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5 Year Plan

Nursing Career Plan

[Name of the Writer]

[Name of the Institution]

Nursing Career Plan

One of the things that I intend to be doing during the course of the next five years is to make sure that how surgical training and experience is going to be gained. The idea is to implement a goal-oriented approach towards the career (Kloster et al. 2017). The volunteering and the training are going to be playing a critical role during these next five years. As there are job restrictions at place at the moment the idea is to gain as much as clinical experience as possible (Kloster et al. 2017). The observation and the virtual classes are going to be an important element in this case. The next five years, the effort is going to be made to ensure that the much more goal-oriented approach towards career prospect is being gained (Kloster et al. 2017).

Five Year Plan in the Hindsight

Some of the broader objectives that I have in my mind when I am going to be formulating the five-year career plan are as followed.

To see myself as a major surgical nurse and to be working in the organization and environment that allows me sufficient opportunities in terms of growth and learning.

To see myself in the middle management role, as trying to opt for the managerial role during the course of the five year is something that is going to be too ambitious.

Making an effort to ensure that I expand my knowledge and expertise with the short-term certifications as well as enrolment in the master’s program so that much more detailed insight is developed about the nursing programs.

These are some of the particulars of the five-year plan in terms of the way I tend to plan my career.

Enrol in the Women and Infant Nursing Job

The first starting point in terms of my career would be to make sure that some sort of experience is gained in terms of how one is supposed to work with women, infants and children programs. It is an important element as I intend to progress through my nursing career. It would also give me insight about different situations that one is expected to face during the course of their career without having to face high pressure environment that one gets to see in hospital these days (Kloster et al. 2017). The other thing that is enrolment is going to do is that it would make sure that I am eligible for the WIC certification (Williams & Hopper, 2015). This certification is going to be an important goal in terms of the way I am supposed to gain career progression with the passage of time. Not only that, enrolment in the community healthcare program would also allow me to broaden my experience at the much extensive level (Kloster et al. 2017). The WIC certification is also going to go a long way towards ensuring that my prospects in terms of my nursing career are secured at the particular point of time (Williams & Hopper, 2015).

Getting a Government Service Job

Again, during the initial phase of my career, the idea is to make sure that I get to work in the environment that is much less intensive as compared to the hospitals but would allow me to ensure that I gain some insight with regards to the way overall development is going to be done at the particular point of time (Timby & Smith, 2016). What the government services job would do is that as I would be already having my WIC certification, it would go a long way towards making sure that I am able to take additional certifications at the particular point of time (Kloster et al. 2017). The degree that I would be having at that point of time would be Bachelors in Surgical Training and Nursing and these trainings and renumerations are going to be provide me with a decent opportunity to make sure that I am able to consolidate my market prospect at the particular point of time (Timby & Smith, 2016). That along with the ACLS, PALS and other such certifications would go a long way towards making sure that the additional qualification is going to add value (Kloster et al. 2017).

Enrolling for the master’s Program in Nursing

At the moment, there is going to be enough experience in terms of the way understanding is developed with regards to the way marketplace is supposed to be developing at the given point of time (Kloster et al. 2017). The idea is to make sure that that I should get myself enrolled in the Masters in the Surgery Program. Not only that would allow me to make sure that I have the necessary insight in terms of the way major decisions are made in terms of the way surgeries are supposed to be done, it would also go a long way towards making sure that I have complete control of the way overall things are supposed to be controlled in terms of the way nursing and surgery are going to be merging together at the gi9ven point of time (Kloster et al. 2017). The enrolment in the Master’s program is going to be one of the most critical decision in my career and the idea on my part would be to make sure that I get to enrol in such a school or institution that allows me to make sure that I have the complete insight about how the academics of the nursing and surgery are supposed to be taken care off (Rushworth & Happell, 2017). The other thing that the master’s program is going to help me with is that it would make sure that I have the technical expertise in terms of the way broader decisions are supposed to made when it comes to the surgery (Rushworth & Happell, 2017).

Becoming a Travel Nurse

Most of the experience that I have accumulated in the past is based on the premise that how relevant nursing experience is going to be developed that would integrate with the surgical training. One of the ways through which this situation can be handled is by enrolling in the travel nurse program (Rushworth & Happell, 2017). The major strengths of these program is that how it tends to ensure that the nurses and the students are being exposed to the tougher situations and at this point of my career, I would be more than comfortable to make sure that I take different situations heads on in terms of the way direction of my career is going to be determined at the particular point of time (Rushworth & Happell, 2017). What I would be doing is that I would make sure that local travel nursing facility so that the coverage in terms of the hospital that are lying in the local region can be managed in an appropriate manner (Rushworth & Happell, 2017). The other thing that I would be doing when I would be comfortable is that I would make sure that how the expansion of the travel nursing portfolio is going to be happening that would again play a major role as far as my learning transformation is supposed to shape up (Rushworth & Happell, 2017).

Becoming a Member of the Professional Organization

When the experience of the travel nursing is going to be completed, the next logical step that is needed to be taken in terms of my career is that I would make an attempt to get myself enrolled in the professional organization (Stevens & Crouch. 2018). One thing that I would make sure when I become a part of such organization is that I would make sure that the organization that I am going to be affiliation is also going to be linked in some ways with the surgical body. That integration is one of the core objectives my career (Stevens & Crouch. 2018).

Going Towards a Humanitarian Assignment

The range of experience that I have at the moment is going to go a long way towards making sure that how I am going to be able to gain some sort of professional experience. Again, during the course of my five years, the effort is about making sure that how I am going to be in the position to integrate my academic learning with my professional experience (Stevens & Crouch. 2018). What it is going to be doing is that it would also allow me to have some insight about how things are different when a nurse and the surgical assistant is linked with the professional organization (Stevens & Crouch. 2018). In that way, I would also be able to learn the language of the knowledge at the particular point of time (Stevens & Crouch. 2018). With my experience as a nurse, I feel that I would be a great asset for a humanitarian assignment. I have researched different programs, and I found a group of nurses that goes to Africa once a year for basic clinical nursing. I would like to go on one of those assignments after I feel comfortable in making quick decisions in patient care.


Kloster, T., Høie, M., & Skår, R. (2017). Nursing students’ career preferences: a Norwegian study. Journal of Advanced Nursing, 59(2), 155-162.

Rushworth, L., & Happell, B. (2017). ‘Psychiatric nursing was great, but I want to be a “real” nurse’: Is psychiatric nursing a realistic choice for nursing students?. Australian and New Zealand Journal of Mental Health Nursing, 9(3), 128-137.

Stevens, J., & Crouch, M. (2018). Frankenstein's nurse! What are schools of nursing creating?. Collegian, 5(1), 10-15.

Timby, B. K., & Smith, N. E. (2016). Introductory medical-surgical nursing. Lippincott Williams & Wilkins.

Williams, L. S., & Hopper, P. D. (2015). Understanding medical surgical nursing. FA Davis.

Subject: Healthcare and Nursing

Pages: 5 Words: 1500

58 Year Old Female With Diabetes


58 Year Old Female With Diabetes

Name of the writer

Name of the institution

58 Year Old Female With Diabetes

According to various research studies it has been proved recently that diabetes and chronic kidney disease are interlinked because diabetes is one of the leading causes of kidney failure, and also it accounts for 44 of various new cases. Some of the recent research findings also suggest that by controlling the blood pressure it is possible to slow down the overall disease. According to some recent surveys, it is proved that every 1 in 4 adults who are diabetic have also kidney disease. The main job of the kidneys is to filter out the waste products of the body and extra water is also excreted from the blood in the form of urine. Kidneys not only help in regulating blood pressure but also they produce hormones which help an individual to stay healthy. Kidney damage as a result of diabetes occurs slowly and along with time. So it is possible to take effective steps in order to protect the kidneys and also delay the kidney damage. Kidneys due to their important functions inside the human body are directly involved in diabetes. Diabetes is the most common and prominent cause of end-stage renal disease in some parts of the world. When kidneys are affected due to diabetes then at that time other parts of the body are also affected directly or indirectly which results in the increase of mortality and morbidity. In case of untreated diabetic nephropathy a prominent reduction in the life expectancy of the individual occurs so it is very important to prevent this severe condition and early diagnosis and treatment of this disease is very important because of all these conditions. The prevalence of diabetes is very common nowadays due to the increased industrialization of societies and also due to the increased in immobility and lifestyle and changes in diets and also due to obesity. Some of the classic and most common symptoms in type 2 diabetes does not occur therefore it is very important to screen out these patients in order to identify the patients for kidney malfunction is very important ADDIN ZOTERO_ITEM CSL_CITATION citationIDz9csvPuk,propertiesformattedCitation(Shahbazian and Rezaii, 2013),plainCitation(Shahbazian and Rezaii, 2013),noteIndex0,citationItemsid1455,urishttp//zotero.org/users/local/4C6u8dIT/items/CV8KC35G,urihttp//zotero.org/users/local/4C6u8dIT/items/CV8KC35G,itemDataid1455,typearticle-journal,titleDiabetic kidney disease review of the current knowledge,container-titleJournal of Renal Injury Prevention,page73-80,volume2,issue2,sourcePubMed Central,abstractDiabetes is the most common cause of chronic kidney disease (CKD) and end-stage renal disease (ESRD) in most parts of the world. 20 to 30 of diabetic patient have diabetic nephropathy in type 1 and type 2. Hyperglycemia is the key of nephropathy creation. Hyperglycemia also by production of toxic materials, advanced glycosylated end product (AGE), increased activity of aldose reductase has some role. Some metabolites of arachidonic acid, hemodynamic derangements and genetic factors have also some role. Although diabetic nephropathy is most common cause of nephropathy in these patients, but diabetic patients are also prone to other urinary tract and renal parenchymal disease and should not be confused with renal failure due to diabetic nephropathy. The principle of treatment of diabetic nephropathy is based on tight control of hyperglycemia, tight control of blood pressure and glomerular pressure, control of dyslipidemia, restriction of protein intake and smoking withdrawal.,DOI10.12861/jrip.2013.24,ISSN2345-2781,notePMID 25340133nPMCID PMC4206005,journalAbbreviationJ Renal Inj Prev,authorfamilyShahbazian,givenHeshmatollah,familyRezaii,givenIsa,issueddate-parts2013,6,1,schemahttps//github.com/citation-style-language/schema/raw/master/csl-citation.json (Shahbazian and Rezaii, 2013).

Although the risk of kidney failure is high because of diabetes but having said that it is also noteworthy that the risk of kidney damage in case of Type 1 diabetes is decreasing due to the advancements in technology which results in early diagnosis of the disease without doing much damage to the body which also includes good control of hyperglycemia. Around the globe, some 20-30 of individuals are suffering from kidney diseases due to diabetes ADDIN ZOTERO_ITEM CSL_CITATION citationIDw1ScLSux,propertiesformattedCitation(Toth-Manikowski and Atta, 2015),plainCitation(Toth-Manikowski and Atta, 2015),noteIndex0,citationItemsid1460,urishttp//zotero.org/users/local/4C6u8dIT/items/Z754GDPX,urihttp//zotero.org/users/local/4C6u8dIT/items/Z754GDPX,itemDataid1460,typearticle-journal,titleDiabetic kidney disease pathophysiology and therapeutic targets,container-titleJournal of diabetes research,volume2015,authorfamilyToth-Manikowski,givenStephanie,familyAtta,givenMohamed G.,issueddate-parts2015,schemahttps//github.com/citation-style-language/schema/raw/master/csl-citation.json (Toth-Manikowski and Atta, 2015). There are various drugs and treatments that are available in order to effectively treat the conditions of both diabetes and kidney disease and one of the most common drug that is currently in practice are the metformin. Metformin is an oral hypoglycemic agent which belongs to the class biguanide which helps in reducing the glucose level of blood majorly by decreasing the hepatic production of glucose and also by enhancing the sensitivity of insulin of the peripheral tissues by increasing the peripheral intake of glucose and its utilization. This drug was approved by the United States of America Food and Drug Administration in the year 1994and in most of the Type 2 diabetes mellitus cases it is recommended as the first line pharmacological agent due to its reduced price, safe administration of the drug and also association with reduced risk of cardiovascular diseases ADDIN ZOTERO_ITEM CSL_CITATION citationIDw6wACxwu,propertiesformattedCitation(Hsu et al., 2018),plainCitation(Hsu et al., 2018),noteIndex0,citationItemsid1463,urishttp//zotero.org/users/local/4C6u8dIT/items/CRVP7P5K,urihttp//zotero.org/users/local/4C6u8dIT/items/CRVP7P5K,itemDataid1463,typearticle-journal,titleEffect of metformin on kidney function in patients with type 2 diabetes mellitus and moderate chronic kidney disease,container-titleOncotarget,page5416-5423,volume9,issue4,sourcePubMed,abstractBackground Impaired renal function can lead to the accumulation of metformin, and elevated concentrations of metformin have been associated with lactic acidosis. The aim of this study was to evaluate the effect of continuous metformin treatment in patients with type 2 diabetes mellitus (DM) and moderate chronic kidney disease (CKD) (estimated glomerular filtration rate (eGFR) 30-0 ml/min/1.73 m2) on renal function.nMethods A total of the 616 patients were enrolled from the research database of Kaohsiung Medical University Hospital from January 1 to 2009 and December 31, 2013. The patients were divided into two groups those who continued metformin treatment (continuation group n 484), and those who discontinued metformin treatment for at least 100 days (interruption group n 132).nResults The slope of eGFR in the metformin interruption group was statistically lower than that in the metformin continuation group (0.75 0.76 vs. -1.32 0.24 mL/min/1.73 m2/year, p 0.0007). After adjusting for baseline covariates in the multivariate linear regression analysis, the continuation of metformin (unstandardized coefficient , -2.072 95 confidence interval, -3.268- -0.876) was a risk factor for the patients with DM and moderate CKD.nConclusions Metformin may have an adverse effect on renal function in patients with type 2 DM and moderate CKD.,DOI10.18632/oncotarget.23387,ISSN1949-2553,notePMID 29435189nPMCID PMC5797060,journalAbbreviationOncotarget,languageeng,authorfamilyHsu,givenWei-Hao,familyHsiao,givenPi-Jung,familyLin,givenPi-Chen,familyChen,givenSzu-Chia,familyLee,givenMei-Yueh,familyShin,givenShyi-Jang,issueddate-parts2018,1,12,schemahttps//github.com/citation-style-language/schema/raw/master/csl-citation.json (Hsu et al., 2018). Diabetes nephropathy is linked with oxidative stress by the continuous hyperglycemia state which further enhances the advancement in the glycation end products. It was shown that hyperglycemia alters the equilibrium of redox, which results in the induction of oxidative stress that ultimately results in the damage of kidneys. So in order to reduce this effect metformin is used due to its multiple effects and associated benefits in both cases, through various studies it was shown that the administration of metformin is safe not only for diabetes but also for associated kidney problems ADDIN ZOTERO_ITEM CSL_CITATION citationIDXLlRnoJi,propertiesformattedCitation(Gong et al., 2012),plainCitation(Gong et al., 2012),noteIndex0,citationItemsid1466,urishttp//zotero.org/users/local/4C6u8dIT/items/QTVJ63LR,urihttp//zotero.org/users/local/4C6u8dIT/items/QTVJ63LR,itemDataid1466,typearticle-journal,titleMetformin pathways pharmacokinetics and pharmacodynamics,container-titlePharmacogenetics and genomics,page820-827,volume22,issue11,sourcePubMed Central,DOI10.1097/FPC.0b013e3283559b22,ISSN1744-6872,notePMID 22722338nPMCID PMC3651676,shortTitleMetformin pathways,journalAbbreviationPharmacogenet Genomics,authorfamilyGong,givenLi,familyGoswami,givenSrijib,familyGiacomini,givenKathleen M.,familyAltman,givenRuss B.,familyKlein,givenTeri E.,issueddate-parts2012,11,schemahttps//github.com/citation-style-language/schema/raw/master/csl-citation.json (Gong et al., 2012).

