The role of nurse leaders in improving health outcomes

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The role of nurse leaders in improving health outcomes

The role of nurse leaders in improving health outcomes

Discuss the most personally meaningful key points you have learned over the past eight weeks about the impact of grassroots policy initiatives and the role of nurse leaders in improving health outcomes and/or impacting barriers to practice by their engagement in policy processes.

Expectations

  • Length: A minimum of 250 words, not including references
  • Citations: At least one high-level scholarly reference in APA from within the last 5 years

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You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

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Aquifer case study based on the course objectives and weekly content.

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Aquifer case study based on the course objectives and weekly content.

Aquifer case study based on the course objectives and weekly content.

For this assignment, you will complete a Aquifer case study based on the course objectives and weekly content. Aquifer cases emphasize core learning objectives for an evidence-based primary care curriculum. Throughout your nurse practitioner program, you will use the Aquifer case studies to promote the development of clinical reasoning through the use of ongoing assessments and diagnostic skills and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice.

The Aquifer assignments are highly interactive and a dynamic way to enhance your learning. Material from the Aquifer cases may be present in the quizzes, the midterm exam, and the final exam.

Learn how to access and navigate Aquifer.

This week, complete the Aquifer case titled “Family Medicine 19: 39-year-old man with epigastric pain”

Apply information from the Aquifer Case Study to answer the following discussion questions:

· Discuss the Mr. Rodriquez’s history that would be pertinent to his gastrointestinal problem. Include chief complaint, HPI, Social, Family and Past medical history that would be important to know.

· Describe the physical exam and diagnostic tools to be used for Mr. Rodriguez. Are there any additional you would have liked to be included that were not?

· Please list 3 differential diagnoses for Mr. Rodriguez and explain why you chose them.  What was your final diagnosis and how did you make the determination?

· What plan of care will Mr. Rodriquez be given at this visit, include drug therapy and treatments; what is the patient education and follow-up?

 

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You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

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Strategic Development – nursing homework essays

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Strategic Development

Strategic Development

discuss:

Strategic development begins with the mission, vision, and values as defined by the organization and then discovers how to best complement the organization’s vision. Providing a strategic plan gives structure to employees to follow a vision, direction for the practice and influences the environment (Strategic Planning, 2009). There are numerous methods for strategy planning, although most all of them have similar principal elements, including assessment, planning, implementation, and evaluation. Furthermore, breaking it down into a nursing process of four stages in the strategy process formulation, operationalizing, execution, and monitoring (Waxman, 2013).

200 words

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You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

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Health Care Topic. – nursing homework essays

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Health Care Topic.

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You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

ORDER NOW FOR CUSTOMIZED, PLAGIARISM-FREE PAPERS

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

ADDITIONAL INSTRUCTIONS FOR THE CLASS

Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
I encourage you to incorporate the readings from the week (as applicable) into your responses.

Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

APA Format and Writing Quality

Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
I highly recommend using the APA Publication Manual, 6th edition.

Use of Direct Quotes

I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
It is best to paraphrase content and cite your source.

LopesWrite Policy

For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.

Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
I do not accept assignments that are two or more weeks late unless we have worked out an extension.
As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

Communication

Communication is so very important. There are multiple ways to communicate with me:
Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

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Use the following coupon code :
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Discussion: HEALTHY PEOPLE 2030 – nursing homework essays

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    CCNmodule2..Homeworkpaper.docx

Overview

This assignment is aligned with the module objective “Demonstrate community assessments and apply the principles of epidemiology.” As part of the written assignment, you will complete the following tasks:

· Identify one health problem you believe to be the most prevalent in your community. You may want to check with your local health department or a community health nurse. Also consider researching the morbidity/mortality rates health problems in your community.  School nurses and are an excellent resource person to contact.

· Analyze the problem using Milio’s framework for prevention from the module 1 readings (Chapter three in your text, pp 41).

· Choose one of your nursing diagnoses and describe how your identified community health problem applies.

· Describe the health people 2030 national goal that relates closest to your chosen Diagnosis.

· Develop one-long term goal, minimum of three short-term goals and interventions for your chosen diagnosis (you will be developing a teaching plan in week 3).

