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[Name of the Writer]

[Name of the Institution]


Essay 1: Choosing at least three standards from the Transcultural Nursing Standards list on the www.tcns.org website, critically evaluate the strengths and limitations of the information presented. Support your position with at least one scholarly journal reference. 

Transcultural Nursing Society has developed 10 standards for the nurses working in the field worldwide to ensure cultural competence in the field of nursing. These standards are developed to provide a unified set of standards that would apply to all the nurses whether they are serving in practice, education, or administration (Giger, 2016). Furthermore, the paramount aim of the standards is to empower nurses that are in direct patient care. Out of the 10 standards developed by the Transcultural Nursing Society, 3 have been selected which will be evaluated based on their strength and limitations (Giger, 2016).

Standard: 1 Knowledge of Cultures

As the world has become truly a global village, people from all sorts of socio-economic background have migrated to the United States. Every culture has its own sets of ideas, beliefs, and practices (Giger, 2016). Nurses must have adequate knowledge of different cultures. The strengths of this are that it would inspire nurses to learn more about other cultures. Limitation of this standard can be that any individual holding bias against any culture would be reluctant to learn about that culture (Giger, 2016).

Standard: 2 Education and Training in Culturally Competent Care

As we have discussed, every culture has its own set of ideas, beliefs, and practices. Nurses need to respect those beliefs and practices. For instance, a nurse must respect the decision of a Muslim man to refuse to administer treatment during the month of Ramadan instead of forcing treatment. Strength of this standard is that it would foster a culture of respect and tolerance about the different culture (Giger, 2016). Limitation of this standard is that any nurse with a lack of knowledge about different cultures may prove to disrespect it unwittingly (Giger, 2016).

Standard: 3 Evidence-Based Practice & Research

Evidence-based practice and research have been declared vital to ensure that the standards of the nursing remain on par with the current acceptable standards. Strength of this standard is that it would ensure that the standards and practices employed by the nurses are up to date with the modern standards (Giger, 2016). Limitation of this standard is that nurses serving in underdeveloped countries might have a difficult time reconciling their practices to modern practices (Giger, 2016).

Essay 2: Conduct a self-assessment with the exercise in Box 2-2 in Chapter 2 of Andrews & Boyle. Analyze what you learned about yourself from the exercise and what resources you would use to learn more about four of the groups mentioned. Give examples of resources

The self-assessment exercise that I have undertaken has helped me realize that how I would react to different persons in the society. Following four groups I have selected from the list of the individuals provided in the self-assessment exercise.

The first group I have selected is the child abuser. Honestly, I would never greet a child abuser. It is because of the harm that person has inflicted to a child (O'Donohue & Fanetti, 2016). Furthermore, it would be difficult for me to accept the child abuser. I would not help the child abuser because I do not have any background knowledge about their psychology behind their deeds. Lastly, I would not advocate for the child abuser. The second group selected is a prostitute. I would greet this individual warmly. Since this individual would have a long story to tell, I would accept them. Furthermore, I will try to help them because they suffer from various healthcare complications (Connelly, 2018). Although I do not have the necessary background about the difficulties that they might suffer, I would advocate for them. I would advocate people to change their attitudes towards them. The third group selected is the person suffering from AIDS. I would greet this individual as they have already suffered a lot due to their disease. Certainly, I am open to accepting them because they suffered enough already. I would help the person suffering from AIDS. I am very well aware of the levels of pain they go through. Therefore, I would advocate for them too (Turan et.al, 2017). The last group selected for this self-assessment exercise is the Native American. I will greet the individual warmly. As they hail from a rich cultural background, I am open to accepting them. Additionally, I would help them. As I know Native Americans have been suffering from a lot of issues, I would advocate for them strongly (Cooper, 2016).


Connelly, M. T. (2018). The response to prostitution in the progressive era. UNC Press Books.

Cooper, P. J. (2016). Continuing Challenges for Native Americans: Problems Persist Despite Civil Rights Gains for Others. In Civil Rights in Public Service (pp. 196-231). Routledge.

Giger, J. N. (2016). Transcultural Nursing-E-Book: Assessment and Intervention. Elsevier Health Sciences.

O'Donohue, W. T., & Fanetti, M. (2016). Forensic interviews regarding child sexual abuse. New York: Springer.

Turan, B., Budhwani, H., Fazeli, P. L., Browning, W. R., Raper, J. L., Mugavero, M. J., & Turan, J. M. (2017). How does stigma affect people living with HIV? The mediating roles of internalized and anticipated HIV stigma in the effects of perceived community stigma on health and psychosocial outcomes. AIDS and Behavior, 21(1), 283-291.

Subject: Healthcare and Nursing

Pages: 2 Words: 600

Transformational Leadership In Change Of Management

Transformational Leadership in Change of Management

[Name of the Writer]

[Name of the Institution]

Transformational Leadership in Change of Management


The field of nursing requires a change of management in various healthcare issues and also in the issues which lead to these problems. The healthcare issues are related to the well-being of patient and staff. The management is based solely on the transformational changes, such as in nursing an effective leadership will directly impact the job satisfaction and retention of the nurses. The nurse leader who has transformational skills of leadership will help in retaining the employees or nurses by encouraging the positivity among the workers. The satisfaction and retention of capable nurses will increase patient satisfaction and this will also result in positive patient outcomes. The turnover rate of nurses and job dissatisfaction is due to the ineffective leadership of nurse leaders in healthcare organizations. This research paper will explore the theory of transformational leadership style, for instance, Kurt Lewin theory, for helping the nurse leaders in creating an objective and positive environment for their subordinates and adopting the modification ns that will adhere to the organization permanently.


Healthcare Issue

The issue of the high rate of turnover among the nurses due to job dissatisfaction is almost inevitable in the hospitals of the United State of America. There has been recorded the shortage of nurses due to a high turnover rate, which merely results in elevated levels of burnout, job dissatisfaction, the problem at work, etc. These issues are not new to the field of nursing because the nature of this profession is critical in itself (Batras, Duff, & Smith, 2016). The job of a nurse is to attend to the need of patient at almost the entire time of their duty; this makes their job very difficult at times. Thus, if their superiors or leaders are not accommodative and motivational it will drive the nurses out of their job and ultimately the healthcare organization, thereby increasing the turnover rate. The leaders with transformational skills are best suited for the healthcare setup. The wellbeing of nurses is highly dependent on the positivity engrained in their work environment. A leader who will be motivational and inspirational will help build that environment in his team which will create a cohesive workforce. Such leaders have an impact and influence on their followers, therefore, the nurses will follow the lead of an optimistic leader who will also assist them in gaining the advantages for themselves. It will also provide the healthcare organization with the best nurse's force, which will have the capacity to engross with each other for work while maintaining the role clarity.

Transformational Leadership

The transformational leadership is where a leader works with the collaboration of his whole team and this involves the staff engagement, organizational culture, and its learning, and continuous improvement (Bender, 2016). It can also devise a successful plan and strategies, along with communicating and empowering the employees, assessing their performance, and improved integration. Various studies have deduced this style of leadership in strengthening and removing the barriers and creating a productive environment to adapt to the changes by the analysis of Kurt Lewin’s theory (Lv, & Zhang 2017). The transformational leaders help the nurses who are highly dissatisfied or tired of their job to build a great vision in guiding them to change through motivation and inspiration. The transformational leadership enhances the leaders do not work for the sake of their self-interest, in fact, it urges the leaders to work with and inspirational motivation and vision and provide the nurses with proper identification and purpose of their job (Bakari, Hunjra, & Niazi, 2017). The leaders of transformational style exhibit certain characteristics which determine the success of their style of leadership, for instance, these leaders are great influencers and confident enough to motivate and inspire their team members. Furthermore, these leaders are creative and intellectually stimulated. They also consider each group member individually, thus this leadership style follows Kurt Lewin's theory.

Kurt Lewin’s Theory

The theory of Kurt Lewin's is based on the change model devised by him. His change model consists of three distinct steps; freeze, unfreeze and refreeze. Many studies have incorporated this model with certain changes for instance due to the criticism received by the Lewin's three-step model, a study introduced a similarly new model of three steps while incorporating it with the planned behavior theory. To determine the dynamic relationship of leader-followers, it conducted a test on the impact on the perception of the employees of the authentic leadership during the change. It showed that to implement the change successfully, transformational and collective leaders should do the change in three steps; unfreezing (readiness), moving (commitment) and refreezing (behavioral support) (Weber, 2018). Therefore, the first step of freezing in the change model is related to preparing the team members to accept the necessary change for the organization. This includes eh breaking of status quo and builds innovative ways for functioning in the organization. The change, in this case, is possible through the determination of the leader to inspire and motivate its employees to not leave the job and serve for the purpose of providing good healthcare to the patients, hence improving the patient's outcomes (McFarlan, O’Brien, & Simmons, 2018).


This research paper focused and discussed the theory of transformational leadership style, and the involved theory by Kurt Lewin, for helping the nurse leaders in creating an objective and positive environment for their subordinates and adopting the modification ns that will adhere to the organization permanently. The job of a nurse is to attend to the need of patient at almost the entire time of their duty; this makes their job very difficult at times. Therefore, it increases the rate of job turnover due to dissatisfaction in the workplace. The change model provided by Kurt Lewin has also been discussed and it consists of three distinct steps; freeze, unfreeze and refreeze which are essential to determine the transformational leadership in the healthcare organizations.


Bakari, H., Hunjra, A. I., & Niazi, G. S. K. (2017). How does authentic leadership influence plan organizational change? The role of employees' perceptions: Integration of Theory of Planned Behavior and Lewin's three-step model. Journal of Change Management, 17(2), 155-187.

Batras, D., Duff, C., & Smith, B. J. (2016). Organizational change theory: implications for health promotion practice. Health Promotion International, 31(1), 231-241.

Bender, M. (2016). Clinical nurse leader integration into practice: developing the theory to guide best practice. Journal of Professional Nursing, 32(1), 32-40.

Lv, C. M., & Zhang, L. (2017). How can collective leadership influence the implementation of change in health care? Chinese Nursing Research, 4(4), 182-185.

McFarlan, S., O’Brien, D., & Simmons, E. (2018). Nurse-Leader Collaborative Improvement Project: Improving Patient Experience in the Emergency Department. Journal of Emergency Nursing.

Weber, N. M. (2018). When Disaster Strikes: a Training Intervention to Improve Nurses' Confidence and Preparedness for the Surge.

Subject: Healthcare and Nursing

Pages: 3 Words: 900


Academic resources

The first professional resource used for achieving success in the field of nursing includes patient care analysis of CITATION Ami14 \l 1033 (Babiker, et al., 2014). The source is important because it explains the need for adopting adequate care standards that will ensure the provision of quality service. The resource is useful in the practical field because it will allow me to apply the principles of patient care for maximizing their welfare. It further identifies the limitations of nursing behaviour that could have a detrimental impact on patients health. The resource will contribute to my career by allowing me to become a better and informed nurse.

I have chosen an academic resource of Gulyas (2015) that stresses the need for effective communications in nursing practice. The resource will allow me to understand the methods required for addressing the patient's concerns about communications. I will also use the resource for identifying issues related to the care and what best methods can be adopted for improved communications. Building effective interaction with patients is crucial for attaining better health outcomes. The source explains that effective communications are crucial for providing a comfortable environment to the patient. I will rely on this source for enhancing my communications.

The third professional resource that can be applied to attain success in nursing specifically includes the work of CITATION AMo13 \l 1033 (McGonigle, Hunter, Sipes, & Hebda, 2014). The source will be used for identifying ways of applying data in the nursing field. The source assists nurses in adopting ways for recording data inappropriate manner. This will help them in minimizing the scope of error and improve health outcomes for the patients. They will develop skills for maintaining records that will allow them to achieve enhanced patient care. The resource provides information about the critical steps involved in using data that leads to improved pertinent care.


BIBLIOGRAPHY Babiker, A., Husseini, M. E., Nemri, A. A., Frayh, A. A., Juryyan, N. A., Faki, M. O., et al. (2014). Health care professional development: Working as a team to improve patient care. Sudan J Paediatr, 14 (2), 9–16.

McGonigle, D., Hunter, K., Sipes, C., & Hebda, T. (2014). Why Nurses Need to Understand Nursing Informatics. AORN Journal, 19.

