The document provides a summary of milestones in medicine, medical education, hospitals/healthcare systems, public health, and the U.S. health insurance system from 1700-2015. It describes key developments such as the establishment of the first medical school in 1765, the Flexner Report in 1910 which led to standardization of medical education, the creation of Medicare and Medicaid in 1965, and the passage of the Affordable Care Act in 2010. The document also summarizes milestones related to the development of hospitals and healthcare delivery systems over time as well as milestones in public health initiatives and the evolution of the U.S. health insurance system.
Background: Pharmacy developed as a profession over several decades with the advent of apothecaries and was formalized as a profession and regulated in India beginning 1948 with the Pharmacy Act. Public health, existent for centuries was only formalized in India in 1987 through the Model Public Health act. Clinical pharmacy through structured and formalized PharmD education is fairly new to 21st century India. Clinical pharmacists play a very important role in promoting public health through various initiatives – health education, health communication, medication review, medication adherence to name a few. There is however, little recognition for clinical pharmacists as public health professionals even in developed countries where public health and pharmacy systems have co-existed for decades. In India, as both fields emerge, it is important to find synergies and open up pathways for collaboration and cooperation to ensure a stronger pool of public health field clinicians, researchers and professionals.
This session will focus on identifying the roles of public health pharmacists with focus on areas of convergence and models for collaboration and cooperation between public health and pharmacy professionals.
Session aim: Discuss strategies to enhance capacity of pharmacists to advance public health outcomes.
Session objectives: At the end of this session, participants will be able to:
• Explain how pharmacists can play pivotal roles in disease prevention and health promotion
• Identify key interdisciplinary approaches where pharmacists can help achieve optimal public health outcomes
• Discuss strategies to integrate public health practice into pharmacological training and pharmaceutical care.
Content: Throughout the world, pharmacy as a profession is evolving. In recent years, several entities involved in pharmacy education have identified public health as a major area for improvement and expansion within the core pharmacy education. Pharmacists have been identified as key healthcare professionals in achieving health goals as mentioned in Healthy People 2020. In order to successfully integrate pharmacists as public health professionals, there is a need to introduce the principles and concepts of public health early on in pharmacy education. It is equally important to create and develop opportunities for practicing pharmacists and demonstrate the impact of pharmacists toward improving the population’s health. In this session, targeted interventions to outcomes assessment, differences and similarities will be discussed with implications for effectively advancing the capacity of pharmacists to achieve public health outcomes.
References
1. Policy Statement: The Role of the Pharmacist in Public Health. Policy Number 200614. American Public Health Association. November 8, 2006.
2. Capper, SA, Sands, CD. The Vital Relationship Between Public Health and Pharmacy. The International Journal of Pharmacy Education. Fall 2006, Issue 2.
Background: Pharmacy developed as a profession over several decades with the advent of apothecaries and was formalized as a profession and regulated in India beginning 1948 with the Pharmacy Act. Public health, existent for centuries was only formalized in India in 1987 through the Model Public Health act. Clinical pharmacy through structured and formalized PharmD education is fairly new to 21st century India. Clinical pharmacists play a very important role in promoting public health through various initiatives – health education, health communication, medication review, medication adherence to name a few. There is however, little recognition for clinical pharmacists as public health professionals even in developed countries where public health and pharmacy systems have co-existed for decades. In India, as both fields emerge, it is important to find synergies and open up pathways for collaboration and cooperation to ensure a stronger pool of public health field clinicians, researchers and professionals.
This session will focus on identifying the roles of public health pharmacists with focus on areas of convergence and models for collaboration and cooperation between public health and pharmacy professionals.
Session aim: Discuss strategies to enhance capacity of pharmacists to advance public health outcomes.
Session objectives: At the end of this session, participants will be able to:
• Explain how pharmacists can play pivotal roles in disease prevention and health promotion
• Identify key interdisciplinary approaches where pharmacists can help achieve optimal public health outcomes
• Discuss strategies to integrate public health practice into pharmacological training and pharmaceutical care.
Content: Throughout the world, pharmacy as a profession is evolving. In recent years, several entities involved in pharmacy education have identified public health as a major area for improvement and expansion within the core pharmacy education. Pharmacists have been identified as key healthcare professionals in achieving health goals as mentioned in Healthy People 2020. In order to successfully integrate pharmacists as public health professionals, there is a need to introduce the principles and concepts of public health early on in pharmacy education. It is equally important to create and develop opportunities for practicing pharmacists and demonstrate the impact of pharmacists toward improving the population’s health. In this session, targeted interventions to outcomes assessment, differences and similarities will be discussed with implications for effectively advancing the capacity of pharmacists to achieve public health outcomes.
References
1. Policy Statement: The Role of the Pharmacist in Public Health. Policy Number 200614. American Public Health Association. November 8, 2006.
2. Capper, SA, Sands, CD. The Vital Relationship Between Public Health and Pharmacy. The International Journal of Pharmacy Education. Fall 2006, Issue 2.
Background: Pharmacy developed as a profession over several decades with the advent of apothecaries and was formalized as a profession and regulated in India beginning 1948 with the Pharmacy Act. Public health, existent for centuries was only formalized in India in 1987 through the Model Public Health act. Clinical pharmacy through structured and formalized PharmD education is fairly new to 21st century India. Clinical pharmacists play a very important role in promoting public health through various initiatives – health education, health communication, medication review, medication adherence to name a few. There is however, little recognition for clinical pharmacists as public health professionals even in developed countries where public health and pharmacy systems have co-existed for decades. In India, as both fields emerge, it is important to find synergies and open up pathways for collaboration and cooperation to ensure a stronger pool of public health field clinicians, researchers and professionals.
This session will focus on identifying the roles of public health pharmacists with focus on areas of convergence and models for collaboration and cooperation between public health and pharmacy professionals.
Session aim: Discuss strategies to enhance capacity of pharmacists to advance public health outcomes.
Session objectives: At the end of this session, participants will be able to:
• Explain how pharmacists can play pivotal roles in disease prevention and health promotion
• Identify key interdisciplinary approaches where pharmacists can help achieve optimal public health outcomes
• Discuss strategies to integrate public health practice into pharmacological training and pharmaceutical care.
Content: Throughout the world, pharmacy as a profession is evolving. In recent years, several entities involved in pharmacy education have identified public health as a major area for improvement and expansion within the core pharmacy education. Pharmacists have been identified as key healthcare professionals in achieving health goals as mentioned in Healthy People 2020. In order to successfully integrate pharmacists as public health professionals, there is a need to introduce the principles and concepts of public health early on in pharmacy education. It is equally important to create and develop opportunities for practicing pharmacists and demonstrate the impact of pharmacists toward improving the population’s health. In this session, targeted interventions to outcomes assessment, differences and similarities will be discussed with implications for effectively advancing the capacity of pharmacists to achieve public health outcomes.
References
1. Policy Statement: The Role of the Pharmacist in Public Health. Policy Number 200614. American Public Health Association. November 8, 2006.
2. Capper, SA, Sands, CD. The Vital Relationship Between Public Health and Pharmacy. The International Journal of Pharmacy Education. Fall 2006, Issue 2.
FIX HEALTHCARE AND HEAL THE NATION (Jamie Koufman)Jamie Koufman
Unethical for-profit healthcare is bankrupting the United States. This presentation makes a convincing argument for a National Health Service (NHS) (not an insurance system) as Tier-One in a Three-Tier medical system.
An overly wordy look at the impact of the Sandinista revolution in NIcaragua and its impact of health care and health care policy. Created for ANTH216 class I'm teaching, New slideset this year so will likely undergo some revision in the future.
