EBT1_Task1
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EBT1_Task1

Course Number: NURSING EBT1_Task1, Winter 2013

College/University: Western Governors

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EBT1 TASK 1 1 Preventative Measures to Eliminate Childhood Obesity Evidence-Based Practice and Applied Nursing Research Melissa Noterman Western Governors University EBT1 TASK 1 2 A 1. The article I chose to critique in APA format: Power, T., Bindler, R., Goetz, S., & Daratha, K. (2010). Obesity prevention in early adolescence: student, parent, and teacher views. The Journal Of School Health, 80(1),...

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TASK EBT1 1 1 Preventative Measures to Eliminate Childhood Obesity Evidence-Based Practice and Applied Nursing Research Melissa Noterman Western Governors University EBT1 TASK 1 2 A 1. The article I chose to critique in APA format: Power, T., Bindler, R., Goetz, S., & Daratha, K. (2010). Obesity prevention in early adolescence: student, parent, and teacher views. The Journal Of School Health, 80(1), 13-19. A 2. This chart depicts how the five areas of a research report. Article Obesity Prevention in Early Adolescence: Student, Parent, and Teacher Views Background Information The authors purpose statement is that obesity causes significant health problems for youth and adolescences. This research is directly correlated in having significant health consequences as well as emotional and social setbacks. The authors of this article are very structured to the type of data and recipients that were in the controlled study. They set it up as structured to cause and effect of the choices adolescents make. Overall, this article presented factual evidence to make me care about the issue at hand. Review of Literature This article is current and thoroughly explains why this research was initially conducted and how healthy eating can be incorporated in schools. The literature presented was articulated well, thorough, and to the point. The authors reviewed past obesity rates that have almost doubled in the last 10 years. They cited over 30 articles to deduce their conclusion. The authors cited nutrition, food preference, and physical activity preference as evidence of the growing problem. Methodology The methodology for this study was quantitative. This type of research bases all preliminary qualities on words and concepts. It is descriptive in that the preliminary outcomes of childhood obesity is based on knowledge about parents, children, and teachers responses. They all ascribe to their actions as reactions to the food choices, parents blame on the children for being picky eaters and children blaming their parents for the bad food at home. Data Analysis The statistical analysis for this article tested the relationship between adolescent and their behavior with health, activity, preferences, and barriers regarding health and wellness. The tests are appropriate for conducting the concluding results. The Authors explained their analysis thoroughly enough to evaluate external validity of all external factors that affect health. EBT1 TASK 1 Conclusion 3 The conclusion of this article is that applicable implications be improved to help implement healthy eating. These includes longterm healthy eating choices, physical activity, education, and activities in school to promote healthy lifestyles. Barriers like food preference, availability, and responsibility to make good choices are also listed to serve as the basis where bad habits form. In all, childhood obesity can be prevented! A 3. Research that supports the conclusion Based on my analysis, the evidence presented in this research report is supported by multiple preventative strategies to prevent obesity among young adolescents. The implications of the findings propose a program integrated in promoting healthy lifestyles at home and in school. The researchers deduce that nutrition and physical activity are key interventions. There are many credible explanations for childhood obesity. For instance, physical activity or inactivity, dietary habits, preferences and barriers are all probable data regarding health. Teachers and schools also play a key role in healthy choices. It is importance to educate young adolescents regarding wholesome nutritious natural foods. There are no other plausible explanations other than genetics. If obesity runs in the family, preventative measures should be taken early. This will in fact lower obesity rates and improve health and wellness. A 4. Ethical issues Research reveals that family roles, school interaction, and healthy eating choices all play a role in influencing a childs physical activity and diet. Ethical concerns address parents interventions regarding letting their child choose what he or she wishes to eat and how much television/internet activity or screen time they allow their child to spend each day. Not only are parents suppose to be role models to their children, but often time they are putting into early practice of their childrens future eating styles. If parents EBT1 TASK 1 are prone to eating and buying junk food, then children are even more prone to adapt to their parents habits and make poor decisions regarding their health. Inadvertently, if parents are buying only healthy food, children make early habits on eating good nutritional foods. Another ethical implication is how much a school can be held responsible for healthy eating and physical activity. School lunches should very well be nutritious and delicious, but not promoting bad food such as soda, chips, and nutritionally dense foods like hamburgers, hotdogs, and macaroni and cheese lunches. Physical activity is incorporated into school curriculum, but