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Week 6 Effective Leadership Styles Discussion NR703Effective Leadership Styles D ...

Week 6 Effective Leadership Styles Discussion NR703

Effective Leadership Styles Discussion NR703

Purpose

The purpose of this discussion is to synthesize the concepts from historical organizational management models, leadership frameworks, and interprofessional collaborative competencies to create your own approach to effective leadership styles.

Instructions

For this discussion, think of a problem you have seen in your current or previous place of employment and address the following:

Provide examples of how you as a transformational leader within an interprofessional team would address the practice problem.
Provide examples of how you as a transactional leader within an interprofessional team would address the practice problem.
Which leadership style do you think would be most effective in addressing this problem? Explain why.

Construct your responses using the CARE Plan method.

Please click on the following link to review the DNP Discussion Guidelines on the Student Resource Center program page:

Link (webpage): DNP Discussion GuidelinesLinks to an external site.

Program Competencies

This discussion enables the student to meet the following program competences:

Applies organizational and system leadership skills to affect systemic changes in corporate culture and to promote continuous improvement in clinical outcomes. (PO 6)
Appraises current information systems and technologies to improve health care. (POs 6, 7)
Creates a supportive organizational culture for flourishing collaborative teams to facilitate clinical disease prevention and promote population health at all system levels. (PO 8)

Course Outcomes

This discussion enables the student to meet the following course outcomes:

Compare and contrast theories of organizational behavior and leadership. (PCs 2, 4; PO6)
Investigate the role of advanced nursing practice in innovation and transformation to propose solutions impacting healthcare systems. (PCs 2, 4; PO 6)
Assimilate attributes for interprofessional collaboration across healthcare settings. (PC 6; PO 8)
Formulate selected strategies for leadership and influence across healthcare systems. (PC 6; PO 8)

Due Dates

Initial?Post: By 11:59 p.m. MT on Wednesday
Follow-Up Posts: By 11:59 p.m. MT on Sunday

NR703 Week 6: Leading Translational Science Student Lesson Plan

Overview

Program Competencies

Applies organizational and system leadership skills to affect systemic changes in corporate culture and to promote continuous improvement in clinical outcomes. (PO 6)
Appraises current information systems and technologies to improve health care. (POs 6, 7)
Creates a supportive organizational culture for flourishing collaborative teams to facilitate clinical disease prevention and promote population health at all system levels. (PO 8)

Course Outcomes

Compare and contrast theories of organizational behavior and leadership. (PCs 2, 4; PO 6)
Investigate the role of advanced nursing practice in innovation and transformation to propose solutions impacting healthcare systems. (PCs 2, 4; PO 6)
Assimilate attributes for interprofessional collaboration across healthcare settings. (PC 6; PO 8)
Formulate selected strategies for leadership and influence across healthcare systems. (PC 6; PO 8)

Weekly Objectives

Integrate concepts from historical models of organizational management into professional practice. (PCs 2, 4, 6; POs 6, 8; COs 1, 2, 5)
Apply leadership theories and conceptual frameworks to guide professional practice. (PCs 2, 4, 6; POs 6, 8; COs 1, 2, 4, 5)
Appraise principles of interprofessional collaboration in leading translational science. (PC 6; PO 8; CO 4)
Synthesize leadership and management competencies. (PCs 2, 4, 6; POs 6, 8; COs 1, 5)
Construct your approach to project management using translation science models. (PCs 2, 4, 6; PO 6; COs 1, 2)

Main Concepts

Organizational management models (PCs 2, 4, 6; POs 6, 8; COs 1, 4, 5)
Leadership theories and conceptual frameworks (PCs 2, 4, 6; POs 6, 8; COs 1, 2, 5)
Interprofessional collaboration challenges (PCs 2, 4, 6; POs 6, 8; COs 4, 5)
Leading through translation science models (PCs 2, 4, 6; POs 6, 8; COs 1, 4, 5)

Schedule

SectionRead/Review/CompleteCourse OutcomesDuePrepareAssigned ReadingsCOs 1, 2, 4, 5WednesdayExploreLessonCOs 1, 2, 4, 5WednesdayTranslate to PracticeDiscussion: Initial PostCOs 1, 2, 4, 5WednesdayTranslate to PracticeDiscussion: Follow-Up PostsCOs 1, 2, 4, 5SundayReflectReflectionCOs 1, 2, 4, 5No submission

Foundations for Learning

Return to Week 1 and review the Management Skills, Leadership Strengths, & Transformational Leadership table.