It was shown that Metformin reduces both the basal and also the PPG. It works by controlling the excessive hepatic glucose level production. By reducing the gluconeogenesis. There are other various potential effects of metformin that includes a higher uptake of glucose increase in the insulin signalling, reduction in fatty acids and triglyceride synthesis and also an increase in insulin signalling and Beta-oxidation of fatty acids. This particular drug can increase the utilization of glucose in the peripheral tissues and it can possibly reduce food intake and glucose absorption by the intestines. It is noteworthy here that there is no proof available yet that Metformin stimulates endogenous insulin secretion therefore so far along with reducing blood glucose levels it does not cause hypoglycemia or hyperinsulinemia which are some of the most common side effects of most drugs that are used as antidiabetic drugs. Given the increased risk of kidney problems in case of diabetic patients, it has been said that Metformin also helps in keeping safe the kidneys, therefore, it does not pose any risk to kidneys functioning ADDIN ZOTERO_ITEM CSL_CITATION citationIDBeHOdJIO,propertiesformattedCitation(Gong et al., 2012),plainCitation(Gong et al., 2012),noteIndex0,citationItemsid1466,urishttp//zotero.org/users/local/4C6u8dIT/items/QTVJ63LR,urihttp//zotero.org/users/local/4C6u8dIT/items/QTVJ63LR,itemDataid1466,typearticle-journal,titleMetformin pathways pharmacokinetics and pharmacodynamics,container-titlePharmacogenetics and genomics,page820-827,volume22,issue11,sourcePubMed Central,DOI10.1097/FPC.0b013e3283559b22,ISSN1744-6872,notePMID 22722338nPMCID PMC3651676,shortTitleMetformin pathways,journalAbbreviationPharmacogenet Genomics,authorfamilyGong,givenLi,familyGoswami,givenSrijib,familyGiacomini,givenKathleen M.,familyAltman,givenRuss B.,familyKlein,givenTeri E.,issueddate-parts2012,11,schemahttps//github.com/citation-style-language/schema/raw/master/csl-citation.json (Gong et al., 2012).

Understanding the blood glucose level can be vital for diabetes self-management. BGL refers to the amount of glucose that is present in the blood it is also referred to as blood glucose level, the concentration of glucose in the blood is expressed as mmol/ L. People who are non-diabetic their blood glucose level should be between 4-5.5mmol/L before eating something and it must be less than 8mmol/L two after eating something. In most people, diabetes is diagnosed when the blood glucose level in fasting is more than 7mmol/L. The glucose level in fasting which is between 5.5-6.9 shows a higher risk for type diabetis especially for those people who are obese and also a history of diabetes in the family ADDIN ZOTERO_ITEM CSL_CITATION citationID3lvvyAiv,propertiesformattedCitation(uc0u8220Diabetes and Hyperglycemia - Hyperglycemia Symptoms and Causes,uc0u8221 n.d.),plainCitation(Diabetes and Hyperglycemia - Hyperglycemia Symptoms and Causes, n.d.),noteIndex0,citationItemsid1469,urishttp//zotero.org/users/local/4C6u8dIT/items/QIMRVFRR,urihttp//zotero.org/users/local/4C6u8dIT/items/QIMRVFRR,itemDataid1469,typewebpage,titleDiabetes and Hyperglycemia - Hyperglycemia Symptoms and Causes,URLhttps//www.diabetes.co.uk/Diabetes-and-Hyperglycaemia.html,accesseddate-parts2019,4,12,schemahttps//github.com/citation-style-language/schema/raw/master/csl-citation.json (Diabetes and Hyperglycemia - Hyperglycemia Symptoms and Causes, n.d.). So in the case of Sharon, her BGL before eating something and after eating are much higher the normal values which mean that she has severe diabetes. In her condition, as she also has kidney problem so the BGL should have been slightly higher than her current BGL values but based on her condition as she has both diabetes and kidney problem her BGL is not very high.

Glucovance is another type of drug that is used to reduce the blood glucose level and its mode of action is also quite simple. In this case study as the BGL of the patient is high therefore along with the use of Metformin she was also recommended to use Glucovance. This type of medication is used along with a proper exercise and diet plan in order to control high levels of sugar in patients who have type 2 diabetes, mostly it is administered along with other diabetes medications. In this product, there are 2 medications that are used. Glyburide belongs to a drug class called sulfonylureas. Its function is to reduce the blood sugar level by releasing the bodys natural insulin and also by reducing the sugar amount that the liver makes ADDIN ZOTERO_ITEM CSL_CITATION citationIDa5Y8B8v3,propertiesformattedCitation(Bruce et al., 2006),plainCitation(Bruce et al., 2006),noteIndex0,citationItemsid1478,urishttp//zotero.org/users/local/4C6u8dIT/items/TR5X4CSW,urihttp//zotero.org/users/local/4C6u8dIT/items/TR5X4CSW,itemDataid1478,typearticle-journal,titleBeta cell response to metformin glibenclamide combination tablets (Glucovance) in patients with type 2 diabetes,container-titleInternational journal of clinical practice,page783-790,volume60,issue7,authorfamilyBruce,givenS.,familyPARK,givenJ.-S.,familyFiedorek,givenF. T.,familyHowlett,givenH. C. S.,issueddate-parts2006,schemahttps//github.com/citation-style-language/schema/raw/master/csl-citation.json (Bruce et al., 2006). Metformin works mainly by lowering the sugar level that is made by the liver and absorbed by the stomach. Both of these help in restoring the bodys response to the insulin that is produced naturally. But it is a high concern in this case because of the side effects of this particular drug. It causes various side effects like nausea, weight gain, diarrhea and other serious health conditions. As in the case of Sharon, she is already using Metformin 1000 mg twice per day so if Glucovance is added in her medication 500mg/ 2.5 mg then it can cause a serious side effect because she is also having kidney problems. So before adding any such medicines, she must be properly analyzed and then any such additions must be made.

As diabetes is becoming a growing concern for healthcare providers and policymakers, therefore, many studies are now on their way in order to design some effective drugs for this type of conditions many new drugs are also underway that can be possible effective treatments for diabetes and also kidney malfunctioning. Until now Metformin was used to treat diabetes but now a new drug is in clinical trials that is canagliflozin, this drug not only increases the blood insulin level in order to regulate the concentration of glucose in the blood but at the same time it can also inhibit the sodium-glucose cotransporter 2 in the kidneys but its proper function on the kidneys have not yet been identified therefore this new drug is still in the clinical trials ADDIN ZOTERO_ITEM CSL_CITATION citationIDOv9Slj7a,propertiesformattedCitation(uc0u8220New diabetes drug possibly protects the kidneys,uc0u8221 n.d.),plainCitation(New diabetes drug possibly protects the kidneys, n.d.),noteIndex0,citationItemsid1471,urishttp//zotero.org/users/local/4C6u8dIT/items/6HYN9K6I,urihttp//zotero.org/users/local/4C6u8dIT/items/6HYN9K6I,itemDataid1471,typewebpage,titleNew diabetes drug possibly protects the kidneys,abstractA new type of drug for treating type 2 diabetes does not only lower blood sugar levels, but also helps to protect the kidneys.,URLhttps//www.umcg.nl/EN/corporate/News/Paginas/New-diabetes-drug-possibly-protects-the-kidneys-.aspx,languageen,accesseddate-parts2019,4,12,schemahttps//github.com/citation-style-language/schema/raw/master/csl-citation.json (New diabetes drug possibly protects the kidneys, n.d.).

In the case of Sharon other effective drugs can be used SGLT2 inhibitors and GLP-1 agonists which not only reduce the blood glucose level but it also maintains the blood pressure, heart failure and control kidney problems and they also help in reducing weights. As the diabetes effects other functions of the body therefore if these two can be used in combination then it is possible to treat this condition effectively along with dealing with other health problems ADDIN ZOTERO_ITEM CSL_CITATION citationID8mtwAurL,propertiesformattedCitation(Manski-Nankervis et al., 2019),plainCitation(Manski-Nankervis et al., 2019),noteIndex0,citationItemsid1473,urishttp//zotero.org/users/local/4C6u8dIT/items/ERJPXWPW,urihttp//zotero.org/users/local/4C6u8dIT/items/ERJPXWPW,itemDataid1473,typearticle-journal,titlePrescribing of diabetes medications to people with type 2 diabetes and chronic kidney disease a national cross-sectional study,container-titleBMC family practice,page29,volume20,issue1,sourcePubMed,abstractBACKGROUND Previous studies in general practice and hospital settings have identified that prescribing of non-insulin diabetes medications may be sub-optimal in people with type 2 diabetes (T2D) and renal impairment. Since these publications, a number of new medications have become available for the management of T2D. Study aims were to, in a cohort of Australians with T2D and renal impairment attending general practice, (1) investigate whether the prescribing of non-insulin diabetes medications is consistent with dosing adjustments recommended within current Australian Diabetes Society (ADS) guidelines and (2) identify patient socio-demographic and clinical factors associated with at least one prescription of a non-insulin diabetes medication inconsistent with current ADS guidelines for medication doses.nMETHODS Cross-sectional study using data from the MedicineInsight general practice database managed by NPS MedicineWise. Patients with T2D who were aged 18 years and over, with an average eGFR 60 ml/min/1.73m2 and at least one prescription of a non-insulin diabetes medication between 1st January 2015 and 30th June 2017 were included. Descriptive statistics were used to summarise patient characteristics and medication use. Marginal logistic regression models were used to estimate associations between sociodemographic and clinical factors and prescribing of e1non-insulin diabetes medicine not consistent with ADS guidelines.nRESULTS The majority of the 3505 patients included (90.4) had an average eGFR of 30-59 ml/min/1.73m2. In terms of absolute numbers, metformin was the medication most frequently prescribed at a dose not consistent with current ADS guidelines for dosing in renal impairment (n 1601 patients), followed by DPP4 inhibitors (n 611) and sulphonylureas (n 278). The drug classes with the highest proportion of prescriptions with dosage not consistent with ADS guidelines were SGLT2 inhibitors (83), followed by biguanides (58) and DPP4 inhibitors (46). Higher HbA1c, longer known diabetes duration and diagnosis of retinopathy were associated with receiving e1prescription with a dosage not consistent with guidelines.nCONCLUSIONS Prescribing of non-insulin diabetes medications at doses inconsistent with current ADS guideline recommendations for dosing adjustments for people with renal impairment was common. Further research is needed to understand how general practitioners access, interpret and apply the ADS guidelines and the impact this may have on patient outcomes.,DOI10.1186/s12875-019-0915-x,ISSN1471-2296,notePMID 30777033nPMCID PMC6378720,shortTitlePrescribing of diabetes medications to people with type 2 diabetes and chronic kidney disease,journalAbbreviationBMC Fam Pract,languageeng,authorfamilyManski-Nankervis,givenJo-Anne,familyThuraisingam,givenSharmala,familySluggett,givenJanet K.,familyKilov,givenGary,familyFurler,givenJohn,familyONeal,givenDavid,familyJenkins,givenAlicia,issueddate-parts2019,2,18,schemahttps//github.com/citation-style-language/schema/raw/master/csl-citation.json (Manski-Nankervis et al., 2019).

The registered nurse standards contain seven standards and among them the third standard can guide the nurse to deal with Sharon condition, the third standard which is the maintenance the capability for practice includes various key points which makes the nurse capable to deal with a variety of problems that include the provision of information to the patients which are required to improve control over various health condition ADDIN ZOTERO_ITEM CSL_CITATION citationID1C9tJev9,propertiesformattedCitation(uc0u8220Nursing and Midwifery Board of Australia - Registered nurse standards for practice,uc0u8221 n.d.),plainCitation(Nursing and Midwifery Board of Australia - Registered nurse standards for practice, n.d.),noteIndex0,citationItemsid1476,urishttp//zotero.org/users/local/4C6u8dIT/items/T7HB82H7,urihttp//zotero.org/users/local/4C6u8dIT/items/T7HB82H7,itemDataid1476,typewebpage,titleNursing and Midwifery Board of Australia - Registered nurse standards for practice,abstractAustralian Health Practitioner Regulation Agency,URLhttps//www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards/registered-nurse-standards-for-practice.aspx,languageen,accesseddate-parts2019,4,12,schemahttps//github.com/citation-style-language/schema/raw/master/csl-citation.json (Nursing and Midwifery Board of Australia - Registered nurse standards for practice, n.d.)0589 / p t vjjjRFFhXCJOJQJaJheCJOJQJaJhCJOJQJaJhBCJOJQJaJhgCJOJQJaJh(CJOJQJaJhhlCJOJQJaJhY 5CJOJQJaJhY hY 5CJOJQJaJhjhx5CJOJQJaJhY CJOJQJaJhjh CJOJQJaJhjhxCJOJQJaJhv_CJOJQJaJhjhxCJOJQJaJ123456789pdagdY mp dgdY mpdagd mp dgd mp

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ADDIN ZOTERO_BIBL uncited,omitted,custom CSL_BIBLIOGRAPHY Bruce, S., PARK, J.-S., Fiedorek, F.T., Howlett, H.C.S., 2006. Beta cell response to metformin glibenclamide combination tablets (Glucovance) in patients with type 2 diabetes. International journal of clinical practice 60, 783 790.

Diabetes and Hyperglycemia - Hyperglycemia Symptoms and Causes WWW Document, n.d. URL https//www.diabetes.co.uk/Diabetes-and-Hyperglycaemia.html (accessed 4.12.19).

Gong, L., Goswami, S., Giacomini, K.M., Altman, R.B., Klein, T.E., 2012. Metformin pathways pharmacokinetics and pharmacodynamics. Pharmacogenet Genomics 22, 820827. https//doi.org/10.1097/FPC.0b013e3283559b22

Hsu, W.-H., Hsiao, P.-J., Lin, P.-C., Chen, S.-C., Lee, M.-Y., Shin, S.-J., 2018. Effect of metformin on kidney function in patients with type 2 diabetes mellitus and moderate chronic kidney disease. Oncotarget 9, 54165423. https//doi.org/10.18632/oncotarget.23387

Manski-Nankervis, J.-A., Thuraisingam, S., Sluggett, J.K., Kilov, G., Furler, J., ONeal, D., Jenkins, A., 2019. Prescribing of diabetes medications to people with type 2 diabetes and chronic kidney disease a national cross-sectional study. BMC Fam Pract 20, 29. https//doi.org/10.1186/s12875-019-0915-x

New diabetes drug possibly protects the kidneys WWW Document, n.d. URL https//www.umcg.nl/EN/corporate/News/Paginas/New-diabetes-drug-possibly-protects-the-kidneys-.aspx (accessed 4.12.19).

Nursing and Midwifery Board of Australia - Registered nurse standards for practice WWW Document, n.d. URL https//www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards/registered-nurse-standards-for-practice.aspx (accessed 4.12.19).

Shahbazian, H., Rezaii, I., 2013. Diabetic kidney disease review of the current knowledge. J Renal Inj Prev 2, 7380. https//doi.org/10.12861/jrip.2013.24

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Subject: Healthcare and Nursing

Pages: 5 Words: 1500

805 DQ 1-2

Cognitive Behaviour Theory

Cognitive behavior theory (CBT) has a point of view on life which revolves around five key regions: thoughts, behavior, feeling/inclination, physiological responses and regular. These all pieces of life are affected by condition; it could be social or physical condition (Caplan, 2002). So change in any of the above factor may cause improvement or further escalating in other factors. It saw in clinical setting at psychiatric ward all the patient were drawn closer to push toward to plant where they have to perform work out, so while playing out the exercises some of them where feeling better and some spot feeling nervous which goes under perspective and performing exercise is behavior of the patients, while performing they experienced augmentation beat and sweating it is a physiological reaction and the patio nursery is nature under which they where performing movement (Caplan, 2002). So through this discernment we can express that all of the components sway each other while playing out any action.

One of the system in CBT is cognitive strategy which imply how people considers, procedure and bode well about condition, alerted sign and events in their lives and how they make sees about themselves, other and the world (Kendall and Hollon, 2013). As show up in a clinical setting, when patient conditions crumble or go into disrepair like high assessment fever so nurse directly off the bat evaluate patients status by using their thinking technique and judgmental limit, in the wake of looking over the insights bounces up at the highest point of the need rundown to associated data reasonably or perform intervention to improve condition of patient which could be tepid wipe or shower and reassess temperature, if they experience any noteworthy issue like heart disappointment or if patient gets unmindful so they will rapidly teach other human administrations partners and begin the intercession in like way. Therefore, while performing undertaking our mind begin thinking reliably and sensibly and act in like way.


Caplan, S. E. (2002). Problematic Internet use and psychosocial well-being: development of a theory-based cognitive–behavioral measurement instrument. Computers in human behavior, 18(5), 553-575.

Kendall, P. C., & Hollon, S. D. (Eds.). (2013). Cognitive-behavioral interventions: Theory, research, and procedures(Vol. 21). Academic Press.

Subject: Healthcare and Nursing

Pages: 1 Words: 300



The Health Information Technology for Economic and Clinical Health Act of 2009 that was set apart for the rule addresses the greatest US action to time that is planned to invigorate widespread usage of electronic prosperity archives. In light of the movements expected after this technique action, the inspiration driving this paper is to analyze the favorable circumstances and impediments of EMR structures. An excellent piece of the written work has fixated on important EMR functionalities, counting clinical choice candidly steady schemes, automated demand area structures, and prosperity info conversation.

