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ELM 570 Grand Canyon Clinical Field Experience B Science and Health Pre Assessme ...

ELM 570 Grand Canyon Clinical Field Experience B Science and Health Pre Assessment

hi, make sure help me out fix for my english and grammar too.. make sure apply for Deaf culture and environment in classroom and visual too ELM 570 Grand Canyon Clinical Field Experience B Science and Health Pre Assessment. can see step to step and myself do my project and show the pictures and with the words make sure match make they are to understand and learning the words and it is instruction list too.

ELM 570 Grand Canyon Clinical Field Experience B Science and Health Pre Assessment

ELM 570 Grand Canyon Clinical Field Experience B Science and Health Pre Assessment 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 on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized ELM 570 Grand Canyon Clinical Field Experience B Science and Health Pre Assessment.

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.

Science Unit Plan: Differentiation and Accommodation

The third step in planning a unit plan is to prepare how you will differentiate and accommodate instruction for your students to meet their specific learning needs.

Differentiation and accommodations are some of the most important components when preparing a unit plan, because it guides the teacher in meeting the diverse needs of all students during instruction. The planning process will help the teacher determine when to differentiate and make accommodations. It is critical for teachers to observe or review academic data in order to appropriately differentiate for their students.

Part 1: Differentiation – Unit Plan

For this assignment, you will complete the Differentiation and Accommodation portion for the “Science Unit Plan” to prepare for students that are below, average, and advanced in academic ability.

Use the “Class Profile” as you are determining differentiation strategies and appropriate accommodations:

Differentiation strategies and learning opportunities that effectively address student’ learning needs identified in the “Class Profile.”
Resources and instructional adaptations to support specific differentiation needs, including testing accommodations required to meet students’ needs.

The details of the “Science Unit Plan” will continue to be fully developed and revised throughout the duration of the course, culminating in a complete unit plan due in Topic 5.

Part 2: Reflection

In 250-500 words, summarize and reflect on the process of planning for differentiation strategies in order to meet the diverse needs of students in the science content area. What issues might arise that would need additional emphasis in the event differentiation was not effective? What resources or support staff could you utilize to meet specific differentiation needs?

Support your reflection with at least two scholarly resources.

Submit the “Science Unit Plan” and reflection as one deliverable.

While APA format is not required for this assignment, solid academic writing is expected, in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

Class Profile

Student Name

English Language Learner

Socio-economic

Status

Ethnicity

Gender

IEP/504

Other

Age

Reading

Performance Level

Math Performance

Level

Parental

Involvement

Internet Available

at Home

Arturo

Yes

Low SES

Hispanic

Male

Tier 2 RTI for Reading

Grade level

One year below grade level

At grade level

Med

Bertie

Low SES

Asian

Female

None

Grade level

One year above grade level

At grade level

Low

Yes

Beryl

Mid SES

White

Female

NOTE: School does not have gifted program

Grade level

Two years above grade level

At grade level

Med

Yes

Brandie

Low SES

White

Female

Tier 2 RTI for Math

Grade level

At grade level

One year below grade level

Low

Dessie

Mid SES

White

Female

Tier 2 RTI for Math

Grade level

One year below grade level

Med

Yes

Diana

Yes

Low SES

White

Female

Tier 2 RTI for Reading

Grade level

One year below grade level

At grade level

Low

Donnie

Mid SES

African American

Female

Hearing Aids

Grade level

At grade level

Med

Yes

Eduardo

Yes

Low SES

Hispanic

Male

Tier 2 RTI for Reading

Grade level

One year below grade level

At grade level

Low

Emma

Mid SES

White

Female

None

Grade level

At grade level

Low

Yes

Enrique

Low SES

Hispanic

Male

Tier 2 RTI for Reading

One year above grade level

One year below grade level

At grade level

Low

Fatma

Yes

Low SES

White

Female

Tier 2 RTI for Reading

Grade level

One year below grade level

One year above grade level

Low

Yes

Frances

Mid SES

White

Female

Diabetic

Grade level

At grade level

Med

Yes

Francesca

Low SES

White

Female

None

Grade level

At grade level

High

Fredrick

Low SES

White

Male

Learning Disabled

Tier 3 RTI for Reading and Math

One year above grade level

Two years below grade level

Very High

Ines

Low SES

Hispanic

Female

Learning Disabled

Tier 2 RTI for Math

Grade level

One year below grade level

Low

Jade

Mid SES

African American

Female

None

Grade level

At grade level

One year above grade level

High

Yes

Kent

High SES

White

Male

Emotion-ally Disabled

None

Grade level

At grade level

One year above grade level

Med

Yes

Lolita

Mid SES

Native American/

Pacific Islander

Female

None

Grade level

At grade level

Med

Yes

Maria

Mid SES

Hispanic

Female

NOTE: School does not have gifted program

Grade level

At grade level

Two years above grade level

Low

Yes

Mason

Low SES

White

Male

None

Grade level

At grade level

Med

Yes

Nick

Low SES

White

Male

None

Grade level

One year above grade level

At grade level

Med

Noah

Low SES

White

Male

None

Grade level

At grade level

Med

Yes

Sharlene

Mid SES

White

Female

None

Grade level

One year above grade level

At grade level

Med

Sophia

Mid SES

White

Female

None

Grade level

At grade level

Med

Yes

Stuart

Mid SES

White

Male

Allergic to peanuts

Grade level

One year above grade level

At grade level

Med

Yes

Terrence

Mid SES

White

Male

None

Grade level

At grade level

Med

Yes

Wade

Mid SES

White

Male

None

Grade level

At grade level

One year above grade level

Med

Yes

Wayne

High SES

White

Male

Learning Disabled

Tier 3 RTI for Math

Grade level

One year below grade level

Two years below grade level

High

Yes

Wendell

Mid SES

African American

Male

Learning Disabled

Tier 3 RTI for Math

Grade level

One year below grade level

Two years below grade level

Med

Yes

Yung

Mid SES

Asian

Male

NOTE: School does not have gifted program

One year below grade level

Two years above grade level

Low

Yes

Emergency Response and Planning Tornado Sentinel City Sample PaperIntroductionWh ...

Emergency Response and Planning Tornado Sentinel City Sample Paper

Introduction

When an emergency such as an earthquake, tornadoes, and terrorist activities occur, many people fall victim. Some die while others are injured. Those injured require urgent care to save their lives. The local government and healthcare systems must have elaborate emergency response reams to ensure such emergencies are well catered for. According to Rafferty-Semon et al. (2017), disasters are on the rise and pose a significant threat to public health. Disaster management is a process involving activities before, during, and after emergencies. This paper reviews the effects of a tornado in sentinel city, Acer Tech, and Casper Park districts, emergency response teams, and the effects of using social media during emergencies.

Potential Effects of a Tornado

A Tornado in Sentinel City would lead to injuries and also death. Injuries would result from people being hit by large objects like bricks, trees, and glass. Severe injuries could also lead to death. Tornadoes would also cause infrastructure damage that is, houses, barns, vehicles, and businesses would be ruined. Other damages to infrastructure would include destroyed powerlines, falling trees, and possible fires. Animals would die in the process, a fire caused by lightning and destroyed power lines, uprooted trees, and destroyed food crops. A tornado can lead to significant damages and potential loss of human and animal life.

Emergency Management Teams

Fire and Rescue Services.

This team would be integral in putting out arising fires and prevent fires in the respective districts. The team could help victims of fires in first aid before getting them to hospitals. They also aid in extracting property and human life trapped in fires. Fire and rescue teams are engaged in building fires, forest fires

Police officers/ Law enforcement.

