CRITICAL APPRAISAL OF A SYSTEMATIC REVIEW AND NARRATIVE...

CRITICAL APPRAISAL OF A SYSTEMATIC REVIEW AND NARRATIVE REVIEW RELATED TO COMPUTERISED PHYSICIAN ORDER ENTRY SYSTEM The author of this paper is a nurse educator working in an Intensive Care Unit (ICU) within the north-west region of England. For the purpose of this paper, the author has chosen a systematic review (SR) and a narrative review (NR) and aims to critically analyse these reviews using the Critical Appraisal Skills Programme (CASP) tool. The CASP tool has been developed by the Solutions for Public Health (SPH) (formerly known as Public Health Resources Unit), which is controlled by the National Health Service (NHS) (SPH, 2006). The tool is based on the guidelines formed by a group of clinicians at McMaster University, Canada†¦show more content†¦The author feels that using two different tools would increase the rigour of the appraisal and its relevance to practice. In the forthcoming sections of this essay, the author will attempt critically analyse the two papers using the CASP tool for SRs. Formulation of the research question Formulation of the research question guides the type of data collection for the study and states what the study will ‘hypothesise’ (Polit and Beck, 2010). The CASP tool acknowledges that clearly-focused research question will describe the population studied, the intervention given and the outcomes considered (SPH, 2006). The research question in the SR is clearly formulated. The population of patients studied were general and critically ill hospital patients, the intervention was a SR and outcome to be assessed was about the safety of the CPOE and clinical decision support systems or CDSS (CDSS is a computerised medication prescription system) based on hierarchy of outcome measures (kindly refer to table 2 of SR) within ICU settings. Likewise, in the NR, the population of patients studied were general and critically ill patients, the analysis was done via a NR and the purpose of the study was to assess the results of CPOE on clinical and surrogate outcomes in hospitalise d patients in both general and critical care settings. Based on this, the author acknowledges that the SR has adopted a narrow and more specific research question asShow MoreRelatedEvidence Based Practice Essay6286 Words   |  26 Pagesapproximately 17 hears to translate research findings into practice (if at all) • Without current best evidence, practice becomes rapidly out of date to the detriment of patients. • In order to keep up with the journals relevant to our practice, we need to review 19 articles a day, 365 days of the year!!! • Textbooks may be out of date by the time they are printed • Traditional continuing education conferences do not significannot ly improve clinical practice. • To advance our profession and enhance lifeRead MoreDeveloping a framework for critiquing health research5723 Words   |  23 Pagesthat are commonly used to critique qualitative research and then presents a single framework that addresses both research approaches. 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Hypertension Free Essays

Hypertension is also called high blood pressure. It is a condition where the blood is pumping harder around the body and the arteries have high blood pressure constantly. Arteriosclerosis is when the artery walls harden and the blood has to be pushed harder to get through the arteries. We will write a custom essay sample on Hypertension or any similar topic only for you Order Now How are they often related? These two conditions are related because when someone gets arteriosclerosis it will lead to getting hypertension. With the arterial walls hardening, the heart has to ump faster and harder to get the blood through causing the hypertension. Why is hypertension called the ‘silent killer? Hypertension is called the silent killer because most people do not get any symptoms and could eventually leads to stroke, heart attack, heart failure and kidney failure. Name three changes in your lifestyle that might help to prevent cardiovascular disease in old age. Three things I can do to prevent cardiovascular disease is; No smoking Having a healthy diet Exercising Undesirable clot formation can occur as a result of endothelial damage due to arteriosclerosis. How does the body form undesirable clots within intact blood vessels? Blood has three factors for it to clot. The three factors are; a hyperbolically state which means the blood can clot quickly because of increased platelets or thick blood due to hydration. Vessel incongruity, meaning there is a disruption in the smooth inner lining in the blood vessel. This can happen because of smoking or naturally due to bends and manipulation of blood vessels over a lifetime. The last thing blood needs to clot is blood stasis which is blood pooling and standing still. When blood is going through a vessel it is called a parabolic refill. This means that the blood in the middle of the vessel is moving the fastest and the blood on the walls is pretty much at a standstill. This will make the blood clot if it is hyperbolically, not moving, and is contact with a damaged vessel or rough surface. Activity 5. 2: At handover you are told a patient/client is cyanic. What would you expect to observe? Occasions is a sign of tissue hypoxia. Define what this means and name three conditions where this could occur: I would be observing my patient’s skin to see if there are any changes in the color. Occasions is where the skin turns a bluish or rupee color because the tissue near the skin is low on oxygen. Tissue hypoxia is one part of the body that is not getting anywhere near the correct amount of oxygen supply. Occasions is a late sign of hypoxia but is not always accurate. Three conditions where this could occur is emphysema, chronic bronchitis and can also lead to heart failure and death. Activity 5. 