The research depicts the possible favorable circumstances of EMRs that fuse clinical consequences, various leveled comes about, and societal outcomes. Despite these points of interest, considers in the written work highpoint weaknesses related with EMRs, which join the extraordinary straightforward achievement charges, advancing upkeep costs, and intrusions to work forms that add to brief hardships in efficiency that are the eventual outcome of taking in another structure. What's more, EMRs are connected with potential saw assurance stresses among patients, which are furthermore tended to definitively in the HITECH Act. All around, specialists and politicians assume that significant preferences to patients and culture can be recognized when EMRs are extensively held onto and utilized as a piece of an "essential" way.

One of the essential purposes of enthusiasm of using computational structures in the therapeutic administration's activity begins with their ability to give supportive information to the fundamental initiative to prosperity specialists. In this paper is made an investigation of the essential central purposes of Electronic Health Records and showed a recommendation of some expansive standards for building them and propel the blend of different information resources.

Functional Elements

For the evaluation of EMR, following elements will e considered:




Security and privacy


Specification appropriateness

Evaluating the EMR

Restorative Informatics relates individual exercises, data handling, and communication undertakings of medicinal repetition, practice, and investigation with the information science and the invention that bolster these errands. Comfort informatics implements incorporate the physical parts, as well as the meaning of clinical conventions, formal therapeutic phrasings, and data and correspondence frameworks (Kern et al. 2014.

For the most part, in a human services association, we have a lot of information generation. This information, which might be of various sorts, shapes and nature, are put away in a few databases with different administration stages and frequently varying in the engineering levels, both in regard to the association of the information and additionally as far as the way they are pictured. The complex nature of this sort of relationships, combined with the expenses regularly thought little of, build the likelihood of disappointment of programming tasks at first arranged (Kern et al. 2014.

There are many undertakings that point the usage of Information and Communication Technologies in Health whose destinations are not reached on time, spending plan and characterized desires, which is mostly because of the expanding many-sided quality, both in the logical, mechanical and regularizing of wellbeing informatics as in the field of national and global clinical conventions (Kern et al. 2014. The different data frameworks that social insurance associations have are the consequence of the usual procedure of improvement throughout the years. These structures were created given various innovative stages and distinctive programming dialects, coinciding in a similar association with an expansive number of different and spread frameworks, set up to bolster particular needs of specific administrations or divisions. This is one reason why interoperability of current data frameworks in therapeutic services units is still extremely feeble and one of the primary reasons why advancement undertakings of common data structures in this area are hard to execute (Weiskopf & Wang, 2013).

In spite of these challenges, it is evident the developing interconnection between the act of prescription and the Information Technology and Communication in regards to the accumulation, stockpiling, preparing and correspondence of clinical information. As in different divisions, in the activity of their exercises, wellbeing experts settle on choices for which, past the fitness and learning, access to data is critical identified with the patient and movement, which ought to be accessible in fitting time and put, and should guarantee the satisfaction of security levels and consistency of information that constitute it (Weiskopf & Wang, 2013).

As to promotion of data and correspondence innovations in human services associations, there is a solid imperviousness to the reception of e-wellbeing frameworks - the utilization of the supposed Electronic Medical Records (EMR). With the use of patient information data structures, data goes from a paper record to an electronic organization as documents, in this way permitting less demanding and more successful administration. Be that as it may, it is fascinating to take note of the inclination of clients to learn and effectively partake in the advancement, counteractive action, and therapeutic services, alongside the rights and enacted principles, have a good effect in the improvement of the data frameworks, which consider these elements (Majore et al. 2014).

The idea of Health Information System rises out of Health Information and Communication Technologies, constituting one of the three principle lines along which they are sorted out. Wellbeing Information Systems are often depicted as the communication between people, procedures, and innovation with a specific end goal to bolster basic data operations, administration and accessibility, so social insurance authorities can be made strides. Mostly, to different segments, the nature of the wellbeing sector has changed after some time from a moderately steady movement to a dynamic setting. Wellbeing Information Systems whose development depends on a few different advancements can be portrayed as the individuals who, through information preparing, give data and improve the learning creation in human services situations. Giving more detail to this definition we can state that a Health Information System can be characterized as a component for putting away, preparing, examining and transmitting data required for arranging, association, execution, and assessment of wellbeing administrations (Weiskopf & Wang, 2013).

The fundamental objective of Health Information Systems is to add to a proficient and fantastic social insurance. These frameworks ought to likewise advance the improvement, defense, and change of its administration. They ought to guarantee effectiveness and security of data streams, disposing of activities duplication, to be specific findings, and all the while improving the speed, productivity, and closeness of wellbeing frameworks.

There are developing requirements for data for the purpose of care, expected to be finished, homogeneous, exact, current and important to clinical choice. A few reviews demonstrate that data frameworks can bring about a beneficial outcome on nature of care, and also being by and by certain their potential monetary advantages (Majore et al. 2014).

Hayrinen, Saranto & Nykanen (2008) presented the idea of EMR that contained an extensive variety of data frameworks, from records ordered in only divisions to longitudinal accumulations of patient information. Just not very many identifications accessible portrayals of the building of EMRs or the wordings utilized. EMRs were employed as a part of necessary, optional and tertiary precaution (Hayrinen, Saranto & Nykanen, 2008). Information was recorded in EMRs by various gatherings of therapeutic services experts. Secretarial staff additionally documented information since correspondence or medical attendants' or doctors' physical records. Some data was additionally logged through patients themselves; this data is approved by doctors. It is imperative that the necessities and prerequisites of various clients are considered later on an improvement of data frameworks (Hayrinen, Saranto & Nykanen, 2008).

Goldschmidt (2005) presented the idea that the constant info accessible to any person who wants it when they require it, and anywhere they need it. By an EMR, lab outcomes could be recouped impressively more rapidly, like this exchangeable period and cash. It would be keen out regardless, that diminishing copied examinations welfares the clients and patients and not clinicians so nearby area misalignment of helpers (Goldschmidt, 2005). Likewise, an initial audit using mechanized demand segment exhibited that mainly appearing former consequences lessened repetition and the rate of challenging through merely thirteen percent.


Kern, L. M., Edwards, A., & Kaushal, R. (2014). The patient-centered medical home, electronic

health records, and quality of care. Annals of internal medicine, 160(11), 741-749.

Majore, S. A., Yoo, H., & Shon, T. (2014). Secure and reliable electronic record management

system using digital forensic technologies. The Journal of Supercomputing, 70(1), 149-165.

McAlearney, A. S., Hefner, J. L., Sieck, C., Rizer, M., & Huerta, T. R. (2014). Evidence-based

management of ambulatory electronic health record system implementation: an assessment of conceptual support and qualitative evidence. International journal of medical informatics, 83(7), 484-494.

Nguyen, L., Bellucci, E., & Nguyen, L. T. (2014). Electronic health records implementation: an

evaluation of information system impact and contingency factors. International journal of medical informatics, 83(11), 779-796.

Weiskopf, N. G., & Weng, C. (2013). Methods and dimensions of electronic health record data

quality assessment: enabling reuse for clinical research. Journal of the American Medical Informatics Association, 20(1), 144-151.

Pocock, S. J. (2013). Clinical trials: a practical approach. John Wiley & Sons.

Sugarman, J., & Califf, R. M. (2014). Ethics and regulatory complexities for pragmatic clinical

trials. Jama, 311(23), 2381-2382.

Piantadosi, S. (2013). Clinical trials: a methodologic perspective. John Wiley & Sons.

Subject: Healthcare and Nursing

Pages: 4 Words: 1200

805 Wk 1

In healthcare facility, one of the main issue was regarding the malpractices, negligence and inefficiency due to procedural and human errors. These inefficiencies significantly affected the overhead cost and decreased the patient satisfaction. The current system of malpractice litigation is not efficient enough to identify and address the quality and malpractice issues in health care facilities. This inefficiency is specifically due to ambiguities that exist within the professional roles and responsibilities of the healthcare system. Therefore, in the case of any malpractice, the burden is automatically laid on the patient and the cost of health care increases specifically.

In order to overcome these procedural inefficiencies, one recommendation was to implement EHR. The regulation of HITECH facilitated the implementation of this recommendation and helped the healthcare domain become more efficient, precise and comprehensive.

The observations have shown that the EHRs were employed as a part of necessary, optional and tertiary precaution (Hayrinen, Saranto & Nykanen, 2008). Information was recorded in EHRs by various sources of therapeutic services experts. Secretarial staff additionally documented information since correspondence or medical attendants' or doctors' physical records. Some data was additionally logged through patients themselves; this data is approved by doctors. It is imperative that the necessities and prerequisites of various clients are considered later on an improvement of data frameworks (Hayrinen, Saranto & Nykanen, 2008).

Goldschmidt (2005) presented the idea that the constant info accessible to any person who wants it when they require it, and anywhere they need it. By an EHR, lab outcomes could be recouped impressively more rapidly, like this exchangeable period and financial resources (Goldschmidt, 2005).


Häyrinen, K., Saranto, K., & Nykänen, P. (2008). Definition, structure, content, use, and impacts of electronic health records: a review of the research literature. International journal of medical informatics, 77(5), 291-304.

Goldschmidt, P. G. (2005). HIT and MIS: implications of health information technology and medical information systems. Communications of the ACM, 48(10), 68-74.

David Blumenthal MD, M. P. P. (2007). Information technology comes to medicine. The New England journal of medicine, 356(24), 2527.

Subject: Healthcare and Nursing

Pages: 1 Words: 300

810 DQ 7 -1

810 DQ 7-1

[Author Name(s), First M. Last, Omit Titles and Degrees]

[Institutional Affiliation(s)]

Author Note

810 DQ 7-1

Topic 7 DQ 1

Discuss how genetic and genomics can play a role in the demand for new health services and how they may impact health care expenditures in the chronic disease population. Give one example.

It was only a couple decade ago when the human genome sequence was just being carried out. The project came to a successful end in 2003 ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"sDTe8Uqc","properties":{"formattedCitation":"(Freimer & Sabatti, 2003)","plainCitation":"(Freimer & Sabatti, 2003)","noteIndex":0},"citationItems":[{"id":"HRzvhUgy/O2r72Dro","uris":["http://zotero.org/users/local/5VyEEXyp/items/EISAIWX7"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/EISAIWX7"],"itemData":{"id":201,"type":"article-journal","title":"The human phenome project","container-title":"Nature genetics","page":"15","volume":"34","issue":"1","author":[{"family":"Freimer","given":"Nelson"},{"family":"Sabatti","given":"Chiara"}],"issued":{"date-parts":[["2003"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Freimer & Sabatti, 2003), yet it will be a while before our knowledge of the human genome is completed. Despite it all, current studies show that genome sequencing has had the greatest impact on healthcare studies ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"xdmSARRR","properties":{"formattedCitation":"(Wagle et al., 2012)","plainCitation":"(Wagle et al., 2012)","noteIndex":0},"citationItems":[{"id":"HRzvhUgy/623JFcl3","uris":["http://zotero.org/users/local/5VyEEXyp/items/DDSDNW4Q"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/DDSDNW4Q"],"itemData":{"id":202,"type":"article-journal","title":"High-throughput detection of actionable genomic alterations in clinical tumor samples by targeted, massively parallel sequencing","container-title":"Cancer discovery","page":"82-93","volume":"2","issue":"1","author":[{"family":"Wagle","given":"Nikhil"},{"family":"Berger","given":"Michael F."},{"family":"Davis","given":"Matthew J."},{"family":"Blumenstiel","given":"Brendan"},{"family":"DeFelice","given":"Matthew"},{"family":"Pochanard","given":"Panisa"},{"family":"Ducar","given":"Matthew"},{"family":"Van Hummelen","given":"Paul"},{"family":"MacConaill","given":"Laura E."},{"family":"Hahn","given":"William C."}],"issued":{"date-parts":[["2012"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Wagle et al., 2012). Thus, exploration of the human genome sequence and genomics have the potential to look into molecular pathways that cause diseases propagation. Additionally, it can also target drug use and give economic efficiency to the existing healthcare system by forgoing risky and wasteful therapeutic treatments ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"j2EfwF1m","properties":{"formattedCitation":"(Harper & Topol, 2012)","plainCitation":"(Harper & Topol, 2012)","noteIndex":0},"citationItems":[{"id":"HRzvhUgy/xkOzPCxu","uris":["http://zotero.org/users/local/5VyEEXyp/items/P7NWTIJL"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/P7NWTIJL"],"itemData":{"id":203,"type":"article-journal","title":"Pharmacogenomics in clinical practice and drug development","container-title":"Nature biotechnology","page":"1117","volume":"30","issue":"11","author":[{"family":"Harper","given":"Andrew R."},{"family":"Topol","given":"Eric J."}],"issued":{"date-parts":[["2012"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Harper & Topol, 2012).

Some of the most common chronic diseases like cancer, diabetes, cardiovascular diseases, and mental disorders have been in the focus of public health programs for years. The integration of genome-wide association in these studies have revealed the most susceptible variations of the disease in populations and has the potential to analyze and study the cause of such diseases in vivid detail. Such a study has a better potential for producing viable results and offers healthcare professionals. For instance, categorization of breast cancer using genomics and associated study can possibly allow mammography to take place sooner than is they normally are. This greatly reduces the risk associated with the procedure, while offering a more intensive primary or secondary preventive measures. This also provides those individuals at greater genomic risk to seek maximum benefit from the program in place, while keeping inconvenience and harm associated with it to bare minimum and provide incredibly cost-effective services ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"Mc1QgVva","properties":{"formattedCitation":"(Burton et al., 2013)","plainCitation":"(Burton et al., 2013)","noteIndex":0},"citationItems":[{"id":270,"uris":["http://zotero.org/users/local/0omESN17/items/EGH4FL8J"],"uri":["http://zotero.org/users/local/0omESN17/items/EGH4FL8J"],"itemData":{"id":270,"type":"article-journal","title":"Public health implications from COGS and potential for risk stratification and screening","container-title":"Nature genetics","page":"349","volume":"45","issue":"4","author":[{"family":"Burton","given":"Hilary"},{"family":"Chowdhury","given":"Susmita"},{"family":"Dent","given":"Tom"},{"family":"Hall","given":"Alison"},{"family":"Pashayan","given":"Nora"},{"family":"Pharoah","given":"Paul"}],"issued":{"date-parts":[["2013"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Burton et al., 2013).

In conclusion, exploration and enhancement of genomic knowledge and associated technologies have opened up exciting opportunities that allow effective disease prevention, protection against diseases as well as efficient diagnosis of diseases. Earlier, this knowledge was primarily confined to research, but now this practice is expanding to the practical application of genomic exploration.

Topic 7 DQ 2

Describe one method that includes using evidence-based data to support a new or innovative way to care for those with the chronic disease now or in the future. How will it impact care and what are the anticipated outcomes?

