immunization in India, Switzerland and Nigeria

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this paper will be on immunization in India, Switzerland and Nigeria  

Overview/Description:

The final project for NSG6101 consists of the development of a novel research proposal specific to your role specialization. The project must include an intervention appropriate to nursing practice and consistent with your MSN role option. An alternative to the above includes the selection of a specialty organization to focus research proposals based on the priorities of that organization. Examples of these organizations could include (but are not limited to): Sigma Theta Tau International, American Nurses’ Foundation, Oncology Nursing Society, Association of Nurses in AIDS Care, American Psychiatric Nursing Association, American Association of Critical Care Nurses, National Association of Pediatric Nurse Associates and Practitioners, National League For Nursing, etc.

Throughout this course you have been developing various sections of the research proposal. This week you will assemble the final proposal (addressing faculty feedback). This paper is to be developed in APA format/style using the required template and not to exceed 8-10 pages (excluding title page/references/appendices).

Criteria:
Introduction

  • Background and Significance of Problem
  • Statement of the Problem and Purpose of the Study

Literature Review

  • Summary of the Evidence for the Proposed Study

Research Question, Hypothesis, and Variables with Operational Definitions

Theoretical Framework

  • Overview and Guiding Propositions(s) Described in Theory
  • Application of Theory to Your Study’s/Project’s Focus

Methodology

  • Sample/Setting: Number and criteria for inclusion and description of place in which data will be collected.
  • Sampling Strategy
  • Research Design: Type (e.g., Quasi-Experimental), description, and rationale for selection. 
  • Extraneous Variables (and plan for how controlled).
  • Instruments: Description, validity, and reliability estimates, which have been performed (on a pre-established measure). Include plans for testing validity and reliability of generating your own instrument(s).
  • Description of the Intervention
  • Data Collection Procedures
  • Data Analysis Plans
    • Describe plan for data analysis for demographic variables (descriptive statistical tests).
    • Describe plan for data analysis of study variables (descriptive and inferential statistical tests).

Ethical Issues

  • Describe ethical considerations and your plan to protect human rights.

Limitation of Proposed Study
Implications for Practice
References
Appendices

  • Informed Consent Letter
    • Procedure section is clear, described in detail, specific, and all inclusive. Written in lay language (as documented by reading level score). Includes risks and benefits relevant to study. Address assent (if applicable).

protection of human subjects

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 Conducting research projects while ensuring the protection of human subjects is necessary.  What are some methods to protect personal rights of someone in one of the groups that is labeled as vulnerable?  Justify your rationale.

Trigeminal Neuralgia and Giant Cell Arteritis

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  topic is Trigeminal Neuralgia and Giant Cell Arteritis

You will research the two areas of content assigned to you and compare and contrast them in discussion post. NOTE: A comparison and contrast assignment is not about listing the info regarding each disease separately but rather looking at each disease side by side and discussing the similarities and differences given the categories below. Consider how each patient would actually present to the office. Consider how their history would affect their diagnosis, etc. Evaluation of mastery is focused on the student’s ability to demonstrate specific understanding of how the diagnoses differ and relate to one another. Address the following topics below in your own words:

Presentation

Pathophysiology

Assessment

Diagnosis

Treatment

RUBRIC

APA format

demonstrate course knowledge by thorough, thoughtful, evidence based discussion of similarities and differences in reference to 

-presentation

-pathophysiology

-assessment

-diagnosis

-treatment

evidence based sources published within last 5 years

intext citations and full references provided

programs for environmental health in Saudi Arabia

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What are important interventions and programs for environmental health in Saudi Arabia? How are public health interventions planned and evaluated for environmental health? From Arab News (2014), Riyadh was ranked one of the most polluted cities globally according to the UN. How can air pollution in Riyadh be resolved by public health intervention?