Additionally, review the following resources:

Lush, M. (2019). The leadership versus management debate: What’s the difference?Links to an external site. NZ Business + Management, 33(4), M20-M23.

Toor, S., & Ofori, G. (2008). Leadership versus management: How they are different, and why.Links to an external site. Leadership and Management in Engineering, 8(2), 61-71.

Student Learning Resources

Click on the following tabs to view the resources for this week.

Required Textbooks

Broome, M. E., & Marshall, E. S. (2021). Transformational leadership in nursing: From expert clinician to influential leader (3rd ed.). Springer Publishing Company.

Read Chapter 1
Read Chapter 6
- Section: Interprofessional Collaboration

Dang, D., & Dearholt, S. (2018). Johns Hopkins Nursing Evidence-Based Practice: Model and guidelines. Sigma Theta Tau International.

Read Chapter 3

White, K., Dudley-Brown, S., & Terhaar, M. (2021). Translation of evidence into nursing and healthcare (3rd ed.). Springer Publishing Company.

Read Chapter 2
- Section: Rogers’s Diffusion of Innovation Model
- Section: Knowledge-to-Action Model
- Section: Promoting Action on Research Implementation in Health Services Model

Required Articles

Scan the following articles on Professional Practice Models:

Watson, J., Porter-O’Grady, T., Horton-Deutsch, S., & Malloch, K. (2018). Quantum caring leadership: Integrating quantum leadership with caring science.Links to an external site.?Nursing Science Quarterly,?31(3), 253-258.

Additional Resources

Review the following additional resources for further exploration of the weekly topics/concepts:

HGS Concepts. (2017, May 16). Neuroscience and leadership [Video]. YouTube. https://youtu.be/cq4nUqEHiIA

Strategy + Business. (2016, December 1). How strategic leaders use their brain [Video]. YouTube. https://youtu.be/T6h1b4ZtLG4

Learning Success Strategies

Review organizational, management, and leadership theories with which you are familiar and reflect on those that have been most impactful in your nursing practice.
Explore the theories that are new to you and entertain incorporating new elements into your leadership identity.
Develop your ideas and thoughts through the interactive discussion. Review the discussion guidelines and rubric to optimize your performance.
You have access to a variety of resources to support your success. Click on the DNP Resources tab on the home page to access program and project resources.
Your course faculty is here to support your learning journey. Reach out for guidance with study strategies, time management, and course-related questions.
Look ahead to the Week 7 assignment. Start your draft paper early and incorporate the feedback from the former assignments from Week 2 and Week 5.

Interacting with Feedback

Each week your course faculty will provide feedback in the rubric and on any assignment you have submitted. Take a moment to review the following video on how to view rubric feedback in Canvas:

Link (video): Looking at FeedbackLinks to an external site.(2:26)

Review the following video on how to accept/reject track changes when viewing course faculty feedback on your assignment:

Link (video): Word: Track Changes and Comments(4:19)

NR703 Week 6 Lesson Leading Translational Science

Leadership and Management

Most nursing education programs have leadership and management courses to introduce students to the concepts of leadership and management. Both are required for efficient nursing governance, and neither is as effective alone as both are together. Today, the integration of both transformational leadership methods and management skills are essential to accomplish organizational goals.

Explore management theories by viewing the following video.

Management Theories (3:21) Transcript

Management is both an art and a science. It is commonplace for managers to use more than one theory to achieve productivity or organizational goals. It is also important for managers to understand these different theories and know how to implement them. Let’s discuss four popular management theories.

Taylor is considered to be the father of scientific management theory. His four principles were based on (a) division and specialization of labor, (b) adherence to a chain of command, (c) structure of organization, and (d) span of control. Taylor consider the staff to be a means to an end with the end justifying the means.

He believed in standardizing job performance in which each job has explicit motion rules, standardized elements, and appropriate conditions of working. The focus of scientific management theory is production efficiency. Scientific management theory fits well with the transactional leadership style. Henri Fayol is considered to be the father of classical management theory. His five principles were based on (a) foresight, (b) organization, (c) command, (d) coordination, and (e) control.

Max Weber expanded on the scientific approach to management. Weber valued principles of logic, order, and legitimate authority. Clear labor divisions and a hierarchical structure were combined with formalized rules and procedures. Mary Parker Follett modified Fayol’s approach. She believed that combining the talents of individuals and forming groups functions for the greater good. We see this notion preserved in current-day 360-degree feedback surveys.