Goals: A goal is a final outcome of what is achieved after you provide the interventions. Goals are broad in nature. Consider the long-term goal to be after one year and short-term goal after six months. These are community goals and will take longer to obtain. Consider a reduction of statistics as a long-term goal as guided by the 2030 Healthy People site. Be specific and measurable to include timeframes. (See the examples on page 89)

Recommended headings include:

· Title Page

· Introduction (No heading needed –assure you introduced the topic of the paper with a purpose statement) – 7 points

· Content (a total of 20 points and please use the following headings)

. Introduction of Your Community Problem/Diagnosis – 2 points

. Analysis of Problem/Diagnosis Using Milo’s Framework of Prevention – 6 points

. Compare Problem/Diagnosis to Healthy People 2030 National Goals – 6 points

. Long-Term and Short Term Goal – 8 points (2 points for long-term goal and 2 points for each of the three short term goals with interventions)

· Conclusion (Again no heading required – use in conclusion or in summary at the beginning of the paragraph)– 7    points

· Stylistic Points– 6 total points – APA formatting with proper word count. Proper citations with 4 references – 2 references from required course material and two peer-reviewed references. See further criteria on rubric and underneath rubric.

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Points: 40

Due Date: Sun, Sep 5 by 11:59 p.m. Eastern Standard Time (EST) of the US.

 

References

Minimum of four (4) total references: two (2) references from required course materials and two (2) peer-reviewed references. All references must be no older than five years (unless making a specific point using a seminal piece of information)

Peer-reviewed references include references from professional data bases such as PubMed or CINHAL applicable to population and practice area, along with evidence based clinical practice guidelines. Examples of unacceptable references are Wikipedia, UpToDate, Epocrates, Medscape, WebMD, hospital organizations, insurance recommendations, & secondary clinical databases.

Style

Unless otherwise specified, all the written assignment must follow APA 7th edition formatting, citations and references.  Click here  to download a Microsoft Word APA template. Review this  annotated student sample paper guide  which draws attention to relevant content and formatting in 7th edition APA style. Make sure you cross-reference the APA 7th edition book as well before submitting the assignment. Refer to the ‘LEARNER SUPPORT’ tab for more information regarding APA 7th edition with comparisons to 6th edition.

Number of Pages/Words

Unless otherwise specified all papers should have a minimum of 600 words (approximately 2.5 pages) excluding the title and reference pages.

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Classify the types of writers

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Classify the types of writers

Classify the types of writers

The Classification assignments requires you to organize a topic into categories and then provide examples of what characteristics fit into each category. You have several options for this assignment, so you will need to choose one:  Classify the types of writers  Classify the types of bosses/supervisors  Classify the types of monsters  Classify the types of characters  Classify the types of heroes  Classify the types of dance  Classify the types of teachers  Classify the types of roommates  Classify the types of dates  Classify the types of mothers Keep in mind that these are general topics.

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You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

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Use the following coupon code :
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What do you know about burns

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What do you know about burns

What do you know about burns

You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages. What do you know about burns

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

ADDITIONAL INSTRUCTIONS FOR THE CLASS

Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
I encourage you to incorporate the readings from the week (as applicable) into your responses.

Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

APA Format and Writing Quality

Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
I highly recommend using the APA Publication Manual, 6th edition.

Use of Direct Quotes

I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
It is best to paraphrase content and cite your source.

LopesWrite Policy

For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.

Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
I do not accept assignments that are two or more weeks late unless we have worked out an extension.
As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

ORDER NOW FOR CUSTOMIZED, PLAGIARISM-FREE PAPERS

Communication

Communication is so very important. There are multiple ways to communicate with me:
Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

Get a 10 % discount on an order above $ 100
Use the following coupon code :
NURSING10

 
"Looking for a Similar Assignment? Get Expert Help at an Amazing Discount!"

Case Study 2: Pernicious Anemia

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Case Study 2: Pernicious Anemia

Case Study 2: Pernicious Anemia

Case Study 1: Edema

Ms. Rand is a 65-year-old woman who spends most of her day sitting on her porch and recovering from a recent surgery involving the removal of suspected cancerous lymph glands in the inguinal area. She is now complaining that her shoes are fitting too tightly, and she has developed poorly healing sores on her legs and ankles. A closer examination also shows distention in her varicose veins. Blood tests reveal a low level of proteins in the plasma.

