Category: Health & Medicine

Why do you think standardized terminology is needed today?

In my opinion, standardized terminologies (STs) are necessary at any time and in any discipline since clear communication between specialists is a must for smooth and fast development and application of knowledge. After all, the efforts that were aimed at STs creation in nursing began in the 1970s (McGonigle & Mastrian, 2015, p. 111), which indicates that their importance was apparent to healthcare specialists for a long period of time.

However, there are several factors that seem to define the need for STs in the present day, and I will be using nursing as an illustration for them. First of all, the strain and demands that are placed upon healthcare nowadays are higher than before; it is a logical outcome given the growing and aging population and the technological and medical developments that change the way we provide healthcare (McGonigle & Mastrian, 2015, p. 107).

Secondly, STs provide nursing with an opportunity to be regarded as a full-fledged, quantifiable discipline; this title is a relatively recent acquisition that we hardly want to lose since its recognition offers greater attention from the scientific community (McGonigle & Mastrian, 2015, p. 112). Finally, the development of technologies offers great opportunities as well but also has some requirements, one of which is standardization.

Consider electronic records that are used in healthcare. They can only function in case all the nurses who use a particular database employ an ST. Similarly, everyone who operates a different ST will not understand these records and will not be able to modify them. With time, nursing is expected to become more technology-dependent (Hudson, Taylor, & Jeffries, 2013; Kish, 2015), and it is a positive forecast since new technologies mean new opportunities, including automatization, data collection, use, and reuse, and improved communication. Therefore, to gain the most from the possibilities that technology has to offer to nurse informatics, we need to create, implement, and learn STs that are as universal as possible.

What do you see as the greatest impact of nursing standardized-terminology use upon healthcare consumers?

STs have a number of impacts on healthcare, which, naturally, affects healthcare consumers. I would not claim that any of the impacts is the most important or the strongest, especially since they work as a system. Also, the adverse effects of the slow adoption of STs can contribute to the overall impact. However, I would like to dwell on the improved safety factor that my practice as a nurse supervisor has proved to be very significant.

In fact, it is the first plus of the consistent use of terminology that McGonigle and Mastrian (2015) mention: the continuity of care from care provider to care provider (p. 111). Also, the importance of care coordination with the help of nursing technologies is highlighted by the American Association of Colleges of Nursing (2011) as a part of the Essential V in the Essentials of Masters Education in Nursing (p. 5).

Indeed, the continuity of care appears to be the most transparent and direct consequence of improved communication between providers, and apart from that, it is of crucial importance. For example, clinical handover is a true communicational challenge that has been defined as a high-risk activity; for instance, by Baker and Watson (2015, p. 599). In other words, this activity is capable of endangering patients, but STs can minimize and even eliminate this danger. To sum up, the communication between healthcare providers has a direct impact on patient safety, which is why the introduction of STs is a similarly direct and reasonable means of improving it.

References

American Association of Colleges of Nursing. (2011). The essentials of masters education in nursing. Web.

Baker, S. & Watson, B. (2015). Understanding the health communication process: Advancing the research agenda to improve health care interactions and patient care. Journal of Language and Social Psychology, 34(6), 599-603. Web.

Hudson, K., Taylor, L., & Jeffries, P. (2013). Incorporating informatics in clinical education through clinical simulations. Web.

Kish, L. (2015). 8 takeaways from Topols latest: The patient will see you now: The future of medicine is in your hands. Web.

McGonigle, D. & Mastrian, K. (2015). Nursing informatics and the foundation of knowledge (3rd ed.). Burlington, MA: Jones and Bartlett.

Introduction

At the Appalachia in West Virginia, the miners were an interest group. They worked in places that caused them to experience noise pollution. As a result, a majority of them had hearing problems. The research would seek to determine if they voluntarily accept the hearing protection aids.

In America, more than 30 million citizens experience noise pollution. In fact, there is a belief that as long as one is a worker, he or she will have a hearing problem sometime in his or her lifetime. Once the occupational hearing problem sets in, the patient experiences social isolation and the inability to take safety precautions.

Other Studies

However, there were new noise standards established towards the end of the year 2000. The Mine Safety and Health Administration now sets the new noise standards for the employers of miners. With the support of the National Institute of Occupational Safety and Health, there was a study to develop voluntary behaviors among the coal miners (Stephenson et al., 2009). The study used persuasive messages in the research. Whereas there were very few sources to determine the use of positive, persuasive messages, the availability of fear appeals was immense (Kai, 2010).

The study explored the effectiveness of positive, negative, and neutral effects of persuasive appeals (Kai, 2010). The three appeals could be effective on the addictiveness to hearing protective behaviors, attitudes, and intentions of Appalachian coal miners (Stephenson et al., 2009). They would also be critical for the defensive mechanisms that relate to defensive avoidance, perceived manipulation, and message derogation. For effective research, there was a need for a fourth control group with a no-message.

The affect-based persuasive messages had three camps. The research on the rational-emotional attitudes towards adverts and life seemed not to be providing conclusive evidence. But the negative or fear-based message researchers appear to have had a field day. The fear arousing messages have worked well to provide adaptive behaviors. They help to bring up beneficial health outcomes when it comes to AIDS and cancer.

Another research dealt with discrete emotions like anger, fear, and happiness. The discovery was that the more negative emotions led people to action more than happy messages. The effectiveness of the negative messages is very high in the three studies.

Persuasion skills vary with mood. One would need a strong argument to persuade a sad person. On the contrary, a weak argument would easily sway a happy person (Stephenson et al., 2009). Negative fear-based messages work more effectively to persuade someone and elicit the change of behavior than positive ones.

The Coal Mine Study

At the coal mine, three message types were available for use to determine their effectiveness towards increasing hearing protection behaviors (Kai, 2010). They were positive, negative, and neutral messages. A no-message experimental control group was available to provide sufficient report. The study produced postcards with messages to provoke behavior in the coal miners.

Conclusion

The answers to this research contributed to new knowledge about the efficacy of different emotional appeals. The study assessed actual behaviors. The positive and neutral messages were more successful than the negative ones. The no message control condition also performed fairly better than negative words. Intentions of people propelled behavior. The positive and neutral affect words also help to elicit and maintain the health protective behaviors.

References

Kai, L. (2010). Proceedings of the 2009 international conference on chemical, biological and environmental engineering, CBEE 2009, Singapore, 2009. Singapore, Singapore: World Scientific Pub. Co.

Stephenson, M., Quick, B., Witte, K., Vaught, C., Booth-Butterfield, S., & Patel, D. (2009). Conversations among coal miners in a campaign to promote hearing protection. Journal of Applied Communication Research, 37(3), 317-337.

What Insights Did I Find Helpful and Interesting?

