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Community Teaching Plan Sample Paper

With nearly two years since the COVID19 epidemic began, there has been a tremendous impact on numerous sectors such as health, education, leisure and hospitality, professional business services among others.  The pandemic prompted the World Health Organization to impose rigorous measures such as movement restrictions, the use of personal protective equipment, hand hygiene, and, later, COVID19 vaccine. These interventions have resulted in a decrease in COVID19 morbidity and mortality. In terms of population health, COVID19 has raised psychological stress due to job loss over the era, in addition to physical debilitation (Rajkumar, 2020). This has exacerbated or created new mental health issues in the population, most notably depression. In the Virginia community, the most pressing health concern is depression, which demands actions to address it. In this paper, a teaching plan is developed to educate community members on depression during the COVID19 era, how to handle and mitigate its effects, and how to prevent it.

Summary of the Community Teaching Plan

Lesson Description

1. The purpose of this session is to provide professional education to community members about depression during the COVID19 era and how the pandemic has exacerbated mental health concerns.
2. This lecture is divided into ten 30-minute sessions and includes in-depth information regarding depression during the COVID19 period. The lesson also provides community members with crucial understanding and needs of depressed individuals, care for early detection of them, and the necessary skills to provide high-quality care to those in need.
3. The lesson also includes teaching the community on strategies to prevent the occurrences of depression and mitigate the repercussions once they occur, as well as an advancement of linking affected individuals to the right community services that support individuals with depression.

Lesson Goals

1. To create awareness about the mental health problems during the COVID19 pandemic while focusing on depression as a diagnostic entity.
2. To encourage community members to be keen in identifying the symptoms and coach them on how to provide the appropriate care for affected individuals to improve their health conditions and maintain their healthy habitus.

Lesson Objectives

1. Understand the symptoms of depression and be able to recognize depressed individuals (Teach DSM-5 Criteria for Diagnosis)
2. Determine the risk factors for depression in community members during the pandemic.
3. Recognize the unique methods for preventing the emergence of depression in high-risk individuals.
4. Develop basic nursing care for affected individuals in order to avoid negative repercussions.
5. Provide community members with resources such as contacts, websites, and organizations that they can contact if they come across an affected individual.

Lesson Materials

1. PowerPoint Presentations
2. Video Clips
3. Texts (useful internet resources): websites

Lesson Outline

1.Introduction

1. History of the various aspects of mental diseases such as depression and anxiety occurring during pandemic times.
2. The reasons for recognizing seriousness of mental health conditions during pandemics
3. Definition of Depression based on DSM-5
4. Epidemiology

2.Recognition

1. DSM-5 Diagnostic criteria (A to E)
2. Associated features supporting diagnosis

3.Risks and Prognostic Factors

1. Environmental
2. Genetics and physiological
3. Temperamental
4. Course Modifiers
5. Culture related factors

4.Functional Consequences of Depressive Disorders during the COVID19 era

5.Treatment and nursing support for the affected individuals

Epidemiological Rationale for Topic: Depression in the era of COVID19

During a poll conducted in the Virginia community, the majority of health professionals said that mental health disorders, particularly depression, are the most concerning. Depression in the COVID19 era has been investigated by a number of scientists, and the available statistics on its occurrence are the result of several epidemiological observations. Listed below are a few of the most current research on the prevalence of depression in the COVID19 era.

Huang and Zhao (2021) conducted a cross-sectional web-based survey of 7236 members of the general public in China and discovered that 20.1% of the population suffered from depression symptoms. In the study, persons with depressive symptoms were identified using the Center for Epidemiology Scale for Depression (CES-D). Wang et al. (2020) conducted an online survey among 1210 respondents in 194 Chinese cities in a different cross-sectional study, and the results show that 53.8% of them had some level of stress, and 16.5% had moderate to severe depressive symptoms. In their cross-sectional online survey study of 2766 Italian participants, Mazza et al. (2020) discovered that the prevalence of severe and moderate depression is 15% and 17%, respectively. The study also discovered that 11.5% and 7.2% of study participants suffered from severe and moderate anxiety, respectively.

Ozamiz-Etxebarria et al. (2020) conducted a cross-sectional survey among 976 adult participants in Spain, and the results are as follows: In males, the prevalence of mild, moderate, severe, and extremely severe depression was 8.7%, 4%, and 2.9%, respectively, while females had the following prevalence: In mild, moderate, severe, and extremely severe depression, the rates were 8.6%, 7.1%, 2.3%, and 3%, respectively. In a different nation, Iran, Moghanibashi-Mansourieh (2020) performs a cross-sectional online survey on anxiety among 10754 people, and the results show that anxiety levels are higher in women than in men. The bottom line is that rates of mental health conditions have risen dramatically during the COVID19 era, which has been attributed to stressful prevailing life conditions such as job loss, death of loved ones, infection, fatigue and loneliness, and separation from family due to measures such as restricted movement in various countries. Depression was chosen because it is the most serious health concern in the Virginia community during the COVID19, and it has been linked to the majority of individuals losing their jobs during that time period, necessitating an intervention to treat it.

Evaluation of Teaching Experiences and Insight into Self-Appraisal

Self-reflection is a technique for regularly reviewing the teaching plan. Critical questions such as “How did the lesson go?” are asked at the end of the lesson. How did the community members participate, and did they appear to learn? Continuous self-evaluation enables beneficial changes in subsequent sessions (Yang et al., 2017). Another method for evaluating the teaching strategy is to solicit feedback from the community. To establish whether or not learning is taking place, it is helpful to solicit input from community members at various points throughout the educational process. For example, if the members meet twice a week for 30-minute sessions, the presenter may want to seek feedback from the members at the end of the week’s session on the week’s teachings. This can be accomplished through the use of an audience response system, in which any individual can volunteer at the end of the session to make random comments about the week’s session over a public address system, or through the use of one-minute papers, in which members write down what they have learned from that session (Yang et al., 2017). Another approach of gathering feedback from members is to employ a traffic light feedback system, in which the instructor uses red, yellow, or green sticky notes to assess learning and comprehension. For example, which teaching approaches do members wish to reduce (red), continue (yellow), or see more of? (green).