At present, there are a number of new and inventive means of preventing chronic diseases that are already in place. For instance, ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"Uj6wnwrV","properties":{"formattedCitation":"(Johnson et al., 2005)","plainCitation":"(Johnson et al., 2005)","noteIndex":0},"citationItems":[{"id":271,"uris":["http://zotero.org/users/local/0omESN17/items/JBIZZR5C"],"uri":["http://zotero.org/users/local/0omESN17/items/JBIZZR5C"],"itemData":{"id":271,"type":"article-journal","title":"PEER REVIEWED: Utah’s Family High Risk Program: Bridging the Gap Between Genomics and Public Health","container-title":"Preventing chronic disease","volume":"2","issue":"2","author":[{"family":"Johnson","given":"Jenny"},{"family":"Giles","given":"Rebecca T."},{"family":"Larsen","given":"LaDene"},{"family":"Ware","given":"Joan"},{"family":"Adams","given":"Ted"},{"family":"Hunt","given":"Steven C."}],"issued":{"date-parts":[["2005"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} Johnson et al. (2005), used family histories rather successfully as a simple genomic tool. This allowed them to modify their long-term lifestyle behavior and enables them to keep a number of chronic diseases at bay. Furthermore, ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"QlYGNtwX","properties":{"formattedCitation":"(Annis, Caulder, Cook, & Duquette, 2005)","plainCitation":"(Annis, Caulder, Cook, & Duquette, 2005)","noteIndex":0},"citationItems":[{"id":272,"uris":["http://zotero.org/users/local/0omESN17/items/Y3FBVAK6"],"uri":["http://zotero.org/users/local/0omESN17/items/Y3FBVAK6"],"itemData":{"id":272,"type":"article-journal","title":"PEER REVIEWED: Family History, Diabetes, and Other Demographic and Risk Factors Among Participants of the National Health and Nutrition Examination Survey 1999–2002","container-title":"Preventing chronic disease","volume":"2","issue":"2","author":[{"family":"Annis","given":"Ann M."},{"family":"Caulder","given":"Mark S."},{"family":"Cook","given":"Michelle L."},{"family":"Duquette","given":"Debra"}],"issued":{"date-parts":[["2005"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} Annis, Caulder, Cook, & Duquette (2005) explored populations and proved that it contained valuable genomic information that serves as a reliable source of detection, prevention, and assessment of chronic diseases. Furthermore, according to ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"MttvpxoJ","properties":{"formattedCitation":"(Irwin, Zuiker, Rakhra-Burris, & Millikan, 2005)","plainCitation":"(Irwin, Zuiker, Rakhra-Burris, & Millikan, 2005)","noteIndex":0},"citationItems":[{"id":273,"uris":["http://zotero.org/users/local/0omESN17/items/J3IBLGNU"],"uri":["http://zotero.org/users/local/0omESN17/items/J3IBLGNU"],"itemData":{"id":273,"type":"article-journal","title":"PEER REVIEWED: Review of State Comprehensive Cancer Control Plans for Genomics Content","container-title":"Preventing chronic disease","volume":"2","issue":"2","author":[{"family":"Irwin","given":"Debra E."},{"family":"Zuiker","given":"Erin Shaughnessy"},{"family":"Rakhra-Burris","given":"Tejinder"},{"family":"Millikan","given":"Robert C."}],"issued":{"date-parts":[["2005"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} Irwin, Zuiker, Rakhra-Burris, & Millikan (2005), states have genomic components for Comprehensive Cancer Control programs as a part of their health plans. This shows the precedence given to family history and genomic exploration, given that 67% of the disease control programs include family histories in the programs in an effort to understand just how the system works. This also includes launching a public education program that can help with this effort ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"iEhVc5Hn","properties":{"formattedCitation":"(Carmona & Wattendorf, 2005)","plainCitation":"(Carmona & Wattendorf, 2005)","noteIndex":0},"citationItems":[{"id":274,"uris":["http://zotero.org/users/local/0omESN17/items/8ZZJCCIM"],"uri":["http://zotero.org/users/local/0omESN17/items/8ZZJCCIM"],"itemData":{"id":274,"type":"book","title":"Personalizing prevention: the US Surgeon General's Family History Initiative.","ISBN":"0002-838X","author":[{"family":"Carmona","given":"R. H."},{"family":"Wattendorf","given":"D. J."}],"issued":{"date-parts":[["2005"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Carmona & Wattendorf, 2005). Using family history maybe an orthodox approach to dealing with diseases and their prevention. However, they can be incredibly helpful in the following ways;

Family histories provide details of chronic diseases that are prevalent in a population through accurate and detailed reporting of disease.

Family histories present a detailed look at the consistent risk factors associated with human diseases ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"sUi4Cpcg","properties":{"formattedCitation":"(Yoon, Scheuner, & Khoury, 2003)","plainCitation":"(Yoon, Scheuner, & Khoury, 2003)","noteIndex":0},"citationItems":[{"id":275,"uris":["http://zotero.org/users/local/0omESN17/items/ZAQIN2JK"],"uri":["http://zotero.org/users/local/0omESN17/items/ZAQIN2JK"],"itemData":{"id":275,"type":"article-journal","title":"Research priorities for evaluating family history in the prevention of common chronic diseases.","container-title":"American journal of preventive medicine","author":[{"family":"Yoon","given":"Paula W."},{"family":"Scheuner","given":"Maren T."},{"family":"Khoury","given":"Muin J."}],"issued":{"date-parts":[["2003"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Yoon, Scheuner, & Khoury, 2003). A look at the family histories of first-degree is more helpful in this case.

The complex association of shared genes with different behaviors, environments, and cultures is within families are easily identified using family histories. This enables them to not only study the progress of a disease but also help in applying viable preventive measures.

Family history cannot be changed, but it does help in targeting diseases prevention and improves health and prevalence of the disease in society ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"lLcBiFck","properties":{"formattedCitation":"(Khoury, 2003)","plainCitation":"(Khoury, 2003)","noteIndex":0},"citationItems":[{"id":277,"uris":["http://zotero.org/users/local/0omESN17/items/P2J8KS2W"],"uri":["http://zotero.org/users/local/0omESN17/items/P2J8KS2W"],"itemData":{"id":277,"type":"article-journal","title":"Genetics and genomics in practice: the continuum from genetic disease to genetic information in health and disease","container-title":"Genetics in Medicine","page":"261","volume":"5","issue":"4","author":[{"family":"Khoury","given":"Muin J."}],"issued":{"date-parts":[["2003"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Khoury, 2003).

Today, family history is the best genomic tool available and compared with other genetic tests, it can be relatively inexpensively collected. However, the future application of genomics for the purpose of healthcare shows a whole lot of better perspectives than those being used at present. One of those measures hails from a field called “Precision medicine” ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"nWg5veiC","properties":{"formattedCitation":"(Williamson, 2018)","plainCitation":"(Williamson, 2018)","noteIndex":0},"citationItems":[{"id":278,"uris":["http://zotero.org/users/local/0omESN17/items/LS2TVWL4"],"uri":["http://zotero.org/users/local/0omESN17/items/LS2TVWL4"],"itemData":{"id":278,"type":"book","title":"The future of precision medicine in Australia","publisher":"Australian Council of Learned Academies","ISBN":"0-9943738-7-2","author":[{"family":"Williamson","given":"Robert C."}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Williamson, 2018). It enables healthcare professionals to customize medical treatments that cater to a patient’s genetic composition. Launched in the US as a part of the National Institutes of Health's “All of Us” research program, under the title “US Precision Medicine Initiative” ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"Kn5Bd4ah","properties":{"formattedCitation":"(Sankar & Parker, 2017)","plainCitation":"(Sankar & Parker, 2017)","noteIndex":0},"citationItems":[{"id":279,"uris":["http://zotero.org/users/local/0omESN17/items/Z4K72EXB"],"uri":["http://zotero.org/users/local/0omESN17/items/Z4K72EXB"],"itemData":{"id":279,"type":"article-journal","title":"The Precision Medicine Initiative’s All of Us Research Program: an agenda for research on its ethical, legal, and social issues","container-title":"Genetics in Medicine","page":"743","volume":"19","issue":"7","author":[{"family":"Sankar","given":"Pamela L."},{"family":"Parker","given":"Lisa S."}],"issued":{"date-parts":[["2017"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Sankar & Parker, 2017), it aims to sequence the genome of 1 million American and analyze their health data to gather environmental and biological information in order to facilitate research and serve as a means to enhance the present healthcare technologies, work on better policies and provide individualized healthcare ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"9sEwXz1k","properties":{"formattedCitation":"(Dyer, 2018)","plainCitation":"(Dyer, 2018)","noteIndex":0},"citationItems":[{"id":280,"uris":["http://zotero.org/users/local/0omESN17/items/RUP399KJ"],"uri":["http://zotero.org/users/local/0omESN17/items/RUP399KJ"],"itemData":{"id":280,"type":"article-journal","title":"\" All of Us\" study begins to sequence and follow a million Americans","container-title":"BMJ: British Medical Journal (Online)","volume":"361","author":[{"family":"Dyer","given":"Owen"}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Dyer, 2018).


ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Annis, A. M., Caulder, M. S., Cook, M. L., & Duquette, D. (2005). PEER REVIEWED: Family History, Diabetes, and Other Demographic and Risk Factors Among Participants of the National Health and Nutrition Examination Survey 1999–2002. Preventing Chronic Disease, 2(2).

Burton, H., Chowdhury, S., Dent, T., Hall, A., Pashayan, N., & Pharoah, P. (2013). Public health implications from COGS and potential for risk stratification and screening. Nature Genetics, 45(4), 349.

Carmona, R. H., & Wattendorf, D. J. (2005). Personalizing prevention: the US Surgeon General’s Family History Initiative.

Dyer, O. (2018). “ All of Us” study begins to sequence and follow a million Americans. BMJ: British Medical Journal (Online), 361.

Freimer, N., & Sabatti, C. (2003). The human phenome project. Nature Genetics, 34(1), 15.

Harper, A. R., & Topol, E. J. (2012). Pharmacogenomics in clinical practice and drug development. Nature Biotechnology, 30(11), 1117.

Irwin, D. E., Zuiker, E. S., Rakhra-Burris, T., & Millikan, R. C. (2005). PEER REVIEWED: Review of State Comprehensive Cancer Control Plans for Genomics Content. Preventing Chronic Disease, 2(2).

Johnson, J., Giles, R. T., Larsen, L., Ware, J., Adams, T., & Hunt, S. C. (2005). PEER REVIEWED: Utah’s Family High Risk Program: Bridging the Gap Between Genomics and Public Health. Preventing Chronic Disease, 2(2).

Khoury, M. J. (2003). Genetics and genomics in practice: the continuum from genetic disease to genetic information in health and disease. Genetics in Medicine, 5(4), 261.

Sankar, P. L., & Parker, L. S. (2017). The Precision Medicine Initiative’s All of Us Research Program: an agenda for research on its ethical, legal, and social issues. Genetics in Medicine, 19(7), 743.

Scheuner, M. T., Yoon, P. W., & Khoury, M. J. (2004). Contribution of Mendelian disorders to common chronic disease: opportunities for recognition, intervention, and prevention. American Journal of Medical Genetics Part C: Seminars in Medical Genetics, 125, 50–65. Wiley Online Library.

Wagle, N., Berger, M. F., Davis, M. J., Blumenstiel, B., DeFelice, M., Pochanard, P., … Hahn, W. C. (2012). High-throughput detection of actionable genomic alterations in clinical tumor samples by targeted, massively parallel sequencing. Cancer Discovery, 2(1), 82–93.

Williamson, R. C. (2018). The future of precision medicine in Australia. Australian Council of Learned Academies.

Yoon, P. W., Scheuner, M. T., & Khoury, M. J. (2003). Research priorities for evaluating family history in the prevention of common chronic diseases. American Journal of Preventive Medicine.

Subject: Healthcare and Nursing

Pages: 2 Words: 600

810 DQ 8 1 AND 2

810 DQ 8 1 AND 2

[Name of the Writer]

[Name of the Institution]

810 DQ 8 1 AND 2

Genetic Technology

Towards the end of 2018, a Chinese scientist named Dr. He Jiankui revealed that he has modified the genes of a pair of twins. Jiankui claimed that the babies will be born with HIV-resistant genes, giving them a much longer life span. Dr. Jiankui allegedly used CRISPR technique to edit the embryo. Using the CRISPR technique, Dr. Jiankui modified the CCR5 gene. CCR5 is a protein on the surface of white blood cells that is involved in the immune system as it acts as a receptor for chemokines (Li et.al, 2015). Chemokines monitor the migration of the cells (Li et.al, 2015). This revelation came as s surprise for most of the scientists that were working on gene modification. CRISPR is a technique used in the gene editing of an organism. CRISPR allows for extremely precise and hasty modification of DNA. CRISPR technique has been favored by a large number of scientists because it enables them with greater flexibility and immense accuracy to cut and paste DNA. Another reason for its popularity might be the cheaper costs of inputs involved. Using CRISPR, scientists can perform large-scale genetic manipulation at cheaper costs. However, despite being cheaper and fast, CRISPR is not considered completely safe or reliable by various scientists. Although Dr. Jiankui claimed that his experiment can be a watershed moment and it can help eliminate the menace of HIV from Africa, a recently published article by Micheal Greshko suggests otherwise. Micheal Greshko, an eminent science writer currently affiliated with National Geographic, suggests that gene-edited babies may die early. The report suggests that people having the same gene that Dr. Jiankui modified in babies have 21 percent more chance of dying earlier than 76 years of age. There are different ethical issues regarding gene editing because the modifications are done will be transferred to generations to come. Considering the fact that in 2014, more than 40 countries placed a ban on research on gene editing. An RN's top priority should always be the safety of the patients. Taking into account the fact that gene editing is discouraged by most of the researchers due to safety implications, an RN should object it too until it is deemed safe to carry out. Cultural issues involved in gene editing are yet to be ascertained. Once gene editing is a widely accepted phenomenon, cultural ramifications would be analyzed. Religious issues regarding gene editing are concerning. A survey conducted by Pew Research Center in 2016 shows that 30 pc of US adults deem gene editing unacceptable. A whopping 41pc highly religious Americans deem it totally unacceptable. This implies that gene editing is not doing particularly well when it comes against religion. Food and Drug Administration (FDA) has not legalized gene editing in the US. This implies that laws are yet to be imposed regarding gene editing. Societal implications of gene editing have a mixture of results. Although gene editing can help with food shortage and fighting disease, a widespread awareness regarding the implications of gene editing is need of the hour. Gene editing of crops can help curb food shortage, while gene editing in mosquitos can help develop a mosquito that ultimately ends malaria (Bao et.al, 2016). However, considering the damning article published by Micheal Greshkosuggest that society is not ready to handle the gene-edited humans and implication involved with them (Bao et.al, 2016).

Rights Of Clients In Genetic Decision Making

There are multiple issues concerning the rights of the patients involved in genetic decision making. Of all issues, consent and privacy of the patients and clients in genetic decision making are discussed ahead. Any scientific research underpins the offerings of research participants (Gyngell, Douglas, & Savulescu, 2017). There is a need to respect the rights of the participants and clients involved in the process. For genetic research, a robust consent process must be created by the researchers (Gyngell, Douglas, & Savulescu, 2017). The clients must be made aware of the risks and benefits involved with the process they are involved in (Gyngell, Douglas, & Savulescu, 2017). Researchers may also need to obtain consent forms that inform the clients involved in the process regarding the consequences of the genetically related decision making. For informing the client or the patient regarding the consent of the process they are involved in, researchers need to carry out a comprehensive dialogue with the participant (Gyngell, Douglas, & Savulescu, 2017). Researchers must bring into the knowledge of the patients about the meanings of the clauses of the consent form.

Another issue concerning the decision making involved in gene editing is the privacy of the data of the patients involved. There are two things that underpin any scientific research (Iyengar, Kundu, & Pallis, 2018). First, the sharing of data on a large scale to help researchers with an ongoing issue (Iyengar, Kundu, & Pallis, 2018). Second, data of the patient should be protected at all costs (Iyengar, Kundu, & Pallis, 2018). These two coupled together can provide balanced scientific research. For an RN, the consent and the privacy of the patient involve are of paramount concern. Obtaining consent and making patients aware of the process they are involved in is the basic obligation of an RN. Moreover, given the data leaks from tech giants doing the rounds in the media, the need to carefully handle the patient data is great. An RN should be responsible enough to handle information on the patient carefully. To ensure privacy, an anonymous database of patients and client should be maintained.


Bao, S., Lv, Z., Li, Y., Ma, J., Zhang, Y., Li, S., ... & Yang, F. (2016). Genetic Engineering: Pros versus Cons in Deciphering Disease Mechanism-ft. Science, 2016.

Gyngell, C., Douglas, T., & Savulescu, J. (2017). The ethics of germline gene editing. Journal of applied philosophy, 34(4), 498-513.

Iyengar, A., Kundu, A., & Pallis, G. (2018). Healthcare Informatics and Privacy. IEEE Internet Computing, 22(2), 29-31.

Li, C., Guan, X., Du, T., Jin, W., Wu, B., Liu, Y., ... & Hu, Q. (2015). Inhibition of HIV-1 infection of primary CD4+ T-cells by gene editing of CCR5 using adenovirus-delivered CRISPR/Cas9. Journal of General Virology, 96(8), 2381-2393.

Subject: Healthcare and Nursing

Pages: 2 Words: 600

: Measurement And Leadership Role In Communicating Assessment Of Learning

Measurement and Leadership Role in Communicating Assessment of Learning

Measurement and Leadership Role in Communicating Assessment of Learning

In nursing education assessment typically focused on the successful prediction of NCLEX by using tests such as ATI predictors and HESI. Much research has been carried out on predictive exam trends ADDIN EN.CITE <EndNote><Cite><Author>Leung</Author><Year>2008</Year><RecNum>308</RecNum><DisplayText>(Leung, Mok, &amp; Wong, 2008)</DisplayText><record><rec-number>308</rec-number><foreign-keys><key app="EN" db-id="2s2s0zrapsf0pbe5efuvv20f9rszvx0sd2fe" timestamp="1574424428">308</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Leung, Sau Fong</author><author>Mok, Esther</author><author>Wong, Daniel</author></authors></contributors><titles><title>The impact of assessment methods on the learning of nursing students</title><secondary-title>Nurse education today</secondary-title></titles><periodical><full-title>Nurse education today</full-title></periodical><pages>711-719</pages><volume>28</volume><number>6</number><dates><year>2008</year></dates><isbn>0260-6917</isbn><urls></urls></record></Cite></EndNote>(Leung, Mok, & Wong, 2008). These exams focus on tests that are given at the start and end of the nursing program. Nursing schools focus on accepting and recruiting students that are based on different variables such as SAT scores and grade point average (GPA). However, recent research has shown that only 68% of nursing students who have matric in a nursing program can progress and graduate in nursing. Nursing schools are judged totally by the state board of nursing (SBNs) and also by higher education accrediting bodies.

