) use of ice to lower back prior
to surgery.
Eligible participants were identified by the coinvesti-
gating surgeons who communicated to the principal in-
7. vestigator (PI), a nurse patient educator. The PI con-
tacted potential participants during the preoperative
scheduling process and served as the primary point per-
son to discuss study details and introduce the consent
form. The PI approached all identified potential partici-
pants before surgery. The consent was reviewed, outlin-
ing the approach and purpose of this study, which was
to determine whether cold therapy in the form of local
application of ice packs is effective in reducing postop-
erative pain in patients who have spine fusion surgery.
The concept of randomization was explained, inform-
ing subjects that they would be chosen by chance, to
give each participant an equal opportunity to be in-
cluded in the ice versus no-ice study group provided
they met study criteria postoperatively. Postoperative
exclusion criteria were as follows: prolonged stay in the
postanesthesia care unit, discharge to a nonstudy inpa-
tient unit, and surgical intervention that changed dur-
ing the operation.
Data on participant refusal were not collected for
analysis. Ninety-three participants who gave study con-
sent were not randomized to either intervention be-
cause of failure to meet postoperative criteria.
measurement
Pain levels were measured using the Numerical Rating
Scale (NRS). This is a valid and reliable measurement of
pain experienced by acute care patients (Hjermstad
et al., 2011; Wewers & Lowe, 1990). Participants ver-
bally reported a score from zero to 10, with zero repre-
senting no pain and 10 representing the worst pain im-
aginable. The NRS score was assessed both prior to and
following study interventions, coincided with the staff
protocol for routine 4-hour pain assessments and con-
tinued for every 4 hours until discharge. Pain checks
9. ice and applied to the lower back, and the pack was sup-
ported with a pillow. The cold packs were applied to the
intervention group and a timer was set for 20 minutes.
After 20 minutes the nurse removed the pack.
Participants were again asked to rate their pain level
using the NRS. Participants were also asked whether
the intervention reduced their pain.
Control Group
Procedures for the control group were the same as for
the intervention groups, with the exception of the cold
packs. During routine pain assessments, participants
were asked to rate their pain level using the NRS.
Participants were turned and positioned to a side-lying
position in bed. After 20 minutes, the nurse asked the
patient to rate his/her pain level using the NRS.
Participants were also asked whether the intervention
reduced their pain.
Nurses provided pain medication to all patients using
a standardized pain medication order set. Data were re-
corded every 4 hours and continued over a 48-hour pe-
riod for both groups.
Data analysis
It was determined that a sample size of 100 patients per
group would provide 98% power at a two-sided α level
of .05 for a two-sample t test to detect a two-point differ-
ence in NRS pain score change between groups (assum-
ing a within-group standard deviation of four points) at
24 and 48 hours postoperation. After an exploratory in-
terim analysis postrandomization of 70 patients, the
power analysis was revised. It was determined that a
sample size of 68 patients per group would provide 80%
power at a two-sided α level of .05 for a two-sample t test
to detect a two-point difference in NRS pain score
10. change between groups (assuming within-group stand-
ard deviation of four points) at 24 hours postoperation.
A total of 150 patients would be enrolled to account for
attrition.
The cold therapy and control groups were compared
for balance on baseline characteristics by calculating
standardized differences. Standardized differences
were calculated as the difference in means or mean
rankings divided by the pooled standard deviation for
normally distributed or ordinal variables and skewed
continuous variables, respectively (Austin, 2009;
Schacht, Bogaerts, Bluhmki, & Lesaffre, 2008). For cat-
egorical variables, standardized differences were calcu-
lated as the difference in proportions divided by the
pooled standard deviation (Austin, 2009). Imbalance
was defined as a standardized difference with an abso-
lute value greater than 21.96 0.322
74
=× (Austin, 2009).
Average change in the NRS pain score pre- to postin-
tervention and cumulative PCA usage across pain
checks one to six and seven to 12 were compared be-
tween groups after adjustment for preoperative pain
level using the generalized estimating equation (GEE)
method with an identity link (Ma, Mazumdar, &
Memtsoudis, 2012; Zeger, Liang & Albert, 1988). The
GEE method accounts for the correlation between re-
peated measurements on the same patient. Average
change in the NRS pain score pre- to postintervention
and cumulative PCA usage across pain checks one to 12
were compared between groups after adjustment for
preoperative pain level using linear regression. Patient
11. perception of intervention benefit was compared be-
tween groups after adjustment for preoperative pain
level using the GEE method with a logit link.
All statistical hypothesis tests were two-sided, with
p < .05 considered statistically significant. Statistical
analyses were performed with SAS Version 9.3 (SAS
Institute, Cary, North Carolina).
