Evidence-Based Practice & Applied Nursing Research Essay Example for Free

Evidence-Based Practice Applied Nursing Research Essay Type of Sources / Appropriateness of Sources / Classification of Sources American Academy of Pediatrics and American Academy of Family Physicians article regarding acute otitis media is a filtered resource. It is an appropriate source for nursing practice because; it establishes clinical guidelines to diagnose and manage AOM. It also establishes guidelines when to treat the signs and symptoms of AOM, watchful waiting, or to treat with an antibiotic. This article is classified as an evidence based guideline because, it reviews multiple research literatures in a systemic manner and provides recommendations of practice. Block’s Causative Pathogens article is an unfiltered resource. It is an appropriate source for nursing practice because it provides the clinician with the most recent and up to date research on the topic. The article is primary research evidence because; its researchers acquired the data first hand. Kelly’s article regarding Current pediatric diagnosis and treatment is a general information resource. This article is not appropriate for clinician use because it only provides basic general background. It does not guide the clinician in diagnosing and treatment. McCracken’s article in the Pediatric Infectious Disease Journal is an unfiltered resource. It is an appropriate for nursing practice because it supports established guidelines and shows what will happen with continued antibiotic use. This is an evidence summary article because it lists all of the important information and the evidence supporting it. The last source of evidence is interviews with parents. This type of source is considered a general information resource. It is appropriate because, the interviews give firsthand experience of onset and signs and symptoms of AOM. This source of classifications is none of the listed. â€Å"Acute otitis media (AOM) is the most common infection for which antibacterial agents are prescribed for children in the United States. As such, the diagnosis and management of AOM has a significant impact on the health of children, cost of providing care, and overall use of antibacterial agents (AAFP, 2004).  Watchful waiting can have many benefits for the children and the provider if used properly. Diagnosing AOM can be tricky. The signs and symptoms can also be related to other illnesses such as an upper respiratory virus. Throwing antibiotics at any illness use to be the course of action. However, now that there is evidence that bacteria have become resistant to some antibiotics, clinicians are testing out other means of treating illnesses. If the child presenting with symptoms of AOM has no underlying conditions and has means to follow up with the doctor if the symptoms progress, watchful waiting is an appropriate app roach for treating the child. According to the research, placebo controlled trials have shown that children have responded well without antibacterial intervention. Giving the opportunity for the illness to resolve without antibacterial intervention not only benefits the child but, the caregivers and the clinician. It benefits the child by not being exposed to antibiotics that are not needed, therefore creating a potential resistance to that antibiotic. It benefits the caregiver by not spending money on a medication their child does not need. Last, it benefits the clinician by preventing resistance to an antibiotic that may be useful in the near future. Watchful waiting is only appropriate if the patient meets the guidelines of uncomplicated AOM, assurance of a follow up if necessary, and access to antibiotics if symptoms progress or worsen. The findings in the AAFP article can be applied in many ways to improve nursing practice in a healthcare setting. The article provides evidence based guidelines on how to properly diagnose AOM and the typical signs and symptoms. It establishes the three criteria the patient must exhibit for a certain diagnosis of AOM. If the patient does not meet the certain criteria, it guides the clinician to continue to assess the patient for another illness, such as an upper respiratory virus. Proper diagnosis will improve clinician treatment and care of the patient. The article also includes a descriptive chart on how to assess and manage pain associated with AOM. It lists for the clinician the recommended medications, remedies, and agents for the clinician to utilize to manage pain. It also lists the effectiveness and the side effects. This will help improve nursing care by implementing the proper medication and or remedies to the patient with the highest effectiveness and the least amount of side effects. The article also very clearly identifies when watchful waiting is  not appropriate and what antibiotics should be prescribed and the usual dosage. This information is helpful to nursing practice by helping the clinician distinguish what patient is suitable for watchful waiting or antibiotic therapy. Another way the article improves nursing practice is, that the article provides information on how to prevent AOM and reoccurrence. This information can be used to help educate patient’s caregivers on ways to prevent AOM and reoccurrence. Ethical issues always arise when it comes to healthcare, especially when it comes to children. When conducting an evidence based research, there is a high likelihood of exposing the child to potential danger, illness, and adverse reactions. The first ethical issue is; is it even right to subject a child to research if there is a high likelihood of helping other children. That is something for the children’s parents to decide. However, it is the responsibility of the researchers to fully explain the process, potential side effects, potential danger, and