Subject: Healthcare and Nursing

Pages: 1 Words: 300

Transition To Graduate Study

Transition to Graduate Study



The mission and vision of Walden University and School of Nursing

Needles to say, academic institutions are the primitive grounds where personality development of the individual takes place. I used the most general term; the personality development because we erroneously attribute academic institutions as the vital sources of academic goal setting, accomplishment and career development only, neglecting their incorporation in the psychological, social, emotional and behavioral development. The institution where I spent the most valuable time of my life; the Walden University is contributing excellently to the career development of enrolled graduates with the valued and dignified mission of providing the individual with the diverse professional career oriented community pool that enables him to refine himself into a brilliant scholar practitioner that is aimed at orchestrating the most effective and meaningful social change (The Walden University, n.d.). Moreover, its vision having a profound applicability with reference to the current societal challenges and galvanizes its students to gain sufficient problem-oriented knowledge and cause a global good. Furthermore, School of Nursing (S0N) shares identical visions and missions regarding the goals of holistic wellbeing encapsulating both physical and psychological goodness. School of Nursing aims at embracing its students with the advanced evidence-based practice grounds to carry nursing practices, research and training so that they could better encounter clinical challenges open heartedly and with comparatively less error ratio (SON, n.d).

As a nursing graduate, I understand that wellbeing is the crux of nursing profession. My affection and emotional proximity for this sacred profession seems to be innately predisposed but there is always some social factor that attempts to deflect or modify our perceptions, thinking patterns, attitudes and orientations. My focus was centralized on the pain management and physical illnesses because they disrupt the normal functioning of patients to a greater extent. However, my childhood friend—who stood by me in the ebb and flows and never let my worries go unnoticed, who acted as a mentor to suggest me best possible solution of the problem, who helped me in getting good grades through sharing my burdens—was no more. She was not actually dead, but she was dead. What does this mean? She was alive but her emotions, aspirations, motivation and feelings were dead. She was diagnosed with Depression that led her to develop the most grotesquely accommodated version of herself; she did not talk to me; ignored my worries; remained indifferent to my happiness and sadness and hold herself aloof; the best possible depiction of depression (Costello et. al., 2006). I was all alone despite her physical presence. At that moment, I realized that emotional and mental wellbeing is equally important as physical one. We pay most of our attention to physical pains and suffering because they are observable but hidden wounds and emotional issues are ignored substantially. This was the turning point of my professional life and I decided to carry Psychiatric Specialization in further.

Based on my profound attraction towards mental health issues, the vision and mission of the Walden University School of Nursing best harmonize with my professional inclination. As mentioned earlier, this institution aims at developing up-to-date professional competence in individuals based on the current actual and potential challenges and research based knowledge. I, too, want to pursue Psychiatry as a post graduate program based on the prevalence of psychological and mental illnesses in the society and I want to apply evidence based interventions to get the problems out of the hook. For that matter, I would include two members in my team. The first one would be a student with psychometric aptitude; who is good or wants to be good at administering psychological testing. Whereas the other one would assist me in the research purpose and would keep me updated about the recent happenings in the psychological world. On the other hand, I would learn and apply evidence based knowledge regarding counseling and psychotherapy for treating the problems diagnosed after psychometric testing. In this way, I would get my goals of holistic wellbeing done effectively.


Home (n.d). School of Nursing, the Walden University. Retrieved from https://www.waldenu.edu/about/colleges-schools/college-of-health-sciences/school-of-nursing

Home (n.d). The Walden University. Retrieved from https://www.waldenu.edu/about/who-we-are

Costello, E. J., Erkanli, A., et. al. (2006). Is there an epidemic of child or adolescent depression? J Child Psychol Psychiatry.47, 1263–71.

Subject: Healthcare and Nursing

Pages: 2 Words: 600

Transition To Graduate Study Module 3 Week 4-5

Title page

Transition to graduate

Strategies to promote academic integrity and professional ethics

Section 1

There has been a significant relationship between academic integrity and writing depicting the need for acknowledging all sources included in the work. It suggests the inclusion of references for pursuing integrity. The writer cannot mention the work of any other author without quoting the actual author. The relationship between academic integrity and writing is also crucial for avoiding plagiarism. Having command on academic writing is a generic skill that is needed for completing a number of courses and academic programs. Students who aim at building adequate writing competency needs to learn about academic integrity. This is also important for the research works that students have to complete in their degrees. The purpose of maintaining academic integrity is to pursue originality of the work. It is not appropriate to present someone's work without mentioning the author's name.

The relationship between professional practices and scholarly ethics stresses following the code of ethics of the Association of Institutional Research. The Code of Ethics suggests that it is curial to provide an ethical statement for conducting research. The broad ethical statement is used for guiding professional lives and determining relevant considerations in case of ethical uncertainties. It stresses that individuals must learn ethical standards before conducting research. The code of ethics is applicable to the academic institutes, research institutes and universities. The individuals must be compatible with institutional values and codes. The document must change and is shaped as the practice of institutional research evolves and develop. The relationship between professional practice and scholarly ethics also states accepting technical standards and maintaining objectivity. The principles of objectivity involve an unbiased attitude and avoiding conflict of interest. The researcher must possess an unbiased attitude during the process of conducting research. This also reflects adopting a neutral approach during the process of data collection and process of inquiring respondents. Conflicts are resolved by understanding the responsibility as a researcher and offering complete information to the participants of research. The scholarly ethics also emphasize on taking consent from the participants of the research. Without information them about the purpose of research, it is not possible to comply with the ethical standards. Grammarly and Safe Assign will be used for paraphrasing because replicating original work is not ethical. By paraphrasing and adding reference the academic integrity is maintained CITATION Peg10 \l 1033 (Piascik & Brazeau, 2010).

Section 2

I intend to pursue different strategies for maintaining integrity and ethics in my work such as by using in-text citation. This will allow me to avoid plagiarism as I will provide a reference to the author. The technique will be adopted for maintaining the originality of work because without a reference it would be unethical to add other scholar’s work.

To maintain integrity in academic work as a student of MSN program I will follow the Ethical Code of Conduct in the process of writing. I will also provide an ethical statement that will assure fulfilment of ethical principles. I will avoid copying the work of other authors because it is unethical CITATION DJP10 \l 1033 (Palazzo & Lee, 2010).

In will maintain integrity and ethics in professional work as a nurse by informing the participants about the purpose of research. I will take informed consent before choosing the respondents for research. In this process, I will provide complete knowledge about the purpose of research. I will also keep the information of the respondents confidential for complying with the ethical standards. Throughout my career, I will follow ethical principles by explaining the conditions of treatment and cost-benefit to the patients.


BIBLIOGRAPHY Palazzo, D. J., & Lee, Y. (2010). Warnakulasooriya R, Pritchard DE. Patterns, correlates, and reduction of homework copying. Physical Review Special Topics. Physics Education Research, 6 (1).

Piascik, P., & Brazeau, G. A. (2010). Promoting a Culture of Academic Integrity. Am J Pharm Educ, 10 (74), 113.

Subject: Healthcare and Nursing

Pages: 2 Words: 600

Transitional Academic Plan

Title page

Transitional academic plan

The first academic resources that can be applied to the MSN program include CITATION Ami14 \l 1033 (Babiker, et al., 2014) because it stresses on team-work that is linked to the quality of patient care service. This source is useful because it highlights the need for adopting adequate healthcare standards. Another source that will be used includes CITATION Mar153 \l 1033 (Bruce, 2015). This source identifies the need for adopting effective communication techniques. The source provides clear details on how nurses can adapt better-communicating methods for establishing an appropriate relationship with the patients. The third source used is CITATION Rob171 \l 1033 (Kok & Reynolds, 2017) that stresses on the adoption of care theory. The source is useful because it explains the procedures required for offering high-quality care to the patients.

The first professional source used for learning nursing practice includes the work of CITATION ELL06 \l 1033 (Kathleen, 2006). The source provides an in-depth analysis of the nursing principles and standards that will allow young nurses to perform better in their careers.

Another professional source used is CITATION AMo13 \l 1033 (McGonigle, Hunter, Sipes, & Hebda, 2014) because it provides information about the integration of right data tools for maintaining information. The source is useful because it highlights the significance of creating the right data and using it appropriately for time-saving. Integration of this source will help me in the professional field as I would be able to use and record data efficiently. This will help me in minimizing the scope of error and improve health outcomes for the patients. I will use another professional source such as CITATION Mar153 \l 1033 (Bruce, 2015) because it involves a collaborative model. The model will allow me to build an adequate relationship with the patients and is effective for patients of different age groups. The collaborative care model is essential for achieving better healthcare outcomes including patient's health and welfare.


BIBLIOGRAPHY Babiker, A., Husseini, M. E., Nemri, A. A., Frayh, A. A., Juryyan, N. A., Faki, M. O., et al. (2014). Health care professional development: Working as a team to improve patient care. Sudan J Paediatr, 14 (2), 9–16.

Bruce, M. L. (2015). CARING FOR DEPRESSION IN OLDER HOME HEALTH PATIENTS. J Psychosoc Nurs Ment Health Serv, 53 (11), 25–30.

Kathleen, E. L. (2006). Depression Care for the Elderly: Reducing Barriers to Evidence-Based Practice. Home Health Care Serv Q, 25 (1), 115–148.

Kok, R. M., & Reynolds, C. F. (2017). Management of Depression in Older Adults. JAMA , 317 (20), 2114-2122.

McGonigle, D., Hunter, K., Sipes, C., & Hebda, T. (2014). Why Nurses Need to Understand Nursing Informatics. AORN Journal, 19.

Subject: Healthcare and Nursing

Pages: 1 Words: 300

Traumatic Brain Injury

Traumatic Brain Injury



Florida International University

Month Year


The brain is the controller for all the functions of body, counting unconscious activities (heart rate, breathing, etc.) and conscious activities (walking, speaking). The brain has the responsibility to control understanding, thought, emotions, and speech. The lesions of the brain may interrupt some or all of these functions, whether as a result of severe trauma or an injury without fracture. Brain injuries can have perpetual and serious impact on mental health and physical functioning, counting loss of memory, consciousness or character disorders and complete or partial paralysis (Harvey, L., & Close, J, 2012). Traumatic brain injuries are mainly the consequence of vehicular accidents, acts of violence, falls, or sports injuries. It is twice as likely in men compared to women. This paper adopted the qualitative method that is based on the review of existing literature to study it in detail. The terms such as Neurofeedback and Vicariation have also been studied in this research paper.

Research Method and Design Appropriateness

Harwoodn & Hutchinson (2009) points out that the research methods are considered as the tools used to collect information, ask and answer questions that help us draw conclusions through the analysis of the information obtained. The research is aimed at finding a truth that has not been fully studied or has not been discovered so far, besides this always seeks to obtain fully reliable conclusions. Every research method has its purpose already established, they coincide in some goals such as obtaining new knowledge, testing hypotheses, having more details about situations and much more (Harwoodn & Hutchinson, 2009).

Research methods are divided according to the characteristics or situations to be studied, in addition to the requirements of the subject. The Scientific or experimental method is considered one of the most rigorous and gives us different techniques and procedures that help us obtain valid and scientifically purchased theoretical knowledge. By using the scientific method one can get answers that have been tested through experiments and reproducing the same fact with other contexts and executed by different individuals. This method is one of the procedures that allow explaining some phenomena in a more objective way, besides providing solutions to different problems (Ostergaard, J. 2007).

The Comparative Method is used to look for similarities and comparisons that help us verify some theories, always trying to find coincidences. Mainly, the comparative method is based on investigating a great variety of cases that are useful to make comparative analysis among them. One of the most important methods for data collection is the Quantitative Method. This method is based on studies or analysis of reality using different processes that are based on measurement. The main goal of the quantitative method is to find a broader knowledge of a case using detailed data. The results obtained with this method are based on statistics, measurements, testing, and others, and are considered generalized results (Harwoodn & Hutchinson, 2009).

On the other hand, Qualitative Method provides us with non-quantifiable data that is based mainly on observation. The information obtained with this research method is very subjective, besides it does not allow us to explain some phenomena in a clearer way. The data obtained from this method can be used later for their respective analysis and in some cases giving a better explanation about the case or phenomenon that is being studied (Ostergaard, J. 2007). It may include a review of the existing literature about a particular topic, which is the case in this study. The reason for adopting this method for the present study is its appropriateness.


