Partial differential equations (PDEs) are mathematical models widely used in physics, engineering, and finance to describe various phenomena. However, solving PDEs is often challenging, especially when the dimensionality is high. Deep learning techniques have shown great promise in solving PDEs in recent years. This review introduced a new approach for modelling local stochastic volatility using deep probabilistic programming. It uses a deep Gaussian process prior to model the volatility surface and using the model to estimate option prices. This paper discusses several papers that use deep learning to solve different PDEs. Specifically, we review papers that deal with rough stochastic volatility models, option pricing, path-dependent PDEs, high-dimensional PDEs, and martingale functional control variates. We summarize the main contributions of each paper and discuss their potential applications and limitations.
Keywords: Deep learning, Pricing function, Stochastic model, Local volatility, Path-dependent PDEs, Option pricing, Neural Networks, BSDE.
1.1 General Objective
To solve PPDEs numerically based on the discretization of the pricing function, which can then be solved using deep learning techniques. This avoids the curse of dimensionality for high-level PDEs
This review discusses several papers that use deep learning to solve different types of PDEs. Specifically, we review papers that deal with rough stochastic volatility models, option pricing, path-dependent PDEs, high-dimensional PDEs, and martingale functional control variates. We summarize the main contributions of each paper and discuss their potential applications and limitations and how they relate to our main paper (Antoine & Mugad, 2019)
Antoine & Mugad (2019) proposed a deep learning framework for solving rough stochastic volatility models and used a deep Gaussian process prior to model the volatility surface and used this model to estimate option prices. According to numerical simulations, this framework provides a better alternative to the Monte Carlo simulations. The authors introduce a new approach for modelling local stochastic volatility using deep probabilistic programming.
In recent years, there has been a surge of interest in using deep learning to solve PDEs. The main advantage of deep learning techniques is that they can learn the underlying structures and patterns in the data without requiring prior knowledge of the equations. Deep learning methods can also handle high-dimensional and nonlinear problems, often challenging traditional numerical methods.
The authors of the paper under review build upon previous research in stochastic volatility modelling, deep learning, and Bayesian inference. Traditional approaches to modelling stochastic volatility, such as the Heston model (Abi, 2019) (Omar, Masaaki, & Mathieu, 2016) (Omar, Gatheral, & Mathieu, 2019) (Omar, Masaaki, & Mathieu, 2016) and the SABR model (Hagan, Kumar, Lesniewski, & Woodward, 2002), have limitations in their ability to capture complex nonlinearities and to predict price options accurately. Deep learning techniques have shown promise in improving the accuracy of option pricing by providing more accurate volatility surfaces (Han, Jentzen, & E, 2018). Bayesian inference is a powerful tool for probabilistic modelling, and deep probabilistic programming has emerged as an important area of research in recent years.
Several deep-learning architectures have been proposed for solving PDEs. One popular approach is to use neural networks to approximate the solutions of the PDEs. Neural networks can be trained using supervised learning techniques to minimize the difference between predicted and true solutions.
Basis of development of Rough local volatility
The basis for the suggested developments is to speed up the calibration process for very high-dimensional PDE via a path-dependent PDE and to propose a numerical scheme that avoids the curse of dimensionality. Consider a one-dimensional asset price process
for some Brownian motion W. The term ‘Rough volatility’ refers to the idea that sample paths of the log volatility are rougher than the sample paths of Brownian motion, that is (Gatheral, Jaisson, & Rosenbaum, 2014).
Classical approaches (Heston, SABR…) suggested that,
(Gatheral, Jaisson, & Rosenbaum, 2014), (Bennedsen, Lunde, & Pakkanen, 2017) proposed across large financial data sets that
This is consistent with , where is a fractional Brownian motion with Hurst parameter and is a continuous Gaussian Process. The simplest rough volatility model and more natural for some Gaussian Volterra process
with B a Brownian motion and K is a singular kernel such that (Bennedsen, Lunde, & Pakkanen, 2017)
Horvath et al. (2019) suggested a Brownian Semi Stationary (BSS) process , with , where is strictly positive affine process independent of . This model could reproduce the VIX smile, which the other models could not reproduce for the VIX products.