  1. Based on the patient history and the signs and symptoms, identify the fluid imbalance the patient is experiencing, and state the rationale for your answer.
  2. Discuss the four general causes of edema and how they apply in the case of this patient.
  3. Discuss the swelling, sores, varicose vein distention, and other effects that edema can have on a patient.

Case Study 2: Pernicious Anemia

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Mr. Alvis, age 57, presented to his physician with marked fatigue, nausea with occasional diarrhea, and a sore, swollen tongue. Lately he also has been experiencing a tingling feeling in his toes and a feeling of clumsiness. Microscopic examination of a blood sample indicated a reduced number of erythrocytes, many of which are megaloblasts, and a reduced number of leukocytes, including many large, hypersegmented cells. Hemoglobin and serum levels of vitamin B12 were below normal. Additional tests confirm pernicious anemia.

  1. Relate the pathophysiology of pernicious anemia to the manifestations listed above.
  2. Discuss how the gastric abnormalities contribute to vitamin B12 and iron deficiency and how vitamin B12 deficiency causes complications associated with pernicious anemia.
  3. Discuss other tests that could be performed to diagnose this type of anemia.
  4. Discuss the treatment available and the limitations.

Case Study 3: Cardiovascular System: Atherosclerosis

Mr. Kelly is a 57-year-old man who consulted his physician after noticing marked leg pains while playing golf. He had previously noticed increasing fatigue and discomfort in his legs associated with moderate exercise. When sitting for extended periods with legs dangling, his legs became red, and sometimes his feet felt numb. His history indicates he smokes cigarettes and is chronically overweight. His blood cholesterol and other lipid levels are abnormal, and his physician suspects peripheral atherosclerosis as the cause of his discomfort.

  1. Discuss the development of atherosclerosis, including the predisposing factors in this case and the pathophysiological changes.
  2. Discuss the complications that might develop in this patient.
  3. Discuss the treatments for all aspects of the patient’s condition, including slowing the progress of the atherosclerosis, maintaining circulation in the leg, and treating complications.

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Cellulitis, infection Essay – nursing homework essays

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Cellulitis, infection Essay

Cellulitis, infection Essay

  • attachment

    Pathoweek2endofweek.docx

Develop a 1- to 2-page case study analysis in which you: ( 6 citations APA style)

•           Explain why you think the patient presented the symptoms described.

•           Identify the genes that may be associated with the development of the disease.

•           Explain the process of immunosuppression and the effect it has on body systems.

 

Diagnosis – cellulitis / infection

 

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Scenario 2: A 42-year-old man comes to clinic with chief complaint of pain, redness, and swelling of his right calf. He states that he had been working in his yard using a string trimmer when the trimmer slipped and cut his leg. He cleaned the wound with water from the garden hose and covered the wound with a large Band-Aid. Several days later, he developed fever to 100.6˚ F and chills and noticed that his leg was swollen and red. He comes to the emergency department for definitive care.

You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

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Use the following coupon code :
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Study Types, Measures Of Association, Statistical Tests, & Interpretation

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Study Types, Measures Of Association, Statistical Tests, & Interpretation

Study Types, Measures Of Association, Statistical Tests, & Interpretation

Directions: Write   the information requested in each column. Please refer to the Variables Supplement found in   the Resources. Each scenario is 14 points each, total 70 points. Question F   is worth 5 points for a total of 75   points. Study Types, Measures Of Association, Statistical Tests, & Interpretation

 

Select from   these study designs, using each only once:

Case   control study

Prospective   cohort study

Retrospective   cohort study

Cross-sectional   study

Intervention   trial

Select from   these measures of association and tests of significance, some of which are   used more than once:

Chi-square

Chi-square   w/o Yate’s Correction

Difference   between the means

Chi-square   Fishers Exact Test

Odds   ratio

p-value

Relative   risk

t-test

 

Scenario   A: A team of researchers set out to study the risk   factors for pancreatic cancer. From   hospital records, they assembled a group of 50 patients who were either still   living or who had a next of kin identified and willing to answer questions   about medical history, lifestyle, and prior experiences of the patient. They assembled another group of 50 patients   from the same hospital who were admitted for other causes and did not have   cancer of any type. The investigators   conducted a review of all available records of these patients, then   interviewed them or their next of kin using a standardized format, either in   person or by telephone. They focused   on ten possible risk factors which could either be answered as yes/no or   rated on an ordinal scale. In this   study, 22 of the 50 pancreatic cancer patients were recorded as having at   least a 20 pack-year history of cigarette smoking, while 7 of the 50 in the   other group of patients had that history.