Traumatic brain injuries (TBI) are a severe public health problem for US. Each year, traumatic brain injuries contribute in large numbers to demises and cases of everlasting infirmity. A traumatic brain injury can be instigated by a blow, shock or jolt impacting the head that impacts the normal operation of the human brain. The degree of a TIB can vary from slight to serious (Karen, 2018).

It is expected that about 1.7 M deaths, emergency room visits, and hospitalizations occur yearly due to TBI in the US. About 80 percent of these people are treated in the emergency rooms of hospitals. TBI is a causal factor to 30% of all deaths related to injuries in the United States of America, equivalent to 52K demises yearly (Taylor, 2017). This data has been kept under consideration during the research study and it is essential to understand the degree of this important public health issue. This study can provide data prevention strategies of TBI and identify education and research urgencies and facilitate the necessity to provide services to those suffering from TBI (Moore, E., Feliciano, D., Mattox, K., Demetriades, D., & Inaba, K, 2017).

Sampling Frame

The search for this study was widespread. Of the 128 articles obtained initially, the study excluded a total of 42 articles after the reading of the title and summary, taking into account the aspects that are closely related to TBI, thus reducing the number of articles to 86. Subsequently, the duplicate items were eliminated, since most of the selected articles were indexed in more than one database, reducing the number of articles to a total of 40. After the complete reading of the texts of these 40 articles, 20 of them were discarded, reaching a total of 20 relevant articles, as given in the references section of the literature review.

Data Collection

To collect the data for this research study, it was required to search extensively through the relevant electronic database. The Search strategy employed multiple databases to find authenticated research studies. The databases include Research gate, Springer, Google Scholar, National Centre for Biotechnology Information, Journal of Educational Technology Development and Exchange, Elsevier, and ICMI. The Search Strategy obtained millions of results from which the research studies lying between 2005 to 2019 were selected.

For this project, the keywords used are TBI, Traumatic Brain Injuries, Neurofeedback, Vicariation, EEG, and Brain Injuries. The search limits used have been idiomatic. Specifically, the search excluded all the language except English because English is the main language of articles related to TBI and is mainly used in the US. The secondary data sources were mainly used for the purpose of this research paper.

Data Analysis

Based on this qualitative data, it can be said that the thing that is most responsible for TBI is constraint of shear on the blood vessels and brain, which arises due to acceleration and deceleration of the head. Traumatic brain injury can either heal itself completely with the passage of time or causes severe disability and often leads to death. The main cause of TBI is falling, specifically among children and elder people. The motorbike accidents are also responsible for brain injuries and it is found more among men as compared to women. The other TBI causes include falling objects, motor vehicle accidents, or machine accidents. The sectors in which people are at most risk of getting traumatic brain injury are transportation, forestry, agriculture, construction, and fishing. This can be controlled by taking the careful measures in these sectors.


Harvey, L., & Close, J. (2012). Traumatic brain injury in older adults: characteristics, causes and consequences. Injury, 43(11), 1821-1826. doi: 10.1016/j.injury.2012.07.188

Harwoodn, E., & Hutchinson, E. (2009). Data Collection Methods Series Part 5. Journal Of Wound, Ostomy And Continence Nursing, 36(5), 476-481. doi:10.1097/won.0b013e3181b35248

Karen. (2018). Traumatic Brain Injury. Retrieved from http://www.traumaticbraininjury.com/about-us/

Moore, E., Feliciano, D., Mattox, K., Demetriades, D., & Inaba, K. (2017). Trauma. New York: McGraw Hill Education.

Østergaard, J. (2007). Differences between Quantitative and Qualitative Research Methods. Nordic Studies On Alcohol And Drugs, 24(2), 212-213. doi: 10.1177/145507250702400208

Taylor. (2017). Get the Stats on Traumatic Brain Injury in the United States | BrainLine. Retrieved from https://www.brainline.org/article/get-stats-traumatic-brain-injury-united-states

Traumatic brain injuries. (2016). Nature Reviews Disease Primers, 2, 16085. doi: 10.1038/nrdp.2016.85

Subject: Healthcare and Nursing

Pages: 4 Words: 1200

Trichomonas Vaginalis.

Trichomonas Vaginalis

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

[Institutional Affiliation(s)]

Trichomonas Vaginalis

Response to Question 1

Trichomonas Vaginalis is a very common sexually transmitted infection and it is not caused by any virus. It is an anaerobic parasitic protozoan flagellated organism that goes to the epithelial cells of the urogenital area and this disease is common in the developed countries. In most of the cases, the infection is only restricted to the urogenital system and the infected condition is referred to as Trichomoniasis (Van Schalkwyk et al., 2015). This infection can be noticed by antigen testing by extracting a sample of vaginal discharge and appraised by nucleic acid amplification test (Van Schalkwyk et al., 2015).

Response to Question 2

The cure for trichomonas vaginalis comprises of oral metronidazole either 500 mg twice a day or 2g per day, consecutive for a week. This treatment by oral metronidazole has a cure rate for up to 88% and the cure rate is higher when sexual partners are treated at once. However, about 5% of trichomonas vaginalis strains are resilient to this antibiotic. Such a situation requires a high dose of metronidazole or an alternative treatment i.e. Tinidazole 2 g orally one time. This drug is only available through special access to health and drugs program (Van Schalkwyk et al., 2015). Test of cure is not recommended following the treatment with the antibiotic, metronidazole. In addition, in pregnancy, preterm birth can be prevented by treating this disease with oral metronidazole (Van Schalkwyk et al., 2015).

Response to Question 3

Several key risk factors associated with trichomonas vaginalis include unprotected intercourse with multiple sexual partners, and a history of STD diagnosis, alongside social and behavioral factors such as poor socioeconomic status, smoking, and drug abuse. Trichomonas vaginalis also contributes to many other health risks such as the high risk of HIV infection, high dangers of preterm labor. Therefore, it is recommended that the patients must be screened for additional sexually transmitted diseases (Paladine & Desai, 2018).

Response to Question 4

What is the first thing you would suggest to a patient just diagnosed with the trichomonas vaginalis?


ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Paladine, H. L., & Desai, U. A. (2018). Vaginitis: Diagnosis and treatment. American Family Physician, 97(5).

Van Schalkwyk, J., Yudin, M. H., Allen, V., Bouchard, C., Boucher, M., Boucoiran, I., … Money, D. M. (2015). Vulvovaginitis: Screening for and management of trichomoniasis, vulvovaginal candidiasis, and bacterial vaginosis. Journal of Obstetrics and Gynaecology Canada, 37(3), 266–274.

Subject: Healthcare and Nursing

Pages: 1 Words: 300

Trigeminal Neuralgia And Giant Cell Arteritis

Trigeminal Neuralgia and Giant Cell Arteritis

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

[Institutional Affiliation(s)]

Author Note

Trigeminal Neuralgia and Giant Cell Arteritis

Trigeminal Neuralgia is a chronic pain condition. It directly affects the trigeminal nerve and carries sensation from one’s face to their brain. It can be triggered by the mildest of stimulations on one’s face and trigger the jolts of excruciating pain. It results in facial pain, headaches, fever, joint pain, and difficulties with vision ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"P371uRec","properties":{"formattedCitation":"(Cruccu et al., 2016)","plainCitation":"(Cruccu et al., 2016)","noteIndex":0},"citationItems":[{"id":281,"uris":["http://zotero.org/users/local/5VyEEXyp/items/MQ9YH7K5"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/MQ9YH7K5"],"itemData":{"id":281,"type":"article-journal","title":"Trigeminal neuralgia: new classification and diagnostic grading for practice and research","container-title":"Neurology","page":"220-228","volume":"87","issue":"2","author":[{"family":"Cruccu","given":"Giorgio"},{"family":"Finnerup","given":"Nanna B."},{"family":"Jensen","given":"Troels S."},{"family":"Scholz","given":"Joachim"},{"family":"Sindou","given":"Marc"},{"family":"Svensson","given":"Peter"},{"family":"Treede","given":"Rolf-Detlef"},{"family":"Zakrzewska","given":"Joanna M."},{"family":"Nurmikko","given":"Turo"}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Cruccu et al., 2016). On the other hand, Giant Cell Arteritis is a type of arteritis. It is rather common among adults over the age of 60. It can sometimes also result in headaches, facial pain, joint pain, fever and loss of vision in one or both eyes ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"v9Sa5qiU","properties":{"formattedCitation":"(Levin, 2002)","plainCitation":"(Levin, 2002)","noteIndex":0},"citationItems":[{"id":282,"uris":["http://zotero.org/users/local/5VyEEXyp/items/D4ZFJD5A"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/D4ZFJD5A"],"itemData":{"id":282,"type":"article-journal","title":"The many causes of headache: migraine, vascular, drug-induced, and more","container-title":"Postgraduate medicine","page":"67-82","volume":"112","issue":"6","author":[{"family":"Levin","given":"Morris"}],"issued":{"date-parts":[["2002"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Levin, 2002).

Excruciating pain is the common denominator in both illnesses. With regard to Giant Cell Arteritis, it is important to diagnose and treat the patient suffering from the disease in the early stages so the probable loss of sight, as a result of inflammation of ophthalmic arteries can be reduced. The pain is usually triggered by chewing mechanism, with the pain being indicative of the disease. The diagnosis for giant cell arteritis can be carried through temporal artery biopsy if no other neurological disease is found.

On the other hand, Trigeminal Neuralgia is further divided into three categories. The first is idiopathic, where a patient suffers through the pain without any apparent cause. Furthermore, a common cause of the pain stem from the trigeminal nerve. Upon vascular compression, it produces the sensation of searing pain in the patient. The third is secondary trigeminal neuralgia, which results on the basis of paroxysmal pain. Trigeminal Neuralgia can only be properly diagnosed on the basis of the pathognomonic pain attacks the patient suffers through. It can occur as a result of the normal facial stimulus, coupled with some external stimulus. The pain usually affects just one side of the face and lasts for only a few seconds at the time.

In a nutshell, both diseases produce a sensation of excruciating pain, but the mode, frequency, intensity and even the origin of pain varies in both sources.


ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Cruccu, G., Finnerup, N. B., Jensen, T. S., Scholz, J., Sindou, M., Svensson, P., … Nurmikko, T. (2016). Trigeminal neuralgia: new classification and diagnostic grading for practice and research. Neurology, 87(2), 220–228.

Levin, M. (2002). The many causes of headache: migraine, vascular, drug-induced, and more. Postgraduate Medicine, 112(6), 67–82.

Subject: Healthcare and Nursing

Pages: 1 Words: 300

Troubled Patient & ROM Exercise

Troubled Patient & ROM Exercise

[Name of the Writer]

[Name of the Institution]

Troubled Patient & ROM Exercise In the enlightenment of the French and English Philosphic Treatsies, it is the patient’s

fundamental right to determine his or her treatment. To avoid any foreseen condition in which the patient refuses for the treatment, informed consent should be obtained before the start of any treatment because it is a major right of the patients to forbid the practitioners from any kind of treatment that they might not like CITATION Kle91 \l 1033 (I., 1991). A practitioners, in such cases should pursue the patient through talking. However, just in case, if any of the things don’t work out, the physician should come in contact with the patient CITATION Jon86 \l 1033 (Jonsen AR, 1986). It is a legal duty for a physician to respect the patients concerns regarding treatment even though the patient is depressed or worried because of the same reason. After reaching out to the patient through a physician, the physician should convince the patient through vigorous persuasion about the ebenfits of the Range of Motion exercises in correspondence with the problems they are facing, and a balance which assures overcoming the irrational fears to pursue the promised treatment. These fears should be explored properly and combined with a proper education f\ the physician at equal time intervals is ethicallty permitted and should result in the favourable outcomes in such cases CITATION Bro90 \l 1033 (Brock DW, 1990)

In circumstances like these, the first assessment should be of the reason the patient is refusing. The first reason that comes across is that the patient has no idea about the happenings or the benefits of the therapy that is going on for him. I would give them an example which would as a result, give them an empowering effect from the exercises. The second method would be to focus on the benefits of the Range of Motion exercises offer like Muscle Strength, Circulation Improvement in the Blood, Flexibility Maintainence of the Body, and Pain Reduction. Throughout the whole session, verbal encouragement in which the patient should necessarily feel safe, is a must. I will make sure that I ear the reasons which are causing frustrations and producing hurdles in the ways of the exercises. Most of the patients have a problem with the time duration of the therapy. For some of the patients, the pronlonged time duration of the exercise can be very hauntful and disturbing instead of relieving. Furthermore, the Range of Motion exercises on any part of the body can make any patient pretty tired. So, instead of just doing this. I would rather, think about it CITATION Lyn16 \l 1033 (Lampert, 2016).

