Archive for category: My Nursing Writer

Department of Anthropology and Institute of Cognitive and Decision Sciences, University of Oregon,
Eugene, Oregon 97403
KEY WORDS healthcare; risk; pathology; human life history; evolution; mortality; Shiwiar

Implications of Health-Risk Buffering for the
Evolution of Human Life History
Lawrence S. Sugiyama*
Department of Anthropology and Institute of Cognitive and Decision Sciences, University of Oregon,
Eugene, Oregon 97403
KEY WORDS healthcare; risk; pathology; human life history; evolution; mortality; Shiwiar
ABSTRACT Human life history is distinguished by
long lifespan, delayed reproduction, intergenerational
asymmetric benefit transfers from adults to juveniles and
between adults, and a large brain able to engage in unprecedented
levels of learning, reasoning, and insight. The
evolution of these traits depends on relatively low human
mortality. Understanding why humans have low mortality
is therefore critical for understanding the evolution of
key human traits. One explanation is that the evolution of
food provisioning during periods of health crisis reduced
mortality. This hypothesis turns on health risk having
posed a significant adaptive problem that could be effectively
buffered by healthcare provisioning. Unfortunately,
the frequency, duration, and fitness effects of temporary
disability are difficult to estimate based on osteological
evidence alone, and systematic ethno-biological research
on these issues among extant small-scale societies with
little access to Western medical care is lacking. Here I
present data on 678 injuries and illnesses suffered by 40
Shiwiar forager-horticulturalists, based on physical evidence
and informant reports. A subsample of 17 individuals
provided data on incidence and duration of disability
for 215 pathological incidents. Results indicate that injury
and illness occur frequently across the lifespan. Most living
individuals have suffered temporarily disabling health
crises likely to have been lethal without provisioning. The
fitness effects of surviving these episodes are high, suggesting
that the Shiwiar population structure and lifeway
are dependent on infrequent extended provisioning to
temporarily disabled individuals, and that provisioning of
aid during healthcare crises effectively lowers mortality in
this small-scale society. Am J Phys Anthropol 123:
371–389, 2004. © 2004 Wiley-Liss, Inc.
Life-history theory examines how natural selection
produced age-related allocation of resources between
somatic (growth and maintenance) and reproductive
(fertility, mating, and parenting) effort (e.g.,
Charnov, 1993; Charnov and Schaffer, 1973;
Hawkes et al., 1997; Hill and Hurtado, 1996; Hill
and Kaplan, 1999; Kaplan et al., 2000; MacArthur
and Wilson, 1967; Schaffer, 1974; Williams, 1966).
Four distinctive features of human life-history traits
are long lifespan, delayed reproduction, intergenerational
and asymmetric benefit transfers from adults
to juveniles and between adults, and a large brain
able to engage in unprecedented levels of learning,
reasoning, and insight (e.g., Bryne, 1997; Geary and
Flinn, 2001; Hawkes et al., 1998, 2000; Hewlett,
1992; Hill, 2002; Hill et al., 2001; Hill and Hurtado,
1996; Hill and Kaplan, 1999; Kaplan et al., 2000;
Tooby and DeVore, 1987). The evolution of each of
these features is dependent on humans experiencing
relatively low mortality rates. Understanding why
humans experience low mortality may therefore
“hold the key for understanding a variety of evolved
human features and . . . the evolutionary history of
our species” (Hill and Kaplan, 1999, p. 413).
This study examines health insults and their consequences
among Shiwiar forager-horticulturalists

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You are asked to see a 20 year old woman who has white blood cells present in her urinalysis results. How would you determine whether she has cystitis or pyelonephritis?

Assignment Objectives: Identify and select appropriate interventions including diagnostic tests and nursing interventions. Analyze physiological and psychological responses to illness and treatment modalities

Purpose: Examine case studies related to renal and urologic systems and fluid and electrolytes. Answer the assigned questions. This assignment should help refine your clinical/critical thinking skills.

Assignment Description: Answer the questions in the grading criteria related to each of the patients provided. Your answer must follow APA 6th edition format. Submit the answer in the assignment area of your course. This assignment is worth 50 points.

Patient 1 – A 52 year old female patient with a long-standing history of COPD and heart failure is being seen for recent onset of headache, muscle cramps, bilateral lower extremity edema, and nervousness. She also reports a 5-day history of watery diarrhea. Her medications include diuretics and long-acting and short-acting beta-2 agonists. The results of a Basic Metabolic Profile (BMP) reveal abnormally low serum sodium, potassium, and chloride levels. Her anion gap is normal.

Describe the relationship of sodium and potassium in the ICF and ECF.
Identify the acid-base imbalances for which this patient is at risk and why she is at risk for them.
Define “anion gap” and the significance of the anion gap being normal in this patient.
Patient 2-You are asked to see a 20 year old woman who has white blood cells present in her urinalysis results. How would you determine whether she has cystitis or pyelonephritis?

Differentiate between cystitis and pyelonephritis. Consider history, possible presenting symptoms, and urinalysis results,.
Provide specific patient education for this patient regarding possible treatments and behaviors to prevent this condition in the future.