Take a few moments to research the contextual elements surrounding P.docxperryk1
Take a few moments to research the contextual elements surrounding President Kennedy’s inauguration in 1961 and then critically examine this speech:
“Inaugural Address,” by John F. KennedyLinks to an external site.<
https://urldefense.com/v3/__https://nam01.safelinks.protection.outlook.com/?url=https*3A*2F*2Furldefense.com*2Fv3*2F__https*3A*2F*2Fwww.jfklibrary.org*2FAsset-Viewer*2FBqXIEM9F4024ntFl7SVAjA.aspx__*3B!!ACPuPu0!nRyVaN_vHAO7VokwK2jIluLRE3Rbgg_zTzlKs2LU0jy7JJDLOQzoLng5O9kq8Ar2xqOxu6ASoTCCAw*24&data=02*7C01*7Cs3521396*40students.fscj.edu*7C3dbff0e6302e40df260508d83ebef2dd*7C4258f8b94f8d44abb87f21ab35a63470*7C0*7C0*7C637328337145689500&sdata=rjSnrpQbmBtBYheBjJTh*2B57JapV8a8uLTbS*2BwaXQFps*3D&reserved=0__;JSUlJSUlJSUlJSUlJSUlJSUlJSUlJSU!!ACPuPu0!lzlmNESbzfxzfV0D2RFZGvC0P4JM5SVIIXnoztdLO3J83rBb44XpTJOZcRrT89Wp_du_$
> is made available by the John F. Kennedy Presidential Library and Museum. It is in the public domain.
In a short rhetorical analysis (minimum of four paragraphs in length), please answer all of the questions below. Your work should include an introduction, a body of supporting evidence, and a conclusion. Please take some time to edit your writing for punctuation, usage, and clarity prior to submission.
Questions for Analysis
1. Which important historical and social realities had an impact on this speech in 1961, and how do these contextual elements figure in President Kennedy’s organization of this speech?
2. What is President Kennedy saying about the nature of human progress (science and technology) and the challenges that we must navigate as a global community? Are these challenges unique to 1961, or relative throughout human history?
3. What are the goals of this speech? Isolate at least three aims of President Kennedy’s address, identify his strategy for supporting these goals, and critique their efficacy. Is this an effective speech? Where applicable, please include a quotation or two from the speech.
In a rhetorical analysis (minimum of eight paragraphs in length), please answer all of the questions below. Your work should include an introduction, a body of supporting evidence, and a conclusion. Please take some time to edit your writing for punctuation, usage, and clarity prior to submission.
Questions for Analysis
1. How does Jefferson organize this important document? How many subdivisions does it have, how do they operate, and how does his approach to organization impact the document’s efficacy?
2. Using at least one citation from the text, analyze Jefferson’s approach to style, voice, and tone. How does he create a sense of urgency in moving toward the conclusion of the work?
3. The complexities of this document’s reach are immense. How many different audiences was Jefferson writing to, and what were the needs of those different groups?
4. In terms of the approaches to formal rhetoric that we studied in the first learning module, which does The Declaration of Independence most closely resemble? .
Table of Contents Section 2 Improving Healthcare Quality from.docxperryk1
Table of Contents Section 2: Improving Healthcare Quality from Within Week 4
Week 4 - Assignment: Interpret Performance Measures
Week 4 - Assignment: Interpret
Performance Measures
Instructions
Course Home Content Dropbox Grades Bookshelf ePortfolio Library The Commons Calendar
You have just been appointed as the administrator of a large managed healthcare organization
with multiple facilities in your state, including facilities in city X and Y (table below). A task your
office is charged with is to reimburse facilities based on how they perform on a set of healthcare
quality measures.
Based on the information provided below, what considerations will you make in your decision-
making process? To complete this assignment, prepare a PowerPoint presentation that
highlights whether or not these two facilities (A and B) should be treated equally when
conducting your assessment. If any, what are the implications of treating these facilities as
equals for the purpose of comparison? Also, address the techniques you will use to ensure these
facilities are assessed fairly.
Measures Facility A Facility B
1
Population
characteristics
City X: Mostly people
with high economic
status and those with
more than high school
education
City Y: Mostly people
with low economic
status, minorities,
high school or less
education
2 Population served All ages
Mostly older adults
and people with
disabilities and
chronic conditions
3
Staff to patient
ratio
1:4 1:8
4
Physician and
nurses continuing
education
Required Required
5 Average number of
hours staff work
per week
50 hours 60 hours
Reflect in ePortfolio
Submissions
No submissions yet. Drag and drop to upload your assignment below.
Drop files here, or click below!
Upload Choose Existing
You can upload files up to a maximum of 1 GB.
Length: 8-10 slides (excluding title slide and references slide)
References: Include a minimum of 3-5 peer-reviewed, scholarly resources referenced on a
separate slide at the end of your presentation.
Your assignment should reflect scholarly academic writing, current APA standards,
Record
Week 4
Course Home Content Dropbox Grades Bookshelf More
Interpreting Performance Improvement Measures
and Benchmarking
As a healthcare administrator/manager, it is in your best
interest to help the facility you serve to move in the
direction charted in the National Quality Strategy (Joshi et
al., 2014). Organizations that fail to meet set standards are
known to face sanctions and sometimes required to close
shop. In consideration of this, you will want to ensure that
the facility you manage is adopting a culture of quality that
puts its patients at the center of healthcare delivery. You will
want to do this by making sure that your facility provides
quality patient care, while also keeping the facility’s
bottom-line healthy.
To ensure you are moving in the right direction, you must
measure and monitor key qual.
More Related Content
Similar to TABLE 1-1 Milestones of Medicine and Medical Education 1700–2015 ■.docx
Background: Pharmacy developed as a profession over several decades with the advent of apothecaries and was formalized as a profession and regulated in India beginning 1948 with the Pharmacy Act. Public health, existent for centuries was only formalized in India in 1987 through the Model Public Health act. Clinical pharmacy through structured and formalized PharmD education is fairly new to 21st century India. Clinical pharmacists play a very important role in promoting public health through various initiatives – health education, health communication, medication review, medication adherence to name a few. There is however, little recognition for clinical pharmacists as public health professionals even in developed countries where public health and pharmacy systems have co-existed for decades. In India, as both fields emerge, it is important to find synergies and open up pathways for collaboration and cooperation to ensure a stronger pool of public health field clinicians, researchers and professionals.
This session will focus on identifying the roles of public health pharmacists with focus on areas of convergence and models for collaboration and cooperation between public health and pharmacy professionals.
Session aim: Discuss strategies to enhance capacity of pharmacists to advance public health outcomes.
Session objectives: At the end of this session, participants will be able to:
• Explain how pharmacists can play pivotal roles in disease prevention and health promotion
• Identify key interdisciplinary approaches where pharmacists can help achieve optimal public health outcomes
• Discuss strategies to integrate public health practice into pharmacological training and pharmaceutical care.
Content: Throughout the world, pharmacy as a profession is evolving. In recent years, several entities involved in pharmacy education have identified public health as a major area for improvement and expansion within the core pharmacy education. Pharmacists have been identified as key healthcare professionals in achieving health goals as mentioned in Healthy People 2020. In order to successfully integrate pharmacists as public health professionals, there is a need to introduce the principles and concepts of public health early on in pharmacy education. It is equally important to create and develop opportunities for practicing pharmacists and demonstrate the impact of pharmacists toward improving the population’s health. In this session, targeted interventions to outcomes assessment, differences and similarities will be discussed with implications for effectively advancing the capacity of pharmacists to achieve public health outcomes.
References
1. Policy Statement: The Role of the Pharmacist in Public Health. Policy Number 200614. American Public Health Association. November 8, 2006.
2. Capper, SA, Sands, CD. The Vital Relationship Between Public Health and Pharmacy. The International Journal of Pharmacy Education. Fall 2006, Issue 2.
FIX HEALTHCARE AND HEAL THE NATION (Jamie Koufman)Jamie Koufman
Unethical for-profit healthcare is bankrupting the United States. This presentation makes a convincing argument for a National Health Service (NHS) (not an insurance system) as Tier-One in a Three-Tier medical system.
An overly wordy look at the impact of the Sandinista revolution in NIcaragua and its impact of health care and health care policy. Created for ANTH216 class I'm teaching, New slideset this year so will likely undergo some revision in the future.
