BLOG: CRITIQUING SOURCES OF ERROR IN POPULATION RESEARCH TO ADDRESS GAPS IN NURSING PRACTICE EPIDEMIOLOGY BLOG: CRITIQUING SOURCES OF ERROR IN POPULATION RESEARCH TO ADDRESS GAPS IN NURSING PRACTICE Respond to  two colleagues in one or more of the following ways: · Ask a probing question, substantiated with additional background information, evidence, or research. · Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives. · Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library. · Validate an idea with your own experience and additional research. · Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings. · Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence. PEER # 1 Josephine Nandzo Week 6 discussion: Initial post Health Issue: Diabetes mellitus (Type 2) is the selected issue for this discussion. Population: Low-income, minority adolescents Practice Gap: While DNP prepared nurses play a vital role in managing diabetes in various settings, a gap exists in developing and implementing culturally sensitive interventions to improve diabetes self-management education (DSME) for low-income, minority adolescents. These adolescents often face social determinants of health that exacerbate diabetes control, requiring a tailored approach (American Association of Diabetes Educators, 2023). DNPs can bridge this gap by: · Implementing telehealth consultations with endocrinologists or diabetes educators for rural patients. · Developing and leading community-based diabetes education and self-management programs. · Partnering with local agencies to enhance access to healthy food choices and opportunities for physical activity. · Advocating for policies that address social determinants of health and improve healthcare infrastructure in rural communities. Biases in Research Understanding potential biases is crucial for DNPs to critically appraise research used to inform practice. The following are brief explanations of four common biases: Selection Bias: This occurs when the sample population studied does not accurately represent the target population, leading to inaccurate generalizability of findings. For example, research on DSME interventions might only recruit adolescents from middle-class backgrounds, neglecting the specific needs of low-income youth (Guyatt et al., 2011]). Information Bias: This arises when how data is collected or measured influences the results. In DSME research, information bias could occur if self-reported adherence to diabetes management plans is not verified with objective measures like blood sugar monitoring (Guyatt et al., 2011). Confounding: This happens when a third variable, not accounted for in the study design, influences both the exposure variable (e.g., DSME intervention) and the outcome variable (e.g., glycemic control). For instance, socioeconomic factors like access to healthy food could confound the results of a DSME program, making it difficult to isolate the intervention’s true effect (Centers for Disease Control and Prevention, 2023). Random Error: This refers to chance variation in the study results unrelated to the intervention itself. Random error can be minimized through robust research designs and large sample sizes (Guyatt et al., 2011). By recognizing these biases, DNPs can critically evaluate research informing DSME interventions for low-income, minority adolescents and advocate for culturally sensitive approaches that address the specific needs of this population. Impact of Bias and Confounding Awareness on Treatment Nurses educated at the doctoral level who have an understanding of bias and confounding elements can critically appraise research used to guide treatment decisions for low-income adults with diabetes. Also, having an awareness of selection bias allows for the identification of generalizability limitations in research findings. DNPs can then seek out studies that include low-income populations to ensure recommendations are applicable. Furthermore, recognizing information bias encourages DNPs to assess the quality of data collection methods used in research and this helps them determine the reliability of study conclusions. Another advantage of understanding confounding allows DNPs to identify and adjust for factors that might skew the results of research on diabetes management in low-income populations leading to the strengthening of the evidence base for treatment decisions. Finaly, by being aware of these potential biases and confounding factors, DNPs can translate research findings into effective and culturally sensitive diabetes management programs for low-income adults. Strategies to Minimize Bias and Confounding These include the following: Study Design: Researchers can employ randomized controlled trials (RCTs) to minimize selection bias and ensure control groups receive alternative interventions (Guyatt et al., 2011). Stratified sampling ensures representation of subgroups within the rural population. Analysis Considerations: Statistical methods like propensity score matching can adjust for confounding variables, accounting for their influence on the observed relationship between diabetes risk factors and outcomes (Rosenbaum, 2010) Consequences of Unmitigated Biases Unrecognized biases can lead to misinterpretations of research, potentially resulting in: Ineffective Interventions: Programs based on biased research might not address the true needs of the target population, leading to poor outcomes. Also, uncontrolled bias can lead to wasted resources on ineffective interventions and missed opportunities to improve health outcomes for low-income, minority communities with diabetes. For example, if a biased study suggests that a particular diabetes education program is ineffective, DNPs may not recommend it to their patients, even though it could be beneficial. Health Disparities: Biased research may exacerbate health disparities if interventions are not tailored to address the unique challenges of different populations. If selection bias goes unchecked, interventions found to be effective in research may not work as well in real-world settings. Confounding variables can lead to misinterpretations of cause-and-effect relationships, potentially leading to inappropriate or ineffective treatment recommendations for patients with diabetes, particularly in vulnerable populations. Conclusion In conclusion by being aware of and minimizing biases, DNPs can ensure research findings are accurately translated into evidence-based practice, improving patient care and health outcomes for all populations.   References American Association of Diabetes Educators. (2023). Standards of practice for diabetes self-management education/support.  to an external site. Centers for Disease Control and Prevention. (2023). Social determinants of health inequalities.  to an external site. Guyatt, G. H., Ospina, T., Cadegiani, G., Payne, M. E., Sullivan, M. J., & Devereaux, R. V. (2011). GRADE: An emerging consensus on rating quality of evidence and strength of recommendations.  BMC Medical Research Methodology, 11, 2.  to an external site. Guyatt, G. H., Ospina, M. B., Sultan, J. A., Strauss, B. E., Bullock, T. L., & Devereaux, R. V. (2011). GRADE: Going from evidence to recommendations.  Canadian Medical Association journal, 183(14), 1613 – 1619.  to an external site. Rosenbaum, P. R. (2010). Observational studies.  Springer Series in Statistics (Vol. 208). Springer.  