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Based on the specialty area and role that you selected in W1 Assignment 4 in a 3- to 5-page paper (excluding the title page references and appendices) create a scenario or case study to illustrate the type of organization you would expect to work in as this type of nursing professional.

Based on the specialty area and role that you selected in W1 Assignment 4 in a 3- to 5-page paper (excluding the title page references and appendices) create a scenario or case study to illustrate the type of organization you would expect to work in as this type of nursing professional. Include in the scenario or case study:
List the type of organization.
List the type of and how many clients it serves.
Identify the professional fit for advanced nursing role.
Implement your new nursing role in the organization.
Identify a board of nursing in your state (specifically the Nurse Practice Act) which would support your role in this type of organization.
Name your document: SU_NSG5000_W3A2_LastName_FirstInitial.doc.
Submit your document to the W3 Assignment 2 Dropbox by Tuesday November 10 2015.
Assignment 2 Grading Criteria
Maximum Points
Created a scenario or case study of the organization you expected to work in as the nursing professional.
20
Illustrated the type and number of clients of organization selected for the advanced practice role.
20
Implemented the fit for the chosen professional nursing role.
20
Identified your State Board of Nursing and referenced Nurse Practice Act which supports role implementation.
20
Used correct spelling grammar and professional vocabulary. Cited all sources using APA format.
20
Total:

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CALCULATE THE APPROPRIATE MEASURE OF ASSOCIATION AND STATE IN WORDS WHAT THIS NUMBER MEANS (ONE SENTENCE). SHOW CALCULATIONS. (6 PTS)

solve the following Which of the following is a measure of disease risk? (2 pts) A. Prevalence B. Median Survival Time C. Adjusted mortality rate D. Relative Risk (RR) E. Odds of Exposure

Questions 2 and 3 are based on the information below:

Incidence of Coronary Heart Disease (CHD) in Men, According to Initial Cholesterol Level, Followed Over a 10 Year Period (1985-1995) CHD incidence (per 1,000 men) Cholesterol level in 1985 (mg/dL) 300 40 80 140

2. The data in the above table have been obtained from a: (2 pts) A. Case-control study B. Cohort study C. Cross sectional study D. Ecological study E. Cannot be determined from these data

3. The relative risk (RR) of coronary heart disease for men in the highest cholesterol group compared to the lowest group is: (3 pts) A. 140 – 40 = 100 per 1,000 B. 40/140 = 0.29 C. 140/40 = 3.50 D. Cannot be determined from these data

4. If there were no association between an exposure and disease, one would expect the following: (2 pts) A. Relative risk = 1.0 ; Proportion attributable risk = 1.0 B. Relative risk < 1.0 ; Proportion attributable risk < 50% C. Relative risk > 1.1; Proportion attributable risk > 50% D. Relative risk = 1.0; Proportion attributable risk = 0%

5. When a new treatment is developed which prevents death but does not result in the recovery from a non-infectious disease, which of the following will occur? (3 pts) A. Incidence of the disease will decrease B. Prevalence of the disease will increase C. Prevalence of the disease will decrease D. Both the incidence and the prevalence of the disease will increase

6. From January 1988 until March 1990 a research group in New Zealand followed 2,607 infants from the day they were born. Mothers were asked, “What position does your baby usually sleep in?” Mothers of 830 infants reported that their baby slept prone (on its stomach). Among this group, there were 9 infant deaths from Sudden Infant Death Syndrome (SIDS). The remaining 1,777 mothers reported that their baby slept on its side or its back. Among this group, there were 6 deaths from SIDS.

a. What type of study is this? (2 pts)

b. Construct a 2 x 2 table for these data. (4 pts)

c. Calculate the appropriate measure of association and state in words what this number means (one sentence). Show calculations. (6 pts)

7. Are the following examples of incidence or prevalence? Please put your answers under each example. (2 pts each) a. “Rates [of pancreatic cancer] increase rapidly with age as seen in data from the United States, where the rates for patients ages 70–74 are about 57 per 100,000 per year compared to rates of 9.8 per 100,000 in patients age 50–54.” (Lowenfels and Maisonneuve, 2006, p. 200.)

b. “Nearly 5 million asthma sufferers are under age 18. It is the most common chronic childhood disease, affecting more than one child in 20.” (Morbidity and Mortality Weekly Report, NCHS, U.S. CDC, 2003.)

c. Over the past five years, 350 cases of over-worked graduate students have been diagnosed at Drexel University.

8. Match the appropriate sequence of data collection (1-3) with each study design listed below (i.e., for each study design, fill in 1, 2 or 3). (2 pts each)

1. Determine exposure status first, and then collect disease status information. 2. Determine disease status first, and then collect exposure history information. 3. Determine disease status and exposure status at the same point in time.

____ Cross-Sectional Study ____ Cohort Study ____ Case Control Study

9. Match the following strengths to the appropriate study design: (2 pts each) a. Investigation of multiple exposures ____ Case Series b. Investigation of new or emerging diseases ____ Cohort c. Investigator assigns exposure ____ Randomized Clinical Trials d. Ability to calculate incidence rates ____ Case-Control

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