Police officers are often the first emergency response team members. They are quite many in Sentinel City. They can help people to safety, prevent further damage by citizens who take advantage of the tornado to steal and destroy. Trained police officers can also offer first aid to victims

Emergency medical teams/ paramedics

Paramedics are medical personnel who have been trained in providing emergency services. They triage patients, provide first aid and more specialized care, and appropriately refer patients requiring more specialized care such as respiratory support (Veenema et al., 2017). Paramedics come in handy during natural disasters, road accidents, terrorist attacks, and floods (Erickson, 2019). Their primary function is to save human life and alleviate further surffering.

Federal Emergency Management Agency

When disasters occur, the Federal Emergency Management Agency responds. The agency is responsible for planning evacuation, mitigation, and managing disaster effects (Erickson, 2019). The agency is also responsible for disaster preparedness. The agency harmonizes all other teams and ensures every team has enough equipment and performs its duties (Erickson, 2019).

Private and Public Resources

Large hospitals have specialized emergency stores to store equipment vital in emergency care involving many victims (Veenema., 2017). These items are retrieved and stores replenished in the recovery phase of the natural disaster. Emergency Alert Systems are integral in informing the public. Trained personnel are also integral in emergency responses (Erickson, 2019). Private resources include private hospitals, which can relieve some burden of the emergency victims from the public hospitals. Private ambulance services can be vital in responding to natural disasters.

Quick Public Responses Shared on Social Media

Sharing information on social media enhances public awareness. People who live in the areas can respond to the posts and flee to safety. Emergency teams can also get information on social media and respond. Members of the public can see the post and also offer help to the victims. Social media posts can be misleading if not correctly done. They can also cause panic. The information can be used to extort money from the public unlawfully. The information can also be collected by unscrupulous characters who can take advantage of the situation to cause more damage to the area.

Conclusion

Emergency management requires planning before, during, and after the emergency. Emergency Management Teams focus on the three areas. They all work in harmony to ensure mitigation of the emergency and recuperation from its effects. The Federal Emergency Management Agency responds to emergencies and harmonies personnel and equipment. It also establishes and pioneers disaster preparedness. Social media platforms can provide a good ground for posting quick public responses but not without risks. Any city should have well-laid out disaster preparedness plans.

References

Erickson, S. (2019). The Federal Emergency Management Agency: A New Era of Weather Disaster Management. Retrieved 19th August 2021 from https://shareok.org/handle/11244/320367
Rafferty-Semon, P., Jarzembak, J., & Shanholtzer, J. (2017). Simulating complex community disaster preparedness: Collaboration for point of distribution. OJIN: The Online Journal of Issues in Nursing, 22(1), 1-10. DOI: 10.3912/OJIN.Vol22No01Man03
Veenema, T. G., Deruggiero, K., Losinski, S., & Barnett, D. (2017). Hospital administration and nursing leadership in disasters. Nursing Administration Quarterly, 41(2), 151-163. https://doi.org/10.1097/NAQ.0000000000000224

Emergency Response Planning Assignment 6Emergency Response Planning Assignment 6 ...

Emergency Response Planning Assignment 6

Emergency Response Planning Assignment 6

Emergency response planning is the organization, coordination, and direction of available resources to respond to an event or bring an emergency under control.

Select one of the scenarios below and complete the activity.

Earthquake Emergency Response

The healthcare team has just been notified that an earthquake in the Sentinel Mountains has destroyed buildings in the Industrial Heights and Casper Park residential area of Sentinel City®.

Visit the Industrial Heights and Casper Park residential areas of Sentinel City® and consider the impact zone of an earthquake. Observe the city’s services, routes, and population due to the quake.

Create a report that describes the potential public health effects, infrastructure damage, and environmental hazards related to the earthquake. Describe the members and roles of the emergency management team and organizations (public and private) that would be activated in Sentinel City®.

Who are the members of the emergency response team that will be deployed? What private and public resources will assist with the response in the short and long term?
What are the risks and benefits of the quick public responses that will be shared on social media?

Tornado Emergency Response

The healthcare team has just been notified that a tornado ripped through Casper Park and Acer Tech Center in Sentinel City®.

Visit the Casper Park and Acer Tech Center areas of Sentinel City® and consider the impact zone of the tornado. Observe the city’s services, routes, and population due to the tornado.
Create a report that describes the potential public health effects, infrastructure damage, and environmental hazards related to the tornado.

Describe the members and roles of the emergency management team and organizations (public and private) that would be activated in Sentinel City®.

Civic Disturbance Emergency Response

The healthcare team has just been notified of a civic disturbance at City Hall with injuries in Sentinel City®.

Visit the area, City Hall. Observe the services, routes, and populations involved with the city due to the civic disturbance.

Create a report that describes the potential public health effects and environmental hazards related to civic disturbance. Describe the members and roles of the emergency management team and organizations (public and private) that would be activated in Sentinel City®.

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NUR 514 Emerging Technology Brief Sample DiscussionEmerging Technologies for Qua ...

NUR 514 Emerging Technology Brief Sample Discussion

Emerging Technologies for Quality Patient Care Outcomes

The use of telehealth has brought various potentials for the expansion and inclusion of patients in their care. Remote monitoring of patients has become easier with the use of technology. However, the associated costs of installation and risks of ethical violations have resulted in significant reluctance in the use of these technologies within healthcare organizations. For instance, the application of patient portals continues to face pertinent challenges relating to usability and accessibility, yet its importance in patient data management and care delivery remain paramount. Therefore, the use of smartphone- and tablet-installed applications to overcome these barriers promises to revolutionize healthcare access and delivery.

Overview of the Technology

Mobile health, also known as mHealth, is a new technology in health care where patient-initiated care promotes patient-centered services through the use of mobile phone applications. Regarding mobile phone use, ownership of smartphones in the US is more than ninety-five percent (Catalyst, 2018). Consequently, the application of mobile health is feasible in promoting remote care such as remote health monitoring, follow-up, medical consultation, and research (Rowland et al., 2020). Mobile software applications for android, iOS, and Microsoft Windows can be generated, downloaded, and used by patients seeking care in different healthcare organizations.

The Purpose and How it Would Function in a Healthcare Setting

Mobile technologies have been introduced in various healthcare facilities in different forms with specific objectives. The purpose mHealth technology is simply to reduce the cost of access to healthcare services y encouraging remote access. The technology reduces the costs associated with traveling to the health facility and the time required to access health services, among other expenses. The technology would promote patient satisfaction primarily by minimizing access time and cost of healthcare (Dugas et al., 2020).

Further, the technology is particularly useful for patients with chronic medical conditions and pregnant women. Monitoring and charting of pregnancies from conception to delivery would best be done over electronic means, thereby enabling easy tracking for anthropometric measures of pregnancy progress. Chronic conditions such as diabetes mellitus, hypertension, asthma, and epilepsy can be monitored remotely via mobile applications (Marcolino et al., 2018), thereby ensuring better patient outcomes. Such easy, remote patient monitoring and relay of reminders, as well as the tracking of health improvements can significantly improve medication adherence and reduce readmission rates.

Ethical or Legal Issues that Would Accompany the Incorporation of the Technology

Mobile phones are susceptible to theft and access by a third party. The association of mobile phones with breach of privacy and confidentiality makes this new technology susceptible to the ethical and legal breach of privacy and patient confidentiality (Marcolino et al., 2018). Further, verifying the patient identity during follow-up would be a challenge with this new technology. Even though this could be minimized by biometric identification, technical failure may occur (Marcolino et al., 2018). In other situations, the patient may share their private information with others with good intentions, yet such a third party may use this information for malicious purposes.