3: Describe the difference between a tracheotomy and endothelial intubations. A tracheotomy is a surgically made incision in the neck into the trachea. This hole is made because there is something blocking the airways. An endothelial intubations is a medical procedure where a tube gets inserted into the trachea through the mouth or nose. The difference between the two procedures is, a tracheotomy has a surgical incision and an intubations is being placed into the throat with no incisions. Activity 5. 4: Why will a patient who is anemic complain of shortness of breath? People with anemia are complaining of shortness of breath because the body is making fewer red blood cells. Because there is fewer red blood cells, there is fewer oxygen being carried around the body and also less carbon dioxide being removed, therefore causing the shortness of breath. Activity 5. 5: Paul is 15 years old, he has a known allergy to cashew nuts, but can eat all other types of nuts with no ill effect. He is eating a chocolate bar that contains mixed nuts. He complained of tingling around the mouth and lips, developed a rapid swelling of the face, and experienced difficulty breathing and inspiration, and within a few minutes had an audible wheeze on expiration. The initial diagnosis was asthma, but Paul was also treated for an allergic reaction. What type of allergic reaction is suspected? Paul is suspected of having nonphysical. Because of how difficult it is for Paul to breath this is also suspected. Nonphysical has a more severe effect on the lungs for people who have asthma. Why has this caused problems with breathing? When you have go into unpatriotic shock, your body will start showing signs within minutes. One sign is the throat swelling up. Due to the throat swelling up it would be quite difficult to breath already but with Paul having asthma, the lungs are being effected quite severely. Activity 6. 1 : Simon is 14 years old, admitted with severe abdominal pain and fever, diagnosed with severe appendicitis. If he is left untreated what would the result be? If you let appendicitis go untreated it will get worse and rupture, causing organ failure and possibly death. Activity 6. 2: Why does a lack of fiber in the diet encourage the formation of divestiture? Fiber helps prevent constipation. Having a lack of fiber in your diet means that stools will be a lot fuller and harder to pass, causing a strain in the bowel. Straining can cause increased pressure in the colon and this will encourage the formation of divestiture. Activity 6. 3: Explain why obstruction in the common bile duct causes interference with the congestion of some foods? The bile firstly goes into the liver and then gets broken down by bile salts. The bile is then on the Journey to the gall bladder, passing through the bile ducts. If there is a blockage in the bile ducts, all the bile stays in the liver and will not be able to reach the gall bladder which will then lead to the bile not reaching the small intestine and will not be able to be digested properly. Activity 6. 4: What nursing observations of their skin, faces and urine would support the diagnosis of an obstructed bile duct? Where would these observations be recorded? Observing the patient’s skin to see if it has gone yellow Induce) is a sign of an obstructed bile duct. Also looking at their urine to see if it is any darker or pale colored stools. These observations would be recorded in their progress notes. Also on fluid balance charts, bowel charts, urinalysis and care plans. Activity 9. 1: Explain why someone who is hemorrhaging. Ii has falling symptoms: blood pressure/volume will have a decreased urine output. (Refer to your Marine textbook and the chapter on the urinary system for a flow chart that will assist you to answer the question. ) When you are hemorrhaging you are losing a lot of blood and in a very short time. Because pressure has dropped, the kidneys are not getting enough blood pumped into them, this is causing the urine output to decrease. The fluid is going other places in the body instead of leaving through the urine. How to cite Hypertension, Papers Hypertension Free Essays

Critical Analysis of 1984 and Consumerism †MyAssignmenthelp.com

Question: Discuss about the Critical Analysis of 1984 and Consumerism. Answer: 1984 and Consumerism George was a socialist who fought for the Republicans in the Spanish war. In the process, he was wounded by a sniper bullet to the throat thus becoming disillusioned. He wrote 1984, as a form of futuristic-cautionary defined by mind control, anxiety, hatred, and cruelty. The Novel satirizes and warns us on the dangers of a totalitarian state. It depicts a society that has gone astray. Citizens are oppressed by the government through being denied freedom to choose and express themselves. Similarly, governments use lies and manipulation to control and stay in power. These factors constitute elements of consumerism. Consumerism plays a critical role in governance. Although it seems to make citizens happier, it makes them easier to control. Citizens are conditioned to like new things as propagated by people in authority. Similarly, they are encouraged to discard old ways of thinking. This is seen in how the society values new items even today.Therefore, this paper provides a critical ana lysis of how the novel 1984 represent consumerism and how W.B Yeates and Mark Slouka would criticize this form of consumerism. Oceania was the superstate where Winston Smith stayed.The ruling party subscribed to Ingsoc. This is a