Her organizational theory paved the way for the leadership theories of transactional leadership. Classical management leads to impersonal interaction with staff, and promotions are achieved solely on merit. Scientific and Classical management theories fit best with a transactional leadership style, although there is some recognition for the unique talents staff bring to an organization, these frameworks form the basis for today’s four functions of management: planning, organizing, leading, and controlling.

Human Relations Management Theory began its development with the research work of Elton Mayo in 1932. Mayo’s hallmark study found that one of the employee groups he studied had increased productivity due to the attention he gave them. This is called the Hawthorne Effect, named for the location in which Mayo’s research was conducted.

His discovery led to Mayo’s realization that motivation was linked to success, group belongingness, cohesiveness was linked to productivity, and morale was linked to output. Interpersonal human relations management style promoted all three. Since then, human relations management theory has emphasized communication, relationship building, negotiating, and conflict resolution.

Management Function and Theories

Click through the following interactive to examine examples of management function and theories.

Click the following link to expand to full screen:

Management Function and Theories Exploration

Management Function and Theories Interactive Transcript

Management Function and Theories

Management Function and Theories Understanding the history of organizational management concepts and theory helps to inform the DNP-prepared nurse’s leadership in contemporary nursing practice and healthcare environments. The following four traditional elements of management continue to provide a useful framework for today’s healthcare organizations. Review each function. Then, click to view the expert’s example.

Function 1 = Planning

Question: Planning is the process of getting organized to function. Provide an example of planning.

Expert’s example: A nurse manager initiates planning through strategic and tactical steps in preparation for organizational interventions. There are two types of planning: strategic and tactical. Strategic involves long-term planning to achieve the organization’s mission and goals. Tactical planning is short-term decision making for operational management, such as the allocation of resources, scheduling staff, and carrying out the daily routine.

Function 2 = Organization

Question: The next step in the traditional management process is organizing. As a future DNP-prepared nurse, what functions of organizing do you foresee in the organizational process?

Expert’s example: Organizing is the creation of order and structure to complete the first function, which is planning. A nurse manager creates a staffing schedule, arranges educational opportunities to meet operational needs, and positions staff to leverage skillsets for patient care. Organizing is applying appropriate power to ensure operational assets are being effectively applied so that outcomes match those that are anticipated.

Function 3 = Leading

Question: Much like Fredrick Taylor’s scientific management principles in the early 1900s, both Fayol’s original and Follett’s modification to the classical ideas of leadership were similarly methodical and focused on training managers in leadership. From your exploration, what might be functions of traditional leading (or “commanding”) that you might use as a DNP-prepared nurse today?

Expert’s example: Supervising is a management function. One traditional management maxim was that you get what you inspect, not what you expect. The application today is that a good supervisor must trust but verify results. Many other traditional management leadership functions are still applicable to today’s DNP leader: motivating, delegating, and even collaborating evolved from these early principles.

Function 4 = Controlling

Question: Traditionally, Fayol’s idea of controlling was adapting to changing circumstances. What might you learn from this traditional approach that you might apply today as a DNP-prepared nurse?

Expert’s example: Controlling is a management function of assessing performance and adjusting actions to accomplish organizational goals. However, controlling is not just reactive; it is also proactive such that the seasoned manager anticipates deviation from the goal and plans to prevent or otherwise overcome anticipated events. Other controlling adjustments are made by using evaluative processes with practice guidelines, quality improvement plans, audits, total quality management milestones, and accreditation standards.

Selected Historical Management Models

Review the following timeline regarding the different management models.

Management Models Timeline Interactive Transcript

TypeTheoryDescriptionScientificFredrick Taylor’s (1911/2014) Scientific Management Theory· Match workers to tasks

· Establish command hierarchy

· Structure the organization through research (Scientific Method)

· Span of control: monitor and incentivize workers (usually negative reinforcement)

Max Weber’s (1919) Theory of Bureaucracy· Rigid division of labor, rules, and regulations

· Hiring and promoting workers based on competencies (specialized roles)

· Hierarchy, responsibility, and accountability

· Impersonal authority and political neutrality

ClassicalHenri Fayol’s (1949) Classical Management Theory· Planning (Foresight)

