Author: joseph

A seizure occurs when the brain functions abnormally, resulting in a change in movement, attention, or level of awareness. Different types of seizures may occur in different parts of the brain and may be localized (affect only a part of the body) or widespread (affect the whole body). Seizures may occur for many reasons, especially in children. Seizures in newborns may be very different than seizures in toddlers, school-aged children, and adolescents. Seizures, especially in a child who has never had one, can be frightening to the parent or caregiver.

• A low percentage of all children have a seizure when younger than 15 years, half of which are febrile seizures (seizure brought on by a fever). One of every 100 children has epilepsy-recurring seizures.
• A febrile seizure occurs when a child contracts an illness such as an ear infection, cold, or chickenpox accompanied by fever. Febrile seizures are the most common type of seizure seen in children. Two to five percent of children have a febrile seizure at some point during their childhood. Why some children have seizures with fevers is not known, but several risk factors have been identified.
• Children with relatives, especially brothers and sisters, who have had febrile seizures are more likely to have a similar episode.
• Children who are developmentally delayed or who have spent more than 28 days in a neonatal intensive care unit are also more likely to have a febrile seizure.
• One of 4 children who have a febrile seizure will have another, usually within a year.
• Children who have had a febrile seizure in the past are also more likely to have a second episode.
• Neonatal seizures occur within 28 days of birth. Most occur soon after the child is born. They may be due to a large variety of conditions. It may be difficult to determine if a newborn is actually seizing, because they often do not have convulsions. Instead, their eyes appear to be looking in different directions. They may have lip smacking or periods of no breathing.
• Partial seizures involve only a part of the brain and therefore only a part of the body.
• Simple partial (Jacksonian) seizures have a motor (movement) component that is located in one portion of the body. Children with these seizures remain awake and alert. Movement abnormalities can “march” to other parts of the body as the seizure progresses.
• Complex partial seizures are similar, except that the child is not aware of what is going on. Frequently, children with this type of seizure repeat an activity, such as clapping, throughout the seizure. They have no memory of this activity. After the seizure ends, the child is often disoriented in a state known as the postictal period.
• Generalized seizures involve a much larger portion of the brain. They are grouped into 2 types: convulsive (muscle jerking) and nonconvulsive with several subgroups.
• Convulsive seizures are noted by uncontrollable muscle jerking lasting for a few minutes-usually less than 5-followed by a period of drowsiness that is called the postictal period. The child should return to his or her normal self except for fatigue within around 15 minutes. Often the child may have incontinence (lose urine or stool), and it is normal for the child not to remember the seizure. Sometimes the jerking can cause injury, which may range from a small bite on the tongue to a broken bone.
• Tonic seizures result in continuous muscle contraction and rigidity, while tonic-clonic seizures involve alternating tonic activity with rhythmic jerking of muscle groups.
• Infantile spasms commonly occur in children younger than 18 months. They are often associated with mental retardation and consist of sudden spasms of muscle groups, causing the child to assume a flexed stature. They are frequent upon awakening.
• Absence seizures, also known as petit mal seizures, are short episodes during which the child stares or eye blinks, with no apparent awareness of their surroundings. These episodes usually do not last longer then a few seconds and start and stop abruptly; however, the child does not remember the event at all. These are sometimes discovered after the child’s teacher reports daydreaming, if the child loses his or her place while reading or misses instructions for assignments.
• Status epilepticus is either a seizure lasting longer than 30 minutes or repeated seizures without a return to normal in between them. It is most common in children younger than 2 years, and most of these children have generalized tonic-clonic seizures. Status epilepticus is very serious. With any suspicion of a long seizure, you should call 911.
• Epilepsy refers to a pattern of chronic seizures of any type over a long period. Thirty percent of children diagnosed with epilepsy continue to have repeated seizures into adulthood, while others improve over time.

One of the greatest aspects of nursing as a profession is the ability to work in many types of environments and in many different roles. It is a field which is constantly evolving.

Registered Nurses (RNs) can work at the bedside with the sickest patients or opt to care for those who are mostly well. They can work directly with patients or indirectly by collaborating with the interdisciplinary team or others involved in healthcare to help patients.

For every individual temperament and personality exists a nursing specialty. The pace of a working environment can be fast and full of adrenaline, or a slower pace with lots of time to spend bonding with patients and families, or somewhere in between. RNs can have a great amount of pressure to do everything perfectly and quickly with extremely high stakes, or they may work in an environment that is more relaxed with basically “well” patients who want to chit-chat while they wait for their physician’s appointment. Registered Nurses (RNs) can work with every age and population from very sick premature newborns to the elderly at the end of life, from school children needing check-ups to adults who are undergoing elective plastic surgery. The options are nearly endless. Learn how to become an RN.

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RNs have the option of working in hospitals, long-term care facilities, clinics, physician’s offices, prisons, from home, as a traveling nurse in hospitals across the country, and in many other specialty roles. Read more to see if a nursing career is right for you.

And, as the political healthcare environment continues to grow and evolve, Registered Nurses (RNs) are finding that the options are growing quickly. There are specialties and niches for nurses of all education levels, from ADN and BSN educated RNs, to graduate degree-level nurses and nurse practitioners, and beyond. The nursing specialty options for RNs are bountiful, and they just keep growing! See our glossary of nursing abbreviations and terms and entry level nursing careers.

Nursing is not for everyone. It takes a very strong, intelligent, and compassionate person to take on the ills of the world with passion and purpose and work to maintain the health and well-being of the planet.

Where Do RNs Work?

