Systematic Reviews in Health Care Essay

Complete this systematic reviews in health care essay assignment on the worksheet attached.
1. Choose the ONE systematic review topic that is of most interest to you, or most relevant to your practice situation, from the required List of Approved Systematic Reviews (Links to an external site.)Links to an external site..
2. Follow the grading criteria below to formulate your practice issue, which must be based on the topic of the systematic review you have selected. Systematic reviews in health care essay.
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3. Download the required Milestone 1 Practice Issue and Evidence Summary Worksheets (Links to an external site.)Links to an external site. (both worksheets appear in ONE form) to document the practice issue presented and approved by your instructor in the Week 2 Discussions. Systematic reviews in health care essay.
4. You are required to complete the form using the productivity tools required by Chamberlain University, which is Microsoft Office Word 2013 (or later version), or Windows and Office 2011 (or later version) for MAC. You must save the file in the “.docx” format. Do NOT save as Word Pad. A later version of the productivity tool includes Office 365, which is available to Chamberlain students for FREE by downloading from the student portal at http://my.chamberlain.edu (Links to an external site.)Links to an external site.. Click on the envelope at the top of the page. Systematic reviews in health care essay.
5. Your practice issue will be the same for all three Milestone assignments in this course.
6. Please type your answers directly into the worksheet.
Evidence Summary Worksheet Directions
1. Develop an evidence summary by following the grading criteria below.
2. Document this on the evidence summary portion of the worksheet.
3. You will use this worksheet to incorporate your evidence summary into your Week 4 Milestone 2 assignment.
4. Please type your answers directly into the worksheet.
systematic reviews in health care essay
THE CHOSEN REVIEW SYSTEM
Obstetrics/Delivery
McFadden, A., Gavine, A., Renfrew, M. J., Wade, A., Buchanan, P., Taylor, J. L., … MacGillivray, S. (2017). Support for healthy breastfeeding mothers with healthy term babies. Cochrane Database of Systematic Reviews, Issue 2. Art. No.: CD001141. doi:10.1002/14651858.CD001141.pub5
Abstract
Background
There is extensive evidence of important health risks for infants and mothers related to not breastfeeding. In 2003, the World Health Organization recommended that infants be breastfed exclusively until six months of age, with breastfeeding continuing as an important part of the infant’s diet until at least two years of age. However, current breastfeeding rates in many countries do not reflect this recommendation. Systematic reviews in health care essay.
Objectives
To describe forms of breastfeeding support which have been evaluated in controlled studies, the timing of the interventions and the settings in which they have been used.
To examine the effectiveness of different modes of offering similar supportive interventions (for example, whether the support offered was proactive or reactive, face-to-face or over the telephone), and whether interventions containing both antenatal and postnatal elements were more effective than those taking place in the postnatal period alone.
To examine the effectiveness of different care providers and (where information was available) training.
To explore the interaction between background breastfeeding rates and effectiveness of support. systematic reviews in health care essay.
Search methods
We searched Cochrane Pregnancy and Childbirth’s Trials Register (29 February 2016) and reference lists of retrieved studies. systematic reviews in health care essay.
Selection criteria
Randomised or quasi-randomised controlled trials comparing extra support for healthy breastfeeding mothers of healthy term babies with usual maternity care.
Data collection and analysis
Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. The quality of the evidence was assessed using the GRADE approach. Systematic reviews in health care essay.
Main results
This updated review includes 100 trials involving more than 83,246 mother-infant pairs of which 73 studies contribute data (58 individually-randomised trials and 15 cluster-randomised trials). We considered that the overall risk of bias of trials included in the review was mixed. Of the 31 new studies included in this update, 21 provided data for one or more of the primary outcomes. The total number of mother-infant pairs in the 73 studies that contributed data to this review is 74,656 (this total was 56,451 in the previous version of this review). The 73 studies were conducted in 29 countries. Results of the analyses continue to confirm that all forms of extra support analyzed together showed a decrease in cessation of ‘any breastfeeding’, which includes partial and exclusive breastfeeding (average risk ratio (RR) for stopping any breastfeeding before six months 0.91, 95% confidence interval (CI) 0.88 to 0.95; moderate-quality evidence, 51 studies) and for stopping breastfeeding before four to six weeks (average RR 0.87, 95% CI 0.80 to 0.95; moderate-quality evidence, 33 studies). All forms of extra support together also showed a decrease in cessation of exclusive breastfeeding at six months (average RR 0.88, 95% CI 0.85 to 0.92; moderate-quality evidence, 46 studies) and at four to six weeks (average RR 0.79, 95% CI 0.71 to 0.89; moderate quality, 32 studies). We downgraded evidence to moderate-quality due to very high heterogeneity. Systematic reviews in health care essay.
We investigated substantial heterogeneity for all four outcomes with subgroup analyses for the following covariates: who delivered care, type of support, timing of support, background breastfeeding rate and number of postnatal contacts. Covariates were not able to explain heterogeneity in general. Though the interaction tests were significant for some analyses, we advise caution in the interpretation of results for subgroups due to the heterogeneity. Extra support by both lay and professionals had a positive impact on breastfeeding outcomes. Several factors may have also improved results for women practising exclusive breastfeeding, such as interventions delivered with a face-to-face component, high background initiation rates of breastfeeding, lay support, and a specific schedule of four to eight contacts. However, because within-group heterogeneity remained high for all of these analyses, we advise caution when making specific conclusions based on subgroup results. We noted no evidence for subgroup differences for the any breastfeeding outcomes. Systematic reviews in health care essay.
Authors’ conclusions
When breastfeeding support is offered to women, the duration and exclusivity of breastfeeding is increased. Characteristics of effective support include: that it is offered as standard by trained personnel during antenatal or postnatal care, that it includes ongoing scheduled visits so that women can predict when support will be available, and that it is tailored to the setting and the needs of the population group. Support is likely to be more effective in settings with high initiation rates. Support may be offered either by professional or lay/peer supporters, or a combination of both. Strategies that rely mainly on face-to-face support are more likely to succeed with women practising exclusive breastfeeding. systematic reviews in health care essay.