perhaps more emphasis on extra curricular activities like sports, music, or art would help lower the rates of childhood obesity. Not mentioned in the article are legal aspects of child abuse. Can under serving or, in this case, over serving children be considered an abuse or neglect to obesity? Some childhood advocates believe it is the parents responsibility to do no harm and prevent childhood obesity by paying more attention to their childs eating habits and spending more time doing physical activities together. The names of the study participants were kept out of the study so that confidentiality is kept and the sole purpose of research is conducted. A 5. Research type The type of research used for this study was qualitative. Qualitative analyses revealed that early adolescents had a good understanding of the relationship between their behavior and their health, although they had a limited understanding of what constitutes healthy eating (Power, Bindler, Goetz, & Daratha, 2010, p 13). It is grounded on descriptive research to base all preliminary qualities on words and concepts. Qualitative research is grounded in the belief that reality can never be 4 EBT1 TASK 1 5 completely known because it is constructed by each individual. Attempts to measure reality are limited to methods that are focused on defining variables and finding manifestations of them (Houser, 2007, p 475). It is a method that focuses completely on human experience and cause and effect. The cause and effect of childhood obesity will serve as valuable understanding for future reference of eating healthy in schools around the nation. Other types of research that would have been appropriate for one aspect of this article is quantitative research in the focus of how many students were obese out of the test subjects. It would be based on numbers to produce evidence of rising childhood obesity. Another way to study childhood obesity is to make a log or journal of all the foods eaten each day and list the activity as well. This would generate a different type of study to show evidence of poor food choice and amount of food eaten versus the recommended daily amounts and types based on the food pyramid. B 1. Problem Statement: During the last several years, childhood obesity has skyrocketed to an all time high and has become a serious public health problem nationwide. More recently, the 20072008 NHANES revealed that 31.7% of 2- to 19-year-old U.S. children are at or have exceeded the 85th percentile for body mass index (BMI) based on age and sex, with 11.9% of these children meeting or exceeding the 97th percentile for BMI by age (Long, Mareno, Shabo, & Wilson 2012). Interventions to combat childhood obesity need to be set at an early age and emphasize how to maintain a healthy weight. This study is crucial because overweight children tend to be overweight or obese adults. Identified risk factors include: coronary heart disease, colon cancer, sleep apnea, Type II EBT1 TASK 1 6 diabetes, asthma, high blood pressure, osteoarthritis, and many other conditions. Its important to start educating children early about healthy eating, diet and exercise. If early educational interventions can be started in schools it can effective reduce or eliminate childhood obesity. In addition, children will be more knowledgeable about obesity risk factors and healthy lifestyles to prevent the increasing obesity problem. B 2. See attached EBT1 Matrix.pdf B 3 a. Annotated Bibliography Ben-Sefer, E. E., Ben-Natan, M. M., & Ehrenfeld, M. M. (2009). Childhood obesity: current literature, policy and implications for practice. International Nursing Review, 56(2), 166-173. doi:10.1111/j.1466-7657.2008.00708.x. Pertinent data is gathered within the last 10 years to support childhood obesity being a global problem. Ben-Sefer, Ben-Natan, & Ehrenfeld deduce that obesity in children specifically lead to cardiovascular disease, Type II diabetes, asthma, hypertension, musculoskeletal discomfort and many other conditions as well. Nurses need to be advocates for health and wellness and should take part in addressing this problem. This article is a Scholarly (Peer Reviewed) journal. This is a great academic source of research-based information because over 40 detailed references are cited from several countries. The multiple references the authors use increase the credibility of their reported data and the credibility on this topic. The authors all have Doctorates in Nursing. This article will be used in the research of this paper to best discuss health consequences of childhood obesity and nursing implications. The fact that most countries are involved EBT1 TASK 1 7 in this study make this article more valuable as a whole, and not just childhood obesity in America. Epstein, S., Geniteau, E., Christin, P., Hermouet, P., Mok, E., Fournier, J., & Hankard, R. (2010). Role of a clinical nurse specialist within a paediatric multidisciplinary weight-management programme team. Journal Of Clinical Nursing, 19(17/18), 2649-2651. doi:10.1111/j.1365-2702.2010.03296.x. The authors focus on nursing diagnoses to effectively provide weight management programs for children and adolescents throughout specified appointments. Emphasis on initial assessments was key to developing a nursing care strategy. This article is a Scholarly (Peer Reviewed) journal. It is also an acceptable academic source of research-based information because a nursing process encompasses multidisciplinary follow up. The authors have few references, but they are also limited to this new concept of a nurses mission against obesity. The authors do not reveal their titles or scholarships. This article will be used in the research of this paper to incorporate nursing intervention