ReplyReply to Comment · PEER # 2 Lucretia Dennise Sanders Week 6 Initial Post:   CRITIQUING SOURCES OF ERROR IN POPULATION RESEARCH TO ADDRESS GAPS IN NURSING PRACTICE  Practice Gap: Lack of accessible transportation for patients living in rural communities significantly affects their ability to reach healthcare appointments, creating a critical barrier to timely and effective medical care. This issue is deeply rooted in the unique challenges of rural living, including sparse public transportation networks, the considerable distances to healthcare providers, and the economic strain of travel costs. Consequently, rural patients often face delays in receiving necessary care, which can lead to the deterioration of health conditions and higher healthcare expenses over time.   Treatment of this population/issue could be affected  Recognizing bias and confounding factors in epidemiologic studies about transportation barriers in rural areas can profoundly influence the approach to mitigating these issues, ensuring that interventions are grounded in a realistic context of the patient’s circumstances. It enables healthcare planners and policymakers to devise strategies that accurately address the specific needs and barriers faced by rural communities, rather than relying on skewed data that may overlook critical aspects of their challenges (Syed et al., 2013). This awareness can lead to more equitable healthcare solutions by highlighting the need for tailored interventions that consider the unique socioeconomic and geographical factors affecting rural populations, thus improving the effectiveness of programs aimed at increasing healthcare accessibility.  Strategies researchers can use to minimize these types of bias in studies  To mitigate bias in studies exploring the lack of accessible transportation for patients in rural areas, researchers can adopt a longitudinal study design, tracking healthcare access over time to better understand the dynamic relationship between transportation barriers and healthcare utilization. This method reduces recall bias and provides a more accurate picture of how transportation issues affect healthcare access longitudinally (Varela et al., 2019). Another effective strategy is to use propensity score matching to control for confounding variables, ensuring that the comparison between individuals with and without transportation barriers is as fair and unbiased as possible. This technique adjusts for factors that might skew the relationship between transportation access and healthcare outcomes, enabling researchers to isolate the effect of transportation barriers more accurately.  Effects these biases could have on the interpretation of study results  Failing to address these biases could result in skewed interpretations of research findings, possibly overstating the accessibility of healthcare for rural patients or understating the severity of transportation challenges. Such inaccuracies might misguide healthcare policy and resource allocation, leading to ineffective solutions that do not adequately tackle the pressing needs of those in rural communities. ((Kaiser & Barstow, 2022)  Reference:  Kaiser, N., & Barstow, C. K. (2022, February 14). Rural transportation infrastructure in low- and middle-income countries: A review of impacts, implications, and interventions. MDPI.  to an external site.  Syed, S. T., Gerber, B. S., & Sharp, L. K. (2013). Traveling towards disease: transportation barriers to health care access. Journal of Community Health, 38(5), 976–993.  to an external site. Varela, C., Young, S., Mkandawire, N. et al. TRANSPORTATION BARRIERS TO ACCESS HEALTH CARE FOR SURGICAL CONDITIONS IN MALAWI a cross-sectional nationwide household survey. BMC Public Health 19, 264 (2019).  to an external site.   Assignment Rubric Details Close Rubric NURS_8310_Week6_Blog_Rubric NURS_8310_Week6_Blog_Rubric Criteria Ratings Pts This criterion is linked to a Learning OutcomeMain Posting: Idea and Content 60 to >49.0 pts Excellent • Thoroughly responds to the blog prompt/s. • Post provides comprehensive insight, understanding, or reflection about the topic through a focused analysis of the topic supported by personal experiences and/or examples. • Personal opinions are expressed and are clearly related to the topic, activity or process identified in blog prompts. • The post reflects in-depth engagement with the topic. • Posts main blog by due date. 49 to >38.0 pts Good • Responds to all of the blog prompt/s. • Post provides insight, understanding, or reflection about the topic through a reasonably focused analysis of the topic supported by personal experiences and/or examples. • Personal opinions are expressed and are but not fully developed to align with blog prompts. • The post reflects moderate engagement with the topic. • Posts main blog by due date. 38 to >27.0 pts Fair • Partially responds to the blog prompt/s. • Posts are typically short and may contain some irrelevant material. • The post is mostly description or summary without connections or analysis between ideas. • The post reflects minimal engagement with the topic. • Posts main blog by due date. 27 to >0 pts Poor • Does not respond to the blog prompt/s or entries lack insight, depth or are superficial. • The entries are short and are frequently irrelevant to the events. • They do not express opinion clearly and show little understanding. • The post does not reflect engagement with the topic. • Does not post main blog by due date. 60 pts This criterion is linked to a Learning OutcomeFirst Response: Post to colleague’s main blogpost shows evidence of insight, understanding, or reflective thought about the topic. NOTE: Responses to faculty are not counted as first or second colleague responses. 20 to >11.0 pts Excellent • Presents a focused and cohesive viewpoint in addressing this response. • Response includes focused questions or examples related to colleague’s post. • Response stimulates dialogue and commentary. • Posts by due date. 11 to >6.0 pts Good • Presents a specific viewpoint that is focused and cohesive. • Response includes at least one focused question or example related to colleague’s post. • There is some attempt to stimulate dialogue and commentary. • Posts by due date. 6 to >2.0 pts Fair • Presents a specific viewpoint but lacks supporting examples or focused questions related to colleague’s post. • The posting is brief and reflects minimal effort to connect with colleague. • Posts by due date. 2 to >0 pts Poor • Response lacks a specific viewpoint and supporting examples or focused questions related to colleague’s post. • The post does not stimulate dialogue or connect with the colleague. • Does not post by due date. 20 pts This criterion is linked to a Learning OutcomeSecond Response: Post to second colleague blog post shows evidence of insight, understanding, or reflective thought about the topic. 20 to >11.0 pts Excellent • Presents a focused and cohesive viewpoint in addressing this response. • Response includes focused questions or examples related to colleague’s post. • Response stimulates dialogue and commentary. • Posts by due date. 11 to >6.0 pts Good • Presents a specific viewpoint that is focused and cohesive. • Response includes at least one focused question or example related to colleague’s post. • There is some attempt to stimulate dialogue and commentary. • Posts by due date. 6 to >2.0 pts Fair • Presents a specific viewpoint but lacks supporting examples or focused questions related to colleague’s post. • The posting is brief and reflects minimal effort to connect with colleague. • Posts by due date. 2 to >0 pts Poor • Response lacks a specific viewpoint and supporting examples or focused questions related to colleague’s post. • The does not stimulate dialogue or connect with the colleague. • Does not post by due date. 20 pts Total Points: 100