Nurses work in many different areas of healthcare and the roles often vary within each environment. All of them can basically be differentiated by either direct or indirect patient care areas.

Direct Patient Care RN

The Registered Nurses (RNs) works “at bedside” in collaboration with the interdisciplinary team and his/her primary role is to work “hands-on” with a patient. This RN works directly with patients, performing various tasks.

Indirect Patient Care RN

The RN works in collaboration with the Bedside Nurse and interdisciplinary team to support the care of patients. This RN may not be as “hands-on” as a direct patient care RN, and may work in more management or administrative capacities.

RNs can work in a variety of healthcare settings, including:

• Hospitals
• Skilled Nursing Facilities
• Outpatient Settings
• Physician Offices
• Clinics
• Insurance Companies
• Government
• Community Health
• Elementary or High Schools
• Universities
• Correctional Healthcare Facilities

Advanced Practice Registered Nursing (APRN) Careers

For nurses with big career aspirations, advanced practice registered nursing (APRN) is a rewarding pathway. These nursing careers require graduate-level degrees, such as a Master’s of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP) degree. APRNs bridge the gap between nurses and physicians, performing high-level duties and often overseeing nursing staff. APRNs are also often a primary source of medical care for many patients, and therefore can enjoy long-lasting relationships. Advanced practice RNs can hold a number of highly coveted specialty nursing positions, including:

• Nurse Practitioner
• Clinical Nurse Specialist
• Nurse Midwife
• Nurse Anesthetist

Experience

Experience in nursing is irreplaceable. Usually the most widely accepted experience for employers is as a direct patient care Registered Nurses (RNs), or Bedside RN, at least at the beginning of the RN’s career. It is essential that the new-graduate RN get at least 1 year of bedside experience. The caveat to this statement is that there are always some exceptions! But, for the most part, this is true even for RNs who wish to work in indirect patient care roles. Therefore, finishing school and getting that first Bedside RN job as fast as possible is the best way to improve lifetime earning potential. Besides, working closely with patients in a Bedside RN capacity is why most nurses chose the profession!

Nursing Specialty

Specialties with the highest need and skill set tend to pay more and be in higher demand. Certain industries have a higher demand for RNs of all types, and may pay nurses in niche areas at the top of the pay grade.

The top 5 industries with the highest levels of RN employment in 2019 were:

• General Medical and Surgical Hospitals
• Offices of Physicians
• Home Health Care
• Skilled Nursing Facilities
• Outpatient Care

Childhood obesity is increasing at alarming rate and it is a matter of concern. Childhood obesity is a serious health issue and can affect both physical and psychological health. Childhood obesity occurs when a child is well above the normal or healthy weight according to his or her age and height. Being overweight or obese in childhood could lead to several health issues in the long run. These include high blood sugar levels, joint pain, high blood pressure, sleep disorders, high cholesterol, asthma and heart diseases. Therefore, it is very important that parents give proper attention to their child’s eating habits and weight for their overall well-being. The primary causes of overweight or obesity in young children are similar to those in adults.

Top 4 causes of obesity in young children:

1. Unhealthy eating habits:

Food choices play an important role in maintaining a healthy body weight whether it is children or adults. One of the main reasons your child is overweight is the excessive intake of fatty, junk or processed and sugary foods.

2. Sedentary lifestyle:

If your child is inactive and spends a lot of time watching television, playing video games or on other electronic devices, this may lead to weight gain.

3. Lack of physical activity:

No physical activity is extremely harmful for your child and can make him obese. Children generally tend to eat sugary stuff or junk food which generally leads to weight gain. But if they are not engaging themselves in some physical activity to burn calories, they tend to become obese or develop some or the other health problem.

4. Genetics:

Some rare gene disorders can also cause childhood obesity. If it runs in the family, parents need to be even more conscious of making healthy food choices for the whole family.

5. Stress:

Yes! Even young children might deal with stress issues. These stress can be personal, parental and family stress. Even these factors could cause obesity in young children. Some children overeat in order to cope with stress or to deal with emotions.

Small lifestyle changes to fight childhood obesity:

• Parents should make sure that children eat balanced meals with high-proteins and fibrous foods
• Snacking is not bad at all. But snacking on unhealthy foods like chips, burger, muffins, pizza can be harmful. So while giving snacks to your children, go for some healthy options like healthy nuts and seeds, protein bars, smoothie, salads, whole eggs or salad
• Children should not indulge in eating processed, junk and fatty foods. Even sweetened beverages are harmful for your kids as they are loaded with preservatives and added sugar. These foods do not provide any nutritional value and can lead to unnecessary weight gain
• Encourage your child to spend lots and lots of time in physical activity
• Limit the screen time of your children
• Ensure that your child sips in adequate water throughout the day as that will help him stay hydrated

At the top of nursing management positions within a healthcare organization is the position of the Chief Nursing Officer (CNO) or sometimes referred to as Chief Nurse Executive (CNE). The CNO’s role is complex and requires several years of nursing and leadership experience to be up to the task. They are responsible for overseeing and coordinating the daily activity within the nursing department by being the spokesperson for nurses while planning, organizing, and directing the overall operations of nursing and patient care services. Chief Nursing Officers take into consideration the business perspective of the hospital system, best practice, and the needs of nursing staff while facilitating efficient and effective departmental operations. Today’s CNOs are frequently involved in implementing the nursing department budget while achieving consistent quality patient outcomes and adhering to healthcare delivery guidelines and standards.