· Organizing

· Command

· Coordinate and control

Mary Parker Follett (1924)* (Neoclassical) Organizational Theory (and Early Transformational Leadership) (*See Fox & Urwick, 1940)· Planning

· Organizing

· Leading (toward transformations)

· Controlling

Human Relations DevelopmentElton Mayo’s (1932)* Management (motivation) Theory (*See Wood & Wood, 2004)· Low cohesive-low norm groups = low productivity

· High cohesive-low norm groups = negative productivity

· Low cohesive-high norms = limited productivity

· High cohesive-high norms = high productivity

Maslow’s (1943) Motivational Theory (Hierarchy of Needs)· Although itself not an organizational (or leadership) theory, it has helped shape human relations theory by helping managers explain and adjust to elements of motivation for employees.Douglas McGregor’s (1960) Theory X and Theory Y Management Theory· Managing Theory X style = Authoritative, negative view of employees, all-controlling, uses a transactional leadership style

· Managing Theory Y style = Participatory, positive approach to people, consensus-seeking, uses transformative leadership styles

Henry Mintzberg’s (1973) Management Theory· Interpersonal

· Informational

· Decision-maker

Modern Human Relations (Management) (Composite) Frameworks· Relationship building

· Organizing/multitasking

· Conflict resolution/negotiation

· Communication

· The movement in human relations theories since Mayo’s 1932 have informed composite versions of the modern human relations management theories or organizational management theories used today.

Selected Historical Management Models

Fayol, H. (1949). General and industrial management (C. Storrs, Trans.). Pitman Publishing.

Fox, E. M., & Urwick, L. (1940). Dynamic administration: The collected papers of Mary Parker Follett. Pitman Publishing.

Maslow, A. H. (1943). A theory of human motivation. Psychological Review, 50(4), 370–396. https://doi.org/10.1037/h0054346

McGregor, D. (1960). The human side of enterprise. McGraw-Hill Book Company, Inc.

Mintzberg, H. (1973). The nature of managerial work. Harper & Row.

Taylor, F. W. (2014). The principles of scientific management (1911 edition reprint). Martino Fine Books.

Waters, T., & Waters, D. (Eds.). (2015). Weber’s rationalism and modern society: New translations on politics, bureaucracy, and social stratification. (T. Waters & D. Waters, Trans.). Palgrave-Macmillan.

Wood, J. C., & Wood, M. C. (2004). George Elton Mayo: Critical evaluations in business and management. Routledge.

Leadership Theories & Conceptual Frameworks

Most of us have been introduced to the common leadership styles of authoritarian, democratic, and laissez-faire that were popularized in the 1950s. However, these styles did not typically match most leaders’ styles; therefore, more operational theories emerged.

View the following activity to examine examples of leadership theories and conceptual frameworks.

ASDA Interactive Transcript

Situational and Contingency Leadership Theories

Mary Parker Follett’s neoclassical management theory also popularized the idea that a leader’s style should be interpersonal (not impersonal) and match the situation and the individuals involved in the situation. Today, her ideas have developed into styles of transformational leadership and grown into successful models like Dr.

Paul Hersey’s (1985) The Situational Leader and developed into a modern theory by Hersey and Blanchard (1977). Success in leading depends on how well leadership style is adapted to the situation, specifically in the styles of directing, coaching, supporting, and delegating. Contingency theory is similar and stresses the interrelationships between the leader and those being led.

Servant Leadership Theory

Greenleaf’s (2002) servant leader is simply leadership serving others or leadership in the service of others. The leader serves others in such a way to ensure that others can fulfill their roles, professionally and personally. There are several ways servant leadership can be demonstrated, with authentic leadership as one example.

Transformational Versus Transactional Leadership

Building on the concepts before them, transformational and transactional leadership styles have evolved today. Even though we tend to think of one as good and the other bad, both have a place in the leadership toolbox. Transformational leaders tend to be outward focused, positive, and inspiring; the transactional style tends to be more impersonal, authoritative, and directive.

Transformational Leadership

Transformational leadership has many of the same characteristics as servant leadership. Transformational leaders empower their followers and are dynamic individuals who recognize that their followers have unique abilities. They see their roles as leaders who are responsible for finding the best fits for their followers. Their style is interactive and highly communicative. They demonstrate a vision for the future and inspire others to share in that vision.