Direct assessment

The HESI assessment test is used by the nursing school to help in their admission process. Different HESI exams (ten potential exams) are scored differently on a scale of zero to a hundred. HESI provides a wide range of exams, such as HESI admission assessment. This is an entrance and specialty exam that is used to assess the specific clinical content. Custom exams are specialty exams that are designed to determine the faculty specifies the content of nursing. HESI exit exam is a comprehensive exit exam that is found in both practical nurses and registered nurse version. RN-BSN is an exam that is outcome measures for Registered nurses who are pursuing a bachelor's degree in nursing. Faculties usually use these scores as a substitute for the teacher-designed final exam ADDIN EN.CITE <EndNote><Cite><Author>Russell</Author><Year>2014</Year><RecNum>310</RecNum><DisplayText>(Russell, 2014)</DisplayText><record><rec-number>310</rec-number><foreign-keys><key app="EN" db-id="2s2s0zrapsf0pbe5efuvv20f9rszvx0sd2fe" timestamp="1574424496">310</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Russell, Bedelia H</author></authors></contributors><titles><title>The who, what, and how of evaluation within online nursing education: State of the science</title><secondary-title>Journal of Nursing Education</secondary-title></titles><periodical><full-title>Journal of Nursing Education</full-title></periodical><pages>13-21</pages><volume>54</volume><number>1</number><dates><year>2014</year></dates><isbn>0148-4834</isbn><urls></urls></record></Cite></EndNote>(Russell, 2014). HESI reports provide scores that can be used to evaluate the strength and weaknesses of curricula.

HESI Exit Exam

HESI exit exam is a comprehensive exam that is formulated for administration near the curriculum completion to measure the preparedness of students for the NCLEX PN and NCLEX-RN. It is used to determine the weakness and strength of nursing students and the remediation need before taking nursing exams. The HESI exit exam includes questions covering reading comprehension, mathematics, physiology, biology, chemistry, anatomy, grammar, and general knowledge. This exam is computerized, and students are given up to 4 hours to complete this test. HESI is very important because much emphasis is placed on the nursing graduate performance on NCLEX. There are different phases of the HESI exam and testing. The first exam HESI A2 is an admission assessment.

ATI Assessment test

ATI nursing assessment test is conducted by some universities and nursing programs to help students of nursing in preparation for the NCLEX test. ATI is usually administered at different stages throughout the nursing program. For example, entrance exam, mid curricular exam, and exit exam). This assessment test is similar to the HESI nursing test. This test is very important for nursing students to get familiar with common techniques, practices, and definitions. This test helps the nursing student to prepare for the NCLEX exam that is a final test taken after graduation. Two ATI assessment tools that are used by nursing schools are ATI review modules known as Review program and the Comprehensive Assessment entrance exam. Some of the nursing schools use this testing as a required test to get admission in the program.

SAT Assessment

SAT assessment is needed in nursing education. This test includes three sections: writing, language, and math sections. This test covers all skills that are required to succeed in bachelor's programs. This test usually comprises of multiple-choice questions. This assessment measures the writing, reading, and math skills of students. There is also an optional essay writing section that is necessary to build critical thinking ability among students.

Indirect Assessment method

Indirect assessment methods usually provide a less concrete view of the learning of students. For example, values, feelings, perceptions, etc. Indirect assessment methods employ self-reported data. These assessment methods help to assess student learning. Indirect assessment methods include surveys, course evaluation, interviews, and reports on placement, retention, and graduation, etc. Indirect assessment methods are best suited for university or college level programs. These methods are used commonly in conjunction with direct assessment methods. These methods provide information on the extent of the learning of students. These methods assess the thoughts and opinions of students. They are also helpful in assessing the skills and knowledge of students. These assessment methods provide information about the perception of students in their learning and how learning is valued by different constituencies. However, indirect assessment methods are not as strong as direct methods. These are only helpful when the attitude, perception, and beliefs of students have to be determined from a different perspective ADDIN EN.CITE <EndNote><Cite><Author>Jassim</Author><Year>2017</Year><RecNum>311</RecNum><DisplayText>(Jassim, Moria, Varghase, Aletani, &amp; Hadi, 2017)</DisplayText><record><rec-number>311</rec-number><foreign-keys><key app="EN" db-id="2s2s0zrapsf0pbe5efuvv20f9rszvx0sd2fe" timestamp="1574424584">311</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Jassim, Rahim</author><author>Moria, Hazim</author><author>Varghase, Saji</author><author>Aletani, Salem</author><author>Hadi, Yasir</author></authors></contributors><titles><title>A Simplified Approach to Link Course Learning Outcomes to Student Outcomes in ABET Accreditation to Perform Program Assessment and Improvement</title><secondary-title>Education Journal</secondary-title></titles><periodical><full-title>Education Journal</full-title></periodical><pages>196</pages><volume>6</volume><number>6</number><dates><year>2017</year></dates><isbn>2327-2619</isbn><urls></urls></record></Cite></EndNote>(Jassim, Moria, Varghase, Aletani, & Hadi, 2017).


Direct assessment methods are helpful in pre-learning as it provides evidence of value-added and growth. By giving the entrance exam, these tests help to assess the student potential for success. These are also helpful in knowing the determination of students towards the program in which student is enrolled. This test provides students a ladder to a path of success who understands concepts and do not study just for the sake of the test. These assessments are meant to predict best which students are more successful in a program and in passing the National Council Licensure Exam for registered nurses. HESI scores help the nursing school to determine whether the student is capable of completing a nursing program successfully or not.

Interviews and surveys are very effective at measuring the effectiveness of the department and program. Well-designed interview questions, surveys, and course evaluation can found to be very helpful in determining the perceptions and attitudes of students about a course and program. It will help in informing key stakeholders about what is working or what is not. Indirect assessment methods such as reports are very effective as different types of reports such as on retention, recruitment, and placement can provide information in determining the department and program effectiveness. This will inform the department as well as a teacher how to tailor existing strategies to meet the need of students and universities. These assessments intend to measure the student's knowledge of prerequisite courses.

General education

These exams are helpful in assessing not only theoretical knowledge of students but also intelligence. In general education, these tests are important because these exams also judge student vocabulary, grammar, and mathematics. Therefore, these students who pass this exam possess excellent knowledge in these subjects. These direct assessment methods also help nursing students to build skills in the specific content of general subjects such as basic math, grammar, decimal functions, and reading comprehension. By reviewing these subject areas provide students with the best opportunity for success in the test. The comprehensive assessment program provides nursing students with comprehensive solutions to learning material. This helps nurse students with diverse learning styles of understanding. This assessment tool offers reading material, practice assessment, videos, and internet sources to enhance the learning of students. All of the direct assessment methods are usually MCQs based. These questions provide an appropriate method of assessment. They are usually formulated to test the student's cognitive domain instead of simple facts. Other than building critical thinking in students, these assessments are also enhanced both surface and deep learning approach. The approach of surface learning helps to cope with heavy workload during the whole course of study within the strict time constraints.

Course level

These tests are important in teaching students time management skills. Regular assessment during the course should be updated regularly, depending on the new data availability. This will help to assess the student outcomes about the expected outcomes. This will help in the continuous improvement of implementation. Course level assessment collects data from different tools, from the assignments of students as well as indirect learning measures. This helps to understand whether the students are meeting their goals of a particular course. At the course level, the assessment will be helpful for several reasons. It can help to identify those things which are working well in the course. It will also help to identify things that need improvement. This will help to make a strategic decision in future and then evaluate the success of the changes. It will also help determine whether the course fits in with the established curriculum. This will also tell whether the resources have been used efficiently or not. HESI specialty exams are used to assess the knowledge of nursing students and their ability to apply the concepts of nursing within specific content areas. The ATI testing helps the nursing faculty members to evaluate their current curricula. This helps to improve in areas where needed. Both direct and indirect assessment is important to identify the weaknesses and strengths of students so that they can take the NCLEX examination. These assessment tools help teachers to give feedback to their nursing students throughout the education

Program level

Program-level assessment collects all course-level assessments along with data collected from indirect assessment methods at the program level to find whether a program is effective or not in accomplishing the goals it has set forth for the nursing graduates. Assessing the student progress throughout the program rather than at the end will allow teachers to have required information to make an effective decision. During their education, students may also have to enroll in different testing. This assessment tool helps students of nursing to improve in areas in which they are lacking. One of the advantages of these assessment tests is that these are online, and students can easily access tools at their convenience. This assessment tool helps provide clear indicators to nursing students on how well they will do in the NCLEX exam. Indirect assessment methods are useful in both program-level and course-level assessment. At the departmental and program level, indirect assessment methods are helpful to determine the efficacy of programs, processes, services, and initiatives. Professors can use indirect assessment methods to determine the attitudes and perceptions of students that can provide insights about the performance of students.

While it is very important to assess and track the success of the program, it is also vital to effectively communicate with other people about the progress that is being observed. Program results and progress can be equally shared with staff members and other interested stakeholders such as teams, outside groups, and other programs within the college. Once the assessment is done, the communication of course or program is required. Communication can occur in different ways, such as reports, through the meeting, management dashboard, and other relevant media. Communication the program status is not easy; therefore, it is necessary to devise effective communicating strategies at the early course and program planning process ADDIN EN.CITE <EndNote><Cite><Author>Flood</Author><Year>2016</Year><RecNum>312</RecNum><DisplayText>(Flood &amp; Higbie, 2016)</DisplayText><record><rec-number>312</rec-number><foreign-keys><key app="EN" db-id="2s2s0zrapsf0pbe5efuvv20f9rszvx0sd2fe" timestamp="1574424660">312</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Flood, Lisa S</author><author>Higbie, Julie</author></authors></contributors><titles><title>A comparative assessment of nursing students&apos; cognitive knowledge of blood transfusion using lecture and simulation</title><secondary-title>Nurse education in practice</secondary-title></titles><periodical><full-title>Nurse education in practice</full-title></periodical><pages>8-13</pages><volume>16</volume><number>1</number><dates><year>2016</year></dates><isbn>1471-5953</isbn><urls></urls></record></Cite></EndNote>(Flood & Higbie, 2016).

The College leaders should assume a proactive role that supports teacher's instructional efforts. They should communicate effectively and directly with other teachers about the students' needs and instructions. The college leaders should make conscious efforts to interact with teachers positively daily. College leaders communicate consistently that academic gains are the main priority. Thirdly teacher analysis should be done by college leaders. The proper amount of time should be allocated in meeting with teachers, and principals should be flexible to meet the need of students. College leaders should assign those roles to the teacher in which they have expertise. College leaders should be aware of what's happening in the classroom. They should provide all the material and resources that are necessary to support teacher instructional efforts. College leaders should arrange a regular meeting with students. Secondly, regular visits to the classroom should be conducted to observe teacher instructional methods. College leaders should use faculty input and data to assess the staff development activities that strengthen the instructional skills of teachers. College leaders should make and implement strategies that are important for the professional development of teachers. The decision about the development of staff should be made based on student progress ADDIN EN.CITE <EndNote><Cite><Author>Vierula</Author><Year>2019</Year><RecNum>313</RecNum><DisplayText>(Vierula, Haavisto, Hupli, &amp; Talman, 2019)</DisplayText><record><rec-number>313</rec-number><foreign-keys><key app="EN" db-id="2s2s0zrapsf0pbe5efuvv20f9rszvx0sd2fe" timestamp="1574424724">313</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Vierula, Jonna</author><author>Haavisto, Elina</author><author>Hupli, Maija</author><author>Talman, Kirsi</author></authors></contributors><titles><title>The assessment of learning skills in nursing student selection: A scoping review</title><secondary-title>Assessment &amp; Evaluation in Higher Education</secondary-title></titles><periodical><full-title>Assessment &amp; Evaluation in Higher Education</full-title></periodical><pages>1-17</pages><dates><year>2019</year></dates><isbn>0260-2938</isbn><urls></urls></record></Cite></EndNote>(Vierula, Haavisto, Hupli, & Talman, 2019). The prompt teacher evaluation will help in achieving the high results of students.

Setting a compelling and clear direction

Develop coherent efforts and shared purpose through belief, mission, and vision.

Develop, communicate and implement a result based strategic action plan

Shaping the culture for learning

Promote a positive, safe and interactive, supportive environment

Sustain and build collaborative relationship and structure for work and learning

Establish college desired culture through traditions, norms, culture competencies, and rituals

Use persuasion, Influence, and advocacy to engage all key stakeholders.

Infuse perspectives, experiences, ideas, and diversity of people into work

Leading and change management

Use group, individuals and organization change process, results and tools. ‘

Use assessment, inquiry and reflection practices for continuous improvement and learning

Excellent leadership to sustain the excellent image of the college.

Transforming learning and teaching

Expect high-quality learning and teaching

Observe the practice of teaching and provide positive feedback for professional learning

Ensure that all students are engaged in the relevant, rigorous and student-centered experience of learning

Become literate as digital learning environment leader

Ensure alignment of teaching assessment, curriculum, professional learning, and standards.

Accountability system Management

Use student performance accountability system in making decisions based

Use a teacher performance-based accountability system to make decisions.

Allocate, acquire and distribute resources equitably

Adopt implications from emerging and current knowledge to improve student and teacher performance and learning


ADDIN EN.REFLIST Flood, L. S., & Higbie, J. (2016). A comparative assessment of nursing students' cognitive knowledge of blood transfusion using lecture and simulation. Nurse education in practice, 16(1), 8-13.

Jassim, R., Moria, H., Varghase, S., Aletani, S., & Hadi, Y. (2017). A Simplified Approach to Link Course Learning Outcomes to Student Outcomes in ABET Accreditation to Perform Program Assessment and Improvement. Education Journal, 6(6), 196.

Leung, S. F., Mok, E., & Wong, D. (2008). The impact of assessment methods on the learning of nursing students. Nurse education today, 28(6), 711-719.

Russell, B. H. (2014). The who, what, and how of evaluation within online nursing education: State of the science. Journal of Nursing Education, 54(1), 13-21.

Vierula, J., Haavisto, E., Hupli, M., & Talman, K. (2019). The assessment of learning skills in nursing student selection: A scoping review. Assessment & Evaluation in Higher Education, 1-17.

Subject: Healthcare and Nursing

Pages: 6 Words: 1800

A Near Miss

A Near Miss

[Name of the Writer]

[Name of the Institution]

A Near Miss

The error that happened in the case was the wrong medication. The patient was given five times a high concentration of potassium chloride. The medication error is a crucial issue in nursing. A report indicates that more than 60% of nurses made medication errors. The child was lucky whose mother was from the healthcare field. As a pharmacist, she knew that her kid does not require much quantity of the potassium chloride ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"ifS4Z6ak","properties":{"formattedCitation":"(Saskatchewan Health Authority - Saskatoon area, n.d.)","plainCitation":"(Saskatchewan Health Authority - Saskatoon area, n.d.)","noteIndex":0},"citationItems":[{"id":883,"uris":["http://zotero.org/users/local/mlRB1JqV/items/EAVT4VCR"],"uri":["http://zotero.org/users/local/mlRB1JqV/items/EAVT4VCR"],"itemData":{"id":883,"type":"motion_picture","title":"Near Fatal: A Patient Safety Story","source":"YouTube","dimensions":"209 seconds","URL":"https://www.youtube.com/watch?v=pcQUnGiuhzM","title-short":"Near Fatal","author":[{"literal":"Saskatchewan Health Authority - Saskatoon area"}],"accessed":{"date-parts":[["2019",7,11]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Saskatchewan Health Authority - Saskatoon area, n.d.). The cooperation and trust of the physician on the mother helped in sorting out the error. However, it is important for nurses to identify and solve these kinds of medication errors.

