Systematic Style Review Essay

This systematic review protocol is registered with PROSPERO, under the registration number CRD42017060339, and may be accessed online at

Multiple antenatal, antepartum, and postpartum challenges are incurred with a BMI of > 45. Miscarriage is at an increased risk among women with elevated BMI as well as prevalence of GDM and preexisting diabetes. First trimester screening for previously unrecognized diabetes with an early glucose screening is recommended. Obese women have an increased risk for hypertensive disorders as well as preeclampsia. It is not clear whether low-dose aspirin therapy is effective in reducing the likelihood of developing preeclampsia among women with an elevated BMI; however, low-dose aspirin is low-risk and therefore, can help decrease the risk for preeclampsia among women with moderate to high risk of developing the disease. Obstructive sleep apnea may be precipitated or exacerbated during pregnancy and may increase the risk of preeclampsia and GDM. Women who are obese have an increased risk for preterm birth. Maternal obesity is also associated with an increase in absolute rate of congenital anomalies. In addition, congenital anomalies are often more difficult to detect by prenatal ultrasound given acoustic limitations. (Detection decreases by 20%) Finally, there is an increased risk of dysfunctional labor in addition to complications that are incurred should an operative delivery be required. Weight gain goals recommended in obesity are 10-15 lb. Unfortunately, weight loss during pregnancy is not recommended. Serial surveillance

Evaluating the eight papers for quality evidence was critical when selecting the two papers to utilise. The evidence hierarchy was considered, aiming to use the highest evidence possible, such as systematic reviews and meta-analyses; and randomized, controlled, double-blind studies, to ensure the most accurate evidence informed the clinical decision for the patient (Bloom, Olinzock, Radjenoic & Trice, 2013). When sorting the results, other various factors were also taken into consideration; credibility, reputability, reasonability and support. With these factors taken into account, the two papers selected are highly esteemed in regards to evidence, and are most relevant to the patient (Stichler, 2010).

Basco, W.J., Hletko, P., West, L., & Darden, P. (2009). Determining the proportion of children too heavy for age-appropriate car seats in practice-based research network. Clinical Pediatrics, 48(1), 37-43. doi:10.1177/00009922808321676

The study was a systematic review of scientific papers selected by a search of the SciELO, Cochrane, MEDLINE, and LILACS-BIREME databases. Among the 2169 articles found, 12 studies proved relevant to the issue and presented an evidence strength rating of B. No publications rated evidence strength A. Seven of the studies analyzed were prospective cohorts and 5 were cross-sectional studies.

Regarding my continuity case, she came into booking with a BMI of 31; meaning she was clinically obese. It is important to take into account that according to NICE guidelines (2014) weight is defined into groups. BMI 18.5-24.9 (Healthy weight); BMI 25.0-29.9 (Overweight) BMI 30.0-34.9 (Obesity class 1); BMI 35.0-39.9 (Obesity class 2); and BMI 40 and over (Obesity class 3 or morbid obesity.) When using this classification method we can see that this lady falls into class 1; meaning that according to NICE they advise at this stage we give general advice on healthy weight and lifestyle, along with diet and physical activity. It is should be remembered that diet is not usually advised before during or immediately after pregnancy; but these women should be encouraged to attempt to eat a healthy, well balanced diet (Nutrition and Development, 2013). Gentle

According to the systematic review covered by Apfel, Turan, Souza, Pergolizzi & Hornuss, 2013 there is a significant reduction in postoperative nausea and vomiting and opioid use when using intravenous acetaminophen. The reviewers used Medline and Cochrane databases to conduct their search along with a hand search of abstracts to identify randomized-controlled trials using intravenous acetaminophen. The review was to determine if the acetaminophen was going to have a significant decline in nausea and vomiting following surgical procedures as

This measure is a reliable indicator of trial quality and is based on each trial’s reporting and quality of randomisation and blinding attribution (CASP 2006).

The risks associated with obesity in pregnancy do not only surround physical issues it also affects effective care given to obese women using maternity services and the outcomes of their delivery. Schmied et al (2010) found a that obesity affects the appropriate care that obese women receive. The midwives documented difficulties palpating the abdomen of obese women and not being able to determine fetal position or auscultation of the fetal heart, in return making it hard to assess fetal well being. In agreeance Singleton and Furber (2013) suggest that a midwife’s role is to promote normality, but for high risk obese women in labour, it is increasingly difficult to do so. The study found that auscultation using a pinard stethoscope and sonicaid proved difficult in many cases for women with a BMI of over 30, therefore the use of a cardiotocography (CTG) was needed to monitor fetal well being. Slavin, Fenwick and Gamble (2013) found that the use of CTG in labour reduces mobility of

Even when kids don’t remember the abuse, they sometimes subconsciously will develop negative behaviors. A. Danese and M. Tan, in their journal article “Childhood Maltreatment and Obesity: Systematic Review and Meta-analysis”( 2014), explain that child maltreatment and obesity are often related. Danese and Tan use factual evidence and a meta- analysis of 41 studies conducted to support that “Improving the psychosocial environment children live in might contribute to the primordial prevention of obesity and its consequence”( Danese and Tan 552). The authors’ purpose is to educate readers on the effects child abuse has on an individual's health in order to lower the obesity rates by helping children who are being mistreated. By keeping their article extremely formal and

CRITICAL APPRAISAL OF A SYSTEMATIC REVIEW AND NARRATIVE REVIEW RELATED TO COMPUTERISED PHYSICIAN ORDER ENTRY SYSTEM

Both clinicians who are enquiring clinical questions and researchers who are conducting in-depth searches for systematic reviews come across a few

This case study will be based on a case holding experience, focusing on the effect that a raised body mass index (BMI) has on a woman. This essay will discuss and critically evaluate the relevant professional issues, psychosocial factors and the role of health and public health strategies, as well as integrate the evidence that supports it. This case study will focus on the care of a primiparous woman. In order to respect her right to privacy and confidentiality in all aspects of her care, and in accordance with the NMC code, she will be referred to under the pseudonym of “Emma” (Nursing and Midwifery Council,

Through the search described above, 398 articles were identified as potential studies. Once duplicates were removed, 79 articles remained to be reviewed, of which 48 were excluded based on title and abstract. An additional 20 were excluded due to the fact that the studies did not adhere to the inclusion/exclusion criteria of our systematic review, mainly for reasons such as: excluding the diagnosis of CRPS, not including the necessary interventions, or being qualified as low-level evidence. Of note, three additional studies were screened in this process after having been identified as relevant via one of the included systematic reviews. At conclusion of the screening process, 11 studies were

This systematic review had a few limitations. There was only one independent reviewer who performed searches, data extraction, and quality assessments. A second independent review was available for discussions during the entire review process. There were limited studies available to inclusion to the