The insights provided by DeNisco and Barker (2016) regarding the U.S health care delivery system were interesting to my understanding of the countrys health care sector because they provided a holistic overview of how the health care system works, including the main issues affecting it and how it compares to other countries. Particularly, I found the insights highlighted in chapter seven useful to my understanding of the recent political debates about the need to undertake health care reform in the country.

Such matters have dominated the U.S social, political, and economic space and culminated in the introduction of Obamacare. More importantly, I understood the need to have significant reforms in the countrys health care sector after the authors compared the U.S health care delivery system with others in the world (DeNisco & Barker, 2016). In their analysis, the U.S health care system was inferior to most countries in Europe that offered universal health care.

I found it ironic that Americas health care system was inferior to other health care delivery systems, such as that of Canada, and yet the U.S spent more on health care than most of its peers. Collectively, the insights contained in the chapter helped me to have a deeper understanding of the economics of health and have a more detailed comprehension of the nature of the U.S health care delivery system.

How did Reading Enhance my Understanding of Trends in the US Health Care System?

The insights provided by DeNisco and Barker (2016) helped to explain emerging trends in the U.S health care system. Particularly, the move towards increased health coverage emerges in this analysis because different sections of chapter seven showed that the U.S was among the few developed countries in the world that did not guarantee universal health coverage for its citizens (DeNisco & Barker, 2016). Most of the information explaining the intrigues of this situation appeared in the section for trends and direction and in the section for insurance and health care reform (DeNisco & Barker, 2016).

In these sections, I learned about the quest by policymakers and other stakeholders in the health sector to reduce the cost of health care and increase its coverage through the introduction of innovative health coverage programs. I also learned of the need to realign the role of private players, employers, and pharmaceutical companies to make this happen.

What Points did I Disagree with?

Throughout the chapter, the authors focused on explaining the role of health care financing and health care safety when addressing the issues affecting the U.S health sector (DeNisco & Barker, 2016). While most of such issues are undisputed, I found it interesting that the authors did not highlight the contextual nature of the health care issues mentioned. Particularly, they failed to do so when making a comparison between the US health care sector and the health systems of other countries. In this regard, I believe the authors ignored significant social, cultural, and political dynamics between the different countries analyzed that were important in explaining some of their differences.

What Parts did I Find Confusing?

When explaining the role of different players in the health sector, the authors identified nursing executives, nursing educators, health practitioners, and entrepreneurs as significant players in the U.S health sector (DeNisco & Barker, 2016). However, they mixed their responsibilities in the health care system. This was confusing because most of these professionals have different roles and responsibilities in the health care sector. Naturally, this would mean that their roles would rarely conflict or overlap because such an outcome would create redundancies in the execution of the countrys overall health strategy. To this extent of analysis, there is a need to differentiate the different roles of health care professionals in the chapter.

Reference

DeNisco, S., & Barker, A. (2016). Advanced Practice Nursing: Essential Knowledge for the Profession (3rd ed). Burlington, MA: Jones & Bartlett Learning.

The Top 10 Things to Do for Your Baby

Look After Yourself

It may sound selfish, but you should put yourself first as you are the whole world for your baby. Remember, you and your child are connected very directly. Make sure your physical, psychological, and emotional state is appropriate.

Healthy Diet

Your blood is literally the blood of your baby. Healthy food and sufficient water consumption are important for the healthy development of your child. Avoiding fatty and overly sweet food is essential.

Exercise

Keeping yourself in shape is vital. Regular exercises can ease childbirth and prevent possible problems after the child is born. However, physical activity during pregnancy requires caution. Consult a medical professional beforehand and follow their instructions carefully.

Maintain a positive attitude

Pregnancy can be hard. Nausea, abdominal pain, and leg cramps are very common (for more information refer to Teen pregnancy: medical risks and realities, 2016). It is important to keep yourself focused on your end goal. Always remember why you decided to keep your child and keep yourself motivated to overcome all of the difficulties of parenthood (for more information refer to Bravo & Noya, 2014).

Engage the father

In many cases, fathers of a child born to a teenage female are not available. They may often be incarcerated, and some males try to alienate themselves from their children or women pregnant with their children (for more information refer to Pinzon & Jones, 2012). Such situations are regarded as common and acceptable. However, the presence and support of the father are crucial for the development of your child. The father can help you feel relaxed, which is essential for the development of the child.

Have enough rest

Being a teenager often means living a hectic life. However, being a teenage mother means focusing on the childs health, which is associated with a lot of rest for the future mother.

Avoid stresses

A teenage mother should feel relaxed and happy. This is why you should avoid any stressful situations. Of course, our life is a set of stressors, so it is vital to be capable of dealing with them. Focus on the positive aspects of everything. Yoga and meditation can help you develop proper relaxation strategies.

Consult

Some teenage mothers are still too shy to address professionals for help. Adolescent mothers may think that their problems are insignificant and try to cope with their issues on their own. However, any detail can have a tremendous impact on you and your childs health. Therefore, do not hesitate to address professionals if you feel that something is not right.

Breastfeed

If you think you are ready to be a mother, you are ready to be a good mother. Your babys health should go first. Breastfeeding is one of the most important aspects of motherhood. It is important for you and your child. The child receives all the necessary nutrients, and your body recovers after the period of pregnancy. Of course, a strong bond between you and your child develops during breastfeeding.

Keep learning

Of course, you should keep learning and try to find out more about your pregnancy, childs development, and so on. You should read a lot. The Internet may be the source of knowledge for you. Of course, professional assistance is also vital. Make sure you get information from diverse but reliable sources (healthcare professionals, social workers, parents, books, the Internet).

The Top Things Not to Do When You Are Expecting a Baby

Since you are a mother, you should understand that there are things you should avoid or never do. In fact, those are things any person should avoid to be healthy and happy. But they are vital for a teenage mother and her child. Thus, you should remember that you CANNOT:

Have Doubts

If you have decided to have a baby, you are ready to be a mother. Do not be afraid! You can handle it and become a perfect mother!

Smoke

You cannot smoke (cigarettes or marijuana). Be sure not to smoke yourself and ask your friends to stop doing so in your presence. Passive smoking is nearly as harmful as smoking yourself (for more information refer to Fleming, ODriscoll, Becker & Spitzer, 2015). Try to avoid environments that will expose you to tobacco smoke. This advice must also be followed as long as you breastfeed your child. Breast milk contains all the substances you consume and their negative effect on the newborn is no less severe.

Drink or Use Drugs

Alcohol as any other harmful substance has a significant negative effect on the development of your child. The intake of the harmful substance (alcohol or drugs) can lead to the development of various genetic disorders in your baby (for more information refer to Behnke & Smith, 2013). It can also lead to miscarriage.