programs for obese adolescents even though it is very limited in research and information; it merely suggests weightless programs as the only solution to weight management. Harrington, J. W., Nguyen, V. Q., Paulson, J. F., Garland, R., Pasquinelli, L., & Lewis, D. (2010). Identifying the "Tipping Point" Age for Overweight Pediatric Patients. Clinical Pediatrics, 49(7), 638-643. doi:10.1177/0009922809359418. This study indicates that the crucial period for avoid childhood obesity is before age 2. The authors conclusive date averaged that observed EBT1 TASK 1 8 subjects with documented onset began at 22 month of age with a Basic Metabolic Index (BMI) equal to or above the 85 th percentile. This article is a Scholarly (Peer Reviewed) journal. This is a superior academic source of research-based information because the authors use over 30 comprehensive references from extremely credible sources. Center for Disease Control and Prevention is just one of the opening sources used in the research to allocate a leading government agency aimed at addressing public health issues like childhood obesity. The excellent statistics in this article will enhance the research of this paper. Hopkins, K. F., DeCristofaro, C., & Elliott, L. (2011). How can primary care providers manage pediatric obesity in the real world?. Journal Of The American Academy Of Nurse Practitioners, 23(6), 278-288. doi:10.1111/j.1745-7599.2011.00614.x. Select treatment options can be grouped by initial screening of children and young adolescents for optimal health. Lifestyle interventions include: diet and activity level, maintaining a healthy BMI, and successful involvement of family. People with extreme obesity have pharmacological options as well as surgical as well. This article is a Scholarly (Peer Reviewed) journal and is an exceptional academic source of researchbased information because the authors include barriers, risk factors, and comorbidities to delayed diagnosis and prevention. The authors of this article either have a Masters in Nursing degree, Nurse Practitioner, or MD and some of which are professors. This article has extremely credible sources like the WHO and the CDC as the top government sights to EBT1 TASK 1 9 advance the credibility of their research. This article had such great points to consider like Medicare not reimbursing Pediatricians before 2004 because obesity was not considered an illness. Also, that awareness and advocacy are effective preventative treatments. Long, J. M., Mareno, N., Shabo, R., & Wilson, A. H. (2012). Overweight and obesity among White, Black, and Mexican American children: Implications for when to intervene. Journal For Specialists In Pediatric Nursing, 17(1), 41-50. doi:10.1111/j.1744-6155.2011.00309.x. Public health and community nurses work to be educators and collaborators because they affect policy to target age groups, racial groups, and gender specific. Nurses can facilitate resources to preventing overweight and obesity by developing interventions to benefit children at an early age. This article is a Scholarly (Peer Reviewed) journal and a suitable academic source of research-based information because the authors help compare my analysis that certain races have a higher risk for obesity. This article has a bundle of credible sources like the CDC government and Healthy People 2010 websites being the best for credibility and research. The authors of this article all have their Doctorate in Nursing. This article will be used in the research paper because it implements why this information would affect nursing practice and it takes into account different racial backgrounds for obesity trends. Also, its important to stay culturally sensitive to different ethnicities and religious practices. EBT1 TASK 1 10 Poon, M., & Tarrant, M. (2009). Obesity: attitudes of undergraduate student nurses and registered nurses. Journal Of Clinical Nursing, 18(16), 2355-2365. doi:10.1111/j. 13652702.2008.02709.x. This article shows the negative affects nurses and patients have on obesity, including self-image, confidence, endurance, and shape. The article deduces that RNs commonly perceives negative outlook on obese people than student RNs because of their experience in the field of them being a strain. The variables are categorized on a fat-phobia scale of 1-5 and a survey of attitudes toward obese adult patients from strongly agrees or disagrees. This article is a Scholarly (Peer Reviewed) journal and is an interesting academic source of research-based information in that obesity doesnt only affect the patient it also affects the staff as well. This article is unique in my paper to include the adverse effects on staff for caring for obese patients- adult or child. This article also carries multiple references the authors use to increase the credibility of their reported data. One author is a Registered Nurse with a Masters degree and the other is a Registered Nurse with a PhD in Nursing. Power, T. G., Bindler, R. C., Goetz, S., & Daratha, K. B. (2010). Obesity Prevention in Early Adolescence: Student, Parent, and Teacher Journal Views. Of School Health, 80(1), 13-19. doi:10.1111/j.1746-1561.2009.00461.x. Discusses the health consequences of childhood obesity and the correlation between behavior and health. Multiple barriers preventing engagement in physical exercise and healthy eating is being blamed on EBT1 TASK 1 11 parents being poor role models and that schools should offer more healthy choices of foods for snacks and lunches. This article is a Scholarly (Peer Reviewed) journal and a good academic source of research-based information to show early adolescents need to be consistently reinforced to lead healthy lifestyle choices. This article is helpful