 

1. What   type of study is this   and what attributes make it so? (See   Week 2 PPT):

Case-control   study

 

2. What is the independent variable in this scenario, and what type is it? What is the dependent   variable in this scenario, and what   type is it?

Independent= 20 pack a year   smoking

type=

 

Dependent=pancreatic cancer

type= 

 

3. A null hypothesis states that   there is no effect, no relationship, or no difference between the variables   being tested. What might be a null hypothesis   for this study?

 

4. Odds   Ratio is the   most appropriate measure of association to evaluate the relationship of each   risk factor for the occurrence of pancreatic cancer and measures 4.47. Use the table and link below to show the data. What do the results   mean?

The   Odds Ratio is calculated as (a/c) / (b/d).

In   this scenario, which group   is ___ times more likely to develop pancreatic CA?

 

What   types of variables can be tested by OR?

 

Odd Ratio   Calculator

# of Ills

# of Wells

Total

 

# of Exposed

A = 

B =

A + B = 50

 

# of Unexposed

C = 

D = 

C + D = 50

 

Total

A + C = 50

B + D = 50

A+B+C+D = 100

 

How   to interpret Odds Ratio:

§ OR = 1 suggests that there   is no difference between the groups; i.e. there is no association between the   suggested exposure and the outcome (being ill)

§ OR > 1 suggests that the   odds of exposure are positively associated with the adverse outcome compared   to the odds of not being exposed

§ OR < 1 suggests that the   odds of exposure are negatively associated with the adverse outcomes compared   to the odds of not being exposed.  Potentially, there could be a protective   effect

 

5. What is the most appropriate test   of significance for this scenario?   (See Week 2 PPT) 

Chi-square   test for Independence w/o Yate’s correction

 

6. Calculate   the chi-square test result using this on-line calculator. What is the result?

 

7. What   is the interpretation of the test result and what do the results mean?

The chi-squared statistic is a   single number that tells you how much difference exists between your observed   counts and the counts you would expect if there were no relationship at all   in the population.

 

Scenario   B: Another team of researchers set out to test a new   medication developed to prevent the onset of diabetes in patients with a   strong family history of diabetes. They assembled a group of 200 patients and randomized them into two   equal groups, one to receive a placebo and the other to receive the   medication. They followed them each   year for five years and ascertained the occurrence of diabetes using a   glucose tolerance test. At the end of   the trial, 11 of 100 patients in the placebo groups had developed diabetes   mellitus, and 8 of 100 patients in the medication group had developed   diabetes mellitus.

 

1. What type of study is this and   what attributes make it so? (See week   2 PPT)

Intervention   trial

 

2. What is the independent variable   in this scenario, and what type is it? What is the dependent variable in this   scenario, and what type is it?

 

 

3. Please   state a null hypothesis.

 

4. What is the most appropriate   measure of association for this scenario? (see week 2 PPT)

Relative   risk

 

5. What is the most appropriate test   of significance for this scenario? (See week 2 PPT.) What do the results mean?

Chi   square

 

6. Fill in the online Chi-square   contingency table.    Set it up just as you did earlier. What   is the result? Chi-square is again the most appropriate test for   significance. Why? 

 

7. What   do the results mean in terms of the null?

 

Relative Risk is very similar to Odds Ratio,   however, RR is calculated by using percentages, whereas Odds Ratio is   calculated by using the ratio of odds.  Relative Risk values are greater   than or equal to zero.  A value of 1 indicates a neutral result meaning   the probability of a variable being present in one group is the same   probability of a variable being present in the other group.  However, a   value of zero indicates that none of the cases in group 1 had the event occur   while x number of cases in group 2 had the event occur; or   in other words, the numerator was a zero (A = 0) and the denominator was any   number greater than zero (B = x, where x >   0).