Results
stuDy participants
One hundred and forty-eight patients completed the
study. Participant characteristics are provided in Table 1.
Data comparisons demonstrate characteristic similarity
across groups. Data were reported on all completed pain
checks at each interval. Because of patient discharge,
withdrawal, or refusal, 63 patients in each group had
complete data for the sixth pain check. The lowest num-
ber of patients with complete data occurred during the
12th pain check with 53 and 61 patients in the cold ther-
apy and control groups, respectively.
nrs score
As summarized in Table 2 and Figure 1, our study
showed the intervention group had a marginally greater
reduction in mean NRS score across all 12 pain checks
(M ± SD = −1.1 ± 0.8 points reduction vs. −1.0 ± 0.8
points reduction, p = .589). The triangles represent the
means. The bottom and top of each rectangle indicate
the first and third quartiles, respectively. The horizon-
tal line within each rectangle indicates the median.
The lines extending out of the bottom and top of each
rectangle represent the minimum and maximum val-
ues that lie within 1.5 times the interquartile range
below and above the first and third quartiles, respec-
tively. The results demonstrate both groups had re-
13. Our finding of significant reduction in analgesia use
by the participants who received cold therapy is consist-
ent with results of two similar studies that measured
this outcome (Brander et al., 1996; Fountas et al., 1999).
Significance of this finding cannot be overstated, as opi-
oids are commonly used postoperatively by patients
table 1. participant characteristics
Control (n = 74) Cold Therapy (n = 74) Standardized Difference
Age, M ± SD 61.4 ± 14.9 62.4 ± 11.7 0.075
Female, n (%) 48 (64.9) 42 (56.8) −0.167
White, n (%) 64 (86.5) 66 (89.2) 0.083
Employment status, n (%)
Employed 42 (56.8) 44 (59.5) −0.047
Unemployed 5 (6.8) 8 (10.8) 0.121
Other 21 (28.4) 22 (29.7) −0.025
Unknown 6 (8.1) 0 (0) −0.420
Medical insurance, n (%)
Yes 70 (94.6) 74 (100) 0.239
Workman’s comp 2 (2.7) 0 (0) −0.239
Unknown 2 (2.7) 0 (0) −0.236
Duration of back pain, n (%) −0.174
16. size, a larger sample is always preferable. The study was
conducted on one inpatient unit at an orthopaedic sur-
gical specialty hospital; therefore, the results may not be
generalized to other institutions.
implications for practice anD research
The results demonstrate decreased analgesic consump-
tion and a trend in lower NRS pain scores in the inter-
vention group and a perceived reduction of pain in both
groups regardless of intervention. The significant de-
crease in narcotic consumption warrants a review of
clinical practice to incorporate cold therapy in the
standard postoperative order data set in this population.
Nurse attention and the continuance of regular turning
and positioning is also an important factor to continue,
as it may positively influence patient perceptions related
to pain. Independent clinical benefits associated with
turning and positioning bear further investigation.
table 2. change in nrs, pca use, anD perceiveD pain reDuction
Control Cold Therapy
Adjusted
Effect Size
n M ± SD n M ± SD
Difference in
means [95% CI] df
Chi-Square
Value
p
19. MPH; Michele Prigo, EdD; Bernard A. Rawlins, MD;
Andrew A. Sama, MD; and Kelsey Vukov, RN.
references
Abramson, D., Chu, L., & Tuck, S. (1966). Effect of tissue
temperatures and blood flow on motor nerve conduc-
tion velocity. JAMA: The Journal of the American
Medical Association, 198, 1082.
Adie, S., Kwan, A., Naylor, J., Harris, I., & Mittal, R. (2012).
Cryotherapy following total knee replacement.
Cochrane Database of Systematic Reviews, 9, 1–82.
Airaksinen, O. V., Kyrklund, N., Latvala, K., Kouri, J. P.,
Gronblad, M., & Kolari, P. (2003). Efficacy of cold gel
for soft tissue injuries: A prospective randomized dou-
ble-blinded trial. The American Journal of Sports
Medicine, 31(5), 680–684.
Amabile, C., & Bowman, B. (2006). Overview of oral modi-
fied-release opioid products for management of chronic
pain. The Annals of Pharmacotherapy, 40, 1327–1329.
Austin, P. C. (2009). Balance diagnostics for comparing the
distribution of baseline covariates between treatment
groups in propensity-score matched samples. Statistics
in Medicine, 28, 3083–3107.
Benyamin, R., Trescot, A., Datta, S., Buenaventura, R.,
Adlaka, R., Sehgal, N., … Vallejo, R. (2008). Opioid
complications and side effects. Pain Physician Journal:
Opioid Special Issue, 11, S105–S120.