  

BLOG: CRITIQUING SOURCES OF ERROR IN POPULATION RESEARCH TO ADDRESS GAPS IN NURSING PRACTICE


EPIDEMIOLOGY

BLOG: CRITIQUING SOURCES OF ERROR IN POPULATION RESEARCH TO ADDRESS GAPS IN NURSING PRACTICE

Respond to
 two colleagues in one or more of the following ways:

· Ask a probing question, substantiated with additional background information, evidence, or research.

· Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

· Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

· Validate an idea with your own experience and additional research.

· Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

· Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

PEER # 1


Josephine Nandzo

Week 6 discussion: Initial post

Health Issue: Diabetes mellitus (Type 2) is the selected issue for this discussion.

Population: Low-income, minority adolescents

Practice Gap: While DNP prepared nurses play a vital role in managing diabetes in various settings, a gap exists in developing and implementing culturally sensitive interventions to improve diabetes self-management education (DSME) for low-income, minority adolescents. These adolescents often face social determinants of health that exacerbate diabetes control, requiring a tailored approach (American Association of Diabetes Educators, 2023). DNPs can bridge this gap by:

· Implementing telehealth consultations with endocrinologists or diabetes educators for rural patients.

· Developing and leading community-based diabetes education and self-management programs.

· Partnering with local agencies to enhance access to healthy food choices and opportunities for physical activity.

· Advocating for policies that address social determinants of health and improve healthcare infrastructure in rural communities.

Biases in Research

Understanding potential biases is crucial for DNPs to critically appraise research used to inform practice. The following are brief explanations of four common biases:

Selection Bias: This occurs when the sample population studied does not accurately represent the target population, leading to inaccurate generalizability of findings. For example, research on DSME interventions might only recruit adolescents from middle-class backgrounds, neglecting the specific needs of low-income youth (Guyatt et al., 2011]).

Information Bias: This arises when how data is collected or measured influences the results. In DSME research, information bias could occur if self-reported adherence to diabetes management plans is not verified with objective measures like blood sugar monitoring (Guyatt et al., 2011).

Confounding: This happens when a third variable, not accounted for in the study design, influences both the exposure variable (e.g., DSME intervention) and the outcome variable (e.g., glycemic control). For instance, socioeconomic factors like access to healthy food could confound the results of a DSME program, making it difficult to isolate the intervention’s true effect (Centers for Disease Control and Prevention, 2023).

Random Error: This refers to chance variation in the study results unrelated to the intervention itself. Random error can be minimized through robust research designs and large sample sizes (Guyatt et al., 2011).

By recognizing these biases, DNPs can critically evaluate research informing DSME interventions for low-income, minority adolescents and advocate for culturally sensitive approaches that address the specific needs of this population.

Impact of Bias and Confounding Awareness on Treatment

Nurses educated at the doctoral level who have an understanding of bias and confounding elements can critically appraise research used to guide treatment decisions for low-income adults with diabetes. Also, having an awareness of selection bias allows for the identification of generalizability limitations in research findings. DNPs can then seek out studies that include low-income populations to ensure recommendations are applicable. Furthermore, recognizing information bias encourages DNPs to assess the quality of data collection methods used in research and this helps them determine the reliability of study conclusions. Another advantage of understanding confounding allows DNPs to identify and adjust for factors that might skew the results of research on diabetes management in low-income populations leading to the strengthening of the evidence base for treatment decisions. Finaly, by being aware of these potential biases and confounding factors, DNPs can translate research findings into effective and culturally sensitive diabetes management programs for low-income adults.

Strategies to Minimize Bias and Confounding

These include the following:

Study Design: Researchers can employ randomized controlled trials (RCTs) to minimize selection bias and ensure control groups receive alternative interventions (Guyatt et al., 2011). Stratified sampling ensures representation of subgroups within the rural population.

Analysis Considerations: Statistical methods like propensity score matching can adjust for confounding variables, accounting for their influence on the observed relationship between diabetes risk factors and outcomes (Rosenbaum, 2010)

Consequences of Unmitigated Biases

Unrecognized biases can lead to misinterpretations of research, potentially resulting in:

Ineffective Interventions: Programs based on biased research might not address the true needs of the target population, leading to poor outcomes.

Also, uncontrolled bias can lead to wasted resources on ineffective interventions and missed opportunities to improve health outcomes for low-income, minority communities with diabetes. For example, if a biased study suggests that a particular diabetes education program is ineffective, DNPs may not recommend it to their patients, even though it could be beneficial.

Health Disparities: Biased research may exacerbate health disparities if interventions are not tailored to address the unique challenges of different populations.

If selection bias goes unchecked, interventions found to be effective in research may not work as well in real-world settings. Confounding variables can lead to misinterpretations of cause-and-effect relationships, potentially leading to inappropriate or ineffective treatment recommendations for patients with diabetes, particularly in vulnerable populations.

Conclusion

In conclusion by being aware of and minimizing biases, DNPs can ensure research findings are accurately translated into evidence-based practice, improving patient care and health outcomes for all populations.

 

References

American Association of Diabetes Educators. (2023). Standards of practice for diabetes self-management education/support. 

to an external site.

