Reply week 4
Please provide positive comments to each paragraph below, independently. Thanks
1-The study and analysis of the role of inflammation and immune dysregulation in psychiatric conditions has a significant impact in the development of new therapeutic interventions in the treatment of these conditions (Köhler et al., 2020). The use of anti-inflammatory agents as adjunctive therapy in mental health disorders. For example, non-steroidal anti-inflammatory drugs (NSAIDs) and selective COX-2 inhibitors have shown promise in reducing depressive symptoms when used in conjunction with traditional antidepressants (Köhler et al., 2020). Minocycline, another anti-inflammatory medication has also been studied for its potential benefits in the treatment of schizophrenia (Deakin et al., 2020). In other hands immunomodulatory therapies such as monoclonal antibodies have been used in treatment-resistant depression with some promised results (Deakin et al., 2020). These therapies are intended to reduce the inflammatory burden and improve psychiatric symptoms (Deakin et al., 2020).
2-Schizophrenia, a complex and severe psychiatric disorder, has also been associated with immune dysregulation. Studies indicate that individuals with schizophrenia often exhibit increased levels of inflammatory markers, such as IL-1β and IL-6. These inflammatory processes might contribute to the pathophysiology of schizophrenia by disrupting neural connectivity and impairing neurotransmission. Inflammatory cytokines can interfere with dopamine and glutamate pathways, which are crucial for cognitive and emotional regulation. This disruption can result in the hallucinations, delusions, and cognitive deficits characteristic of schizophrenia (Upthegrove, R., et Al.) (2020)
Interview a Leader of Your Choice
"Interview a leader of your choice who has experience with creating and managing budgets, and write a 3–5 page analysis of your findings from the interview.","and write a 3–5 page analysis of your findings from the interview.
For this assessment, you will speak with a leader of your choice who has experience with creating and managing budgets, learn about that person's approach to budget management, and consider techniques or strategies you may emulate when you create and manage budgets.
Nurse leaders must be well-versed in the fundamentals of health care economics. A firm understanding of these concepts is essential in order to examine national trends and diverse health care organizations. At the organizational level, health care economics operate in a manner very similar to other competitive industries and businesses.
Within any organization, regardless of size, nurse leaders must understand the purpose and complexity of building a solid budget. Nurse leaders must be able to recognize the organizational or unit goals and then be adept and competent in the planning, designing, and defending a budget to meet those needs.
You are the nurse manager of a new urgent care clinic, and one of your first tasks is to prepare next year's operating budget. Like many nurses, you have had little or no direct experience with the budgeting process and realize that financial management is not one of your strengths as a leader. Consequently, you have decided that you need to reach out for help from someone in the facility with budgeting experience and financial management expertise who can offer you help and insight.
As you prepare to complete this assessment, you may want to think about other related issues to deepen your understanding or broaden your viewpoint. You are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community. Note that these questions are for your own development and exploration and do not need to be completed or submitted as part of your assessment.
Capital and operating budgets each play a major role in the financial expenditures of nursing units.
What is the purpose of each type of budget?
How does managing these two types of budgets differ?
What financial management techniques are common to both types?
Reflect on your experience with either type of budget.
How have one or the other of these two budgets affected the provision of care in your organization or unit?
Conduct an interview with your site supervisor, or other nurse leader whom you consider to be a mentor in the area of health care finance. Discuss their experience with operations and capital budgets in their current or previous role. Explore the following topics in your interview:
Their experience managing an operating budget.
Their approach to managing productivity within the parameters of the budget.
Their approach to oversight of the appropriate use and availability of equipment and supplies.
The experience of managing a capital budget.
How managing a capital budget differs from managing an operating budget.
Their application of finance principles to fulfill the organization's mission and goals.
Analysis
Note: The requirements outlined below correspond to the grading criteria in the assessment scoring guide. Be sure that your written analysis addresses each point, at a minimum. You may also want to read the Guiding Questions: Mentor Interview [DOCX] Download Guiding Questions: Mentor Interview [DOCX]to better understand how each criterion will be assessed.