Search the Internet for an article about a recent environmental disaster.
Consider the following questions as you read the article:

• How did human actions contribute to this disaster?
• Which biotic and abiotic factors were involved?
• How did the disaster affect the flow of materials and energy in the ecosystem

 
Review the Crash Course: Ecology videos on the Khan Academy website.
Consider the following questions as you watch the videos:https://www.khanacademy.org/science/biology/crash-course-bio-ecology

• How do biotic and abiotic environmental components interact, and how does this affect population growth and regulation?
• How have human activities affected ecosystems and the biosphere?
• How do energy and materials flow in an ecosystem?

Week 2 Assignment – Indications for Cardiopulmonary Exercise 
· Due Saturday by 11:59pm
 
· Points 120
· Submitting a file upload

Learning Objectives Covered

1. Explain the rationale for exercise conditioning and psychosocial support of patients with chronic pulmonary diseases

2. List and describe the indications for cardiopulmonary exercise testing for evaluation of hypoxemia and desaturation

3. Identify and interpret parameters measured during cardiopulmonary exercise testing

Background

Medical therapy is important in alleviating symptoms of chronic obstructive pulmonary disease (COPD), particularly the frightening symptom of dyspnea (breathing that is labored making it difficult). However, patients are still left to cope with the consequences of a chronic, irreversible condition. These individuals who are often: dyspneic, depressed, dysfunctional, disabled, desperate, and difficult to deal with often visit physician’s offices, emergency departments and hospitals in part because of their inability to cope with their distressing symptoms. Pulmonary rehabilitation programs must incorporate a program with physical and psychological components to assist the patient in returning to the highest level of independent function.