in my paper to include healthy eating and activity patterns for children and young adolescents. This article also carries multiple references of data used for school health. Three out of the four authors have a PhD in Nursing; the other has a Bachelors degree in Science. Skinner, A., Perrin, E. M., & Steiner, M. J. (2010). Healthy for Now? A Cross-Sectional Study of the Comorbidities in Obese Preschool Children in the United States. Clinical Pediatrics, 49(7), 648-655. doi:10.1177/0009922810362098. Authors prove that counseling the parents of overweight children is more effective when given immediate health problems results like asthma, headaches, or increased healthcare costs. Limitations on activity may be a trajectory of worsening overall health. This article is a Scholarly (Peer Reviewed) journal and a great academic source of research-based information to incorporate statistics of direct weight related health conditions. This article is helpful in my paper because healthcare professionals need to help overweight children as son as possible and encourage them to be active. This article carries over 30 references used for clinical Pediatric research. The authors have Doctorate and Masters degrees. EBT1 TASK 1 12 Steele, R. G., Wu, Y. P., Jensen, C. D., Pankey, S., Davis, A. M., & Aylward, B. S. (2011). School Nurses' Perceived Barriers to Discussing Weight With Children and Their Families: A Qualitative Approach. Journal Of School Health, 81(3), 128-137. doi:10.1111/j.1746-1561.2010.00571.x. The authors elaborate how difficult communication can be with families about weight in relation to health. Family orientation, child fear and drive, and trouble establishing communication with children are all considered to be barriers, but nurses can allocate treatment programs or community resources available for outreach. This article is a sufficient reference of research-based information because over 30 different sources are used from several different states. Most of the authors have Doctorates. The number of references the authors cite only enhances the credibility of the final presentation. This article will be used in the research paper for its new generation of problems nurses face having to address this global problem. Also, the reference list has valid source of credible articles about this topic. The article also helps nurses address acceptable weight in light of body size. Walker, O., Strong, M., Atchinson, R., Saunders, J., & Abbott, J. (2007). A qualitative study of primary care clinicians' views of treating childhood obesity. BMC Family Practice, 81-7. Provides a focused perspective on clinicians view for treating childhood obesity without upsetting the child or family. The overall Doctor-Patient relationship may be negatively jeopardized if a family approach isnt EBT1 TASK 1 13 initiated. Studies in this article show that obesity is a social issue at home and that clinicians should not manage the problem, but bring it to their attention. This article is a Scholarly (Peer Reviewed) journal and it is an excellent academic source of research-based information to help prove my research in that childhood obesity is hard to treat, but easier to prevent. This article also has multiple references to back up credibility and thoroughness of the research this topic entails. The authors do not list their scholarly titles, but one email is addressed to doctors.org.uk which give rise to that author may be a Medical Doctor in the UK. This article will definitely be used in the research of this paper to best discuss global health consequences of childhood obesity and that the family is primary responsible for finding a solution to the problem. The fact that this article was published in 2007 only make it an early review of what was to come in 2012 and 2013s pandemic of childhood obesity. B 3 b. Researchers present a case The researchers made an efficient and effective case for me as a user of their evidence. The best way to treat childhood obesity and morbidity is to prevent it. Higher healthcare costs are associated with overweight children along with having many negative effects on their health. Positive reinforcement is crucial to keep and build relationships with collaborating healthcare professionals. Negative behavior towards obesity can be detrimental to the healing process and lose communication with patient relationships. As a group, the 10 articles researched make a case for me to take their study recommendations and approaches into my practice starting now. This means that EBT1 TASK 1 14 information in my paper will help develop preventative care for future patients and for nurses while implementing evidence-based practice. Most of my research methodologies are quantitatively designed to include quantified characteristics like age, gender, race, eating habits, exercise, and sedentary lifestyle. This descriptive design allows me to gather sufficient evidence that may contribute to the prevalence of childhood obesity. B 3 c. Researchers tools The majority of the researchers all used similar survey tools to gather feedback and conduct sample studies to assess student knowledge and gather feedback. The surveys had specific questions for each field of questions. Several verified survey instruments are indicated in certain journals. Most researchers emphasized age, gender, and strict BMI measurements using the formula height in meters divided by weight in kilograms. These values were then compared to gender-specific and agespecific growth charts to determine percentile. The tools used to measure the variables were innovative research, surveys, and use of resources. Focus groups were also conducted in some research articles to deduce by question and answer