Prepare a written analysis of your findings from the interview, supplemented by your own research and evaluation of budget management techniques.
Compare the process of managing an operating budget to that of managing a capital budget.
Describe the process of allocating resources for labor, equipment, and services.
Describe an effective approach that contributes to planning for profitability and fiscal success
Medical Certificate
I need a formal medical certificate stating that I need to on going treatment in state of Texas. PLease use Texas Health Letter and a legit doctor. Date must be june 28 till sep 12
PowerPoint presentation sentinel city
Summary
A community is a group of individuals with a shared characteristic or interest living together within a larger society. Per Saarloos, D., Kim, J., & Timmermans, over the course of twenty years, the field of health promotion has revealed increased attention for the likely impact of the environment on health. It has become the standard approach to categorizing the various environmental influences on individual health behavior (2009. para. 3). In a community, there are eight subsystems; they are physical, health and social, safety and transportation, education, recreation, politics and government, communication, and economics. In Sentinel City, there are four communities. In this paper, I will continue my window survey and discuss four of the eight subsystems with exploring the different communities.
please read the paper below to find some information to complete the assignment. you can also find more information on the internet.
Physical Environment
The Physical Environment features of communities have been linked to disability, mortality, general health status, chronic conditions, birth outcomes, health behaviors and other risk factors for chronic disease. Along with mental health, injuries, violence, and other important health indicators (Cubbin, Pedregon, Egerter, & Braveman. 2008).
Sentinel City’s first community, Nightingale Square the sidewalks and streets have hardly any rubbish on them and are not in bad shape, buildings are mostly big and bright, there may be some graffiti but it is not much, and it is not that obvious. The trees are nicely trimmed, and beautiful cars line the road. Nightingale Square has tennis courts, a basketball court, and parks, large condominiums, beautiful storefronts for clothing, jewelry, and various other shops. There are a grocery store and a gas station located at the end of the community, where it seems to be not as clean, and a small amount of garbage is outside a few buildings. Buildings are not quite as attractive but are still nice, and there is more graffiti on the buildings. There is a large pharmacy, a dentist office and barber shop in the vicinity. Residents are walking, running biking, and walking dogs. Nightingale Square is a community that has “everything” there is a sense of friendliness and openness to other people towards grocer, but in the other areas, there seems to be a feeling of superiorness to the remainder of the community. At and across from the grocer seems to be a place that people like families, couples and others will stop by and watch the entertainment or come to meet people to “hang-out.”
The second community is Acer Tech Center the sidewalks and streets are mostly clean, buildings are in good shape, there is more garbage outside buildings, sidewalks are nice, and there is a bit more graffiti than Nightingale Square but not too bad. A few loose dogs and cats are running around, the trees are neatly trimmed, and the cars are in good shape. A large hospital, Sentinel City Healthcare Center is one of the first things to see and then there is Acer Center Business Center next to it. In between the hospital and the business center, there is a large fruit stand and courtyard where people are “hanging -out.” There is a small grocer, but the large one is not too far away clothing shops, a barber shop, and trade shops. City Hall is in Acer Tech Center where there is a bunch of protesters (middle-class?) protesting about taxes. There is a Historic Hotel in Acer which is more than likely a tourist attraction or something like that. People are walking, riding bikes and running. There is another “hang-out” area in a courtyard across from the Affordable Housing Project, where there are a small fruit and vegetable stand with people sitting on benches, standing, or walking around. Acer Tech seems to be friendly, and a more pleasant area to welcome strangers because there is a large mixture of people throughout the community in various classes, races, and ages. The third community Casper Park is unlike the first two communities, the streets are dirty, there is, even more, garbage outside buildings, there is more noticeable graffiti, and the buildings need repair, some of them have windows boarded up and some vacant. Low-Income Housing is available, there are fewer cars, and the are not in top working order. The park is in appalling shape with garbage, and crates all around, homeless people, dogs, cats, and rats running around. The trees and grass are overgrown and need some attention. There is a small fruit and vegetable stand and courtyard across from Low-income Housing; people are sitting on benches and walking around. There is a small grocer, a check cashing store, clothing store, pawn shops, and a barber shop. Casper Park at first seems to be welcoming and friendly but going deeper into the community you get a sense of territoriality.