Transactional Leadership

Transactional leaders are typically concerned with maintaining the status quo. Rather than seeing the big picture, transactional leaders focus on details. They are sometimes accused of paralysis by analysis. They are unilateral leaders and function best in a no-growth environment. The transactional leader extrinsically motivates. They are best suited for emergency or military leadership, and the transactional style is most successful when used in critical situations, battlefield leadership, or emergency response efforts. Transformational leaders should be able to use transactional styles of leadership when necessary.

Quantum Leadership and Quantum Caring Leadership

Quantum leadership has also been described as a transformational style of leadership that leads from the future (Porter-O’Grady & Malloch, 2011). Quantum leadership means having the ability to anticipate future trends and then engaging innovative strategies to achieve potential future outcomes. Quantum leaders use skills, knowledge, and integrative abilities to encourage others to reach ever-higher levels of functioning. By doing so, they become inspirational and motivating.

A quantum leader creates nurturing relationships, empowers others, and provides a moral compass while leading from an Ethic of Care. In the traditional meaning of the word, a quantum is the smallest increment of something. Applied to leadership, the quanta might be the very basic elements of interprofessional relationship-building that transform others. Just as the electron is the smallest particle of an atom yet essential for its charge, each small element of leadership creates that same dynamic.

The extension of quantum leadership is defined by Quantum Caring Leadership (Watson et al., 2018). This synthesized concept blends the caring science of nursing with quantum leadership to create a dynamic, universal leadership. This incorporates the intent of relationship-based care, patient-centered care, universal connectedness, mindful leadership, the Ethic of Care, and many of the other caring concepts this course has explored.

The Interprofessional Collaboration Challenge

Transformational leaders in healthcare today must develop interprofessional collaboration skills to successfully accomplish day-to-day operations as well as project management. Creating partnerships with other disciplines is no simple task. Just as we have examined that leaders must establish trust with their teams, so must nursing leaders foster trust with other professionals. Just as nurses are socialized to the nursing family, other professional disciplines are socialized to theirs.

Each has their own professional education, organizations, cultures, standards, licensing process, and occupational language. To ask other professionals to be open to collaborating as professional equals is often incomprehensible for them. Such partnerships are often seen as beneath them. It often takes champions from each camp to help bridge the professional gaps between them.

One helpful guide to initiating interprofessional collaboration as a healthcare leader is the Interprofessional Education Collaborative Expert Panel’s (2016) Practice Competency Domains. (See the Interprofessional Collaboration section in this week’s readings from Broome & Marshall, 2021.) The four domains and their sub-competencies can help align all professionals to contemporary standards to bridge the interprofessional gaps.

Leading Translational Science: Four Translation Science Models

Leading a practice change project requires a transformational leadership style that employs both management structure and leadership strengths. Four translation science models widely used to organize practice change projects include the following:

Johns Hopkins Nursing Evidence-Based Practice Model
Rogers’s Diffusion of Innovations Theory
Canadian Knowledge-to-Action Model
Promoting Action to Research Implementation in Health Services (PARHiS) Framework

These four models provide a management structure for knowledge translation and project implementation.

Click on the tabs to see a graphic of each model.

The Johns Hopkins Nursing Evidence-Based Practice Model

Effective Leadership Styles Discussion NR703

Click on the tabs to see a graphic of each model.

The Johns Hopkins Nursing Evidence-Based Practice Model

Rogers’s Diffusion of Innovations Theory

Knowledge-to-Action Model

Promoting Action on Research in Health Services (PARHiS) Framework

Four Models Images Transcript

Tab: The Johns Hopkins Nursing Evidence-Based Practice Model

Inquiry
Practice Question – Evidence – Translation (encircled in Practice Learning): Leads back to Inquiry or forward to Best Practices
Best Practices
Practice Improvements (Clinical Learning, Operational): Leads back to Inquiry

©The Johns Hopkins Hospital / Johns Hopkins University School of Nursing

Tab Title: Rogers’s Diffusion of Innovations Theory

Knowledge
Persuasion
Decision
Implementation
Confirmation

Tab Title: Knowledge-to-Action Model

Action Cycle (Application)
- Identify problem – Identify, review, select knowledge
- Adapt knowledge to local context
- Assess barriers to knowledge use
- Select, tailor, implement interventions
- Monitor knowledge use
- Evaluate outcomes
- Sustain knowledge use
Knowledge Creation (inverted pyramid from top to bottom – tailoring knowledge)
- Knowledge inquiry
- Synthesis
- Products/tools