Gatheral et al. (2014) for historical measures where the volatility is rough then;
Here, the stochastic differential equation for X is a Volterra system generally, not Markovian.
According to Zhang & Zhuo (2014) β and σ depend on the past trajectory Xr for any t≥0 and r ∈ [0,t]. This would, for example, enable the inclusion of systems with delays.
Dupire (2009) and Gyongy (1986) calibrated the leverage function 1(·), which is of the form
to ensure the model calibrated exactly to the European option prices.
This model depends only on the stock price and time, making this a perfect model for calibrating the European option prices, particularly path-dependent options.
Pricing function of the PPDE
The goal is to solve
via path-dependent PDEs and to propose a numerical scheme. Here is the infinite-dimensional stochastic process adapted to the filtration process
(Antoine & Mugad, 2019) assumes existence of a function
The option price has a unique solution to the linear path-dependent PDE
According to Ekren et al. (2016), uniqueness and its existence is guaranteed.
Where the space derivatives are defined as Gateaux derivatives given by
Discretization of the PPDE
From the option price unique solution of a PPDE equation (??) for each t ∈ [0,T], consider a basis of cadlag functions
Then introducing the approximation
The PPDE becomes a very high-dimensional PDE
Where the differential operators are defined, for each i, j = 1,…, n as
We can rewrite this system in a more concise way as
This is a very high-dimensional PDE.
The Backward stochastic differential equation (BSDE) formulation
One can associate a BSDE solution (X, Y, Z) to a given PDE where Y = P where this is an element of the BSDE written in backward form for any t ∈ [0,t]
Discretizing (Euler) the backward SDE gives
Simulation of the Volterra process was performed using a hybrid scheme as discussed by (Bennedsen, Lunde, & Pakkanen, 2017)
Han et al. (2018) computation via neural networks was used where at each time step, price and model parameters are known, but is unknown. This value is inferred by neural networks where is the number of layers per sub-network and is the number of neurons per layer.
The loss function to minimize is
In conclusion, (Antoine & Mugad, 2019) presents a novel approach for modelling local stochastic volatility using deep probabilistic programming. The authors demonstrate the advantages of their approach over existing models, including its ability to capture complex nonlinearities and improve the accuracy of option pricing and risk management. While the paper may have limitations, such as its technical complexity and the need for further comparison with other models, it represents an essential contribution to quantitative finance. It may pave the way for future research in this area.
Overall, the paper presents an exciting and innovative approach to solving PDEs in finance using deep learning. The authors demonstrate the effectiveness of their approach in numerical experiments for option pricing under various rough stochastic volatility models.
However, there are a few limitations and potential areas for improvement in the paper. First, the authors use a relatively small number of training examples (5000) and do not perform a detailed sensitivity analysis on the hyperparameters of the neural network. This raises concerns about their results’ robustness and their approach’s generalizability to other models or settings.
Second, the paper lacks a comprehensive comparison of the proposed approach with existing methods for solving PDEs in finance, such as finite difference or finite element methods. While the authors briefly compare their results with the analytical solutions for some simple models, comparing their approach with other numerical methods in more realistic and complex settings would be more informative.
Finally, the paper does not discuss the potential limitations or drawbacks of using deep learning for solving PDEs. For example, deep learning approaches may suffer from overfitting or instability, especially in high-dimensional or ill-posed problems. Therefore, it would be helpful if the authors provided some insights or guidelines on how to mitigate these issues in practice.
Abi, J. E. (2019). Lifting the Heston Model. Quantitative Finance.
Antoine, J., & Mugad, O. (2019, June 6). Deep PPDEs for Rough Local Stochastic Volatility. Mathematics Subject Classification.
Bennedsen, M., Lunde, A., & Pakkanen, M. S. (2017). Decoupling the short-and-long-term behaviour of stochastic volatility. Energy Economics.
Dupire, B. (2009). Functional Ito Calculus.
Ekren, I., Touzi, N., & Zhang, J. (2016). Viscosity solution of fully nonlinear parabolic path-dependent PDEs: Part I. Annals of Probability.