The first factor that could lead to medication error was the lack of pharmacological knowledge. It could be identified through the kidney condition of the patient which suggests that the normal quantity of potassium chloride was enough. Therefore, the nurse could prevent the error by preventing the wrong infusion rate and dosage. The second error observed was the communication gap. The communication between the nurses, nurse with physicians, and nurses with parents is really important for safe practice. It helps when the thing goes out of hand. Therefore, the nurse could reduce the communication gap to avoid any complication in the case. The last thing where the nurse could prevent the error was the handwritten report. The report indicates that numbers of time medication error happen due to the abbreviation used by the nurses. In the video, it can be observed that nurse cut the words various time. Hence, technology advancement is important. The report should not be handwritten instead it should be typed through the computer for better understanding. The bottom line is that the nurse could prevent the error through pharmacological knowledge, better communication, and digital reporting system ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"qupmdwcs","properties":{"formattedCitation":"(Cheragi, Manoocheri, Mohammadnejad, & Ehsani, 2013)","plainCitation":"(Cheragi, Manoocheri, Mohammadnejad, & Ehsani, 2013)","noteIndex":0},"citationItems":[{"id":881,"uris":["http://zotero.org/users/local/mlRB1JqV/items/R5NW7MVN"],"uri":["http://zotero.org/users/local/mlRB1JqV/items/R5NW7MVN"],"itemData":{"id":881,"type":"article-journal","title":"Types and causes of medication errors from nurse's viewpoint","container-title":"Iranian Journal of Nursing and Midwifery Research","page":"228-231","volume":"18","issue":"3","source":"PubMed Central","abstract":"Background:\nThe main professional goal of nurses is to provide and improve human health. Medication errors are among the most common health threatening mistakes that affect patient care. Such mistakes are considered as a global problem which increases mortality rates, length of hospital stay, and related costs. This study was conducted to evaluate the types and causes of nursing medication errors.\n\nMaterials and Methods:\nThis cross-sectional study was conducted in 2009. A total number of 237 nurses were randomly selected from nurses working in Imam Khomeini Hospital (Tehran, Iran). They filled out a questionnaire including 10 items on demographic characteristics and 7 items about medication errors. Data were analyzed using descriptive and inferential statistics in SPSS for Windows 16.0.\n\nResults:\nMedication errors had been made by 64.55% of the nurses. In addition, 31.37% of the participants reported medication errors on the verge of occurrence. The most common types of reported errors were wrong dosage and infusion rate. The most common causes were using abbreviations instead of full names of drugs and similar names of drugs. Therefore, the most important cause of medication errors was lack of pharmacological knowledge. There were no statistically significant relationships between medication errors and years of working experience, age, and working shifts. However, a significant relationship was found between errors in intravenous injections and gender. Likewise, errors in oral administration were significantly related with number of patients.\n\nConclusion:\nMedication errors are a major problem in nursing. Since most cases of medication errors are not reported by nurses, nursing managers must demonstrate positive responses to nurses who report medication errors in order to improve patient safety.","ISSN":"1735-9066","note":"PMID: 23983760\nPMCID: PMC3748543","journalAbbreviation":"Iran J Nurs Midwifery Res","author":[{"family":"Cheragi","given":"Mohammad Ali"},{"family":"Manoocheri","given":"Human"},{"family":"Mohammadnejad","given":"Esmaeil"},{"family":"Ehsani","given":"Syyedeh R."}],"issued":{"date-parts":[["2013"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Cheragi, Manoocheri, Mohammadnejad, & Ehsani, 2013).


ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Cheragi, M. A., Manoocheri, H., Mohammadnejad, E., & Ehsani, S. R. (2013). Types and causes of medication errors from nurse’s viewpoint. Iranian Journal of Nursing and Midwifery Research, 18(3), 228–231.

Saskatchewan Health Authority - Saskatoon area. (n.d.). Near Fatal: A Patient Safety Story. Retrieved from https://www.youtube.com/watch?v=pcQUnGiuhzM

Subject: Healthcare and Nursing

Pages: 1 Words: 300

A Solution To A Specific Ethical Dilemma Faced By A Healthcare Professional By Applying Ethical Principles.

A solution to a specific Ethical Dilemma faced by a healthcare professional by applying Ethical Principles

[Name of the Writer]

[Name of the Institution]

A solution to a specific Ethical Dilemma faced by a healthcare professional by applying Ethical Principles

Case study 3

Vaccine hesitancy is a big threat to human health. As child vaccination is essential and highly effective for maintaining the health of the community. Likewise, the case study tells that how people are being manipulated against the vaccination of children among East African immigrants. People are told to avoid the vaccination against measles among those people which can bring health threats to the community. It is a serious matter and parents are getting worried as a result of those fake information. As a result of those worries vaccine hesitancy among the people is growing. However, parents have very little information regarding the vaccination, or they are informed but confused, are vaccine hesitant (Williamson & Glaab, 2018).

Measles was growing among the people, and at the same time, the anti-vaccination groups were spreading incorrect information among the people. Therefore, it became the goal of healthcare providers like Piper Banks aimed to counter the fear and misinformation among the community. The open-armed organization has to work against falsifications which brainwashed the minds of the people for almost ten years (Capella University, 2018). However, Piper was well aware of professionalism and ethical values which provide an implied basis for public health practice. Therefore, engaging the faith organizations has shown positive results and improved the participation of parents in the vaccination of their children. It is an excellent ethical approach to seek help from religious leaders and groups. Religious leaders are used to be highly esteemed, and they have the power to convince the community members in favor of vaccination of their children.

Although it is not a very easy task to get the attention of the immigrants, in this case, improvements can be seen. People have been reluctant to vaccination for a long time because the anti-vaccine community convinced them for so many years. Now, it will take time to accept reality. However, continuous efforts can give better results. Another approach which is used by the health care professionals, in this case, is "Patient-centered Communication." The health professionals are trying to understand the patients’ perspective regarding the illness. At the same time, they are also expressing empathy for the patients. However, understanding the patient’s perception requires exploring the patient’s feeling, thoughts, fears and involvements regarding the influence of the illness, as well as the expectations of the patients (Hashim, 2017).

Likewise, staff members of Open Armed are optimistic about the positive response from the community. Felcia says, “They are more open to believing us than I’ve ever seen” (Capella University, 2018). It means that communicating effectively with patients can give better results than enforcing the decisions. No one can deny the fact that poor communication can bring severe errors in the medical field. Under this approach, the two-way exchange between healthcare providers and parents is essential to support informed decision-making and determine whether parents are willing to immunize their children or not.

However, Patient-centered care is undermined by incoherent deliverance and contradictory policy approaches, so other ethical approaches can be used to solve this ethical dilemma. Public health concepts such as herd immunity can help to get the attention to encounter parents and health professionals. As parents are unaware of herd immunity so they will show little interest. In this case, the medical professionals need to directly discuss the issue and address their parents within their social context. However, the four principles of healthcare ethics cannot be ignored because they play a crucial role in ensuring the safety and care of individuals. The ethical standards at health sector demand the autonomy of the patients. Hence, the actions of healthcare providers can be limited to suggestions or advice, but any action that attempts to persuade the patients is a violation of autonomy.

In addition, public deliberation is also essential for positive results, because it will just not help the people to express the challenges but also legitimize some strong policies to address those challenges. However, in this case, the health practitioners can involve the other influential groups like civil society members to communicate with the immigrants. They can also include the government to take some measure steps against those who are spreading untrue information among the people. It is the duty of health professionals to benefit the citizens in every situation. They are responsible for preventing patients from harm, remove the challenges regarding health and promote healthy initiatives. Thus, the principle of beneficence will be assured.

Throughout the process, the medical officials of Piper’s team need to deal the issue with care. They can take such measures which will not damage the east African immigrants. Moreover, involving the religious leaders is an ideal option because it follows the principles of the ethics. Likewise, non-maleficence is best known among all other principles of ethics. According to the ethical principle of non-maleficence, healthcare providers should not harm the patients. Thus, a practitioner cannot mistreat people through their decisions even if it is made for the benefits of them.

Moreover using clear and simple language to present the pieces of evidence for the risk of disease and communicating the benefits of vaccination in a fair and accurate manner might help. As the outbreak of measles is a big challenge for the community, conveying the message can overcome the serious complications. Poor communication is identified as a determinant of vaccine resistance. However, framing can be a good option in which communicating the positive gains along with the negative losses will make people think about the effects of the disease.


Capella University (2018). Measles making a comeback. Retrieved from http://media.capella.edu/CourseMedia/NHS-FP4000/ethicalCaseStudies/transcript.html

Hashim, M. J. (2017). Patient-Centered Communication: Basic Skills. American family physician, 95(1).

Williamson, L., & Glaab, H. (2018). Addressing vaccine hesitancy requires an ethically consistent health strategy. BMC medical ethics, 19(1), 84.

MacDonald, N. E. (2015). Vaccine hesitancy: Definition, scope and determinants. Vaccine, 33(34), 4161-4164.

Subject: Healthcare and Nursing

Pages: 3 Words: 900

Ability To Learn

Ability to Learn

[Name of the Writer]

[Name of the Institution]

Ability to Learn

Due to an increase in mobility a huge population of people is living in different parts of the world far from their cultures and origins. However cultural background represents the social identity of the people which includes a depiction of their religion, ethnicity, and their other social habits. The difference in gender and culture influences the ability to learn or adapting something. Every culture consists of certain characteristics that sometimes acts as a barrier in adopting new changes and traditions and often restricts a person in fulfilling the desires of a person. There are certain cultures that motivate gender discrimination between males and females due to the concept of male dominance and authority. The main mediums that influence severe gender discrimination are media, environment, and society.

Students face the most difficulties while adjusting to a new environment and culture. Around 4 million people leave their countries for the sake of becoming international students every year. They face multiple problems due to being from a totally different cultural background, and they face difficulties in following their norms and set of rules. (Dumitrašković, T. (2015). They find themselves separated from other students who not only make them lack in understanding the educational system, but it creates a distance and difficulty in developing an interaction with their teachers. Such problems develop a feeling of frustration and dissatisfaction in the students which stays as a barrier between them and their motivation to adapt to the environment. (Brunton, M., & Jeffrey, L. (2014). The willingness or unwillingness of a person is linked with the intention of a person to adapt or learn something from a specific culture or a person from another ethnic group. If a person initially doesn't develop an interest in making efforts than surviving with different ethnicities will be a difficulty. (Liu, M. 2017).


Liu, M. (2017). Adult Chinese as a second language learners' willingness to communicate in Chinese: Effects of cultural, effective, and linguistic variables. Psychological Reports, 120(3), 423-442.

Brunton, M., & Jeffrey, L. (2014). Identifying factors that influence the learner empowerment of international students. International Journal of Intercultural Relations, 43, 321-334.

Dumitrašković, T. (2015). Culture, Identity and Foreign Language Teaching And Learning. Journal of Foreign Language Teaching and Applied Linguistics, 2(2).

Subject: Healthcare and Nursing

Pages: 1 Words: 300


The Abortion Divide

Student name



Women mean motherhood, birth, and parenting. However, the realities of our lives are such that not every woman receives the news of pregnancy with enthusiasm. Pregnancy and the decision a woman makes concerning her unborn child is today an indicator of the social well-being and psychological maturity of not only women but also society as a whole. With a gestation period of up to 12 weeks, a woman's desire is enough for an abortion. Medicine, in turn, is working on improving abortion techniques, looking for new ways to terminate a pregnancy that are safe for a woman. Abortion is never an easy decision for any woman.

In America, there is a confrontation between Republicans and Democrats. The issue of abortion for them today is one of the key issues on the agenda of both parties. But their opinions on this matter differ radically: Democrats are supporters of freedom of reproductive choice, and Republicans believe that life begins from the moment of conception.

The results of emancipation are such that at present, a woman is a full-fledged and very active citizen of society. More recently, women were sitting at home with children and doing household work. Currently, a woman is actively involved in public life; practices are engaged in politics and business. Sometimes earns more than a man and sometimes is the only breadwinner in the family. However, no one has canceled all previous worries about children, home, family. The stress level increased two or even fold, and the resources of the female body are not unlimited. The following is a question of liability and abortion-related expenses. "Abortion is a subject that can rapidly become overcome by radical and legal battles" (Husted p.1).

Neither the female body nor her psyche is adapted to overcome a large number of stresses. Of course, in such a situation, the support of her husband, relatives, close associates of work colleagues is necessary. Sometimes there is neither one nor the other, nor the third. Then the woman is left alone with her thoughts and emotional state. "The lack of legal and safe abortion before the Roe v. Wade decision of 1973 killed and maimed thousands of young women"(Ingelfinger p.2).

As a result, a modern woman in pregnancy often finds herself in a challenging, stressful situation. The arguments in this inference chain are the absence of a husband, lack of work, low salary, housing difficulties, incomplete education, young age, illnesses of relatives or the presence of children in the family. However, at heart, every pregnancy is desired; the rejection of motherhood is due only to rational reasons. For me, terminating my pregnancy was not a natural choice, but it was my choice. That is the single thing that has allowed me to live with the consequences of my decisions" (Jayapal p.1).

According to the concept drawn up, a woman (after sexual intercourse) will have to take care of establishing the fact of pregnancy because she is the direct "carrier." A woman will have to set aside time to visit a free gynecologist to establish the truth of pregnancy or her absence. After that, provide a copy of the document with the help of state organizations involved in sending documents with this degree of importance directly to the alleged biological father of the child. The trace formula calculates the notification deadline: From the deadline for safe abortion, subtract the period spent on an adequate decision by a primary consideration of the application responsible management body, as well as the necessary period for the operation. If a woman, for whatever reasons, concealed from the second side of the fact of her pregnancy, then it is assigned a penalty and the second side is granted the right of abandonment.


Ingelfinger, J. R. (2018). A Remembrance of Life before Roe v. Wade. New England Journal of

Medicine, 379(8), 708–709. doi:10.1056/nejmp1809150

Husted,A.(2019). FRONTLINE Goes Inside America's Fight Over Abortion in "The Abortion

Divide". Retrieved from https://www.pbs.org/wgbh/frontline/announcement/frontline-goes-inside-americas-fight-over-abortion-in-the-abortion-divide/.

Jayapal, P. (2019, June 13). Rep. Pramila Jayapal: The Story of My Abortion. Retrieved from


Subject: Healthcare and Nursing

Pages: 2 Words: 600

Abuse And Neglect: Orientation Project

Abuse and Neglect: Orientation Project

[Author’s name]

Abuse and Neglect: Orientation Project

Child Abuse and Neglect Definitions

The perspective of abuse is defined as the inappropriate use of the thing or the individual. Child abuse is one growing concern that influence communities in different and adverse forms. The federal definition of the phenomenon of the child abuse recognized as any action or failure of the act that eventually cause a great form of risk of serious harm for the children. In other words, any improper act by parents or caretaker that cause serious physical, emotional, or sexual harm for the children recognized as the approach of child abuse ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"qdcBAdoo","properties":{"formattedCitation":"(Widom, Czaja, & DuMont, 2015)","plainCitation":"(Widom, Czaja, & DuMont, 2015)","noteIndex":0},"citationItems":[{"id":2084,"uris":["http://zotero.org/users/local/lMSdZ3dY/items/9M4Q55I9"],"uri":["http://zotero.org/users/local/lMSdZ3dY/items/9M4Q55I9"],"itemData":{"id":2084,"type":"article-journal","title":"Intergenerational transmission of child abuse and neglect: Real or detection bias?","container-title":"Science","page":"1480-1485","volume":"347","issue":"6229","author":[{"family":"Widom","given":"Cathy Spatz"},{"family":"Czaja","given":"Sally J."},{"family":"DuMont","given":"Kimberly A."}],"issued":{"date-parts":[["2015"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Widom, Czaja, & DuMont, 2015). Child neglect is one form of child abuse that indicates about the failure of meeting the basic needs of children. The state law of California defines the issue of child abuse as the activity by the other person that inflicted children in different physical, emotional, and sexual forms. Child neglect is the approach of negligence behavior that ultimately threatens the health or welfare of the children.