Note: Knowledge-to-action model. Adapted from “Lost in Knowledge Translation: Time for a Map?” by I. D. Graham, J. Logan, M. B. Harrison, S. E. Straus, J. Tetroe, W. Caswell, & N. Robinson, 2006, The Journal of Continuing Education in the Health Professions, 26, 13–24 (https://doi.org/10.1002/chp.47). CC-BY-SA 2.0

Tab Title: Promoting Action on Research in Health Services (PARHiS) Framework

Evidence: research, clinical and patient experience, local data
Context: culture, leadership, evaluation
Facilitation: purpose, role, skills and attributes

What these four models do not explicitly describe is the leadership skills that must be used to implement translation science models to improve outcomes. However, you have many of these skills already stored in your leadership toolbox as we have polished them in the last five weeks.

Reflection

Reflect on your chosen translation science model and the skills in your leadership toolbox. Imagine how you will blend the two into a synthesized leadership approach to implement and sustain a practice change, especially in an interprofessional environment.

Effective Leadership Styles Discussion NR703 Week 6 References

Broome, M. E., & Marshall, E. S. (2021). Transformational leadership in nursing: From expert clinician to influential leader (3rd ed). Springer Publishing Company. https://doi.org/10.1891/978082613505

Fayol, H. (1949). General and industrial management (C. Storrs, Trans.). Pitman Publishing.

Fox, E. M., & Urwick, L. (1940). Dynamic administration: The collected papers of Mary Parker Follett. Pitman Publishing.

Greenleaf, R. K. (2002).?Servant leadership: A journey into the nature of legitimate power and greatness?(25th anniversary edition). Paulist Press.

Hersey, P. (1985).?The situational leader?(4th ed.). Warner Books.

Hersey, P., & Blanchard, K. H. (1977).?Management of organizational behavior: Utilizing human resources?(3rd ed.). Prentice-Hall.

Maslow, A.H. (1943). A theory of human motivation. Psychological Review, 50(4), 370–396. https://doi.org/10.1037/h0054346

McGregor, D. (1960). The human side of enterprise. McGraw-Hill Book Company, Inc.

Mintzberg, H. (1973). The nature of managerial work. Harper & Row.

Porter-O’Grady, T., & Malloch, K. (2011).?Quantum leadership: Advancing innovation, transforming healthcare?(3rd ed.). Jones & Bartlett Publishers.

Taylor, F. W. (2014). The principles of scientific management (1911 edition reprint). Martino Fine Books.

Waters, T., & Waters, D. (Eds.). (2015). Weber’s rationalism and modern society: New translations on politics, bureaucracy, and social stratification (T. Waters & D. Waters, Trans.). Palgrave-Macmillan.

Watson, J., Porter-O’Grady, T., Horton-Deutsch, S., & Malloch, K. (2018). Quantum caring leadership: Integrating quantum leadership with caring science. Nursing Science Quarterly, 31(3), 253-258. https://doi.org/10.1177/0894318418774893

Wood, J. C., & Wood, M. C. (2004). George Elton Mayo: Critical evaluations in business and management. Routledge.

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Elisabeth Jacks Case Study Bipolar I DisorderElisabeth Jacks Case Study Bipolar ...

Elisabeth Jacks Case Study Bipolar I Disorder

Elisabeth Jacks ran a catering service with her second husband, Donald, the main informant.

At age 38, Elisabeth already had two grown children, so Donald could understand why this pregnancy might have upset her. Even so, she had seemed unnaturally sad.

From about her fourth month, she spent much of each day in bed, not arising until the afternoon, when she felt less tired. Her appetite, voracious during her first trimester, fell off so that by the time of delivery, she was several pounds lighter than usual for a full-term pregnancy.

She had to give up keeping the household and business accounts because she couldn’t focus her attention long enough to add a column of figures. Still, the only time Donald became alarmed was one evening at the beginning of Elisabeth’s ninth month, when she told him that she had been thinking for days that she wouldn’t survive childbirth and he would have to rear the baby without her. “You’ll both be better off without me, anyway,” she had said.

After their son was born, Elisabeth’s mood brightened almost at once. The crying spells and the hours of rumination disappeared; briefly, she seemed almost her normal self. Late one Friday night, however, when the baby was 3 weeks old, Donald returned from catering a banquet to find Elisabeth wearing only a bra and panties and icing a cake.

Two other just-iced cakes were lined up on the counter, and the kitchen was littered with dirty pots and pans.