 

Scenario   C: A team of health sciences students decided on a   project that would give them experience with their statistical analysis   skills as well as some practice in taking vital signs. They assembled a group of 40 undergraduate   students, 20 science majors and 20 majors in other fields of study, brought   them to a makeshift clinic in the science building and measured their blood   pressures with a hand-held BP cuff. The results were as follows:

The science majors’ SBPs were: 100, 110, 116, 120, 122, 128, 128, 128, 130, 132, 132, 134, 140, 144,   146, 146, 150, 152, 154, 158.

The other majors’ SBPs were: 112, 118, 120, 126, 130, 130, 132, 134,   140, 142, 144, 144, 148, 150, 158, 160, 170, 172, 176, 190

 

1. What type of study is this and   what attributes make it so? (See Week   2 PPT)

Cross-sectional   study

 

2. What is the independent variable   in this scenario, and what type is it? What is the dependent variable in this   scenario, and what type is it?

 

 

3. Please   state a null hypothesis.

 

4. What is the most appropriate   measure of association for this scenario (see week 2 PPT)? Calculate that measure of association.

Significance of the difference   between the means

 

5. What is the most appropriate   statistical test of significance of this measure of association. Why?

Independent   t-test

 

6. Calculate the independent t-test result using the on-line calculator (Formula) What are the results?

 

7. What   do the results   mean and how   do we state our conclusion regarding the null hypothesis?

 

Scenario D: Another team of   investigators reviewed medical records to determine which military personnel   among several basic training units had received a previous type of meningitis   vaccine during training two decades ago. Two study groups were formed, those who had not received the vaccine   and those who had. These were followed   forward by record review throughout the duration of their active military   service, and if they had a record of care through the VA system, these   records were searched as well. The   outcome of interest was the occurrence of any of a number of autoimmune   diseases that were thought to have a possible association with the   vaccine. In this study, of a vaccine   group of 70, 4 individuals were found to have been diagnosed with lupus at   some subsequent point in time. In the   non-vaccine group of 105, only 2 individuals had that diagnosis

 

1. What type of study is this and   what attributes makes it so? (See week   2 PPT):

Retrospective   cohort study

 

2. What is the independent variable   in this scenario, and what type is it? What is the dependent variable in this   scenario, and what type is it?

 

 

3. State a null hypothesis.

 

4.  What is the most appropriate measure   of association to compare the rates of occurrence of autoimmune disease   between the two groups and Why?   Calculate that measure of association. 

Relative risk

 

5. What is the most appropriate   statistical test of significance of this measure of association and Why? Calculate the test result using   the on-line calculator.  Which test option should you use? What is the result?

Chi square, fisher’s   exact test

 

6. Using the same on-line calculator as for problems #1 and #2,   perform this test. What are the   2-tailed p-value results? 

 

7. What do the results mean   regarding the null hypothesis?

 

Scenario   E: Yet another team of investigators embarked on a   long-term study to assess the impact of low versus high levels of blood   cholesterol in Native Americans on subsequent occurrence of myocardial   infarction. They recruited 100   patients from three Indian Health Service hospital systems, and divided them   into two groups based on cholesterol LDL/HDL ratio (high ratio is bad) – 42   in the high group and 58 in the low group. By the end of the fifteen-year follow-up period, 16 in the high group   and 7 in the low group had experienced a myocardial infarction.

 

1. What type of study is this and   what makes it so?

Prospective   cohort study

 

2. What is the independent variable   in this scenario, and what type is it? What is the dependent variable in this   scenario, and what type is it?

 

 

3. State   a null hypothesis.

 

4. What is the most   appropriate measure of association to compare the rates of myocardial   infarction in the two groups and Why?   (See Week 2 PPT) Calculate that measure of association. What are the results?

Relative   risk

 

5. Chi square w/o   Yates correction   is the most appropriate statistical test to test the significance of this   measure of association. Why and what   are the 2-tailed p-results?

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6. What do the results mean in terms   of the null hypothesis?

 

Question   F. From your readings, describe:

 

1.   How the study design is selected.

 

2.   How the measure of association is determined.

 

3.   How the measure of significance is determined.

 

4.   How interpretation of the results is accomplished.

 

5.   What you would like to understand better.

 

Total

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