Neighborhood perceptions and hypertension among low-income black women: a qualitative study

Neighborhood perceptions and hypertension among low-income black women: a qualitative study

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Critique #1 Qualitative Research Article:  

Effective strategies for addressing diversity inherent in healthcare organizations

Effective strategies for addressing diversity inherent in healthcare organizations

The purpose of this assignment is to prepare the DNP student for professional practice at the doctoral level through a practice immersion experience aligned with DNP Essential II. The student will utilize the practice site of their choice to develop and/or evaluate effective strategies for addressing diversity inherent in healthcare organizations, research, and patient care.

Paper Sections and Headers

The following sections should be included and denoted via APA section headings throughout the paper.

• Executive Summary
  • Introduction and Purpose Statement

Language barrier communication between patients and medical staff despite having technological resources.

After interview, the findings are medical staffs often rush to finish their job due to long process of having an interprets for patients having translators. The translators are necessary to communicate with the patients, but staffs are often disinterested since the back-and-forth communication takes longer to get the job done. Also, nurses are not well educated on the available resources. Some details sometimes also get lost in translation, which results to miscommunication and, sometimes, needing another translator for a second opinion. The other is that most patients like to have face to face translating. The purpose of this project is to increase nurses’ awareness of current resources and adopt new practice

• Objectives

To improve nurses and medical staff about available resources for cultural competency

• Strategies

• Provided information to the frontline nurses regarding some of the resources available regarding cultural competence.
• Encourage the stakeholder to offer translation certification to nurses instead of hiring certified translator
• Add the cultural training to their annual employee

• Action Plan

Talk to stakeholders in the human resource and education department to add at least yearly  mandatory cultural competency training

adding a program for multilingual medical staff to be certified to translate

• Financial Implications

The financial implication is not much when it comes to available resources. For example, nurses can print the discharge material in different languages and providing information in patient’s native language. However, the only financial increase will be providing certification for nurses to be able to use their native language for translation instead of paying certified translator. The benefit of this strategy is patients communicate better specialty face to face is preferred than phone translation.

How does the organization address cultural competence and diversity?

Effective strategies for addressing diversity inherent in healthcare organizations

Effective strategies for addressing diversity inherent in healthcare organizations

Preparing the Paper Content

1. How does the organization address cultural competence and diversity?  The organization uses modules that are assigned via the portal website and is mandatory at the hiring orientation. not yearly mandatory requirement.

2. What are the organization’s strengths related to cultural competence and diversity?

1. What are the organization’s weaknesses related to cultural competence and diversity? Weakness is the lack of continuous education on staff and how to utilize the available resources.
2. Obtain feedback from the organizational leader on all aspects.
   1. Did they agree or disagree with your assessment and gap analysis? yes
   2. Did they view the presented strategies as feasible or not?yes
3. Modify your strategies based on feedback

Organizational Cultural Competence Assessment

Effective strategies for addressing diversity inherent in healthcare organizations

1. Collect race, ethnicity and language preference (REAL) data.
   1. Do you systematically collect race, ethnicity and language preferences of all your patients? yes

2. Identify and report disparities.
   1. Do you use REAL data to look for variations in clinical outcomes, resource utilization, length of stay, and frequency of readmissions within your organization? yes
   2. Do you compare patient satisfaction ratings among diverse groups and act on the information? NO
   3. Do you actively use REAL data for strategic and outreach planning? NO

3. Provide culturally and linguistically competent care.
   1. Have your patient representatives, social workers, discharge planners, financial counselors and other key patient and family resources received special training in diversity issues? YES, however not on continuous basis.
   2. Has your organization developed a “language resource,” identifying qualified people inside and outside your organization who could help your staff communicate with patients and families from a wide variety of nationalities and ethnic backgrounds? YES, culture link however, nurses are reluctant to use the video and unaware of available technologies. Per interview, the organization research shows that patient prefer face to face interpretation instead of phone interpretation.
   3. Are your written communications with patients and families available in a variety of languages that reflect the ethnic and cultural makeup of your community? Yes, however nurses are not well trained to use the resources,
   4. Based on the racial and ethnic diversity of the patients you serve, as well as those in your service area, do you educate your staff at orientation and on a continuing basis about cultural issues important to your patients? Not on continues basis, at the hire orientation thus the needs of education specifically for nurses and other staff are necessary.
   5. Are core services in your organization, such as signage, food service, chaplaincy services, patient information and communications, attuned to the diversity of the patients for whom you care? YES