Take a few moments to research the contextual elements surrounding P.docxperryk1
Take a few moments to research the contextual elements surrounding President Kennedy’s inauguration in 1961 and then critically examine this speech:
“Inaugural Address,” by John F. KennedyLinks to an external site.<
https://urldefense.com/v3/__https://nam01.safelinks.protection.outlook.com/?url=https*3A*2F*2Furldefense.com*2Fv3*2F__https*3A*2F*2Fwww.jfklibrary.org*2FAsset-Viewer*2FBqXIEM9F4024ntFl7SVAjA.aspx__*3B!!ACPuPu0!nRyVaN_vHAO7VokwK2jIluLRE3Rbgg_zTzlKs2LU0jy7JJDLOQzoLng5O9kq8Ar2xqOxu6ASoTCCAw*24&data=02*7C01*7Cs3521396*40students.fscj.edu*7C3dbff0e6302e40df260508d83ebef2dd*7C4258f8b94f8d44abb87f21ab35a63470*7C0*7C0*7C637328337145689500&sdata=rjSnrpQbmBtBYheBjJTh*2B57JapV8a8uLTbS*2BwaXQFps*3D&reserved=0__;JSUlJSUlJSUlJSUlJSUlJSUlJSUlJSU!!ACPuPu0!lzlmNESbzfxzfV0D2RFZGvC0P4JM5SVIIXnoztdLO3J83rBb44XpTJOZcRrT89Wp_du_$
> is made available by the John F. Kennedy Presidential Library and Museum. It is in the public domain.
In a short rhetorical analysis (minimum of four paragraphs in length), please answer all of the questions below. Your work should include an introduction, a body of supporting evidence, and a conclusion. Please take some time to edit your writing for punctuation, usage, and clarity prior to submission.
Questions for Analysis
1. Which important historical and social realities had an impact on this speech in 1961, and how do these contextual elements figure in President Kennedy’s organization of this speech?
2. What is President Kennedy saying about the nature of human progress (science and technology) and the challenges that we must navigate as a global community? Are these challenges unique to 1961, or relative throughout human history?
3. What are the goals of this speech? Isolate at least three aims of President Kennedy’s address, identify his strategy for supporting these goals, and critique their efficacy. Is this an effective speech? Where applicable, please include a quotation or two from the speech.
In a rhetorical analysis (minimum of eight paragraphs in length), please answer all of the questions below. Your work should include an introduction, a body of supporting evidence, and a conclusion. Please take some time to edit your writing for punctuation, usage, and clarity prior to submission.
Questions for Analysis
1. How does Jefferson organize this important document? How many subdivisions does it have, how do they operate, and how does his approach to organization impact the document’s efficacy?
2. Using at least one citation from the text, analyze Jefferson’s approach to style, voice, and tone. How does he create a sense of urgency in moving toward the conclusion of the work?
3. The complexities of this document’s reach are immense. How many different audiences was Jefferson writing to, and what were the needs of those different groups?
4. In terms of the approaches to formal rhetoric that we studied in the first learning module, which does The Declaration of Independence most closely resemble? .
Table of Contents Section 2 Improving Healthcare Quality from.docxperryk1
Table of Contents Section 2: Improving Healthcare Quality from Within Week 4
Week 4 - Assignment: Interpret Performance Measures
Week 4 - Assignment: Interpret
Performance Measures
Instructions
Course Home Content Dropbox Grades Bookshelf ePortfolio Library The Commons Calendar
You have just been appointed as the administrator of a large managed healthcare organization
with multiple facilities in your state, including facilities in city X and Y (table below). A task your
office is charged with is to reimburse facilities based on how they perform on a set of healthcare
quality measures.
Based on the information provided below, what considerations will you make in your decision-
making process? To complete this assignment, prepare a PowerPoint presentation that
highlights whether or not these two facilities (A and B) should be treated equally when
conducting your assessment. If any, what are the implications of treating these facilities as
equals for the purpose of comparison? Also, address the techniques you will use to ensure these
facilities are assessed fairly.
Measures Facility A Facility B
1
Population
characteristics
City X: Mostly people
with high economic
status and those with
more than high school
education
City Y: Mostly people
with low economic
status, minorities,
high school or less
education
2 Population served All ages
Mostly older adults
and people with
disabilities and
chronic conditions
3
Staff to patient
ratio
1:4 1:8
4
Physician and
nurses continuing
education
Required Required
5 Average number of
hours staff work
per week
50 hours 60 hours
Reflect in ePortfolio
Submissions
No submissions yet. Drag and drop to upload your assignment below.
Drop files here, or click below!
Upload Choose Existing
You can upload files up to a maximum of 1 GB.
Length: 8-10 slides (excluding title slide and references slide)
References: Include a minimum of 3-5 peer-reviewed, scholarly resources referenced on a
separate slide at the end of your presentation.
Your assignment should reflect scholarly academic writing, current APA standards,
Record
Week 4
Course Home Content Dropbox Grades Bookshelf More
Interpreting Performance Improvement Measures
and Benchmarking
As a healthcare administrator/manager, it is in your best
interest to help the facility you serve to move in the
direction charted in the National Quality Strategy (Joshi et
al., 2014). Organizations that fail to meet set standards are
known to face sanctions and sometimes required to close
shop. In consideration of this, you will want to ensure that
the facility you manage is adopting a culture of quality that
puts its patients at the center of healthcare delivery. You will
want to do this by making sure that your facility provides
quality patient care, while also keeping the facility’s
bottom-line healthy.
To ensure you are moving in the right direction, you must
measure and monitor key qual.
Take a company and build a unique solution not currently offered. Bu.docxperryk1
Take a company and build a unique solution not currently offered. Build a
Lean Business Model Canvas.jpg
and present your idea using all 5 frameworks below:
1.Start with Why (by Simon Sinek)
2.Blue Ocean Strategy(by Chan Kim & Renee Mauborgne)
3.Being re"Markable"
4.The Tipping Point (by Malcolm Gladwell)
5.Story Brand (by Donald Miller)
.
Tackling a Crisis Head-onThis week, we will be starting our .docxperryk1
Tackling a Crisis Head-on
This week, we will be starting our work on Assignment 2. Go to
The Wall Street Journal
menu item and find an article about a crisis that occurred at a specific organization in the last year.
Considering the course materials for this week, answer the following:
Describe the crisis faced by the organization.
What communication tactics did the organization use to address its crisis? Refer to Jack and Warren's guidance for dealing with crises.
To what extent, if any, was the organization's crisis communication plan effective?
If you were a senior leader in the organization, would you have responded differently? Why or why not?
This week and next, continue to research this specific crisis so that you can better prepare for Assignment 2.
Post your initial response by Wednesday, midnight of your time zone, and reply to at least 2 of your classmates' initial posts by Sunday, midnight of your time zone.
1st response
The Bank of America Earnings Crisis
In 2020, many businesses experienced notable challenges due to the outbreak of the coronavirus. The Bank of America was no exception based on its reports of firm earnings in 2020. According to Eisen (2021), many large financial organizations in the United States withstood the recession due to COVID-19. However, the author explains that the banks have not been fully protected against the minimal rates brought about by the pandemic. For Bank of America, the outcomes of the COVID-19 outbreak have been felt in many ways, particularly the reduction of earnings by 22%. Additionally, lenders have also experienced significant challenges based on low-interest rates, and Bank of America is among them. Since the financial institution gains earnings on the difference between their lending payments and what they pay to depositors, the bank's interest rates downfall. The earnings crisis also affected the firm's operations in the last quarter of 2020 even though it made considerable profits.