Conclusion

The use of mHealth in caring for patients with chronic medical conditions and monitoring pregnancy has more benefits in reducing cost and access to healthcare. This technology has a huge potential in overcoming barriers to healthcare access. However, there are pertinent challenges associated with breach of patient privacy and confidentiality, aspects that warrant further caution in its adoption and extensive use.

References

Catalyst, N. (2018). What Is Telehealth? Innovations in Care Delivery, 4(1). https://doi.org/10.1056/CAT.18.0268
Dugas, M., Gao, G. G., & Agarwal, R. (2020). Unpacking mHealth interventions: A systematic review of behavior change techniques used in randomized controlled trials assessing mHealth effectiveness. Digital Health, 6, 2055207620905411. https://doi.org/10.1177/2055207620905411
Marcolino, M. S., Oliveira, J. A. Q., D’Agostino, M., Ribeiro, A. L., Alkmim, M. B. M., & Novillo-Ortiz, D. (2018). The impact of mHealth interventions: Systematic review of systematic reviews. JMIR MHealth and UHealth, 6(1), e23. https://doi.org/10.2196/mhealth.8873
Rowland, S. P., Fitzgerald, J. E., Holme, T., Powell, J., & McGregor, A. (2020). What is the clinical value of mHealth for patients? npj Digital Medicine, 3(4). https://doi.org/10.1038/s41746-019-0206-x

NUR 514 Topic 6 Assignment – Emerging Technology Brief Instructions

New health care innovations offer the advanced registered nurse an opportunity to apply emerging technologies in practice to improve quality and patient outcomes. For this assignment, research an emerging health care technology that you think has the potential to overcome current or emerging barriers to care.

Write a 500-750 word brief. Include the following:

Provide an overview of the emerging technology and its role/function in health care. Consider its potential for improving access to care and promoting patient safety and quality.
Describe ethical or legal issues that would accompany the incorporation of the technology.
Explain the nurse’s informatics role in regard to the technology. Provide examples of the roles and job functions.
Outline the role of workflow analysis, human factors, and user-centered design concepts for your chosen technology example.

Refer to the topic Resources for samples and resources to help you construct your brief.

You are required to cite three to five sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Complete the “APA Writing Checklist” to ensure that your paper adheres to APA style and formatting criteria and general guidelines for academic writing. Include the completed checklist as an appendix at the end of your paper.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

NUR 514 Emerging Technology Brief Sample Discussion Rubric Criteria

Collapse All Rubric CriteriaCollapse All

Overview of Emerging Technology

18.75 points

Criteria Description

Overview of Emerging Technology

5. 5: Excellent

18.75 points

The emerging technology and its role and function in health care are clearly discussed. Potential for improving access to care and promoting safety and quality is detailed. The narrative is well supported.

4. 4: Good

17.25 points

The emerging technology and its role and function in health care are discussed. Potential for improving access to care and promoting safety and quality is included in the narrative.

3. 3: Satisfactory

16.5 points

An overview of the emerging technology is presented. Its role and function in health care are summarized. Potential for improving access to care and promoting safety and quality is outlined.

2. 2: Less Than Satisfactory

15 points

An overview of the emerging technology is only partially discussed.

1. 1: Unsatisfactory

0 points

An overview of the emerging technology is omitted.

Ethical or Legal Issues

18.75 points

Criteria Description

Ethical or Legal Issues

5. 5: Excellent

18.75 points

Ethical or legal issues that would accompany the incorporation of the technology are accurate and thoroughly described.

4. 4: Good

17.25 points

Ethical or legal issues that would accompany the incorporation of the technology are described.

3. 3: Satisfactory

16.5 points

Ethical or legal issues that would accompany the incorporation of the technology are summarized.

2. 2: Less Than Satisfactory

15 points

Ethical or legal issues that would accompany the incorporation of the technology are only partially discussed.

1. 1: Unsatisfactory

0 points

Ethical or legal issues that would accompany the incorporation of the technology are omitted.

Role of Nurse Informatics Technology

18.75 points

Criteria Description

Role of Nurse Informatics Technology

5. 5: Excellent

18.75 points

The informatics role of the nurse regarding the technology is clearly explained. Well supported examples of roles and job functions are presented.

4. 4: Good

17.25 points

The informatics role of the nurse regarding the technology is explained. Examples of roles and job functions are presented.

3. 3: Satisfactory

16.5 points

The informatics role of the nurse regarding the technology is outlined. Some general examples of the roles and job functions are presented.

2. 2: Less Than Satisfactory

15 points

The informatics role of the nurse regarding the technology is only partially discussed.

1. 1: Unsatisfactory

0 points

The informatics role of the nurse regarding the technology is not discussed.

Outline Role of Workflow Analysis, Human Factors and User Centered Design Concepts

25 points

Criteria Description

Outline Role of Workflow Analysis, Human Factors and User Centered Design Concepts

5. 5: Excellent

25 points

The role of workflow analysis, human factors, and user-centered design concepts for the chosen technology is clearly outlined. The narrative is well supported.

4. 4: Good

23 points

The role of workflow analysis, human factors, and user-centered design concepts for the chosen technology is outlined. Some detail or information is needed for clarity or accuracy.

3. 3: Satisfactory

22 points

The role of workflow analysis, human factors, and user-centered design concepts for the chosen technology is outlined. There are some omissions or inaccuracies.

2. 2: Less Than Satisfactory

20 points

The role of workflow analysis, human factors, and user-centered design concepts for the chosen technology is only partially discussed.

1. 1: Unsatisfactory

0 points

The role of workflow analysis, human factors, and user-centered design concepts for the chosen technology is omitted.

Required Sources

3.75 points

Criteria Description

Required Sources

5. 5: Excellent

3.75 points

Number of required resources is met. Sources are current, and appropriate for the assignment criteria and nursing content.

4. 4: Good

3.45 points

Number of required sources is met. Sources are current, but not all sources are appropriate for the assignment criteria and nursing content.

3. 3: Satisfactory

3.3 points

Number of required sources is met, but sources are outdated or inappropriate.

2. 2: Less Than Satisfactory

3 points

Number of required sources is only partially met.

1. 1: Unsatisfactory

0 points

Sources are not included.

Appendix

2.5 points

Criteria Description

Appendix

5. 5: Excellent

2.5 points

The APA Writing Checklist is complete and attached in the appendix. It is clearly evident by the quality of the paper that the APA Writing Checklist was used in development.

4. 4: Good

2.3 points

The APA Writing Checklist is complete and attached in the appendix. It is apparent that the APA Writing Checklist was used in development of the paper.

3. 3: Satisfactory

2.2 points

The APA Writing Checklist is complete and attached in the appendix. The APA Writing Checklist was generally used in development of the paper, but some aspects are inconsistent with the paper format or quality.

2. 2: Less Than Satisfactory

2 points

The APA Writing Checklist is attached, but an appendix has not been created. The paper does not reflect the use of the use of the APA Writing Checklist during development.

1. 1: Unsatisfactory

0 points

The appendix and APA Writing Checklist are omitted.

Thesis Development and Purpose

8.75 points

Criteria Description

Thesis Development and Purpose

5. 5: Excellent

8.75 points

Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.

4. 4: Good

8.05 points

Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.

3. 3: Satisfactory

7.7 points

Thesis is apparent and appropriate to purpose.

2. 2: Less Than Satisfactory

7 points

Thesis is insufficiently developed or vague. Purpose is not clear.

1. 1: Unsatisfactory

0 points

Paper lacks any discernible overall purpose or organizing claim.