Becoming a Chief Nursing Officer

Becoming a Chief Nursing Officer requires years of dedication beginning with completing a nursing education and obtaining a state license as a registered nurse by passing the NCLEX-RN, administered by the National Council of State Boards of Nursing. To be a successful CNO, the nurse should work several years in the clinical setting while eventually gaining experience in leadership roles. It is a common expectation that a nurse aspiring to be a CNO will have 5+ years of managerial experience before pursuing an executive administrative role.

What Are the Educational Requirements for Chief Nursing Officers?

Chief Nursing Officers are required to have a Bachelor’s of Science in Nursing (BSN) degree from an accredited four-year nursing school. If already a registered nurse, it’s possible to complete an RN to MSN degree program, bypassing the BSN step. Receiving a Master’s of Science in Nursing (MSN) degree that is concentrated in Nursing Administration or Leadership in Health Care Systems, or a dual MSN degree alongside a Master of Health Administration (MHA) – see Dual MSN/MHA, or a Master of Business Administration (MBA) – see Dual MSN/MBA, is quickly becoming the standard for achieving leadership roles within the business of healthcare. In some cases, large health organizations will prefer candidates with a Doctor of Nursing Practice (DNP) specializing in executive administration.

Are Any Certifications or Credentials Needed?

There are various credentialing centers that offer certification options that compliment a Chief Nursing Officer’s degree education and professional experience. The decision to work toward one of these certifications, and which one, may depend on the specific job setting. One certification option is the Nurse Executive certification (NE-BC) through The American Nurses Credentialing Center (ANCC). Nurse executives must have an active RN license, hold at least a bachelor’s degree, be working in a mid-level administrative role, and complete 30 hours of continuing education in nursing management every three years to be eligible. Certifications in Executive Nursing Practice and Management and Leadership (CNML) can be obtained from the American Organization for Nursing Leadership (AONL), which also offers a tailored certification course for nurse leaders specifically involved in executive nursing practice called the CENP. The American College of Healthcare Executives (ACHE) is another credentialing resource. Read more for further clarify on nurse executive certifications.

Where Do Chief Nursing Officers Work?

Chief Nursing Officers typically work overseeing nursing departments and are the voice for nurses to other healthcare and business administrative professionals in boardrooms. They usually work full-time, although their hours may be irregular (such as 12-hour shifts), in the evenings, overnight, or on the weekends, depending on the employer and situation.

Settings where Chief Nursing Officers may find employment include:

• Hospitals
• Outpatient care centers
• Clinics
• Group physician practices
• Rehabilitation facilities
• Government agencies
• Healthcare system corporate office

What Does a Chief Nursing Officer Do?

A Chief Nursing Officer is usually involved in advising senior management on best nursing practices, creating retention programs, establishing compensation wages, managing nursing budgets, planning new patient services, conducting performance assessments, and representing nurses at board meetings. They manage personnel via implementing the recruitment, hiring, and retention processes. Chief Nursing Officers may be required to manage the staff working in multiple nursing departments in their health care system while reporting directly to the organization’s Chief Executive Officer (CEO).

What Are the Roles and Duties of a Chief Nursing Officer?

• Creating a nursing environment that fosters collaboration
• Partnering with physicians to ensure a smooth workflow
• Ensuring that nursing standards are upheld
• Maintaining regulatory and compliance approvals and accreditations
• Working with senior management and medical staff to develop strategic plans
• Cultivating relationships across functions and departments
• Serving as a spokesperson for the entire nursing department
• Promoting the mission, vision, and values of the organization.
• Organizing, directing and administering nursing-patient care service best practice
• Maintaining quality assessment and improvement
• Facilitating opportunities for education and professional advancement of employees
• Establishing and monitoring evaluation of performance improvement

A gastroenterology nurse is an RN who specializes in illnesses and disorders related to the entire GI tract. Gastroenterology nurse also assist physicians with procedures, education, and treatments. Some of the disorders they are familiar with are:

• Constipation
• Acid reflux
• Crohn’s disease
• Celiac Disease
• Food allergies
• Irritable Bowel Syndrome
• Cancers of the GI tract including:
  • Small intestine
  • Large intestine
  • Rectum
  • Gallbladder
  • Stomach
  • Esophagus
  • Liver
  • Pancrease

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Becoming a Gastroenterology Nurse

RNs considering GI nursing should have an interest in performing and assisting with procedures, pre-and post-operative care, and patient education and counseling. Task-oriented nurses with good customer service skills do well in the role. After graduating with a nursing degree and becoming licensed, many GI nurses get their start as ICU or ER nurses, and experience with conscious sedation is a big plus.

What Are the Educational Requirements for a GI Nurse?

Those interested in the field of gastroenterology nursing should first pursue a nursing degree through a two- or four-year university. Obtaining an associate’s degree (ADN) or bachelor’s degree (BSN) in nursing is required. It’s important to note that many hospitals are moving towards requiring BSN-educated nurses for some specialty roles.

After completion of an accredited nursing program, successful completion of the NCLEX-RN is required for licensure.

Any Certifications or Credentials Needed?

While formal certification is not required for many positions as a GI nurse, it is recommended. Obtaining certification in the GI specialty demonstrates a commitment to the field and holds the RN at a higher standard of care.

The American Board of Certification for Gastroenterology Nurses (ABCGN) offers certification and is the only Certified Gastroenterology Registered Nurse (CGRN) certification program accredited by the American Board of Nursing Specialties (ABNS). Eligibility requirements for certification are as follows:

• Must have employment in a clinical, supervisory, administrative, teaching/educational/research role for a minimum of two years, full time (4,000 hours part-time equivalent) within the last five years in the specialty of gastroenterology
• Work as an RN for a minimum of two years prior to sitting for the exam
• Submit contact information for two practitioners who can verify work experience and qualifications
• Demonstrate they hold a current, unrestricted RN license

The certificate is good for five years. Recertification is either completed via exam or completion of continuing education units.