Communication Tactics and Addressing the Crisis
Handling a crisis in organizations presents notable problems for managers and leaders that do not understand the proper ways of solving a crisis. Warren Buffet explains that there are four significant steps a leader can take to address a crisis. First, getting the crisis right and understanding why it happens and what can stop it will help address the crisis. The Bank of America leaders understood that the company needs to introduce measures that will increase the earnings. Secondly, according to Buffet, responding to the crisis fast is also a core step in managing a crisis. The Bank of America did not wait until the last quarter of 2020 to react to the earnings crisis. Rather, they resorted to ensuring the loan demands are stabilized by business consumers and focused more on investment activities (Eisen, 2021). The third and fourth steps based on Warren's advice involve getting the crisis out by dealing with it and getting over with. Th.
take a look at the latest Presidential Order that relates to str.docxperryk1
take a look at the latest Presidential Order that relates to strengthening cybersecurity that relates to critical infrastructure:
https://www.whitehouse.gov/presidential-actions/presidential-executive-order-strengthening-cybersecurity-federal-networks-critical-infrastructure/
Let’s look at a real-world scenario and how the Department of Homeland Security (DHS) plays into it. In the scenario, the United States will be hit by a large-scale, coordinated cyber attack organized by China. These attacks debilitate the functioning of government agencies, parts of the critical infrastructure, and commercial ventures. The IT infrastructure of several agencies are paralyzed, the electric grid in most of the country is shut down, telephone traffic is seriously limited and satellite communications are down (limiting the Department of Defense’s [DOD’s] ability to communicate with commands overseas). International commerce and financial institutions are also severely hit. Please explain how DHS should handle this situation.
please explain how DHS should handle the situation described in the preceding paragraph.
.
Take a look at the sculptures by Giacometti and Moore in your te.docxperryk1
Take a look at the sculptures by Giacometti and Moore in your text. Both pieces are good examples of the relationship between form, content, and subject matter. How do you feel the form of each sculpture expresses the content? What specific characteristics give us clues and communicate meaning?
Select a third work of art from the text and discuss how the form and content relate. Identify at least five visual elements and/or principles of design in your analysis of the third piece.
.
Table of ContentsLOCAL PEOPLE PERCEPTION TOWARDS SUSTAINABLE TOU.docxperryk1
Table of Contents
LOCAL PEOPLE PERCEPTION TOWARDS SUSTAINABLE TOURISM IN DENMARK1
Declaration:2
ACKNOWLEDGEMENT2
CHAPTER:15
Introduction5
1.1 Background of the study6
1.2 Problem Statement:7
1.3 Research Questions:8
1.4 Research Objectives:8
1.5 Thesis Structure8
CHAPTER:29
Literature review9
2.1 Attitudes of local people towards Sustainable tourism9
2.2 Practices of Sustainable tourism10
2.3 Sustainable tourism development.12
2.4 Involvement of people in Sustainability.14
2.5 Theoretical Framework.15
3.1 Introduction17
3.2 Research Design17
3.3 Sampling method18
3.4 Data collection18
3.5 Measurements and Variables18
3.6 Data analysis19
CHAPTER:1Introduction
Sustainable tourism is a form of tourism, which requires a tourist to respect the local culture, environment, preserving cultural heritage, and supporting local economies by purchasing local products which also benefits the people of that country. Sustainable tourism is a form of development, which is Social development, Economic development and Nature protection. According to the World Tourism Organization, Sustainable tourism is “Tourism that takes full account of its current and future economic, social and environmental impacts, addressing the needs of visitors, the industry, the environment, and host communities” UNWTO (2013). Denmark is more concerned about sustainable environment, for instance the Government is aiming at Copenhagen becoming the world’s first carbon-neutral capital by 2025. Government have put high taxation on vehicles, cars so Danes have to think twice before buying or using them. This could be the strategy of the nation. As they are on the way to gain something remarkable, they also have some challenges. The tourism industry has a million of turnover in Danish economy and Danish government puts a high effort in order to make it more sustainable. The big topic could be how the tourist react on it? All the government efforts could be result less if the customer and the business does not act smart. To the Danes, sustainability is a holistic approach that includes renewable energy, water management, waste recycling and green transportation including bicycle culture. Most of the local restaurants use re-usable things during their service also, practices waste deposable for take away.
Tourism is the best way to experience the culture however, damage and waste can occur due to inappropriate behavior of tourists. According to the Denmark statics (2019), every year tourist spends around 128 billion DKK in Denmark. Denmark is very responsible towards environment and most of the hotels are practicing Corporate Social Responsibility (CSR). For example, Scandic Kødbyen is one of the hotels practicing sustainability, first to implement CSR. It plays a significant support in sustainable tourism business, which includes hotel, restaurant and the service provided sectors. Visit Copenhagen states that 70% of hotels hold an official eco-certification and also known as the hap.
Table of Contents Title PageWELCOMETHE VAJRA.docxperryk1
Table of Contents
Title Page
WELCOME
THE VAJRACCHEDIKA PRAJÑAPARAMITA SUTRA
COMMENTARIES
PART ONE - THE DIALECTICS OF
PRAJÑAPARAMITA
Chapter 1 - THE SETTING
Chapter 2 - SUBHUTI’S QUESTION
Chapter 3 - THE FIRST FLASH OF LIGHTNING
Chapter 4 - THE GREATEST GIFT
Chapter 5 - SIGNLESSNESS
PART TWO - THE LANGUAGE OF
NONATTACHMENT
Chapter 6 - A ROSE IS NOT A ROSE
Chapter 7 - ENTERING THE OCEAN OF REALITY
Chapter 8 - NONATTACHMENT
PART THREE - THE ANSWER IS IN
THE QUESTION
Chapter 9 - DWELLING IN PEACE
Chapter 10 - CREATING A FORMLESS PURE
LAND
Chapter 11 - THE SAND IN THE GANGES
Chapter 12 - EVERY LAND IS A HOLY LAND
Chapter 13 - THE DIAMOND THAT CUTS
THROUGH ILLUSION
Chapter 14 - ABIDING IN NON-ABIDING
Chapter 15 - GREAT DETERMINATION
Chapter 16 - THE LAST EPOCH
Chapter 17 - THE ANSWER IS IN THE QUESTION
PART FOUR - MOUNTAINS AND
RIVERS ARE OUR OWN BODY
Chapter 18 - REALITY IS A STEADILY FLOWING
STREAM
Chapter 19 - GREAT HAPPINESS
Chapter 20 - THIRTY-TWO MARKS
Chapter 21 - INSIGHT-LIFE
Chapter 22 - THE SUNFLOWER
Chapter 23 - THE MOON IS JUST THE MOON
Chapter 24 - THE MOST VIRTUOUS ACT
Chapter 25 - ORGANIC LOVE
Chapter 26 - A BASKET FILLED WITH WORDS
Chapter 27 - NOT CUT OFF FROM LIFE
Chapter 28 - VIRTUE AND HAPPINESS
Chapter 29 - NEITHER COMING NOR GOING
Chapter 30 - THE INDESCRIBABLE NATURE OF
ALL THINGS
Chapter 31 - TORTOISE HAIR AND RABBIT
HORNS
Chapter 32 - TEACHING THE DHARMA
CONCLUSION
Copyright Page
WELCOME
WELCOME
BROTHERS AND SISTERS, please read The Diamond
That Cuts through Illusion with a serene mind, a mind
free from views. It’s the basic sutra for the practice of
meditation. Late at night, it’s a pleasure to recite the
Diamond Sutra alone, in complete silence. The sutra is
so deep and wonderful. It has its own language. The
first Western scholars who obtained the text thought it
was talking nonsense. Its language seems mysterious,
but when you look deeply, you can understand.
Don’t rush into the commentaries or you may be
unduly influenced by them. Please read the sutra first.
You may see things that no commentator has seen. You
can read as if you were chanting, using your clear body
and mind to be in touch with the words. Try to
understand the sutra from your own experiences and
your own suffering. It is helpful to ask, “Do these
teachings of the Buddha have anything to do with my
daily life?” Abstract ideas can be beautiful, but if they
have nothing to do with our life, of what use are they?
So please ask, “Do the words have anything to do with
eating a meal, drinking tea, cutting wood, or carrying
water?”