“She said she’d made one for each of us, and she wanted to party,” Donald told the clinician. “I started to change the baby—he was howling in his basket—but she wanted to drag me off to the bedroom. She said ‘Please, sweetie, it’s been a long time.’ I mean, even if I hadn’t been dead tired, who could concentrate with the baby crying like that?”

All the next day, Elisabeth was out with girlfriends, leaving Donald home with the baby. She spent nearly $300 on Christmas presents on Sunday at an April garage sale. She seemed to have boundless energy, sleeping only 2 or 3 hours a night before arising, rested and ready to go. On Monday, she decided to open a bakery; by telephone, she tried to charge over $1,600 worth of kitchen supplies to their Visa card. She’d have done the same the next day but talked so fast that the person she called couldn’t understand her. In frustration, she slammed the phone down.

Elisabeth’s behavior became so erratic that for the next two evenings, Donald stayed off work to care for the baby, but his presence only provoked her sexual demands. Then there was the marijuana. Before Elisabeth became pregnant, she would have an occasional toke (she called it her “herbs”). During the past week, not all the smells in the house had been fresh-baked cake, so Donald thought she might be at it again.

Yesterday Elisabeth awakened him at 5 A.M. and announced, “I am becoming God.” That was when he made the appointment to bring her for an evaluation.

Elisabeth herself could hardly sit still during the interview. In a burst of speech, she described her renewed energy and plans for the bakery. She volunteered that she had never felt better in her life. In rapid succession, she then described her mood (ecstatic), how it made her feel when she put on her best silk dress (sexy), where she had purchased the dress, how old she had been when she bought it, and to whom she was married at the time.

Patients who may have bipolar I disorder need a careful interview for symptoms of addiction to alcohol; alcohol use disorder is diagnosed as a comorbid disorder in as many as 30%. Often alcohol-related symptoms appear first.

Elisabeth Jacks Case Study Bipolar I Disorder

This vignette provides a fairly typical picture of manic excitement. Elisabeth Jacks’ mood was elevated. Aside from the issue of marijuana smoking (which appeared to be a symptom, not a cause), her relatively late age of onset was the only atypical feature.

For at least a week, Elisabeth had had this high mood (manic episode criterion A), accompanied by most of the other typical symptoms (B): reduced need for sleep (B2), talkativeness (B3), flight of ideas (a sample run is given at the end of the vignette, B4), and poor judgment (buying Christmas gifts at the April garage sale—B7).

Her disorder caused considerable distress for her family if not for her (C); this is usual for patients with manic episodes. The severity of the symptoms (not their number or type) and the degree of impairment were what would differentiate her full-blown manic episode from a hypomanic episode.

The vignette does not address the issue of another medical condition (D). The admitting clinician would have to rule out medical problems such as hyperthyroidism, multiple sclerosis, and brain tumors before a definitive diagnosis. Delirium must be ruled out for any postpartum patient, but she was able to focus her attention well.

Although Elisabeth may have been smoking marijuana, misuse of this substance should never be confused with mania; neither cannabis intoxication nor withdrawal presents the combination of symptoms typical of mania.

Although the depression that occurred early in her pregnancy would have met the criteria for major depressive episodes, her current manic episode would obviate major depressive disorder.

Because the current episode was too severe for hypomanic symptoms, she could not have the cyclothymic disorder. Therefore, the diagnosis would have to be bipolar I disorder (because she was hospitalized, it could not be bipolar II). The course of her illness was not compatible with any psychotic disorder other than brief psychotic disorder, and that diagnosis specifically excludes bipolar disorder (B).

The bipolar I subtypes, as described earlier, is based on the nature of the most recent episode. Elisabeth’s, of course, would be the current episode manic.

Next, we’ll score the severity of Elisabeth’s mania (see the footnotes in Table 3.2). These severity codes are satisfactorily self-explanatory, though there’s one problem: Whether Elisabeth was psychotic is not made clear in the vignette. If we take her words literally, she thought she was becoming God, in which case she would qualify for severe with psychotic features. These would be judged mood-congruent because grandiosity was in keeping with her exalted mood.

The only possible episode specifier (Table 3.3) would be with peripartum onset: She developed her manic episode within a few days of delivery. With a GAF score of 25, the full diagnosis would be.

F31.2 [296.44]Bipolar I disorder, currently manic, severe with mood-congruent psychotic features, with peripartum onset

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.