The last community is Industrial Height, the first thing in the community is the school which is nice with a large playground attached. There is a church with a soup kitchen, the streets dirty but not too bad. However, the deeper into the community, the more garbage there is that lines the streets. Graffiti is all over, from the church with signs of tagging in various buildings like the Better Health Clinic and the building next to it, which seems to be a gang’s hang out due to the massive skull sign out front. There are cars broke down, one on fire, garbage can on fire, buildings have large gang related murals painted on the some of the sides. The Department of Transportation is located here, down the street there is a rundown grocery with not much to choose from, there are boarded up store fronts and one store with busted out windows. Construction for re-development housing with burst sewage pipes with more dogs, cats, and rats running free. There are few cars on the road, an occasional motorcycle every so often and some people walking. This community is not welcoming; it has a feeling of being very unsafe, it is very closed-up and territorial areas.
Health and Social Services
“Access to comprehensive, quality health care services is essential for promoting and maintaining health, preventing, and managing the disease, reducing unnecessary disability and premature death, and achieving health equity for all Americans. This topic area focuses on three components of access to care: insurance coverage, health services, and timeliness of attention. When considering access to health care, it is important also to include oral health care and obtaining necessary prescription drugs” (Access to Health Services. n.d.).
Sentinel City Healthcare System has various healthcare and social service facilities in all the diverse communities. There is the main hospital with the Emergency, Inpatient, and ambulatory care. Spread throughout the city are nine primary care clinics with Eighty-two physicians and eight specialty clinics with thirty-three doctors. The dental care there are three orthodontist clinics, one endodontist clinic, three dental hygiene clinics and two pediatric oral surgery clinics which are also spread throughout the city. Mental Health services are also available throughout the city the Mental facilities range from case management service to the State Mental Hospital to have a total of five options. The vision clinics and vision therapy centers are also spread throughout. Depending on the community is the deciding factor to what is available, unfortunately, the communities needing the most healthcare, the poor and impoverished communities have the least available or needs to travel the furthest. Eldercare social services that are available are medical assistance advocates, service animals, Government Entitlement Assistance, Senior Community Centers, Meals on Wheels, and Elder Abuse Prevention Advocates. There are 3472 senior living units, twenty-four Swing bed, thirty-six Long Term Care, and sixty-four Skilled Nursing facilities. More facilities are two hundred forty-eight Assisted Living, 2874 Nursing Home units, and 1048 independent senior living apartments, these are all spread through the city.
Healthy food choices are also of importance there is Jo’s Grocery in Nightingale Square that sells organic food for most their sales, there are three fruit and vegetable carts in two of the communities Acer Tech, and Casper Park placed at the courtyards in the community. The fourth community has a Soup Kitchen at the church that feeds the homeless and hungry healthy meals. Besides the large grocery store, there are many small groceries and one that is moderately sized in Industrial Heights. There are numerous fast food restaurants, Italian, donut shops, Sushi, Pizza shops, to name a few. There are a few of restaurants that are sit down dinners with healthy choices available.
Safety and Transportation
Per the website, County Health Rankings, Community Safety considers not only intentional acts in neighborhoods and homes but also injuries caused accidentally. Many injuries are predictable and preventable. Living in unsafe neighborhoods can accelerate aging and harm health because of the chronic stress associated with it. Neighborhoods that are unsafe causes anxiety, depression, and stress, keeping people indoors, away from neighbors, exercise, and healthy foods due to the fear of violence. Jobs are harder to find because companies may be less willing to invest in unsafe neighborhoods (2017).