Centers for Disease Control and Prevention. (2023). Social determinants of health inequalities. 

to an external site.

Guyatt, G. H., Ospina, T., Cadegiani, G., Payne, M. E., Sullivan, M. J., & Devereaux, R. V. (2011). GRADE: An emerging consensus on rating quality of evidence and strength of recommendations. 
BMC Medical Research Methodology, 11, 2. 

to an external site.

Guyatt, G. H., Ospina, M. B., Sultan, J. A., Strauss, B. E., Bullock, T. L., & Devereaux, R. V. (2011). GRADE: Going from evidence to recommendations. 
Canadian Medical Association journal, 183(14), 1613 – 1619. 

to an external site.

Rosenbaum, P. R. (2010). Observational studies. 
Springer Series in Statistics (Vol. 208). Springer.

 ReplyReply to Comment

·

PEER # 2


Lucretia Dennise Sanders

Week 6 Initial Post:  

CRITIQUING SOURCES OF ERROR IN POPULATION RESEARCH TO ADDRESS GAPS IN NURSING PRACTICE 

Practice Gap: Lack of accessible transportation for patients living in rural communities significantly affects their ability to reach healthcare appointments, creating a critical barrier to timely and effective medical care. This issue is deeply rooted in the unique challenges of rural living, including sparse public transportation networks, the considerable distances to healthcare providers, and the economic strain of travel costs. Consequently, rural patients often face delays in receiving necessary care, which can lead to the deterioration of health conditions and higher healthcare expenses over time.  

Treatment of this population/issue could be affected 

Recognizing bias and confounding factors in epidemiologic studies about transportation barriers in rural areas can profoundly influence the approach to mitigating these issues, ensuring that interventions are grounded in a realistic context of the patient’s circumstances. It enables healthcare planners and policymakers to devise strategies that accurately address the specific needs and barriers faced by rural communities, rather than relying on skewed data that may overlook critical aspects of their challenges (Syed et al., 2013). This awareness can lead to more equitable healthcare solutions by highlighting the need for tailored interventions that consider the unique socioeconomic and geographical factors affecting rural populations, thus improving the effectiveness of programs aimed at increasing healthcare accessibility. 

Strategies researchers can use to minimize these types of bias in studies 

To mitigate bias in studies exploring the lack of accessible transportation for patients in rural areas, researchers can adopt a longitudinal study design, tracking healthcare access over time to better understand the dynamic relationship between transportation barriers and healthcare utilization. This method reduces recall bias and provides a more accurate picture of how transportation issues affect healthcare access longitudinally (Varela et al., 2019). Another effective strategy is to use propensity score matching to control for confounding variables, ensuring that the comparison between individuals with and without transportation barriers is as fair and unbiased as possible. This technique adjusts for factors that might skew the relationship between transportation access and healthcare outcomes, enabling researchers to isolate the effect of transportation barriers more accurately. 

Effects these biases could have on the interpretation of study results 

Failing to address these biases could result in skewed interpretations of research findings, possibly overstating the accessibility of healthcare for rural patients or understating the severity of transportation challenges. Such inaccuracies might misguide healthcare policy and resource allocation, leading to ineffective solutions that do not adequately tackle the pressing needs of those in rural communities. ((Kaiser & Barstow, 2022) 

Reference: 

Kaiser, N., & Barstow, C. K. (2022, February 14). Rural transportation infrastructure in low- and middle-income countries: A review of impacts, implications, and interventions. MDPI. 

to an external site.

 Syed, S. T., Gerber, B. S., & Sharp, L. K. (2013). Traveling towards disease: transportation barriers to health care access. Journal of Community Health, 38(5), 976–993. 

to an external site.

Varela, C., Young, S., Mkandawire, N. et al. TRANSPORTATION BARRIERS TO ACCESS HEALTH CARE FOR SURGICAL CONDITIONS IN MALAWI a cross-sectional nationwide household survey. BMC Public Health 19, 264 (2019). 

to an external site.

 

Assignment Rubric Details

Close

Rubric

NURS_8310_Week6_Blog_Rubric

NURS_8310_Week6_Blog_Rubric

Criteria

Ratings

Pts

This criterion is linked to a Learning OutcomeMain Posting: Idea and Content

60 to >49.0 pts

Excellent

• Thoroughly responds to the blog prompt/s. • Post provides comprehensive insight, understanding, or reflection about the topic through a focused analysis of the topic supported by personal experiences and/or examples. • Personal opinions are expressed and are clearly related to the topic, activity or process identified in blog prompts. • The post reflects in-depth engagement with the topic. • Posts main blog by due date.

49 to >38.0 pts

Good

• Responds to all of the blog prompt/s. • Post provides insight, understanding, or reflection about the topic through a reasonably focused analysis of the topic supported by personal experiences and/or examples. • Personal opinions are expressed and are but not fully developed to align with blog prompts. • The post reflects moderate engagement with the topic. • Posts main blog by due date.

38 to >27.0 pts

Fair

• Partially responds to the blog prompt/s. • Posts are typically short and may contain some irrelevant material. • The post is mostly description or summary without connections or analysis between ideas. • The post reflects minimal engagement with the topic. • Posts main blog by due date.

27 to >0 pts

Poor

• Does not respond to the blog prompt/s or entries lack insight, depth or are superficial. • The entries are short and are frequently irrelevant to the events. • They do not express opinion clearly and show little understanding. • The post does not reflect engagement with the topic. • Does not post main blog by due date.

60 pts

This criterion is linked to a Learning OutcomeFirst Response: Post to colleague’s main blogpost shows evidence of insight, understanding, or reflective thought about the topic. NOTE: Responses to faculty are not counted as first or second colleague responses.

20 to >11.0 pts

Excellent

• Presents a focused and cohesive viewpoint in addressing this response. • Response includes focused questions or examples related to colleague’s post. • Response stimulates dialogue and commentary. • Posts by due date.