Feedback from a colleague is also important in evaluating my teaching strategy. Colleagues who accompany me during community teaching can provide comments on the instruction, identify specific problems, and suggest methods to improve the next time. A colleague can provide an honest evaluation about the teaching plan and may be a good source for my improved performance in a future similar assignment.

Finally, course evaluation questionnaires can be employed to assess the teaching plan. One can engage the level of learning that has occurred by distributing evaluation questionnaires (Yang et al., 2017). The educator prioritizes the information he/she wants to collect from the learners while creating the questionnaires, and if possible, involves them in the design of the questions. In order to get a quick answer, assessment questionnaires are designed with single questions, few questions, and questions that are brief and unambiguous.

Community Response to Teaching

            The reaction to community teaching can be immediate or delayed. The instant reaction to the teaching was positive, as evidenced by positive responses from community members, confirming that learning had happened. When asked questions at the end of the event, the majority of the community members replied correctly. The majority could understand how depression manifests, identify risk and prognosis indicators, offer the most basic nursing care to whoever is affected, and connect the many affected individuals to relevant community services. The number of community members who become aware and wary about depression, the number of individuals linked to various community resources that support afflicted individuals, and the reduction in the occurrence rate of depression during the COVID19 period will be used to measure delayed response. During the teaching sessions, the members were eager to learn, attentive, and passionate about getting to know more outside of the confines of the lesson plan. This is a good indicator that the community’s reaction to the depression education was positive.

Strengths and Weaknesses

            The fact that an issue of greatest interest to the community was picked is a significant achievement to be proud of. Following the huge psychological impact of the epidemic, the frequency was inflated during COVID19. The teaching plan was designed in the most basic way possible so that community members could readily understand it. Every component of the application was written in easy language and in English because the bulk of the inhabitants spoke English fluently. As a result, there was no language barrier during the presentation, as even the elderly appeared to have an easy time interpreting the information.

Audiovisuals were utilized, and simulations were constructed where practical, to help participants internalize the topics. To optimize patient learning, modern learning approaches go beyond didactic lectures and include the presentation of information through audiovisuals and simulation (Johnston et al., 2017). Furthermore, the fact that the program was brought to the community in close proximity to the residents is a significant step forward. Weaknesses included the amount of time required to arrange the sessions, the number of weeks required to finish the training, and the inflexibility of the teaching plan—it was supposed to happen twice a week for 5 weeks without any lesson being postponed. Such areas of weakness will be investigated and rectified should there be a need to create a future teaching plan.

Conclusion

            The unprecedented COVID19 brought with it a slew of physical, emotional, social, and psychological issues. As seen in the Virginia community, among the social issues were job loss and financial constraints. As a result of being anxious and unable to provide for their families, people developed mental health problems, particularly depression. The teaching plan therefore concentrated on depression. It took 10 sessions of 30 minutes each over the course of 5 weeks. Despite the positive response from the community, a future program must be adaptable in order to meet the needs and preferences of the community members. Among the goals of the teaching plan were the ability to recognize depressive signs, identify patients at risk, and create basic nursing care for patients in need.

References

• Huang, Y., & Zhao, N. (2021). Corrigendum to Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 outbreak in China: a web-based cross-sectional survey [Psychiatry Research, 288 (2020) 112954]. Psychiatry Research, 299(113803), 113803. https://doi.org/10.1016/j.psychres.2021.113803
• Johnston, S., Parker, C. N., & Fox, A. (2017). Impact of audio-visual storytelling in simulation learning experiences of undergraduate nursing students. Nurse Education Today, 56, 52–56. https://doi.org/10.1016/j.nedt.2017.06.011
• Mazza, C., Ricci, E., Biondi, S., Colasanti, M., Ferracuti, S., Napoli, C., & Roma, P. (2020). A nationwide survey of psychological distress among Italian people during the COVID-19 pandemic: Immediate psychological responses and associated factors. International Journal of Environmental Research and Public Health, 17(9), 3165. https://doi.org/10.3390/ijerph17093165
• Rajkumar, R. P. (2020). COVID-19 and mental health: A review of the existing literature. Asian Journal of Psychiatry, 52(102066), 102066. https://doi.org/10.1016/j.ajp.2020.102066
• Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., Ho, C. S., & Ho, R. C. (2020). Immediate psychological responses and associated factors during the initial stage of the 2019 Coronavirus disease (COVID-19) epidemic among the general population in China. International Journal of Environmental Research and Public Health, 17(5), 1729. https://doi.org/10.3390/ijerph17051729
• Yang, X.-F., Talmy, T., Zhu, C.-H., Li, P.-F., Wang, W., Zhang, P., Zhang, H.-W., Bulis, S., Wang, K.-X., Chen, X., Wang, Y.-L., Jiang, D.-P., Zong, Z.-W., & Zhou, J. (2017). Evaluation of teaching and learning: A basis for improvement in medical education: A basis for improvement in medical education. Chinese Medical Journal, 130(10), 1259–1260. https://doi.org/10.4103/0366-6999.205851

Compare vulnerable populations Discussion

Compare vulnerable populations Discussion

Topic 3 DQ1: Compare vulnerable populations. Describe an example of one of these groups in the United States or from another country. Explain why the population is designated as “vulnerable.” Include the number of individuals in this group and the specific challenges or issues involved. Discuss why these populations cannot advocate for themselves, the ethical issues that must be considered when working with these groups, and how nursing advocacy would be beneficial.

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Compare vulnerable populations Discussion Instructions

You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort, and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized.

Read over your paper – in silence and then aloud – before handing it in, and make corrections as necessary. Often, having a friend proofread your essay for obvious errors is advantageous. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12-point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. Letting your essay run over the recommended number of pages is better than compressing it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted and double-spaced with a one-inch margin on each page’s top, bottom, and sides. When submitting a hard copy, use white paper and print it out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

ADDITIONAL INSTRUCTIONS FOR THE CLASS

Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, including a minimum of one scholarly source, and be at least 250 words.