format. A different instrument used in Epstein et. al research was the Marjorie Gordons nursing diagnostic procedure at the first visit of the weight-management program. This method of nursing diagnosis focuses on the patient rather than on the disease. The assessment performed as a semi-directive interview including 11 fields of questions (Epstein et. al 2010). Tools that should be emphasized more in healthcare in terms of obesity should be critical pathways and protocols for a standard care plan. B 3 d. Tools that cold have affected results EBT1 TASK 1 15 Tools that could have affected results are small sample sizes and misinformation. Small sample sized data can illegitimately prove an inaccurate result. Misinformation can inaccurately measure false results. I believe that BMI calculations are proven to be accurate and a standard in healthcare to measure accurate weight to height ratio. However, it does not measure health. For example, anyone that has lost a significant amount of weight knows that their internal organ may still feel the effects of excess plaque build up in arteries leading to arthrosclerosis- a condition known for being obese. Less accurate tools can be question and check mark answer surveys because they are already made up of appropriate responses. Sometimes none will apply forcing an inaccurately answered question. B 4. Synthesis Research suggests that childhood obesity is preventative. The sudden increase in childhood obesity has become a significant healthcare concern and a global epidemic. The increasing prevalence of overweight children and young adults has drawn negative effects on their health along with several risk factors associated with being overweight. Preventative measures have to be initiated by all medical professionals, not just Nurses to make a difference. Ben-Sefer et. al, Hopkins et. al, Skinner et. al, and all conclude that diet, healthy eating, and exercise all contribute to an overall healthy lifestyle pattern that must start at an early age. Parents should also be included to help maintain an active lifestyle for their children. Evidence based practice concludes that diet, healthy eating, and exercise all contribute to healthy weight maintenance and overall healthy lifestyles, even in comparison to some medication trials. Ben-Sefer et. al, Steele et. al, Power et. al, and Long et. al all similarly believe EBT1 TASK 1 16 that a nurse has the primary role in the community to serve as advocates, role models, and educators for children and their families while communicating expectations for weight-related health development. Young adolescents would consistently be reinforced with the same message that could improve health by implementing school strategies to combat obesity not only at school, but at home as well. On the contrary, Epstein et. al deduce childhood obesity would benefit from an approach driven by ongoing nursing diagnoses (Epstein et. al 2010) and Harrington et. al recommends that health care providers begin screening for excessive weight gain as early as possible Harrington et. al 2010). The UK study by Walker et. al concludes that GPs and practice nurses role in obesity management is centered upon only raising the issue and that childhood obesity is the familys responsibility (Walker et. al 2007). From a purely scientific view, these studies prove that more ongoing research is coming into effect from the correlation of obesity to major health diseases and mortality. The effects of overweight children are they will most likely have shorter life spans than their parents, will have low self-esteem, and a dissatisfied body image, or more importantly, acquire a medical condition like Type II Diabetes. The data used to carry out this study was apparent and to the point. The statistics reflect dramatic confirmation that new and upcoming ideas are already in works to fight the global epidemic of childhood obesity. The most important key criteria I found that influenced my belief was revising how healthcare professions view childhood obesity as a medical problem may significantly reduce pounds and facilitate losing more weight. Ultimately, all of my references are well documented and include examples of how influencing factors affect change. Perhaps those whose families work together to overcome their weight battles EBT1 TASK 1 17 would lower their chances of gaining excess weight and make healthier lifestyle changes. This is important because weight gain and weight loss can directly or indirectly affect others. This type of research informs individuals, assess past and current practices to successfully generate change. B 5. Recommended strategies Based on the evidence in my research, I recommend using preventative measure to fight against childhood obesity. Because treatment has not been proven to be effective for the most part, it follows that nurses, along with all health professionals, have a stake in the prevention of childhood obesity (Ben-Sefer et. al, pg172, 2009). However, parents should not wait until their child becomes noticeably large to seek medical advice. Healthcare professionals should all collaborate at each visit to ensure children eat healthy and remain as active as possible. Encourage eating fresh foods and vegetables versus canned or preserved goods will help parents and children think alike. Behavior modification focusing on lifestyle changes in regard to diet, physical activity, and sedentary behavior is successful for both initial weight loss and maintenance, even in comparison to some medication trials ( Hopkins et. al, pg 285, 2011). I would physically change my practice to incorporate preventative health by maintaining a healthy active lifestyle. Before, Pediatricians and nurses