Argument Logic and Construction

10 points

Criteria Description

Argument Logic and Construction

5. 5: Excellent

10 points

Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.

4. 4: Good

9.2 points

Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.

3. 3: Satisfactory

8.8 points

Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis.

2. 2: Less Than Satisfactory

8 points

Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.

1. 1: Unsatisfactory

0 points

Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.

Mechanics of Writing (includes spelling, punctuation, grammar, language use)

6.25 points

Criteria Description

Mechanics of Writing (includes spelling, punctuation, grammar, language use)

5. 5: Excellent

6.25 points

Writer is clearly in command of standard, written, academic English.

4. 4: Good

5.75 points

Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech.

3. 3: Satisfactory

5.5 points

Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed.

2. 2: Less Than Satisfactory

5 points

Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied.

1. 1: Unsatisfactory

0 points

Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.

Paper Format (Use of appropriate style for the major and assignment)

6.25 points

Criteria Description

Paper Format (Use of appropriate style for the major and assignment)

5. 5: Excellent

6.25 points

All format elements are correct.

4. 4: Good

5.75 points

Template is fully used; There are virtually no errors in formatting style.

3. 3: Satisfactory

5.5 points

Template is used, and formatting is correct, although some minor errors may be present.

2. 2: Less Than Satisfactory

5 points

Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.

1. 1: Unsatisfactory

0 points

Template is not used appropriately or documentation format is rarely followed correctly.

Documentation of Sources

6.25 points

Criteria Description

Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)

5. 5: Excellent

6.25 points

Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

4. 4: Good

5.75 points

Sources are documented, as appropriate to assignment and style, and format is mostly correct.

3. 3: Satisfactory

5.5 points

Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.

2. 2: Less Than Satisfactory

5 points

Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.

1. 1: Unsatisfactory

0 points

Sources are not documented.

NUR 514 Topic 6 Emerging Technology Brief Essay Example 2

Emerging technology refers to any technology in development (Abdi et al., 2020). Emerging technologies usually have a considerable social and economic impact. Healthcare technology spans medications, vaccines, procedures, and systems to devices. Over the past decade, technology has spearheaded the advancement of the healthcare industry through various innovations in the diagnosis, prevention, and treatment of different disease states.

Examples of emerging technologies include artificial intelligence (AI), telemedicine, extended reality, and wearables (Abdi et al., 2020). The subsequent sections of this paper will discuss the role of emerging technologies in healthcare, ethical and legal considerations, the nurse’s informatics role, and the importance of concepts such as workflow analysis, human factors, and user-centered design in technology.

Role of Emerging Technologies in Healthcare

Emerging technologies have significantly impacted the healthcare sector. New healthcare technology offers educational, supportive, organizational, informational, rehabilitative, preventive, diagnostic, and therapeutic solutions that considerably improve healthcare accessibility and providers’ capabilities (Schiavone & Ferretti, 2021). For instance, a virtual concierge allows patients to schedule appointments flexibly and provides real-time communication and advanced analytics.

Similarly, artificial intelligence facilitates better decision-making and minimizes medication errors, enhancing patient safety (Schiavone & Ferretti, 2021). This advanced technology also spearheads the efficiency and precise nature of the current treatment modalities. Wearables enable constant patient monitoring. Consequently, emerging technologies have improved efficiency, productivity, performance, and security in healthcare without sacrificing accessibility or reliability.

Ethical or Legal Issues

Despite the overwhelming impact of emerging technologies in healthcare, these new technologies must be governed and regulated (Mathews et al., 2022). Ethical and legal concerns accompany the incorporation of technology. For instance, the use of technology in processing patient information raises issues related to patient privacy, confidentiality, and autonomy. Similarly, personal information may be misused, particularly by other parties, after it has been entered into the various online platforms.

Likewise, the implementation of artificial intelligence has raised concerns over the replacement of jobs (Mathews et al., 2022). Finally, lack of oversight and acceptance of responsibility is a critical ethical concern as most healthcare technologies have blended ownership. It is, therefore, prudent that the incorporation of healthcare technologies accounts for these concerns.

The Nurse’s Informatics Role

Nurse informaticists play a central role in technology. For instance, nurse informaticists act as a crosslink between clinicians and the IT staff. They facilitate communication between clinicians and IT staff, facilitating strategies for implementing, optimizing, procuring, and maintaining a technologically active healthcare environment (McGonigle & Mastrian, 2021).

Similarly, informaticists consistently strive for quality improvement to support better clinical and patient outcomes through patient data analysis and isolation of patterns that facilitate clinical decision-making. Nurse informaticists also enhance patient safety through staff training and process improvements (Denisco, 2019). Finally, nurse informaticists are involved in policy making and act as patient advocates, ensuring the acceptability and prosperity of healthcare technologies.

Workflow Analysis, Human Factors, and User-Centered Design

Workflow analysis, human factors, and user-centered design are elemental concepts to consider for any healthcare technology. Workflow analysis, for instance, reviews, examines, and evaluates structures and subprocesses of the technology to ensure efficiency (Staras et al., 2021). Meanwhile, human factors are critical to the utilization of technology. For example, individual attitudes and skills may impact the adoption and use of emerging technologies.

Individuals must have the right attitude, skills, and expertise to utilize a given technology effectively. Finally, technologies should be designed to have an appropriate user-centered design. User-centered interphase creates a user-friendly environment that facilitates the usability of the given technology (Dopp et al., 2019). Consequently, it is critical to consider human factors, user-centered design, and workflow analysis during the design and implementation of technology.

Conclusion

Emerging technologies are the driving forces behind the current advanced healthcare technology. These technologies improve access to care, patient safety, and efficiency within healthcare organizations. Ethical and legal concerns related to technology must be recognized and addressed. Nurse informaticists play a central role in the implementation and use of healthcare technology. Finally, healthcare technologies should consider workflow analysis, human factors, and user-centered design during the implementation of healthcare technologies.

NUR 514 Emerging Technology Brief Sample Discussion References

Abdi, S., de Witte, L., & Hawley, M. (2020). Emerging technologies with potential care and support applications for older people: Review of gray literature. JMIR Aging, 3(2), e17286. https://doi.org/10.2196/17286

Denisco, S. M. (2019). Advanced practice nursing: Essential knowledge for the profession: Essential knowledge for the profession (4th ed.). Jones & Bartlett.

Dopp, A. R., Parisi, K. E., Munson, S. A., & Lyon, A. R. (2019). Integrating implementation and user-centered design strategies to enhance the impact of health services: protocol from a concept mapping study. Health Research Policy and Systems, 17(1), 1. https://doi.org/10.1186/s12961-018-0403-0

Mathews, D. J. H., Balatbat, C. A., & Dzau, V. J. (2022). Governance of emerging technologies in health and medicine – creating a new framework. The New England Journal of Medicine, 386(23), 2239–2242. https://doi.org/10.1056/NEJMms2200907

McGonigle, D., & Mastrian, K. (2021). Nursing informatics and the foundation of knowledge (5th ed.). Jones and Bartlett.

Schiavone, F., & Ferretti, M. (2021). The FutureS of healthcare. Futures, 134(102849), 102849. https://doi.org/10.1016/j.futures.2021.102849

Staras, S., Tauscher, J. S., Rich, N., Samarah, E., Thompson, L. A., Vinson, M. M., Muszynski, M. J., & Shenkman, E. A. (2021). Using a clinical workflow analysis to enhance eHealth implementation planning: Tutorial and case study. JMIR MHealth and UHealth, 9(3), e18534. https://doi.org/10.2196/18534

Employee Engagement Survey PaperIn any organization, employee engagement is one ...