Successful responses are substantive (i.e., add something new to the discussion, engage others in the debate, well-developed idea) and include at least one scholarly source.

One or two-sentence responses, simple statements of agreement or “good post,” and off-topic responses will not count as substantive. Substantive responses should be at least 150 words.

I encourage you to incorporate the readings from the week (as applicable) into your responses.

Weekly Participation

Your initial responses to the mandatory DQ are graded separately and do not count toward participation.

In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days for three answers.

Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).

Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything due during the week.

APA Format and Writing Quality

Please familiarize yourself with the APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the resources tab in LoudCloud, for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).

Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
I highly recommend using the APA Publication Manual, 6th edition.

Use of Direct Quotes

I discourage the overutilization of direct quotes in DQs and assignments at the Master’s level and deduct points accordingly.

As Master’s level students, you must be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding or critical analysis of the content.

It is best to paraphrase content and cite your source.

LopesWrite Policy

For assignments that need to be submitted to LopesWrite, please be sure you have received your report, and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.

Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to study instead of getting counted for these mistakes.

Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper more of someone else’s thoughts than yours?

Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud, for tips on improving your paper and SI score.

Late Policy

The university’s policy on late assignments is a 10% penalty PER DAY LATE. This also applies to late DQ replies.

Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.

If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.

I do not accept assignments that are two or more weeks late unless we have worked out an extension.

Per policy, no assignments are accepted after the last day of class. Any work submitted after midnight on the previous day of the course will not be carried out for grading.

Communication

Communication is so essential. There are multiple ways to communicate with me:
Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
Individual Forum: This is a private forum to ask questions or send messages. This will be checked at least once every 24 hours.

Comparing Health Outcome in Adjoining Counties

Comparing Health Outcome in Adjoining Counties

This assignment consists of four paragraphs in length, word document and double spacing.  12 point new roman front.  If you have any questions, please let me know

HCM -320 1-2 Journal:Guidelines and Rubric Overview : In this journal, you will have the opportunity to consider the healthcare economics of two adjacent counties in the Kansas Ci ty metropolitan area. Read Case 2.1 in Chapter 2 of your textbook.

In your journal assignment, answer the following case study questions:

? What are the main inputs to health mentioned in this case? Are there important inputs to health that the case does not mention?

? What health behaviors should get priority?

? Does income play a role in improving health?

? How important is health insurance in improving health?

? Wyandotte County has relatively few primary care physicians. Should the number of primary care physicians be a priority?

? What role, if any, should the federal government play in improving health?

? How do you think your answers would differ if you were a resident of Wyandotte County? Support your responses with examples from the case or references to your textbook.

Use the journal as an opportunity to familiarize yourself with the final project requirements and case study. Journal activities in this course are private between you and your instructor. Only the instructor can view and comment on your assignments. Rub ric

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Guidelines for Submission: Your journal assignment should be 2 to 4 paragraphs in length. Submit assignment as a Word document with double spacing, 12 – point Times New Roman font, and one -inch margins.

Critical Elements Proficient (100%) Needs Improvement (75%) Not Evident (0%) Value Inputs Discusses the main health inputs mentioned in this case, identifies important inputs not mentioned and supports stance with examples from the case or references to the textbook Discusses the main health inpu ts mentioned in this case, identifies important inputs not mentioned but does not support stance.

Does not discuss the main health inputs mentioned in this case 14 Health Behavior Discusses what health behaviors should get priority and supports stance with examples from the case or references to the textbook Discusses what health behaviors should get priority, but does not support stance.

Does not discuss what health behaviors should get priority 14 Income Level Describes how income plays a role in improving health and supports description with examples from the case or references to the textbook Describes how income plays a role in improving health but does not support description.

Does not describe how income plays a role in improving health 14 Health Insurance Describes the importance of health insurance in improving health and supports description with examples from the case or references to the textbook Describes the importance of health insurance in improving health, but does not support description.

Does not describe the importance of health insurance in improving health 14 Primary Care Providers Discusses the quantity of primary care physicians and determines whether or not this quantity should be a priority and supports response with examples from the case or references to the textbook Discusses the quantity of primary care physicians and determines whether or not this quantity should be a priority, but does not support response with examples from the case or references to the textbook.

Does not discuss the quantity of primary care physicians 14 Government Role Defines the role of the federal government plays in improving health and supports description with examples from the case or references to the textbook Defines the role of the federal government plays in improving health, but does not explain why or why.

Does not define the role of the federal government plays in improving health 15 Resident Perspective Discusses whether healthcare economics issues would be different from the perspective of a Wyandotte County resident, and explains why or why not.

Discusses whether healthcare economics issues would be different from the perspective of a Wyandotte County resident, and explains why or why not, but does not explain why or why not Does not discuss whether healthcare economics issues would be different from the perspective of a Wyandotte County resident 15 Total 100%

Comparing Humanistic Existential Psychotherapy with Other Approaches

Psychotherapy is a viable treatment for a variety of mental health issues. Wheeler (2020) defines psychotherapy as a process of treating emotional difficulties and mental illnesses by way of verbal and psychological techniques. Currently, several psychotherapeutic approaches are in existence including but are not limited to existential therapy and cognitive behavioral therapy. Humanistic existential psychotherapy is a psychotherapeutic approach that focuses on the human condition as a whole (Wheeler, 2020).

However, cognitive-behavioral therapy (CBT) which has gained its popularity since its establishment in the 1960s is deployed as a treatment modality for a multitude of mental disorders such as anxiety, substance use disorders, and depression. This piece of writing concentrates on comparing humanistic-existential therapy with cognitive behavioral therapy along with their associated outcomes when used in the treatment of patients.

