Neurobiological Effects of Traumatic Brain Injury on At-Risk

Neurobiological Effects of Traumatic Brain Injury on At-Risk Neurobiological Effects of Traumatic Brain Injury on At-Risk Populations Throughout adolescence, the brain is not fully formed. The growth occurs in Executive Functioning. Executive functioning is your ability to plan, organize, and to defer instant gratification. Its like the air traffic control center of the brain (Executive Function Self-Regulation, 2015, p. 1. It helps to regulate certain brain tasks to guard against impulsive decisions. It helps to see the big picture so you can form different hypotheses. With executive functioning, everythings not black and white. In adolescents, this form of brain functioning is not fully formed during that stage. The executive functions of the brain are not fully formed and complete until about the age of 25 (Understanding the Teen Brain , n.d., p. 1. Kids can think logically so by the time theyre fifteen and sixteen they really do know how to think logically but they dont make logical decisions. This is because of the lack of formation within the executive function of the brain. If a teen is injured during this stage of their developmental years, it could possibly be devastating for them. This is because it would change the way they view their world and their place in it. This could have serious implications for a teenager. Even a mild brain injury or MBI. A post-concussion may take 2 years for a teenager to recover. But, a more moderate or severe injury my not be fully realized. This may be true for a teen. A teenager who has experienced a brain injury not have had previous physical disabilities but they know that something has changed, something is different about them. The adolescent stage brings its own set of challenges. Even a teen with no previous physical or mental health history has to grapple with an adjustment period. During this adolescent stage of development, the teen is trying to find out who they are, where they fit in and how to cope with peer pressures. A teenagers goal at this stage of their adolescent years is to find out who they are. Its hard to imagine at the age of 16 or 17 how a brain injury can change your life drastically. As a teen, they have begun to find their place in school, their place with friends and family . They may bet thinking about college or a career, what they want to do with their life and an injury of this magnitude completely changes them, forever. The injury changes the way they think, the way they react, the way they normally would look at a situation. Although they may not understand fully, they know that something is different but may find it difficult to admit because their goal is to fit in. They may be desperately trying to find out who they are and struggle with their new reality, one dont fully comprehend. Some way, something has changed you. They may get to a point where they dont even know who they are anymore.. Friends are acting differently towards them (be it real or imagined), parents react differently to them. Tasks that once completed almost effortlessly with no problem or much though given to it, becomes a struggle. Concepts and mechanics of ADLs become arduous. Things that they could control before, now they cant. Frustration sets in and the teen starts to act out in ways they never would have. Situations they and tasks once mastered, becomes a chore. Their study habits have changed. They may not have had to study hard and tests may have been a breeze for them previously. But not now. Words dont seem to make sense any more. The star athlete has hand- eye coordination problems as well as following complex schemes from playbooks. Moderate Brain Injuries and Traumatic Brain Injuries are devastating for adolescents up to the age of 25 at this stage of their development. Functions of the Lobes of the Brain The frontal lobe the parietal lobe the temporal lobe occipital and the cerebellum associated with the frontal lobe or various control they control certain of our behaviors and when is injured that a certain consequences changes that are seen when there is an injury to frontal lobe include problems with sequencing, difficulty making decisions or perseveration. Someone can experience decisions people experienced decreased attention, changed personality, problem-solving difficulties, a decrease in their ability to verbally express oneself. A lack of spontaneity and uncontrollable emotions, social and sexual behaviors decreased initiation of voluntary movements. The changes that we see when temporal lobe is injured is that people a problem understanding the spoken word. They have problems with selective attention. There can also be sexuality changes. sexuality changes. A person with a temporal lobe injury may be found to persistently talk. With a temporal lobe injury, there is an increas e in aggressive behavior. They have problems recognizing faces, identifying objects and categorizing them. The parietal lobe is an area of the brain that where there is a higher level of functioning. Injury to the parietal lobe can cause difficulty naming objects. There can be problems processing their tactile sensations (the sense of touch) and problems processing and understanding what their fingers are telling them. A persons academic skill set declines as a result of an injury to this part of the brain. Things that they were easily able to do in the workplace or in the academic setting from a cognitive standpoint are now diminished or gone. Theres also confusion between the left and the right, a loss of hand eye coordination and a decrease orientation of where the body is from a spatial standpoint. Damages to the occipital lobe is where issues of vision defects, the loss of the visual field. One may also have problems visually locating objects. Importantly, they may also have problems identifying colors. They may also have distorted vision and even hallucinations. They can also have w hat some call word blindness. There is an additional challenge of the inability to perceive the way objects move. It would not be farfetched to connect problems with reading and writing in light of an injury of this magnitude. One may experience an overall slowing of our brains processing visual information. Now for the cerebellum, the area located in the back at the base of the brain and on top of the spinal column. With the cerebellum, there are different things that are more like areas of specialty, things that our cerebellum does for us each and every day. It controls the gross and fine motor coordination. When we decide, we want to reach out and grab a jar off the shelf, we put our arm out and do it. Thats the cerebellum in action. We are balancing our equilibrium, the ability to stand up and not fall over. The cerebellum gives us the ability to be able to ride a skateboard, bicycle or to go for a jog down the block. Our postural (causes dizziness from standing up too fast)cont rol and our eye movements, moving our eyes back and forth up and down and utilizing our eyes to obtain visual information so that it can be processed by our brain. The brainstemcontrols so much of what happens in our body. It controls so many of the different functions that allow us to survive as human beings. It is an area of the brain that really, we take for granted and we should be able to take it for granted. But, when it becomes injured through an accident or whatever, the brainstem and the injuries that flow from that have horrible consequences. When a person has an injury to the brainstem we see the damage to the regulation of our ability to hold our body temperature. It needs to be kept at a healthy temperature as opposed to getting too hot or too cold. We can lose the ability with an injury to the brainstem, efficient and effective management of our heart rate or the rate at which we breathe. Someone with injuries to their brainstem also experience problems with balance an d their movement. They have problems with swallowing food and liquid, something each of us should be able to take for granted but an injury to the brainstem would revoke that privilege. Brainstem injuries classically can be associated with symptoms of vertigo where the world spins. Often, its uncontrollable and unfixable. Theres dizziness and nausea. In summary, the different lobes of the brain carry out many cognitive behavioral and social functions in terms of all the different aspects of our physical life of our emotional life. I have summarized the lobes of the brain to illustrate the way we think, the way to process information, down to larger impacts of injuries to the brain. Talking about the brainstem illustrated functions of how we swallow food, how our body regulates our temperature and so on. The key point in describing the different areas of the brain and the different functions can be summed up this way. When any of the lobes of our brain are, damaged or injured either by accident, by a driver, by a drug, or by a Dr there are horrible consequences that are inescapable. References Executive Function Self-Regulation. (2015). Center on the Developing Child at Harvard University. Retrieved from http://developingchild.harvard.edu/science/key-concepts/executive-function/ Understanding the Teen Brain . (n.d.). In University of Rochester Medical Center Rochester, NY (Ed.), Health Encyclopedia. Retrieved 0February 27, 2017, from https://www.urmc.rochester.edu/ Bay, E., Mclean, S. A. (2007). Mild Traumatic Brain Injury. Journal of Neuroscience Nursing,39(1), 43-51. doi:10.1097/01376517-200702000-000090692