Employee Engagement Survey Paper

In any organization, employee engagement is one of the most significant business aspects. For good running of an organization it is paramount that the employees be committed to its success. Moreover, if employees aren’t fully engaged, a firm may record limited success and low performance. Thus, an organization needs to put in place structures that help identify employee’s engagement (Kang & Sung, 2017). Such structures will help in the communication of any challenges that the employees face and thus tackle them.

The data from the employment engagement survey of Metro Dental Services depicts that the firm has favorable working condition. The health organization working condition is more than 70%, a figure that reflects high employee engagement. Additionally, the orientation quality of the company is also above 70%. Further, the employees confer that the organization’s strategies for employee training and empowerment is favorable, which can translate to high employee motivation. Nonetheless, for better scores, the organization’s employees need to know the exact objectives and goals and how the same align with their individual development.

Other than employee training to improve engagement, the leaders of the organization should also get the relevant training (Albrecht et al., 2018). This will help improve employee engagement as well as help the leaders of the organization do their managerial roles better. Therefore, managers and leaders at Metro Dental Services should get additional training to assist them recognize best measures to improve engagement and motivate employees. Celebrating high scores is significant in improving employee engagement hence the need to identify quality operations and good teamwork (Nazir & Islam, 2017). Employees can be offered the opportunity to enjoy paid vacations by the organization to show appreciation for their commitment to organization’s success. Such action will subsequently improve employee engagement.

As portrayed by the employee engagement data, Metro Dental Services is an organization with a good work environment. However, as it looks into innovative approaches of maintaining the high scores, it should celebrate the role played by the employees. Communication channels for employees should be kept open for better employee engagement. In the end, it is the organization that will benefit from better employee performance.

Reference

Albrecht, S., Breidahl, E., & Marty, A. (2018). Organizational resources, organizational engagement climate, and employee engagement. Career Development International, 23(1). https://www.emerald.com/insight/publication/issn/1362-0436
Kang, M., & Sung, M. (2017). How symmetrical employee communication leads to employee engagement and positive employee communication behaviors. Journal of Communication Management, 21(1), 82-102. DOI: 10.1108/JCOM-04-2016-0026
Nazir, O., & Islam, J. U. (2016). Enhancing organizational commitment and employee performance through employee engagement. South Asian Journal of Business Studies, 6(1). DOI: 10.1108/SAJBS-04-2016-0036

Employee Self Assessment Discussion CUEmployee Self Assessment Discussion CUHow ...

Employee Self Assessment Discussion CU

How do you feel you have contributed within the last twelve months?
What areas do you feel there is an opportunity for your own improvements?
What specific goals would you like to achieve
Specifically what steps do you see taking these goals

ORDER THROUGH BOUTESSAY

Employee should fill out this section prior to meeting with reviewer, and be brought to meeting with reviewer.

How do you feel you have contributed to MSMC/MHI over the past 12 months? Provide specific examples.
What areas do you feel there is an opportunity for your own improvement?
What specific goals would you like to achieve at MSMC/MHI?
Specifically, what steps do you see taking to achieve these goals (i.e. education, training etc.)?
Additional Comments or Concerns to be discussed during meeting.

Employee Self Assessment Discussion CU Instructions

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.
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 review instead of getting counted off for these mistakes.
Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
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 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.
As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

Communication

Communication is so very important. 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 me questions or send me messages. This will be checked at least once every 24 hours.

End of Life Care Sample PaperEthical issues take centre stage in instances where ...

End of Life Care Sample Paper

Ethical issues take centre stage in instances where choices need to be made, the solution may not be clear, and the available options may not be most suitable (Gaines, 2020). Such a dilemma causes a decrease in the quality of care a patient receives, problems with the clinical relationship between a patient and a practicing nurse, and moral distress. As a practicing nurse, I have found myself in ethical situations when providing end of life care. While working at the UT Health East Texas in 2019, I was once faced with an ethical situation where a patient requested to be withdrawn from a life sustaining treatment. Being fully aware that the patient’s decision-making capacity was compromised, I found myself between a rock and a hard place. Ultimately, I did not pull the patient out of the life sustaining treatment. I believe I got the most out of the situation, because my patient’s liberty of interest to refuse treatment which is constitutionally protected was violated.

The ethical consideration in this stage usually includes breakdown of communication where nurses find it difficult to understand the demands of the patient. Normally, it is advised that nurses should ask the patient their preferences earlier for documentation. Furthermore, poor symptom management is another factor where medication side effects outweigh the benefits and shared decision-making when more than one person is involved in decision-making (Gaines, 2020).

The legal concern in the scenario arises since patients have a constitutionally protected liberty of interest in refusing unwanted medical treatment, deducing earlier decisions. Patients may withdraw a life sustaining treatment, and this happens when a seriously ill patient may feel captive of the machine required to support the life; thus, they will require the machine to be removed (American Medical Association, 2018).

Even though patients are constitutionally protected from refusing unwanted medical treatment, I felt the patient is not in the right capacity to pull out of the life-sustaining treatment. Besides, the treatment was necessary to keep my patient alive. The person who benefits from the situation was the patient, and the people hurt by it are the families and the doctors or nurses. The major influential factor is that the nurses can engage with the patients and educate them on their situation through counselling (Flückiger et al., 2020). In such situations, one of the core concern issue is the decision-making course. It becomes an ethical issue since it involves more than one person, both the practicing nurse and the patient are involved in making the decision, and both sides having contradicting approaches to the matter.

References

American Medical Association. (2018, November 14). Withholding or withdrawing life-sustaining treatment. https://www.ama-assn.org/delivering-care/ethics/withholding-or-withdrawing-life-sustaining-treatment#:~:text=%20When%20facing%20decisions%20about%20withholding%20or%20withdrawing,record%20and%20ensure%20that%20the%20reco
Flückiger, C., Del Re, A. C., Wlodasch, D., Horvath, A. O., Solomonov, N., & Wampold, B. E. (2020). Assessing the alliance–outcome association adjusted for patient characteristics and treatment processes: A meta-analytic summary of direct comparisons. Journal of Counseling Psychology, 67(6), 706–711. https://doi.org/10.1037/cou0000424
Gaines, K. (2020). What is the nursing code of ethics? Nurse.org. https://nurse.org/education/nursing-code-of-ethics/#:~:text=%204%20Principles%20of%20Ethics%20for%20Nurses%20,in%20all%20medical%20and%20nursing%20decisions…%20More%20

Epidemiologic Measurement In Population Health OutcomesEpidemiologic Measurement ...

Epidemiologic Measurement In Population Health Outcomes

Nursing-Doctorate level Discussion questions. 2 pages for each question. Please present with at least 2 references with answer to each question. References must be within 5 years. Absolutely plagiarism free.

These are 2 separate questions– Each to be presented separately. It can be on one attachment or separately.

Question #1.

The Morbidity and Mortality Weekly Report (MMWR (Links to an external site.)) is an epidemiological report published by the Centers for Disease Control and Prevention (CDC). This weekly report contains data on specific diseases as reported by state and regional health departments, as well as recommendations issued by the CDC. Access the MMWR (Links to an external site.) and select a report pertaining to one of the eight national practice problems to address the following:

Describe the epidemiologic principles and measures used to address the practice problem.
Discuss the use of descriptive and/or analytic epidemiology to address the practice problem.
Recommend additional measures required to integrate proposed changes into practice.
Share your professional experience related to the topic.

Question #2. Using Surveillance to Address a Practice Problem

Data mining is an important component of any population health outcome analysis. Select one of the following information hubs to address a health-related topic of your choice:

CDC Surveillance Resource Center and Interactive Database Systems, (Links to an external site.)
World Health Organization (WHO) (Links to an external site.) or Our World in Data (Links to an external site.)