11 to >6.0 pts

Good

• Presents a specific viewpoint that is focused and cohesive. • Response includes at least one focused question or example related to colleague’s post. • There is some attempt to stimulate dialogue and commentary. • Posts by due date.

6 to >2.0 pts

Fair

• Presents a specific viewpoint but lacks supporting examples or focused questions related to colleague’s post. • The posting is brief and reflects minimal effort to connect with colleague. • Posts by due date.

2 to >0 pts

Poor

• Response lacks a specific viewpoint and supporting examples or focused questions related to colleague’s post. • The post does not stimulate dialogue or connect with the colleague. • Does not post by due date.

20 pts

This criterion is linked to a Learning OutcomeSecond Response: Post to second colleague blog post shows evidence of insight, understanding, or reflective thought about the topic.

20 to >11.0 pts

Excellent

• Presents a focused and cohesive viewpoint in addressing this response. • Response includes focused questions or examples related to colleague’s post. • Response stimulates dialogue and commentary. • Posts by due date.

11 to >6.0 pts

Good

• Presents a specific viewpoint that is focused and cohesive. • Response includes at least one focused question or example related to colleague’s post. • There is some attempt to stimulate dialogue and commentary. • Posts by due date.

6 to >2.0 pts

Fair

• Presents a specific viewpoint but lacks supporting examples or focused questions related to colleague’s post. • The posting is brief and reflects minimal effort to connect with colleague. • Posts by due date.

2 to >0 pts

Poor

• Response lacks a specific viewpoint and supporting examples or focused questions related to colleague’s post. • The does not stimulate dialogue or connect with the colleague. • Does not post by due date.

20 pts

Total Points: 100

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During the decades of exile, the composition of what would become the full Torah took shape. The contributions of the Priestly (P) writers/scribes and the Deuteronomists’ compositions were completed by scribes, perhaps sponsored by the exiled Judean royal family of Jehoiachin in Babylon.  The oracles and lives of the prophets, especially Jeremiah, were composed.  Several other full compositions were achieved, among them: the Priestly (P) contributions (including the first creation story), Lamentations, Ezekiel, and the oracles of an exilic prophet, who remains unknown to us, whom we simply call Second Isaiah (Is 40-54).  Each offered something distinctly useful for exiled communities then and always.   Based on a few glances (see below) at the first creation story and at each of these three books, in this second discussion, describe what you identify as the contributions of this creation story and of these three very distinct books written during the exilic period.  What do you surmise each offered to the exiles, again, based on what you now know about the exiles and the exilic period?  Genesis 1:1-2:3 Lamentations Ezekiel Second Isaiah (Isaiah 40-54) Submission Instructions: Your initial post should be at least 250-300 words for each discussion post, formatted and cited in the current APA style. Provide support for your work from at least two academic sources less than five years old.

During the decades of exile, the composition of what would become the full Torah took shape. The contributions of the Priestly (P) writers/scribes and the Deuteronomists’ compositions were completed by scribes, perhaps sponsored by the exiled Judean royal family of Jehoiachin in Babylon.  The oracles and lives of the prophets,

The purpose of this exercise is to conduct a brief examination of the book of the prophet Amos employing the ‘three-world’ organizing framework for literary analysis.  At the same time, it is an opportunity to explore the book about the oracles and life of one of Israel’s great prophets, the function of prophecy as a concern not for foretelling but of forthtelling, a call to reform and transformation.  The prophets were also poets, and the oracles bear witness to an oral and written genre that has shaped the ‘consciousness and consciences’ of people and civilizations for millennia.  As a result of this analysis of Amos, you should also gain a sense of the meaning of being prophetic today in response to the many challenges of the Church and the world that we have inherited and are passing on.      Instructions:  You could consult a biblical commentary for this exercise if you wish, but your work should be primarily the result of your analysis.  Do indicate what sources you consulted. (This is not a paper; it is an exercise.) Follow the outline below and use it as the template of your writing: An introduction to the book that includes your reactions to reading Amos.  This should be written following the reading and writing process (.5 page). Briefly describe the ‘world behind the text’ of Amos by identifying the book’s historical context (.5 page). Conduct a partial literary analysis on Amos’s world of/within the text (1 page outline format). Focus on three aspects: The imagery in Amos and how it offers examples of how its artistry can communicate its main exhortations more effectively.  The prophetic oracles are richly poetic, galvanizing imagery taken from various sectors of life: natural, agricultural, cultic, commercial, political, and cultural.  To do so, describe the imagery employed for the ruling class of the Northern Israelite kingdom, the poor (the majority of the population at the time), imagery regarding justice/injustice, and other images. Identifying the layout and features of the book similarly alerts the reader to the creative way its central message is effectively delivered.  For example, the type of genre employed, geographical references, structure, and tenor. What is the ‘theology’ of Amos?  How is God envisioned/presented? How does Amos interpret “the day of the LORD,” which was typically imagined as the day/time of national vindication? Consider ‘the world in front of the text’ of Amos.  Focus on today’s audiences: How does/can Amos’ prophetic message address today’s many societal and global challenges?  What does it challenge people today to do?  Where do you see resistance to a message like this?  How are/can people be prophetic today?  (1 page) Submission Instructions:   The paper must be clear and concise, and students will lose points for improper grammar, punctuation, and misspelling. The paper is to be no shorter than 3 pages in length and no more than 3.5 pages in length. The student will automatically lose points if these limits are not followed. Journal articles and books should be referenced according to the current APA style (the library has a copy of the APA Manual). The work should be academic, written in an academic voice.