Ekren, I., Touzi, N., & Zhang, J. (2016). Viscosity solutions of fully nonlinear parabolic path-dependent PDEs: Part II. Annals of Probability.
Gatheral, J., Jaisson, T., & Rosenbaum, M. (2014). Volatility is rough. Quantitative Finance.
Gyongy, I. (1986). Mimicking the one-dimensional marginal distributions of processes having an Ito differential. Probability Theory and Related Fields.
Hagan, P. S., Kumar, D., Lesniewski, A. S., & Woodward, D. E. (2002). Managing smile risk. The Best of Wilmott 1, 249-296.
Han, J., Jentzen, A., & E, W. (2018). Solving high-dimensional partial differential equations using deep learning. Proceedings of the Natural Academy of science.
Horvath, B., Jacquier, A., & Tankov, P. (2019). Volatility options in rough volatility models.
Omar, E. E., & Mathieu, R. (2019). The characteristic function of rough Heston Models. Math. Finance 29(1), 3-38.
Omar, E. E., Gatheral, J., & Mathieu, R. (2019). Roughening Heston. Risk, 84-89.
Omar, E. E., Masaaki, F., & Mathieu, R. (2016). The microstructural foundations of leverage effect and rough volatility. arXiv preprint arXiv: 1609.05177.
Ren, Z., & Tan, X. (2017). On the convergence of monotone schemes for path-dependent PDEs. Stochastic Processes and their Application.
Viens, F., & Zhang, J. (2019). A martingale approach for fractional Brownian motions and related path-dependent PDEs. Annals of Applied Probability.
Zhang, J., & Zhuo, J. (2014). Monotone schemes for fully nonlinear parabolic path-dependent PDEs. Journal of Financial Engineering.
Developmental Analysis – Oprah Winfrey Essay Example
Oprah Winfrey is a media magnate, philanthropist, and television personality who is well-known around the world. Oprah Winfrey’s Childhood: Oprah Winfrey was born in Kosciusko, Mississippi, on January 29, 1954, to an unmarried young mother. (Gillespie, 2015). Vernon Winfrey, her father, was a coal miner who subsequently became a barber, a city councilman, and the mayor of Kosciusko. Oprah grew up in poverty, often living with family, and was subjected to physical and sexual abuse. Her mother eventually placed her with her father, who gave her more structure and discipline. She was raised in poverty as a youngster and sexually abused by relatives and family members. She eventually relocated to Milwaukee, where she attended Nicolet High School. Oprah had a rough background, but she was able to overcome the odds thanks to her dedication and passion. She earned a bachelor’s degree in speech and theater from Tennessee State University in 1976. After college, she traveled to Baltimore, Maryland, to work as a reporter and news anchor. Oprah went to Chicago in 1983 and began her professional life as the host of WLS-TV’s A.M. Chicago. (Gillespie, 2015). The show was instantly successful, renamed The Oprah Winfrey Show in 1986. Oprah has interviewed innumerable celebrities, corporate leaders, and average individuals throughout her career. Oprah is a highly successful businesswoman. She launched several other media and commercial companies, including Oxygen Media, Harpo Films, The Oprah Winfrey Network, and The Oprah Winfrey Show. She also serves as the chairman and CEO of Harpo Productions. (Gillespie, 2015). Oprah has also made significant charitable contributions. She has made numerous charity contributions and formed the Oprah Winfrey Foundation to assist educational endeavors. She also established the Oprah Winfrey Leadership Academy for Girls in South Africa. Oprah Winfrey is a source of inspiration for millions of people worldwide. She has defied all odds to become one of the world’s most accomplished and influential persons. Her narrative exemplifies perseverance, determination, and dedication.