4. Develop culturally competent disease management programs.
   1. Does your organization gather information to determine conditions of high prevalence within your community’s minority populations? yes
   2. Does your organization offer disease management programs that effectively address these conditions? yes
   3. Do your disease management programs address the barriers to care that are particularly challenging for minority patients? yes

5. Increase diversity and minority workforce pipelines.
   1. Does your organization have a mentoring program in place to help develop your best talent, regardless of gender, race or ethnicity? YES
   2. Are search firms required to present a mix of candidates reflecting your community’s diversity? Yes
   3. Do your recruitment efforts include strategies to reach out to racial and ethnic minorities in your community? Yes
   4. Do you acknowledge and honor diversity in your employee communications, awards programs and other internal celebrations? YES
   5. Does your human resources department have a system in place to measure diversity progress and report it to you and your board? YES

6. Involve the community.
   1. Has your community relations team identified community organizations, schools, churches, businesses and publications that serve racial and ethnic minorities for outreach and educational purposes? YES
   2. Do you have a strategy to partner with community leaders to work on health issues important to community members? yes

7. Make cultural competency an institutional priority.
   1. Has your board set goals on improving organizational diversity, providing culturally competent care and eliminating disparities in care as part of your strategic plan? YES, recent mandatory training was on LGBTQ community and understanding the culture and how to provide care
   2. Is diversity awareness and cultural competency training mandatory for all senior leadership, management, staff and volunteers? Once at the time of hiring orientation. NO continuous one

Sample grant paper

Sample grant paper

We propose to explore whether total energy density, frequency of consumption, and portion sizes of high-energy-dense foods contribute to body weight, body fatness, and related chronic conditions within a nationally representative sample of US adults using the 2005-2006 National Health and Nutrition Examination Survey (NHANES) (5) data.  This research would logically extend previous research activities by our group targeting dietary energy density and the consumption of fruits and vegetables, and legumes for purposes of improving diet quality, controlling weight, and cancer prevention and control.

Using a nationally representative sample of US adults, our specific aims are to:

Aim 1.  Determine whether the consumption of an energy-dense diet is positively associated with established risk factors for cancer including weight/BMI, waist circumference, and biomarkers of insulin insensitivity and inflammation.

Our hypothesis is that after controlling for important confounders such as age, gender, race, and physical activity, consumption of high-energy-dense diets will be positively associated with overweight and body fatness and with increased fasting levels of plasma insulin, glucose, and C-reactive protein. 

Aim 2.  Establish whether the proportion of total energy intake contributed by high-energy-dense foods is positively associated with established risk factors for cancer including weight/BMI, waist circumference and biomarkers of insulin insensitivity and inflammation.

Our hypothesis is that after adjustment for relevant confounders, proportionally higher consumption of high-energy-dense foods will be positively associated with overweight and larger waist circumferences and with increased fasting levels of the aforementioned biomarkers.

3. Identify whether portion size of high-energy-dense foods is an important contributor to weight/BMI, waist circumference and biomarkers of insulin sensitivity and inflammation.

Our hypothesis is that intake of larger portions of high-energy-dense foods is positively associated with overweight, waist circumference and biomarkers of insulin sensitivity and inflammation after controlling for confounders. 

To our knowledge, our proposed research will be the first of it’s kind to be conducted using the most recently available NHANES nutrition data.  The results will provide important information for the implementation of the WCRF/AICR cancer prevention recommendations including guidance for scientists interested in the development of dietary interventions targeting weight and related conditions.