Stress out

The pregnancy is stressful by itself. That stress can negatively affect the fetus and prevent the healthy neurological development of the child. That means possible issues with emotional and intellectual development (for more information refer to Lazinski, Shea, & Steiner, 2008). Start by creating a healthy atmosphere for yourself.

Be Passive

Some think that being pregnant means being very cautious. Some pregnant females try to move as little as possible and avoid any pleasures. Of course, this approach is absolutely wrong. Live your life! Get positive emotions walking, spending time with friends, doing sports. Of course, it is vital to consult the professional about some activities.

Have an Unhealthy Diet

Your diet should be balanced. Clearly, you cannot eat junk food or keep to a doubtful diet (for more information refer to Fleming et al., 2015). Ask your doctor about a healthy diet during pregnancy.

Try to Handle Everything by Yourself

Of course, you are an adult person, and you are capable of making important decisions. Nonetheless, it does not mean that you should deal with all your problems on your own. Involve your relatives and especially the childs father in solving your problems. This cooperation will help you create strong bonds within your family. Of course, it will help you stay relaxed.

Become Isolated from Your Close Ones

Ask your family and friends for help and support. Simply having somebody you can share your troubles with can help a lot. If you notice mood swings or anxiety in yourself, do not hesitate to contact a specialist.

Listen to Scary Stories

There will always be websites where various horror stories about severe disorders and death are provided. Peers also often tell such stories. Do not focus on that kind of information. It will only cause stress and negative emotions to you and your child. Use only reliable information. Address professionals whenever needed.

Have a too Hectic Lifestyle

You are a young and strong female. Nevertheless, you should understand that you need a lot of rest to make sure your child develops properly. Enough sleep for a mother translates into good health of the child.

Helpful Sources to Refer To

Behnke, M., & Smith, V.C. (2013). Prenatal substance abuse: Short- and long-term effects on the exposed fetus. Pediatrics, 131(1). Web.

Fleming, N., ODriscoll, T., Becker, G., & Spitzer, R.F. (2015). Adolescent pregnancy guidelines. Journal of Obstetrics and Gynaecology Canada, 37(8). Web.

Lazinski, M. J., Shea, A. K., & Steiner, M. (2008). Effects of maternal prenatal stress on offspring development: A commentary. Archives of Womens Mental Health, 11(5-6), 363-375.

Bravo, I. M., & Noya, M. (2014). Culture in prenatal development: Parental attitudes, availability of care, expectations, values, and nutrition. Child & Youth Care Forum, 43(4), 521-538.

Pinzon, J.L., & Jones, V.F. (2012). Care of adolescent parents and their children. Pediatrics, 130(6). Web.

Teen pregnancy: Medical risks and realities. (2016). Web.

Summary

In their article, The Endocrinology of Aging: A Mini-Review, C. M. Jones and K. Boelaert discuss the role of hormonal composition alterations, which take place within the body during aging, in the process of disease development. As the authors note, the decrease in hormonal secretion affects multiple body systems and functions including reproduction, nutrition, and metabolism. It leads to various adverse changes in older adults including reductions in bone, skin and skeletal muscle mass and strength, derangement of insulin signaling, increases in adipose tissue and effects on the immune function (Jones and Boelaert 291). The researchers discuss this problem in detail based on the evidence collected from scholarly peer-reviewed sources and draw some recommendations regarding targeted treatment strategies aimed to improve elderly patients outcomes.

In the article, a few studies revealing a potential connection between longevity and the mechanisms of hormonal secretion are reviewed. It is stated that cell-autonomous reduced signaling through the insulin and IGF-I pathways leads to a reduction in the phosphorylation of their downstream intracellular targets AKT/protein kinase B (PKB) and serum/glucocorticoid-regulated kinase (SGK), which ultimately results in transcription of longevity genes and inhibition of their pro-aging counterparts (Jones and Boelaert 292). It indicates a possible role of humoral factors in tissue aging. As for specific diseases defined by loss of hormones, the authors provide an example of osteoporosis. The disorder associated with the low mineral density of bones is especially common among menopausal women. It may occur due to estrogen loss, which provokes changes in the bone remodeling cycle. Additionally, it is observed that misbalances in steroid hormones, e.g., adrenal steroids DHEA and DHEA-S, increase the risk of immunodeficiency and cancer, while changes in the secretion of gut hormones, e.g., insulin, result in greater susceptibility to developing diabetes.

Commentary

Aging is commonly associated with diseases. It seems almost natural to experience the deterioration of body functions as you get older. As the study by Jones and Boelaert demonstrates, age-defined morbidities occur due to complex changes in essential organism networks, whereas an alteration in one body system inevitably affects another. In this way, hormonal loss impacts the dynamics of biological processes happening within the physical structure and consequently leads to altered health conditions. Nevertheless, the evidence summarized in the reviewed article suggests that the hormonal factor of aging and age-related morbidity can be intervened to enhance the quality of life and functionality in aging individuals. Clinical hormone replacement treatment can help patients at high risk of disease development. For instance, it may be suitable for women at the early stages of menopause as estrogen supplementation can prevent tissue loss and, in this way, decrease their propensity to osteoporosis.

However, one can also easily maintain hormonal balance through adherence to healthier lifestyles. Moreover, it is better to intervene in dieting behaviors and physical exercise engagement earlier in life than wait until the problems occur. One can also try to eliminate possible risk factors leading to hormonal misbalance including gut issues, overweight and obesity, high levels of inflammation, interaction with various toxins, excess exposure to stress, and so on. It is worth noticing that both mild and severe problems with hormonal secretion can take place across the lifespan and may affect even a young individual and then become aggravated with age. Sometimes they are defined by genetics and are hard to eliminate. Hormonal replacement treatment will be of tremendous help in this case. Nevertheless, one should still aim to maintain their own healthy psychological and physiological status to minimize the risks.

Introduction

The problem of insufficient patients compliance to the medication regimens remains a burning health care issue in Australia. Millions of patients miss their medications on a regular basis that leads to the worsened patient outcomes and increased costs of care. The following project will observe the scope of the problem along with its causes and will provide the IT solution applicable to the needs of both patients and health care providers.

The Issues of Medication Compliance in Australia

Patients incompliance with medication is as dangerous and costly as the majority of illnesses (Currie et al., 2016). Medication compliance in patients in Australia is connected with the following major issues:

1. missing medications in case of relief;
2. poor knowledge of certain medicines storage rules (Grover, Armour, Van Asperen, Moles, & Saini, 2013).

One of the health issues that illustrate the situation is asthma. Since asthma is a chronic condition, it cannot be fully cured but it can be significantly improved if properly managed with the help of medications (National Asthma Council Australia, 2014). In Australia, asthma is getting a health issue of special concern given that over two million people are already affected by the disease (National Asthma Council Australia, 2014).