Bleakley, C., McDonough, S., & MacAuley, D. (2004). The
use of ice in the treatment of acute soft-tissue injury: A
20. systematic review of randomized controlled trials. The
American Journal of Sports Medicine, 32(1), 251–261.
Block, J. (2010). Cold and compression in the management
of musculoskeletal injuries and orthopedic operative
procedures: A narrative review. The Journal of Sports
Medicine, 1, 105–113.
Brander, B., Munro, B., Bromely, L., & Hetreed, M. (1996).
Evaluation of the contribution to postoperative anal-
gesia by local cooling of the wound. Anaesthesia, 51,
1021–1025.
Fountas, K., Eftychia, K., Johnston, K., Smission, H.,
Vogel, R., & Robinson, J. (1999). Postoperative lumbar
micro discectomy pain. Spine, 24, 1958–1960.
Gordon, D. B., Stevenson, K. K., Griffie, J., Muchka, S.,
Rapp, C., & Ford-Roberts, K. (1999). Opioid equianal-
gesic calculations. Journal of Palliative Medincine, 2,
209–219.
Hjermstad, M. J., Fayers, P. M., Haugen, D. F., Caraceni, A.,
Hanks, G. W., & Loge, J. H. (2011). European Palliative
Care Research Collaborative (EPCRC). Studies com-
paring numerical rating scales, verbal rating scales,
and visual analogue scales for assessment of pain in-
tensity in adults: A systematic literature review.
Journal of Pain and Symptom Management, 41(6),
1073–1093. doi:10.1016/j.jpainsymman.2010.08.016
Konrath, G., Lock, T., & Goitz, H. (1996). The use of cold
therapy after anterior cruciate ligament reconstruc-
tion: A prospective randomized study and literature
review. American Journal of Sports Medicine, 24,
629–633.
21. Kullenberg, B., Ylipaa, S., Soderlund, K., & Resch, S.
(2006). Postoperative cryotherapy after total knee ar-
throplasty: A prospective study of 86 patients. The
Journal of Arthroplasty, 21(8), 1175–1179. doi:10.1016/j.
arth.2006.02.159
Lessard, L., Scudds, R., Amendola, A., & Vaz, M. (1997).
The efficacy of cryotherapy following arthroscopic
knee surgery. Journal of Orthopaedic & Sports Physical
Therapy, 26(1), 14–22.
Levy, A., & Marmar, E. (1993). The role of cold compres-
sion dressing in the postoperative treatment of total
knee arthroplasty. Clinical Orthopaedics, 297, 174–178.
Liu, S. S., Carpenter, R. L., Mulroy, M. F., Weissman, R. M.,
McGill, T. J., Rupp, S. M., & Allen, H. W. (1995).
Intravenous versus epidural administration of hydro-
morphone: Effects on analgesia and recovery after
radical retropubic prostatectomy. Anesthesiology,
82(3), 682–688.
Ma, Y., Mazumdar, M., & Memtsoudis, S. G. (2012). Beyond
repeated-measures analysis of variance: Advanced sta-
tistical methods for the analysis of longitudinal data in
anesthesia research. Regional Anesthesia and Pain
Medicine, 37, 99–105.
Murata, K., Yoshimoto, M., Takebayashi, T., Ida, K.,
Nakano, K., & Yamashita, T. (2014). Effect of cryother-
apy after spine surgery. Asian Spine Journal, 8(6), 753–
758. doi:10.4184/asj.2014.8.6.753
Schacht, A., Bogaerts, K., Bluhmki, E., & Lesaffre, E.
(2008). A new nonparametric approach for baseline
22. covariate adjustment for two-group comparative stud-
ies. Biometrics, 4, 1110–1116.
Stefee, A., Booher, J., & Biscup, R. (1996). Evaluation of
cold therapy in postoperative spine patients. Surgical
Technology, 5, 385–387.
Wahern, L., Torebjork, E., & Jorum, E. (1989). Central sup-
pression of cold-induced C-fiber pain by fiber myeli-
nated fiber input. Pain, 38, 313–319.
Wewers, M. E., & Lowe, N. K. (1990). A critical review of
visual analogue scales in the measurement of clinical
phenomena. Research in Nursing & Health, 13(4), 227–
236.
Wu, C. (2005). Acute postoperative pain. In R. D. Miller,
(Ed.): Miller’s anesthesia (6th ed., pp. 2745–2747).
Philadelphia, PA: Elsevier Churchill Livingstone.
Zeger, S., Liang, K., & Albert, P. (1988). Models for longitu-
dinal data: A generalized estimating equation ap-
proach. Biometrics, 44, 1049–1060.