Controversies in Global Control and Eradication of Infectious Diseases

Controversies in Global Control and Eradication of Infectious Diseases. The science and discovery of new and innovative vector and disease control methods is expanding rapidly. From gene drive to bacterial superinfection of vectors (e.g. Wolbachia) to new plant-based vaccine strategies to phone-based surveillance and/or compliance methods, these new methodologies have the potential to markedly extend our disease control reach. This paper will be a comprehensive review of new and innovative control strategies that have recently been deployed or are in the planning or conceptual stages. Some examples are: 1) Social network-based gamification of vector control strategies; 2) depot methods of pharmaceutical prophylaxis; 3) sterile male vector introduction; 4) new detection/surveillance methodology (onchocerciases urine test); microparticle controlled release of multivalent vaccines.

Discuss potential for a particular disease for widespread elimination or high levels of suppressive control – in a specific country of your choice

What are some of the challenges in the control and eradication of infectious diseases?

Controversies in Global Control and Eradication of Infectious Diseases

This paper should have the following sections:

1. Background:
   1. Burden of disease caused by the infectious disease – why is this a problem, including social, development and economic impact;
   2. Epidemiology of disease, including life cycle, mode of transmission, force of infection, R₀ if known, any reservoirs (and specifically how these will be overcome), infectivity, virulence.

• SES, population and cultural factors (if appropriate) that may affect the implementation of your eradication/elimination plan in the chosen specific country.

1. Control Tools: Known treatments, effective prophylaxis, tools for control, vector control capabilities, including a broad consideration of costs, if available/appropriate. You can include a description of plausible tools that are not yet developed, inclusive of mHealth, electronic surveillance or other digital or innovative technology.
2. Propose an Elimination/Eradication Plan for a specific country/region.
   1. This should include a broad summary of the plan and its specific components (e.g. vector control, vaccination, mass treatment, environmental management).
   2. Describe how you would include high levels of stakeholder participation through communication strategies, incentive approaches. If appropriate, discuss the establishment of potential alliances such as public private partnerships (e.g. Rotary) that are possible/appropriate.

• Describe the frequency (i.e. how often for IRS, vaccination, mass treatment) and duration of anticipated program plan.

1. Discuss potential anticipated barriers, problems, reasons for failure.

Potential Example Diseases (others acceptable but check with me):

1. Trachoma
2. Varicella
3. Hep A or Hep C
4. Yaws
5. Diphtheria
6. Pertussis
7. Visceral leishmaniasis
8. Schistosomiasis

Systematic Reviews—Meta-Analysis and Meta-Synthesis

Introduction

1. 1. Statement of Problem
      • This is usually one or two paragraphs and informs the reader of the problem, the scope of the problem, the significance of the problem (complications, negative outcomes, etc.), how the problem originated (article you read or clinical practice, etc.), and the significance of the problem to nursing.
   2. Background and Significance of Problem
      • This section takes each of the major points you made in the statement of the problem and expands on them. Statements in this section need to be referenced.
   3. Justification (includes a statement that really brings the issue home)
   4. Possible questions you might be answering in conducting a review of the literature and evidence
   5. Note: This section should not exceed one page.
2. Review of the Evidence
   1. Introduction to the ROE
      • This should tell the reader what databases you searched, the search terms you used, what types of information you are including, and the order in which you are going to present the data.
   2. Review the relevant articles. Synthesize the findings for the reader.
   3. Review standards of practice, practice guidelines, patient data as appropriate.
3. Analysis
   1. Summarize your appraisal of the evidence, the gaps in the evidence (if any), and the course you would take given what you have found.
   2. If further research is recommended, what would be your research question?
   3. If you were to move forward with this project, which EBP model would you work with? Briefly describe your next steps based on the model.
4. Discussion
   1. The discussion section develops a plan to implement the best practice with the support of the literature.
5. References and Grammar

1. • This is usually one or two paragraphs and informs the reader of the problem, the scope of the problem, the significance of the problem (complications, negative outcomes, etc.), how the problem originated (article you read or clinical practice, etc.), and the significance of the problem to nursing.
2. Background and Significance of Problem
   • This section takes each of the major points you made in the statement of the problem and expands on them. Statements in this section need to be referenced.
3. Justification (includes a statement that really brings the issue home)
4. Possible questions you might be answering in conducting a review of the literature and evidence
5. Note: This section should not exceed one page.