Definition of trust versus mistrust and the Erikson theory
In psychology, trust vs. mistrust is a prominent developmental theory. According to this view, people must learn to trust other individuals and the world around them during their formative years. According to this notion, a lack of trust can create psychological suffering and make it harder to develop connections. (Lumineau, 2017). Erik Erikson, a developmental psychologist and psychoanalyst popularized trust against mistrust. The hypothesis proposes that early childhood events impact an individual’s trust or distrust in the environment around them. According to Erikson, the first stage of psychological development is trust against mistrust, in which the kid must learn to believe that their basic needs will be supplied. If the child develops trust in their surroundings, they will feel comfortable, confident, and able to create meaningful relationships with others. (Syed & McLean, 2017). If youngster does not acquire trust in their surroundings, they may become skeptical of people and struggle to form solid relationships. Erik Erikson’s trust vs. distrust theory is based on the premise that the initial years of life are crucial for creating trust. He claimed that the child must learn to trust that their basic needs will be addressed and that the world is safe and supportive throughout this time. If youngster learns to trust, they may become unduly suspicious of people and find it easier to create stable relationships. (Lumineau, 2017). He thought that the child’s growth of trust was influenced by the quality of care they received in their early years and their environment. Erikson’s trust vs. distrust hypothesis has been applied to various psychological concerns, ranging from depression and anxiety to relationships and self-esteem. It has been used to clarify why some people are more trustworthy than others and why other people have difficulty forming stable connections. It has also been used to explain why some people suffer from trust issues, even as adults. As a result, Erik Erikson established trust versus mistrust as a significant developmental paradigm in psychology. According to the hypothesis, the early years of life are crucial for creating trust, and the quality of care and environment the kid encounters during this time determines trust formation. (Syed & McLean, 2017). From depression and anxiety to relationships and self-esteem, the idea has been used to explain a broad spectrum of psychological difficulties.
The infancy of Oprah Winfrey is a superb example of the trust against mistrust stage of development. According to psychiatrist Erik Erikson, this is when a person learns to trust or distrust their surroundings. Oprah’s childhood was marred by several terrible occurrences that affected her growth of trust versus mistrust. Her mother’s boyfriend abused her, and her mother could not offer constant care. Oprah was taken to live with her father in Milwaukee when she was six. Several family members and associates of her father sexually molested her while she was there. (Gillespie, 2015). It produced a lot of mistrust in her surroundings. Oprah formed an independent personality to cope with her distrust and found consolation in reading. This developed an intense feeling of self-respect, which helped her overcome the mistrust of her surroundings. Oprah’s father also provided her with a secure and steady atmosphere. He pushed her to work hard and gave her opportunities to grow her skills, such as an after-school job as a radio announcer. These events highlight how trust and mistrust may shape a person’s formative years. In Oprah’s case, her early experiences with abuse and abandonment caused her to distrust her surroundings. (Gillespie, 2015). She overcame this mistrust and established a strong sense of self via hard work, self-respect, and a supportive father. According to Erikson’s psychosocial theory, the trust vs. mistrust stage is a vital era in which an individual establishes a basic sense of confidence in their environment.
Oprah’s life-changing event of trust against mistrust throughout her adolescence, or between puberty and 17 years old, influenced her life. Oprah was taken to live with her father at 14 after her mother struggled with drug addiction. Her father’s stringent standards drew her in after she arrived in Nashville. She was supposed to go to school, do her chores, and help her father clean up after himself. Despite the pressures and expectations, Oprah found consolation in her studies and church activities. (Gillespie, 2015). She built a strong feeling of self-worth and began to trust herself throughout this time. Erik Erikson’s psychosocial theory of human development can be used to understand Oprah’s experience of trust versus mistrust during adolescence. Adolescents, according to Erikson, must establish a sense of “industry versus inferiority” throughout this time of life. To do so, kids must acquire a sense of autonomy and trust in themselves, something Oprah could do despite her terrible living circumstances. This experience of trust versus mistrust significantly impacted Oprah’s life. She cultivated a strong feeling of self-worth that she carried with her throughout her life. As a result, she has emerged as an inspirational leader and a role model in her professional and personal lives. (Gillespie, 2015). She is an education and self-empowerment advocate who has become a formidable voice in the struggle for social justice. (Gillespie, 2015). As a result, Oprah Winfrey’s adolescent experience with trust versus mistrust had a long-lasting impact on her life. She acquired a strong sense of self-worth and a loud voice in the battle for social justice due to her tenacity and determination. This incident exemplifies Erik Erikson’s psychosocial theory of human development. It serves as a reminder that finding strength and trust in oneself is possible even amid adversity.