Sentinel City, has a high rate of violence, depending on the community is greater the risk of being a crime victim, There are Police patrolling in police cars in all communities. The police seem to have the city covered a good as possible, they are at the Grocery Store in Nightingale Square, directing traffic at the hospital in Acer Tech, and the School in Industrial Heights. Other that having an increased amount at City Hall for obvious the obvious reason of the protest there are also increased in Industrial Park for the broken storefront windows and patrolling on foot in Casper Park. Even tough there seems to be somewhat adequate police presence; I feel that it is highly possible for crime to be committed, especially in Industrial Heights and Casper park. Due to gang involvement, low-income and poverty, this makes it a greater chance for there to be crimes and aggravated assault being the top crime.
Transportation in Sentinel City appears to be mostly by taking the bus, the next would be by bicycle, and then by car. Traveling on foot seems to be another means used by the residents. The least costly is bicycling/walking, the riding the bus and last would be by car. Another form of transportation ing Sentinel City that would be to travel from city to city is the train systems; it passes above Pine Street behind City Hall in Acer Tech. There is a highway close by because of there is an overpass over Station Road in Nightingale Square. There are fire hydrants throughout Sentinel city, and there is a Fire Department that responds to the car and garbage can fire in Industrial Heights.
Conclusion
Sentinel City is just like any other city; there are kinds of people with many different situations. These people are rich, poor, or somewhere in between. There are no clear natural boundaries in Sentinel City, but you can see the conditions of the different communities an indication of these limits. The various communities where the people live, work, play, and how they live to affect their health. “Poverty and poor health worldwide are inextricably linked. The causes of poor health for millions globally are rooted in political, social, and economic injustices. Poverty is both a cause and a consequence of poor health” (Key Facts Poverty and Poor Health. n.d.).
References:
Access to Health Services. (n.d.). Retrieved June 05, 2017, from https://www.healthypeople.gov/2020/topics-objectives/topic/Access-to-Health-Services
Community Safety. (n.d.). Retrieved June 06, 2017, from http://www.countyhealthrankings.org/our-approach/health-factors/community-safety
Cubbin, Pedregon, Egerter, & Braveman. (2008, September). Where We Live Matters for Our Health: Neighborhoods and Health. Retrieved June 5, 2017, from http://www.commissiononhealth.org/PDF/888f4a18-eb90-45be-a2f8-159e84a55a4c/Issue%20Brief%203%20Sept%2008%20-%20Neighborhoods%20and%20Health.pdf
Key Facts Poverty and Poor Health. (n.d.). Retrieved June 05, 2017, from https://www.healthpovertyaction.org/info-and-resources/the-cycle-of-poverty-and-poor-health/key-facts/
Saarloos, D., Kim, J., & Timmermans, H. (2009, June). The Built Environment and Health: Introducing Individual Space-Time Behavior. Retrieved June 05, 2017, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2705214
The 10 Strategic Points for the Prospectus, Proposal, and Direct Practice Improvement Project” that you completed in DNP-815.
In the prospectus, proposal, and scholarly project there are 10 strategic points that need to be clear, simple, correct, and aligned to ensure the research is doable, valuable, and credible. The 10 strategic points emerge from researching literature on a topic that is based on or aligned with the learner's personal passion, future career purpose, and degree area. These 10 points provide a guiding vision for DPI Project. In this assignment, you will continue the work begun in DNP-815, working on your draft of a document addressing the 10 key strategic points that define your intended research focus and approach.
General Requirements:
Use the following information to ensure successful completion of the assignment:
Locate the ""The 10 Strategic Points for the Prospectus, Proposal, and Direct Practice Improvement Project” that you completed in DNP-815.
Doctoral learners are required to use APA style for their writing assignments. The APA Style Guide is located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please Review the rubric prior to the beginning to become familiar with the expectations for successful completion.
You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.
Directions:
Use the ""The 10 Strategic Points for the Prospectus, Proposal, and Direct Practice Improvement Project"" resource to draft statements for each of the 10 points for your intended research study.