The purpose of this exercise is to conduct a brief examination of the book of the prophet Amos employing the ‘three-world’ organizing framework for literary analysis.  At the same time, it is an opportunity to explore the book about the oracles and life of one of Israel’s great prophets, the

Key Assignment Draft Part 1 Craft a 1 page memo. Make sure to include the following points in the memo: Explain how legal barriers may or may not prohibit information sharing at the different levels of government. Include decision-making products as they relate to your chosen Key Assignment topic. Review the Key Assignment selected strategy and determine what (if any) barriers there may be to information sharing. Determine whether or not any barriers to information sharing are identified. Determine whether or not an implementation plan addresses those identified barriers. Determine how the strategy that you have selected fits into the overall information-sharing global structure. Part 2 Review your selected strategy, conduct an assessment of the primary policies within the strategy (or the goals and objectives), and provide a detailed assessment of the pros and cons of each. Consider the intelligence cycle and the processing of information as well as interagency coordination and information sharing. Complete a PowerPoint presentation of 8–10 slides, and include the following: Assess the primary policies of the selected Key Assignment strategy. Assess the pros and cons of each policy, taking into consideration the intelligence cycle and interagency coordination. Provide any recommendations for improvements to the overarching goals and objectives or primary polices of the strategy. Provide recommendations for implementation. Submit a 1–2-page executive summary of your findings. Include a cover slide and a reference slide. Part 3 Please submit a draft of your Key Assignment, drawing from your work in previous weeks and 2–3 new pages. Provide a written analysis of a specific intelligence and information-sharing strategy. Your draft should examine the strategy of an agency, such as the Federal Bureau of Investigation (FBI), or any national strategy that involves intelligence and information sharing, such as intelligence-led policing. Your draft should be 15–20 pages in length and should provide an in-depth analysis to determine whether or not the current strategy meets the intelligence and information sharing needs for homeland security (HLS), and make recommendations for improvement. The analysis will examine factors such as, but not limited to the following: A brief description of the strategy to include the agency responsible for the strategy and the history and evolution of the document An analysis of the agency’s past and current structure and capabilities Identification of information-sharing barriers and an explanation of how and why they are classified as barriers A description of the specific policies within the strategy Identification of legal entities and legal barriers A description of whether or not there are ethical and privacy considerations The intelligence cycle Interagency coordination You must include a reference page using APA formatting.

Key Assignment Draft Part 1 Craft a 1 page memo. Make sure to include the following points in the memo: Explain how legal barriers may or may not prohibit information sharing at the different levels of government. Include decision-making products as they relate to your chosen Key Assignment topic. Review

see attachment Health Care Quality Management Identify one activity or concept covered in this course which you found to be most valuable and explain why. Then briefly discuss how the material presented in this course will benefit you in your future professional or academic pursuits. Your journal entry must be at least 200 words in length. No references or citations are necessary.

see attachment Health Care Quality Management Identify one activity or concept covered in this course which you found to be most valuable and explain why. Then briefly discuss how the material presented in this course will benefit you in your future professional or academic pursuits. Your journal entry must be

Assignment Readings Stress not only affects the structure and function of the brain, but its genetic makeup as well. In this module you were introduced to the various effects stress has on each body system, including the reproductive system. New research suggests that experiencing intense psychological trauma may have a genetic impact on a person’s future children. In the following video, Dr. Rachel Yehuda studied the genetic effects in a population of Holocaust survivors and found variations from the norm in both generations for the gene associated with depression and anxiety disorders. The findings imply that children of individuals who experience profound stress in life may be more likely to develop stress or anxiety disorders themselves. Can Trauma Be Passed to the Next Generation Through DNA?  PBS Learning Media. Accessed at Answer the following questions in essay format. For additional details, see the Case Assignment directions below. How does experiencing trauma affect a person’s life? Describe the term epigenetics. How does stress play a role in epigenetics? Describe an event in history that could have caused stress-related changes to the next generation (some examples include the Holocaust, 9-11 terrorist attack, the Dutch famine of 1944). Include the disorders these children experienced (such as anxiety, depression, mental disorders, etc). Why might it be helpful to know how children will be affected by trauma their parents experienced? What kinds of events going on in the world right now could be producing similar effects in future generations? Organize this essay assignment using subtitles that summarize the topic from each question above. For example, to answer Question 1, use a descriptive subtitle like the following: Effects of Trauma. Answer each question under the subtitle using complete sentences that relate back to the question. Be sure to use APA formatting throughout your essay with 1-inch margins, 12-pt font, and double spacing throughout. Include a title page, introduction, answers to the questions with subtitles, and concluding paragraph. Remember to include in-text citations within the body of the essay referencing your resources (i.e., Murray, 2014). Also, be sure to include a reference section at the end of your assignment listing all required readings and any additional resources you used to complete your essay. M.H.M. Reul, J., Gutierrez-Mecinas, M., Collins, A., & F. Trollope, A. (2012).  Epigenetics of stress .  Epigenetics of lifestyle (pp. 70-89). BENTHAM SCIENCE PUBLISHERS.  https://doi.org/10.2174/978160805299811201010070.  Chapter 3 Epigenetics of Stress Chapter 5 Epigenetics of Nutrition OpenStax College, Chapter 14. Stress and Illness Publishing, H. H. (n.d.). Uncovering the link between emotional stress and heart disease. Retrieved September 28, 2017, from Norris, J. (2011, February 03). Aging, Chronic Disease and Telomeres Are Linked in Recent Studies. Retrieved September 28, 2017, from Henderson, D. F., Nelson, D. L., & Quick, J. C. (2017). Social class, health, stress, and heart disease. In C. L. Cooper, & J. C. Quick (Eds.), The handbook of stress and health (pp. 630-645). John Wiley & Sons, Ltd. Chapter 2 Impact of Stress Chapter 3 Personality