Analyze the data presented at the national and state levels to address the following.

Identify the information hub and topic selected. Provide a brief summary of the practice problem.
Compare and contrast national and state levels of data. Use the state of your residence as a basis for the comparison.
Describe how data from your home state compares to data from other states.
Identify one national organization or intervention related to your selected topic that is addressing the burden of this disease. Describe the impact of the organization or intervention to improve outcomes.
Share your professional experience related to the topic.

ORDER THROUGH BOUTESSAY

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 apparent 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.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting a 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.

Epidemiology of Mononucleosis Sample PaperIntroductionEpstein-Barr virus is the ...

Epidemiology of Mononucleosis Sample Paper

Introduction

Epstein-Barr virus is the pathogen that causes mononucleosis. Mononucleosis is also referred to as “the kissing disease” or mono and the virus is transmitted via contact with bodily fluids of an infected person, particularly saliva. The spread through saliva is responsible for the name “kissing disease”, as the virus is spread via kissing, sharing silverware such as cups, spoons or forks, drinks, or food with the infected individual. It is also spread when an infected person sneezes or coughs near a healthy person. The symptoms of infection include fatigue, fever, sore throat, sore muscles, swollen lymph nodes, vomiting and loss of appetite (Naughton et al., 2021).

Additional symptoms include palatal petechiae, rash and periorbital and eyelid edema. Some infected individuals may present with no symptoms or extremely mild symptoms that they go unnoticed. The majority of persons with mono recover within 2 to 4 weeks, but fatigue may last for several weeks more. Other individuals take as much as 6 months or longer to clear the symptoms. The diagnosis of mononucleosis is based on a high index of suspicion by the doctor, focusing on the symptoms. The doctor may assess the patient for swollen lymph nodes, tonsils or enlarged liver or spleen (Naughton et al., 2021). A complete blood count determines whether white blood cells are elevated and presence of atypical leukocytes. Antibody tests check for presence of specific antibodies within the circulation produced by the body’s immune system in response to Epstein Barr Virus, which is the gold standard test.

Complications of mononucleosis include swollen tonsils, enlarged spleen, enlarged liver, blood disorders, heart disease and nervous system pathology. Swollen tonsils result from increased immune response to the infection, causing enlargement of lymph nodes due to hyper-active reticulo-endothelial system (Naughton et al., 2021). Swollen tonsils result in difficulty in swallowing or breathing through the oral cavity. An enlarged spleen results from a hyper-active reticulo-endothelial system in response to active infection. Also, since the body destroys infected red blood cells at an alarming rate, the spleen engages in hematopoiesis to replace lysed red blood cells, in a process referred to as extramedullary hematopoiesis. An enlarged spleen presents as a sharp pain of sudden onset on the left hypochondriac region of the abdomen.

Since damaged red blood cells pass through the liver to conjugate and metabolize the hemoglobin, the patient may present with jaundice or hepatitis following infection of liver cells. The body’s immune system may actively destroy large numbers of erythrocytes, resulting in a hemolytic anemia. Platelet destruction results in thrombocytopenia (Naughton et al., 2021). The infection may also result in inflammation of the heart. i.e. myocarditis, presenting with an irregular heart beat and murmur. Infection of the nervous system may present with symptoms such as seizures, inflammation of the brain (encephalitis) or inflammation of the meninges covering the brain (meningitis). More severe complications from mononucleosis ensue in a host with a weakened immune system, for instance, in HIV/AIDS patients and persons taking immunosuppressive medications such as corticosteroids and cancer chemotherapy.

No definitive treatment exists to cure mononucleosis. As such, the disease is managed by placing the patient on bed rest, administering intravenous fluids for rehydration and managing the pain and fever using pain relievers such as acetaminophen or NSAIDS. The enlarged tonsils are managed by corticosteroids (Naughton et al., 2021). Also, there is no vaccine to prevent infection and the virus may stay in the host’s saliva for several months without physical symptoms of disease. Thus the best way of prevention includes washing hands often and avoiding sharing drinks, foods, toothbrushes and silverware.

Studies reveal that 75 % of adults of ages 18 to 22 years develop infectious mononucleosis following EBV infection. Among infected persons, 10 % are asymptomatic while 15 % exhibit atypical symptoms (Dunmire, Hogquist & Balfour, 2015). The incidence within the United States is 500 cases per 100 000 per year, with an annual incidence rate of 200 to 800 cases per 100 000 for young adults between 15 and 19 years. The prevalence of EBV worldwide is 95 %. The mortality rate is 17 % globally and morbidity is undetermined.

Social Determinants of Health

Infectious mononucleosis has higher incidence among individuals from upper socioeconomic groups compared to lower socioeconomic groups, as revealed by a study conducted in London (Dunmire, Hogquist & Balfour, 2015). This observation is attributable to the fact that individuals from high socioeconomic groups escape subclinical infection with Epstein Bar Virus during childhood to later develop the infection in adulthood. Moreover, individuals from lower socioeconomic groups may have under-diagnosis of the infection owing to inability to access medical care. This proposition is further supported by the presence of antibodies to Epstein-Barr virus among persons of lower socioeconomic groups, such as military recruits and pediatric patients in poor neighborhoods (Dunmire, Hogquist & Balfour, 2015). The higher prevalence of the antibody is also observed among students in universities and colleges. These findings are attributable to overcrowded living conditions since the disease is spread mainly via salivary contact. In overcrowding, an infectious person coughs salivary droplets containing the infectious virus, which are inhaled by healthy occupants of the room who acquire the infection. The prevalence of antibodies to EBV is lower in persons from middle-class environments, owing to adequate spacing and less risks for overcrowding. Among occupations, the incidence of mononucleosis is higher among nurses, doctors and other medical personnel and lower among manual workers. In addition to higher exposure risk to infected patients, medical workers may access diagnostic facilities with ease, resulting to high rates of detected illnesses.

A study by Cambridge University assessed the social determinants of mononucleosis as household socioeconomic position using mother’s educational level (Higher, degree, A, As, S level, GCSE), equivalised income rank with the partner’s joint income and the employment status (managerial, intermediate, small employers, own account workers, lower supervisory/technical occupations and semi-routine/routine occupations) (Black & Black, 2018). The area environment was determined as Large urban, Town or rural while the home environment was described by variables assessing for overcrowding (less than 1.5 rooms per person), collective child care (using nannies) and temperature in the child’s room. The housing tenure was described as owner, rent privately, social housing and other. The likelihood for EBV infection was significantly lower in children from higher social class, higher equivalised income and with mother having higher educational level (Black & Black, 2018). The likelihood for infection was higher among children sleeping in cold rooms, overcrowded homes, rented accommodation, and larger towns/cities. Urban dwelling exposes individuals to higher risks of contacting the virus via reduced personal space such as in public transport and living within small shared spaces. The low socioeconomic status (education, income and occupation) leads to inadequate living conditions within households, especially overcrowding and social renting, that increases the chances of spreading or acquiring the virus.

Epidemiologic Triangle

Host factors favoring infection with Epstein-Barr virus include genetic susceptibility, immunodeficiency, immunosuppression, intimate salivary contact with a carrier and airborne virus. Genetic susceptibility was identified in a study investigating individuals with inborn immune system errors, who exhibited higher susceptibility to and increased frequency of disease induced by the virus infection (Barros et al.,2019). Infants also have higher risks of developing EBV infection as maternal antibody (IgG) disappears from their bloodstream.