Early adulthood stage
Oprah Winfrey is a well-known media magnate and philanthropist in the United States as well as the world. She is the first African-American female millionaire, and her platform has helped empower millions. Winfrey has led an inspiring and prosperous life but has yet to arrive there quickly. Learning to trust again was one of the most challenging obstacles she experienced as a young adult, from the age of 18 to 35. Winfrey married a man she met at work when she was 18. (Gillespie, 2015). The marriage was short-lived, and Winfrey quickly realized that he had broken her trust by gambling with her money. Winfrey felt betrayed and emotionally upset because of this occurrence and found it impossible to trust again. From 18 to 35, Winfrey resolved to avoid repeating the same mistake. She began concentrating on her career, determined to succeed through hard work and dedication. She started her career as a news anchor before becoming a talk show host. She also established her production firm and founded her magazine and television network. (Gillespie, 2015). This achievement allowed her to demonstrate her strong work ethic and perseverance in the face of betrayal in her early twenties. Erik Erikson’s Theory of Psychosocial Development is one theory that can be utilized to understand this occurrence.
Trust against mistrust is one of the four stages of development in a person’s life, according to this philosophy. This stage occurs during infancy and early childhood and serves as the foundation for a person’s interpersonal relationships. Children at this age learn to trust their caregivers and their environment. It is also the time at which children begin to believe in themselves. For Winfrey, her 18-year-old encounter with betrayal left her with a suspicion of others and a mistrust of herself. To succeed in her work and relationships, she had to relearn trust. (Gillespie, 2015). Winfrey was able to overcome her mistrust and make use of her success to inspire others through hard work and dedication. Finally, when her confidence was abused, Oprah Winfrey faced a significant obstacle in her early adulthood. She overcame this hurdle and achieved achievement via hard work and perseverance. Erik Erikson’s Theory of Psychosocial growth, which stresses the importance of trust in a person’s development, can be used to assess this occurrence. Winfrey’s tale inspires many people because it demonstrates that even after a big betrayal, it is possible to go ahead and use one’s triumphs to encourage others.
Oprah was openly accused of plagiarism in her television show at 44. A former show producer made the charge, and it had the potential to harm her image and career. The controversy was widely covered in the media and sparked widespread public scrutiny and distrust. Oprah was compelled to defend her credibility and honesty. She had to demonstrate her trustworthiness and honesty, which she eventually achieved. Oprah could turn the issue around and prove to the world that she was a responsible and trustworthy individual. This was a significant turning point in her maturity, as she demonstrated to the world that she was reliable despite copying charges. (Gillespie, 2015). In Oprah’s case, the plagiarism incident was a big test of her faith in the world. She had to establish her credibility with the public, which she did. It was a significant accomplishment, allowing her to repair her reputation and continue her career. Oprah Winfrey’s adulthood has been an incredible journey of faith and perseverance. Despite the mistrust she encountered at the age of 44, she has proven to be a trustworthy and responsible individual. This story demonstrates her strength and character and exemplifies how trust may be developed even in the face of adversity. The scandal surrounding Oprah Winfrey’s alleged plagiarism at the age of 44 was a watershed moment in her life regarding trust against mistrust. It was a pivotal juncture in her life with significant ramifications. A former producer of her television show made the charges, which had the potential to harm her reputation and career. The plagiarism claim was widely publicized in the media, causing widespread public scrutiny and distrust. At the time, this was a significant problem for Oprah. She had spent years cultivating her brand and image as an honest, dependable, and respected individual. The accusation can undo all of your hard work and accomplishment. When confronted with this scenario, Oprah answered with strength and optimism. She used the occasion to be upfront and honest with her audience, explaining her creative process. (Gillespie, 2015). She also demonstrated a willingness to accept responsibility and make any required revisions to ensure the accuracy of her writing. This technique successfully regained confidence with her audience and preserved her reputation. Erik Erikson’s psychosocial theory can be used to understand this event. This hypothesis explains how people evolve in phases throughout their lives.