You worked on this last in DNP 815. Pick up from where you left off (if you transferred in and did not complete this, you will have to begin fresh). Please include a copy of your last instructor feedback when you submit this assignment. You can either copy and paste the instructor feedback into your current paper (as an appendix and clearly marked); or upload two separate papers. I expect significant improvement from your last submission.
Please review the 10 Strategic Points document for additional instructions and an example. Add references to this document, I suggest 5-10 at this point. You need to realize that your literature review chapter will need at least 50+ articles by the time you get to DNP 955, so work on expanding your literature search each week, to include more and more to this paper as you move through each course. If you cannot locate 50+ articles you can ask your faculty for assistance or chose a different topic.
For the methodology and design sections. Methodology should cover the broad methods you plan to use (qualitative, quantitative, or mixed methods). The design portion will then go into more detail and discuss the design (i.e. correlational, cross-sectional, pre/posttest, etc.). Describe each and explain why your chosen methodology and design are appropriate to your topic and project questions. You may NOT use qualitative, GCU leadership does not support a qualitative methodology.
Intervention. You must have an intervention that you implement. Since you cannot evaluate a project that has already been implemented, please write up a description of your intervention and what your role will be in implementing this intervention. This is not a section listed on your 10 Strategic Points document as of yet, so add it after the methodology and design sections. Describe step by step what the intervention consists of, how it is evidence based, how you will implement, and your role in implementation.
Data collection should go step by step (extremely over-detailed) on how you will collect the data. Tell me about all instruments, surveys, and/or questions you will ask of participants. One MUST be a valid and reliable tool.
Data Analysis. Tell me the specific statistics you will use. Start with descriptive statistics, which ones will you use, why (cite current primary sources). Then tell me how you will compare your data (which statistic), what your p value will be before you start your data collection.
Apply Rubrics
Clinical/PICOT Questions:
In adult patients with CVC at a Clear Lake Regional Medical Center, does interventional staff education about hub hygiene provided to RN’s who access the CVC impact CLABSI rates compared to standard care over a one-month period?”
P: Patients with Central Venous Catheters
I: Staff re-education related to Hygiene of the hub
C: Other hospitals
O: Reduce probability of CLABSIs
T: Two months
“In Patients > 65 years of age with central line catheters at a Clear Lake Regional Medical Center, how does staff training of key personnel and reinforcement of central line catheter hub hygiene after its insertion, along with the apt cleansing of the insertion site, before every approach compared with other area hospitals, reduce the incidence of CLABSIs (Central Line Associated Blood-stream Infections) over a one-month period?”
P: Patients > 65 years of age with a Central line
I: Staff training and reinforcement of Central Catheter, Hub Hygiene
C: Other area hospitals
O: Reduce probability of CLABSIs
“In adult patients, with define CVC (CVC), does interventional staff education about hub hygiene provided to RN’s who access the CVC impact CLABSI rates compared to pre and post-intervention assessments
1. I used central Missouri as an example, replace with a description of your site.
2. While you might be interested in CLASBI rates as a primary variable, there are other patient outcomes that would also be important to consider
3. Ensure you can find validity and reliability measures on CLASBI rates if you cannot, we need to determine another question to help
4. How are your two comparison groups different, as they are currently stated the groups seem very much the same, could you state, standard care instead of pre and post intervention assessments?
5. One month is the longest time you can use for a prospective project
Please note the following regarding the instructors grading
IMPORTANT INFORMATION ABOUT MY GRADING STYLE
As you prepare for written papers and manuscripts I’d like to give you some details about my grading style. I provide significant feedback on your papers, this is because I believe you should be working towards improving your writing so that at the end of this program you are able to successfully write your DPI project. In order to write well, you need feedback and you need to review that feedback and make progress on the next written work. To that end I always grade accordingly. This means that if I provide feedback one an item (for example APA format of your reference page) I expect that this will be improved on the next written submission. Otherwise I will deduct additional points. In addition, some other criteria to get down pat now. References should always
1. Be current, no older than 5 years that means 5 years from your proposed graduation date (2014-2019). Otherwise you will have to redo everything in DNP 955.
