WRITTEN ASSIGNMENT 1

 Aim

The aim of this assignment is for you to review one of the selected pathologies outlined below and present two randomized controlled trials (RCTs) relating to and supporting the use of a commonly used health intervention to manage this disease. This will enable you to expand your knowledge in one area of applied science. You will gain the skills required to access current literature, and thus facilitate the underpinning of practice by current scientific research.

 Topic

First, choose one of the following pathologies for your assignment: cardiovascular disease (this includes cardiac pathologies, stroke, and peripheral vascular disease); type 1 or type 2 diabetes, cancer, or a pathology associated with one of the following body systems – central nervous system, immune, renal, gastrointestinal or respiratory. You may choose a rare pathology (but please check with the course lecturers that it is a suitable topic.

Second, choose a widely used intervention for managing this pathology. Examples of suitable interventions include a drug (such as Flixotide); an immunization program (i.e. the meningococcal vaccine); a screening program (mammography)or a comparison of different interventions. Review the literature to ensure there are suitable RCTs before you decide on an intervention.

Third, identify and present two well-designed RCTs that support the use of this intervention. Outline the characteristics of the study and participants, the major findings, and their relevance within a New Zealand setting (including ‘numbers needed to treat’). Explain the biological (or mechanism of) action of intervention and how it improves the underlying pathophysiological process or health outcome. In your discussion comment on how good the evidence is. For example, have there been additional RCTs conducted that also support the intervention or perhaps findings have been mixed (positive, neutral, or negative)? Have there been other types of other epidemiological studies carried out (case-control, cohort, or cross-sectional studies) that support the intervention?

 For this assignment, you need to either post a patient case profile from your area of practice or post a response to one of your colleague’s case profiles. If you work in secondary care (hospital-based) you are asked to post a patient case profile and address the questions outlined below. The case profile is due by the end of week 6. If you work in primary health or a community setting you are asked to respond to one of the patient case profiles posted and address the questions outlined below. This case response is due by the end of week 11. When you complete your case profile OR case response upload your assessment on Canvas under ‘Assignments‘ and ‘Case Profile‘ OR ‘Case Response‘ for marking. You are also required to upload your ‘Case Profile’ OR your ‘Case Response’ on Piazza so that your colleagues can read the case profiles and responses.

CASE PROFILE

For those of you who work in secondary care (hospital-based) you will present a patient case profile from your area of practice. This is to be submitted on ‘Canvas under Assignments’ and ꞋCase ProfileꞋby by the end of week 5. For this

1. Profile your selected patient using the template below and include all relevant clinical and laboratory findings. Please delete or write over the example below to present your patient and remember to write your name and the date you upload the case profile.

2. Choose and describe how one of the clinical or laboratory findings outlined relates to the patient’s underlying disease or pathology. Following the tabulated example outlined below. A patient (Mr. Wilson) has been admitted to the hospital after a myocardial infarction. One of the clinical findings is ‘difficulty breathing’ due to pulmonary edema. You would explain how this is most likely due to left ventricle dysfunction, a decrease in stroke volume, and cardiac output. An increase in blood volume and pressure throughout the pulmonary veins and capillaries are likely to increase the volume of water filtering out of the pulmonary capillaries into the surrounding interstitial space and explain how this has contributed to Mr. Wilson’s ‘difficulty in breathing.¹

 Table 1.     Patient case profile.

cholesterol; COPD, chronic obstructive pulmonary disease; HR, heart rate, LDL-C, low-density lipoprotein-cholesterol; BMI, body

mass index; TAGs, triglycerides; ACR, serum albumin: creatinine ratio.

 Description of one important finding related to the underlying pathology 

CASE RESPONSE

For those of you who work in primary health care, a community setting (or outside of a hospital) please choose one of the patient profiles posted on Piazza and address the questions outlined below. This is to be submitted on ‘Canvas under ‘Assignments’ and ‘Case Response by the end of week 11. For this assignment.

1. Choose one of the patient case profiles on ‘Canvas’ under ‘Assignments’. Clearly indicate the case profile you have chosen by including the details outlined below describing the patient profile.

2. Choose one clinical or laboratory finding listed in the case profile and describe how it relates to the patient’s underlying pathology. This may be the same finding that has been previously described but the pathology description needs to differ.

3. Identify and describe an intervention currently used to improve this finding and support this with one peer-reviewed (published) reference. Include a discussion of the biological action of this intervention. Using Mr. Wilson as an example, frusemide is often used to reduce peripheral and pulmonary edema following myocardial infarction. For this, you would need to outline the action of frusemide and explain how it reduces pulmonary edema and improves breathing.

WRITTEN ASSIGNMENT 2 –PORTFOLIO CASE STUDIES

 Create a separate word document to write and save the portfolio case studies as you complete them. Remember to make copies of your portfolio and email this document to yourself after completing each case study (as another backup). When you have completed all the case studies, I suggest you print out a hard copy for reading and final editing. When you are ready to submit your portfolio, upload it through ‘Canvas’ and ‘Portfolio assignment for marking. You will find each case study and the questions to complete listed under the ‘Portfolio’ heading which appears along the top on most web pages of the online course.

Topic1:    Defence System

1. Vaccine Case Study

2. Viral infection Case Study

3. Bacterial infection Case Study

Topic 2:   Cardiovascular Pathology

4. Cardiovascular Case Study (Adult OR pediatric)

 Topic 3: Acid-Base Imbalances

5. Acid-Base Case Study

Topic 4: Renal Pathology

6. Renal Case Study –(Adult OR pediatric)

Topic 5: Endocrine Pathology

7. Diabetes type I Case Study

8. Diabetes type 2 Case Study

Topic 6: Respiratory Pathology

9. Asthma Case Study

10. RespiratoryCase Study (Adult OR pediatric)