The vegetarian diet is the healthiest

The vegetarian diet is the healthiest

Your Argumentative essay, otherwise known as a persuasive essay, will begin with a controversial topic. You will select a topic of interest, take a stand on the topic, and persuade your audience to agree with the stance taken. Avoid presenting both sides of the argument, but instead focus on the best arguments to convince your audience to agree with your chosen stance on the topic.

The topic must be debatable and relate to current social, political, or cultural topics. Alternatively, you may choose to write on a topic specific to your field of study. Topic choices will be submitted to your instructor for final approval.

Finally, your essay should present the argument without using first or second person pronouns (I, me, mine, we, us, ours, you, or yours). Though your opinion will be given, statements such as “I think” or “I would argue” should be avoided.

Topic Selection: Selecting a topic that is debatable and of interest is really important. Use the list below to help you begin brainstorming topics, but you are absolutely allowed to choose a topic not listed here as long as I approve it.

• LGBT rights
• The electoral college
• Socialized health care
• Separation of church and state
• Immigration
• Paid paternity leave
• Standardized testing
• Online vs. ground education
• Police reform
• College tuition
• Social media
• Arts education
• The beauty industry
• Universal basic income
• Animal testing
• Online dating
• Topic related to field of study

Who is healthier vegans or vegetarians?

The vegetarian diet is the healthiest

For this assignment, you will be writing the thesis statement for your argumentative essay along with at least four topic sentences for the body paragraphs.

Create a single-sentence thesis statement that succinctly states the major argument that you will make in your essay. Your thesis statement:
Should match your previously approved topic
Is a single declarative sentence (not a question)
Must be written in third person
Must make an argument that others may disagree with and not simply state facts

Is it better to be vegetarian or nonvegetarian?

Create four topic sentences for four body paragraphs. Keep in mind the following hints as you develop your topic sentences. A topic sentence:
Makes a mini-argument that supports the larger argument made in your thesis statement
Is the main idea that you will discuss throughout one single body paragraph
Is a single declarative sentence
Must directly support your overarching argument
Must be written in third person
NOTE: The second, third, and fourth topic sentences must also serve as transition sentences, creating smooth links between related mini-arguments. Make sure to underline the part of the topic sentences that is meant to be the transition.

Life skills are vital to the change process for substance-abusing clients

Life skills are vital to the change process for substance-abusing clients

Between 2002 and 2007, there were over 8.3 million children under the age of 18
that lived with at least one parent who was dependent on or abused alcohol or an
illicit drug in a given year (SAMSHA, 2009). It is estimated that as many as 8% of
these children resided in single-parent households in which their mother was
dependent on or abused substances. Children in the care of substance abusing
mothers are at serious risk for maltreatment, neglect, and abuse, as well as
economic, academic, and socio-emotional problems (Conners, et al., 2004; Jones,
2007). Additionally, drug-abusing parents can be up to three times more likely to
engage with child protective services (CPS), and most parents will do what is
necessary to regain custody of their children.
Assessment is the act of determining the nature and causes of a client’s problem.
During the early sessions of treatment, counselors gather data and increase their
understanding of their clients. To understand our clients’ substance abuse
problems, we must try to understand our clients. This involves interviewing them,
taking a history, and administering psychological tests, It is vital that clinicians avoid
preconceived notions about the client and that they make treatment
determinations based only on data collected during the initial evaluation
For this final exam, watch the application videos below and respond to the