Moreover, the rate of asthma incidence in the country is one of the highest in the world (National Asthma Council Australia, 2014). Asthma is also a huge concern in the youngest age category since one of eight children is likely to be diagnosed with this disorder at a certain moment of their lives (Grover et al., 2013).

According to National Asthma Council Australia (2014), over fifty percent of patients having asthma reported to have over one case of medications missing a week during the periods of relief. Over thirty percent of these patients stated that they lacked knowledge on proper storage regimen for keeping their asthma drugs (National Asthma Council Australia, 2014). The example of asthma medications demonstrates that patients with the chronic illnesses tend to forget to take their medicines quite often. Research conducted by Currie et al. (2016) supports this conclusion by stating that patients with acute illnesses have higher adherence rates to the medications they have been prescribed.

Overall, insufficient adherence to medications in Australian people causes further problems decreasing effectiveness of the countrys healthcare system including complications, poor therapeutic outcomes in patients, and low degree of care cost-effectiveness (Hatah, Braund, Tordoff, & Duffull, 2014). The problem is especially the case in the rural southern territories of Australia (Hatah et al., 2014).

Description of the System Design

In order to provide a solution to the problem of insufficient compliance to the medication regimen in Australian residents, this project aims to offer the IT system application for the use by both patients and health care professionals. This application will target the main problems and barriers that prevent patients in Australia from being fully complaint to their medications.

The major problems associated with patients incompliance to medicines are forgetfulness and loss of medical scripts. Another problem that is in connection with the issue is poor knowledge of storage techniques by patients with the lack of medical knowledge. The outcome of this problem is the loss of the medical value of a drug, and therefore, even if the patient continues to use this drug timely, the benefit is reduced.

Other common barriers include language barrier, insufficient education and especially insufficient education in the area of health care and health promotion, and ineffective patient-doctors communication (Schrijvers, Uitslager, Schuurmans, & Fischer, 2013). To address these problems, the application design will be maximally simplified and laconic to make it easy to use to all clients. This is especially the case for the patients menu to allow them convenient usage of the tool even if they have poor knowledge of medical terms as well as if they have language barriers. Another option the system will provide is using the application for all family members. As such, one account will provide a chance to serve all family members who will like to do so.

The purpose of the application is to provide the patient an opportunity to connect ones primary care provider and pharmacist when consultation is needed and ensure the client does not miss the due time to take the medications prescribed. In the application interface, the data on all medications prescribed to every specific client is available along with the time and dosage of its use and the remaining period of its intake. In addition, with the use of this application, a client may connect ones pharmacist to inform that he or she got low of the medicine and intend to come to borrow ore on a specific date agreed.

Approaching this application from the point of view of a physician, its benefit is an option for the patients care provider to see all the medications one is currently on to avoid any side effects and possible threats. In addition, the application will provide a health care provider with an option to fill in the information regarding the complication and side effects the patient had as a result of therapy with certain types of drugs. This option will help the specialist to make the right decisions in future to avoid the side effects and choose the medication proving the optimal outcomes for each particular client.

The Major Components of the System

The major components of the offered system are the main interface with the two buttons for patients and for medical specialists. Appearing in their menu, the patients find the options they may use including the list of their medications, the time of intake, the remaining period of medication, the dosage, and an option to connect the care provider, and pharmacist (see Fig. 1).

The menu for the health care providers will make available the options to overview the profiles of their patients that contain data on all the medications they are currently on, the status of their compliance to the medical regimen, and a way to connect the patient online along with ones personal contacts including the phone number and home address.

Addressing the algorithm of the application usage, the user will need to choose ones account, then one will need to proceed to the current date, and he or she will see the list of medications for the current moment. History of medications intake can also be seen as well as the history of communication with the care providers and pharmacists. In addition, the application will provide a clear plan of medicines intake along with the dosage and timing if more than one medicine is used at the same time.

This solution is very important for the chronically ill people who may miss their medications due to the complexity of their treatment regimen and multiple components it may include. The patient interface will have the option to change the user if one account is shared by more than one family member. At that, upon the user request, privacy settings can be installed on the account so that the client could choose an option of not allowing other family members navigate through ones account.

For clients to modulate the emergency issues when they appear in the circumstances when the energy charging is unavailable or similar issues of electronic devices usage arise, the application system features an option of generating the list of medication for the chosen time period and sending it to printing. This solution appeared to be helpful for users as it was demonstrated by the situations when people survived a natural disaster, fire or other emergency situation and were left without electricity for some time (Berry & Schleser, 2014).).

The Intended Users of the System

The intended users of the system are patients, physicians, and pharmacists. While patients are the primary clients the system is intended for, physicians and pharmacists can also benefit from using the system by having the stable connection with their customers and tracking their adherence rates to the prescribed medication regimen. In addition, the patients family members may have access to the system to extend help to their aged or somehow disabled family members in remaining adherent to their medication regiment despite the limitations their condition may place on them.

Interface Changes to Accommodate Different Users

The system will have two different interfaces: one for the patients and one for the physicians and pharmacists. The patients interface will have more options aiming to make it convenient for the user to keep on track of ones medication regimen, while the health care providers interface will be focused on tracking the patients adherence to the medication regimen, communicating with them, and storing data on the side effects of particular medications the patients have identified.

Besides, the health care providers will be able to keep the record of the dates when patients will need the refilling of their drugs. In addition, physicians will be able to trace the information on patients allergies, as well as they will always have access to other useful data on the patient profile such as emergency contacts or patients professional status to make sure the chosen medicine corresponds to the clients needs.

Design Innovation that Enhances the Efficient and Safe Practice of Managing

Medication Compliance

The design innovation that enhances the efficient and safe practice of managing medication compliance is the elaboration of the application design in such a way that allows using it with the help of a variety of IT devices ranging from the smartphones and ending with desktop computer. The smartphones of various kinds are the primary intended devices for this application. However, research on the availability of such devices in Australian families demonstrated that in the older users, these devices may not be readily available (Berry & Schleser, 2014).

Since these users are also the most active users of medications because their health condition is vulnerable to the higher number of threats, it is important to develop the versions of these applications for other devices such as lap tops of desktop computers.

Another innovation option for the application is the improved security system that will allow a better level of information protection. Australian legislation has the strict regulations as for the patients personal information protection. To meet these requirements and address the advancements made by security hackers, the application will implement the sophisticated system of data encryption utilized in combination with the encodings program component installed on user accounts. This barrier aims to hamper the hackers capable of unlocking the user accounts with the technique of password selection since even if they are able to enter the personal cabinet they will need a decoding component to be installed on their device.