If nothing worksout in any of the cases and the circumstances as described above, the last call would be to call the executives and administratives of the Nursing Care center. This nothing working out status will hold the Nursing Care Center liable for this action as the patient or the person will still not be able to perform the certain tasks and assist the practitioners for the sake of improvement in his/her health. Even at that point, nurses will still respond to the query of the patients and will go at grat lengths to achieve the patient’s agreement. The nurse centers are held liable for the event, however, at the point, it is sometimes considered that the consent is preferred but not essential. If the paitent doesn’t agree on the procedure, there are evidences that a nurse without the submission of informed consent administered the needed procedure or the material or whatsoever CITATION HAv04 \l 1033 (Aveyard, 2004). However, such actions in circumstances like these will impose a bad liability in the name of the nursing care center. Even, in the case of non-administration, the nursing care center would be held responsible imposing a bad image on the nursing care center.


BIBLIOGRAPHY Aveyard, H. (2004). The patient who refuses nursing care. Journal of Medical Ethics, 346-350.

Brock DW, W. S. (1990). When competent patients makes irrational choices. New England Journal of Medicine, 1595-1599.

I., K. (1991). The right to refuse treatment: ethical considerations for the competent patient. . CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne,.

Jonsen AR, S. M. (1986). Clinical Ethics: a Practical Approach to Ethical Decisions in Clinical Medicine, 2nd Ed. New York: Macmillan.

Lampert, L. (2016, 10 11). What to do when a patient refuses assistance. Retrieved from AUSMED: https://www.ausmed.com/articles/when-a-patient-refuses-assistance/

Subject: Healthcare and Nursing

Pages: 2 Words: 600

Turabian Rule Of Style Part II


Turabian Rule of Style Part II

[Course Code and Title]


Sinan A Akrawi



Turabian Rule of Style Part II


As a researcher and writing dissertations for academic purposes or writing research articles in journals demand the authors to present authentic data. Researching the right material and then justifying it in accordance with the context is the most important step in academic writings. Secondly, researchers must cite the sources from where they have picked the data from. Anything that has been taken from any other articles, books, theses, websites and reports must be given a proper reference. Taking credit for someone’s work is unethical as well as it shows that the researcher lacks the ability of critical thinking and writing his own thoughts. It is a convention that should be avoided by all the academicians and primarily at the doctoral level.

Students must be able to understand the subject, think through and write their papers themselves. In the case of material taken from outer sources, the work should be given a proper recognition. Thus, it is imperative to learn different kinds of citations and the correct method to follow in academic writings. However, the kind of source is also an important topic that should be kept in mind while extracting data. The selected sources should either be primary or secondary, peer reviewed, authentic websites, articles and books. Maintaining a bibliography is the most essential part of citation and its proper style should be followed. The defined pattern in different types of bibliographies, endnotes, footnotes and arrangement of data in the citation style is also very important. Moreover, the citation style is different for specific types of sources and so are the in-text referencing and the order of elements in the citation. There are some software programs that can also assist in adding citations. Kate Turabian, in her book ‘A Manual for Writers of Research Papers, Theses, and Dissertations’, has provided with all the required things to follow the Chicago/ Turabian style of writing for students as well as researchers.

Citation Practices

While writing, the foremost step is to make sure that the citation of the work is accurate, authentic and complete. I have written several research papers, my undergraduate and graduate theses, project reports and course assignments and freelancing throughout my academic life. I used many citation styles and for my work. However, when I read this book, I realized there were so many technical things about formal writing that we often omit and many other things that we add but are not needed. The purpose and the minute details that are so commonly ignored during the citation are clearly mentioned in the book. This part of the book deals with the source citing and everything related to it. The main reasons for proving a validated citation is to give credits to the individuals who have worked hard and made their work available for everyone to get benefits from it. Thus, they should be given reward in the form of acknowledgments. The citations in any work make the readers know that the facts stated here are accurate. It also promotes the research traditions such that the readers may follow the citations and extend the research.

Though the citation styles differ from each other but their aim is to provide the common information about the author, editors, date, publishers, URL or DOI. However, the trivial details about the use of commas, parenthesis, full stops and parenthesis may vary. I have seen that for most of the papers, APA style is used, nonetheless, in the case of papers and dissertations, Turabian is also being used. There are two different styles used for Turabian, bibliography style where a superscript number is used while in the case of author-date style, author’s name, date and page number are added in the parenthesis. The pattern is a little different for the electronic and other sources such as visual representation, manuscripts, constitution, journal, report etc. All these details provide the complete knowledge about the sources being used in the work and allows people to believe the results of the study. It also improves the authenticity and chances for the work to be recognized by fellow researchers. Knowledge sharing is the biggest favor that the disciples can do for each other.

Creating Style

My university recommends the use of Chicago or Turabian style for assignments and other projects. The Gregg’s model provides the complete guideline for using the Turabian style. However, I have noticed that people often deviate from the formal style of citation, but the basic always remain the same.The critical step in the preparation of the citations is not a difficult task if we follow the guidelines. It is important to remain to the date as there come in several editions in the original Turabian format. The process of creating the citation is done by identifying a reliable source, recording the bibliographical information and number of pages. It is important to manage the citation just while writing the citations, as it helps in finding out the quotations and paraphrasing. At the end, it is important to add the complete bibliography with an ascending pattern. Though this work is tedious, it creates a lot of easiness in the final compilation of their data in the case of longer paper. The citation management programs such as EndNote, Zotero, Mendley and some other authentic programs help in building a library that saves the bibliography and can be accessed any time the writer wants.

The creation of citations provides the use of resources such as guidelines, tools and manuals and writers are seem to be complying with it. People need to understand the difference among different documents as well the style. The use of all the rules in writing also depend on the writer and their way of proceeding with any work with the limited amount of information they have about the paper. However, I always try to juggle the variations in the sampling and improve my writing along with my communication skills. I always aspire to meet the expectations of the academic writing styles and make sure the readers also approve of the work. This book has helped me a lot in improving my writing skills in all domains such as technical, academic, magazines, novels and articles. Nonetheless, I believe that the writers should be given a free style to write and struggle to make way among huge writing societies.

Make it Your Own!

The significance of this book, in my view, is to credit the authors of the original work and using it in official work in order to give them the tribute. Therefore, it is important to make sure that the work being submitted is not copied or plagiarized from any source without adding any sources. It can only be done in the case of direct quotations with the use of proper citation. Moreover, it is important to write ones’ thoughts and information as is without manipulating it with any similar work. The writers must interpret the meaning of original work and then write it in their own words because paraphrasing does not always work or changes the exact meaning that the researchers was trying to convey to its audience. The citations may be done manually or by using software such as Zotero that auto-generates the citations in the required format. It is also important to analyze the exact the bibliography style as there are minute variations that may affect the style. These changes include the pattern of elements and the details like abbreviations, capitalization, italics, quotation marks, indentation. The list of the sources in the bibliography should be accurate and in a proper sequence. It is also important to know that there are a number of sources that can be removed from the bibliography such as newspapers, Scriptures, individual or public documents, encyclopedias and reviews of the articles, books and performances. However, in order to fulfil the citation requirements, one must know that in what places within an essay or paper, citations should be used.


The Turabian style of citation has been simplified in Kate Turabian’s book and helps the students of research in writing their academic documents with authenticity. Many editions have been brought in the original template as per need of the research community but the main idea and pattern remains the same. It is mainly used by the doctorate aspirants for their dissertations. This book can help as a guideline to check for all the details for writing a good thesis or research paper. Different institutions have different citation styles. I have done a lot of written work from all the fields and therefore, I have the writing experience of all different patterns that are used in this particular style. Still, I wanted to read this book and take this course in order to improve my research skills and become the ultimate master of writing. My instructors have always appreciated my work and I aspire to write more and better than before by using the instructions written in the book.


ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Booth, Wayne C., Gregory G. Colomb, and Joseph M. Williams. “A Turabian Manual Supplement for Help in Writing Research Papers at BMATS” (2017).

Felix, Mark Stephan, and Ian Smith. A Practical Guide to Dissertation and Thesis Writing. Cambridge Scholars Publishing, 2019.

Hjortshoj, Keith. From Student to Scholar: A Guide to Writing Through the Dissertation Stage. Routledge, 2018.

Joyner, Randy L., William A. Rouse, and Allan A. Glatthorn. Writing the Winning Thesis or Dissertation: A Step-by-Step Guide. Corwin press, 2018.

Kornuta, Halyna M., and Ron W. Germaine. A Concise Guide to Writing a Thesis Or Dissertation: Educational Research and Beyond. Routledge, 2019.

Lipson, Charles. Doing Honest Work in College: How to Prepare Citations, Avoid Plagiarism, and Achieve Real Academic Success. University of Chicago Press, 2019.

Rice, Amy. “John E. Riley Library: Citations & More: Turabian” (2018).

Sabin, William. The Gregg Reference Manual. Tenth Edition edition. Boston: McGraw-Hill, 2004.

Turabian, Kate L. A Manual for Writers of Research Papers, Theses, and Dissertations: Chicago Style for Students and Researchers. University of Chicago Press, 2013.

Valentin, Anidza, and Grisell Rodriguez. “Open Access Reference Management: Zotero and Mendeley” (2018).

Subject: Healthcare and Nursing

Pages: 5 Words: 1500

Turnitin Assignment #2 (Literature Review)

Literature Review

[Name of the Writer]

[Name of the Institution]

Traumatic Brain Injury

Literature Review

Traumatic Brain Injury (TBI) is a serious issue. In the United States, TBIs in excess of 1.7 million lead to 235,000 hospitalization cases every year, and approximately 3.2 people develop some disability. The estimated cost of Traumatic Brain Injury in the United States in the year 2000 was $60.4 billion; this cost was apart from the cost of care and some deficiency in life (Schneider et al., 2018). In the armed forces, mild TBI is called "signature wound" of the war in Afghanistan and Iraq. According to an estimate, 22% of soldiers who returned from these areas have sustained TBA during their duties (Gaitens et al., 2017). Traumatic Brain Injury may harm patients in the long-term. In this paper, different aspects of TBI are analyzed. The treatment of TBI is not easy. It is a complex disorder according to the sensitivity of the injury. In addition, diffuse axonal injury is hard to detect with traditional approaches. A few patients recover quickly, whereas others take quite a lot of time. In this respect, patients who make are considered to have been benefited from the process of vicariation, while neurons loss due to injury is essentially substituted by "redundant" neurons; however, the process itself is complicated to measure. In the overall context of TBI, three important concept; the overview of neurofeedback, vicariation, and Ayres findings are presented in this paper.

Overview of Neurofeedback

It is biofeedback of any measure of the brain function. The term neurofeedback refers to the utility of electroencephalogram (EEG) to generate biofeedback; however, there is a possibility of the use of more measurements, for example, blood oxygenation (Robbins, 2017). As a result of Neurofeedback, the overall symptoms have improved for patients alongside the history of mild TBI, but according to the previous studies, there were limitations that led to more research. This particular literature review was carried out to explore those suggestions further. During the practice of Neurofeedback, a visual signal is employed to facilitate patient to a strong EEG signal. This attitude has not been located to interrelate with subjective thought processes at patients' end. Also, the clear picture of the model and attention to the task are usually considered prerequisites.