How Hard Is the CGRN Exam, and How Frequent Is Recertification?

In 2019, 506 candidates took the CGRN, and 351 (69.4%) passed the exam, earning their CGRN certification. Once achieving the certification, you must recertify every five years. Candidates may recertify their credentials by retaking the CGRN certification exam or by submitting an application with contact hours that you earn through an educational seminar or workshop.

Where Does a Gastroenterology Nurse Work?

Gastroenterology nurses can work in a variety of settings where GI testing and procedures are performed, but most often work in:

• Hospitals
• Private practice/clinics
• Long-term care facilities
• Surgery centers

Gastroenterology nurses assist in procedures such as colonoscopies/endoscopies and conscious sedation. They also educate patients on medications and diet and perform assessments on patients receiving treatment.

What Are the Roles of a GI Nurse?

The role of a GI nurse is multi-faceted. Utilizing the nursing process of assessing, diagnosing, planning interventions, implementing treatment, and evaluating the patient’s response, the GI nurse:

• Assists with endoscopy/ colonoscopy
• Performs pre- and post-procedure patient education
• Educates patients in diet changes needed to maintain a healthy GI tract
• Works collaboratively with physicians, nutritionists, and other ancillary staff to ensure the patient’s needs are met
• Medication management/education
• Maintain a clean and safe environment during GI procedures
• Administers, maintains, and monitors conscious sedation
• Ensures patient pain is controlled
• Ensures patients are clinically stable before discharge

How Will Becoming a Certified Gastroenterology Registered Nurse (CGRN) Help My Nursing Career?

Earning your CGRN allows you an opportunity to become a nurse expert within the gastroenterology field. It also helps you improve patient care, expand your role in providing patient services, and potentially accelerate your career growth within your chosen specialty.

GI Nurse Salary & Employment

As medicine is evolving and growing, more patients are undergoing outpatient diagnostic procedures. GI nurses have many employment opportunities in varied clinical settings, from procedure nurses to supervisory or research roles. According to payscale.com, the annual salary for certified GI nurses range from $79,284 to $100,000 based on the role (nurse manager, staff RN, clinical director).

The early symptoms of dementia can include memory problems, difficulties in word finding and thinking processes, changes in personality or behavior, a lack of initiative or changes in day to day function at home, at work or in taking care of oneself. This information does not include details about all of these warning signs, so it is recommended that you seek other sources of information. If you notice signs in yourself or in a family member or friend, it is important to seek medical help to determine the cause and significance of these symptoms. 

Obtaining a diagnosis of dementia can be a difficult, lengthy and intensive process. While circumstances differ from person to person, Dementia Australia believes that everyone has the right to:

• A thorough and prompt assessment by medical professionals, 
• Sensitive communication of a diagnosis with appropriate explanation of symptoms and prognosis, 
• Sufficient information to make choices about the future,
• Maximal involvement in the decision making process, 
• Ongoing maintenance and management, and 
• Access to support and services.  

For some people, there may be barriers to diagnosis, especially to an early diagnosis. These include the belief that memory problems are a normal part of ageing, the perceived stigma attached to dementia, the lack of a cure and fear about the future. However, there are many reasons why early diagnosis is important, some of which are detailed within this page. Early diagnosis and awareness about dementia are the first steps in designing management strategies. As more effective treatments become available in the future, early diagnosis will become even more important.  

What are the benefits of early diagnosis?

Early planning and assistance

Early diagnosis enables a person with dementia and their family to receive help in understanding and adjusting to the diagnosis and to prepare for the future in an appropriate way. This might include making legal and financial arrangements, changes to living arrangements, and finding out about aids and services that will enhance quality of life for people with dementia and their family and friends. Early diagnosis can allow the individual to have an active role in decision making and planning for the future while families can educate themselves about the disease and learn effective ways of interacting with the person with dementia.

Checking concerns
Changes in memory and thinking ability can be very worrying. Symptoms of dementia can be caused by several different diseases and conditions, some of which are treatable and reversible, including infections, depression, medication side-effects or nutritional deficiencies. The sooner the cause of dementia symptoms is identified, the sooner treatment can begin. Asking a doctor to check any symptoms and to identify the cause of symptoms can bring relief to people and their families.

Treatment
There is evidence that the currently available medications for Alzheimer’s disease may be more beneficial if given early in the disease process. These medications can help to maintain daily function and quality of life as well as stabilise cognitive decline in some people; however, they do not help everyone and they are not a cure. Early diagnosis allows for prompt access to medications and medical attention.

Health management
Receiving a diagnosis can also help in the management of other symptoms which may accompany the early stage of dementia, such as depression or irritability. Also reviewing management of other medical conditions is critical, as memory problems may interfere with a person remembering to take important medications such as for diabetes, heart disease or high blood pressure.  

Current practice in diagnosing dementia

The remainder of this information will provide an overview of the diagnosis process and a guide to what happens after diagnosis. 

It is important to remember that there is no definitive test for diagnosing Alzheimer’s disease or any of the other common causes of dementia. Findings from a variety of sources and tests must be pooled before a diagnosis can be made, and the process can be complex and time consuming. Even then, uncertainty may still remain, and the diagnosis is often conveyed as “possible” or “probable”. Despite this uncertainty, a diagnosis is accurate around 90% of the time. 