were only diagnosing obesity or morbid obesity. With early interventions, we can prevent children from becoming overweight. Obesity can be preventative! B 6. Theoretical model Theoretical model for nursing research is very important because it will help analyze, evaluate, and explain interrelated concepts for new and emerging nursing EBT1 TASK 1 18 applications. Researchers are able to investigate concept and relationships to essentially build a framework of problem solving. Theory influences research to prove a point. It is not a proven fact yet, just a way to understand reality. Therefore, theories are clinically tested to be either not an accepted practice or evidence-based practice proven, but can never be 100% completely proven. Thus, theories become ongoing tests that are used in nursing research studies. Nursing theory is the final product of hypothesized statements. It is considered very valuable to both hospitals and their patients because the tested research is used as a guide to exceptional holistic care. The point of nursing theories is to factually build a problem statement with provided concept maps and a guided solution. References Ben-Sefer, E. E., Ben-Natan, M. M., & Ehrenfeld, M. M. (2009). Childhood obesity: current literature, policy and implications for practice. International Nursing EBT1 TASK 1 19 Review, 56(2), 166-173. doi:10.1111/j.1466-7657.2008.00708.x. Epstein, S., Geniteau, E., Christin, P., Hermouet, P., Mok, E., Fournier, J., & Hankard, R. (2010). Role of a clinical nurse specialist within a paediatric multidisciplinary weight-management programme team. Journal Of Clinical Nursing, 19(17/18), 2649-2651. doi:10.1111/j.1365-2702.2010.03296.x. Harrington, J. W., Nguyen, V. Q., Paulson, J. F., Garland, R., Pasquinelli, L., & Lewis, D. (2010). Identifying the "Tipping Point" Age for Overweight Pediatric Patients. Clinical Pediatrics, 49(7), 638-643. doi:10.1177/0009922809359418. Hopkins, K. F., DeCristofaro, C., & Elliott, L. (2011). How can primary care providers manage pediatric obesity in the real world?. Journal Of The American Academy Of Nurse Practitioners, 23(6), 278-288. doi:10.1111/j.1745-7599.2011.00614.x. Houser, Janet (8/17/2007). Nursing Research: Reading, Using, and Creating Evidence [1] (VitalSource Bookshelf), Retrieved from http://online.vitalsource.com/books/9781284024234/id/ch17lev1sec1 . Long, J. M., Mareno, N., Shabo, R., & Wilson, A. H. (2012). Overweight and obesity among White, Black, and Mexican American children: Implications for when to intervene. Journal For Specialists In Pediatric Nursing, 17(1), 41-50. doi:10.1111/j.1744-6155.2011.00309.x. Poon, M., & Tarrant, M. (2009). Obesity: attitudes of undergraduate student nurses and registered nurses. Journal Of Clinical Nursing, 18(16), 2355-2365. doi:10.1111/j.1365-2702.2008.02709.x. Power, T. G., Bindler, R. C., Goetz, S., & Daratha, K. B. (2010). Obesity Prevention in Early Adolescence: Student, Parent, and Teacher Views. Journal Of School EBT1 TASK 1 20 Health, 80(1), 13-19. doi:10.1111/j.1746-1561.2009.00461.x. Skinner, A., Perrin, E. M., & Steiner, M. J. (2010). Healthy for Now? A Cross-Sectional Study of the Comorbidities in Obese Preschool Children in the United States. Clinical Pediatrics, 49(7), 648-655. doi:10.1177/0009922810362098. Steele, R. G., Wu, Y. P., Jensen, C. D., Pankey, S., Davis, A. M., & Aylward, B. S. (2011). School Nurses' Perceived Barriers to Discussing Weight With Children and Their Families: A Qualitative Approach. Journal Of School Health, 81(3), 128-137. doi:10.1111/j.1746-1561.2010.00571.x. Walker, O., Strong, M., Atchinson, R., Saunders, J., & Abbott, J. (2007). A qualitative study of primary care clinicians' views of treating childhood obesity. BMC Family Practice, 81-7.

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1EBT1 TASK 3724.8.3-06, 8.4-01-05Evidence-Based Practice and Applied Nursing ResearchMelissa NotermanWestern Governors University2A. Perioperative procedure:Prevention of Deep Vein Thrombosis (DVT) before and after surgeryA1. Procedure changeThe
Western Governors - NURSING - EBT1 MATRI
EBT1 TASK 11Primary Research MatrixEBT Task 724.8.1-01-06, 8.2-01-06Melissa NotermanWestern Governors UniversityEBT1 TASK 12Author(s)SourceDateyearResearchTypePopulation/sample size(Power,Bindler,Goetz, &Daratha2010)AcademicSearchCo
Western Governors - NURSING - GPT 1
1GPT TASK 3GPT Task 3Community Health PracticeMelissa NotermanWestern Governors University2A. Severe Acute Respiratory Syndrome (SARS)Severe Acute Respiratory Syndrome, also known as SARS, is an airborne viraldisease that was a global epidemic mo
Western Governors - NURSING - GPT 1
1GPT TASK 4GPT Task 4Community Health PracticeMelissa NotermanWestern Governors University2A. Role of the public health personnelThe role of public health personnel is very important in disasters andcommunity bereavement because they are responsi
Western Governors - NURSING - GPT 1
1 GPT TASK 4GPT Task 4Community Health PracticeMelissa NotermanWestern Governors UniversityGPT TASK 42 A. Role of the public health personnelThe role of public health personnel is very important in disasters andcommunity bereavement because th
Western Governors - NURSING - GPT 1
1GPT1 TASK 1GPT1 Task1Community Health PracticeMelissa NotermanWestern Governors University2A 1. Riverside County communityRiverside County is one of the biggest counties in California also known as partof the Inland Empire. It has approximately
Western Governors - NURSING - KOT
KOT111KOT Task 2Melissa NotermanWestern Governors UniversityKOT121Medicare health insurance is a government plan for people 65 years or older.Some people whom are under the age of 65 may also be covered if they qualify fromcertain disabilities.