Normally, the treatment is based on five to sixty sessions with a duration of half an hour to one hour, according to the condition of the patient and the way they respond to the intervention. Moreover, treatment can be supervised by a technician, and anecdotal suggests that motivation during training can help the patient a great deal. However, a procedure for interaction with patients has not been regularized. According to the research by Double-blind, Neurofeedback can be useful for the intervention of refractory epilepsy. Besides, it has side effects that remain for some hours following the treatment, and these are headache, dizziness, cognitive interferences, headache, destabilization, anxiety, and nausea. Neurofeedback is mostly facilitated through patients' quantitative electroencephalogram (QEEG). It gives power density measurement at every EEG level and measurement of consistency or density that relates between channels. In this regard, consistency and power measures at 64 frequencies in relation to 19channles give thousands of measures that may be the targets of biofeedback.

Target is selected through a normative procedure, developed from the QEEGs of health studies. In this respect, Neurofeedback has not got any fame in a clinical discipline. Inadequate empirical evidence and QEEG's non-diagnostic specificity are quoted as contributors to the experimental state. It is purely a technical treatment and makes fundamental adjustments during therapy and stays as an operator dependent procedure. The equipment of Neurofeedback is approved by FDA as relaxation devices, only and treatment of any particular disorder is demoted to off label use. Neurofeedback is standard in databases as far as medical publications are concerned. Neurofeedback uses the neuronal circuit of learning which has been displayed by functional magnetic resonance images. This is different from the entertainment episodes, whereas an audiovisual aid or electromagnetic fluctuates in the form of a wave which is the same as the patient's EEG. In these modalities, plastic changes are imagined to occur in reaction to a changed physiological act.

Overview of Vicariation

Vicariation is described in the motor or sensory loss perspective because of the cerebrovascular accidents, and the following recovery of function with the help of training as these functions are directly associated with recordable behavior. Some features of cognition can be observed as a result of the usage of EEG. The opening psychological trait leads to the process of Vicariation. However, the training time is less than the Vicariation tasks; the effects of EEF neurofeedback have been exhibited by QEEG (Harris-Love, & Harrington 2017). The operant would essentially depend on the network of vicarious neural to be spatially same to the pre-trauma configuration.

Vicariation has been in place for a long time, and it is a mechanism for the recovery of brain function that gets affected due to the injury. In this context, the concept refers to the capability of one portion of the brain to replace for the function of other. In the field of neuroscience, Vicariation has been the topic of discussion, and it was at the mid of a controversy called localization of function. The concept that another part of the brain can replace the function of the injured or affected area is somewhat hard to comprehend with the idea that specific functions are situated in specific regions of the brain.

In case, there is an isomorphic connection between the behaviors and neurological, how can the behavior get along with no side by side growth of neural tissues. Similarly, if other parts of the brain also have an isomorphic connection with different types of behavior, how one or more of neurological regions to replace new behavior? Therefore, the theory to replace the damaged part of the brain with the other functional one does not seem realistic.

Overview of Ayers findings

Ayres became the first person to report a positive outcome of EEG Neurofeedback for TBI-related symptoms. According to his reports, 250 patients were relieved in their post-concussive symptoms that included depression, dizziness, headache, memory loss for a short period (Thompson & Thompson 2015). According to the reports, QEEG got normalized also; but, no quantitative survey reports endorse this. However, more research was conducted to evaluate the positive outcomes of the published literature regarding the therapeutic efficiency of Neurofeedback for TBI and give suggestions for further research in this field.

The guidelines are issued collectively by the Association Biofeedback and Applied Psychophysiology to organize Neurofeedback researches. As a result of the inadequate published material, subjects with all stages of serious injuries are included. All comparisons, outcomes, reports, and designs were taken into account. Any treatment that includes operant conditions of the EEG is involved.

One may like the findings of Ayres in the context of TBI-specific symptoms, but the question arises why his findings were not supported by the quantitative report surveys. The recommendations that were given about the more research should be considered. In order to evaluate the authenticity of any report, it should be cross-checked by other published literature and quantitative research. Finally, the recovery of the patient largely depends on the severity of the injury. Sometime severe injuries may take several years to recover, while the healing process for mild injuries may be less.


Gaitens, J. M., Condon, M., Squibb, K. S., Centeno, J. A., & McDiarmid, M. A. (2017). Metal Exposure in Veterans With Embedded Fragments From War-Related Injuries: Early Findings From Surveillance Efforts. Journal of occupational and environmental medicine, 59(11), 1056-1062.

Harris-Love, M. L., & Harrington, R. M. (2017). Non-invasive brain stimulation to enhance upper limb motor practice poststroke: A model for selection of cortical site. Frontiers in neurology, 8, 224.

Robbins, E. P. (2017). Effects of Neurofeedback Therapy on Patients with Traumatic Brain Injuries.

Schneider, A. L., Wang, D., Ling, G., Gottesman, R. F., & Selvin, E. (2018). Prevalence of self-reported head injury in the United States. New England journal of medicine, 379(12), 1176-1178.

Thompson, M., & Thompson, L. (2015). The neurofeedback book. Wheat Ridge, CO: Association for Applied Psychophysiology and Biofeedback.

Subject: Healthcare and Nursing

Pages: 4 Words: 1200

Two Issues Leasders Face In Healthcare Organizations

Two Issues Leaders Face in Healthcare Organizations

[Name of the Writer]

[Name of the Institution]

Two Issues Leaders Face in Healthcare Organizations


In the healthcare industry, doctors and nurses are the most needed and valued entities, as without them formation of the healthcare industry is not possible. Thereby, there are certain issues faced by them that are of crucial nature. Nurses are more critically involved in the wellbeing of the society's healthcare; therefore they make up most of the population in the healthcare sector. The two main issues which are adversely impacting the healthcare industry are, firstly the nurse’s staff shortage and secondly poor job satisfaction which ultimately leads to higher turnover rates. Being a manager of the critical unit it is necessitated by the department to have an adequate amount of nurses at all times along with certain other factors, the critical unit needs more nurses in abundance than any other department. The issues of insufficient staffing and job dissatisfaction are hugely faced by the current organization and the leading factors are merely the cost of hiring and retaining the nurses. The nurses are required at a higher rate to cater to the old age population who need assistance almost at every hour of the day. This essay focuses on informing the staff about these two main problems the organization is going through and the ways it will impact the workings of every department, and also it will focus on the recommendations for improvement.


The report by World Health Statistics (WHO) in 2013 gave an estimated number of nurses that was about 2.9 million in the United States, and further one million nurse’s force will be needed by the year 2020 (Haddad & Toney-Butler, 2018). The projections made by the Bureau of Labor Statistics (2018) in the US states the 1.1 million nurses who are required additionally for altering the shortage of nurses encountered by the healthcare sector. The profession of nurses is itself very demanding and challenging in nature. They go through problems such as burnout, fatigue, frustration, and tiredness due to the nature of their job. This all leads to the increased turnover rate which in turn decreases the nursing staff thus increasing the nurse’s shortage in healthcare organizations (Squires et al., 2017). The issue or concerns and problems are numerous in relation to the shortage of nurses. The nurses are responsible to cater to the needs of larger old age population which is increasing day by day as baby boom generation is requiring extensive healthcare services. The higher numbers of Americans are above the age of 65 and are mostly admitted in healthcare vicinities (Haddad & Toney-Butler, 2018). The nurses are therefore required at a higher rate to cater to the old age population who need assistance almost at every hour of the day. The patients in the critical unit also need care like the adult population at every instance. The nurses treating these long term and critical illnesses can be affected by strain at the work.

As the aging population, nurse staff is serving, the staff also includes nurses who are aging. The rate of the aging population in the organization is estimated to be above a million nurses who are working above than 50 years, which means that within next 10 years this workforce will be at retiring stake (Haddad & Toney-Butler, 2018). The nursing staff is facing a shortage which leads towards the limited enrollment and therefore restricting the nurse's staff generated by nursing school. This causes a greater decline in the quality of school courses and the number of student nurses also decreases. The turnover rate increases due to nurse’s burnout and job dissatisfaction which is caused merely due to the violence in healthcare and increased workload due to the shortage of staff. All of the above-mentioned issues, including the inability of educating the nurses are the additional lacking factor for the availability of nurses (Squires et al., 2017).

The experts from the human resource department have raised the issue as nurses described the requirement for more nurses in the healthcare organization or hospital. This will benefit in lowering the workload of the nurses and also it will relieve the strain or stress of the daily workings in the organization. The issues of insufficient staffing and job dissatisfaction are hugely faced by the current organization and the leading factors are merely the cost of hiring and retaining the nurses. For reducing these issues in an organization it is important to reduce the cost and enhance the training which is needed for the nurses who require more education and reach to an optimum level of education which is desired by their profession. The other internal strategies effective in reducing these two issues are the collaboration improved communication, and teamwork by which the over workload among nurses faculty can be managed and reduced.

Collaboration among nurses in relation to their work helps in easing out the amount of work which cannot be handled by the insufficient workforce. Therefore, it is important for the hospital organizations to increase the collaborative efforts of individual nurses by enhancing the communication between these employees and reduce the gap which is created between the nurses. For the efficient and comprehensive treatment of the patients in the hospital, it is necessary for the healthcare professionals to collaborate and effectively communicate with each other to provide the smooth system of healthcare to the patients. The collaborative teamwork is essential in performing the tasks assigned to individual nurses in unified form or a nurse leader leading the teams (Squires et al., 2017).

Role clarity is an important aspect of improving the efforts of teamwork and effective communication (Bosch & Mansell, 2015). To effectively work in a team it is important for every individual to know his or her task according to the specified specialty they have in their profession. For instance, a nurse giving anesthesia is required to stay on that work while working in a team or collaborative effort. The team or collaborative works is only productive when the people involved in that group have individually defined roles and they know how to work in their own capacity. The other factor which is hugely involved in maintaining the teamwork and collaboration, along with the communication is to develop the ability for overcoming the adversity and personal differences (Bosch & Mansell, 2015). This is possible through focusing on the common goal that is for any nurse to improve the patient outcomes by providing effective treatment and care. These two factors when enabled in the functioning of the organization will foster improved and better communication, teamwork and collaboration.


This essay by the manager of the secondary service department concentrated on informing the staff about these two main problems the organization is going through and the ways it will impact the workings of every department, and also it will focus on the recommendations for improvement. Nurses are more critically involved in the wellbeing of the society's healthcare; therefore they make up most of the population in the healthcare sector. The nursing staff is facing a shortage which leads towards the limited enrollment and therefore restricting the nurse's staff generated by nursing school. Therefore, it is important for the hospital organizations to increase the collaborative efforts of individual nurses by enhancing the communication between these employees and reduce the gap which is created between the nurses. The clarity of role and developing ability for overcoming the adversity and personal differences are important aspects in improving the efforts of teamwork and effective communication.


Bosch, B., & Mansell, H. (2015). Interprofessional collaboration in health care: Lessons to be learned from competitive sports. Canadian Pharmacists Journal/Revue des Pharmaciens du Canada, 148(4), 176-179.

Haddad, L. M., & Toney-Butler, T. J. (2018). Nursing shortage.

Squires, A., Jylhä, V., Jun, J., Ensio, A., & Kinnunen, J. (2017). A scoping review of nursing workforce planning and forecasting research. Journal of nursing management, 25(8), 587-596.

Subject: Healthcare and Nursing

Pages: 4 Words: 1200

Two Page Reaction Book Review

Patty Duke: A Brilliant Madness

[Name of the Writer]

[Name of the Institution]

Book Review

In “A Brilliant Madness”, Patty Duke shares her story of suffering from mental illness as hope for those who are suffering from the disease. This book is a complete and profound account on the challenges of mental illness because the author narrated everything from her experience of living with the disease to the latest findings along with the most effective treatments that are in practice nowadays. The disease that Patty suffered from was, “Manic Depression” and this book acts as a guide, a light of hope and a word to the feelings of the people who are suffering from manic depression. The author expresses and laments “living with Manic Depressive Illness"(Duke, 1993). In this book, she shared that she was nearly thirty-five years old when she was actually diagnosed with the disease. It took almost twenty years for the correct and complete diagnosis of the disease. However, Patty Duke has suffered from the episodes of manic depression since she was a teen but she was not aware of the actual disease or the idea that what she feels is a disease. The author shared the feelings of a patient when diagnosed that diagnosis of disease especially a mental one is necessary to ensure and let others know that you are not mad(Duke, 1993).