Assignment Readings Stress not only affects the structure and function of the brain, but its genetic makeup as well. In this module you were introduced to the various effects stress has on each body system, including the reproductive system. New research suggests that experiencing intense psychological trauma may have a

please see attachment  Please review the attachment below and address the following 4 questions in a 1-page essay: 1. In the case study, do you believe the ends justify the means? In other words, does the goal of discharging the patient from an institutional setting into everyday community living justify deceiving him? Explain your reasoning. 2. Do you think it is ever ethically permissible to deceive clients? Under what circumstances? Why or why not? 3. To what degree should family members or legal guardians have full capacity to make decisions or give consent on behalf of those under their care? Explain. 4. Do you think severely mentally ill people retain any rights “to determine what shall be done with their own bodies?” Why or why not? Case Study In the context of U.S. healthcare, Justice Benjamin Cardozo expressed the value of autonomy and liberty in Schloendorff v. Society of New York Hospitals (1914), stating that individuals have the right to determine what happens to their own bodies. This case established informed consent as a crucial principle in modern medical ethics. However, subsequent events have shown instances where patient autonomy has been overridden. For example, in Buck v. Bell (1927), involuntary sterilization of “mental defectives” was deemed justified by Justice Oliver Wendell Holmes. The Tuskegee Syphilis Study, which lasted from 1932 to 1972, also violated patient autonomy by withholding treatment from African-American males. The President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research emphasized the importance of informed consent, recognizing that adults have the right to accept or reject healthcare interventions based on personal values and goals. However, there are cases where patients are deemed incompetent, and someone else is designated to make decisions on their behalf. Consider the following case: A middle-aged man, declared mentally incompetent, was involuntarily committed to a psychiatric hospital due to severe paranoid thinking. His adult son, granted guardianship and medical power of attorney, made decisions regarding the use of psychotropic medications to control the patient’s violent behavior. Despite the medications’ limited impact on the patient’s paranoid symptoms, a new drug in pill form showed promise for his return to the community. The suggestion to mix the pill in his pudding to address the patient’s fear of being poisoned arose. Hospital staff obtained informed consent from the son, who prioritized the patient’s living outside the institution and close to loved ones. However, the staff felt uneasy about deceiving the patient despite obtaining consent from the guardian. Use this scenario as the basis for your assignment. You are the caregiver. How would you feel?

please see attachment  Please review the attachment below and address the following 4 questions in a 1-page essay: 1. In the case study, do you believe the ends justify the means? In other words, does the goal of discharging the patient from an institutional setting into everyday community living justify

For this assignment, you will research the different ways that managers and leaders use communication to guide their organizations. Find an instance where the organizational leader communicates directly with his or her employees, investors, or customers. Analyze the message, the channel, and the potential for feedback. Do you believe that it is effective? Do you believe that it is the same type of message that a manager would send? Why, or why not? Remember to focus on the communication styles of both leaders and managers. Strive for an equal balance between the two types of communication styles in your assignment. Example: The Apple events that occur in Cupertino whenever Apple unveils a new product or service are examples of the type of communication you should be analyzing in this assignment. During the events, CEO Tim Cook addresses an audience of employees, investors, and the general public. Cook uses multiple channels to communicate with the audience, including a live face-to-face discussion, live streaming of the discussion, and a recorded video. For the assignment, you would view one of the events, analyze Cook’s message and the effectiveness of the channels, and discuss the potential for feedback. Analyze whether or not the message is an effective example of leadership. Explain whether or not you believe a manager could, or should, use the same types of channels to relay a message. Would it be effective? Note: You do not need to use Apple for this assignment. It is provided as an example only. Use the standard five-paragraph format (introduction/body/conclusion). Include at least two academic sources. APA format should be used. The assignment should be a minimum of two pages in length, not including the title and reference pages. Content, organization, and grammar/mechanics will be evaluated.

For this assignment, you will research the different ways that managers and leaders use communication to guide their organizations. Find an instance where the organizational leader communicates directly with his or her employees, investors, or customers. Analyze the message, the channel, and the potential for feedback. Do you believe that

* Cholelithiasis *Power point -> 12-14 slides   In short summary format, include Patient/client (use initials), Age, Gender/Gender identity, Race/ethnicity, diagnosis, and health care setting. Explain the pathophysiology of the condition Describe the typical clinical manifestations Briefly describe the best practice medical treatment Describe the nursing intervention(s) and health education Correlate the nursing intervention/education to a nursing theory Identify the theorist and how the theory supports nursing intervention/education for this condition. References: Include the text and at least two scholarly NURSING journal articles within five (5) to ten (10) years that are appropriately cited and referenced Include slides and speaker notes with citations to support your information

* Cholelithiasis *Power point -> 12-14 slides   In short summary format, include Patient/client (use initials), Age, Gender/Gender identity, Race/ethnicity, diagnosis, and health care setting. Explain the pathophysiology of the condition Describe the typical clinical manifestations Briefly describe the best practice medical treatment Describe the nursing intervention(s) and health education

4/14/2024- CLASS 2 ***** PLEASE MAKE SURE THAT ALL WORK IS AUTHENTIC***** ****** THIS ASSIGNMENT HAS 3 PARTS / PLEASE LABEL EACH PART SEPARATELY WITH REFERENCES WHEN COMPLETED****** PART 1- Module 1- DISCUSSION – (SHEILA)- 1. This discussion board post will take the form of a debate about DEONTOLOGICAL ETHICS. You must make an initial post (200 words) trying to defend taking your stance of DEONTOLOGICAL ETHICS as best for your business. You should number your arguments for clarity, and if you are referencing anything, provide documentation to back up your claims through citations. You need to put forward the best argument you can to persuade others on behalf of your team’s ethical position. 2. Provide a counter argument (50 words) to a response of someone who might choose VIRTUE ETHICS for their business. SUBMISSION INSTRUCTIONS: Your initial post should be at least 200 words, formatted and cited in current APA style with support from at least 2 academic sources.  PART 2- Module 1- DISCUSSION – (VAL)- An Overview of ORGANIZATIONAL DEVELOPMENT Interventions What are some of the thinking that should go into planning and implementing ORGANIZATIONAL DEVELOPMENT interventions? SUBMISSION INSTRUCTIONS: Your initial post should be at least 200 words, formatted and cited in current APA style with support from at least 2 academic sources.  PART 3- Module 1- ASSIGNMENT- (VAL)- Constructing an Intervention Strategy  A.   Describe one (1) thing you would like to change in your work community if you could? Be sure to explain what it is, why you would like to make this change and what impact this change could have on your workplace at large. B.    Construct an intervention strategy that will assist you in improving this problem. a) Describe the activity.b) Explain why and how you think this activity will create change.c) Make sure you focus on your topic of change and your work community. SUBMISSION INSTRUCTIONS: Assignment should be 2 pages, formatted and cited in current APA style, and incorporate a minimum of 3 current (published within last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work.