Humanistic existential therapy uses a positive approach that appreciates human capacities and aspirations while simultaneously acknowledging their limitations (Feizi et al., 2019). This form of psychotherapy is a long-term process that helps an individual get in touch with the real experiences they are feeling. It deals with the last concerns of human beings’ existence such as death along with fears of isolation, meaninglessness, guilt lack of relationships, and emptiness (Grande, 2019). The fundamental aim of this therapy is to enable a patient to reach self-actualization in the presence of existential dilemmas. Nevertheless, existential therapy has been criticized for several reasons.

To begin, as opposed to other modalities of psychotherapy, this particular therapy lacks specific and concrete techniques for its administration. Similarly, existential therapy is nondirective which at times makes it restrictive and frustrating to the patients (Grande, 2019). Cognitive-behavioral therapy on the other hand is a goal-oriented, structured, and deductive hands-on form of therapy in which the therapist and the patient work in a collaborative manner with the target of modifying patterns of behavior and thinking to effectuate beneficial transformation in the patient’s mood and way of living (Fordham et al., 2018). Cognitive-behavioral therapy finds its basis through its theorization of the bidirectional nature of cognitive, physical, emotional, and behavioral relationships.

CBT has widely been criticized for focusing on individuals’ capacity to change themselves. Also, this therapy receives a setback for dwelling only on specific and current problems without taking a look at the underlying etiologies of mental health conditions. The above two modalities of psychotherapy differ in several ways which are discussed in the subsequent paragraphs.

CBT as a talking therapy focuses on the recognition of maladaptive thoughts and behaviors and subsequently challenges the patient to inaugurate a distinct course of action and thinking to enhance his overall psychological and physical wellbeing (Fordham et al., 2018). Existential therapy on the other hand focuses on evaluating human consciousness of oneself including the core existence which facilitates self-actualization and self-flourishing. Arguably, CBT is a well-structured, directed and designed form of psychotherapy that is utilized in various settings such as individual, family, and group whereas existential therapy, lacks specific concrete techniques, it is nondirective and is greatly elemental in an individual setting (Feizi et al., 2019).

Additionally, CBT emphasizes patient safety and happiness by encouraging the adoption of pristine thoughts and alterations in behaviors in the presence of maladaptive thoughts and behaviors that lead to good psychological and physical wellbeing. Nonetheless, existential therapy strongly contemplates the absence of permanent safety and happiness in life thus prioritizing the formation of identity (Feizi et al., 2019). The above dissimilarities are crucial and impact the practice of PMHNP. The PMHNP must recognize the mental health issue of concern and select the appropriate therapy that will be beneficial to the patient based on the pros and cons as well as the distinctive characteristics of each of the above psychotherapeutic modalities.

From the PsychotherapyNet (2009) in the James Bugental live case consultation psychotherapy video, the patient complains of “not feeling alive” and being “constricted in his life” warrants the use of humanistic-existential therapy as the treatment of choice. The rationale behind this is that existential therapy enables self-awareness, authenticity and increases awareness about life decisions. Moreover, this kind of therapy helps an individual find purpose and meaning in life, creates a positive attitude towards life, self-actualizes and self-nourishes an individual. Therefore, the patient benefited from a deeper discovery of the larger sense of himself (Feizi et al., 2019).

Cognitive-behavioral therapy could also be used in the management of the patient in the above video. However, this modality would necessitate the identification of maladaptive behaviors and thoughts behind being “constricted in life” and “not feeling alive” and then imposing a positive change. The expected potential outcome with the use of CBT depends on a multitude of factors including patient commitment, effective communication, patient-therapist relationships, and therapist skills (Fordham et al., 2018).  In the event that all the named variables are at optimum, the patient would likely develop novel ways of thinking and positive attitudes towards life.

Summary

Psychotherapy is a critical treatment modality for mental health illnesses and emotional difficulties. It is vital to select the appropriate psychotherapeutic technique based on the patient to achieve the most effective patient outcomes. Humanistic existential therapy seeks an in-depth understanding of the large sense of oneself to facilitate self-actualization. CBT deploys the bidirectional interconnection between cognitive, emotional, behavioral, and physical relationships to impact positive change in behavior and thinking for better physical and psychological wellbeing. Lastly, the sources used are scholarly since they are peer-reviewed journal articles, published within the last five years and from sites recommended for scholarly articles such as NCBI, PubMed, CINAHL, and MEDLINE.

References

• Feizi, M., Kamali, Z., Gholami, M., Abadi, B. A. G. H., & Moeini, S. (2019). The effectiveness of existential psychotherapy on attitude to life and self-flourishing of educated women homemakers. Journal of Education and Health Promotion, 8, 237. https://doi.org/10.4103/jehp.jehp_473_18
• Fordham, B., Sugavanam, T., Hopewell, S., Hemming, K., Howick, J., Kirtley, S., das Nair, R., Hamer-Hunt, J., & Lamb, S. E. (2018). Effectiveness of cognitive-behavioral therapy: a protocol for an overview of systematic reviews and meta-analyses. BMJ Open, 8(12), e025761. https://doi.org/10.1136/bmjopen-2018-025761
• Grande, T. (2019, January 9). Theories of counseling – Existential Therapy. Youtube. https://www.youtube.com/watch?v=YvAvc2aWup0
• PsychotherapyNet. (2009, June 29). James bugental live case consultation psychotherapy video. Youtube. https://www.youtube.com/watch?v=Zl8tVTjdocI
• Wheeler, K. (2020). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. Springer Publishing Company. https://doi.org/10.1891/9780826193896

Complete the HRSA Data Warehouse Website Activity

Complete the HRSA Data Warehouse Website Activity

What are the responsibilities of community and public health nurses in promoting health and decreasing illness and injury in populations, families, and individuals? Provide specific examples from your community.