For this final exam, watch the application videos below and respond to the
following:
Part I – Video: Case of Torey who’s Mother is Addicted to Opioids.
1) According to the video, Torey has basically raised herself with the help of a uncle
who recently passed away. Torey’s mother has presented in for treatment due to a
court order in an effort to regain full custody of her daughter. Torey is devastated
over the loss of her uncle and has been granted weekend visits with her mom.
Refer to Chapter 5 and prepare an outline of at least three of the skills and,
strategies that facilitate client change. This process must be develop in order to
create a safe space that encourages the mother to move towards open dialogue
about her addiction. Customize your strategies by using techniques such as lead-in,
questions, restatement, reflection, etc.
2) Life skills are vital to the change process for substance-abusing clients. First,
clients need coping skills to deal with situations that would otherwise be associated
with drug use. Discuss how your would incorporate the seven life skills to support
the mother’s change process.

Should hospitals eliminate infant formula giveaways?

Opposing side’s arguments/points of view 

Give a thorough description of at least two main arguments made by proponents of the opposing side of the debate from the one you included above.  You need to include BOTH (1) credible, factual arguments, and (2) persuasive appeals to morality, ethics, and/or social justice in your descriptions for this side as well and clearly identify the sources of these in your writing along with parenthetical citations of the sources

Identify the food issue that you have chosen and summarize two opposing sides/points of view that have been put forward in the debate about this issue. 

First side’s arguments/points of view 

Give a thorough description of at least two main arguments made by proponents of one site of the debate on the food issue that you have chosen.  You need to include BOTH (1) credible, factual arguments, and (2) persuasive appeals to morality, ethics, and/or social justice in your descriptions and clearly identify the sources of these in your writing along with parenthetical citations of the sources

Opposing side’s arguments/points of view 

Give a thorough description of at least two main arguments made by proponents of the opposing side of the debate from the one you included above.  You need to include BOTH (1) credible, factual arguments, and (2) persuasive appeals to morality, ethics, and/or social justice in your descriptions for this side as well and clearly identify the sources of these in your writing along with parenthetical citations of the sources

Legal and ethical scenarios

Legal and ethical scenarios

Identify and analyze any legal and ethical issues. Apply legal concepts and make potential arguments as directed using laws, cases, examples, and/or other relevant materials. Consider using short headings (consult APA materials) to separate the topics. Summarize the facts; do not copy the scenarios into the paper. Support your answers with information from the textbook and at least four scholarly sources other than the text and course lectures. Sources must reference U.S. law. By the due date assigned, prepare a 4 to 7 page paper that identifies the legal issues and potential solutions and answers all questions presented, supported by relevant legal authority. Do not exceed the page length by more than two pages

What are legal and ethical practices?

Legal and ethical scenarios

Scenario 1: Courts and ADR

Ben Watson works as a project manager at the corporate headquarters of Jabil Circuits in St. Petersburg, Florida. Watson regularly spends time on the office computer surfing the Internet for sports news and playing his favorite slot machine games with the sound muted. Watson usually sends personal e-mails from his own Gmail account, but he occasionally uses his Jabil account when he is too lazy to access his personal account.

The manager of human resources, Freda Fitch, called Watson into her office on Friday afternoon, where he was asked about the emails sent to friends containing jokes of a sexual nature. The director also questioned him about the use of the Internet to play slot machines and other computer games. Watson was terminated for violating provisions of the employee handbook and escorted out of the building.

The employee handbook contained standard provisions explaining that company property, including computers, email, software and access to the Internet, were for business purposes and employee use was subject to monitoring. The company policy also prohibited any form of sexual harassment, discrimination, violence and other illegal acts, which includes transmitting such information by computer. Violations of the stated policies include disciplinary action that may result in termination. The handbook also contained a provision that required all disputes arising from the employment relationship that cannot be resolved internally to be resolved through the alternative dispute resolution process of mediation.

Since Watson believes he was wrongfully terminated and various rights were violated, he plans to consult with a lawyer and sue his employer. What are Watson’s options concerning resolution of his claims through the court or ADR?