Western Governors - NURSING - KOT
KOT111RKOT Task 1Melissa NotermanWestern Governors UniversityKOT121Being a leader is an outward expression that comes from within and it isexpressed in the workplace and with the well being of patient care. Dr. Nancy Huberexplained that Being a
Western Governors - NUT - 1
724.4.2-01-05 TASK 21NUT1Melissa NotermanWestern Governors University1724.4.2-01-05 TASK 212Nursing involvement makes a huge contribution to health care as a whole for vitalinput. As part of a multidisciplinary team of a 100-bed community hospit
Western Governors - NUT - 1
724.4.2-01-05 TASK 21NUT1Melissa NotermanWestern Governors University1724.4.2-01-05 TASK 212Nursing involvement makes a huge contribution to health care as a whole for vitalinput. As part of a multidisciplinary team of a 100-bed community hospit
Western Governors - NURSING - NVT2 Task
CHRONIC CARE NVT2 INTERVIEW11NVT2 Task 724.7.1-02, 04, 7.2-06, 08, 7.4-01-08Melissa NotermanWestern Governors UniversityCHRONIC CARE NVT2 INTERVIEW21Nurses are required to deliver the most up-to date current research to support anddeliver the hi
Western Governors - NURSING - NVT2 Task
CHRONIC CARE NVT211NVT2 Task 3Melissa NotermanWestern Governors UniversityCHRONIC CARE NVT221Delegation is a unique skill nurses are able to utilize everyday. It requiresauthority, clinical judgment, responsibility, and accountability for all pa
Western Governors - NURSING - QRST1
CAN ORGAN DONATION MEET SUPPLY AND DEMAND?Can Organ Donation Meet Supply and Demand?QBT1Andrew WagnerWestern Governors University1CAN ORGAN DONATION MEET SUPPLY AND DEMAND?2In about the time it takes to almost read this paper another citizen in th
LSU - ACCT - 4221
CHAPTER 1-UNDERSTANDING AND WORKING WITH THE FEDERAL TAXCHAPTER 1-UNDERSTANDING AND WORKINGWITH THE FEDERAL TAX LAWLAWStudent: _1. A major, but not the sole, objective of the tax laws is to raise revenue.True False2. Revenue neutrality means that a
LSU - ACCT - 4221
CHAPTER 2-CORPORATIONS: INTRODUCTION ANDOPERATING RULESStudent: _1. Tomas owns a sole proprietorship, and Lucy is the sole shareholder of a C corporation. In the current yearboth businesses make a net profit of $60,000. Neither business distributes an
LSU - ACCT - 4221
CHAPTER 3-CORPORATIONS: SPECIAL SITUATIONSCHAPTER 3-CORPORATIONS: SPECIAL SITUATIONSStudent: _1. The ACE adjustment applies to business entities other than corporations.True False2. The penalty taxes of 531 and 541 apply to S corporations as well as
LSU - ACCT - 4221
CHAPTER4-CORPORATIONS: ORGANIZATION AND CAPITALSTRUCTURECHAPTER 4-CORPORATIONS: ORGANIZATION AND CAPITAL STRUCTUREStudent: _1. Section 351 (which permits transfers to controlled corporations to be tax deferred) can be justified under thewherewithal
LSU - ACCT - 4221
CHAPTER 6-CORPORATIONS: REDEMPTIONS AND LIQUIDATIONSCHAPTER 6-CORPORATIONS: REDEMPTIONS AND LIQUIDATIONSStudent: _1. The Code treats corporate distributions that are a return of a shareholders investment as sales or exchangesand corporate distribution
LSU - ACCT - 4221
CHAPTER 7-CORPORATIONS: REORGANIZATIONSCHAPTER 7-CORPORATIONS: REORGANIZATIONSStudent: _1. The Federal income tax treatment of a corporate restructuring is an extension of allowing entities to formwithout taxation.True False2. Obtaining a positive l
LSU - ACCT - 4221
CHAPTER 8-CONSOLIDATED TAX RETURNSCHAPTER 8-CONSOLIDATED TAX RETURNSStudent: _1. Business reasons, and not tax incentives, constitute the primary motivation for most corporations to form aconglomerate and file tax and financial accounting reports on a
LSU - ACCT - 4221
CHAPTER 12-S CORPORATIONSCHAPTER 12-S CORPORATIONSStudent: _1. Net operating losses incurred before an S election do not flow through to the shareholders once the election isin effect.True False2. For Federal income tax purposes, taxation of S corpo
LSU - ACCT - 4221
CHAPTER 13-COMPARATIVE FORMS OF DOING BUSINESSCHAPTER 13-COMPARATIVE FORMS OF DOING BUSINESSStudent: _1. A business entity is not always taxed the same way as its legal form.True False2. Daniel, who is single, estimates that the profits of his busine
LSU - ACCT - 4221
CHAPTER 14-TAXESON THE FINANCIAL STATEMENTSCHAPTER 14-TAXES ON THE FINANCIAL STATEMENTSStudent: _1. If a corporation has no subsidiaries outside the U.S., its book and taxable income are identical.True False2. Only U.S. corporations are included in
LSU - ACCT - 4221
CHAPTER 15-EXEMPT ENTITIESCHAPTER 15-EXEMPT ENTITIESStudent: _1. A church is one of the types of exempt organizations.True False2. While the major objective of the Federal income tax law is to raise revenue, social considerations andeconomic objecti
LSU - ACCT - 4221
CHAPTER 16-MULTISTATE CORPORATE TAXATIONCHAPTER 16-MULTISTATE CORPORATE TAXATIONStudent: _1. Roughly five percent of all taxes paid by businesses in the U.S. are to state, local, and municipaljurisdictions.True False2. Usually a business chooses a l
LSU - ACCT - 4221
CHAPTER 17-TAX PRACTICE AND ETHICSCHAPTER 17-TAX PRACTICEAND ETHICSStudent: _1. The tax professional can do more than just tax compliance work. He or she can work with the client inconsultation over the strategy and tactics of dealing with a Federal
LSU - ACCT - 4221