Each stage has a crisis that must be overcome for the individual to advance. Oprah was at the scene of generativity vs. stagnation at 44. Individuals must find purpose in their profession, parenting, and other activities that include caring for others at this period. (Gillespie, 2015). Oprah has to deal with plagiarism claims to go forward. She replied with strength and optimism, allowing her to keep her reputation and find significance in her profession. She was able to get past the problem and continue to advance her career as a result. This event was a critical turning point in her life and demonstrated her courage and tenacity. At 44, Oprah Winfrey’s encounter with trust versus mistrust was a watershed moment. (Gillespie, 2015). Allegations of plagiarism had the potential to harm her image and career, but she demonstrated tenacity and optimism in the face of adversity. This occurrence can be evaluated using Erik Erikson’s psychosocial theory, which describes how people develop throughout their lives. Oprah was able to find significance in her work and overcome the crisis, allowing her to advance her career and reputation.
Oprah Winfrey is one of the most successful women in the world. Her determination, hard effort, and optimistic attitude have all contributed to her success. Her success, however, was only sometimes guaranteed. Winfrey experienced various situations as a youngster and throughout her four growth phases up to adulthood that affected her trust and mistrust in the world around her. Despite these obstacles, Winfrey was able to achieve success as an adult. She worked hard to overcome her distrust of authority and other people and developed a strong feeling of self-worth. Winfrey could believe in her strengths and use them to achieve great success. She gained a strong sense of self-confidence and used it to become a powerful advocate for constructive social change. Finally, Winfrey’s childhood and grownup experiences with trust and mistrust significantly impacted her life. Her experiences made her a powerful force for good and an inspiring role model for many. Her tale exemplifies the strength of resilience and courage in adversity.
Gillespie, K. (2015). Oprah Winfrey. Weigl Publishers.
Lumineau, F. (2017). How contracts influence trust and distrust. Journal of Management, 43(5), 1553-1577.
Syed, M., & McLean, K. C. (2017). Erikson’s theory of psychosocial development.
Evaluation Of Mr. C.’s Health History And Medical Information Essay Sample For College
Subjective and Objective Clinical Manifestations
Concerning subjective and objective clinical signs are also evident in Mr. C. He has seen a 100-pound weight gain over the previous several years, increased difficulty breathing while active, swelling in his ankles, and pruritus during the past six months. These symptoms might be signs of more severe conditions, including heart failure or renal illness. Mr. C. also has high blood pressure and sleep apnea, increasing the likelihood of cardiovascular disease likelihood. Based on the objective data gathered during the evaluation, Mr. C. has a body mass index of 64,2. This places him in the third class of obesity. He also has 3+ pitting edema in both feet and ankles, tachycardia, and tachypnea. His HDL level is low, and his fasting blood glucose, total cholesterol, and triglyceride levels are all increased. His blood’s elevated creatinine and urea nitrogen amounts also point to end-stage renal failure (ESRD).
Potential Health Risks for Obesity
Cardiovascular disease, type 2 diabetes, sleep apnea, and musculoskeletal diseases are some health problems that may develop due to obesity. Several of these dangers, such as sleep apnea, hypertension, and diabetes, are already present in Mr. C. He now has the end-stage renal disease (ESRD) because of his weight, which is a dangerous medical condition that may severely reduce his quality of life and needs constant medical attention (Schoenberg et al., 2020).
Appropriateness of Bariatric Surgery as an Intervention
Bariatric surgery is an intervention for weight reduction that has been shown to assist people who are very obese to lose much weight and keep it off. While many people see improvement in health concerns connected to obesity after undergoing bariatric surgery, it is not the best option for everyone. Given the severity of Mr. C.’s obesity and related health concerns, bariatric surgery may be an appropriate choice. However, he would need to be evaluated extensively to determine whether the treatment is safe and what kind of surgery would be best for him. Bariatric surgery is not a quick fix and involves a commitment to a healthier lifestyle and continued medical attention to keep the weight off and control any complications (Paul et al., 2020).