The role of nurses is immensely crucial at all three levels of prevention in the case of childhood abuse and neglect. The participation of nurses at the primary level of prevention is essential in the form of enhancing awareness level within the general population about the risk of child abuse and neglect. Active participation of nurses in different campaigns is essential to meet the targets of primary prevention. Identification of the population with a high risk of child abuse and neglect demands to convey an important message of prevention to the community. It is obligatory for the nurses to provide better healthcare services to vulnerable families ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"AGvakcRD","properties":{"formattedCitation":"(Caneira & Myrick, 2015)","plainCitation":"(Caneira & Myrick, 2015)","noteIndex":0},"citationItems":[{"id":2085,"uris":["http://zotero.org/users/local/lMSdZ3dY/items/EKUQWAQG"],"uri":["http://zotero.org/users/local/lMSdZ3dY/items/EKUQWAQG"],"itemData":{"id":2085,"type":"article-journal","title":"Diagnosing child abuse: the role of the nurse practitioner","container-title":"The Journal for Nurse Practitioners","page":"640-646","volume":"11","issue":"6","author":[{"family":"Caneira","given":"Laura"},{"family":"Myrick","given":"Karen M."}],"issued":{"date-parts":[["2015"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Caneira & Myrick, 2015). Tertiary level of prevention requires the effective role of nurses as the parent support groups who provides them with assistance in the form of proper parenting. Risk factors in case of childhood abuse are significantly recognized as the features of social isolation, family disorganization, violence, mental instability, etc.


Timely identification of the issue of child abuse and neglect in the form of recognition of particular signs and symptoms is essential to propose better domain of treatment.

Emotional Signs and Symptoms

The improper approach of emotional development

Low level of self-confidence

Loss of interest



Behavioral Signs and Symptoms

Show less concern about different matters

Loss of interest in academic performance

Physical Signs and Symptoms

Different forms of injuries such as bruises, fractures, etc.

Intervention, Treatment and Reporting

The state of California set a proper guideline structure when it comes to the matter of reporting a case of child abuse or neglect. Parents and guardians of children have the legal right to report the complaint of child abuse. Qualified and experienced agencies are legally mandated to report the incident of child abuse. California Penal Code Section 11165.7 defines the extensive list of the individuals who can be mandated, reporters. It comprised of school/district workers, administrators, and athletic coaches etc. Different family resource centers (FRC) are examples of the treatment sources available in case of child abuse and neglect ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"RDCYgV0s","properties":{"formattedCitation":"(California Department of Education, 2019)","plainCitation":"(California Department of Education, 2019)","noteIndex":0},"citationItems":[{"id":2083,"uris":["http://zotero.org/users/local/lMSdZ3dY/items/F8AKH4QE"],"uri":["http://zotero.org/users/local/lMSdZ3dY/items/F8AKH4QE"],"itemData":{"id":2083,"type":"webpage","title":"Child Abuse Identification & Reporting Guidelines","container-title":"Cde.Ca.Gov","author":[{"family":"California Department of Education","given":""}],"issued":{"date-parts":[["2019"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (California Department of Education, 2019). El Modena Family Resource Center in Orange County is one significant example of the treatment sources. There are different collaborative resources specifically in case of intervention and treatment for the issue of child abuse and neglect. Proper investigation of child abuse reports by agencies at the state level is a crucial example of the proper approach of intervention and treatment.

Interdisciplinary Resources

A multidisciplinary approach is adopted by state law to successfully address the issue of child abuse or neglect. Child abuse is recognized as a sensitive concern that requires more attention as compared to other forms of abuse in case of mandated authorities for reporting. This form of difference eventually creates a difference in case of treatment. The role of nurses is immensely critical when they are dealing with the vulnerable population of children.


ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY California Department of Education. (2019). Child Abuse Identification & Reporting Guidelines. Retrieved from:


Caneira, L., & Myrick, K. M. (2015). Diagnosing child abuse: The role of the nurse practitioner. The Journal for Nurse Practitioners, 11(6), 640–646.

Widom, C. S., Czaja, S. J., & DuMont, K. A. (2015). Intergenerational transmission of child abuse and neglect: Real or detection bias? Science, 347(6229), 1480–1485.

Subject: Healthcare and Nursing

Pages: 2 Words: 600

Academic And Professional Success Plan Template

-3810053975035052000NURS 6003: Transition to Graduate Study for Nursing

00NURS 6003: Transition to Graduate Study for Nursing


Academic and Professional Success Plan Template

Prepared by:

Name of the Student

This document is to be used for NURS 6003 Transition to Graduate Study for Nursing to complete Assessments 1-6. Just as importantly the document serves to organize your thoughts about planning for your academic and professional success.

For specific instructions see the weekly assessment details in the course or ask your instructor for further guidance.

Week 1 | Part 1: My Academic and Professional Network

I have identified and secured the participation of the following academic (at least two) and professional (at least two) individuals and/or teams to form the basis of my network. This network will help me to clarify my vision for success and will help guide me now and in the future.

Directions: Complete the information below for each member of your network. For more than four entries repeat the items below with details of your additional network member(s) in the ‘ADDITIONAL NETWORK MEMBERS’ section.



Samad Rehman


Team Leader


Muller & Phipps Pakistan (Private) Limited

Academic or Professional:

Qualified professional who has done master’s in business administration in Finance.

Why I selected this individual and/or team and how they will support my success in the MSN program and as a practicing nurse:

One of the reasons that he was selected was due to the fact that he brings with him wealth of experience working at the Pharmaceutical sectors. He has been the part of the compliance and management teams of different organizations. It has to be noted that despite the fact that his medical knowledge is likely to be far from ideal, the management insight is going to be an important part of the way this project is going to turn out. The other reason that he is going to be an important part of the team is due to the fact that he has the vast knowledge of ethical standards and compliance policies that are witnessed in the industry. The nature of the project is such that this insight is going to be quite valuable in terms of how the broader decision making is going to be done at the level of the organization at the particular point of time. UNV has worked on many development projects and peace contexts with qualified medical doctors and other health-related professionals. These skilled professionals in medical and health services are often deployed to many locations throughout a country and provide immediate medical care to the local population and UN staff.


He has contacts in the banking industry as well that would auger well for the future prospects of the project.



Marian McEntee


Medical Professional


Medical Professionals

Academic or Professional:

Executive Vice President

Why I selected this individual and/or team and how they will support my success in the MSN program and as a practicing nurse:

Now we are getting to the people who have the right set of business expertise, technical knowledge and the relevant experience so that they are going to be in the position to make sure that they are contributing to the project in an appropriate manner. One of the reasons that this profile is particularly interesting is that in the short span of time, the incumbent has been able to make sure that necessary knowledge accumulation is gained as well as making sure that how the other particulars and the technicalities of the project are suppose to be working out at the given point of time. His experience in the project management is something that is going to be extremely important as well in the long-term prospect and management of the project at the appropriate point of time. He has been speaking in seminars as well and his extensive knowledge about the MSN is going to be an important value for the project. They volunteer in hospitals, peacekeeping missions, ministries of health and UN dispensaries. Through the transfer of specialized skills and knowledge, international UN Volunteers support in building capacity to reinforce local health infrastructure and ensure lasting impact.


He has proficient experience in creation of multimedia projects, and this is something that can be used for the better advantage of the project at the particular point of time.



Kim Perry


Radiographers and Sonographers


Horn dean Technology College

Academic or Professional:

Biomedical Scientists

Why I selected this individual and/or team and how they will support my success in the MSN program and as a practicing nurse:

At the moment, there is a need for the team member who relatively has less experience, but they are newly entering into the professional field. One of the reasons that this incumbent is selected is due to the fact that they are going to be able to make sure that they are adding value to the project in a sense that some of the theoretical concepts that are being used in the modern radiography are needed for the completion of this project and this is where her knowledge and insight is going to be quite important. At the same time, being newly entering into the professional field, she has the knowledge about some of the new changes that are happening into the field and how they are going to be helping when it comes to making sure that the right path is created in terms of the way resolution of the problem is supposed to be carried out at the particular point of time. Examples of requests from UNV’s partners for volunteers knowledgeable and experienced in the medical and health professions, with a minimum of two years of experience in their specialized field, include: general practitioners with clinical experience, surgeons, medical specialists such as anaesthesiologists, orthopaedic trauma surgeons, This varied experience is going to be quite helpful in the long run.


She has fair insight about the quality management programs as well, so she is going to be able to provide good value in this regard.



Rahul Pratap Singh


Analytical Chemist 


Pharmaceutical & Medical Professionals Association

Academic or Professional:

Sr. Ex. Quality Control

Why I selected this individual and/or team and how they will support my success in the MSN program and as a practicing nurse:

The last member that is going to be added into the team is going to be the one that should bring about experience in terms of how the quality management and coordination is being done at the large-scale projects. He is someone who is working in the middle management thus the baggage that he is likely to be bringing is going to be much lower as compared to some of the other applicants in the whole process. He has the right set of abilities when it comes to analytical chemistry. At the same time, he has worked on various research tools and the nature of the MSN program and the scope is such that eventually those set of skills are going to be needed to be needed at one point or another time.


Even though it is not going to be an important consideration, it is important to make sure that there is some sense of diversity and representation as we are going to be moving ahead with the project.



Donofrio, N., Spohrer, J., Zadeh, H. S., & Demirkan, H. (2010). Driven medical education and practice: A case for T-shaped professionals. MJA Viewpoint.

Greendale, K., & Pyeritz, R. E. (2001). Empowering primary care health professionals in medical genetics: how soon? How fast? How far?. American journal of medical genetics, 106(3), 223-232.

McLeod, T. C. V., Schwartz, C., & Bay, R. C. (2007). Sport-related concussion misunderstandings among youth coaches. Clinical Journal of Sport Medicine, 17(2), 140-142.

Trix, F., & Psenka, C. (2003). Exploring the color of glass: Letters of recommendation for female and male medical faculty. Discourse & Society, 14(2), 191-220.

Subject: Healthcare and Nursing

Pages: 4 Words: 1200

Academic Intergrity Violations

Academic integrity violations

Your Name (First M. Last)

School or Institution Name (University at Place or Town, State)

Academic integrity violations

In accordance with the Walden’s Academic Integrity Policy, three student paraphrases are evaluated. It is asserted that the paraphrase of Student B is effective because both citation and the content are equally acceptable. The rephrased paragraph is adequately cited and it is followed by the maximum quality of the content. Moreover, the citation is also appropriate in terms of structure (Academic Guides, 2019). So the paraphrase by student B is most effective because it follows all the directions of Walden Academic Integrity Policies.

The response of Student C is less effective than B because the citation is not appropriate. Although the source is directly cited by mentioning the name of the author it lacks “Quotation Marks” without which a text could be plagiarized (Academic Honesty, 2019). Moreover, the citation also lacks the page number citation. So the two flaws, lack of quotation marks and missing page number violates the Walden Academic Integrity Policies.

The least effective paraphrase is of Student A, it is found that the student has paraphrased the text without any citation from the source. Moreover, this paraphrase is just the displacement and skipping of major or some content words. The underlying information is similar to that of the source. So, this paraphrase violates the Walden Academic Integrity Policy by two reasons, one refers to no citation and the other refers to lack of paraphrased content (Academic Honesty, 2019).



Academic Guides: Academic Integrity: Overview. (2019). Academicguides.waldenu.edu. Retrieved from https://academicguides.waldenu.edu/studentaffairs/academicintegrity

Academic Honesty | Walden's Path School. (2019). Walden's Path School. Retrieved from https://waldenspath.com/academic-honesty/

Subject: Healthcare and Nursing

Pages: 2 Words: 600



[Author Name(s), First M. Last, Omit Titles and Degrees]

[Institutional Affiliation(s)]

Author Note



A harmful compulsion, or an obsession, is a tragic human flaw. It can make them lose their morals and their beliefs and all that they stand for in a heartbeat just to feed their addiction. Substance or drug abuse is one of the most common, forms of addiction in the 21st century ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a5OQ2amO","properties":{"formattedCitation":"(Amlung, Vedelago, Acker, Balodis, & MacKillop, 2017)","plainCitation":"(Amlung, Vedelago, Acker, Balodis, & MacKillop, 2017)","noteIndex":0},"citationItems":[{"id":225,"uris":["http://zotero.org/users/local/5VyEEXyp/items/H36LSVNP"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/H36LSVNP"],"itemData":{"id":225,"type":"article-journal","title":"Steep delay discounting and addictive behavior: A meta‐analysis of continuous associations","container-title":"Addiction","page":"51-62","volume":"112","issue":"1","author":[{"family":"Amlung","given":"Michael"},{"family":"Vedelago","given":"Lana"},{"family":"Acker","given":"John"},{"family":"Balodis","given":"Iris"},{"family":"MacKillop","given":"James"}],"issued":{"date-parts":[["2017"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Amlung, Vedelago, Acker, Balodis, & MacKillop, 2017). Given how easy it is to access the drug of your choice using the internet, the number of teens and young adults being obsessed with this life-threatening form of addiction comes as no surprise. It not only adversely affects their social lives, but it also takes a toll on their bodies, both physically and mentally ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"nc5SPFfY","properties":{"formattedCitation":"(Hall, Carter, & Forlini, 2015)","plainCitation":"(Hall, Carter, & Forlini, 2015)","noteIndex":0},"citationItems":[{"id":226,"uris":["http://zotero.org/users/local/5VyEEXyp/items/HM7XXNSE"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/HM7XXNSE"],"itemData":{"id":226,"type":"article-journal","title":"The brain disease model of addiction: is it supported by the evidence and has it delivered on its promises?","container-title":"The Lancet Psychiatry","page":"105-110","volume":"2","issue":"1","author":[{"family":"Hall","given":"Wayne"},{"family":"Carter","given":"Adrian"},{"family":"Forlini","given":"Cynthia"}],"issued":{"date-parts":[["2015"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Hall, Carter, & Forlini, 2015). An estimate carried out by United Nations Office on Drugs and Crime (UNODC) shows that drug use is more prevalent between the ages of 17 to 32. However, more concentrated use was found among the members of the age group 21 to 27 CITATION UNO18 \l 1033 (UNODC, 2018). This shows how alarming the situation has been and is becoming, given the number of people going through addiction, drug abuse and over-dosing is increasing per annum. This increases the need for an immediate interventive measure to be put in place.


Characterized as a chronic disorder, addiction can be described as a compulsive need to both seek and use the drugs despite their detrimental effects on an individual physical and mental wellbeing. According to the National Institute of Drug Abuse (NIDA), Americans spend more than $700 billion in a year to feed their nicotine, alcohol and illicit substance addiction. This figure is not limited to expenditure towards access to these substances, but also on healthcare, criminal tendencies and even loss of productivity among its users CITATION NID16 \l 1033 (NIDA, 2016). Furthermore, a stark decline in the health and well-being of teenagers and those in their twenties have been observed in recent years. Given the inclination of this group towards processed, fatty and fast food, poor lifestyle choices and affinity to substance abuse, people belonging to this particular age group need an effective change ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"xkWO5M4d","properties":{"formattedCitation":"(Van Wormer & Davis, 2016)","plainCitation":"(Van Wormer & Davis, 2016)","noteIndex":0},"citationItems":[{"id":227,"uris":["http://zotero.org/users/local/5VyEEXyp/items/IJV6D5DZ"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/IJV6D5DZ"],"itemData":{"id":227,"type":"book","title":"Addiction treatment","publisher":"Cengage Learning","ISBN":"1-337-51410-1","author":[{"family":"Van Wormer","given":"Katherine"},{"family":"Davis","given":"Diane Rae"}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Van Wormer & Davis, 2016).