Richard Wright :: essays research papers

“The Man Who Was Almost a Man';   Ã‚  Ã‚  Ã‚  Ã‚  In “The Man Who Was Almost a Man'; by Richard Wright, the main character Dave expresses his needs to be acknowledged as an adult. Yet he also exhibits his immaturity and the fact that he is not yet an adult and can not handle adult problems. His actions lead him into trouble that proves the fact that he is still an adolescent who can not handle problems of the adult world. The characters around Dave make him feel like he is still a child. His wants to purchase a gun to feel more powerful. In the beginning of this story, Dave talks about how a gun would change the way people acted towards him. He feels that if he owns this power, the men in the fields who work with him will have more respect for him, and his mother will start treating him as an adult. Dave feels as if he is surrounded by people who treat him as a child and he does not like this at all. “You ain’t nothing but a boy. You don’t need a gun.'; This statement said by Joe, is the main reason why Dave truly wants a gun, to feel independent. Even though Dave wants to be acknowledged as an adult, his actions are very immature and childlike. The act of cornering his mother for a gun is one good example of immaturity. Dave feels as though he can not ask his dad for the gun for fear of rejection, a perfect example of immaturity. Daves defiance to his mother’s rules is another example of immaturity. Dave’s mother agrees to allow Dave to buy the gun as long as he promises to bring it straight to her. He agrees to this, yet he does not go along with her wish. The next morning, Dave set out to the fields early to shoot his gun. He ends up accidentally killing Mr. Hawkins mule, Jenny. The way Dave goes about dealing with this problem is childish. He panics and decides to lie about what really did happen. He makes up a story which he knows nobody will believe, yet he feels that if everyone does in fact believe him he can avoid his problems more easily.