Functional Health Patterns Assessment
Mr. C. is seeking medical advice about having bariatric surgery since he is overweight and has health problems. He may not know how the operation would affect his long-term health and what dangers he will face. Mr. C. has high blood pressure and has been told to reduce his salt intake. The management of his obesity and its accompanying health issues, however, may need extra instruction on lifestyle adjustments such as food and exercise. Mr. C. has poor dietary habits, as evidenced by his high fasting blood glucose, total cholesterol, and triglyceride readings. He might enhance his nutritional condition with the help of counseling and close monitoring of his food. Evidence of metabolic dysfunction, such as insulin resistance and dyslipidemia, which are linked to obesity and end-stage renal disease, may be seen in Mr. C.’s metabolic profile (Schoenberg et al., 2020). He will require long-term medical care and behavioral adjustments to avoid additional metabolic issues.
Reduced renal function necessitating dialysis or kidney transplantation has eliminated Mr. C. Because of his kidney condition; he requires constant medical attention. Physical Activity Mr. C.’s extreme obesity and accompanying health concerns severely restrict his ability to engage in physical exercise. Physical therapy and exercise counseling might help him feel better and live better. Mr. C. has reported experiencing sleep apnea, which may result from his overweight condition. He may benefit from sleep hygiene education and therapies like CPAP or BiPAP (bi-level positive airway pressure) to enhance his sleeping breathing. Sleep apnea symptoms may be reduced, and general health can be improved by losing weight via healthy lifestyle changes, including eating less junk and exercising regularly. Mr. C. has sleep apnea and high blood pressure, which he tries to manage by reducing his salt intake. Mr. C. is at risk for cardiovascular disease, stroke, and renal disease due to his high blood pressure and other medical issues (Cao et al., 2020).
Due to his obesity and associated health problems, Mr. C may benefit from bariatric surgery. It is possible, but it should be carefully evaluated only after other failed treatments. Infection, hemorrhage, and intestinal blockage are just some of the dangers associated with bariatric surgery, which may aid with weight reduction and improve overall health. Bariatric surgery is not a fast remedy; it takes significant adjustments to one’s way of life before it can be successful (Strain et al., 2014).
Functional Health Patterns
Mr.. C. has many possible health issues, as shown by an analysis of his functional health patterns. Cognitive-perceptual, self-perception/self-concept, role-relationship, sexuality/reproduction, coping/stress tolerance, and other patterns contribute to one’s overall well-being. Regarding his health, Mr. C. may not accurately grasp the gravity of his obesity, hypertension, and other medical concerns. A lack of drive to make positive adjustments in one’s lifestyle may result from this. It is unclear if Mr. C. regularly treats his other medical issues via medication and other treatments, despite his indication of trying to control his blood pressure by dietary salt restriction. Mr. C. needs to enhance his dietary intake because of his obesity, high blood sugar, and high cholesterol levels (Cao et al., 2020). It is unknown what his current diet consists of or whether he has been taught about the need to maintain a healthy diet.
High glucose and triglyceride levels in Mr.. C.’s blood indicate a possible problem with glucose and lipid metabolism, which, if left untreated, might cause significant health issues. Exclusion: Mr. C presents with pruritus and has increased blood creatinine and BUN levels, which point to renal failure. Further testing and care may be necessary. Mr.. C. might benefit from an activity-based fitness program that considers his unique requirements and skill level since he experiences growing shortness of breath with exertion. Mr.. C. may need to be evaluated for sleep apnea since it likely contributes to his weariness (Docherty & Roux, 2020). The cognitive and perceptual abilities of Mr.. C. may be negatively impacted by his weight and its associated health problems.
Mr.. C.’s self-perception and -concept may take a hit due to his weight and associated health problems. The effects of Mr.. C.’s weight and accompanying health conditions on his capacity to perform his office function and relationships are unknown. Sexuality/Reproductive: Mr. C may benefit from information and treatments about how obesity and associated health conditions might affect sexual function and fertility. Tolerance for stress and coping: Mr.. C. may be under considerable stress because of his health problems and might benefit from coping skills and emotional support (Strain et al., 2014).