People with significant memory loss without other symptoms of dementia, such as behaviour or personality changes, may be classified as having a Mild Cognitive Impairment (MCI). MCI is a relatively new concept and more research is needed to understand the relation between MCI and later development of dementia. However, MCI does not necessarily lead to dementia and regular monitoring of memory and thinking skills is recommended in individuals with this diagnosis.  

The diagnosis process

The first step in the diagnosis process is to assess symptoms through a thorough medical history, physical examination and evaluation of memory and thinking abilities. Other causes of dementia-like symptoms must be ruled out through laboratory tests and in some cases, brain scans. The next step is to determine the cause of the dementia, most commonly Alzheimer’s disease, vascular dementia, Lewy body dementia or frontotemporal dementia.  

Medical history

The doctor will obtain a complete medical and family history. Questions will be asked about forgetfulness, orientation, problem solving, coping with everyday life, alcohol consumption and medication usage. The doctor needs to establish when the change in function was first noticed, whether the change was sudden or gradual and whether the person’s difficulties are getting worse. Determining the onset and progression of symptoms can help to differentiate types of dementia. Descriptions of the person’s difficulties from family members, obtained if the person consents, are vital in the diagnosis process.  

Medical testing

• Medical tests, including blood, urine and genetic tests, as well as brain scans, are sometimes used in the diagnosis of dementia. 
• Blood or urine tests are carried out to exclude other causes of dementia symptoms, by testing for infections, vitamin and nutrient levels, as well as kidney, liver and thyroid function. Psychological evaluation

Tests of mental functioning are very important in the diagnosis process. These tests are used to determine the extent of any memory or thinking problems and can be used to track progression over time. 

Brief screening tests can be followed up by more detailed tests of mental function. These tests are known as neuropsychological tests and examine different areas of function such as memory, language, reasoning, calculation and ability to concentrate. 

These tests are able to distinguish between different patterns of decline and are therefore important in helping to identify the type of dementia affecting the individual.  

Types of Dementia

There are many different causes of dementia. The most common is Alzheimer’s disease, which is associated with distinctive changes in the brain. While Alzheimer’s disease can develop in younger people, it is most common after the age of 65 years. Vascular dementia is thought to be the second most common form of dementia and is associated with problems of blood circulation in the brain. However, mixed dementia containing elements of vascular dementia and Alzheimer’s disease is also common. 

Future directions in diagnosis research

Considerable research effort is being put into the development of better tools for accurate and early diagnosis. Research continues to provide new insights that in the future may promote early detection and improved diagnosis of dementia, including: 

• Better dementia assessment tests that are suitable for people from diverse educational, social, linguistic and cultural backgrounds.
• New computerised cognitive assessment tests which can improve the delivery of the test and simplify responses.
• Improved screening tools to allow dementia to be more effectively identified and diagnosed by GPs.
• The development of blood and spinal fluid tests to measure Alzheimer’s related protein levels and determine the risk of Alzheimer’s disease.
• The use of sophisticated brain imaging techniques and newly developed dyes to directly view abnormal Alzheimer’s protein deposits in the brain, yielding specific tests for Alzheimer’s disease. 

After the diagnosis

Early diagnosis of dementia is the first step in understanding and managing the condition. Communicating a diagnosis of dementia can allow for planning to begin. Early diagnosis of dementia means that in the vast majority of cases, it is appropriate for people to be told about their diagnosis, as they have a right to information about their health.

In the past, some people argued against telling a person of their diagnosis because of the belief that there is no benefit in knowing, the fear of provoking distress, and that the diagnosis would be difficult for the person to understand. However, although many people with early stage dementia will initially feel ‘shattered’ by the diagnosis, many also say that they feel a sense of relief that the cause of their difficulties is identified, and knowing the diagnosis can increase their sense of independence and enable an active role in planning for their future.

It can be difficult to take in information at the time of diagnosis, so scheduling another time to talk to the doctor is important. Take time and ask as many questions as you like. It may also be helpful to have someone supportive with you at the time of diagnosis. You may want to ask your doctor about the possible benefits of medication and side effects.

Air pollution has been a focus of several studies on cognitive impairment and dementia risk. There is evidence that tiny air pollution particles can enter the brain, but at this time we can’t say if they play a role in the development of dementia. There is a strong case for further research into the effect of air pollution on brain health; that’s Alzheimer’s disease.

What is air pollution?

Air pollution is made up of several different components including gases, chemical compounds, metals and tiny particles known as particulate matter. Long term exposure or exposure to high levels of air pollution can be hazardous, leading to health conditions that affect the lungs and heart. Most research has focused on a component of air pollution known as fine particulate matter or PM 2.5 – tiny particles that are 40 times smaller than the width of a human hair. A form of iron called magnetite is often found within fine particulate matter and can be studied in body due to its magnetic properties. 

Does air pollution affect the brain?

Magnetite particles are released into the air by burning fuel, but they are also produced naturally in the brain. A study of brain tissue from people in Mexico City and Manchester conducted in 2016 confirmed that magnetite from air pollution can pass into the brain. Using a special electron microscope, the researchers examined surface properties of the magnetite particles to prove that they had been generated at the high temperatures found in an engine rather than through natural processes. This study confirmed that fine particulate material can pass into the brain via the blood stream or directly through the thin lining of the nose.

The particles were seen inside protein deposits called amyloid plaques which are abundant in the Alzheimer’s brain, leading to speculation that magnetite could be involved in the development of Alzheimer’s disease. However, the study did not provide evidence that magnetite is involved in the formation of amyloid plaques or that it can lead to the death of brain cells. Alternatively magnetite particles could enter the brain from polluted air and end up in amyloid plaques as a consequence of the brain’s waste disposal processes. 