  • Requirements:
  1. Be sure to support your statements with logic and argument,
  2. More citing all sources referenced through the text 
  3. APA style
  4. 2 pages
  5. no plagiarism
  6. 3 Minimum references 
  7. The references not older than 5 years ago

Post Millennium Development Goals

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For this critical thinking assignment, compare the main healthcare-related components of the Rio Policy Statement (as found in the article, For a Global Agenda or Post Millennium Development Goals) to the health components of Saudi Arabia’s Vision 2030. 

For this critical thinking assignment, compare the main healthcare-related components of the Rio Policy Statement (as found in the article, For a Global Agenda or Post Millennium Development Goals) to the health components of Saudi Arabia’s Vision 2030. 

Matida, A. (2016). For a global agenda on post millennium development goals. Ciência & Saúde Coletiva, 21(6).

In your analysis, highlight those components that are in agreement. Also, be sure to include the components where there may be disagreement.

You will develop a written paper including the following sections to organize your writing:

  1. Rio Policy Statement,
  2. Saudi Vision 2030,
  3. Compare and Contrast, and
  4. Discussion.

Your paper should meet the following structural requirements:

  1. The paper should be 5-6 pages in length, not including the cover sheet and reference page.
  2. Formatted according to APA  standards.
  3. Provide support for your statements with in-text citations from a minimum of six scholarly articles. Two of these sources may be from the class readings, textbook, or lectures, but four must be external.
  4. Utilize headings to organize the content in your work with introduction and conclusion and so on.
  5. Add more citation through the text.
  6. No plagiarism at all.
  7. The references not older than 5 years back.

) to the health components of Saudi Arabia’s Vision 2030. 

Matida, A. (2016). For a global agenda on post millennium development goals. Ciência & Saúde Coletiva, 21(6).

In your analysis, highlight those components that are in agreement. Also, be sure to include the components where there may be disagreement.

You will develop a written paper including the following sections to organize your writing:

  1. Rio Policy Statement,
  2. Saudi Vision 2030,
  3. Compare and Contrast, and
  4. Discussion.

Your paper should meet the following structural requirements:

  1. The paper should be 5-6 pages in length, not including the cover sheet and reference page.
  2. Formatted according to APA  standards.
  3. Provide support for your statements with in-text citations from a minimum of six scholarly articles. Two of these sources may be from the class readings, textbook, or lectures, but four must be external.
  4. Utilize headings to organize the content in your work with introduction and conclusion and so on.
  5. Add more citation through the text.
  6. No plagiarism at all.
  7. The references not older than 5 years back.

Womens Health

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 Reply Amanda

Question #1

An ultrasound in third trimester could show many clinical indicators of fetal well-being.  First it shows us the fetal number-which most likely is already known.  It also shows us the baby’s presentation.   “If breech, describe the “type” of breech” Frank, Complete, Incomplete, Footling” (TOP, 2017).  This ultrasound will also tell us the fetal biometry and estimated fetal weight, Amniotic Fluid Volume, Placentation, Fetal movements, and Consider re-visualizing select fetal anatomic structures when a third trimester assessment is being performed (TOP, 2017). Its also important to check the babies heart tones and the mother’s vital signs, particularly the blood pressure.  Always ask if the mother is having any bleeding, leaking, constant contractions and is she feeling the baby move well.  It is also important to check the mother’s urine. 

Steps to take if findings are not reassuring during third trimester depend on the finding.  If the baby is breech.  External cephalic version is one way to turn a baby from breech position to head down position while it’s still in the uterus. It involves the doctor applying pressure to your stomach to turn the baby from the outside(Healthline, 2018).  For high blood pressure and signs of preeclampsia, “You may have to stay at the hospital for observation and to manage your blood pressure until the baby is old enough for delivery. If your baby is younger than 34 weeks, you will probably be given medication to speed up the baby’s lung development”(Healthline, 2018).  For most findings that are not reassuring the patient will be sent to the hospital for monitoring for mother and baby.