Assignment

1. Read about the HRSA Data website and what it does here: https://datawarehouse.hrsa.gov/about/abouthdw.aspx
2. Explore the rest of the tabs on the site.
3. Watch the “How-To Video: Find a Health Center Locator Tool” tutorial found at the following link: https://data.hrsa.gov/how-to-videos
4. Explore some data by selecting Clark County, Nevada using the Data by Geography tool here: https://data.hrsa.gov/hdw/tools/DataByGeography.aspx
5. Next use the HRSA Fact Sheets tool located here: https://data.hrsa.gov/data/fact-sheets to look up HRSA’s activities in HHS regions, states, counties, and congressional districts and compare the data to the Clark County, Nevada data you found using your geography results. Analyze the data included in the fact sheets. Consider the data sets found in the fact sheets. How does Nevada compare nationwide when it comes to the data sets? What about Clark County?
6. Complete a new search using the Data for Geography tool for your state and county. Compare the results of your query to your Clark County, Nevada search.
7. Identify HRSA program resources for HIV/AIDS in your state and county. What are they? How many clinics are funded by HRSA?

Write a two-page paper reflecting on the data you collected and analyzed. How will this data warehouse be useful to you as a professional nurse? Your paper should be at least two pages in length, in APA format, typed in Times New Roman with 12-point font, and double-spaced with 1” margins.

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You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

ADDITIONAL INSTRUCTIONS FOR THE CLASS

Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
I encourage you to incorporate the readings from the week (as applicable) into your responses.

Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

APA Format and Writing Quality

Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
I highly recommend using the APA Publication Manual, 6th edition.

Use of Direct Quotes

I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
It is best to paraphrase content and cite your source.

LopesWrite Policy

For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
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Comparison Of Research Articles Sample Paper

Part 2: Analysis of the Two Articles

Introduction

Diabetes is an ailment that occur in humans when the blood sugar/blood glucose rises above the recommended level. The body derives its sugar from blood glucose that comes from the food consumed. Too much glucose in the body may have a negative impact on the body due to the inability of insulin to keep check on blood sugar (Raghavan et al., 2019). These article compares two research articles published by a scholarly journal on diabetes. One of the articles chosen for comparison is Deaths Attributable to Diabetes in the United States: Comparison of Data Sources and Estimation Approaches by Stokes and Preston, (2017). The second journal article chosen on diabetes is Diabetes Mellitus–Related All?Cause and Cardiovascular Mortality in a National Cohort of Adults by Raghavan et al., (2019).

1.Summary of the topic you chose with rationale

            I chose the topic diabetes because it is one of most prevalent and fast-rising disease in my community, country and the world by extension. Secondly, diabetes is rated as one of the top-5 killer diseases in America which means it requires urgent attention. Medically, diabetes is the inability of the body to regulate the body’s blood sugar resulting into complications (Noubiap et al., 2019). Some of the medical conditions and mental disorders that may be experienced due to diabetes include; stroke, heart disease, depression, anxiety, obesity, high blood pressure, frustration, bodily pain especially at the joints among other related problems.  It can either be acute, which means short in nature or it can be chronic which means on-going and long. Type 1 diabetes is the most common type of diabetes that affects millions of people worldwide. It is usually short in nature and lasts between a few days and or weeks. It is usually caused by a number of factors such as unhealthy life styles and other health risks such as bad eating habit. On the other hand, chronic diabetes may go for many months or even longer.

Consequences of Diabetes

Productivity

One of the negative consequences of diabetes which goes to affect quality of life is reduced productivity. Lack of sleep at night leaves one weak, stressed and frustrated which affects both the quality and quantity in terms of production. Many aspects of modern life are measured on one’s productivity. School, work and jobs are all measured on quality and quantity of production. People experiencing diabetes are not able to be as productive as required by the virtue of the fact that they are not well (Cowie et al., 2018) This reduction in their productivity will affect the quality of lives they live because, high production is associated with much returns and vice versa.

Increased Chances of Accidents

As seen in the results/findings of the two studies, diabetes greatly weakens people’s reflexes which lead to individuals being slow or reacting slower than usual.  Slow reflexes increase an individual’s vulnerability to accidents. For example, many drivers with diabetes may cause an accident mainly because they failed to respond to an emergency situation on the road because they did not respond fast enough. A good example is when a driver in front brakes suddenly, the driver behind will need to react to this situation by hitting the brakes hard to avoid a collision. Those with diabetes may not be in a position to react fast enough in such situations.

Worsening Medical Conditions

The many researchers on the relation between diabetes and medical conditions attest to the fact that diabetes can worsen existing medical conditions and, in some cases, though rare may lead to a medical condition. People with diabetes, heart diseases, and other chronic illnesses may see their conditions worsening because of the inability to get adequate sleep. Many doctors nowadays advice their patients on the importance of having as much sleep at night as possible because their recovery squarely lies on having enough sleep, medication and other factors.

2. Description of the Major Functions Provided by Research and Data Monitoring of Health Care Delivery in the United States

A critical function performed by the two articles is two evaluate the vulnerable demographics in society for diabetes. In the article by Raghavan and colleagues, the study focuses trend of mortality in diabetes and related causes of mortality such as cardiovascular among adults. This study is critical because it brings critical information on diabetes and its relation with other chronic ailments such as heart disease and its impact on adults. This study links diabetes with cardiovascular disease. Through the cohort study group, this research shows critical link between diabetes and other conditions that people having diabetes are likely to suffer from.

Conversely, the study by Stokes and Preston is critical because it studies the prevalence of diabetes since 1980-2104. The data contained in this research is critical in evaluating the trends of diabetes from the 1980s till present. For example, this study reveals that the prevalence rate of diabetes in America has jumped from 4.3% to 9.0% in men from 1980 and 2014 (Stokes, & Preston, 2019). The research also shows that the prevalence of the disease for women for the same period jumped from 5.0 to 7.9% for the same period. These statistics are critical for governments because they can use it to monitor and manage the disease.

3. Potential Environments Within Health Care Delivery Appropriate To Research And Data Monitoring.

In healthcare industry, the importance of research and data monitoring cannot be overemphasized. Research deals with creating/finding out new information about diseases/health trends. Data deals with collection of data, access, and retrieval of data. Research plays a pivotal role in the discovery of new treatments while finding answers to the things are not known. Secondly research fill gaps in available knowledge and change the way professionals in the healthcare industry operate (Harding et al., 2019). Concerning data monitoring, the two articles, like other credible research studies improve the quality of patient care by providing critical information concerning specific conditions-for this case diabetes. In the healthcare industry, data benefits the world because they it plays critical multiple roles such as revealing trends diseases and treatments, health surveillance, monitoring disease outbreaks.