any other concerns to the parents. It also the responsibility of researchers to determine if the parents have the capability to comprehend the information and the risk of the research. Not doing so would be unethical and could tarnish the results of the research. Another major ethical dilemma that comes with involving children in research is that the children do not have the capability of making that decision themselves. Research should be a voluntary thing and not left up to someone else to decide. However, when it comes to children that is not an option. The ethical problem is should the child be subjected to potential harm because of the parents’ willingness to allow it. The needs to be guidelines established prior to the start of the research that regulate the risks that the child might be subjected to. The risk should be very minimal with a very high benefit. Involving children in any type of evidence based research can be very tricky and has the potential of bringing up multiple ethical issues. It is the researcher’s responsibility to ensure the child is protected, not exposed to unneeded harm, and the caregivers are knowledgeable of the risk factors and are competent enough to make an informed decision. Besides ethical issues, there are other issues that need to be taken into consideration when research involves children. Vulnerable populations, such as low income families, families with different cultural backgrounds, and families with insufficient education can be at risk when it  comes to research involving children. For an example, low income families may not have the opportunity to participate in evidence based research because they might not fit certain criteria. In the AAFP research, in order for the child to be a candidate of the watchful waiting, they had to have means of a follow up appointment. For low income families, coming to the doctor multiple time may not be option. Financially they may not be able to afford, parents may not be able to get time off from work, or have means of transportation for a follow up appointment. These circumstances may subject the child to unneeded antibiotic treatment simply because the patient is unable to follow up with the doctor. Also, families with a cultural difference may not fully understand the benefits or risks of allowing their child to participate in this research. Without informed consent, the results of the research are tarnished and run the risk of jeopardizing the study. Informed consent when it comes to research involving children is extremely important for validity of a project and prevents any ethical problems. Any research involving children can be extremely tricky and should be held to the highest ethical standards and involve minimal risk to children. References American Academy of Pediatrics and American Academy of Family Physicians. (2004.) Clinical practice guideline: Diagnosis and management of acute otitis media. Retrieved from http://aappolicy.aappublications.org/cgi/content/full/pediatrics;113/5/1451 Block, S. L. (1997). Causative pathogens, antibiotic resistance and therapeutic considerations in acute otitis media. Pediatric Infectious Disease Journal, 16, 449–456. Kelley, P. E., Friedman, N., Johnson, C. (2007). Ear, nose, and throat. In W. W. Hay, M. J. Levin, J. M. Sondheimer, R. R. Deterding (Eds.), Current pediatric diagnosis and treatment (18th ed., pp. 459–492). New York: Lange Medical Books/McGraw-Hill. McCracken, G. H. (1998). Treatment of acute otitis media in an era of increasing microbial resistance. Pediatric Infectious Disease Journal, 17, 576–579.

she said yes :: essays research papers

I read "She Said Yes" by Misty Bernall. The publishing company is The Plough Publishing House, and it is 140 pages long. Cassie Bernall, a 17 year old junior at Columbine High School in Littleton, Colorado, was a typical teen having a typical day, when two rampaging classmates put a gun to her head and asked her if she believed in god. She said yes. Its a story of growing up in the 90’s, of peer pressure, adolescents, turmoil, and the role parents play; a story of tough choices and the battle between good and evil in every person. But in the end, its a story of redemption more enduring than the tragedy that cut Cassie Bernall’s life short. It was a relatively simple question. Do you believe in God? On April 20th, 1999 Cassie Renà © Bernall said "Yes". It was the last word she would ever speak. On the day of the tragedy Cassie became a martyr for her God. In the aftermath of the tragedy its easy to raise Cassie up the status of a saint. Cassie was nothing more then a typical teenager worried about their future, her looks and the things that almost every other teenager worries about, but Cassie also sported a deep love for her God. But it wasn’t always that way. While Cassie had always been a sweet and loving child she took a turn for the worst in her teenage years, and headed down a dark, dangerous path, just like those ones as her killers. Her friends were less then good role models, Cassie became fascinated with witchcraft, drinking, suicide and perhaps the death of her parents. Fortunately, her parents found letters written to Cassie by a close friend which were talking about things that they could do to her parents that would be tragic. Afraid of what might happen, the Bernalls turned the letters over to the local police. A youth pastor spent a lot of time talking with Cassie, only to later say that there was no hope for her. But like most parents Cassia’s wouldn’t give up. The pulled her out her current school and enrolled her in a Christian school, they cut off all contact with her old friends, and basically put her under house arrest. Anything to get their sweet little girl back. Cassie hated them for it. They also hated having to get so serious with their daughter.