In this informative book, the author shared the symptoms that she got such as extreme euphoria, prone to delusion, attraction towards suicide attempts and experiencing panic attacks along with temper tantrums. All these symptoms are expressed in terms of age and the intensity of each symptom such as inability to make way back to home or staying at home for days due to panic attacks, accompanied by sleepless nights. After that, the author shares her married life which was an amalgamation of either extreme euphoria or sheer depression that resulted in a few suicide attempts. After a few years, the marriage was ended and ultimately her symptoms got worse. One of the examples of the severity of symptoms shared by author is of the “Invasion of White House by some external force and Patty thought she is the only who could stop it” (Duke, 1993). The mood swings were getting worse with every passing day and then, one day she came to now that she is pregnant. Under the impact of the situation, she married again and the marriage annulled thirteen days later. Here, the author start off with another version of her life where the last manic episode that Patty remembers was before marriage.

The author asserts that marriage and motherhood have the potential to calm some moods. Author married John Astin and took custody of John’s children from previous marriage. Patty shared that she again suffered from depression when they have to perform to earn a living and John was not getting work in Hollywood. After a few years, the marriage with John ended and the author came to know about her disease actually when she fell on a stage and Dr. Arlen, John's friend treated her (Duke, 1993).

Dr. Arlen gave her treatment and Patty started feeling better. She recognized the destruction in her life because of the disease and began to amend her life by learning to forgive and control. After sometimes, Patty was better enough to get into a marriage and adopt a child so that she could live a normal and familial happy life (Duke, 1993). It would not be wrong to say that this book is a literal and personal account of getting ways back to life despite manic depression. The book deciphers hope to live along with the idea that struggle can bring ease to life that will automatically restore peace, comfort, and love.


Duke, P. (1993). A brilliant madness: Living with manic-depressive illness. Bantam.

Subject: Healthcare and Nursing

Pages: 2 Words: 600

Understanding The Patterns Of Others

Learning pattern

Student’s Name


Learning pattern

Learning pattern is referred as the coherent learning activities which an individual employs, the belief, and activities which motivate a person through the learning process. In case I identify the learning pattern of my friend and classmate. The learning pattern being used by my friend is the confluent pattern. Confluent pattern depends on intuition and creativity of an individual. Through interaction with my friend I have identified that he likes to do assignment in a unique way and use his ideas CITATION Ric09 \l 1033 (Richard & CIngranelli, 2009). Besides he likes to explore new things, places and ideas not only when completing his assignment but in real life. His presentation of ideas is consistent and follows the same pattern to communicate his mind. Above all, my friend is a good risk taken with new concept and not afraid to fail, because every time he makes mistake he pursue the same thing again but with new approach.

However, my learning pattern is precise pattern. I like to have correct information and I do not like making mistakes. I always provide detailed information and take detailed notes as well to avoid errors. During learning process, I like to ask many questions so that I do not make any mistake CITATION Ric09 \l 1033 (Richard & CIngranelli, 2009). I also like to show what I know by conducting research. The different my friend and I learning patterns is the way we focus on the information. I like detail information while my friend like imagination and exploring new ideas and activities in the process of learning. He is a risky taken and learning from mistake while I do not like mistakes. Moreover, the learning pattern is used at the secondary stage of learning. The learning pattern can lead to friction when it causes confusion and fail to understand others. The expectation of the learning could be higher than what is being provided.


BIBLIOGRAPHY Richard, D. L., & CIngranelli, D. (2009). Measuring the level, pattern and sequence of Government Respect for Physical Integrity Rights. International Studies Quarterly , 2-15.

Subject: Healthcare and Nursing

Pages: 1 Words: 300



Marine Balias

[Institutional Affiliation(s)]

Author Note


Unionization carries a number of benefits for workers in any organization. The process of collective bargaining allows unions to negotiate better benefits and wages for workers. It also provides them with a platform to formally process their complains and disputes and to negotiate on the worker's behalf with the management. Thus any grievances, complains and disputes can be handled through formal processes. However, for workers, unions often demand dues while for organizations, they make it difficult to dismiss underperforming staff and raise overall labor costs CITATION Yat09 \l 1033 (Yates, 2009).

In the nursing profession, unionization provides nurses with a voice against health care management. Organizations often require budget-cuts that in turn impact nursing wages while those nurses without union support are often fired-at-will. A union, therefore, can negotiate a better wage for nurses and help provide them career security and longevity. Furthermore, unionization helps nurses bargain for better safety and health measures, higher nurse-to-patient ratios, and demand no mandatory overtime CITATION NNU10 \l 1033 (NNU, 2010). In contrast, nursing unions often ask for a certain percentage as dues. A nurse is often required to skip work upon a union strike and thus not get paid CITATION Mar092 \l 1033 (Marquis & Huston, 2009). Moreover, unionization makes it difficult to fire and replace nurses for incompetence or bad behavior and can impact the manager-worker relationship. The California Nurses Association used collective bargaining to have the safe staffing ratios bill become part of the law despite opposition from healthcare organizations CITATION NNU101 \l 1033 (NNU, 2010).

Among the different initiatives taken by the National Nurses United, the safe patient rations campaign and the safe patient handling program are the most important. Healthcare organizations often put nurses under challenging situations by demanding that a nurse cares for a larger number of patients than what is considered a safe ration. Higher nurse-to-patient ratios, however, are proven to bring improved patient outcomes and prevent nurse injuries, stress, and burnout CITATION NNU10 \l 1033 (NNU, 2010). The safe patient handling program is necessary to address injuries at work, such as strains, sprains, and tears that nurses face in handling patients. The NNU campaign advocates promoting better training, equipment, and education, along with negotiating stronger contracts with the management for this purpose.


BIBLIOGRAPHY Marquis, B. L., & Huston, C. J. (2009). Understanding Collective Bargaining, Unionization and Employment Laws. In Leadership Roles and Management Functions in Nursing: Theory and Application (6th ed., pp. 513-535). Philadelphia, PA.

NNU. (2010). National Campaign for Safe RN-to-Patient Staffing Ratios. Retrieved January 19, 2019, from National Nurses United: https://www.nationalnursesunited.org/ratios

NNU. (2010). Safe RN-to-Patient Staffing Ratios. Retrieved January 19, 2019, from National Nurses United: https://www.nationalnursesunited.org/health-and-safety

Yates, M. (2009). Why unions matter (2nd ed.). New York, NY: Monthly Review Press.

Subject: Healthcare and Nursing

Pages: 1 Words: 300


[Title Here, up to 12 Words, on One to Two Lines]

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

[Institutional Affiliation(s)]

Author Note

[Include any grant/funding information and a complete correspondence address.]

Planning for a meeting

The monthly department meeting for a HIM department in any facility providing healthcare facilities is the best way to exchange initiatives and ideas that should be applied in practice. Participants of the meeting can attain direct access to the ways of collaborating with the senior management and discussion of various topics is possible to ensure efficiency.

Members of the meeting

The monthly meeting for Perry Johnson and Associates in Louisiana Long Term Care Center will comprise of the following members:

Manager for Administration and Coordination of the long-term care center

Administrative staff and clerks

General therapists of the care facility

Health IT staff, HIM technicians

Healthcare data analyst

Agenda of the meeting

Establishment of proper guidelines for the confidentiality and proper maintenance of the patients’ records in the care facility. The significance of this agenda is self-evident because it will provide accurate information about specific patients, justify the diagnosis and treatments, and duly promote the care center’s credibility among its competitors.

The appropriate time to hold the department meeting

The optimal time to hold the meeting between the administration of the care facility and the hospital information and management department is at the end of a working month when the therapy forms and medical records of the patients’ are fully documented and digitally recorded by the administrative staff. At the end of a working month, 3-4 hours from any day can be allocated for this meeting when the workload for all the members of the meeting is relatively low.

Clinical trial


Parkinson’s disease Biomarker Program (PDBP) ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"QsyFvq9y","properties":{"formattedCitation":"(\\uc0\\u8220{}Parkinson\\uc0\\u8217{}s Disease Biomarker Program - Full Text View - ClinicalTrials.gov,\\uc0\\u8221{} n.d.)","plainCitation":"(“Parkinson’s Disease Biomarker Program - Full Text View - ClinicalTrials.gov,” n.d.)","noteIndex":0},"citationItems":[{"id":67,"uris":["http://zotero.org/users/local/R3lWGnc9/items/2YU4SEXX"],"uri":["http://zotero.org/users/local/R3lWGnc9/items/2YU4SEXX"],"itemData":{"id":67,"type":"webpage","title":"Parkinson's Disease Biomarker Program - Full Text View - ClinicalTrials.gov","abstract":"Parkinson's Disease Biomarker Program - Full Text View.","URL":"https://clinicaltrials.gov/ct2/show/NCT01767818","language":"en","accessed":{"date-parts":[["2019",11,10]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} ("Parkinson's Disease Biomarker Program - Full-Text View - ClinicalTrials.gov," n.d.)

Official title:

Longitudinal, Single-center Prospective Study to Assess Progression of Clinical Features and Biologic Markers of Parkinson's Disease Subjects of Varying Levels of Disease Severity

The condition under study:

Parkinson’s disease

Location of the trial:

UT Southwestern Medical Center, Dallas, Texas, United States

Recruitment Status:


Eligibility criteria:

Ages Eligible for Study:

30 years and older (adult, older adult)

Sexes Eligible for the study:


Acceptance of healthy volunteers:


The phase of the trial:

Phase I.

The opinion of the clinical trials:

Clinical research is very important for the discovery and potential development of new medicines but whatever works in the laboratory on mice and test tubes do not always successfully translate to humans. Many trials have to be completed before a new product or medicine is launched in the market for human use.

Pros and Cons of the trial:

The use of biomarkers is a definite advantage for the trial because it can help identify Parkinson’s disease even before the appearance of motor symptoms or when neuro-degeneration in an individual is about to begin ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"OHzEGXnP","properties":{"formattedCitation":"(Berg, 2008)","plainCitation":"(Berg, 2008)","noteIndex":0},"citationItems":[{"id":73,"uris":["http://zotero.org/users/local/R3lWGnc9/items/M7TSRZIT"],"uri":["http://zotero.org/users/local/R3lWGnc9/items/M7TSRZIT"],"itemData":{"id":73,"type":"article-journal","title":"Biomarkers for the Early Detection of Parkinson’s and Alzheimer’s Disease","container-title":"Neurodegenerative Diseases","page":"133-136","volume":"5","issue":"3-4","source":"www.karger.com","abstract":"In the aging population of many countries in the world, neurodegenerative diseases like Parkinson’s disease (PD) are becoming an increasing burden. Therefore, early therapy and ultimately disease prevention is essential, which is only possible with an early diagnosis. Besides a genetic predisposition, a number of biomarkers are being discussed to indicate vulnerability to PD, some of them many years before disease manifestation. These include hyperechogenicity of the substantia nigra as well as premotor symptoms like olfactory and autonomic dysfunction, depression, REM sleep behavior disorder, and neuropsychological impairment. Moreover, first signs of affection of the substantia nigra like PET and SPECT abnormalities and slight motor signs can be included, as they may be detected before a definite diagnosis according to motor symptoms can be made. Interestingly, other frequent neurodegenerative disorders like Alzheimer’s disease (AD) are also characterized by a long preclinical period, with several biomarkers discussed as indicative for disease vulnerability including cerebrospinal fluid, serum, and neuroimaging biomarkers, olfactory dysfunction as well as subtle neuropsychological deficits. However, future studies are necessary, which establish the predictive value of these markers singularly and in combination to detect a subgroup of the population at risk for PD and AD not only to accelerate research on etiology and pathophysiology but also to promote testing for neuroprotective strategies.","DOI":"10.1159/000113682","ISSN":"1660-2854, 1660-2862","note":"PMID: 18322370","journalAbbreviation":"NDD","language":"english","author":[{"family":"Berg","given":"Daniela"}],"issued":{"date-parts":[["2008"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Berg, 2008). The biomarkers can also help to avoid misdiagnosis in the patients of Parkinson’s disease which is a common occurrence.

However, it is unlikely that any single biomarker will satisfy all needs for higher quality Parkinson’s disease neuroprotection trials. Furthermore, validity and generalizability criteria are not well delineated in the biomarker field which proves to be a limitation of this trial.