Studies in mice have shown some effects of breathing polluted air on the brain. Mice that are exposed to polluted air collected from near busy roads show biological changes that are known to cause damage to the brain, as well an increase in levels of the protein amyloid, which is one of the hallmarks of Alzheimer’s disease. However, we know from human brain imaging studies that an increase in brain amyloid protein alone doesn’t necessarily mean that Alzheimer’s disease will develop.

Could air pollution be a cause of dementia?

A direct link between air pollution and Alzheimer’s disease has not been found, however there are many questions still unanswered. A growing number of studies looking at exposure to pollution from around the world combined with increasingly sophisticated techniques for seeing fine particulate matter in the brain and body is creating a case for further research.

Studies of mice and dogs living in polluted areas suggest that air pollution could be associated with cognitive impairment. Exposure of mice and rats to traffic pollution in the lab resulted symptoms such as poorer learning ability, memory and motor skills. In people, there are a couple of studies showing that those who are exposed to high levels of pollutants perform poorer on cognitive tests over time, but this does not mean they have or will develop dementia. 

The most convincing evidence so far comes from study of 6.6 million people from Canada published in 2016 that reported a potential link between dementia and living close to very busy roads. The study found that those living within 50 metres of a major road were 7% more likely to develop dementia than people living more than 300 meters away, where fine particulate matter levels can be up to 10 times lower. As there are other factors associated with living on a busy road, such as high noise pollution and stress, this study doesn’t prove that air pollution causes dementia. However, it does suggest that the study of air pollution and dementia should be prioritised for future research.

The practice of quieting the mind, otherwise known as mindfulness, is increasingly being practiced across the world. Mindfulness specifically refers to the practice of paying attention to the present moment non-judgmentally. Observation of our thoughts and feelings allows us to better understand our emotions and react rationally to negative situations. This practice is very important to children with autism.

Imagine snacking on a bag of chips. We then think about yesterday’s meeting, or all the dishes that need to be washed. Eventually, without even noticing, a few chips turn into half of the bag. Our minds are constantly wandering, ruminating on anything but the present, which can lead to increased anxiety or depression. This is where mindfulness comes in. Despite all the recent buzz, mindfulness is backed by hard science: the practice has been shown to not only reduce stress, depression, and aggression but also change brain regions associated with emotional regulation, introspection, and awareness.

Although most of the research has been done on typically developing adults, a new body of work has shed light on the benefits of mindfulness in children with Autism. Aggression, an especially challenging behavior, has been an important behavior of study in the scope of mindfulness techniques. In contrast to the current behavioral and psychopharmacological interventions for aggressive behaviors, mindfulness-based interventions empower individuals to develop self-management strategies to regulate their challenging behaviors. In a longitudinal study and intervention, researchers had adolescents with autism learn the “Soles of the Feet Procedure,” which involved shifting attention from the emotional trigger to the soles of their feet. Aggressive acts were significantly reduced from 14-20 per week to 4-6 per week after the 3-year follow up period. 

Additionally, mindfulness techniques have been shown to improve parent-child relationships and significantly reduce parental stress, improve parental wellbeing and overall health after just a few weeks. This parental change in behavior has the reciprocal effect of reducing stress and anxiety among their kids. In addition to parents, mindfulness training can allow teachers to better regulate their reactions to stressful classroom situations and manage the social, emotional, and educational needs of their students with Autism Spectrum Disorder (ASD). A five-week mindfulness teacher training intervention introduced stress management and relaxation techniques as well as the application of mindfulness techniques to teaching. The training not only improved teacher’s self-efficacy beliefs but also allowed teachers to better cope with challenging situations. 

Therefore, mindfulness practices may be a viable technique in not only improving behavioral and cognitive responses in those with ASD, but also the overall well-being of their caregivers. Although mindfulness may seem like foreign territory, incorporating mindful practices into daily life can be quite simple.

Here are six simple mindful practices you can introduce to your child (and yourself!)

1. Bell Listening Exercise: Ring a bell, either a physical bell or one from an App or online, and ask your kid to close their eyes and listen to the vibration of the bell. Tell them to raise their hand once the ringing stops and pay attention to any other sounds they hear for about another minute. This is a simple but powerful exercise that shifts one’s attention to the present moment and the surroundings.
2. Bedtime Mindfulness: Ask your child to lie in their bed, close their eyes, and bring their attention to various parts of their body. Start at the toes and slowly move up to the head. This is a calming method to return to one’s body at the end of the day and develop a sense of gratitude for their body.
3. Mindful Walks: Stroll through your neighborhood in silence for a few minutes and have your child pay attention to all the sounds they hear. Then have them report back what they heard. You can also guide them to other sensations such as the breeze through their hair or the crunching of the leaves as they walk. If your child is particularly active, you may ask them to run or skip and notice their increased heartbeat or breath.
   
   
4. Mindful breathing and meditation: Ask your child to close their eyes and sit comfortably. Direct their attention to the sensation of breathing in and out. Ask them to put their hands on their stomach and feel the rise and fall of each breath. You can do this for about five cycles then guide them to any present feelings or thoughts. Tell them to observe those thoughts and feelings and let them go like a balloon. You can repeat this as many times as needed or possible. Here is a guided meditation. 
5. Soles of the Feet: This technique was developed by researchers to manage angst, anger and aggression. When faced with emotionally arousing situations, you can teach your child to redirect their attention and awareness to a neutral part of the body such as the soles of their feet. This technique helps calm and clear one’s mind during stressful and arousing situations.
6. Glitter Jar: Fill a clear jar with water, some glitter, and glycerin or baby oil. A snow globe would be equally great for this activity. Particularly when your child is having a stressful day, ask them to shake up the jar and watch as the glitter settles after swirling chaos. This technique allows for a powerful metaphor that relates the internal state of the mind to a visual object.