** Adapted from: Rosswum: Image J Nurs Sch, Volume 31(4).
Fourth Quarter 1999.317-322
Kaiser Permanente Regional Nursing Research Committee;
modified June 2007
Topic: Journal
Author (Yr):
Title:
23. QUANTITATIVE REVIEW WORKSHEET
Purpose/Research
Questions/Hypotheses
Research
Variables Design Major Findings and Limitations
Purpose of Study: Independent: Quantitative Design: Findings:
(continue on back)
Research Questions /
Hypotheses: Dependent:
Theoretical Framework/
Conceptual Model:
Sample Setting Major Tools Limitations: (continue on back)
Number: Type: Name(s):
Type: #1
Age: #2
Gender: Location: #3 Levels of Evidence
Health Status: Urban or Rural Evidence Rating:
Statistics: Reliability:
Diagnosis: Descriptive: #1 Feasibility:
#2 Could this practice change be implemented easily
in
Other: #3 your organization and with minimal
resources?
24. Correlational: Yes No
Validity: Benefit/Risk:
#1 Would the benefits of the practice change outweigh
Inferential: #2 the risks to patients? Yes No
#3
Comments:
Statistics:Benefit/Risk:
PrintButton1: TextField1: DropDownList1: Select
One:DropDownList2: Evidence Level: Select Evidence
Rating:DropDownList3: Select Method:CheckBox1:
0CheckBox2: 0CheckBox3: 0CheckBox4: 0CheckBox5:
0CheckBox6: 0TextField2: TextField3:
NUR 440 Critique Guidelines and Rubric
Overview: When caring for patients it is essential that as a
nurse you are using evidence-based practice. In order to identify
what is best practice, you must be
able to read research critically. Terminology used in research
can be difficult to interpret and understand; therefore securing a
solid foundation is essential to the
success of identifying and implementing current best practice.
What is a critique? It is a professional analysis of the
weaknesses and strengths of a particular
piece of research. A critique may be done for a variety of
purposes: acting as an expert reviewer to assess whether this
research paper should be published;
providing helpful comments on a work before it is submitted for
25. publication; or, as in the case here, as a learning experience for
emerging scholars to practice
their developing research skills.
Prompt: Choose one of the two provided articles located in the
module Reading and Resources folder. Start by filling out the
provided worksheet. Then, using the
worksheet as your guide, write a critique to dig deeper into each
section and identify the specific examples of each element (e.g.,
what is the research question?
Does the author justify the importance of the research? In the
case of a literature review, has the author examined the relevant
literature?). Elaborate on each
section and evaluate it for its strengths and limitations. Be sure
to identify your chosen article and address the following critical
elements:
x Critique
o Purpose and Research Question: What is the research
question? Does the author justify the importance of the
research?
o Design and Methods: What design and methods were used?
Are they rigorous and systematic?
o Validity and Reliability: Is the study valid and reliable? (For
qualitative research, this section of your critique should
consider the study’s
trustworthiness and rigor.)
o Findings and Conclusions: Are the conclusions reasonable
given the findings?
x Evaluation: What are the strengths and weaknesses of the
research article? Do you agree with the author’s conclusions?
Why or why not? Did the author
succeed or fail in the purpose of the study? Recommend areas
26. for improvement or suggest direction for future research.
Guidelines for Submission: Your paper must be submitted as a
1–2 page Microsoft Word document with double spacing, 12-
point Times New Roman font, one-
inch margins, and in APA format.
Critical Elements Exemplary (100%) Proficient (85%) Needs
Improvement (55%) Not Evident (0%) Value
Critique Meets “Proficient” criteria and
includes examples from the
article and an insightful
discussion of validity and
reliability or trustworthiness
and rigor where applicable
Critiques each section identified
above and elaborates by using
content from the course;
includes a discussion of validity
and reliability or
trustworthiness and rigor
where applicable
Briefly critiques most of the
sections identified above but
does not discuss validity and
reliability or trustworthiness
and rigor where applicable
Does not critique any of the
sections
27. 45
Evaluation Meets “Proficient” criteria and
offers insightful suggestions for
improvement or direction of
future research
Evaluates the research article
for its overall strengths and
weaknesses and offers
suggestions for improvement or
direction for future research
Briefly evaluates the research
article for its overall strengths
and weaknesses and does not
offer suggestions for
improvement or direction for
future research
Does not evaluate the research
article
45
Articulation of
Response
(APA/Mechanics)
Submission is free of errors
related to citations, grammar,
28. spelling, syntax, and
organization and is presented in
a professional and easy-to-read
format
Submission has no major errors
related to citations, grammar,
spelling, syntax, or organization
Submission has major errors
related to citations, grammar,
spelling, syntax, or organization
that negatively impact
readability and articulation of
main ideas
Submission has critical errors
related to citations, grammar,
spelling, syntax, or organization
that obstruct understanding
10
Earned Total 100%