The sutra’s full name is The Diamond That Cuts
through Illusion, Vajracchedika Prajñaparamita in
Sanskrit. Vajracchedika means “the diamond that cuts
through afflictions, ignorance, delusion, or illusion.” In
China and Vietnam, people generally call it the Diamond
Sutra, emphasizing the word “diamond,” but, in fact,
the phrase “cutting through” is the most important.
Prajñaparamita means “per.
Take a few minutes to reflect on this course. How has your think.docxperryk1
Take a few minutes to reflect on this course. How has your thinking (e.g., worldview, knowledge, etc.) been challenged from what you thought prior to taking this course? What are your thoughts now on the significance of correctly diagnosing mental health disorders? What are your thoughts on the treatment of psychopathology? In general, what thoughts do you have about psychopathology and its impact on an individual and the family?
.
Taiwan The Tail That Wags DogsMichael McDevittAsia Po.docxperryk1
Taiwan: The Tail That Wags Dogs
Michael McDevitt
Asia Policy, Number 1, January 2006, pp. 69-93 (Article)
Published by National Bureau of Asian Research
DOI: 10.1353/asp.2006.0011
For additional information about this article
Access provided by Florida International University (9 Sep 2013 16:14 GMT)
http://muse.jhu.edu/journals/asp/summary/v001/1.mcdevitt.html
http://muse.jhu.edu/journals/asp/summary/v001/1.mcdevitt.html
asia p olicy, number 1 (january 2006 ), 69–93
Michael McDevitt (Rear Admiral, retired) is Vice President and Director
of the Center for Naval Analyses at the CNA Corporation. These views are his
own and do not represent the views of the CNA Corporation. He can be reached
at <[email protected]>.
keywords: taiwan; china; united states; japan; foreign relations
Taiwan: The Tail That Wags Dogs
Michael McDevitt
[ 70 ]
execu tive summary
asia p olicy
This essay explores how Taiwan has been able to seize the political initiative
from China, Japan, and the United States.
main argument
Taiwan has attained this leverage due to the interrelationship of four factors:
• Strategic considerations stemming from Taiwan’s geographic position lead
Tokyo and Washington to prefer the status quo, while leading China to
strive for reunification. China’s increasing military power, however, may
suggest a Chinese intention to change the status quo.
• Shared democratic values and the fact that the “democracy issue” has great-
ly prolonged the timetable for reunification give Taipei political influence
in both Washington and Tokyo.
• China’s constant threats of force actually empower Taipei in its relationship
with Washington, and cause the United States to plan for the worst.
• Taiwan is a litmus test of U.S. credibility as an ally, a condition that in turn
creates a perception on the island that U.S. military backing is uncondi-
tional.
policy implications
• Taipei’s high-risk diplomatic approach carries with it the very real possibil-
ity of miscalculation, which could easily lead to great power conflict.
• The United States would benefit from exploring with Beijing ways in which
to demilitarize the issue of Taiwan independence so that the threat of great
power conflict over Taiwan is greatly moderated.
• Tensions may eventually lessen substantially if Beijing can be encouraged to
substitute political deterrence for military deterrence.
• In order to ensure that the U.S. position in the region would survive a
Taipei-provoked conflict should the United States choose not to become
directly involved, Washington can undertake extensive talks with Japan de-
signed to ensure that Japan does not lose confidence in Washington.
organization of the essay
The first four sections of the essay respectively explore the four factors of the
complex U.S.-Taiwan-Japan-China relationship outlined above:
Geostrategic Issues and Considerations . . . . . . . . . . . . . . . . . ..
Tackling wicked problems A public policy perspective Ple.docxperryk1
Tackling wicked problems : A
public policy perspective
Please note - this is an archived publication.
Commissioner’s foreword
The Australian Public Service (APS) is increasingly being tasked with solving very
complex policy problems. Some of these policy issues are so complex they have
been called ‘wicked’ problems. The term ‘wicked’ in this context is used, not in the
sense of evil, but rather as an issue highly resistant to resolution.
Successfully solving or at least managing these wicked policy problems requires
a reassessment of some of the traditional ways of working and solving problems
in the APS. They challenge our governance structures, our skills base and our
organisational capacity.
It is important, as a first step, that wicked problems be recognised as such.
Successfully tackling wicked problems requires a broad recognition and
understanding, including from governments and Ministers, that there are no quick
fixes and simple solutions.
Tackling wicked problems is an evolving art. They require thinking that is capable
of grasping the big picture, including the interrelationships among the full range of
causal factors underlying them. They often require broader, more collaborative
and innovative approaches. This may result in the occasional failure or need for
policy change or adjustment.
Wicked problems highlight the fundamental importance of the APS building on the
progress that has been made with working across organisational boundaries both
within and outside the APS. The APS needs to continue to focus on effectively
engaging stakeholders and citizens in understanding the relevant issues and in
involving them in identifying possible solutions.
The purpose of this publication is more to stimulate debate around what is
needed for the successful tackling of wicked problems than to provide all the
answers. Such a debate is a necessary precursor to reassessing our current
systems, frameworks and ways of working to ensure they are capable of
responding to the complex issues facing the APS.
I hope that this publication will encourage public service managers to reflect on
these issues, and to look for ways to improve the capacity of the APS to deal
effectively with the complex policy problems confronting us.
Lynelle Briggs
Australian Public Service Commissioner
1. Introduction
Many of the most pressing policy challenges for the APS involve dealing with very
complex problems. These problems share a range of characteristics—they go
beyond the capacity of any one organisation to understand and respond to, and
there is often disagreement about the causes of the problems and the best way to
tackle them. These complex policy problems are sometimes called ‘wicked’
problems.
Usually, part of the solution to wicked problems involves changing the behaviour
of groups of citizens or all citizens. Other key ingredients in solving or at least
managing complex policy problems include successfu.
Tahira Longus Week 2 Discussion PostThe Public Administration.docxperryk1
Tahira Longus Week 2 Discussion Post:
The Public Administrations may entrust the development of collective bargaining activities to bodies created by them, of a strictly technical nature, which will hold their representation in collective bargaining before the corresponding political instructions and without prejudice to the ratification of the agreements reached by the bodies. Government or administrative with competence for it. In addition, public bargaining involves the process of resolving labor-management conflicts. It alsoensuresboth the employee and the employer fair treatment during the negotiation process. The Tables will be validly constituted when, in addition to the representation of the corresponding Administration, and without prejudice to the right of all legitimate trade union organizations to participate in them in proportion to their representatives, such union organizations represent, at least, the absolute majority of the members of the unitary representative bodies in the area in question.
www.ilo.org ›
The Public Administrations may entrust the development of collective bargaining activities to bodies created by them, of a strictly technical nature, which will hold their representation in collective bargaining before the corresponding political instructions and without prejudice to the ratification of the agreements reached by the bodies. Government or administrative with competence for it. In addition, public bargaining involves the process of resolving labor-management conflicts. It also assures both the employee and the employer fair treatment during the negotiation process. The Tables will be validly constituted when, in addition to the representation of the corresponding Administration, and without prejudice to the right of all legitimate trade union organizations to participate in them in proportion to their representatives, such union organizations represent, at least, the absolute majority of the members of the unitary representative bodies in the area in question.
Tara St Laurent Post
.
Tabular and Graphical PresentationsStatistics (exercises).docxperryk1
Tabular and Graphical Presentations
Statistics (exercises)
Aleksandra Pawłowska
April 7, 2020
Glossary (part 1)
Categorical data Labels or names used to identify categories of like items.
Quantitative data Numerical values that indicate how much or how many.
Frequency distribution A tabular summary of data showing the number (fre-
quency) of data values in each of several nonoverlapping classes.
Relative frequency distribution A tabular summary of data showing the fraction
or proportion of data values in each of several nonoverlapping classes.
Percent frequency distribution A tabular summary of data showing the percent-
age of data values in each of several nonoverlapping classes.
Bar chart A graphical device for depicting qualitative data that have been sum-
marized in a frequency, relative frequency, or percent frequency distribution.