Use of human subjects in the trial:

Three categories of patients were employed in the trial:

Previously treated Parkinson’s disease patients

Previously untreated Parkinson’s disease patients

The healthy age-matched control group

As this clinical trial is an attempt to study and research a neurodegenerative disease with varying rates of the age of onset and decline in the level of quality, therefore the use of human subjects in the trial is inevitable.

Federal labor regulation regarding healthcare

The Occupational Safety and Health Act (1970) which ensures the workplace environments to be safe and healthy was not adhered to in a recent incident ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"EDplWCX1","properties":{"formattedCitation":"({\\i{}Occupational Safety and Health Act - (1970).pdf}, n.d.)","plainCitation":"(Occupational Safety and Health Act - (1970).pdf, n.d.)","noteIndex":0},"citationItems":[{"id":76,"uris":["http://zotero.org/users/local/R3lWGnc9/items/SF3ST2V4"],"uri":["http://zotero.org/users/local/R3lWGnc9/items/SF3ST2V4"],"itemData":{"id":76,"type":"article","title":"Occupational Safety and Health Act - (1970).pdf","URL":"http://www.historyspeak.com/Occupational%20Safety%20and%20Health%20Act%20-%20(1970).pdf","accessed":{"date-parts":[["2019",11,10]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Occupational Safety and Health Act - (1970).pdf, n.d.). Following the report of the incident, U.S. Department of Labor charged AB Specialty Silicones with penalties amounting to $1,591,176 when four of its employees died in a plant explosion ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"esPiOfxi","properties":{"formattedCitation":"(\\uc0\\u8220{}U.S. Department of Labor Issues $1,591,176 in Penalties To AB Specialty Silicones After 4 Fatalities in Illinois Plant Explosion | Occupational Safety and Health Administration,\\uc0\\u8221{} n.d.)","plainCitation":"(“U.S. Department of Labor Issues $1,591,176 in Penalties To AB Specialty Silicones After 4 Fatalities in Illinois Plant Explosion | Occupational Safety and Health Administration,” n.d.)","noteIndex":0},"citationItems":[{"id":71,"uris":["http://zotero.org/users/local/R3lWGnc9/items/H8XTLF8V"],"uri":["http://zotero.org/users/local/R3lWGnc9/items/H8XTLF8V"],"itemData":{"id":71,"type":"webpage","title":"U.S. Department of Labor Issues $1,591,176 in Penalties To AB Specialty Silicones After 4 Fatalities in Illinois Plant Explosion | Occupational Safety and Health Administration","URL":"https://www.osha.gov/news/newsreleases/region5/10252019","accessed":{"date-parts":[["2019",11,10]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (“U.S. Department of Labor Issues $1,591,176 in Penalties To AB Specialty Silicones After 4 Fatalities in Illinois Plant Explosion | Occupational Safety and Health Administration,” n.d.).

Project management life cycle and tools

The project management life cycle consists of the following phases:

Initiation: This phase may include the development of a business case, setting up a project office or a charter, performing a phase review or appointing a competitive project team.

Planning: This phase of project management includes the creation of project plans, risk plans, acceptance plans, or issuing statement plans or requesting information.

Execution: The third stage may entail building deliverables or whatever the project demands.

Monitoring and control: Performance of time management, change and risk management, and control of quality and quantity can be some of the activities of monitoring and evaluation.

Closure: Project closure and periodic review of project completion are the finals steps of project management.

Budgeting and supplies (Questions and Answers)

Revenue and expenses for releasing information within a hospital or clinic would include the costs for hardware, software, maintenance, personnel required for the project, materials, consulting fees, travel charges, etc. Some assumptions before starting might be the heavy bulk of workload if the services are provided from in-house. The in-house requests for ROI would require: invoicing, taking status inquiries over the phone, and other non-technical tasks as well. The things considered before evaluating an ROI contract would be the potential interaction of ROI employees' with the patients, engagement of the patients, and their guidance regarding the release of information within a hospital.

The pros of the release of information in-house are the maintenance of high service levels, validation of requests, location of relevant records, and determination of the correct information to release. On the other hand, the in-house release of information services also have disadvantages regarding the heavy workload and collection of fewer rates of fees. The pros of out-sourcing this task is that the hospitals lose much of the unwanted hassle of gathering records and files for patients, physicians, accounting departments, and other government agencies. Other benefits of out-sourcing ROI include savings across the board, security, and compliance. The disadvantage, in this case, is the potential loss of service control and associated revenue.

If the return on investment from in-house training is positive, then it is evident that the training is working. Observational analysis of the current employees, staff appraisals, costs of the training programs and associated costs would be needed for in-house training. The supplies included might entail manpower, training agencies, hardware, software, extra material, writing material, maintenance costs, etc. the accounts that would be needed to set up will be the revenues and expenditures accounts and a separate account will also be maintained in which miscellaneous costs will be included. The increase or decrease in the number of the above-mentioned supplies or manpower can cause a variance in the budget.

If I were a supervisor over the release of information within a hospital or a clinic, I would prefer out-sourcing it because I am chiefly interested in partnerships for the efficient running of the hospital management and the privacy of patients' information.

Wisconsin health system, Marshfield (Wis.) Clinic Health System and Pennsylvania Hospital are some of the companies which are currently outsourcing their release of information.

Accounting methodology:

Annual project cost for in-house training

Cumulative project-cost for in-house training

Total annual benefits

Total cumulative benefits

Things to be added to the budget will be project cost components, IT cost components, cost of analytical applications, etc.

The manager should keep a delegation attitude and ask himself that who else can do this task if an employee is not performing the task adequately.

A manager should provide training and guidance, define the authority level, monitor progress and give regular feedback to ensure the success of a new employee.

Health information management directors: Trained for the business aspect of the health data

Health information management supervisors: Guidance, oversight, and workflow of the junior staff

I would like to get enrolled in the Career theatre and fair someday as a volunteer activity ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"FDGNteap","properties":{"formattedCitation":"(\\uc0\\u8220{}Volunteer Program At Convention,\\uc0\\u8221{} n.d.)","plainCitation":"(“Volunteer Program At Convention,” n.d.)","noteIndex":0},"citationItems":[{"id":69,"uris":["http://zotero.org/users/local/R3lWGnc9/items/TRRBD8DX"],"uri":["http://zotero.org/users/local/R3lWGnc9/items/TRRBD8DX"],"itemData":{"id":69,"type":"webpage","title":"Volunteer Program At Convention","URL":"http://ahima.org/careers/volunteer-convention","accessed":{"date-parts":[["2019",11,10]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (“Volunteer Program At Convention,” n.d.).


ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Berg, D. (2008). Biomarkers for the Early Detection of Parkinson’s and Alzheimer’s disease. Neurodegenerative Diseases, 5(3–4), 133–136. https://doi.org/10.1159/000113682

Occupational Safety and Health Act - (1970).pdf. (n.d.). Retrieved from http://www.historyspeak.com/Occupational%20Safety%20and%20Health%20Act%20-%20 (1970).pdf

Parkinson’s disease Biomarker Program - Full-Text View - ClinicalTrials.gov. (n.d.). Retrieved November 10, 2019, from https://clinicaltrials.gov/ct2/show/NCT01767818

U.S. Department of Labor Issues $1,591,176 in Penalties to AB Specialty Silicones after 4 Fatalities in Illinois Plant Explosion | Occupational Safety and Health Administration. (n.d.). Retrieved November 10, 2019, from https://www.osha.gov/news/newsreleases/region5/10252019

Volunteer Program at Convention. (n.d.). Retrieved November 10, 2019, from http://ahima.org/careers/volunteer-convention

Subject: Healthcare and Nursing

Pages: 3 Words: 900

US Healthcare System Free Market Paper

US Healthcare System Free Market Paper

[Author’s name]

[Institute’s name]

US Healthcare System Free Market Paper


The healthcare system of the US is recognized as one of the major and unique healthcare domains established around the globe. It is critical to assess the effectiveness of this system in the context of free-market because there are many stakeholders actively involves in this scenario. It is observed that most healthcare facilities in the country are largely owned by private entities. The facet of health insurance for many citizens is usually delivered by their employers, independent entity, or the approach of government-based programs. It is critical to indicate that some specific healthcare services are also associated with the paradigm of non-profit organizations operating in the country. The US healthcare system is illustrated in the form of the free-market approach ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"319cRfTZ","properties":{"formattedCitation":"(Council & Population, 2013)","plainCitation":"(Council & Population, 2013)","noteIndex":0},"citationItems":[{"id":1325,"uris":["http://zotero.org/users/local/7Hi3kAOD/items/7MVHYTZU"],"uri":["http://zotero.org/users/local/7Hi3kAOD/items/7MVHYTZU"],"itemData":{"id":1325,"type":"book","title":"US health in international perspective: Shorter lives, poorer health","publisher":"National Academies Press","ISBN":"0-309-26414-6","author":[{"family":"Council","given":"National Research"},{"family":"Population","given":"Committee","dropping-particle":"on"}],"issued":{"date-parts":[["2013"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Council & Population, 2013). It is vital to examine the basic aspects of this system under the domain of the free-market. This paper focuses to critically examine the primary characteristics of the US healthcare system in the context of a free-market approach.

Primary Characteristics of the US Healthcare System

A free-market approach in case of healthcare system is characterized as priority in case of different countries. A free-market healthcare approach is defined as an active role of different market forces without any intervention of government authorities. It is one great debate exist in case of the US healthcare system to characterized it as a free-market approach. It is vital to assess the basic characteristics of the US healthcare system to define its specific practical approach concerning the perspective of the free market.

The US healthcare delivery system is comprised of different aspects of consideration that involves practical implication of various market forces. It is critical to indicate that the healthcare delivery system of the US never allows all American citizens to avail basic healthcare services. It is observed that healthcare system of country evolved concerning the features of cost, access, quality, and the overall paradigm of system. Consideration of certain external effects is necessary to determine the basic character of the healthcare system of the country. These exterior driving forces specifically recognized as political environment, economic development, technological progress, social and cultural domains, physical climate conditions, characteristics of population, and the international influence ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"8tZpTIlj","properties":{"formattedCitation":"(Cebul, Rebitzer, Taylor, & Votruba, 2008)","plainCitation":"(Cebul, Rebitzer, Taylor, & Votruba, 2008)","noteIndex":0},"citationItems":[{"id":1326,"uris":["http://zotero.org/users/local/7Hi3kAOD/items/2LPI8M3U"],"uri":["http://zotero.org/users/local/7Hi3kAOD/items/2LPI8M3U"],"itemData":{"id":1326,"type":"article-journal","title":"Organizational fragmentation and care quality in the US healthcare system","container-title":"Journal of Economic Perspectives","page":"93-113","volume":"22","issue":"4","author":[{"family":"Cebul","given":"Randall D."},{"family":"Rebitzer","given":"James B."},{"family":"Taylor","given":"Lowell J."},{"family":"Votruba","given":"Mark E."}],"issued":{"date-parts":[["2008"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Cebul, Rebitzer, Taylor, & Votruba, 2008). All these practical domains play vital role to determine fundamental characteristics of healthcare system developed for the citizens. There are ten primary characteristics of the US healthcare system that helps to differentiate it from the healthcare delivery system of other countries ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"HzANrWfd","properties":{"formattedCitation":"(Papanicolas, Woskie, & Jha, 2018)","plainCitation":"(Papanicolas, Woskie, & Jha, 2018)","noteIndex":0},"citationItems":[{"id":1324,"uris":["http://zotero.org/users/local/7Hi3kAOD/items/A8HJG2SL"],"uri":["http://zotero.org/users/local/7Hi3kAOD/items/A8HJG2SL"],"itemData":{"id":1324,"type":"article-journal","title":"Health care spending in the United States and other high-income countries","container-title":"Jama","page":"1024-1039","volume":"319","issue":"10","author":[{"family":"Papanicolas","given":"Irene"},{"family":"Woskie","given":"Liana R."},{"family":"Jha","given":"Ashish K."}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Papanicolas, Woskie, & Jha, 2018). Consideration of these basic features is also vital to examine the perspective of a free market.

No central government agency is responsible when it comes to governing the system.

The accessibility of healthcare services is relevant to the broad approach of insurance coverage.

The perspective of health care is practically concerned with the domain of imperfect market circumstances.