4/14/2024- CLASS 2 ***** PLEASE MAKE SURE THAT ALL WORK IS AUTHENTIC***** ****** THIS ASSIGNMENT HAS 3 PARTS / PLEASE LABEL EACH PART SEPARATELY WITH REFERENCES WHEN COMPLETED****** PART 1- Module 1- DISCUSSION – (SHEILA)- 1. This discussion board post will take the form of a debate about DEONTOLOGICAL ETHICS.

These videos are a great preview to applying for graduate school. Watch both and post your take-aways. Your response should be 12-15 sentences long and include a description of the GRE. Pay attention to your paragraph formation, orthography, grammar, spelling, and punctuation; Proofread your work!

These videos are a great preview to applying for graduate school. Watch both and post your take-aways. Your response should be 12-15 sentences long and include a description of the GRE. Pay attention to your paragraph formation, orthography, grammar, spelling, and punctuation; Proofread your work!

Most of the discussion revolves around comparing prisons and different levels of prison. Let’s expand and discuss some elements that are important to corrections. Respond to the following in a minimum of 175 words:  How do prisons work to accommodate juveniles, individuals with mental illness, and individuals with substance abuse issues? What can be done to make this better?

Most of the discussion revolves around comparing prisons and different levels of prison. Let’s expand and discuss some elements that are important to corrections. Respond to the following in a minimum of 175 words:  How do prisons work to accommodate juveniles, individuals with mental illness, and individuals with substance abuse

1 Literature Review Social Environment of Social Media The purpose of social media is to connect people; therefore, social media inherently is an online social environment. It is also helpful that many members who are connected on social media platforms tend to be like-minded peers, so there is often a more relaxed and encouraging environment. One qualitative study focusing on videos from a language learning vlogger showcased this when reporting a difference between likes and dislikes on the vlogger’s videos: 28,278 likes versus 251 dislikes, 3,738 likes versus 80 dislikes, 2,283 likes versus 3 dislikes (Combe & Codreanu, 2016). Online, users have the ability to filter out content that does not interest them allowing them to focus on preferred content. This means, users can attract other language learners from around the world, allowing them to learn from and encourage each other on a larger scale than a regular classroom. Another aspect that comes with a more relaxed environment is more relaxed language. Often the language found in textbooks can sound overly formal and/or unnatural to native speakers. Therefore, it is important that language learners find ways to engage in more natural settings to use language. A qualitative study conducted by Baſöz (2016) sent questionnaires to pre- service English as a Foreign Language (EFL) teachers. Of those teachers, 85% believed that language learners could be exposed to more “authentic” language through social media (p. 434). Online, people are more likely to use a style suited for everyday use, including less complex vocabulary, less business jargon, and more slang. However, because social media’s sole purpose is not for teaching language, learns need to be aware that certain styles of language may not always fit their needs 2 Using a platform that was not developed for language learning can leave holes where formal learning would be able to fill. For example, sometimes there are no teachers, just a collective of people working together. Usually in these types of communities there are rules that help guide learners and those with knowledge find the best way to meet the needs of the participants. Isbell (2018) conducted a qualitative study observing a subreddit (i.e., r/Korean) and found that there were both official and unofficial rules, and the power to enforce the rules lied with the community as a whole. This idea was reiterated by those active on the page. One of the users stated that, “the poor sources are usually downvoted and pointed out in the comments to deter users from using them” (p. 93). Along with official and unofficial rules to guide users, there is another aspect of social media that can assist users in their language learning journey. In the same way teachers can use multiple media to teach in a formal classroom setting, social media often has multiple functions like the ability to post videos or photos or to upload text. With these tools, learners can experience the same vocabulary multiple times in multiple ways. One study, which used both qualitative and quantitative measures, aimed to determine how well Facebook could be used as a learning tool (Mykytiuk et al., 2020). The post-experimental assessment of this study was the final test for a class, half of which was taught in a formal learning setting and the other half of which was added to a Facebook group. The results showed that the experimental group (those in the Facebook group) out-performed the control group (those in a formal learning setting) after they had been exposed to the target vocabulary in multiple ways (Mykytiuk et al., 2020). While language learners can be exposed to repeated content in a formal classroom setting, online they can be more active participants in using their target language more naturally. 3 References Baſöz, T. (2016). Preservice EFL teachers’ attitudes towards language learning through social media. Procedia-Social and Behavioral Sciences, 232, 430-438. Combe, C., & Codreanu, T. (2016). Vlogging: A new channel for language learning and intercultural exchanges. Research-Publishing.Net. Isbell, D. R. (2018). Online informal language learning: Insights from a Korean learning community. Language Learning & Technology, 22(3), 82-102. Mykytiuk, S., Lysytska, O., & Melnikova, T. (2020). Facebook group as an educational platform f or foreign language acquisition. Postmodern Openings/Deschideri Postmoderne, 11.

1 Literature Review Social Environment of Social Media The purpose of social media is to connect people; therefore, social media inherently is an online social environment. It is also helpful that many members who are connected on social media platforms tend to be like-minded peers, so there is often a