Caring for children with congenital heart defects can be challenging. The following tips may help you care for your child so that he or she is as healthy and comfortable as possible. These tips may also help you cope with the difficulties that parents often experience.

Caring for your child in the hospital

You and your child might take many trips to the hospital or doctor’s office for tests, procedures, or surgery.

It’s normal to be frightened and worried about your child being in the hospital. Ask questions about any procedures that you don’t understand or any special care that is needed. In general, try to be with your child as much as possible.

What to expect

While your child is in the hospital for surgery, treatment may involve:

• Receiving intravenous (IV) fluids until your child wakes up after surgery and can eat.
• Having oxygen levels in the blood measured with a pulse oximeter.
• Making adjustments to help make breathing easier. Your child may have the head of the bed or crib raised, be given oxygen (through a hood, tent, or face mask), or sometimes be given treatment with a breathing machine called a ventilator.
• Draining fluids from the chest after surgery. Pressures within the body also may be measured.

How to help

The following are tips to help your child while he or she is in the hospital:

• Take some of your child’s familiar things to the hospital. Favorite toys or blankets will help the child feel more at ease.
• If you cannot stay with the child, visit often.
• Take some pictures of the family. Place them where your child can easily see them. Talk about what is happening with other family members or sing favorite songs.
• Tell the nurses about your child’s habits, typical routines, and general preferences.
• Tell the nurses about any special words that your child may use to tell others what he or she needs.
• If your child is a newborn, hold and touch him or her often to promote bonding.
• As much as possible, help the hospital staff with your child’s care. Find out whether you will be responsible for any treatments at home. Take this time to learn how to do these treatments while the hospital staff is there to teach you.

Coping with oxygen problems

Some heart defects, called cyanotic defects, cause oxygen problems. This means that the child’s body isn’t getting a normal amount of oxygen. Children with cyanosis may have a bluish tint to the skin.

If your child has “blue spells”:

• Attempt to calm the child. This is the most important thing you can do.
• Try placing the child with his or her knees to the chest—either on the back with the knees drawn up to the chest or in a sitting position with the chest to the knees.
• You may need to give your child oxygen if the spells are severe and don’t improve with a change in position. Oxygen is given by placing a small tube at the entrance to the nostrils. Your doctor will determine the proper amount of oxygen needed.
• Try to prevent the cyanosis by keeping your child warm, decreasing activity, and frequently feeding small meals.
• Notify your child’s doctor when a blue spell occurs.

Oxygen therapy

Your child may need extra oxygen at home. It is given through a small tube that rests at the entrance to your child’s nose. Oxygen can cause a fire to burn very rapidly, so no smoking or open flames are allowed in the room where oxygen is being used. The amount of oxygen will be prescribed by your child’s doctor. Don’t change the amount of oxygen you give your child without the advice of your doctor.

Giving medicine

Be sure you know how to give your child’s medicines safely. Heart medicines can be very strong, so they can be dangerous if they are not given correctly.

• Be sure you understand how much medicine to give and how to give it.
• If your child takes a blood thinner, be sure to get instructions about how to give this medicine safely. Blood thinners can cause serious bleeding problems.
• If you aren’t comfortable giving medicine to your child, ask a health professional to help you.
• A home health nurse can help. Talk to your doctor about having a home health nurse visit you. The nurse can set up a schedule for the medicines, show you how to store them, and help you become more comfortable giving them.

Getting your child to eat well

Nutrition is very important for children who have heart defects. Getting your child to eat right can be a challenge. Children with congenital heart defects:

• Often tire when eating, so they eat less and may not get enough calories. Feeding may take longer than you expect.
• Tend to use more calories (have a higher metabolic rate) than other children.

To help overcome feeding difficulties or lack of weight gain:

• Learn to recognize your baby’s first signs of hunger, such as fidgeting and sucking on a fist. This will help you to begin feeding before your baby starts to cry. Your baby will have more energy to eat well if he or she isn’t tired from crying.
• Use a soft, special nipple made for babies born early (premature infants). These nipples make it is easier for your baby to get enough formula or breast milk if you bottle-feed.
• Burp your baby often, especially when using a bottle. Babies who have trouble sucking take in large amounts of air when they eat, which makes them feel full before they get enough breast milk or formula.
• Feed small, frequent meals. Smaller meals don’t require as much energy to eat or digest.

If you have difficulty preparing balanced meals, talk with a registered dietitian. Ask your doctor whether you should increase the number of calories in each meal.

Preventing infections

A congenital heart defect can raise the risk of an infection in the heart called endocarditis. To help prevent this infection, your child needs to take excellent care of his or her teeth throughout life. Good oral care can limit the growth of mouth bacteria that could get into the bloodstream and lead to infection. Call your child’s doctor if he or she has signs of a skin infection or infected wound.

Some children take antibiotics before having any dental and surgical procedures that could put bacteria or fungi into the blood. The antibiotics lower the risk of getting endocarditis.

Make sure that your child gets all the recommended vaccines, which helps keep your child healthy. Make sure family members and people who are in close contact with your child also get recommended vaccines.