Accreditation Audit Essay

With all of the possible problems that could occur during surgery, a wrong-site, wrong-patient mistake is one that should never arise. Nightingale Community Hospital (NCH) fully understands the importance of doing away with these errors and has set up protocol to work towards this goal. While the protocol is in place, it is not fully compliant with Joint Commission (JC) standards. Standard: UP.01.01.01: Conduct a preprocedure verification process. Nightingale Community Hospital has a Site Identification and Verification policy and procedure. Within this policy, and Preoperative/Preprocedure Verification Process is addressed. There is also a Preprocedure Hand-Off form present. This form is a bit misleading as it is essentially a hand-off form in general with a few extra boxes possible for check-off. To prepare for inspection and audit, NCH should create and implement a form for use within the Operating Theater or wherever procedures are performed, such as bedside procedures. This form needs to be more specific in addressing at least the minimum requirements by JC. The form needs to cite that all relevant documentation is present, such as signed consent form, nursing assessment, preanesthesia assessment, history and physical. The form also needs to specify that the necessary diagnostic and radiology test results, rather they be images and scans, or biopsy reports, and properly displayed and labeled. Finally, to fulfill the minimum requirements by JC, any and all required blood products, implants, devices, and special equipment needs to be labeled and matched to the patient. Standard: UP.01.02.01: Mark the procedure site. NCH covers the procedure site marking standard fairly well within their Site Identification and Verification Policy. It mentions that site marking is needed for those cases involving laterality, multiple structures, or levels. Several times in their policy NCH mentions that it is best to have the patient involved, if at all possible. If the patient is unable to mark the site, the policy states that the physician will be called to mark the site. The policy states that the mark shall be made in permanent black marker so it will remain visible after skin preparation, and also in a location that will remain visible after sterile draping is in place. The policy also  includes circumstances in which the marking will be unable to be performed based on the location of the surgery being in an area that is unable to be marked. Standard: UP.01.03.01: A time-out is performed before the procedure. Nightingale Community Hospital has an adequate procedure in place for the time-out performance. Within the Site Identification and Verification Policy, the Time-Out Procedure complies with JC standards. A time-out is to be conducted immediately prior to performance of the procedure, it is initiated by the nurse or technologist, it involves all personnel involved in the procedure, the team members agree to a minimum of patient identity, correct site, and correct procedure to be performed, and all of this information is documented in the record, including those involved and the duration of the time-out. The only issue not addressed fully is the possibility of multiple procedures occurring on the same patient by different practitioners, and in that case, an additional time-out needs to be done for every new procedure. The Communication priority focus area is an extremely important area for any hospital. This is a common sense area that should be able to reach complete compliance. A wrong-patient, wrong-site issue should never arise and is completely avoidable. In 2010, Joint Commission reported that wrong-patient/site surgeries continued to be the most frequently reported sentinel event(Spath 2011).Jay Arthur states that JC reports between four and six wrong-site surgeries per day(2011). The World Health Organization believes that at least 500,000 deaths per year could be prevented if the WHO Surgical Safety Checklist was correctly implemented. These numbers, when compared with the possibility of 100% compliance, are astounding and completely avoidable. Nightingale Community Hospital is well on their way to avoiding these types of sentinel events through usages of proper protocol, procedures, and policy as is seen by the upward trend from their last year of self-checks. With continued diligence and appropriate modifications made, this can be an area that NCH, and any other hospital can be fully compliant in. References Arthur, J. (2011). Lean six sigma for hospitals: Simple steps to fast, affordable, flawless healthcare. New York, NY: McGraw-Hill. Spath, P. L. (2011). Error reduction in health care: A systems approach to improving patient safety (2nd ed.). Hoboken, NJ: Jossy-Bass. WHO (2013). WHO | Safe surgery saves lives. Retrieved from http://www.who.int/patientsafety/safesurgery/en/ [Last Accessed November 5, 2013]. Accreditation Audit Essay A1. Evaluation Nightingale Community Hospital (NCH) is committed to upholding the core values of safety, accountability, teamwork, and community. In preparation for the upcoming readiness audit, NCH will be launching a corrective action plan in direct response to the recent findings in the tracer patient. Background information on the tracer patient is as follows: 67 year old female postoperative patient recovering from a planned laparoscopic hysterectomy turned open due to complications. Patient developed infection that formed an abscess and was readmitted to the hospital for surgical abscess removal and central line placement for long term IV antibiotics. The tracer methodology was employed when auditors reviewed this patient’s course. Many things were done well and right with this patient and NCH is pleased to know that the majority of items analyzed with this patient proved that NCH was in compliance with regulatory standards; however, there were some troublesome areas that we need to focus on. The primary focus area that we will put our energies into will be the fact that there was not a history and physical completed on the patient within 24 hours of admission, and in fact it was greater than 72 hours before one was completed. See more: My Writing Process Essay The Joint Commission mandates standards that are to be met in order to maintain compliance. Standard PC.01.02.03 states that history and physicals must be documented and placed in the patient’s medical record within 24 hours of admission and prior to procedures involving conscious sedation or anesthesia. History and physicals are also considered in compliance if documented 30 days prior to procedures as long as there are no changes documented or the changes in status are specifically noted. (Joint Commission Update, n.d.) A2. Plan Often, rules and regulations are met with disdain and it is usually because there is no explanation provided as to why the rule exists. The rules for History and physical documentation are in place for a reason and are not just to make things more complicated. History and physicals provide  all health care providers that participate in a patient’s care a glimpse into that patient’s health status and immediate concerns. (Shuer, 2002) The information provided in a history and physical paints a portrait for all other health care team members to follow and treat accordingly. Often, emergent situations may arise where other health care specialty providers may not have the time to glean medical background information from patients and/or their representatives and the history and physical then serves as the go to source of information. Compliance regulations can be hard to understand the reasoning behind them sometimes, but if we all work together to make sure that we meet them, then NCH will continue to embrace the core values that we have worked so hard to instill and embrace. The following outline is a corrective action plan that will ensure compliance with the Joint Commission and bring us up to par for the readiness audit. Action Accountable Parties Timeframe Measurement History and Physical Physicians & physician assistants 1. Within 24 hours of admission. 2. Within 30 days prior to a procedure involving conscious sedation or anesthesia. Chart reviews and if requirements are not met, patients will be held in the surgical admitting unit and procedures will be delayed. There must be 100% compliance. B. Sources Joint Commission Update Study Guide. (n.d.). Retrieved August 31, 2014, from med2.uc.edu/libraries/GME_Forms/Joint_Commision_Upd_1.sflb.ashx Shuer, L. M. (2002). Improvement needed on h&p documentation. Medical Staff Update, 26(5), Retrieved from med.stanford.edu/shs/update/archives/May2002/chief.html