4. Assessment of The Role the Allied Health Professional Does, Or Could, Play, In Research and Data Monitoring of Health Care Delivery in The United States.

Allied health professionals provide critical services that enhances and maintains the quality of care they provide to their patients within the settings of their practice. Allied healthcare professionals such as Athletic Training, mmusculoskeletal, injury geriatric, assessment physiotherapist, and Health Care Provider are some of the groups that benefit from research and data monitoring. The first critical importance of the two articles to allied healthcare workers is that they can use the result of the studies to improve patient care and outcomes. These professionals use critical information contained in research studies to create effective treatment plans and solutions based on the findings of critical research studies.

References

• Animaw, W., & Seyoum, Y. (2017). Increasing prevalence of diabetes mellitus in a developing country and its related factors. PloS one, 12(11), e0187670.
• Cowie, C. C., Casagrande, S. S., Menke, A., Cissell, M. A., Eberhardt, M. S., Meigs, J. B., … & Fradkin, J. E. (2018). Diabetes in America.
• Harding, J. L., Pavkov, M. E., Magliano, D. J., Shaw, J. E., & Gregg, E. W. (2019). Global trends in diabetes complications: a review of current evidence. Diabetologia, 62(1), 3-16.
• Noubiap, J. J., Nansseu, J. R., Nyaga, U. F., Nkeck, J. R., Endomba, F. T., Kaze, A. D., … & Bigna, J. J. (2019). Global prevalence of diabetes in active tuberculosis: a systematic review and meta-analysis of data from 2· 3 million patients with tuberculosis. The Lancet Global Health, 7(4), e448-e460.
• Raghavan, S., Vassy, J. L., Ho, Y. L., Song, R. J., Gagnon, D. R., Cho, K., … & Phillips, L. S. (2019). Diabetes mellitus–related all?cause and cardiovascular mortality in a national cohort of adults. Journal of the American Heart Association, 8(4), e011295
• Stokes, A., & Preston, S. H. (2017). Deaths attributable to diabetes in the United States: comparison of data sources and estimation approaches. PloS one, 12(1), e0170219

Comprehensive Adult Health History and Physical Examination Sample

PATIENT INFORMATION

Name: Mr. V.O

Date of Birth: 5/5/1965

Age: 46

Ethnicity: African American (Nigerian)

Gender: Male

Source: Patient

Date of Assessment: 4/1/2021

Occupation: Photographer

Allergies: Allergic to pollens and house dust mites. The allergens make him have a runny nose and watery eyes

Current Medications:

1. Metoprolol ER Succinate 50mg tablet, Dosage 1 tablet=50mg, , Route-PO, frequency-Daily
2. Losartan/HCTZ 100/12.5mg, Dosage- 1 tablet-100/12.5mg, Route -PO, frequency-Daily
3. Aspirin 81mg chewable tablets, Dosage- 1 tablet=81mg, Route-PO, frequency-Daily
4. Metformin 500mg tablets, Dosage- 1 tablet=500mg, Frequency-Daily, Route-PO
5. Vitamin D3 5,000 IU tablet, Dosage5000 IU – 1 Tablet, route – PO, Frequency- Daily

PMH:

Childhood Illnesses: Presbyopia diagnosed at 10 years of age.

Allergic rhinitis since childhood

Adult Illnesses: Diabetes diagnosed in 2012

-Hypertension diagnosed in 2012

-There is a history of past hospitalization due to hyperosmolar non-ketotic coma. No previous blood transfusion. No history of TB or HIV. No previous history of surgical procedures.

Immunizations: All up to date. Last tetanus vaccine given on 10th 7/2020

Personal/social History: Studied photography for 2-years at a college level (Associate in Arts degree), He smokes and he is a social drinker.

Family History: His grandpa is John Onuchukwu, who succumbed to Cholera at the age of 96yrs (1871-1967). The grandmother, Elizabeth onuchukwu, died at 91(1886-1977). The cause of death was not determined as she died in sleep. His dad, Benjamin Onuchukwu, died at age 79 (1930-2009) of prostate cancer while the mother, Theresa Onuchukwu died at age 84(1936-2020) of corona virus. He has four other siblings: Josephat Onuchukwu born in 1957, 64 years old today, alive and suffering from presbyopia; Uche Onuchukwu born in1978, 43yrs old today suffers from ulcer; Mark onuchukwu born in 1973, 48yrs old today and has high blood pressure and Chimezie Onuchukwu (1976), 45 years old, suffers from high blood pressure.

He has 2-children 1. Oluebube Onuchukwu born in 2007, aged 14 today, suffers from presbyopia 2. David Onuchukwu born in 2011, aged 10 today, suffers from presbyopia

Nutritional History: three major meals per day with frequent snacks in between.

Subjective Data:

Chief Complaint: I can’t read very well even with my eye- glasses

Symptom analysis/HPI:

The client is a known presbyopic patient. He has been using eye glasses since childhood but for the past three months, complaints of inability to read with or without the glasses. He reports that he cannot read clearly prints that are at a close distance to him; he has to move the reading materials away from the eyes. Further, he has a problem reading smaller prints; he therefore uses larger fonts for his phone. He requires a bright light to read and is unable to see in a dim room. Sometimes he strains a lot until the eyes aches. He reports frequent headaches. He also reports squinting quite often. As a photographer, his eyes are the most important organs; therefore, the condition has adversely affected his job and a cause of his current financial strains since he is the breadwinner.