The children infected with Epstein Barr virus are often asymptomatic, and the infection could be confused for other differential diagnoses of common pediatric illnesses. But infection in adolescence and young adulthood results in characteristic features of infectious mononucleosis. Adolescents and young adults have increased risk of acquiring the infection, particularly in crowded living conditions such as in hostels, and intimate salivary contact involved in sexually active individuals. Sharing of silverware including cups, knives, forks and spoons is also common within this population, further increasing the likelihood of acquiring an infection (Bar-Or et al.,2020).

The epithelial linings of the oropharynx and uterine cervix are composed of squamous cells that the virus easily infects by bypassing the physiological barriers such as salivary and mucoid secretions. The role of a weakened immune system in developing the disease cannot be ignored. EBV has higher likelihood of developing into infectious mononucleosis in individuals who have immunosuppression secondary to organ transplant, chemotherapy, diabetes mellitus or human immunodeficiency virus.

Factors contributing to the virulence of EBV include increased antigen variation, selective infection of B lymphocytes, presence of a glycoprotein for attachment to cells and a latent phase. During the latent phase, the virus resides within the host without detection by the host’s immune system, enabling sustained viral replication and infection of more cells and tissues (Bar-Or et al.,2020). The replication cycle is also enhanced by the promoter of the viral gene ZEBRA that halts the latent phase and initiates the replication. Infecting B lymphocytes of hosts enables the virus to go undetected by the immune system, since B lymphocytes are involved in processing pathogen antigens, regulating immune responses and producing antibodies against infection. As a result, autoreactive infected B cells circulate, reaching specific target organs and initiate tissue damage, B cell damage, and release of the virus to infect new cells (Barros et al.,2019). The viral glycoprotein present on the lipid envelope enables the virus to attach to uninfected cells and commence the infection process.

Environmental factors contributing to spread of the virus include cold temperatures, poorly ventilated accommodations, humid environments and overcrowding. Exposure to cold triggers the human body to release cortisol into the circulation, which leads to reduced numbers of circulatory lymphocytes (Dunmire, Hogquist & Balfour, 2015). Since lymphocytes are the immune cells involved in combating virus infection, their reduced numbers makes it easier for the virus to cause infection in the host. Poorly ventilated rooms translate to air being stationary within confined spaces. In such cases, the airborne virus stays in the room air for longer periods, increasing the chances of its inhalation by an occupant. Likewise, overcrowding translates to less personal space between individuals, leading to higher chances of transmitting the virus via aerosol droplets incase an infected person coughs.

Role of a Community Health Nurse

The role of a community health nurse in dealing with infectious mononucleosis cannot be ignored. Since the disease is airborne, the community health nurse works with other health professionals to formulate appropriate strategies regarding sanitation, public practices, business interactions and personal interactions that would prevent the spread of the Epstein-Barr Virus (Naughton et al., 2021). For instance, the community health nurse may discourage kissing a person presenting with fever, malaise and other symptoms of infection.

The nurse may also encourage construction of buildings with adequate ventilation to prevent virion aerosols from being confined to rooms with stationary air that would favor transmission. The nurse also educates the caregivers interacting with the infected on the best practices to avoid acquiring the infection. Additional roles of a community health nurse involve holding educational campaigns to increase awareness of mononucleosis among the population, especially in crowded places like churches and schools.

In case finding, the nurse should have a high index of suspicion. A patient presenting with fever, muscle pain, lymphadenopathy and a sore throat should be highly suspected of Epstein-Barr virus infection (Naughton et al., 2021). In assessment, the nurse should check the temperature, respiratory rate, blood pressure and pulse rate to rule out life-threatening complications from the illness. Also, the health worker should order for laboratory workups to confirm the presence of antibodies to the virus within the circulation to provide a definitive diagnosis.

Every case should be documented in the facility’s medical records. The nurse then calculates the incidence of the disease and compares with other reported incidences from the records. A figure that is higher than expected is characteristic of an outbreak, which the nurse ought to report to the Centers for Disease Control and Prevention (Naughton et al., 2021). The department of health may then formulate strategic preventive measures to curb the outbreak before transformation into a pandemic. The nurse is directly involved in providing care to persons infected with Epstein Barr Virus, including administering the appropriate medication for symptoms relief and educating the individual on how to prevent spreading the pathogen to other persons.

The Centers for Disease Control and Prevention

The Centers for Disease Control and Prevention keeps track of infectious mononucleosis. The CDC is the national agency that develops and applies disease control and prevention, promotes environmental health and holds health education activities for improved health of U.S. citizens (Black & Black, 2018). To achieve its objectives, the CDC carries out epidemiologic studies and laboratory analyses to keep relevant surveillance of diseases, enabling the body to identify, define and prevent health problems. The organization actively engages in collection, analysis and distribution of data pertaining to disease and acts as the leading agency in formulating and implementing solutions to environmental health challenges.

The agency also operates series of studies focused on developing and testing effective disease prevention, control and health promotion programs (Black & Black, 2018). At the national level, CDC formulates and assesses the occupational health and safety standards recommended by professionals, and provides training, research and technical aid to provide healthy and safe working environments for professionals across various disciplines. An additional responsibility involves conducting a nationwide program to improve hospital laboratories’ performance.

Worth-noting, the CDC controls both introduction and spread of an infectious disease, besides providing consultation and aid to international agencies and other nations seeking to promote health, preserve environmental health or improve disease prevention and control (Levinson, 2017). An intriguing finding is that the organization provides the Preventive Health and Health Services Block Grant to applicants, in addition to program expertise and assistance to State, Federal, local or private organizations dealing with disease control and prevention.

In the case of infectious mononucleosis, since no vaccine for EBV has completed successful clinical trial to date, the appropriate prevention strategy taken by CDC is to enhance awareness of the spread of the virus among U.S. citizens. CDC educates the community on the importance of proper hygiene practices, appropriate ventilation of buildings and avoiding overcrowding in public and private places (Levinson, 2017). Also, members of the population are cautioned against engaging in close salivary contact with suspected infected persons, including acts of kissing or sharing silverware such as forks, spoons and cups.

Global Implication of Infectious Mononucleosis

While the global incidence of infectious mononucleosis remains undetermined, an incidence of 90% is noted among children in developing nations (Dunmire, Hogquist & Balfour, 2015). The children experience asymptomatic EBV infection before they attain five years and are insusceptible to mononucleosis at later stages in their lives. Also, infectious mononucleosis has no specific racial or ethnic predilections, but its incidence is higher among persons of high socioeconomic class in developed countries.

Whereas the disease shows no preference for either sex, splenic rupture as a complication is more common in males, with only 10 % of splenic ruptures being among women(Dunmire, Hogquist & Balfour, 2015). In Central Africa, Epstein Barr-virus is associated with an increased risk of developing Burkitt Lymphoma, particularly in children. The virus is closely linked to nasopharyngeal carcinoma among Alaskan Eskimos and Cantonese Chinese.

Conclusion

Curtly, infectious mononucleosis is an infectious disease that poses a significant public health problem, primarily owing to ignorance of the public on existence of the Epstein-Barr virus and its mode of transmission. The role of the community nurse in identifying the cases, diagnosing, providing appropriate relief of symptoms and educating the public on prevention measures cannot be overemphasized. The mentioned facts have been adequately discussed in this paper.