Psychological, emotional and social issues are common among patients with chronic lung disease as they struggle to deal with symptoms that are often poorly understood. Those diagnosed with chronic lung disease often experience depression, fear, anxiety, and dependency. Dyspnea is a frightening symptom! When experiencing dyspnea upon exertion, many patients prefer to reduce their exercise, which leads to more anxiety, which aggravates the dyspnea, and the patient becomes caught in a cycle. In extreme cases, the patient can become housebound.

Subsequent hospital visits follow patients who do not have social support. Therefore, when assessing a patient for cardiopulmonary rehabilitation we must include an assessment of the patient’s: psychological state, cognition, family and social support, activities of daily living and employment history. Identifying key support individuals is paramount. Many programs also measure baseline dyspnea and health-related quality of life at the time of enrollment and at the time of follow-up.

Common Goals of a Pulmonary Rehabilitation Program 

· Controls of respiratory infections

· Basic airway management

· Improvement of ventilation and cardiac status

· Improvement in ambulation and other types of physical activity

· Reduction of overall medical cost

· Reduction of hospitalization

· Psychosocial retaining and replacement

· Family education, counseling and support

· Patient education, counseling and support

Program Design Format

· Opened ended design-this format allows patients to enter the program and progress through until predetermined objectives are met. This format is best suited for self-directed patients or patients with scheduling difficulties. Major drawback is the lack of group support and involvement.

· Closed designed-this format is more traditional with a set time period to cover content of the program. A typical program run 6-16 weeks, with classes meeting 1-3 times a week. All sessions are formal and group support and involved are encouraged. A major drawback to this format is that the schedule and not objectives determines program completion.

Content

The program will combine physical reconditioning and educational content. The education portion of the program is necessary and an especially important part of the pulmonary rehabilitation program. There are twelve typical education topics for a program.

· Introduction and welcome

· Respiratory structure, function, and pathology*

· Breathing control methods*

· Relaxation and stress management

· Proper exercise techniques and personal routines*

· Methods to aid secretion clearance (bronchial hygiene)*

· Home oxygen and aerosol therapy*

· Medications

· Use of MDI’s and spacers*

· Dietary Guidelines

· Recreation and vocational counseling

· Planning for the future

The educational topics with an * are typically taught by a registered respiratory therapist.

Physical Reconditioning

The physical reconditioning will consist of an exercise prescription with a target heart rate based on the initial exercise evaluation. The prescription usually includes:

· Lower extremity (leg) aerobic exercises

· Time walking (6 or 12 minute walk)

· Upper extremity (arm) aerobic exercises

· Ventilator muscle training

Program Implementation

· Staffing-should be multidisciplinary involving various health care professionals involved in the planning, implementation, and evaluation of the program. It is recommended that staff members be certified in basic life support or advance cardiac life support.

· Facilities- the quality and location of the program is directly related to patient’s attendance. Patients are more likely to attend if they have access to public transportation and parking arrangement.

· Scheduling-timely scheduling of the session, usually three times a week for 1-2 hours. The length of the program is often projected by insurance coverage.

· Class size-the ideal size of a group should range from 3-10 participants.

Watch the video below on Pulmonary Rehabilitation and Exercise (Total time 38:17 minutes). This video will provide you with an understanding of how patients are instructed on exercise and fitness to promote a healthier life with pulmonary disorders.

https://www.youtube.com/watch?v=nwxy9FLBMjk (Links to an external site.)Links to an external site.
Prompt
Choose three of the asterisked rehabilitation education topics above. These topics are based on the information covered during a 12-week rehabilitation program as outlined in your reading. Based on the program outlined in your reading, explain how you would teach the information to a patient participating in the pulmonary rehabilitation program. Be creative!
Submit your answers in at least 500 words on a Word document. You must cite at least three references in APA format to defend and support your position.
Please proceed to the remaining item for week two when you are ready