Healthline. (2018). What Might Go Wrong in the Third Trimester?. Retrieved on February 23, 2019 from https://www.healthline.com/health/pregnancy/third-trimester-complications#post–term

Toward Optimized Practice (TOP). (2017). THIRD TRIMESTER FETAL WELL-BEING STUDIES: CRITERIA AND MANAGING RESULTS.  Retrieved on February 23, 2019 from http://www.topalbertadoctors.org/download/2129/Third%20Trimester%20Fetal%20Well-Being%20Studies.pdf?_20180914050143

 Reply Hollie

Question 1—Third Trimester

Fetal growth is an important part of fetal assessment in the third trimester. Studies show that poor fetal growth in the second and third trimesters are associated with increased risks of preterm birth, low birthweight, and long-term adverse health outcomes (Gaillard, Steegers, de Jongste, Hofman, & Jaddoe, 2014). Fundal height is often used to assess fetal growth. If fundal height differs by 3 cm or more from gestational age, a follow-up ultrasound is advised to assess further (McCowan, Figueras, & Anderson, 2018).

Fetal heart rate and fetal activity should also be routinely assessed. The mother should be asked about fetal activity. Counting the kicks should be highly encouraged starting at week 28 (Bryant & Thistle, 2019). A kick count of less than 10 in 2 hours may be cause for concern (Bryant & Thistle, 2019). Fetal heart rate should also be assessed at every prenatal visit in the third trimester (ACOG, 2018). A typical fetal heart rate is between 120 and 160 beats per minute. Changes in fetal activity or fetal heart rate indicate a need for further testing. A non-stress test and/or a biophysical profile (BPP) may be ordered when results are nonreassuring (ACOG, 2018). A biophysical profile is an ultrasound that assesses: fetal breathing movement, fetal movement of the body or limbs, fetal tone and amniotic fluid volume (Bryant & Thistle, 2019).

Maternal blood pressure, urinalysis, and degree of edema are also important measurements that can affect the health of the fetus (Zolotor & Carlough, 2014). Blood pressure measurements can help identify chronic hypertension or hypertensive disorders that develop during pregnancy, such as preeclampsia or gestational hypertension (Zolotor & Carlough, 2014). Edema may be a normal finding but can also be a sign of preeclampsia (Zolotor & Carlough, 2014). Protein in the urine may also indicate preeclampsia risk (Zolotor & Carlough, 2014). These findings may also suggest the need for blood tests, fetal ultrasounds, nonstress tests, or a BPP (Zolotor & Carlough, 2014).

Lastly, fetal presentation is encouraged to be assessed beginning at 36 weeks gestation (Zolotor & Carlough, 2014). This is most often done using the Leopold maneuvers (Zolotor & Carlough, 2014). External cephalic version may be used to turn a fetus from a breech or transverse position into a vertex position before birth (Zolotor & Carlough, 2014).

References

ACOG. (2018). Special tests for monitoring fetal health. Retrieved from https://www.acog.org/Patients/FAQs/Special-Tests-for-Monitoring-Fetal-Health?IsMobileSet=false#exam

Bryant, J. & Thistle, J. (2019). Fetal movement. Treasure Island, FL: StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK470566/

Gaillard, R., Steegers, E. A., de Jongste, J. C., Hofman, A., & Jaddoe, V. W. (2014). Tracking of fetal growth characteristics during different trimesters and the risks of adverse birth outcomes. International Journal of Epidemiology, 43(4), 1140-1153. https://dx.doi.org/10.1093%2Fije%2Fdyu036

McCown, L., Figueras, F., & Anderson, N. (2018). Evidence-based national guidelines for the management of suspected fetal growth restriction: Comparison, consensus, and controversy. American Journal of Obstetrics & Gynecology, 218(2),855–868. doi: 10.1016/j.ajog.2017.12.004.

Zolotor, A., & Carlough, M. (2014). Update on prenatal care. American Family Physician, 89(3), 199-208. Retrieved from https://www.aafp.org/afp/2014/0201/p199.html

Edited by Hollie Finders on Feb 24 at 2:57pm Reply 

Healthcare Innovation Strategies

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Apply principles of organizational learning, innovation, and change in healthcare organizations.