Pie chart A graphical device for presenting data summaries based on subdivision
of a circle into sectors that correspond to the relative frequency for each class.
Dot plot A graphical device that summarizes data by the number of dots above
each data value on the horizontal axis.
Aleksandra Pawłowska Tabular and Graphical Presentations
Glossary (part 2)
Histogram A graphical presentation of a frequency distribution, relative frequency
distribution, or percent frequency distribution of quantitative data constructed
by placing the class intervals on the horizontal axis and the frequencies, relative
frequencies, or percent frequencies on the vertical axis.
Cumulative frequency distribution A tabular summary of quantitative data show-
ing the number of data values that are less than or equal to the upper class limit
of each class.
Cumulative relative frequency distribution A tabular summary of quantitative
data showing the fraction or proportion of data values that are less than or equal
to the upper class limit of each class.
Cumulative percent frequency distribution A tabular summary of quantitative
data showing the percentage of data values that are less than or equal to the
upper class limit of each class.
Ogive A graph of a cumulative distribution.
Scatter diagram A graphical presentation of the relationship between two quan-
titative variables. One variable is shown on the horizontal axis and the other
variable is shown on the vertical axis.
Trendline A line that provides an approximation of the relationship between two
variables.
Aleksandra Pawłowska Tabular and Graphical Presentations
Useful tips (part 1)
1 Often the number of classes in a frequency distribution is the same as the
number of categories found in the data. Most statisticians recommend
that classes with smaller frequencies be grouped into an aggregate class
called „other”. Classes with frequencies of 5% or less would most often be
treated in this fashion.
2 The sum of the frequencies in any frequency distribution always equals
the number of observations. The sum of the relative frequencies in any
relative frequency distribution.
Table 4-5 CSFs for ERP ImplementationCritical Success Fact.docxperryk1
Table 4-5 CSFs for ERP Implementation
Critical Success Factors
Description
Management Support
Top management advocacy, provision of adequate resources, and commitment to project
Release of Full-Time Subject Matter Experts (SME)
Release full time on to the project of relevant business experts who provide assistance to the project
Empowered Decision Makers
The members of the project team(s) must be empowered to make quick decisions
Deliverable Dates
At planning stage, set realistic milestones and end date
Champion
Advocate for system who is unswerving in promoting the benefits of the new system
Vanilla ERP
Minimal customization and uncomplicated option selection
Smaller Scope
Fewer modules and less functionality implemented, smaller user group, and fewer site(s)
Definition of Scope and Goals
The steering committee determines the scope and objectives of the project in advance and then adheres to it
Balanced Team
Right mix of business analysts, technical experts, and users from within the implementation company and consultants from external companies
Commitment to Change
Perseverance and determination in the face of inevitable problems with implementation
Question 11 pts
The melody of a piece of music is
the harmony
the rhythm
the tune
the chords
Flag this Question
Question 21 pts
Chords are an element of
melody
rhythm
all of the above
harmony
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Question 31 pts
The distance between pitches is called
a space
an interval
a beat
all of the above
Flag this Question
Question 41 pts
Rhythmic organization in pre-Conquest Native American music was
divisive
in duple meter
in triple meter
additive
Flag this Question
Question 51 pts
Pan-Indian music often uses:
all of the above
the Navajo language
vocables
English
Flag this Question
Question 61 pts
Pre-conquest Native American musicians were primarily valued for their expertise in spiritual matters.
True
False
Flag this Question
Question 71 pts
Traditional Native American melodies have a wide melodic range
True
False
Flag this Question
Question 81 pts
Early Native American music features intervals that are:
rhythmically longer
rhythmically shorter
farther apart than what we have in the western system
closer together than what we have in the western system
Flag this Question
Question 91 pts
In the early New England colonies folk songs were:
derived from Irish melodies
derived from English melodies
all of the above
usually sung without accompaniment
Flag this Question
Question 101 pts
Early Anglo - American folks songs were:
often in polymeters
often in triple meter
often in duple meter
often in free meter
Flag this Question
Question 111 pts
Of the following, which is not a form of early Anglo-American folk songs?
ballads
lyric songs
work songs
jubilees
Flag this Question
Question 121 pts
Of the following which instrument was not brought to the Americas by European colonists?
clavichord
recorder
viol
banjo
Flag this Question
Quest.
TableOfContentsTable of contents with hyperlinks for this document.docxperryk1
TableOfContentsTable of contents with hyperlinks for this documentExcluding standard worksheets that come with the original dataSheet namePurposeNotesOnDataPrep!A1Tips and tricks for students in doing data analysis in ExcelSalaryPivotTable!A1Using a histogram of salary to compare other variables in terms of chunks of salaryDescriptiveStatsForFrequency!A1Example of producing descriptive stats for chunks of a numeric variable (grouping, frequency table as 'categories')VariableDescriptiveStatsPHStat!A1Example of descriptive stats produced by PHStat and then edited, items removed that are not neededCorrelations!A1Instructor reference for how all variables are inter-relatedRegressionAge!A1Example of regression output highighting output to pay attention toSPSSRegressionAllEnter!A1Instructor reference - regressing salary on all independent variables to discern stongest, independent predictorsPivotTableCreatePercentPolygon!A1Example of comparing distributions between two categories with different number of cases or different scales, i.e., version of percent polygonAnalysis resultsGender univariate descriptive statisticsGenderAnalysis!A1Gender/Salary; Gender/Job Grade Classification analysis; Gender/other independent variables Salary histogram, distributionCompare gender/salary descriptive statisticsGenderCompareDescriptives!A1Comparison Table gender descriptive statistics in terms of all variables. This might be something worth doing.EthnicitySalaryAnalysis!A1Ethnicity/Salary analysisOptionalEthnicitySalaryAnalysis!A1Optional ethnicity/salary analysis - distribution of ethnicity over chunks of salary, percent polygonEthnicityJGClassAnalysis!A1Ethnicity/Job Grade Classification analysisAgeSalaryAnalysis!A1Age/Salary analysisAgeJobGradeClassAnalysis!A1Age/Job grade classification analysisYearsWorkedSalaryAnalysis!A1Years worked/Salary analysisYears worked/Job grade classification analysisRelationship between endogenous variablesJob grade classification/Salary analysisRelationship between independent variablesPercentPolygonGenderYearsWorked!A1Compare years worked distribution by gender; Example of comparing distributions between two categories with different number of cases or different scales, i.e., version of percent polygon Standard sheets that come with the dataVariable INFO'!A1Information on variablesHuman Resources DATA'!A1DataCross-Class-Table'!A1Summary Table'!A1Histogram!A1% Polygons 2 Groups'!A1Freq. & % Distribution'!A1
Variable INFOTableOfContents!A1The data are a random sample of 120 responses to a survey conducted by the VP of Human Resources at a large company.Source:INFO 501 class at Montclair State UniversityVariablesSalaryin thousands of dollars (K)Age in years YrsWorkin years JGClassjob-grade classification of 1, 3, 5, 7, 9, 11 (lowest skill job to highest skill job)Ethnicity1=Minority0=Not MinorityGender(Male, Female)Named ranges created in this worksheet - use these names to address the data more quickly then manually selecting dat.
Tajfel and Turner (in chapter two of our reader) give us the followi.docxperryk1
Tajfel and Turner (in chapter two of our reader) give us the following definition of Social Identity Theory: "SIT proposes that individuals make sense of their social environment by categorizing themselves and others into groups that can be contrasted with others" (Oksanen et al., 2014). SIT brings order to chaos, you might say, in that individuals define themselves as being different from everyone else.
Considering what we have read about the perpetrators of group violence, how do you suppose that it is that people make the leap from their own social identity to group violence? What social and psychological mechanisms are at work that would go from simple categorization to overt violence?
.
Tableau Homework 3 – Exploring Chart Types with QVC Data .docxperryk1
Tableau Homework 3 – Exploring Chart Types with QVC Data
Getting familiar with the data
You will focus on five dimensions as you start to explore the QVC data:
• order date (Order Dt)
• merchandise department (Merchandise Dept)
• region of the country (Region)
• customer state (Ship To State)
• location of the originating warehouse (Warehouse Zip).