Newspeak neologism for English socialism. The citizens believed that the Big Brother, nominal leader, created a revolution by being a focal point in love, reverence, and fear. Similarly, the citizens used Newspeak (Orwell, Nineteen Eighty-Four, 1949). The structure of this language eliminated unorthodox social and political thoughts by withdrawing words used in their expression. One of the ways in which consumerism is presented by Orwell the endless war on a global scale. There is strong enemy between world powers.There are three nations; Oceania, Eastasia, and Eurasia. They all have an equal share of control on global resources (Flink, 2013). Orwell notes that the countries were fighting a warfare of limited aims through combatants who were not able to outdo each other. Further, they lacked a genuine reason for fighting each other. For example, Oceania was at war with Eurasia. The Oceania Party encouraged this using misleading slogans like War is Peace to make the citizens of Oceania believe that it was okay to be at war with other states. The perpetual warfare in the novel shows compromise for both individual and collective freedom. The Big Brother considered ignorance as strength. Therefore, any transgression against the party was seen and treated as a capital crime. As a result, what existed in Oceania is invisible ignorance where orthodoxy exists without people necessarily knowing that it does exist. Further, the Big Brothers worldview was upheld by people who have not been empowered to understand . The Society of Oceania was divided into three main categories; Inner Party, Outer Party, and Proles. The Inner Party was made up of a small group of people. On the other hand, the Outer Party had numerous and indoctrinated people. The Proles were kept from political control through being engaged in sports and entertainment. Those who seemed aware of any political problems were controlled using by the Police (Nourbakhsh, 2015).This ensured that the Ocean citizens continue to remain under the control and manipulation of governments that do not want them to prosper beyond control. Also, the Outer Party members were used to encourage ignorance among citizens. For example, Winston Smith worked in the Records Department of the Ministry of Truth (Orwell, Nineteen Eighty-Four, 1949). Here, his role was to revise historical records to be in alignment with the ever-changing stand of the Inner Party members. Also, he was charged with deleting references to unpersons-people who were killed by the state. Every aspect of Orwells fictional world was monitored by telescreens. These instruments also broadcast propaganda, announcements, and news. They kept a 24-hour surveillance (Inwood, 2013). Therefore, every move, word, facial expression and involuntary reaction is detected and investigated by the Big Brother.Orwell notes that everywhere Winston went, the party watched him using telescreens.He saw the face of the Partys omniscient leader referred as the Big Brother (Orwell, Politics and the English Language, 1968). Further, Orwell writes that the Party controls everything in Oceania. In fact, it was in the process of inventing the Newspeak language that would prevent rebellion through omission of worlds related to that field. The language of newspeak in 1984 presented impotent distortion of the English language. Orwell showed that there was a strong connection between the success of tyrannical government and the deterioration of English as a language. 1984 shows how Modern English, especially written, has become worse due to imitation which can be avoided when people commit time, will and energy to do so (Allan, 2012). He states that the decline of the English language has been caused by political and economic factors. Further, he states that the language, especially written, has been made ugly by factors like lack of precision, worn-out metaphors, inappropriate verbs, pretentious diction, meaningless words, vague phrases and staleness of imagery and bringing (Inwood, 2013). To bring the change he recommends the application of holistic approaches; not only professional writers (Susan, 2016). Moreover, he assures the audience that if everyone takes responsibility for correcting the Modern English language, then it will lead to political regeneration where language is unpretentious and unfashionable. The use and misuse of journalism in spreading propaganda showed some elements of consumerism. The media manipulated the people thus leading to loss of critical thinking, self-expression. This is shown when Winston Smith tries to start a journal. Orwell stated that Winston had been contemplating to start a journal for a while even though he knew it was wrong to do so (Isaac, 2015). He bought a journal, pen and some ink from some shop. It is clear that he wanted to note down something for himself or the society. Orwell notes that Winston hoped he could transfer what had been running in his head for so long. However, as soon as he began writing, he realized that he had spent so much time thinking about writing a journal without thinking about the content. This shows that he lost the power to express himself. Also, it shows lack of critical thinking (Cooper, 2014). Evidently, no one needs to write in Oceania because all the information is conveyed by telescreens (Flink, 2013). This dysto pic environment was created and encouraged by Big Brother to steer hate, misinformation, and misunderstandings. Further, the concept of double-thinking created by the Party members in 1984 enabled the forceful exercise of power. It is the ability to hold two contrary opinions at the same time and believe that they are both true. Orwell portrayed it as the ability by the Big Brother