Instructions

As the leader of this healthcare organization, you have been invited to a healthcare symposium to discuss organizational learning, innovation, and change in healthcare organizations. You are requested to give a presentation on your organization’s changes for improvement, learning methods employed in the change process, and what innovations your organization used for the improvements.

You are presented with the following details to complete your presentation.

· Explain the concepts of organizational learning in a healthcare setting. Cover at least three concepts with an example of each.

· Outline steps used to create innovation in a healthcare setting in the face of a recessive marketplace. Provide a minimum of three steps with examples.

· Discuss the overwhelming need for continuous change in a healthcare setting; provide examples.

On a separate slide, provide references in APA format.

NOTE – APA formatting and proper grammar, punctuation, and form are required

breast changes

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 Reply Cathy

Asking the patient about any breast changes including size change, dimpling, or nipple discharge would be helpful (Centers for Disease Control and Prevention, 2018). In addition, asking the patient about any family history of breast cancer and her menstrual cycle timing could be helpful. A  breast exam would be appropriate during this patient’s physical exam. The patient reported feeling a lump in the shower. By the provider doing their own exam, the patient’s technique and lump placement could be verified (Centers for Disease Control and Prevention, 2018). 

       Some possible differential diagnosis for this patient include breast cancer, a cyst, fibroadenoma, lipoma, mastitis, and breast injury (Mayo Clinic, 2018). Getting a full health history and ordering tests would be needed to know for sure. Some tests that may be ordered include imaging to see what the potential lump looks like and placement.  A mammogram is commonly used along with a biopsy to test the breast tissue cells to determine if they could be cancerous (Mayo Clinic, 2018).  

       Based on the results for this patient, it is possible that a referral could be necessary. This patient may need to see an oncologist or even a surgeon. If this patient has cancer, radiation or chemotherapy may be an necessary intervention (Mayo Clinic, 2018). Making sure this patient has access to information and support is also important when considering management of care.  

Reference
 

Centers for Disease Control and Prevention. (2018). “What Are the Symptoms of Breast Cancer”. Retrieved from:  (Links to an external site.)Links to an external site.https://www.cdc.gov/cancer/breast/basic_info/symptoms.htm
 

Mayo Clinic. (2018). Breast lumps. Retrieved from https://www.mayoclinic.org/symptoms/breast-lumps/basics/causes/sym-20050619 (Links to an external site.)Links to an external site. 

 Reply Quiana

A 35-y.o. woman is seen in the office with a chief complaint of a breast mass. She states she found the lump when she was in the shower, and she is quite visibly distressed. Her medical history is unremarkable, although she reports that she has not had a mammogram. She takes no prescription medications.

What additional questions should you ask the patient and why?

  • Additional questions to ask this patient would be if the lump is painful, pain in fibrocystic disease is bilateral and increases before the monthly menstruation.
  • Has the lump changed in size or remained the same, has she ever noticed a lump before, is she menstruating. Cyst gets smaller and pain decreases when the menstrual cycle starts. If the patient is menstruating it is important to have her come back at the end of her menstrual period. This is because the breast cysts can fluctuate during the menstrual cycle (So you found a lump, now what? 2015).
  • Does she have a nipple discharge? A nipple discharge that is unilateral, pink or bloody, non-milky or associated with a mass is an indicator of breast cancer.
  • Ask at what age did she begin menstruating because early menarche increases the risk of breast cancer.
  • Does she have a family history of breast cancer? If a mother or sister had breast cancer there is twice the risk and if both have it there is three times the risk of developing breast cancer.
  • Does she have any children? Null parity increases your risk of breast cancer (Seller, & Symons, 2018).

What should be included in the physical examination at this visit?

            A complete breast exam should be included in this visit. The breast lump should be assessed to determine if it is firm, with indistinct borders and if it is attached to the skin. Assessment should include if there is any dimpling or nipple retraction, and unilateral nipple discharge, all of which are a signs of breast cancer. Benign lumps usually have well-defined borders and are mobile (Sellers, & Symons, 2018).