Conclusion

In conclusion, it should be noted that patients insufficient adherence to the medication regimen remains the central health care issue that affects the health of the nation as well the health care cost effectiveness in Australia. The problem is especially serious in the patients who are on medication due to the chronic conditions as compared to those that take drugs due to the acute problems. This project has observed the illustration of the state of affairs with the patients who have been diagnosed with asthma.

To provide assistance to the patients, physicians, and pharmacists, this paper has proposed an application aiming to help each participant of the medication process achieve better results. The offered system has the two types of interfaces: the patients interface and health care providers interface. Each of these system components has addressed the needs of the categories of users mentioned above correspondingly.

References

Berry, M., & Schleser, M. (Eds.). (2014). Mobile media making in an age of smartphones. Sydney: Palgrave Macmillan.

Currie, C. J., Peyrot, M., Morgan, C. L., Poole, C. D., Jenkins-Jones, S., Rubin, R. R.,& & Evans, M. (2012). The impact of treatment noncompliance on mortality in people with type 2 diabetes. Diabetes Care, 35(6), 1279-1284.

Grover, C., Armour, C., Van Asperen, P. P., Moles, R. J., & Saini, B. (2013). Medication use in Australian children with asthma: users perspective. Journal of Asthma, 50(3), 231-241.

Hatah, E., Braund, R., Tordoff, J., & Duffull, S. B. (2014). A systematic review and metaanalysis of pharmacistled feeforservices medication review. British Journal Of Clinical Pharmacology, 77(1), 102-115.

National Asthma Council Australia.(2014). Australian Asthma Handbook  Quick Reference Guide,Version 1.0. National Asthma Council Australia, Melbourne. Web.

Schrijvers, L. H., Uitslager, N., Schuurmans, M. J., & Fischer, K. (2013). Barriers and motivators of adherence to prophylactic treatment in haemophilia: a systematic review. Haemophilia, 19(3), 355-361.

Waxing up teeth appears simple, but the procedure is more complex. The first stage involves preparing a cast. This process commences with marking of the Triangular, Mesial, and Distal cusp ridges. The cast has to be reduced to about 4mm from cusp tip to give enough space for wax clearance. The sticky wax is then placed on the Occlusal table. The second step is the most challenging, especially closing the articulator at an appropriate length and Intercuspal position. However, through arch alignment, it is possible to minimize any collision of cones at Protrusive (P), Working (W), and Non-Working (NW) movements. Such movements must be constantly controlled to ensure the proper clearance of the developed DB and MB embrasures.

In waxing the Buccal, M & D, Triangular ridges, and Mandibular lingual tips, it is important to avoid any side interference by properly placing lingual cones. The next step is the cleaning of the Lingual cusp, which should be done while observing the height contour for ML and DL embrasures for effective functional clearance. The new information I gathered in this process is the significance of proper convergence at the center of every tooth. This action ensured that clearance and angular movements were well-distributed.

The most difficult part is working on M and D marginal ridges. Specifically, forming the centric contact on the premolars and molars MR to complete the embrasures on Occulusal, Buccal, and Lingual ridges is very time-consuming. Generally, sustaining desired movements and clearance might be a daunting task to accomplish with little experience. For instance, the proper use of the Occlusal powder before the integration of the articulating paper will give a different result to doing the opposite.

I failed to engineer stable and equal stops of similar intensity to avoid interfering with posterior teeth. Next time, I will ensure that there are no P, W, and NW interferences. Professionalism as a guiding principle can make a difference between proper teeth waxing and a poor job. The finishing stage involves polishing, which guarantees that the final product is smooth with evenly burnished grooves.

Description of Intestinal Obstruction: Pathophysiology, Etiology & Risk Factors

Intestinal obstruction is characterized by a blockage in the intestine. Such blockages subsequently result in solids, gas, and fluid building up in the proximal intestine, causing severe abdominal pain, increased tension in the wall of the intestine, and increased tension in the intestine. This tension can also be accompanied by impairment of the blood supply of the intestine associated with the external pressure and twisting. In nearly 25% of small bowel obstruction, the blood flow is extremely compromised (Ansari & Hofstra, 2017). This type of obstruction is usually linked to intussusception, hernia, and volvulus. It is important to mention that strangulating obstruction of the intestine can develop into further complications such as gangrene or infection in a very short space of time (around six hours). First, venous obstruction takes place and is then followed by arterial occlusion, which subsequently results in the bowel wall ischemia.

Perforation and gangrene of the intestine can develop because of the ischemic bowel becoming edematous and later experiencing an infarct (Ansari & Hofstra, 2017). With regards to obstruction of the large-bowel, the process of strangulation rarely occurs, with the exception of volvulus. There are a range of symptoms of intestinal obstruction, depending on the severity of the condition; nausea and vomiting, constipation or diarrhea, severe pain in the abdomen and bloating, cramps, bloating, and swelling are the most common symptoms. In some cases, patients can also experience dehydration, dizziness, and fever when they have experienced intestinal obstruction for a long period of time without treatment. For instance, early stages of the condition are characterized by vomiting while later stages, such as complete obstruction, are accompanied by the patients inability to pass stools (constipation) and gas, which can also lead to inflammation and infection if untreated.

The etiology of intestinal obstruction includes several causes, the most common of which is the cancer of the colon. Another is intestinal adhesions, which are characterized by bands of fiber-like tissue that can form after a patient has undergone pelvic or abdominal surgery. When it comes to intestinal obstruction among children, the most common reason for the conditions development is intussusception. Other reasons for the condition can include the presence of other inflammatory bowel diseases (e.g., Crohns disease), hernias, volvulus or colon twisting, diverticulitis, as well as impacted feces. If left untreated, intestinal obstruction can lead to more serious complications as tissue death and infections. In the case of tissue death, the lack of blood in the organ causes its tissue to die; the subsequent perforations in the walls of the intestine result in infection.

When peritonitis develops in the abdominal cavity, the infection can be an extremely life-threatening condition that needs immediate medical attention, and possibly surgery. Overall, when it comes to intestinal obstruction, it is essential to consider its etiological causes and control the possible risk factors for decreasing mortality and morbidity (Ojo et al., 2014). Risk factors for diagnosing intestinal obstruction are associated with the additional complications of being able to differentiate between actual mechanical obstruction and other causes that may have the same symptoms (Jackson & Raiji, 2011). Tachycardia and hypotension can indicate dehydration, which is a risk factor in itself that can cause further complications. In patients with proximal or early intestinal obstruction, the usual symptoms of a tympanitic abdomen may not be present, which makes for an even more complicated diagnosis of the condition.