The Rise of Monarchies

A new monarchy brings power to the royal family. It does this in many ways. A new monarchy reduces the power of nobility, and confiscates land from the nobles that are on â€Å"their† land. They also impose taxes and tariffs on whatever they want. A new monarchy will also create standing armies and hire mercenaries to protect their land and to grow their empire. Basically a new monarchy wants to bring money, power, and control to the royal family that is in rule. An example of two new monarchies is Henry VII of England and Ferdinand I of Spain.Both the royal families and states they represent are great examples of a new monarch from the time period of 1450 to 1550. Spain exemplifies the key characteristics of a new monarch. It all starts with the centralization of power in Spain towards one royal family. This all starts with the marriage of King Ferdinand II of Aragon and Queen Isabella of Castile. Before this marriage modern day Spain was fragmented into 4 four separate state s, Aragon, Castile, Granada, and Navarre. The marriage combined Castile and Aragon, which allowed Ferdinand I of Spain and Queen Isabella to control most of modern day Spain.Along with this event Ferdinand and Isabella centralized the system of justice and made towns more subservient to the royal will in Castile. Ferdinand now is gaining control and power of his land, so he does what a new monarch should do and rips power and authority from the nobilities on his land. Ferdinand stripped the Castilian nobles of some of their privileges while he dispenses their titles and positions. In Aragon he has trouble with the nobles but they later will alliance with the King in fear of a revolt in the lower class. Now The Spanish Royal Family has gained control of their land.In order for Ferdinand to keep his kingdom safe and undisturbed from outsiders, he takes the province of Granada from the Moors. This shows Ferdinand's rise in power in 1492 and shows Ferdinand having military power as well . Even though new monarchies impose taxes on whatever they want, the Spanish monarchy didn't as much as other monarchies, like England. The royal family did take money from the church by handling the populace's tithes and the sales of indulgences and keeping some for royalty, which shows rising power of the monarch.The monarchy also only got about 10% of its income from the people. Spain's real income came from the America's. The silver from the Potosi and Spain's trade really defined the monarchs economy, power, and control during the monarchs climax years. In result of the wealth Spain had they are able to build standing armies and state themselves as the most powerful state at the time. With Ferdinand being able to control his lands, become extremely wealthy, and have power, he has created a true new monarch. As well as Spain, the English and King Henry VII of England also created a new monarch.The key factor in the start of this monarch is definitely the War of the Roses. With t he Tudor Family â€Å"victory†, Henry Tudor, the last claimant of the throne of the Lancaster's, became the beginning of the Tudor's Monarch. Henry was an ambitious ruler. He wanted to make the Tudor state so powerful, no noble factions or challengers could challenge him or his state. As most monarchs did, Henry strengthened royal authority in England by creating the Star Chamber, which became one of the highest courts in the land.These justices dispensed justice, collected taxes, enforced troop levies, and maintained order. Even though this makes the government, or the royal family, more decentralized, it strengthened the efficiency and prestige of the monarchy. It helps Henry control his land which ultimately is a goal of a new monarch. Even though Henry has a justice system, he also exemplifies that the monarch has the most power. In fact he obtained from parliament writs of attainder and forfeiture, which allows him to declare anyone of treason, have them killed and take their property from them.This definitely states that the king has the most power and he can do whatever he wants. Along with gaining more power, Henry won the loyalty of most of the nobles on his land, which now centralizes the power of England to the royal family.. Another key characteristics of this new monarch is the fact that Henry imposed tariffs protecting the cloth and wool industries in his monarch. This decreed acts unifying weights and measures, and constructed edicts punishing vagabondage and begging.This not only states more power of the throne but shows Henry building his economy with protecting his industries. All in all Spain and England exemplifies the true new monarch and all of its characteristics. Both Henry and Ferdinand strip power from the nobility, build their wealth in industry, natural resources, taxes, and/or tariffs. Their wealth allows them to create armies and gain power and control on their own lands and in the lands they conquer. Basically they gain co ntrol of their lands, get wealth and ultimately have power, which states a new monarch. The