Possible differential diagnoses at this time are as follows:

  • Breast cancer–Patients that develop breast cancer with no family history are normally older than 40 years.
  • Fibrocystic breast disease-Patients have cyclic bilateral breast pain, especially near and during menstruation. The pain and tenderness worsen before menstruation.
  • Fibroadenoma- Usually presents in patients 20-40 years. Usually, a solitary lump that is firm, mobile, smooth, and rubbery (Seller, & Symons, 2018).

What tests should you order and why?

            A mammogram is the first test to order. If the mammogram is inconclusive or the breast has dense tissue then a breast ultrasound should be ordered to differentiate between a cystic mass and a solid mass. If needed a needle aspiration breast biopsy should be ordered. In some cases an MRI can be ordered, especially in high-risk patients (Sellers, & Symons, 2018).

How should this patient be managed?

            If it is fibrocystic breast disease the patient should be advised to wear a firm bra even at night. Dietary restrictions will include coffee, chocolate, and tea. The patient should also take 400 IU of vitamin E daily. If the patient is experiencing pain or moderate to severe fibrocystic breast disease, the therapeutics to prescribe are oral contraceptives, NSAIDs and/or progestin. The patient should also be educated on the importance of conducting breast self-exams monthly even though the breasts may be lumpy (Dunphy, Winland-Brown, Porter, & Thomas, 2015).

References

Dunphy, L. M., Winland-Brown, J. E., Porter, B. O., & Thomas, D. A. (2015). Primary

care. The art and science of advanced practice nursing. (4th Ed.). Philadelphia, PA. F. A. Davis Company.

Seller, R. H., & Symons, A. B. (2018). Differential diagnosis of common complaints. (7th Ed.). Philadelphia, PA. Elsevier, Inc.

Diversity Plan

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Competency

Design a plan for conducting business and managing employees in a global society.

Scenario Information

You have been hired as the Human Resources Director for a global organization that is headquartered in the United States. Your job is to evaluate and make recommendations in the area of diversity for your company. Each section will contain specific areas within diversity for you to focus on. You will be tasked with choosing from one of the diversity areas that are provided to you. Be sure to conduct research using the university library and other relevant sources.

Diversity Area-Race

Instructions

Now that you have selected your area of diverse concentration, you are now tasked with designing a plan to aid your selected group in the organization’s workforce. Your CEO has asked you to develop a diversity plan for your diversity area. The following questions should be included in your 3-5 page report. The report should be in proper APA format.

  1. Introduce your diversity area and importance for diversity planning.
  2. What are some of the steps you would include in your diversity plan?
  3. What would be some of the challenges in the implementation of your plan in the US workforce, and in a global workforce?
  4. What would be some of your control measures used to ensure your plan’s success? Remember this should go beyond being legally compliant.  
  5. Conclude your diversity plan.

the role of the project manager

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Scenario Information

You are assuming the role of the project manager for a company called SuperPacks to provide a new backpack product with a built-in refrigeration pouch and radio module. Your customer for this project is the U.S. Army, Ground Forces and Special Operations. As the project manager for your team, you will be submitting to your manager a project management report.

Instructions

Work Breakdown Schedule

As the project manager, your role is to track and manage the projects you are working on; creating a Statement of Work and a Work Breakdown Structure are tools that can help you manage a project or projects. Below you will create a Statement of work consisting of the basics of the project(s) you are working on. Consider this similar to a business or marketing report, but this will define the project, project scope, and overall strategy of the project.

Part One
Statement of Work (SOW) Document:

Develop the project Statement of Work document to include the following information:

  • Business need
  • Product scope description
  • Strategic plan

Part Two
As part of your Statement of Work for your project, you will create a Work Breakdown Structure (WBS). The WBS allows for project managers to compose all tasks of the projects into smaller components to ensure a more manageable project(s).

Develop the project Work Breakdown Structure using the WBS Template.