You will use five measures:
• price (Total Line Amt)
• number of orders (Number of Records)
• average order value (AOV to be calculated)
• delivery time ([Days Shipped] to be calculated)
Create two calculated fields:
AOV = SUM([Total Line Amt])/SUM([Number of Records]). On the Data Pane, change the number
format to Currency with 2 decimal places.
Days Shipped = CEILING( [Delivery Confirmation Dt]-[Shipped Dt])
In the next homework, we will explore additional measures to address the QVC analytics challenge more
explicitly. In this homework, the primary goal is to continue to build basic Tableau skills for creating
tables, maps, and charts.
Change the label in the Region dimension for Alaska and Hawaii:
Alaska and Hawaii were not assigned a region in the input data, but we are going to change the Null
label to AK/HI. Depending on the context, we may filter out these states.
To change the label, go to the blue pill for Region and right-click (or click on the down arrow) to get the
menu of actions. Select Aliases…. In the pop-up box, change the alias for Null to AK/HI.
For the rest of the course, you are expected to have complete titles on every worksheet you complete. I
will guide you through this process for the first few worksheets.
Chapter 19 – Highlight Tables
1. Create a text table with merchandise departments for rows and the sum of sales (Total Line Amt) in
the table. Sort in descending order by sales.
Add Region to the Columns Shelf. You should have a crosstab table with 5 columns and 11 rows of data.
Drag the Total Line Amt to the Color marks card. Change the mark type to Square. Note that the East
region has highest sales overall and the ordering within region is similar. Name the sheet Highlight
Table.
Edit the title (double-click on the Highlight Table text and type over <Sheet Name>) to be something like
‘Total sales by region and merchandise department’.
Chapter 22 – Scatter Plot
2. Open a new worksheet. Create a scatter plot of average Days Shipped (Columns Shelf) and average
order value AOV (Row Shelf). Make sure you change the default SUM aggregate function to AVG for
Days Shipped. Drag Merchandise Dept to the Detail marks card. Drag Total Line Amt to the Size marks
card.
At this point, you will want to change the axis settings so they do not include 0. Right-click on each axis,
select Edit Axis, and uncheck the Include zero box.
Add an average line for each measure. This plot highlights that the jewelry department has high average
ship times, though is a small revenue department. .
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
Instructions for Submissions thorugh G- Classroom.pptxJheel Barad
This presentation provides a briefing on how to upload submissions and documents in Google Classroom. It was prepared as part of an orientation for new Sainik School in-service teacher trainees. As a training officer, my goal is to ensure that you are comfortable and proficient with this essential tool for managing assignments and fostering student engagement.
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
This is a presentation by Dada Robert in a Your Skill Boost masterclass organised by the Excellence Foundation for South Sudan (EFSS) on Saturday, the 25th and Sunday, the 26th of May 2024.
He discussed the concept of quality improvement, emphasizing its applicability to various aspects of life, including personal, project, and program improvements. He defined quality as doing the right thing at the right time in the right way to achieve the best possible results and discussed the concept of the "gap" between what we know and what we do, and how this gap represents the areas we need to improve. He explained the scientific approach to quality improvement, which involves systematic performance analysis, testing and learning, and implementing change ideas. He also highlighted the importance of client focus and a team approach to quality improvement.
We all have good and bad thoughts from time to time and situation to situation. We are bombarded daily with spiraling thoughts(both negative and positive) creating all-consuming feel , making us difficult to manage with associated suffering. Good thoughts are like our Mob Signal (Positive thought) amidst noise(negative thought) in the atmosphere. Negative thoughts like noise outweigh positive thoughts. These thoughts often create unwanted confusion, trouble, stress and frustration in our mind as well as chaos in our physical world. Negative thoughts are also known as “distorted thinking”.
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
Ethnobotany and Ethnopharmacology:
Ethnobotany in herbal drug evaluation,
Impact of Ethnobotany in traditional medicine,
New development in herbals,
Bio-prospecting tools for drug discovery,
Role of Ethnopharmacology in drug evaluation,
Reverse Pharmacology.
The Art Pastor's Guide to Sabbath | Steve ThomasonSteve Thomason
What is the purpose of the Sabbath Law in the Torah. It is interesting to compare how the context of the law shifts from Exodus to Deuteronomy. Who gets to rest, and why?
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
MARUTI SUZUKI- A Successful Joint Venture in India.pptx
TABLE 1-1 Milestones of Medicine and Medical Education 1700–2015 ■.docx
1. TABLE 1-1 Milestones of Medicine and Medical Education
1700–2015 ■ 1700s: Training and apprenticeship under one
physician was common until hospitals were founded in the mid-
1700s. In 1765, the first medical school was established at the
University of Pennsylvania. ■ 1800s: Medical training was
provided through internships with existing physicians who often
were poorly trained themselves. In the United States, there were
only four medical schools, which graduated only a handful of
students. There was no formal tuition with no mandatory
testing. ■ 1847: The AMA was established as a membership
organization for physicians to protect the interests of its
members. It did not become powerful until the 1900s when it
organized its physician members by county and state medical
societies. The AMA wanted to ensure these local societies were
protecting physicians’ financial well-being. It also began to
focus on standardizing medical education. ■ 1900s–1930s: The
medical profession was represented by general or family
practitioners who operated in solo practices. A small percentage
of physicians were women. Total expenditures for medical care
were less than 4% of the gross domestic product. ■ 1904: The
AMA created the Council on Medical Education to establish
standards for medical education. ■ 1910: Formal medical
education was attributed to Abraham Flexner, who wrote an
evaluation of medical schools in the United States and Canada
indicating many schools were substandard. The Flexner Report
led to standardized admissions testing for students called the
Medical College Admission Test (MCAT), which is still used as
part of the admissions process today. ■ 1930s: The healthcare
industry was dominated by male physicians and hospitals.
Relationships between patients and physicians were sacred.
Payments for physician care were personal. ■ 1940s–1960s:
When group health insurance was offered, the relationship
between patient and physician changed because of third-party
payers (insurance). In the 1950s, federal grants supported
2. medical school operations and teaching hospitals. In the 1960s,
the Regional Medical Programs provided research grants and
emphasized service innovation and provider networking. As a
result of the Medicare and Medicaid enactment in 1965, the
responsibilities of teaching faculty also included clinical
responsibilities. ■ 1970s–1990s: Patient care dollars surpassed
research dollars as the largest source of medical school funding.
During the 1980s, third-party payers reimbursed academic
medical centers with no restrictions. In the 1990s with the
advent of managed care, reimbursement was restricted. ■ 2014:
According to the 2014 Association of American Medical
Colleges (AAMAC) annual survey, over 70% of medical schools
have or will be implementing policies and programs to
encourage primary care specialties for medical school students.
TABLE 1-2 Milestones of the Hospital and Healthcare Systems
1820–2015 ■ 1820s: Almshouses or poorhouses, the precursor
of hospitals, were developed to serve primarily poor people.
They provided food and shelter to the poor and consequently
treated the ill. Pesthouses, operated by local governments, were
used to quarantine people who had contagious diseases such as
cholera. The first hospitals were built around areas such as New
York City, Philadelphia, and Boston and were used often as a
refuge for the poor. Dispensaries or pharmacies were
established to provide free care to those who could not afford to
pay and to dispense drugs to ambulatory patients. ■ 1850s: A
hospital system was finally developed but hospital conditions
were deplorable because of unskilled providers. Hospitals were
owned primarily by the physicians who practiced in them. ■
1890s: Patients went to hospitals because they had no choice.