How Globalization Influence the Hospital Industry.

How Globalisation Influence the Hospital Industry? Prof. Sandhya Shrivastava, Head of the Department (MBA), India Abstract In the 21st century, with the increasing levels of globalization in hospitality industry, hotel companies will need to learn different management approaches to survive and develop in environmental circumstances with high levels of uncertainty as well as understand the implication of future impacts, both positive and negative, of the changing environment in which they operate. As international trade and business expand, there is no question that international linkage will become more important for the hotel industry. This essay focuses on globalization in the hotel industry and explains how the increasing levels of†¦show more content†¦Some bemoan the resulting consumerism and loss of languages. Also see Transformation of culture. o Spreading of multiculturalism, and better individual access to cultural diversity (e.g. through the export of Hollywood and Bollywood movies). Some consider such imported culture a danger, since it may supplant the local culture, causing reduction in diversity or even assimilation. Others consider multiculturalism to promote peace and understanding between peoples. o Greater international travel and tourism. WHO estimates that up to 500,000 people are on planes at any one time? o Greater immigration, including illegal immigration o Spread of local consumer products (e.g., food) to other countries (often adapted to their culture). o Worldwide fads and pop culture such as Pokà ©mon, Sudoku, Numa Numa, Origami, Idol series, YouTube, Orkut, Facebook, and MySpace. Accessible to those who have Internet or Television, leaving out a substantial segment of the Earths population? o Worldwide sporting events such as FIFA World Cup and the Olympic Games. o Incorporation of multinational corporations in to new media. As the sponsors of the All-Blacks rugby team, www.theinternationaljournal.org RJCBS: Volume: 01, Number: 04, Feb-2012 Page 7 Adidas hadShow MoreRelatedSuccess For The New Change Plan1741 Words   |  7 PagesDecker, Durand, Mayfield, McCormack, Skinner, Perdue (2012) introduce the concept of critical failure factors as a way to analyze implementation risks. Careful identification of what will constitute a failure in the new change plan will positively influence the scope and definition of success for the new change plan (Decker et al., 2012). 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