to control the thoughts of Oceania citizens by making them forget things done to them. Ultimately, Oceania citizens lost the power to form independent thoughts. Throughout the novel, Orwell has provided occurrences that can be deemed doublethink. For example, the partys four ministries; Plenty, Love, Peace and Truth. The Ministry of Plenty was in charge of overseeing shortage of resources. The Ministry of Peace declared and conducted war (Isaac, 2015). The Ministry of love issued punishments and torture while the Ministry of Truth spread propaganda and revised historical facts. Employees in the Ministry of Truth would falsely historical records. Then, they would believe and act according to the revised version. Similarly, when Oceania and Eurasia were at war with each other, the Party made them believe- from revisionist history- that this has always been the situation between the two of them (Allan, 2012). Doublethink can also be found in the three slogans of the Party; War is Peace, Ignorance is Strength and Freedom is Slavery.Apart from being a total contradiction, the statements were untrue (Slouka, 2009). Sadly, the citizens of Oceania were brainwashed to the point of not recognizing the difference. In 2009. Mark Slouka wrote an article, Dehumanized, to show the state of the American education and its effects on democracy and citizens freedom (Slouka, 2009). He talked about the unqualified triumph of particular ways of thinking or seeing the value (Orwell, Politics and the English Language, 1968). Further, he said that as arts and humanities were becoming marginalized, citizens were being taught on what to think instead of how to formulate their own worldview (Susan, 2016). Admittedly, what is taught in schools is a measure of what is valued in our society. Meaning, if our curriculum does not encourage critical thinking and self-expression, our children grow up lacking skills in the same (Thompson, 2015). Consequently, our society will be made up of people who are willing to take anything as the gospel truth. This is what was envisioned in 1984 by George Orwell and sadly, it is has been noted by current scholars as well. Orwells sentiments are similar to the lines of a poem, The Second Coming, by William Butler Yeates in 1919. The poem was first printed in The Dial in 1920. Yetaes used the Christian imagery on the second coming of Christ to enlighten people on the atmosphere of the post-war Europe where totalitarianism was prevalent (Chenoweth, 2010). Just like Orwell, Yeates used poetry to describe political turmoil characterized by chaotic and unpleasant beliefs (Yeats, 1920). The second coming described is not of the Messiah, but humanity. Although the Scripture paints a perfect picture of the second coming of Christ, Yeates showed the worry and instability to be experienced by future generations. Orwell affirms his worries by describing what the society had become in 1984. In conclusion, as much as Orwells novel was an exercise in futuristic imagination, it was a warning against a society and government that deny people the capacity for critical thinking, the creation of accurate information and authentic self-expression. Although what he wrote during his time seemed absurd to most people, current events in the society show no difference in the world George Orwell envisioned. He was right to show concern for the direction taken by the society since the problems are being experienced today. The contemporary society is facing a myriad of challenges among them being insecurity, civil conflicts, racism, corruption, terrorism, and neocolonialism. Further, there has been a clash between governments and citizen over the latters disagreement with the methods used by the state to exercise power. At the center of the conflict is the media which is being used to further exploitation and manipulation instead of bringing to light the evils done by governments. All these, are indications of the reality painted by George Orwell in 1984. Thus, there is a need to reassess the direction headed by the society and introduce a change that will bring freedom, favor critical thinking and advocate for truth. References Allan, K. (2012). Pragmatics in the English Lexicon. Cambridge: Cambridge University Press. Chenoweth, E. (2010). Democratic Competition and Terrorist Activity. The Journal of Politics , 16-30. Cooper, W. H. (2014). Free Trade Agreements: Impact on US trade and implications for US trade policy. Current politics and Economics of the United States, Canada, and Mexico , 425. Flink, A. (2013). Conducting research literature reviews: from the Internet to paper. Sage Publications . ID Mitchell, R. B. (2012). Concepcion and Preemption Under the Federal Arbitration Act. Penn State Yearbook of Arbitration and Mediation, Forthcoming. , 35-60. Inwood, D. A. (2013). Street naming and the politics of belonging: spatial injustices in the toponymic commemoration of Martin Luther King Jr. Social Cultural Geography , 211-233. Isaac, R. K. (2015). Every Utopia turns into dystopia.Tourism Management , 329-330. Martin, C. J. (2004). Reinventing welfare regimes employers and the implementation of active social policy Management. World Politics , 34-70. Nourbakhsh, I. R. (2015). The Coming Robot Dystopia. Foreign Aff , 23. Orwell, G. (1949). 1984. Orwell, G. (1968). Politics and the English Language. Slouka, M. (2009). Dehumanized. Harper's Magazine , 32-40. Susan, R. T. (2016). Coping with Grim Dystopia: A Re-Reading of The Fire-Dwellers. Studies in Literature and Language , 27-34. Thompson, C. (2015). Book Review: General Politics: Analysing Political Speeches: Rhetoric, Discourse, and Metaphor. 124-127. Yeats, W. B. (1920). The Second Coming. The Dial.