Nursing Diagnosis and Interventions

A patient is likely to have intestinal obstruction because he/she has deficient volumes of fluid associated with severe vomiting and nausea, which are accompanied by diaphoresis and fever. Interventions targeted at the management of the diagnosis will have the objective of meeting fluid requirements, normalizing vital signs, and balancing input and output. The first intervention should address the problem of dehydration because the patients nausea and vomiting will have contributed to the poor fluid intake. Hypodermoclysis is a viable intervention that is less invasive than intravenous infusion and can be efficiently performed even by low-skilled personnel. The rationale for this is the following: when implemented correctly, this balances the fluid volumes in the body, and an accurate intake and output can be achieved. The second intervention is associated with the administration of analgesics or antibiotics to relieve pain and eliminate fever for balancing the patients vital signs. The rationale for this intervention is associated with relieving the discomfort that the patient experiences in order to proceed with further management. The third possible intervention that can be implemented in the patients case is to protect the patients airway due to the high risks of vomiting leading to aspirations. This intervention is explained by the fact that when caring for the patient, a nurse should place the patients head in a position in which the mouth would be lower than the vocal cord to avoid aspiration. The last intervention should be targeted at relieving distension in the bowel. Nasogastric intubation is a rational strategy for doing so because it can remove gastrointestinal secretion, as well as swallowed air, to subsequently decrease the distension.

References

Ansari, P., & Hofstra, N. (2017). Intestinal obstruction. MSD manual professional version. Web.

Jackson, P., & Raiji, M. (2011). Evaluation and management of intestinal obstruction. American Family Physician, 83(2), 159-165.

Ojo, E., Ihezue, C., Sule, A., Ismaila, O., Dauda, A., & Adejumo, A. (2014). Etiology, clinical pattern and outcome of adult intestinal obstruction in Jos, North Central Nigeria. African Journal or Medicine and Medical Sciences, 43(1), 29-36.

Description of the Method

Since I do not have an opportunity to arrange two groups of respondents, the research design was chosen for the project is non-experimental. I intend to investigate the healing power of Botox in dentistry that is emphasized by some researchers (Azam, Manchanda, Thotapalli, & Kotha, 2015; Nayyar, Kumar, Nayyar, & Singh, 2014). Although some studies investigate the use of Botox in dentistry, its capability of reducing pain has not been analyzed to a sufficient extent.

The non-experimental design is known to have the least power to block out extraneous variables. Also, the lack of a control group may undermine the validity of the study. However, the non-experimental design is the most frequently applied one. To carry out my research project, I will use a survey, the questions of which will provide answers to the hypothesis of the study.

The survey will include closed-ended questions. In order to measure the degrees of difference, a Likert scale will be employed. The participants will be required to read statements and choose how they feel about them. The following options will be provided: strongly disagree, disagree, neither agree nor disagree, agree, strongly agree.

A self-administered survey is not only less expensive and time-consuming but also faster to conduct. Although interview schedule surveys are known to provide better response rates, I came up with the idea of enhancing my chances for good response rates. I will approach several dentists offices that employ Botox for relieving pain and ask doctors to request their patients participation in the study. I think that if the inquiry is made by someone people respect and trust, they will gladly agree to answer the questions.

To increase the likelihood of peoples agreement to answer survey questions, I will add a cover page to the survey. The survey will consist of five statements:

1. I find it difficult to go to the dentists office because I am afraid of pain.
2. I had never heard of Botox therapy before I joined this dentists office.
3. The doctor used Botox to help me manage my pain, and it was successful.
4. To my knowledge, few people know about the pain-relieving qualities of Botox.
5. I find Botox therapy the most successful in pain reduction.

Sample Population

The lack of a control group in a non-experimental design should be compensated by the number of participants. The sample needs to be large so as to give me the possibility to draw the most accurate results. At the same time, it is necessary to limit the focus of research in order to reduce the difficulties associated with processing too much data. Since I am planning to deliver the surveys to dentists and pick up the patients answers myself, I need to limit the geographic area of research.

I decided to focus on several hospitals in Saint Paul, Minnesota. Because I need the participants to answer questions about their prior experiences of visiting dentists offices and their pain perceptions, I need to limit the sample by age. Thus, only people at the age of eighteen and older will be eligible for participation. No limitations concerning gender, ethnicity, or occupation will be set.

The number of participants will be 500. I find such a sample sufficient for providing the most accurate results and eliminating the invalidity of results.

Data Collection

I want to collect the data concerning the frequency of patients visits to the dentists office and their impression of Botox as a pain-relieving technique. Additional data that might be helpful to analyze the results is patients age and gender. No personal information will be inquired, but I will leave my email address for the participants in case they have some questions.

Hypothesis

The hypothesis that will be tested in research is, The use of Botox in dentistry promotes pain reduction.

Variables

The hypothesis requires the identification of independent and dependent variables of research. The independent variable of the study is the use of Botox. The dependent variable is pain reduction. Thus, the study aims at investigating the connection between the two variables that will enable the support or rejection of the hypothesis.

References

Azam, A., Manchanda, S., Thotapalli, S., & Kotha, S. B. (2015). Botox therapy in dentistry: A Review. Journal of International Oral Health, 7(Suppl. 2), 103-105.

Nayyar, P., Kumar, P., Nayyar, P. V., & Singh, A. (2014). Botox: Broadening the horizon of dentistry. Journal of Clinical and Diagnostic Research, 8(12), ZE25-ZE29.

Introduction

Noise-induced hearing loss (NIHL) is an irreversible and gradually developing condition caused by exposure to excess noise. The disorder affects the sound-receiving department of the auditory analyzer (neuroepithelial structures of the inner ear) and is manifested as a chronic bilateral sensorineural hearing loss (Mohammadi, Mazhari, Mehrparvar, & Attarchi, 2009). The given health outcome is widespread in the United States. According to the statistical data provided by the National Institute on Deafness and Other Communication Disorders (2017), approximately 24 percent of the U.S. adults aged 20 to 69 years have symptoms of NIHL in one or both ears. A high rate may indicate the lack of awareness of the disease risk factors, symptoms, identification techniques, and prevention methods in the population. The research of NIHL is important and presents a significant interest as it may help to design strategies aimed to reduce the incidence of the given public health issue.

Occupational exposure to excess noise (over 85 dBA) is one of the major factors contributing to NIHL development. As Kitcher, Ocansey, Abaidoo, and Atule (2014) state, the number of hearing loss cases reported in different mill markets is three times greater if workers exposed to high levels of noise and do not undertake the preventive measures. Additionally, Wells et al. (2015) claim that over 7 percent of the deployed U.S. Army soldiers are diagnosed with NIHL, and the exposure to high intensity and impulse noise during the military operations is considered to be the major contributing factor.