Legal and ethical scenarios: What are examples of legal and ethical issues?

Scenario 2: Constitutional Rights

Since Watson had some free time after being dismissed, he stopped by the Daiquiri Shak, hoping a drink would make him feel better. Several hours later as he was on the way home, Watson was pulled over by Dale Crespo, an officer on the local police department. The officer noticed a slight slurring of Watson’s words and poor motor skills when exiting the vehicle. Crespo requested that Watson take a breathalyzer test, but he refused. The officer spotted a beer can on the seat of the car and searched Watson’s car. When searching the car, the officer found a loaded handgun and an unmarked bag of pills that looked like OxyContin.

Did Officer Crespo violate any of Watson’s constitutional rights? Explain.

Scenario 3: Torts

One week after Watson was terminated, Jabil received a phone call from the human resources department at Tech Data seeking to obtain a reference for Watson. Fitch, the human resources manager for Jabil answered the standard questions, but when asked if she would rehire Watson, she made the following comment.

“Off the record, Watson was terminated for theft. I would not re-hire him because he is lazy and may have been involved with drugs too.”

Fitch rationalized the part about theft since Watson stole time from the company and made up the part about drugs because she did not want Watson to get the job. Tech Data did not hire Watson.

Did Fitch commit any torts? Explain.

Scenario 4: Intellectual Property
A new position in advertising was created for Vicki Talley, the niece of Jabil’s CEO. Talley was a senior at Southeast University, majoring in marketing. Talley was in charge of revitalizing the company’s website. Talley copied images from various websites and pasted them into Jabil’s site. Delores Banks was a full time law student who worked as an intern for Jabil. After reviewing the new website, Banks explained to Talley that using images and text without permission violates intellectual property laws. Talley explained that she could use the images because everything on the Internet is free for people to use. Talley also suggested that Banks needed to read about the fair use doctrine that was covered in her business law class.

Did Talley violate intellectual property laws?

Scenario 5: Constitutional Law
After Watson resolved the issues with his arrest, he created a blog called Jabil Exploding Electronics. The blog contained a picture of the Jabil logo, along with various images of buildings blowing up and the CEO in a casket. Watson promises readers that he will provide stories about working for Jabil and invites his readers to tell their stories. In the first article, Watson included a cartoon of his boss in compromising sexual positions. The second article provided details about a coworker who is having an affair with her manager.

Has Watson committed any violations in his Internet postings concerning his former employer?

Scenario 6: Intellectual Property

Felicia worked part time for Jabil while attending Hillsborough Community College. As part of her final project for a degree in information technology, Felicia designed a computer program that provided the fastest and most economical methods of retrieving parts for filling customers’ orders from the distribution center. The program also tracked the locations of the forklift drivers in the warehouse. Felicia called the program Fast Route & Tracker (FRT). The program was designed to be used by any type distribution facility and not specifically for Jabil. When Jabil found out about the software, they claimed they owned the program since Felicia was employed by the company when she developed the program. Felicia believes she owns the rights to the invention since it was created for her school project and could be used for any type of distribution company.

Provide arguments for Felicia and Jabil regarding ownership of the invention, Fast Route & Tracker. Determine which party should win and provide support for your answer.

Scenario 7: Negligence

Carl and his girlfriend Heather were having coffee in the cafeteria at Jabil when the couple started to argue. The argument escalated and employees heard Carl shout that he was going to kill Heather. When Carl stormed outside, Heather asked the manager to help her. The manager said he could not get involved in domestic disputes, but he called 911. Heather hid in the women’s restroom. Carl returned with a gun that he used to shoot the manager, a security guard, an employee and Heather. When the police officers arrived, one officer shot and killed Carl. Heather died at the scene, but the manager, security guard and employee survived, although they were severely injured. A wrongful death lawsuit filed against Jabil by Heather’s parents.

Discuss the legal issues of the lawsuit between Heather’s parents and Jabil. Determine which party will win and provide legal support for your decision.
What claims might be brought by the injured employee, security guard and the manager?