CHAPTER 18-THEFEDERAL GIFT AND ESTATE TAXESCHAPTER 18-THE FEDERAL GIFT AND ESTATE TAXESStudent: _1. Sometimes also known as transaction taxes, Federal gift and estate taxes are excise taxes.True False2. A lifetime transfer that is supported by full
LSU - ACCT - 4221
CHAPTER 19-FAMILY TAX PLANNINGCHAPTER 19-FAMILY TAXPLANNINGStudent: _1. One of the objectives of family tax planning is to minimize income taxes on transfers of property within thefamily unit.True False2. In arriving at the valuation of assets for
LSU - ACCT - 4221
CHAPTER 20-INCOME TAXATION OF TRUSTS AND ESTATESCHAPTER 20-INCOME TAXATION OF TRUSTS AND ESTATESStudent: _1. Tax planning motivations usually are secondary to other objectives in deciding whether to create a trust.True False2. A trust might be used b
LSU - ACCT - 4221
1. The forensic accounting field is broader than fraud auditing.*a. Trueb. False2. Forensic accountant qualifications work together to support eachother like a four-layered wedding cake.a. True*b. False3. A forensic accountant can normally assume t
LSU - ACCT - 4221
1. President George W. Bush established the Corporate Fraud Task Forcewithin the Department of Justice.*a. Trueb. False2. Transparency is one of the nine qualities and characteristics thatmake financial information useful for investors and creditors
LSU - ACCT - 4221
1. Prior to Enron, auditors cut costs by reducing the labor-intensiveprocess of reviewing millions of transactions and hundreds of corporateaccounts.*a. Trueb. False2. One of the two fieldwork stages of gathering audit evidence is theaccount balance
LSU - ACCT - 4221
1. Misappropriation of assets means obtaining something of value oravoiding an obligation by deception.*a. Trueb. False2. The most common method of detecting occupational fraud is byinternal auditors.a. True*b. False3. The second most common metho
LSU - ACCT - 4221
1. Elmer Irey, a special agent of the IRS, developed a strategy to helpindict Al Capone.*a. Trueb. False2. In civil disputes, district attorneys may obtain tax records inorder to indirectly calculate income.*a. Trueb. False3. A forensic accountant
LSU - ACCT - 4221
1. The Treasury Department is the U.S. government agency charged withenforcing the most specific statutes against money laundering in theUnited States.*a. Trueb. False2. Correspondent banks allow citizens from all over the world to havebank accounts
LSU - ACCT - 4221
1. Accountants acting as consultants (who will not testify) are notprotected from disclosure under the attorney work product doctrine.a. True*b. False2. Information reviewed by a testifying expert will not be subject todisclosure, including drafts of
LSU - ACCT - 4221
1. The admissibility of different forms of evidence varies widely fromjurisdiction to jurisdiction.*a. Trueb. False2. Technical errors in the testimony of an expert witness can be anattack against the evidence of an accountant on cross-examination.*
LSU - ACCT - 4221
1. What exactly constitutes an expert is really in the eye of thebeholder. Just about anybody could qualify as an accounting expertdepending on which judge makes the evaluation.a. True*b. False2. The United States Supreme Court in the Daubert case ch
LSU - ACCT - 4221
1. Most antitrust cases deal with allegations of nationwide monopolieslike the United States case against the Microsoft Corporation.a. True*b. False2. The United States Justice Department is the only entity that canbring antitrust cases against a bus
LSU - ACCT - 4221
1. In a personal injury case, as with most commercial damages cases,the time period covered by the damage period is always fixed.a. True*b. False2. A financial expert witness usually does not offer an opinion as tothe extent of injuries sustained in
LSU - ACCT - 4221
1. COBIT issues official SEC accounting guidelines for audits ofcorporate networks.a. True*b. False2. Deleting a file creates slack space.*a. Trueb. False3. Deleted files can always be fully recovered.a. True*b. False4. Time stamps cannot be alt
LSU - ACCT - 4221
1. TCP/IP services use acknowledgment responses to establish aconnection between sending and receiving computers.*a. Trueb. False2. Every network Ethernet card has an address, typically assigned at thefactory, called an IP address.a. True*b. False
LSU - ACCT - 4221
1. Unauthorized access is usually not a cybercrime.a. True*b. False2. Technological sophistication is needed to commit net frauds.a. True*b. False3. At auction sites, customer testimonials are a good way to determinethe reputation of an online sell
LSU - ACCT - 4221
1. Intangible losses from cyber attacks are likely to be recognized inthe provision of a company's business insurance policy.a. True*b. False2. Overtime paid to workers is an overhead cost.*a. Trueb. False3. A tiger team is a high-tech security tea
LSU - ACCT - 4221
1. Business valuations are prepared primarily for closely heldbusinesses.*a. Trueb. False2. A certified business appraiser (CBA) and a certified valuationanalyst (CVA) are two common certifications that professional valuationanalysts hold.*a. True
LSU - ACCT - 4221
1. Most cases of fraud begin with innocent mistakes.a. True*b. False2. The perpetrator's intent to defraud must be demonstrated.*a. Trueb. False3. It is usually best to work out a forensic accounting engagement asthe investigation proceeds, and a w