Evidence-Based Practice Project Research Paper Example | Topics and Well Written Essays - 3750 words

Evidence-Based Practice Project - Research Paper Example The study found that the combination of blood glucose lowering and blood pressure medication slows the progression of microvascular complications. Similarly, the Turnbull (2009) meta-analysis study found that intensive glucose control leads to a reduced risk of major cardiovascular events, showing a reduction of 9% for major cardiovascular events. Advance Collaborative (2008) found that intensive blood glucose lowering with gliclazide and other drugs resulted in a reduced incidence of combined major macrovascular and microvascular events, as well as major microvascular events, because there also was a reduction of nephropathy. Still another study suggests that any kind of benefit attained by intensive lowering of blood glucose is lost after one year. The study conducted by Hollman et al. (2008) found that the patients who were assigned intensive glucose lowering were compared to patients who were assigned the standard treatment of dietary restriction. While the immediate results were that the intensive glucose lowering showed that the patients had a lower risk of microvascular complications then the patients with conventional dietary therapy, after one year, these advantages were lost. Introduction Patients with diabetes suffer from a variety of ailments. Among these ailments are microvascular and macrovascular diseases. Therefore, therapeutic intervention should be investigated to reduce the risks of a diabetic patient suffering from these ailments. One such intervention is aggressively lowering blood glucose levels through drugs such as glicazide. Therefore, this article will examine studies that are focused around the intervention of blood glucose lowering, and will examine whether this is an intervention that is positive for diabetic patients, with regards to lessening the risk of micro and macrovascular ailments. PICO Question In patients with Type II Diabetes Mellitus (P), what is the effect of intensively lowering the blood glucose (I) as compared with s tandard treatment (C) on the incidence of major macro- and microvascular outcomes (O)? Clinical Question Selection Criteria Inclusion Criteria 1. Journals and studies featuring patients who are who are subjected to either intensive glucose lowering or standard treatment. 2. The participants in these studies had either a microvascular or macrovascular cardiac event. 3. The journals were either randomized trials or meta-analyses. 4. Were published in peer reviewed journals. 5. Were reported in English. Exclusion Criteria 1. Journals that reported on either type I diabetes, juvenile diabetes or gestational diabetes. 2. Qualitative studies. 3. Studies that focused upon patients who were under the age of 18. Search Process The process began by looking for studies that had, as their focus, type II diabetes, intensive glucose lowering therapy verses traditional therapy and micro and macrovascular outcomes. These peer-reviewed journals were ones that were written in English. The data bases that were used were Pubmed, Psychosocial Instruments, British Nursing Index, Cumulative Index to Nursing and Allied Health Library, Psychosocial Instruments, Allied and Alternative Medicine and Sociofile. These databases were searched with the initial terms of type II diabetes, intensive glucose lowering therapy and micro and macrovascular cardiac. The articles were then narrowed down to studies that were randomized or studies which were

3three Case Study Example | Topics and Well Written Essays - 500 words

3three - Case Study Example The student has spelling mistakes and grammatical error in the written response. The error is as a result of mixture of Spanish language and English. She does not know how to differentiate the correct English word from other Spanish language. The other issue is oral presentation among the group’s members. She speaks English that is mixtures of different languages which her fellow students could not understand even the teacher. Sentence construction also was a problem. She does not follow the order, she starts from any word. The words are not in a logical sequence which disobeys the order of grammar and sentence construction. The instructional strategy that could be challenging to the student is group discussion. The student could not interact with other student because of her oral presentation. She could not comprehend and give meaning as she interacted with other class member. The student could not interact with other students because of the difficulty in language. Interaction involves communication between and among the students. If she could not speak fluent English, others could not understand her. Group discussion becomes lively and appreciative if the entire student can speak and understand each other. The student could express herself but not fully because of inadequate vocabularies among her friends. The group discussion a strategy toward the student could be adjusted in order to accommodate the students. Before involvement in the group, the student could be taken through English vocabularies and how to arrange the sentence that could be used to guide the students before the group discussion. Close interaction with other students would give the student another opportunity to learn new language. Intensified written work would help to support. Learning vocabularies, written presentation and close interaction would give the student the opportunity to learn new ideas and words that would help her in interacting with other students