Rise of Monarchies A new monarchy brings power to the royal family. It does this in many ways. A new monarchy reduces the power of nobility, and confiscates land from the nobles that are on â€Å"their† land. They also impose taxes and tariffs on whatever they want. A new monarchy will also create standing armies and hire mercenaries to protect their land and to grow their empire. Basically a new monarchy wants to bring money, power, and control to the royal family that is in rule. An example of two new monarchies is Henry VII of England and Ferdinand I of Spain.Both the royal families and states they represent are great examples of a new monarch from the time period of 1450 to 1550. Spain exemplifies the key characteristics of a new monarch. It all starts with the centralization of power in Spain towards one royal family. This all starts with the marriage of King Ferdinand II of Aragon and Queen Isabella of Castile. Before this marriage modern day Spain was fragmented into 4 four separate state s, Aragon, Castile, Granada, and Navarre. The marriage combined Castile and Aragon, which allowed Ferdinand I of Spain and Queen Isabella to control most of modern day Spain.Along with this event Ferdinand and Isabella centralized the system of justice and made towns more subservient to the royal will in Castile. Ferdinand now is gaining control and power of his land, so he does what a new monarch should do and rips power and authority from the nobilities on his land. Ferdinand stripped the Castilian nobles of some of their privileges while he dispenses their titles and positions. In Aragon he has trouble with the nobles but they later will alliance with the King in fear of a revolt in the lower class. Now The Spanish Royal Family has gained control of their land.In order for Ferdinand to keep his kingdom safe and undisturbed from outsiders, he takes the province of Granada from the Moors. This shows Ferdinand's rise in power in 1492 and shows Ferdinand having military power as well . Even though new monarchies impose taxes on whatever they want, the Spanish monarchy didn't as much as other monarchies, like England. The royal family did take money from the church by handling the populace's tithes and the sales of indulgences and keeping some for royalty, which shows rising power of the monarch.The monarchy also only got about 10% of its income from the people. Spain's real income came from the America's. The silver from the Potosi and Spain's trade really defined the monarchs economy, power, and control during the monarchs climax years. In result of the wealth Spain had they are able to build standing armies and state themselves as the most powerful state at the time. With Ferdinand being able to control his lands, become extremely wealthy, and have power, he has created a true new monarch. As well as Spain, the English and King Henry VII of England also created a new monarch.The key factor in the start of this monarch is definitely the War of the Roses. With t he Tudor Family â€Å"victory†, Henry Tudor, the last claimant of the throne of the Lancaster's, became the beginning of the Tudor's Monarch. Henry was an ambitious ruler. He wanted to make the Tudor state so powerful, no noble factions or challengers could challenge him or his state. As most monarchs did, Henry strengthened royal authority in England by creating the Star Chamber, which became one of the highest courts in the land.These justices dispensed justice, collected taxes, enforced troop levies, and maintained order. Even though this makes the government, or the royal family, more decentralized, it strengthened the efficiency and prestige of the monarchy. It helps Henry control his land which ultimately is a goal of a new monarch. Even though Henry has a justice system, he also exemplifies that the monarch has the most power. In fact he obtained from parliament writs of attainder and forfeiture, which allows him to declare anyone of treason, have them killed and take their property from them.This definitely states that the king has the most power and he can do whatever he wants. Along with gaining more power, Henry won the loyalty of most of the nobles on his land, which now centralizes the power of England to the royal family.. Another key characteristics of this new monarch is the fact that Henry imposed tariffs protecting the cloth and wool industries in his monarch. This decreed acts unifying weights and measures, and constructed edicts punishing vagabondage and begging.This not only states more power of the throne but shows Henry building his economy with protecting his industries. All in all Spain and England exemplifies the true new monarch and all of its characteristics. Both Henry and Ferdinand strip power from the nobility, build their wealth in industry, natural resources, taxes, and/or tariffs. Their wealth allows them to create armies and gain power and control on their own lands and in the lands they conquer. Basically they gain co ntrol of their lands, get wealth and ultimately have power, which states a new monarch.