2. Be primary sources. You can no longer cite Young declared literary war in 1956 (as cited by Brown 2006). You must cite Young 1956. That means go find that paper and read it and make sure that you agree with what Brown said. What if you don’t agree due to some very valid points? Then the literary war is not what occurred, but instead you have concerns regarding point ____, ____, and ____.
3. You may no longer cite textbooks, they are 1) secondary sources and 2) not current enough, and please use peer reviewed manuscripts.
One more item that is not a reference. You may not use direct quotes any longer. There is no need. This may be difficult at first, but you are moving towards a different type of writing. This is manuscript writing (scientific writing). Scientific writing is terse, clear, and concise. No frilly words. In order to avoid the use of direct quotes you will synthesize the literature. There is a great resource for synthesizing the literature under Resources – Add-ons. These are also some other great writing resources there.
10 Strategic Points for the Prospectus, Proposal, and Direct Practice Improvement Project
10 Strategic Points for the Prospectus, Proposal, and Direct Practice Improvement Project
Week Two Assignment Instructions DNP 820
Please read the instructions thoroughly there are strict requirements
I need at least 10 different articles/literature reviews added to the ones in the 815 attachment. I have also included the chart to be filled out All within 5 years and pertinent to the subject.
Tutor MUST have a good command of the English language
The Rubric must be followed, and all the requirements met
This is a thorough professor, and she has strict requirements
I have attached the PICOT and the first 10 points (DNP 815) assignment. This is a continuation of that assignment. Please read the attachments
The following needs to be addressed:
Please note the followings: The introduction and the literature review are complete and thorough. The problem statement is written clearly PICOT is clear and very good Sample:
· How will you determine the sample size?
· What are the inclusion/exclusion criteria of the subjects? Methodology: Why is the selected methodology is appropriate? Please justify!
· Data collection approach needs to be clear. How will you collect your data? What is needed here is to describe the process of collecting data form signing the informed consent until completing the measuring.
· Data analysis-What test will you use to answer your research question?
Annotated Bibliography
Policy Analysis,"This assignment is an analysis of local, state, or federal health policy.
Select a state health policy reform innovation
Discuss the rationale for the policy, how it was adopted (e.g., federal waivers, passage by state legislature), the funding structure, and (to the extent statistical data are available) its impact. ethical outcome based on evidence.
Examples of state innovations include Maryland’s hospital rate setting, Vermont’s single payer system, and Massachusetts’ health reforms
Submission Requirements:
The assignment is to be clear and concise and students will lose points for improper grammar, punctuation and misspelling.
The assignment is to be formatted per current APA style, 5-7 pages in length, excluding the title, abstract and references page.
Incorporate a minimum of 5 current (published within last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work.
Journal articles and books should be referenced according to current APA style
Discussion
Examine the science and art of theory development and evaluation.
Submission Instructions
Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. Your initial post is worth 8 points
Integration of Evidence
Integration of Evidence: Integrate relevant scholarly sources as defined by program expectations.
Cite a scholarly source in the initial post.
Cite a scholarly source in one faculty response post.
Cite a scholarly source in one peer post.
Accurately analyze, synthesize, and/or apply principles from evidence with no more than one short quote (15 words or less) for the week.
Include a minimum of two different scholarly sources per week. Cite all references and provide references for all citations.
Engagement in Meaningful Dialogue: Engage peers and faculty by asking questions, and offering new insights, applications, perspectives, information, or implications for practice.
Peer Response: Respond to at least one peer on a topic.
Faculty Response: Respond to at least one faculty post.
Communicate using respectful, collegial language and terminology appropriate to advanced nursing practice.
Professionalism in Communication: Communicate with minimal errors in English grammar, spelling, syntax, and punctuation.
Reference Citation: Use current APA format to format citations and references and is free of errors