In order to understand the relationships between the environmental factor and health outcome selected for the study, we will evaluate three articles in this paper. One of the articles is a cohort study, and two others are cross-sectional studies. All three papers are focused on the investigation of the effects of occupational noise on different population groups. The review findings will be evaluated based on Bradford Hill Criteria, and summarized in the table. The findings of the literature review will allow us to identify possible clinical, individual, and social implications associated with the health concern and the physical hazard existing in industrial and military working environments.

Methods

The selected articles were located via Washington State University online database by sing Smart Search option. Since the study is devoted to the research of the relations between the health outcome and one factor defining it, we used only two keywords including NIHL and occupational noise. In order to ensure a higher level of credibility and validity, we focused on research papers published in high-quality scholarly and professional journals such as Noise and Health and European Journal of Public Health. As a result, we chose one cohort study that addresses the problem of hearing impairments in the military environment, and two cross-sectional studies focusing on the same health problem in the industrial environment. Additionally, one of the cross-sectional papers analyzes how smoking may increase the chances of NIHL development.

Results

Study 1: Hearing Loss Associated with US Military Combat Deployment

In their article, Wells et al. (2015) employ data collected from the Millennium Cohort Study (MCS)  a longitudinal cohort study designed to assess the effects of US military service on the health of participants over a follow-up period of at least 21 years (p. 35). The researchers aim to identify the prevalence of risk for hearing loss among the U.S. soldiers and how it is correlated with their deployment experiences. Wells et al. (2015) evaluated the sample comprised of 48.540 participants. According to the MCS data, 7.5 percent of the assessed U.S. military members self-reported the onset of hearing impairment throughout the follow-up period. The initial analytical tools used by the researchers were Chi-square tests, percentages, and frequencies. The secondary analysis was conducted by using multivariable logistic regression which allowed identifying the odds of the progress in hearing loss development and their links to combat deployment, exposure to head traumas, and explosion blasts.

Noise is a significant physical hazard in the military service environment. The researchers suggest that the exposure to excess noise may be the major cause of suffering additional hearing damage in the target population, and especially in those military members who report a greater incidence of combat exposures. Along with the noise determinants to hearing impairments, the researchers investigated other contributing factors including combat exposures, smoking status, exposure to chemicals and pesticides, the use of protective devices, etc.

To substantiate their hypothesis, Wells et al. (2015) drew the statistical data retrieved from another study which indicates that hearing loss constitutes over 68 percent of post-deployment diagnoses in soldiers. The research findings are consistent with the evidence obtained from the previous studies related to a similar subject. Wells et al. (2015) observe that the deployed individuals with a higher level of combat experience tend to report the onset of hearing impairments in nearly 1.5 times more frequently comparing to the non-deployed individuals. Combat experiences are regarded as an essential determinant for the development of hearing impairment in soldiers. It is important to notice that combat is usually associated with the increased amount of impulse noise, i.e., noise with a duration of <1 second and with peak levels 15 dB louder than background noise, produced by various weapons and detonation of explosives (Wells et al., 2015, p. 38).

Along with this, the likelihood of hearing impairment proportionally increases if a person was exposed to combat-related head traumas or was insignificant proximity to an explosive blast. Soldiers who had head traumas reported hearing loss in six times for often, while those who were proximate to a blast  in two times more frequently. Wells et al. (2015) also claim that such factors as tobacco use, advancing age, non-black ethnicity, and exposures to other occupational hazards may contribute to the development of hearing loss in soldiers.

Study 2: Occupational Hearing Loss of Market Mill Workers in the City of Accra, Ghana

In their study, Kitcher et al. (2014) investigated the correlation between a continual exposure to excess noise (higher than 85 dBA) and hearing loss in a sample of Ghanian market mill workers (n = 101). The researchers measured the participants pure-tone hearing thresholds and then compared the data to the similar measures collected from the control group comprised of small-scale traders (n = 68). Additionally, Kitcher et al. (2014) aimed to evaluate the prevalence of NIHL in market mill workers, as well as the level of their awareness of the effects of noise on health.

To measure the occupational noise in the selected setting, the researchers used a standardized RS-232 sound level meter. Additionally, they administered the audiometric assessment of the study participants and the control group members in fourteen hours after their last exposure to occupational noise. The researchers carried out a standard eight-frequency pure tone audiometric behavioral threshold test at frequencies from 250 to 8000 Hz. They identified hearing damages by implementing the average frequencies of 500, 1000, 2000, and 4000 Hz; and then classified the collected data according to the criteria proposed by the World Health Organization. The hearing threshold level of lower than 25 dB implies normal hearing, 26-40 dB threshold level  mild hearing loss, 41-60 dB threshold  moderate hearing loss, and 61-80 dB threshold level  severe hearing loss (Kitcher et al., 2014). The initial data was evaluated using the Statistical Package for the Social Sciences (SPSS). A t-test was conducted to contrast the average threshold levels of all study participants for different pure tone frequencies.

The average level of noise in the market mill ranged from 85.9 to 110.8 dBA, while the controls were exposed merely to an average level of noise ranging from 61.5 to 69.4 dBA. It means that noise in the selected industrial setting exceeded the maximum permitted level (85 dBA). At the same time, the analysis results indicate the sensorineural hearing loss in one or both ears in nearly 40 percent of study participants, while only 3.9 percent of controls showed the symptoms of the disorder.

Another important finding in the study by Kitcher et al. (2014) is related to employees noise-protective behaviors. The researchers observe that 5 percent of study participants reported the regular use of hearing protection devices. At the same time, the largest part of the sample population (54.5 percent) had sufficient awareness of the negative impacts of exposure to noise. Thus, there is no correlation between knowledge about the effects of excess noise on employees behaviors.

Lastly, Kitcher et al. (2014) state that the data on self-reported hearing loss and the results of audiometric testing were not similar. It means that the majority of the assessed individuals do not know how to recognize the impairment.

Study 3: Cigarette Smoking and Occupational Noise-Induced Hearing Loss

The cross-sectional study by Mohammadi et al. (2009) is devoted to the investigation of the relationship between such factors contributing to NIHL as noise and cigarette smoking. It is suggested that tobacco use may increase the risk for the development of hearing loss and is regarded as one of the causes of cochlear damage (Mohammadi et al., 2009). The research of links between the two factors is of great interest because smoking is very common among workers.