Christianity During The Roman Empire - 1526 Words

Christianity in Rome Religion is an important feature in most cultures throughout time. Different religions have been more prominent than others, one of the most popular being Christianity. Christianity developed during the time of the Roman Empire. It began as a minority religion and grew into something much more than that. Christianity’s importance to the empire increased over time. At first, Christian values seemed different than those of pagan Roman civilization and Romans were not sure how to react to this growing minority religion. The difference between the two religions became clearer as Christianity became more prominent. Paganism was present in Rome since its founding. A majority of Roman culture developed from Greek culture. Roman paganism adopted many of its beliefs from Greek paganism. Roman pagans believed in more than one god as the Greeks did. Religion was very prevalent in Roman architecture, art, plays, writings, and money. Romans also held their values as being rather important. This is evident through the many writings about Roman culture that have survived to this day such as Aeneid and The Confessions. Roman citizens throughout the empire highly valued honor. An account proving the importance of honor is the story of Lucretia. This account also aids in explaining the origins of Rome as well as the establishing of the Republic of Rome. Lucretia was a noblewoman and was staying in her estate alone. One of her guests rapes her while her husband andShow MoreRelatedThe Rise Of Christianity During The Roman Empire2111 Words   |  9 PagesThe rise of Christianity in the Roman Empire, was by far not a simple one. The Roman Empire was generally quite tolerant in the treatment of other religions. So why did they persecute the Christians, and how did this all begin? These persecutions mainly started in 64 A.D when a great fire broke out under the rule of Emperor Nero. In order to deflect the public s opinion on him, he blamed the Christians and this blame then allowed, and paved way for the aggressive persecutions of Christians in theRead MoreThe Revival Of Christianity During The Late Roma n Empire1357 Words   |  6 PagesThe revival of Christianity during the late Roman period was set into motion in 313 CE with the Edict of Milan, which legalized Christianity in the Roman Empire. Emperor Constantine helped move the revival along by ordering the construction of the Church of the Holy Sepulcher, which started around 326 CE, and was completed in 335 CE. Throughout its existence, the Church of the Holy Sepulcher has been destroyed and reconstructed numerous times, which means that the current Church in Jerusalem is notRead MoreJustinian And The Byzantine Empire1568 Words   |  7 PagesByzantine Empire. Although it is currently referred to as the Byzantine Empire, many citizens and leaders, including Justinian, considered themselves to be Roman and part of the Roman Empire. This mentality led to the revival of the Roman Empire in Byzantine and in its capital, Constantinople. During his rule, Justinian led the empire to its greatest size both in the amount of controlle d land and influence over groups in Europe and Asia. He also contributed to the spread of Christianity both withinRead MoreChanges and continuities of Roman empire1432 Words   |  6 Pages Between 500 BCE and 500 CE, the Roman civilization experienced changes both politically and culturally. Firstly, Rome’s government transitioned from a Republic to an Empire. Later, that empire was split into two parts; east and west. In terms of changes in culture, it was impacted by the shift in religion, as the Romans shifted from polytheism to monotheism. Despite all the changes, Rome still remained culturally diverse. 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This composition will focus the historical-social context, ecclesial context, and modifications to the Church that occurred from three critical events; Fall of the Roman Empire, World War II, and the CelebrationRead MoreThe Theodosian Code1250 Words   |  5 PagesThe Roman Empire was a marvelous civilization stretching from the far ends of the Mediterranean Sea to the nutrient rich soils of the Fertile Crescent and all the way north to what is now known as the United Kingdom. In fact, the empire was so expansive that there was a need for organized law; and so with each emperor there came new constitutions and decrees for the Roman people to follow. The Theodosian Code was just one of the many juristic materials that helped define Roman law and keep legalRead MoreThe Legend Of Dante s Aeneid1286 Words   |  6 Pageswas once Troy. The Roman empire was a very complex civilization that had managed to sp read to various places of the ancient world. Noticeably, The entity had an underlying impact on religion since during this era Christianity rose to prominence all around the world. The civilization contributed significantly to the development of literature with notable figures, such as Cicero writing creative works of literature. During this period the date system was developed by the Romans, which had a key effectRead MoreThe Rise And Fall Of Empires1580 Words   |  7 Pagesthat the rise and fall of empires was due to tolerance, inclusion, difference, and diversity is shown to be true of the Roman Empire because of the way that tolerance allowed and caused the empire to rise, enter its golden age, and fall. The Roman Empire was a â€Å"hyperpower† that lasted from 44 BCE to 476 CE. The empire contained Western, Southern, and Eastern Europe, along with North Africa; thus, there was an abundance of culture from many different conquered groups. Romans wanted to make these con quered