Helping with emotional issues

Children and teens with congenital heart defects may have self-esteem issues because of how they look. They may have scars from surgery, and they may be smaller, have clubbing, or have limits on how active they can be.

Children may feel alone and have trouble coping because they have to stay in the hospital often. Most children deal well with having a heart defect. But some children with serious heart defects may have a hard time feeling “normal.”

Taking care of yourself

Dealing with a lifelong and possibly life-threatening illness in your child can have a strong impact on your life as a parent. It can be hard to accept that your child has a serious illness. And it’s normal to worry about the effect the condition will have on your child’s future.

Try to take good care of your own physical and emotional healths. Doing so will help give you the energy needed to care for your child with special needs.

It might help to:

• Learn all you can about your child’s heart defect.
• Stop blaming yourself. You didn’t cause the heart defect. Many things occurred for the defect to happen. No single factor causes congenital heart defects.
• Allow yourself to grieve about having a child with a heart defect.
• Ask questions. Don’t expect to remember everything that is involved in caring for your child. Ask questions when you don’t understand. Ask your doctor for written directions on caring for your child. If directions are written, you can look at them later and call the doctor if you have questions.
• Join a support group. It’s helpful to be in contact with organizations and people who can offer support and answer your questions. Talk with your health professional to see whether there is a local support group you might join. A support group is a good place to meet other parents who are dealing with similar issues.
• Talk to a counselor. It’s normal to feel sad. You may grieve because your baby is not the perfectly healthy infant you imagined. If you or a family member continues to feel extremely sad, guilty, or depressed or is otherwise having trouble dealing with your child’s illness, talk with a doctor.
• Get financial help if needed. Expenses can quickly multiply if your child’s heart defect requires several hospital stays and tests. You may qualify for help from organizations. Talk with your doctor about a referral to a social worker or financial counselor who can help you.

Family counseling

Coping with a child who has a lifelong illness impacts the entire family. If you feel that you or your family needs help dealing with the condition, talk with a health professional about counseling.

Case studies are in-depth investigations of a single person, group, event or community. Typically, data are gathered from a variety of sources and by using several different methods (e.g. observations & interviews). The case study research method originated in clinical medicine (the case history, i.e. the patient’s personal history). In psychology, case studies are often confined to the study of a particular individual.

The information is mainly biographical and relates to events in the individual’s past (i.e. retrospective), as well as to significant events which are currently occurring in his or her everyday life.

The case study is not itself a research method, but researchers select methods of data collection and analysis that will generate material suitable for case studies.

How is a case study conducted?

The procedure used in a case study means that the researcher provides a description of the behavior. This comes from interviews and other sources, such as observation.

The client also reports detail of events from his or her point of view. The researcher then writes up the information from both sources above as the case study, and interprets the information.

The research may also continue for an extended period of time, so processes and developments can be studied as they happen.

Amongst the sources of data the psychologist is likely to turn to when carrying out a case study are observations of a person’s daily routine, unstructured interviews with the participant herself (and with people who know her), diaries, personal notes (e.g. letters, photographs, notes) or official document (e.g. case notes, clinical notes, appraisal reports).

The case study method often involves simply observing what happens to, or reconstructing ‘the case history’ of a single participant or group of individuals (such as a school class or a specific social group), i.e. the idiographic approach.

The interview is also an extremely effective procedure for obtaining information about an individual, and it may be used to collect comments from the person’s friends, parents, employer, workmates and others who have a good knowledge of the person, as well as to obtain facts from the person him or herself.

Most of this information is likely to be qualitative (i.e. verbal description rather than measurement) but the psychologist might collect numerical data as well.

How to analyze case study data

The data collected can be analyzed using different theories (e.g. grounded theory, interpretative phenomenological analysis, text interpretation, e.g. thematic coding).

All the approaches mentioned here use preconceived categories in the analysis and they are ideographic in their approach, i.e. they focus on the individual case without reference to a comparison group.

Interpreting the information means the researcher decides what to include or leave out. A good case study should always make clear which information is the factual description and which is an inference or the opinion of the researcher.

Strengths of Case Studies

• Provides detailed (rich qualitative) information.
• Provides insight for further research.
• Permitting investigation of otherwise impractical (or unethical) situations.

Case studies allow a researcher to investigate a topic in far more detail than might be possible if they were trying to deal with a large number of research participants (nomothetic approach) with the aim of ‘averaging’.

Because of their in-depth, multi-sided approach case studies often shed light on aspects of human thinking and behavior that would be unethical or impractical to study in other ways.

Research which only looks into the measurable aspects of human behavior is not likely to give us insights into the subjective dimension to experience which is so important to psychoanalytic and humanistic psychologists.

Case studies are often used in exploratory research. They can help us generate new ideas (that might be tested by other methods). They are an important way of illustrating theories and can help show how different aspects of a person’s life are related to each other.

The method is therefore important for psychologists who adopt a holistic point of view (i.e. humanistic psychologists).

Limitations of Case Studies

• Lacking scientific rigour and providing little basis for generalization of results to the wider population.
• Researchers’ own subjective feeling may influence the case study (researcher bias).
• Difficult to replicate.
• Time-consuming and expensive.
• The volume of data, together with the time restrictions in place, impacted on the depth of analysis that was possible within the available resources.

Because a case study deals with only one person/event/group we can never be sure if the case study investigated is representative of the wider body of “similar” instances. This means the the conclusions drawn from a particular case may not be transferable to other settings.

Because case studies are based on the analysis of qualitative (i.e. descriptive) data a lot depends on the interpretation the psychologist places on the information she has acquired.