He also reports associated dyspnea only on exertion. He had one episode of chest pain in the past three months. He reports he has had problems achieving a weight loss since childhood. Due to his job, he travels quite often and eats a lot of junk food at different restaurants. He also reports to eat three meals per day with snacks and sweetened drinks in between the main meals. Moreover, he could occasionally miss medications while he travelled. He is a known diabetic and hypertensive patient since 2012.

Review of Systems (ROS)

CONSTITUTIONAL: Denies fever, fatigue. Reports added weight.

NEUROLOGIC: Reports headaches. Denies loss of consciousness

HEENT: Head: Denies head injury. Eyes: Reports blurred vision and pain. He uses glasses. He reports watery eyes on exposure to pollen and house dust mites. Ears: Denies pain, discharge, loss of hearing, tinnitus, and vertigo. No previous ear infections. Nose: reports runny nose on exposure to pollen and house dust mites. He denies congestion, stuffiness, itching, bleeds or sinus tenderness. Throat: Denies sore throat, voice changes and halitosis.

RESPIRATORY: Reports exertional dyspnea. He denies cough, sputum production and hemoptysis.

CARDIOVASCULAR: He is hypertensive. He denies palpitations, orthopnea, limb edema, paroxysmal nocturnal dyspnea.

GASTROINTESTINAL: Denies nausea and vomiting. Denies abdominal pain, diarrhea, constipation, flatulence and any bowel changes

GENITOURINARY: Denies urgency, frequency, nocturia, dysuria, burning sensation, flank pains and hematuria. Denies previous or current urinary tract infections

MUSCULOSKELETAL: Denies joint pain or stiffness.

SKIN: Denies rushes, hypo/hyper pigmentations, pruritus or skin infections.

Objective Data:

General appearance: An African American male adult in a fair general condition. He walks into the examination room in a normal gait. He is obviously obese. He is relaxed, calm and well composed. He is well kempt and groomed with nicely coiffed hair and with a nice fragrance. He is friendly, and overfamiliar with the environment. He is in a conscious mind. He has a clear and a coherent speech.

He is not in an obvious respiratory distress. He is not pale or jaundiced. No edema, cyanosis, lymphadenopathies. He is well hydrated

Measurement:

Weight=230lbs; Height- 5 feet 4 inches; BMI-39.5 kg/m2;

Vital signs: BP-125/83 mmHg; HR-83 beats/minute; RR- breaths/minute; SPO2-98%; Pain score-0

Skin: He has a dark complexion and black hair. The skin is moist and warm. The skin has a smooth and with normal turgidity. The fingernails are pink in color, oval shaped, and have no pathologic lesions. The toe nails are pink in color, round shaped without pathologic lesions. No primary or secondary skin lesions.

Head & Face: The head is normocephalic with no lacerations, deformities or asymmetry. The hair dark and well distributed throughout the scalp. The scalp is dry with no lesions, infective or inflammatory.

The face is oval shaped. Facial movements are symmetric. No drooping of eyelids, no involuntary facial movements.

Right eye: Present. Primary position, looking straight ahead and the visual axis is parallel to the head’s sagittal plane. Allergic shiners present. Visual acuity is less than 6/12. The eye lids’ opening is symmetrical. There are no lumps, scales, discharge, pus or mucus around the eyelids margins. The conjunctiva is white. The cornea is clear, and has a lustrous surface. The iris is flat and brownish in color with a centrally located pupil. The pupil is round, 3mm in diameter in a bright lit room and constrict to direct light (illumination). The lens is transparent with increased curvature. Extra ocular muscles are intact. On ophthalmoscopy, red reflexes are normal, there is mild macular edema with dot and blot hemorrhage.

Left eye: Present. Primary position, looking straight ahead and the visual axis is parallel to the head’s sagittal plane. Allergic shiners present. Visual acuity is 6/12. The eye lids’ opening is symmetrical. There are no lumps, scales, discharge, pus or mucus around the eyelids margins. The conjunctiva is white. The cornea is clear, and has a lustrous surface. The iris is flat and brownish in color with a centrally located pupil. The pupil is round, 3mm in diameter in a bright lit room and constrict to direct light (illumination). The lens is transparent with increased curvature. Extra ocular muscles are intact. On ophthalmoscopy, red reflexes are normal. Macular edema is not as marked as on the right side. Dot and blot hemorrhage present.

Ear: Both ears are present on either sides of the face. The auricles are symmetric. On otoscopy, the external auditory meatus are clear without wax impaction. The tympanic membrane are translucent and pale gray in color with a cone of light at the 5 o’clock position.

Tuning fork tests:

-Weber’s test is central

Rhine’s test-air conduction is greater than bone conduction. Normal results

Nose: Normal external nasal anatomy with bilateral symmetrical nares. A transverse nasal crease is present. Using a speculum, the mucosa is moist and pink in color. Normal septum; no deviation, perforations, tumors or ulcers. Turbinates are boggy and pale blue in color. Maxillary sinuses are non-tender

Mouth & Throat: the lips are symmetrical and pink in color. Oral mucosa is moist and pink in color; no ulcerations, erythema or other lesions. The gums are pink in color, no bleeds, not swollen, no odor, no ulcerations. 32-teeth, whitish in color; 2 maxillary incisors are yellow; no dentures or prosthesis. Tongue is pink, central, rough dorsal surface, no ulcers, hairs or furrows, smooth ventral surface, comfortably fits the oral cavity. Palate is pink with a ridged hard palate. Pharynx: Tonsils are present, no enlargement, or exudates. Uvula present and upwardly movable.