The role of third-party insurers is crucial to develop the necessary association between different financing and delivery operations.

The complexity of this healthcare system linked with the active involvement of multiple payers.

The idea of balancing power connects with the approach of various players when it comes to dominating the healthcare delivery system by a single strong authority.

The threat of legal aspects eventually impacts the practice behavior of physicians and other healthcare professionals.

The creation of new technology advancement is closely linked with overall automatic demand.

The objective of the new service setting is comprised of the overall range established in case of healthcare services.

The criteria of quality can never be embraced in the form of unachievable objective considering the overall paradigm of delivery of healthcare for American citizens.

No Central Agency

This is one of the most significant features of free-market that the healthcare system of the country is not solely administered by any government entity. Allocation of resources is closely connected with the facet of the budgetary domain. The health care system of country is mainly recognized as a private system of financing.

Partial Access

The criteria of access to healthcare services in the country are restricted specifically in forms of health insurance paradigms for employers, government healthcare program, consideration of private funds, and the entire private services. Uninsured individuals can only access some forms of healthcare services.

Imperfect Market

The detailed examination of the practical domain of healthcare system of the US system clearly indicates that there are many private entities associated with the healthcare services. Furthermore, it is also essential to indicate that the perspective of healthcare is partially administered by different free-market forces. The aspects of delivery and consumption of healthcare are not suitably reflected as an approach of free market. The mixed market conditions help to determine this system as an imperfect market system.

Third-Party Insurers and Payers

The process of insurance is usually operated through the involvement of third-party insurers. The procedure of insurance recognized as a transaction between the client and the service provider ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"dZjvIjHN","properties":{"formattedCitation":"(Shortell, Gillies, & Wu, 2010)","plainCitation":"(Shortell, Gillies, & Wu, 2010)","noteIndex":0},"citationItems":[{"id":1327,"uris":["http://zotero.org/users/local/7Hi3kAOD/items/WFR6QJVK"],"uri":["http://zotero.org/users/local/7Hi3kAOD/items/WFR6QJVK"],"itemData":{"id":1327,"type":"article-journal","title":"United States innovations in healthcare delivery","container-title":"Public Health Reviews","page":"190","volume":"32","issue":"1","author":[{"family":"Shortell","given":"Stephen M."},{"family":"Gillies","given":"Robin"},{"family":"Wu","given":"Frances"}],"issued":{"date-parts":[["2010"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Shortell, Gillies, & Wu, 2010). The process of insurance can never be considered complete without the consideration of third-party in case of payment functions.

Multiple Financiers

The free-market approach of the healthcare system of the country can also observe in case of involvement of different payers. The active multiplicity of the healthcare system is basic condition of existing healthcare system of the country. This approach can also be examined in the scenario of the integration of different insurance institutions.

The Approach of Power Balancing

It is crucial to understand that the healthcare system of the US involves the active intervention of different players. Physicians, administrators of health service organizations, insurance companies, large employers, and the government are recognized as main stakeholders in this context. The consensus of economic interest of all shareholders develops a range of healthcare prospects.

High Technology

The feature of medical research and innovation are greatly acknowledged under the approach of the country’s broad healthcare system. It is observed that growth in medical technology ultimately enhances demands for some specific healthcare services ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"s0npv5A3","properties":{"formattedCitation":"(Shi & Singh, 2005)","plainCitation":"(Shi & Singh, 2005)","noteIndex":0},"citationItems":[{"id":1328,"uris":["http://zotero.org/users/local/7Hi3kAOD/items/HZDGCLT9"],"uri":["http://zotero.org/users/local/7Hi3kAOD/items/HZDGCLT9"],"itemData":{"id":1328,"type":"book","title":"Essentials of the US Health Care System","publisher":"Jones and Bartlett","URL":"https://books.google.com.pk/books?id=zOOPmMLusq4C","ISBN":"978-0-7637-3151-9","author":[{"family":"Shi","given":"L."},{"family":"Singh","given":"D. A."}],"issued":{"date-parts":[["2005"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Shi & Singh, 2005). The physicians and other healthcare service providers are keen to adopt new advance measures to facilitate all American citizens.

Legal Hazards

Litigation is one main element or characteristic greatly associated with practical implications of the healthcare system in the country. The complex process of lawsuit eventually influences the healthcare delivery approach established by healthcare professionals. The risk of misconduct of legal prospects is one real consideration exist for the healthcare system of the country.

Range of Healthcare Services

The healthcare services are primarily devised into three major classes of curative, restorative, and preventive domains. Different healthcare services are classified under these three main categories to enhance the overall performance level of the healthcare sector. It is vital to indicate that specialized services are mainly focused on healthcare professionals under the broad domain of healthcare system.

Consideration of Quality

The healthcare sector of the country is keen to develop some basic standards of quality when it comes to the delivery of basic healthcare services to citizens. The pressure of quality enhancement is increasing by establishing specific standards of performance. The main aim of this consideration is to improved health results for the individuals and the community.


In a nutshell, it is vital to indicate that the healthcare system of the country is closely linked with the involvement of different stakeholders. Moreover, different crucial driving forces of market also play critical role to determine basic healthcare services approaches for the citizens.


ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Cebul, R. D., Rebitzer, J. B., Taylor, L. J., & Votruba, M. E. (2008). Organizational fragmentation and care quality in the US healthcare system. Journal of Economic Perspectives, 22(4), 93–113.

Council, N. R., & Population, C. on. (2013). US health in international perspective: Shorter lives, poorer health. National Academies Press.

Papanicolas, I., Woskie, L. R., & Jha, A. K. (2018). Health care spending in the United States and other high-income countries. Jama, 319(10), 1024–1039.

Shi, L., & Singh, D. A. (2005). Essentials of the US Health Care System. Retrieved from https://books.google.com/books?id=zOOPmMLusq4C

Shortell, S. M., Gillies, R., & Wu, F. (2010). United States innovations in healthcare delivery. Public Health Reviews, 32(1), 190.

Subject: Healthcare and Nursing

Pages: 4 Words: 1200



CPOE is a reliable, efficient and effective approach that can be used by the healthcare practitioners to generate and replicate accurate scenarios for better decision making and healthcare management plans. When integrated with CDSS, the healthcare professionals can produce reliable applications that are customized for specific use. For instance, in case of managing and controlling obesity in different patients, and integrated application can be created that would consider all aspects of the patients such as health history, gender, fat ratio, etc. and would generate a detailed structured diet and exercise plan for the patients.

Issue that requires CDSS Development

The objective of this application is to exhibit how CDSS Application instructing people in general, bringing issues to light to the overall population, advance wellbeing (diet and exercise), decide reasons for obesity and decide how one may change their way of life using persuasive meeting. Applications in virtual situations may extend from detached picking up (settling on simple decisions) to very dynamic (persistent investigation).

The applications in this introduction will comprise of communication with programed modified Stakeholders and different items in a little network town condition. These are intuitive dependent on a lot of predefined rules for reactions to explicit inquiries asked of the member. The substance of the applications will score and evaluate a person's comprehension of the ecological variables impacting obesity are: age, sexual orientation, conjugal status and instruction. Being overweight or obese are key hazard markers for hypertension, coronary illness and Type II diabetes. Obesity can likewise add to the improvement of elevated cholesterol, back issues, osteoarthritis and specific types of diseases. Different illnesses, for example, dejection and certain neurological issues may prompt indulging.

The applications inside this introduction will start with a meeting with a modified Stakeholders the place the understudy will be approached to enter their weight and stature to evaluate their BMI. The understudy at that point will be met by the modified Stakeholders with inquiries in regards to their objectives identified with their weight and will be furnished with starting data identified with conduct change. Next, the patients will be coordinated to different applications identified with:

Adjusting Calories

Counteracting Weight Gain

Smart dieting

Sustenance Pyramid and Food Labels

Causes and Consequences

Inspirational Interviewing

Nourishment Serving.

Nourishment and Activity Journal.

For the respective case, it is important that the patients must be provided with an effective, precise and comprehensive structured exercise regime and diet plan to overcome obesity. Since every patient has a different body type with a different BMI, fat ratio, health complications, etc. it is important that their structured plan is also designed according to these specifications. For this purpose, an integrated CDSS system can be created. CPOE allows integrated CDSS to develop an application that would help the physicians in generating a personalized and accurate structured exercise and diet plan for their patients.

The new CDSS system was developed very efficiently after proper analysis of the requirements. This made the system very beneficial in following ways:

Establishment of reliable safety stock levels;

Fighting back the inventory issues related to uncertainty and supply chain management;

Centralized system for training and assisting users;

Helps in identification and formulation of best inventory setting policies;

Laid foundation for the formulation of other models including Raw and Packaging Materials Inventory Model; Extended Inventory Model; and a Retailer Inventory Model;

Briefly, it has increased the Healthcare Intelligence by allowing them to make more precise and effective decisions related to inventory and supply chain management.

Challenges and Limitations

The greatest challenge confronted by operating staff could be the expense cutting system that just about all the organizations will actualize, particularly in the occasion of worldwide budgetary emergency. with restricted stores and resources, operating staff still needs to split their heads to accomplish it anticipates in time and make beyond any doubt services are conveyed obviously. it is additionally an extra challenge to operating staff to handle innovative it services and items in such troublesome period with constrained store and resources for research and improvement, particularly when managing the high-end technology that requires a huge measure of cash.

in addition, the advancing role of operating staff that requires them a healthcare ability is challenging. operating staff is presently needed to make decision for unusual future, which is the regular of healthcare environment. while picking up stress of accomplishing occupation, a operating staff additionally need to act as a pioneer that gives good backings to the team throughout the troublesome times. It is an enormous changes compare to the customary roles of operating staff, whereby now he need to adjust IT and healthcare procedure of the organization as well.

Some of the challenges and limitations of the current system include cost of implementation, lack of training and staff orientation, maintenance cost, etc. These costs may make the project appear less feasible and favorable in initial phases. However, long term investment can ensure a long term improvement and efficiency in regards to the healthcare institutional objective.

Another recommendation to improve the efficiency of CDSS is to make it web based. it will be better to make the DSS web based. This is because the company has branches at various geographic locations and their employees are also diversified. Having a web based DSS will help them gather input from these locations more efficiently with ease of macro conversion. Compatibility issue that is currently prevailing in DSS system will also be resolved.

First of all, in order to sustain in a highly competitive and rapidly changing market, it is important to formulate a precise and highly effective decision making system; secondly, the system including DSS and all other systems being used by the organization must be regularly updated, reviewed and upgraded for enhancing their quality and dependability; and third, aspects of globalization and diversity must be considered and for that purpose, DSS must be created to be web based.


To overcome the danger of losing this worth information of the organization, a legitimate disaster recovery plan ought to be ready. The operating staff is responsible to assemble a team who responsible for disaster recovery. as a pioneer, operating staff ought to lead the team in working together impact dissection, created plan for disaster recovery, actualize it, practice it and maintain it. The motivation behind practice is to test whether there is any vital steps forgot in the methodology expressed in occasion of disaster recovering procedure. The disaster recovery plan need to be maintained too for at regular intervals or one year in the event that the organization had actualized new IT infrastructure or individuals in control may had left the company.


Ayed, M. B., Ltifi, H., Kolski, C., & Alimi, A. M. (2010). A user-centered approach for the design and implementation of KDD-based DSS: A case study in the healthcare domain. Decision Support Systems, 50(1), 64-78.

Kohli, R., & Devaraj, S. (2004). Contribution of institutional DSS to organizational performance: evidence from a longitudinal study. Decision Support Systems, 37(1), 103-118.

Chae, Y. M., Kim, H. S., Tark, K. C., Park, H. J., & Ho, S. H. (2003). Analysis of healthcare quality indicator using data mining and decision support system. Expert Systems with Applications, 24(2), 167-172.

Rajalakshmi, K., Mohan, S. C., & Babu, S. D. (2011). Decision support system in healthcare industry. International Journal of computer applications, 26(9), 42-44.

Kohli, R., & Piontek, F. (2008). DSS in healthcare: Advances and opportunities. In Handbook on Decision Support Systems 2 (pp. 483-497). Springer, Berlin, Heidelberg.

Subject: Healthcare and Nursing

Pages: 4 Words: 1200

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