The impact of drug addiction is seen on the streets as well as within the confines of high-end hotel suites and clubs. This shows that this disease is equally effective with its adverse effects in both high and low socioeconomic classes of society ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"A1CeLyHK","properties":{"formattedCitation":"(Lewis, Hoffman, Garcia, & Nixon, 2018)","plainCitation":"(Lewis, Hoffman, Garcia, & Nixon, 2018)","noteIndex":0},"citationItems":[{"id":228,"uris":["http://zotero.org/users/local/5VyEEXyp/items/JL2NPYIZ"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/JL2NPYIZ"],"itemData":{"id":228,"type":"article-journal","title":"Race and socioeconomic status in substance use progression and treatment entry","container-title":"Journal of ethnicity in substance abuse","page":"150-166","volume":"17","issue":"2","author":[{"family":"Lewis","given":"Ben"},{"family":"Hoffman","given":"Lauren"},{"family":"Garcia","given":"Christian C."},{"family":"Nixon","given":"Sara Jo"}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Lewis, Hoffman, Garcia, & Nixon, 2018). Considering the avid lack of opportunities available to them, it is highly likely that the people from poor socioeconomic class of society would be at a higher risk of not only developing a long term habit of addiction and drug abuse, but their general quality of life would be poor at best ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"N1mqhyiO","properties":{"formattedCitation":"(Marques et al., 2015)","plainCitation":"(Marques et al., 2015)","noteIndex":0},"citationItems":[{"id":229,"uris":["http://zotero.org/users/local/5VyEEXyp/items/M3I6XKM3"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/M3I6XKM3"],"itemData":{"id":229,"type":"article-journal","title":"The impact of oral health conditions, socioeconomic status and use of specific substances on quality of life of addicted persons","container-title":"BMC Oral Health","page":"38","volume":"15","issue":"1","author":[{"family":"Marques","given":"Tais Cristina Nascimento"},{"family":"Sarracini","given":"Karin Luciana Migliato"},{"family":"Cortellazzi","given":"Karine Laura"},{"family":"Mialhe","given":"Fábio Luiz"},{"family":"Castro Meneghim","given":"Marcelo","non-dropping-particle":"de"},{"family":"Pereira","given":"Antonio Carlos"},{"family":"Ambrosano","given":"Glaucia Maria Bovi"}],"issued":{"date-parts":[["2015"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Marques et al., 2015). Furthermore, they would also find it harder to kick the habit to the curb. On the other hand, drug abuse and substance addiction showed signs of alcohol and drug dependences between the ages of 23 and 27. According to the results obtained, it is shown that parental protective power is the biggest reason for inclination towards drug abuse among the youth belonging to high socioeconomic classes. This follows them into adulthood as well. However, they have a better chance of being admitted to a rehabilitation facility to recover from their drug abuse, probably a number of times over the course of their lives ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"SafarQ2l","properties":{"formattedCitation":"(Thomaidis et al., 2016)","plainCitation":"(Thomaidis et al., 2016)","noteIndex":0},"citationItems":[{"id":230,"uris":["http://zotero.org/users/local/5VyEEXyp/items/U69FW6BX"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/U69FW6BX"],"itemData":{"id":230,"type":"article-journal","title":"Reflection of socioeconomic changes in wastewater: licit and illicit drug use patterns","container-title":"Environmental science & technology","page":"10065-10072","volume":"50","issue":"18","author":[{"family":"Thomaidis","given":"Nikolaos S."},{"family":"Gago-Ferrero","given":"Pablo"},{"family":"Ort","given":"Christoph"},{"family":"Maragou","given":"Niki C."},{"family":"Alygizakis","given":"Nikiforos A."},{"family":"Borova","given":"Viola L."},{"family":"Dasenaki","given":"Marilena E."}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Thomaidis et al., 2016)

This presents a need within the community to work towards the betterment of all, despite their socioeconomic backgrounds or relative history of drug abuse. They are a vital part of a thriving community. Thus, through rehabilitation and better lifestyle choices, they have the potential to become contributing members of society ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"C90d43mB","properties":{"formattedCitation":"(DiClemente, 2018)","plainCitation":"(DiClemente, 2018)","noteIndex":0},"citationItems":[{"id":231,"uris":["http://zotero.org/users/local/5VyEEXyp/items/GBPSP8B8"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/GBPSP8B8"],"itemData":{"id":231,"type":"book","title":"Addiction and change: How addictions develop and addicted people recover","publisher":"Guilford Publications","ISBN":"1-4625-3323-X","author":[{"family":"DiClemente","given":"Carlo C."}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (DiClemente, 2018).


Educating the masses on making good lifestyle choices is vital towards ensuring the fact that the detrimental effects of drug abuse are taken care of. They need to understand how this issue affects society as a whole and what measures can be taken to promote healthy lifestyle choices among teens and young adults that are at high-risk towards developing drug abuse. Furthermore, ostracized and marginalized groups like the addicts and the homeless are also part of our society. Thus, taking the steps necessary to rehabilitate them would be a step in the right direction.


ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Amlung, M., Vedelago, L., Acker, J., Balodis, I., & MacKillop, J. (2017). Steep delay discounting and addictive behavior: A meta‐analysis of continuous associations. Addiction, 112(1), 51–62.

DiClemente, C. C. (2018). Addiction and change: How addictions develop and addicted people recover. Guilford Publications.

Hall, W., Carter, A., & Forlini, C. (2015). The brain disease model of addiction: is it supported by the evidence and has it delivered on its promises? The Lancet Psychiatry, 2(1), 105–110.

Lewis, B., Hoffman, L., Garcia, C. C., & Nixon, S. J. (2018). Race and socioeconomic status in substance use progression and treatment entry. Journal of Ethnicity in Substance Abuse, 17(2), 150–166.

Marques, T. C. N., Sarracini, K. L. M., Cortellazzi, K. L., Mialhe, F. L., de Castro Meneghim, M., Pereira, A. C., & Ambrosano, G. M. B. (2015). The impact of oral health conditions, socioeconomic status and use of specific substances on quality of life of addicted persons. BMC Oral Health, 15(1), 38.

BIBLIOGRAPHY NIDA. (2016). Drugs, Brains, and Behavior: The Science of Addiction. Retrieved from National Institute of Drug Abuse: https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/drug-misuse-addiction

Thomaidis, N. S., Gago-Ferrero, P., Ort, C., Maragou, N. C., Alygizakis, N. A., Borova, V. L., & Dasenaki, M. E. (2016). Reflection of socioeconomic changes in wastewater: licit and illicit drug use patterns. Environmental Science & Technology, 50(18), 10065–10072.

UNODC. (2018). Drug Use. Retrieved from United Nations on Drugs and Crime: https://www.unodc.org/unodc/en/data-and-analysis/statistics/drug-use.html

Van Wormer, K., & Davis, D. R. (2016). Addiction treatment. Cengage Learning.

Subject: Healthcare and Nursing

Pages: 2 Words: 600






Among all the professions that exist today, healthcare is quite unique one because of the relationships between the training and education of health professionals and the patient care delivery. To deliver major portions of care to patients around the world hospitals and healthcare specialists depend upon the trainees. These trainees including medical students, pharmacists or other allied health professional students are often placed at the sharp end which means that they are next to action where any error is considered to be serious and complicated to patient safety. Learning process in healthcare is considered to be full of errors as the learners always strive to develop and polish their professional role. Even if a healthcare individual is competent in his role, there is no assurance that he will remain like that. With the advances in healthcare technology, the untrained healthcare professionals are as dangerous to the patient as the new trainee, due to their unfamiliarity with the equipment and devices ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"eeYCremN","properties":{"formattedCitation":"(Cheung, 2016)","plainCitation":"(Cheung, 2016)","noteIndex":0},"citationItems":[{"id":613,"uris":["http://zotero.org/users/local/4C6u8dIT/items/U57NCL3C"],"uri":["http://zotero.org/users/local/4C6u8dIT/items/U57NCL3C"],"itemData":{"id":613,"type":"webpage","title":"Using the ADDIE Model of Instructional Design to Teach Chest Radiograph Interpretation","container-title":"Journal of Biomedical Education","genre":"Research article","abstract":"Interpreting basic chest radiographs is an important skill for internal medicine residents to help them adequately diagnose and manage respiratory diseases. Educators need tools to ensure that they take a systematic approach when creating a curriculum to teach this, as well as other skills, knowledge, or attitudes. Using an instructional design model helps educators accomplish this task by giving them a guide they can follow to ensure that the curriculum meets the needs of the learners. Using the creation of a curriculum to teach chest radiograph interpretation as an example, this paper illustrates how educators can use the ADDIE model of instructional design to help develop their own curricula.","URL":"https://www.hindawi.com/journals/jbe/2016/9502572/","note":"DOI: 10.1155/2016/9502572","language":"en","author":[{"family":"Cheung","given":"Lawrence"}],"issued":{"date-parts":[["2016"]]},"accessed":{"date-parts":[["2019",2,2]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Cheung, 2016).

Therefore, it is important that education and other training activities must be designed very carefully to be effective. So strict abidance to the ADDIE model is very important. ADDIE model has five main integrated steps which are; analysis, design, development, implementation, and evaluation. This model is not new to healthcare, nor it is new to the professionals, but the unfortunate fact is that this model is not widely used for the safety of patients. The main purpose of this model is to help the healthcare educators to make sure that they are teaching all the relevant materials in an efficient way. It is one of the recently introduced instructional models. The main purpose of this model is to improve the primary care physician’s clinical performances. In the first step, i.e. analysis, which is also one of the most important steps of this model. The current performance of the healthcare individuals is compared with the expected performance, and then performance deficiencies and gaps in knowledge and skills are identified. The main questions that are asked to analyze are; Are the healthcare professionals are selecting relevant protocols? Are they using correct skills? Next is the design phase, where the knowledge that is obtained from the analysis phase is used to develop the overall structure and content of the particular training or course. The main factors of this step are the delivery methodology and sequencing the instructions delivery ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"mnWk6IvV","properties":{"formattedCitation":"(Kholifah & Widyawati, 2017)","plainCitation":"(Kholifah & Widyawati, 2017)","noteIndex":0},"citationItems":[{"id":616,"uris":["http://zotero.org/users/local/4C6u8dIT/items/PIYY8XHA"],"uri":["http://zotero.org/users/local/4C6u8dIT/items/PIYY8XHA"],"itemData":{"id":616,"type":"article-journal","title":"Using ADDIE Model to Design Early Detection System of Child Growth and Development in The Community Health Center of Bendosari, Semarang Indonesia","container-title":"Belitung Nursing Journal","page":"205-212","volume":"3","issue":"3","author":[{"family":"Kholifah","given":"Liliana Nur"},{"family":"Widyawati","given":"Melyana Nurul"}],"issued":{"date-parts":[["2017"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Kholifah & Widyawati, 2017). Efforts of the professionals are directed towards specific matter analysis and lesson planning. In the development step, actual learning materials that will be used during instructions are created. The educators will take the overview which they created in the design step and think step by step on how to practically deliver every feature of the instructions given. Next is the implementation step, where all the instructions will be delivered, or they will be implemented. Instructors who want to go for the long and complicated course are bound to go for beta test first. Then comes the last step which is an evaluation, this step should be considered during the analysis step. After implementing the instructions, tools should be designed that whether the instructions are helpful in achieving the desired goals and if not then what should be the strategy.

The ADDIE model is a good model design, the objectives of this model are quite clear. It helps in the implementation of a systematic and thorough model. In healthcare department, this model helps to implement approaches that are not only advance but also quality assured. All of these steps in this model helps to teach the medical trainees and other nurses to deal with patients according to their medical needs. Also in case of patient-centric tasks the model is helpful because here problems are first analyzed and then they are dealt accordingly. Such models are helping to recognize the root cause of the problem and then to design an effective treatment for the problem and disease, which is only present in this healthcare model. Also for teaching medical practices, the approach is also effective because all the five steps in this model help to deliver effective instruction to the medical trainees which enable them to deal with any crisis because of the advanced nature of the method. Currently, most of the medical teaching practices are changing their practices and modifying them according to this one model because all the important aspects are being covered in ADDIE model which helps the practitioners to deliver their services for patients effectively ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"9iP1YJn9","properties":{"formattedCitation":"(Choi & Kang, 2015)","plainCitation":"(Choi & Kang, 2015)","noteIndex":0},"citationItems":[{"id":610,"uris":["http://zotero.org/users/local/4C6u8dIT/items/ZHS8KKSD"],"uri":["http://zotero.org/users/local/4C6u8dIT/items/ZHS8KKSD"],"itemData":{"id":610,"type":"article-journal","title":"The effects of patient-centered task-oriented training on balance activities of daily living and self-efficacy following stroke","container-title":"Journal of Physical Therapy Science","page":"2985-2988","volume":"27","issue":"9","source":"PubMed Central","abstract":"[Purpose] This study aimed to determine whether a task-oriented training program improved\nbalance, activities of daily living (ADL) performance, and self-efficacy in stroke\npatients. Twenty patients with stroke were recruited from a hospital in Cheongju, Korea.\n[Subjects] Ten of the subjects were assigned to an experimental group that participated in\nthe task-oriented training program, and the other 10 were assigned to a control group that\nreceived traditional rehabilitation therapy. [Methods] In the two groups, balance was\nmeasured with the Berg Balance Scale (BBS), ADL performance with the Modified Barthel\nIndex (MBI), and self-efficacy with the Self-Efficacy Scale (SES), before and after 4\nweeks of training. [Results] Comparative analysis of the experimental group’s pretest and\npost-test results showed statistically significant differences in the BBS, MBI, and SES\nscores. There were also significant between-group differences in the BBS, MBI, and SES\nscores. [Conclusion] The results suggest that a task-oriented training program can be an\neffective intervention to improve balance ability, ADL performance, and self-efficacy in\nstroke patients.","DOI":"10.1589/jpts.27.2985","ISSN":"0915-5287","note":"PMID: 26504340\nPMCID: PMC4616141","journalAbbreviation":"J Phys Ther Sci","author":[{"family":"Choi","given":"Jin-Uk"},{"family":"Kang","given":"Soon-hee"}],"issued":{"date-parts":[["2015",9]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Choi & Kang, 2015)


ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Cheung, L. (2016). Using the ADDIE Model of Instructional Design to Teach Chest Radiograph Interpretation [Research article].

Choi, J.-U., & Kang, S. (2015). The effects of patient-centered task-oriented training on balance activities of daily living and self-efficacy following stroke. Journal of Physical Therapy Science, 27(9), 2985–2988.

Kholifah, L. N., & Widyawati, M. N. (2017). Using ADDIE Model to Design Early Detection System of Child Growth and Development in The Community Health Center of Bendosari, Semarang Indonesia. Belitung Nursing Journal, 3(3), 205–212.

Subject: Healthcare and Nursing

Pages: 2 Words: 600


ADHD and prefrontal cortex Full name University’s name

ADHD referring to attention deficit hyperactivity disorder makes it hard for a person to focus, pay attention and leads towards uncontrollable behaviors. A person with ADHD is mostly fidget or is constantly active. ADHD affects children and teens and can continue in adulthood. This is a mental disorder often diagnosed among children. CITATION Gor16 \l 1033 (Gordon, 2016) On the other hand, the prefrontal cortex is a located at the front lube of the brain. It plays a great role in the implication of a diversity of extreme complex behaviors, including planning and it gives towards personality evolution.

Studies have found out that ADHD is associated with the prefrontal cortex. A weaker prefrontal cortex circuit especially in the right hemisphere can be a cause of ADHD. CITATION Jpe10 \l 1033 (pediatr, 2010) The prefrontal cortex needs a particular amount of norepinephrine (NE) and dopamine (DA) for proper functioning and when the level of these two is low, it weakens the prefrontal cortex CITATION Jpe10 \l 1033 (pediatr, 2010) CITATION Gor16 \l 1033 (Gordon, 2016)and furthermore, creates the inability to concentrate, control impulsive behaviors or make decisions. Hence, causing Attention-Deficit/Hyperactivity Disorder (ADHD). Attention-deficit/hyperactivity disorder is a complex mental health disorder. Symptoms include an amalgamation of different problems. For example, difficulty in paying attention, unable to control impetuous behaviors, and hyperactivity. ADHD in adults can lead to unsteady relationships, poor work or study performance, low self-esteem.

           The first-line treatments for ADHD include the therapeutic approach. But, recently it has been shifting towards environmental restructuring, behavioral therapy, developments in behavioral parental therapy, behavioral classroom management, and psychotherapy are first-line treatments and for adults specifically, the best first-line option is the therapeutic option. CITATION Ste19 \l 1033 (Stephen Soreff & Faculty, oct 1 2019) All the symptoms of ADHD should be treated as a whole. But, mostly the hyperactive behavior should be taken into consideration. This can usually be overcome by medication and talk therapy. 

             Comorbid and tic disorders are complex. Tic disorder is defined as repeated or unexpected fast muscle movements including sounds and vocalizations. While co-morbid disorder are two or more disorders occurring in the same person. Pharmacological considerations for individuals with these disorders include medication that can block or reduce dopamine. Fluphenazine, haloperidol (Haldol), risperidone (Risperdal) and pimozide (Orap) can help sway tics. Whereas, for co-morbid disorders, individuals should try Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), Therapeutic Communities (TCs) moreover, Exposure Therapy.


BIBLIOGRAPHY (2016). Attention-Deficit/Hyperactivity Disorder (ADHD): The Basics. NIH Publication No. QF 16-3572.

clinic, M. (2019). Adult attention-deficit/hyperactivity disorder (ADHD). https://www.mayoclinic.org/diseases-conditions/adult-adhd/symptoms-causes/syc-20350878.

Gordon, J. (2016). Attention-Deficit/Hyperactivity Disorder (ADHD): The Basics. Boulevard: NIMH.

pediatr, J. (2010). The Emerging Neurobiology of Attention Deficit Hyperactivity Disorder: The Key Role of the Prefrontal Association Cortex. 8600 Rockville Pike, Bethesda MD, 20894 USA: HHS Author manuscripts .

Stephen Soreff, M. P., & Faculty, B. U. (oct 1 2019). Attention Deficit Hyperactivity Disorder (ADHD) Treatment & Management. Medscape .

Subject: Healthcare and Nursing

Pages: 1 Words: 300

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