Neck: No cervical lymphadenopathies. Trachea centrally located. No palpable central neck mass

Back: Inspection: No deformity, no skin lesions, no surgical scars, no masses. Palpation: No tenderness over the spine and muscles. Shoulder symmetrical

Posterior Thorax & Lungs: inspection: No masses, moves with respiration. Palpation: bilateral symmetrical, normal tactile fremitus, no tenderness or masses. Percussion: Normal resonance. Auscultation: Bilateral equal air entry, bilateral vesicular breath sounds heard. vocal fremitus normal

Breasts, Axillae, and Epitrochlear Nodes: Being male, no significant findings. Absent axilla and epitrocheal nodes

Upper Extremities: Hands: no color discoloration, no masses/swelling, no deformity, warm temperature, no tenderness, wrist, metacarpo-phalangeal and inter-phalangeal joints exhibit full range of motions. Arm: No color discoloration, no masses, no deformity, warm temperature, elbow joint full flexion and extension. Shoulder joints symmetrical, shoulder joint full range of motions. Full neck flexion, extension, rotation and cervical side-bending. Bulk, tone, reflexes are normal. Muscle power of 5/5 in both upper limbs. Radial and brachial pulse present, symmetrical, regular, and of good volume.

Anterior Thorax: Inspection: symmetrical, moves with respiration, no skin lesions, no masses. Palpation: No masses, no tenderness, bilateral equal chest expansion, tactile fremitus normal. Percussion: Normal resonance. Auscultation: Bilateral equal air entry, bilateral vesicular breath sounds heard. Vocal fremitus normal

Cardiovascular: Normal jugular venous pressure. Carotid pulse is present, regular, strong, good volume, no bruits. The precordium is normal and not hyperactive. Point of maximum impulse is at 5th intercostal space, an in mid-clavicular line. S1 and S2 are heard, no thrills, murmurs or any other added sounds.

Abdomen: Inspection: Marked abdominal distension with central obesity. No dilated veins, no surgical scars, no therapeutic marks, moves with respiration. On light palpation, no tenderness is elicited, no masses, no organomegally. On deep palpation, no tenderness elicited, no masses, no organomegally. No tenderness over the costovertebral angles. Liver and spleen not enlarged. Percussion: Tympanic. Auscultation: Bowel sounds heard

Lowe Extremities: femoral, popliteal, dorsalis pedis and posterior tibial pulses are present, regular, strong and of good volume bilaterally. No palpable inguinal lymphadenopathy. No discoloration or ulcerations of the lower extremities. No lower limb edema. Hip joint, knee joint, ankle joint, metatarsophalangeal and inter-phalangeal joints are flexible, and exhibit full range of motions specific for the particular joint. There is normal muscle bulk, tone and reflexes. Muscle power 5/5 bilateral lower limbs. No varicose veins. The right and left legs are neutrally aligned (no varus or valgus deformities). External genitalia is normal, no hernia findings. Negative Romberg’s test

Nervous System: GGCS-15/15. Patient is oriented in time, person and place. CN I, II, III, IV, VI are intact. CN VI, VIII, IX, X are normal. There is normal sensation to pain, light touch and vibration. Normal muscle bulk, tone, and reflexes. Muscle power 5/5 in both limbs.

Active Problems

1. Diabetes-the patient was diagnosed of diabetes in 2012. He is obese, a risk factor for diabetes (ADA, 2019). Further, the patient is an active smoker and an occasional drinker. Smoking and alcohol are modifiable risk factor for diabetes mellitus (ADA, 2019). Moreover, the patient is an African American, an ethnic community with higher risks for diabetes mellitus (Sapra & Bhandari, 2020). Diabetes mellitus causes chronic micro vascular complications such as retinopathy. Patients with retinopathy presents with blurred vision and a progressive and an insidious visual acuity loss (Shukla & Tripathy, 2021). Therefore, diabetic retinopathy is a differential diagnosis in the case described. The findings in the patient including a low visual acuity, macular edema and dot and blot hemorrhages could underpin the diagnosis.
2. Hypertension-the patient has been hypertensive since 2012. Long durations of hypertension predispose an individual to complications such as retinopathies and cardiovascular events. The patient reports a one episode of chest pain in the past three months. Prescription of Aspirin, as evidenced in the medication list is an intervention to prevent the cardiovascular events such as myocardial infarction or coronary artery disease (Zanchetti, 2017). Retinal complications include hypertensive retinopathy, a possible differential diagnosis in the patient.
3. Allergic rhinitis: on exposure to allergens, the condition is characterized by watery eyes, itchy nose, sneezing and nasal obstruction (Akhouri & House, 2021). The patient is allergic to pollen and house dust mites which are perennial allergens. She reports to have runny nose and watery eyes on exposure to the allergens. The diagnosis is underpinned by the physical examination findings which reveal a boggy and pale blue turbinates. Further, the patient has allergic shiners and a transverse nasal crease which are ocular and nasal signs respectively of allergic rhinitis (Akhouri & House, 2021).
4. Presbyopia: Age related condition characterized by a loss in the flexibility of the lens. In children, it occurs as farsightedness. Characteristic features include inability to read prints closer to the eye, moving reading materials far away from the eyes, straining, headaches, and squinting (Singh & Tripathy, 2020). Visual acuity is decreased on physical examination. The patient present with the typical features; however, his case could be superimposed with diabetic and hypertensive retinopathy.

Risk Profile

1. Obesity
2. Physical inactivity

References

• Akhouri, S., & House, S. A. (2021). Allergic Rhinitis. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK538186/
• Sapra, A., & Bhandari, P. (2020). Diabetes Mellitus. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK551501/
• Shukla, U. V., & Tripathy, K. (2021). Diabetic Retinopathy. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK560805/
• Singh, P., & Tripathy, K. (2021). Presbyopia. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK560568/#_NBK560568_pubdet
• Zanchetti, A. (2017). Predisposing factors, accompanying diseases and complications of hypertension. Journal of Hypertension, 35(4), 655–656. https://doi.org/10.1097/HJH.0000000000001306

Died: 96yrs

From cholera

Died: 91yrs

Died while sleeping

Cause: Unknown

Died: 90

Cardiac arrest

Died: 86

Stroke

Died: 79

Prostate Cancer

Died: 84

COVID-19

Age: 46yrs

DM; HTN; Obesity; Allergic rhinitis; Presbyopia

Presbyopia

HTN

Brother: Uche

Gastric Ulcers

Finding: No supraclavicular lymphadenopathy

Pro Tip: Palpating the lymph nodes helps to identify characteristics relaying information about inflammation