References

Bar-Or, A., Pender, M. P., Khanna, R., Steinman, L., Hartung, H. P., Maniar, T., … & Joshi, M. A. (2020). Epstein–Barr virus in multiple sclerosis: theory and emerging immunotherapies. Trends in molecular medicine, 26(3), 296-310. https://www.sciencedirect.com/science/article/pii/S1471491419302941
Barros, M. H. M., Vera-Lozada, G., Segges, P., Hassan, R., & Niedobitek, G. (2019). Revisiting the tissue microenvironment of infectious mononucleosis: identification of EBV infection in T cells and deep characterization of immune profiles. Frontiers in immunology, 10, 146. https://www.frontiersin.org/articles/10.3389/fimmu.2019.00146/full
Black, J. G., & Black, L. J. (2018). Microbiology: principles and explorations. John Wiley & Sons.
Dunmire, S. K., Hogquist, K. A., & Balfour, H. H. (2015). Infectious Mononucleosis. Current topics in microbiology and immunology, 390(Pt 1), 211–240. https://doi.org/10.1007/978-3-319-22822-8_9
Levinson, W. (2017). Review of medical microbiology and immunology.
Naughton, P., Healy, M., Enright, F., & Lucey, B. (2021). Infectious Mononucleosis: diagnosis and clinical interpretation. British Journal of Biomedical Science, 1-10. https://www.tandfonline.com/doi/abs/10.1080/09674845.2021.1903683

Episodic Focused SOAP Note on Back Pain DiscussionPatient Information:A 42-year- ...

Episodic Focused SOAP Note on Back Pain Discussion

Patient Information:

A 42-year-old male.

S.

CC (chief complaint): Lower back pain

HPI: The patient is a 42-year-old male who reports lower back pains for the past month. He reports that the pain occasionally radiates to his left leg.

I would like to know if the onset of the pain was sudden or gradual. I would like to know the character of the pain. Is it sharp, aching, or burning? Is it continuous or intermittent?

I would also like to know if there are any associated symptoms. These symptoms include fecal or urinary incontinence, weakness and numbness of the limbs, weight loss, fever, night sweats etc.

I would like to know if there are any exacerbating or relieving factors to this pain. Is it worse when walking, sitting, or lying flat? Is the pain worsened by coughing or straining? What does he do to relieve the symptoms? Has he taken any medications to try and relieve the symptoms?

I would like to know if the pain is getting better or worse. I would also like to know the severity of the pain by asking the patient to grade the severity on a scale of 1-10

I would ask the patient if he has ever experienced back pain in the past and if it is similar to what he’s experiencing now.

I would ask if the patient has any previous trauma or injuries that might have preceded his symptoms.

Current Medications: I would ask for any medications the patient is taking e.g. steroids or analgesics.

PMHx: I would check if the patient has any musculoskeletal condition such as osteoarthritis.

I would ask the patient if he has had spinal surgery before.

Soc Hx: I would ask about the patient’s occupation. Does it involve carrying around heavy loads?

Does the patient take alcohol or tobacco?

Travel Hx: I would ask about any recent visits to TB endemic areas or areas with a high prevalence of TB. This is important as TB can cause Pott’s disease (Wong et al., 2017).

Fam Hx: I would ask if anyone in his family has had similar symptoms before.

ROS:

GENERAL: I will ask for constitutional symptoms such as weight loss, fatigue, fevers, night sweats and chills.

GENITOURINARY: I will ask for urinary incontinence or retention.

NEUROLOGICAL: I will ask for weakness, numbness, paralysis, or tingling in the extremities. I will ask in changes in bowel or bladder control

MUSCULOSKELETAL: I will ask for muscle pain, joint stiffness.

HEMATOLOGIC: I will ask for signs of anemia, bleeding or bruising.

LYMPHATICS: I will ask for the presence of enlarged lymph nodes.

Physical exam: I will check the vital signs i.e., the temperature, BP, respiratory rate and pulse rate.

MUSCULOSKELETAL:

Inspection: Check for the spinal alignment. Check for muscle wasting. Check for bruising which might suggest recent trauma or surgery. Gait and Posture test to observe the overall posture and how the patient walks. Range of motion. To test for extension of the spine, forward flexion, lateral flexion and lateral rotation of the spine.

Palpation and percussion of the spine. Done to assess the alignment of the spine and note any tenderness and muscle spasms. Palpation of the sciatic notch. Tenderness over this area with radiation of pain to the leg may indicate an irritation of the sciatic nerve.

NEUROLOGICAL (of the lower limb).

Inspection: Check for muscle wasting, fasciculations, and tremors

Palpation: this includes assessing the tone and power of the muscle groups

Reflexes. Testing the ankle and knee reflexes can help with determining the level of spinal cord compromise.

Motor testing and sensory testing to assess for muscle weakness and sensation. The nerve roots that are most likely affected are L4, L5, and S1.

L5: The sensory component is tested on the dorsum and medial aspect of the big toe. The motor component is tested by asking the patient to dorsiflex the great toes (Stecco et al., 2019)

L4: The sensory component is tested on the medial aspect of the lower leg and ankle. Dorsiflexion of the great toe can be used to check for some L4 root dysfunction of the motor component.

S1: The sensory component is tested on the dorsum and lateral aspect of the little toe. The motor component is assessed by asking the patient to flex their knee so that the foot lies flat on the bed. This test assesses the hamstrings. Testing for these nerves can help to detect nerve root dysfunction.

Diagnostic tests:

A complete blood count (CBC) is necessary. By studying the blood parameters, we can rule out an infection or a malignancy. A raised white cell count can suggest an infection. Iron deficiency anemia can be a sign of malignancy.
Erythrocyte sedimentation rate should be tested. A raised ESR can point towards ankylosing spondylitis (Ranganathan et al., 2017).
Liver function tests. An elevated ALP may be a sign of bony
Bone profile. Hypercalcemia may be a sign of malignancy.
Plain X-rays of the spine. Done to screen for possible fractures or other bony deformities.

A.

Differential Diagnoses

Nerve tumors such as neurofibroma of the cauda equina. This can present with sciatica. The pain is usually continuous (Solomon & Wakeley, 2017).
Intervertebral disc prolapse. This is caused by physical stress. Herniation of the nucleus can cause compression of the cauda equina which may present with pain in the lower limb (Solomon & Wakeley, 2017).
TB of the spine. This can also lead to degeneration of the spinal and compression of the surrounding structures. Pain is a common presentation (Solomon & Wakeley, 2017).
Vertebral fracture. Pain is a common symptom of fractures. Fractures can also lead to compression of the nerve roots which may present with pain and weakness of the lower limbs (Solomon & Wakeley, 2017).
Muscular strain and spasms. These can result in pain in the lower back and difficulty in forward flexion (Solomon & Wakeley, 2017).

This section is not required for the assignments in this course (NURS 6512) but will be required for future courses.

References

Ranganathan, V., Gracey, E., Brown, M. A., Inman, R. D., & Haroon, N. (2017). Pathogenesis of ankylosing spondylitis—recent advances and future directions. Nature Reviews Rheumatology, 13(6), 359-367. https://doi.org/10.1038/nrrheum.2017.56
Solomon, L., & Wakeley, C. (2017). Diagnosis in orthopaedics. In Apley and Solomon’s System of Orthopaedics and Trauma (pp. 450-500). CRC Press.
Stecco, C., Pirri, C., Fede, C., Fan, C., Giordani, F., Stecco, L., & De Caro, R. (2019). Dermatome and fasciatome. Clinical Anatomy, 32(7), 896-902. https://doi.org/10.1002/ca.23408
Wong, Y. W., Samartzis, D., Cheung, K. M. C., & Luk, K. (2017). Tuberculosis of the spine with severe angular kyphosis: mean 34-year post-operative follow-up shows that prevention is better than salvage. The Bone & Joint Journal, 99(10), 1381-1388. https://doi.org/10.1302/0301-620x.99b10.bjj-2017-0148.r1