The study setting selected by Mohammadi et al. (2009) was a large Iranian wagon manufacturing factory where the noise was the major and sole occupational hazard pertaining to hearing loss. The factory employees were regularly exposed to excess noise levels over 85 dBA. The total study sample was comprised of 252 smokers and 453 non-smokers. All study participants were males. The study was conducted as a part of the regular medical examinations. Along with clinical data, the researchers collected self-reported information by using questionnaires. The analysis was carried out by implementing the SPSS. A t-test was administered for quantitative variables, and a Chi-square test  for the qualitative ones. Additionally, the researchers applied the regression analysis. The estimated average age of the workers was 42.25 years, the average time of exposure to noise  18.14 years, and the mean hearing loss rate at 4000 Hz  25.46 dB.

The analysis results indicate a significant difference in predisposition to NIHL in smokers and non-smokers. Although both study populations were exposed to excess noise in a similar degree, Mohammadi et al. (2009) observe that the likelihood of hearing impairment significantly increases when the pack-years ratio related to smoking increases accordingly. The researchers claim that tobacco use modifies blood viscosity and oxygen saturation. In this way, it may contribute to the impairment of cochlear circulation which may consequently result in hearing loss.

Discussion

Based on the study results discussed in the previous section, it is possible to presume that hearing loss may be largely defined by the level of occupational noise and the overall period of employees exposure to it. NIHL is usually manifested as the sensorineural impairment in one or both ears and is characterized by the increase in the sound reception thresholds at the initial stages of disorder development due to the long-lasting contact with the excess noise. However, it is also possible to say that the likelihood of hearing ability deterioration does not depend on the level of noise alone can be defined but multiple environmental and individual behavioral and health factors as well. For instance, as Mohammadi et al. (2009) state, when combined with exposure to occupational hazards, such endogenic determinants as smoking-related hypertension and cardiovascular conditions increase the risks for NIHL progression. Wells et al. (2015) also note that such demographic factor as age may largely affect the course of the disorder development. Thus, when trying to identify the causes of hearing impairments in individuals, one should consider the changes in sound reception ability associated with aging and other etiologic factors.

The main instrument used by the researchers in the selected studies was the pure-tone threshold audiometry  a standardized tool which helps to identify the symptoms and the type of NIHL. However, the fact that audiometry does not provide any data on etiology and pathogenesis of hearing loss may be considered the major weakness associated with the assessment instrument. Therefore, 2e should consider the non-specificity of clinical testing measures used in the studies to indicate NIHL and the polietiologic nature of the health problem.

Nevertheless, despite the potential limitations of the assessment tool, the studies provided sufficient information supporting the direct links between the exposure to high level of noise and hearing loss. For example, the findings obtained by Wells et al. (2015) demonstrate that the incidence of hearing impairment and hearing loss among military veterans is greater than in members of the civilian population. Therefore, the continual military service characterized by the exposure to multiple physical hazards and high-impulse noise, in particular, is correlated with hearing loss. Additionally, the evidence provided by Kitcher et al. (2014) makes it clear that market mill workers who are regularly exposed to noise over 85 dBA are predisposed to the development of the hearing impairment in a greater extent than traders who work in less hazardous environments. The researchers observe that the pattern of hearing impairment in workers, coupled with the significant presence of 4 kHz audiometric notch implies that the hearing loss among the study participants was likely associated with NIHL (Kitcher et al., 2014, p. 186). First of all, the differences in hearing impairment rate in two population groups (continually exposed to excess noise and non-exposed) signify that there are the direct relations between the hazardous physical factor and the evaluated health outcome.

Overall, it is possible to say that excess noise is the primary cause of hearing loss that may be developed in unfavorable working environments. There is a significant dependence between the health outcome and the level, and duration of noise exposure, as well as various socio-demographic determinants. These secondary factors define the dynamic nature of the relationship between the noise factor and individual health outcomes. It is possible to conclude that the combination of those factors may increase the risk for hearing loss development.

Conclusion

According to the researchers, about 600 million employees around the globe are exposed to occupational noise (Mohammadi et al., 2009). Since the findings of the literature review support the assumption that the exposure to noise exceeding the permissible levels is detrimental to human health and can be regarded as the major risk factor for NIHL, it is essential to design prevention and intervention strategies aimed to reduce the incidence of hearing loss within the target population. Occupational hearing loss is a topical public health concern. It leads to adverse consequences at both individual and social levels affecting the functionality of people diagnosed with NIHL and leading them to social isolation. It is apparent that the condition deteriorates the quality of life and, therefore, the effective methodology should be designed to reduce the current rate of occupational hearing loss.

As Mohammadi et al. (2009) state, an important point is that NIHL is permanent and irreversible, but it is completely preventable (p. 452). The given statement emphasizes the importance of policies regulating employees behaviors, working environments, health monitoring criteria, and training on health risks and prevention methodologies.

The review of the literature helped to understand that individual employees noise-protective behaviors and the level of awareness are correlated with the progress of hearing impairment development. Overall, the irregular use of protection devices, along with the inability to identify the hearing loss without the professional help identified by Kitcher et al. (2014), prompt the areas which should be addressed in the prevention strategy. First of all, the government and organizational control of occupational hearing protection should be increased because it seems that the absence of efficient policies contributes to the high prevalence of the adverse condition among workers in the industrial sectors associated with the exposure to excess noise. Moreover, it can be recommended to make regular audiometric testing and assessment of the working environment the integral parts of a complete NIHL prevention program.

Due to the multifactorial nature of NIHL, the policies and prevention programs should target as many areas of concern as possible. We should consider that if preventive measures implemented independently of each other, their positive effect may be reduced. Therefore, it is important to develop an integrated approach to improving the situation by targeting many factors contributing to NIHL simultaneously. Therefore, a population-based prevention program is needed. When developing the policy, we should focus on both qualitative and quantitative aspects of prevention efforts. The policy should stimulate the involvement of as many stakeholders, individuals, and organizations as possible. Moreover, it should address causal and, at the same time, modifiable risk factors such as employees behavior (e.g., promotion of healthier lifestyles, smoking cessation, etc.). In this way, it will be possible to reduce NIHL incidence and achieve sustainable positive outcomes.

Appendix 1: Summary of Studies

Appendix 2: Bradford Hill Criteria

References

Kitcher, E., Ocansey, G., Abaidoo, B., & Atule, A. (2014). Occupational hearing loss of market mill workers in the city of Accra, Ghana. Noise and Health, 16(70), 183. Web.

Mohammadi, S., Mazhari, M., Mehrparvar, A., & Attarchi, M. (2009). Cigarette smoking and occupational noise-induced hearing loss. European Journal of Public Health, 20 (4), 452455.

National Institute on Deafness and Other Communication Disorders. (2017). U.S. adults aged 20 to 69 years show signs of noise-induced hearing loss. Web.

Wells, T., Seelig, A., Ryan, M. K., Jones, J., Hooper, T., Jacobson, I., & Boyko, E. (2015). Hearing loss associated with US military combat deployment. Noise and Health, 17(74), 34. Web.