Renal Disease and Prevention
Mr. C is likely in the early stages of renal illness due to his increased blood creatinine and BUN values, which indicate kidney failure. A steady deterioration in kidney and nephron function characterizes the phases of renal disease leading to end-stage renal disease (ESRD). Proteinuria, hematuria, and electrolyte abnormalities are possible throughout stages 1 and 2; the kidneys can still filter blood and keep creatinine and BUN levels regular. The kidneys’ filtration capacity further declines in stage 3, with the GFR falling to 30-59 mL/min. Patients are at increased risk for anemia, bone disease, and hypertension. Patients in stage 4 may feel weakness, nausea, vomiting, and uremic symptoms, and their GFR ranges from 15 to 29 mL/min. With ESRD stage 5, the GFR is less than 15 mL/min, and dialysis or a kidney transplant is needed to prolong life (Docherty & Roux, 2020).
Mr. C has a low GFR (glomerular filtration rate) of less than 30 mL/min due to his elevated blood creatinine and BUN levels. Obesity, which may promote chronic inflammation and oxidative stress in the kidneys, may have contributed to the loss of renal function with high blood pressure and blood glucose levels. Low HDL cholesterol and high triglyceride levels may contribute to developing renal disease.
Methods for preventing end-stage renal disease (ESRD) include avoiding nephrotoxic drugs and chemicals and controlling risk factors such as high blood pressure and obesity. A healthy lifestyle, which includes eating well, exercising regularly, not smoking, and managing stress, should be the primary emphasis of patient education (Paul et al., 2020). Other services that may help patients with ESRD include referrals to nephrologists and transplant centers, support groups, and counseling.
Patients with ESRD have access to resources such as dialysis centers, home dialysis kits, transportation services, and charity grants. Patients with ESRD may benefit from the expertise of a multidisciplinary care team consisting of nephrologists, nurses, social workers, nutritionists, and pharmacists. Patients in need of non-acute care may also be able to receive services in the comfort of their own homes (Docherty & Roux, 2020). To ensure that patients have access to the resources and services they need, it is necessary to evaluate their living situation, social support system, and work status.
Mr. C has many obesity-related symptoms, including high blood pressure, sleep apnea, and metabolic abnormalities. He also exhibits renal failure symptoms, including high creatinine and BUN values and ankle edema. Careful examination and consideration of Mr. C’s overall health state are required to determine whether bariatric surgery is acceptable for weight reduction and improving his metabolic profile. Mr. C’s functional health patterns indicate that he has or may soon have issues with his outlook on health, diet, metabolism, physical activity, and coping mechanisms. Comprehensive treatment for ESRD patients is best provided via a multidisciplinary approach that emphasizes education and assistance for patients to avoid and manage problems.
Cao, Y., Raoof, M., Szabo, E., Ottosson, J., & Näslund, I. (2020b). Using Bayesian networks to predict long-Term health-Related quality of life and comorbidity after bariatric surgery: A study based on the Scandinavian obesity surgery registry. Journal of Clinical Medicine, 9(6), 1895. https://doi.org/10.3390/jcm9061895
Docherty, N. G., & Roux, C. W. L. (2020). Bariatric surgery for the treatment of chronic kidney disease in obesity and type 2 diabetes mellitus. Nature Reviews Nephrology, 16(12), 709–720. https://doi.org/10.1038/s41581-020-0323-4
Paul, R., Andersson, E., Wirén, M., & Frisk, J. (2020). Health-Related quality of life, sexuality and hormone status after laparoscopic Roux-En-Y gastric bypass in women. Obesity Surgery, 30(2), 493–500. https://doi.org/10.1007/s11695-019-04197-5
Schoenberg, N. C., Argula, R. G., Klings, E. S., Wilson, K. R., & Farber, H. W. (2020). Prevalence and mortality of pulmonary hypertension in ESRD: A systematic review and meta-Analysis. Lung, 198(3), 535–545. https://doi.org/10.1007/s00408-020-00355-0
Strain, G. W., Kolotkin, R. L., Dakin, G., Gagner, M., Inabnet, W. B., Christos, P. J., Saif, T., Crosby, R. D., & Pomp, A. (2014). The effects of weight loss after bariatric surgery on health-Related quality of life and depression. Nutrition & Diabetes, 4(9), e132. https://doi.org/10.1038/nutd.2014.29