More cohesiveness developed among providers because they had
to rely on each other for referrals and access to hospitals, which
gave them more professional power. ■ 1920s: The development
of medical technological advances increased the quality of
medical training and specialization and the economic
development of the United States. The establishment of
hospitals became the symbol of the institutionalization of health
3. care. In 1929, President Coolidge signed the Narcotic Control
Act, which provided funding for construction of hospitals for
patients with drug addictions. ■ 1930s–1940s: Once physician-
owned hospitals were now owned by church groups, larger
facilities, and government at all levels. ■ 1970–1980: The first
Patient Bill of Rights was introduced to protect healthcare
consumer representation in hospital care. In 1974, the National
Health Planning and Resources Development Act required states
to have certificate of need (CON) laws to qualify for federal
funding. ■ 1980–1990: According to the AHA, 87% of hospitals
were offering ambulatory surgery. In 1985, the EMTALA was
enacted, which required hospitals to screen and stabilize
individuals coming into emergency rooms regardless of the
consumers’ ability to pay. ■ 1990–2000s: As a result of the
Balanced Budget Act cuts of 1997, the federal government
authorized an outpatient Medicare reimbursement system. ■
1996: The medical specialty of hospitalists, who provide care
once a patient is hospitalized, was created. ■ 2002: The Joint
Commission on the Accreditation of Healthcare Organizations
(now The Joint Commission) issued standards to increase
consumer awareness by requiring hospitals to inform patients if
their healthcare results were not consistent with typical results.
■ 2002: The CMS partnered with the AHRQ to develop and test
the HCAHPS (Hospital Consumer Assessment of Healthcare,
Providers and Systems Survey). Also known as the CAHPS
survey, the HCAHPS is a 32-item survey for measuring
patients’ perception of their hospital experience. ■ 2007: The
Institute for Health Improvement launched the Triple Aim,
which focuses on three goals: improving patient satisfaction,
reducing health costs, and improving public health. ■ 2011: In
1974, a federal law was passed that required all states to have
certificate of need (CON) laws to ensure the state approved any
capital expenditures associated with hospital/medical facilities’
construction and expansion. The act was repealed in 1987 but as
of 2014, 35 states still have some type of CON mechanism. ■
2011: The Affordable Care Act created the Centers for Medicare
4. and Medicaid Services’ Innovation Center for the purpose of
testing “innovative payment and service delivery models to
reduce program expenditures … while preserving or enhancing
the quality of care” for those individuals who receive Medicare,
Medicaid, or Children’s Health Insurance Program (CHIP)
benefits. ■ 2015: The Centers for Medicare and Medicaid
Services posted its final rule that reduces Medicare payments to
hospitals that have exceeded readmission limits of Medicare
patients within 30 days. TABLE 1-3 Milestones in Public Health
1700–2015 ■ 1700–1800: The United States was experiencing
strong industrial growth. Long work hours in unsanitary
conditions resulted in massive disease outbreaks. U.S. public
health practices targeted reducing epidemics, or large patterns
of disease in a population, that impacted the population. Some
of the first public health departments were established in urban
areas as a result of these epidemics. ■ 1800–1900: Three very
important events occurred. In 1842, Britain’s Edwin Chadwick
produced the General Report on the Sanitary Condition of the
Labouring Population of Great Britain, which is considered one
of the most important documents of public health. This report
stimulated a similar U.S. survey. In 1854, Britain’s John Snow
performed an analysis that determined contaminated water in
London was the cause of a cholera epidemic. This discovery
established a link between the environment and disease. In
1850, Lemuel Shattuck, based on Chadwick’s report and Snow’s
activities, developed a state public health law that became the
foundation for public health activities. ■ 1900–1950: In 1920,
Charles Winslow defined public health as a focus of preventing
disease, prolonging life, and promoting physical health and
efficiency through organized community efforts. During this
period, most states had public health departments that focused
on sanitary inspections, disease control, and health education.
Throughout the years, public health functions included child
immunization programs, health screenings in schools,
community health services, substance abuse programs, and
sexually transmitted disease control. In 1923, a vaccine for
5. diphtheria and whooping cough was developed. In 1928,
Alexander Fleming discovered penicillin. In 1933, the polio
vaccine was developed. In 1946, the National Mental Health Act
(NMHA) provided funding for research, prevention, and
treatment of mental illness. ■ 1950–1980: In 1950, cigarette
smoke was identified as a cause of lung cancer. In 1952, Dr.
Jonas Salk developed the polio vaccine. The Poison Prevention
Packaging Act of 1970 was enacted to prevent children from
accidentally ingesting substances. Childproof caps were
developed for use on all drugs. In 1980, the eradication of
smallpox was announced. ■ 1980–1990: The first recognized
cases of AIDS occurred in the United States in the early 1980s.
1988: The IOM Report defined public health as organized
community efforts to address the public interest in health by
applying scientific and technical knowledge and promote health.
The first Healthy People Report (1987) was published and
recommended a national prevention strategy. ■ 1990–2000: In
1997, Oregon voters approved a referendum that allowed
physicians to assist terminally ill, mentally competent patients
to commit suicide. From 1998 to 2006, 292 patients exercised
their rights under the law. ■ 2000s: The second Healthy People
Report was published in 2000. The terrorist attack on the United
States on September 11, 2001, impacted and expanded the role
of public health. The Public Health Security and Bioterrorism
Preparedness and Response Act of 2002 provided grants to
hospitals and public health organizations to prepare for
bioterrorism as a result of September 11, 2001. ■ 2010: The
ACA was passed. Its major goal was to improve the nation’s
public health level. The third Healthy People Report was
published. ■ 2015: There has been an increase nationally of
children who have not received vaccines due to parents’ beliefs
that vaccines are not safe. As a result, there have been measles
outbreaks throughout the nation even though measles was
considered eradicated decades ago. TABLE 1-4 Milestones of
the U.S. Health Insurance System 1800–2015 ■ 1800–1900:
Insurance was purchased by individuals in the same way one
6. would purchase car insurance. In 1847, the Massachusetts
Health Insurance Co. of Boston was the first insurer to issue
“sickness insurance.” In 1853, a French mutual aid society
established a prepaid hospital care plan in San Francisco,
California. This plan resembles the modern health maintenance
organization (HMO). ■ 1900–1920: In 1913, the International
Ladies Garment Workers began the first union-provided medical
services. The National Convention of Insurance Commissioners
drafted the first model for regulation of the health insurance
industry. ■ 1920s: The blueprint for health insurance was
established in 1929 when J. F. Kimball began a hospital
insurance plan for school teachers at Baylor University Hospital
in Texas. This initiative became the model for Blue Cross plans
nationally. The Blue Cross plans were nonprofit and covered
only hospital charges so as not to infringe on private
physicians’ income. ■ 1930s: There were discussions regarding
the development of a national health insurance program.
However, the AMA opposed the move (Raffel & Raffel, 1994).
With the Depression and U.S. participation in World War II, the
funding required for this type of program was not available. In
1935, President Roosevelt signed the Social Security Act (SSA),
which created “old age insurance” to help those of retirement
age. In 1936, Vassar College, in New York, was the first college
to establish a medical insurance group policy for students. ■
1940s–1950s: The War Labor Board froze wages, forcing
employers to offer health insurance to attract potential
employees. In 1947, the Blue Cross Commission was
established to create a national doctors network. By 1950, 57%
of the population had hospital insurance. ■ 1965: President
Johnson signed the Medicare and Medicaid programs into law. ■
1970s–1980s: President Nixon signed the HMO Act, which was
the predecessor of managed care. In 1982, Medicare proposed
paying for hospice or end-of-life care. In 1982, diagnosis-
related groups (DRGs) and prospective-payment guidelines were
developed to control insurance reimbursement costs. In 1985,
the Consolidated Omnibus Budget Reconciliation Act (COBRA)
7. required employers to offer partially subsidized health coverage
to terminated employees. ■ 1990–2000: President Clinton’s
Health Security Act proposed a universal healthcare coverage
plan, which was never passed. In 1993, the Family Medical
Leave Act (FMLA) was enacted, which allowed employees up to
12 weeks of unpaid leave because of family illness. In 1996, the
Health Insurance Portability and Accountability Act (HIPAA)
was enacted, making it easier to carry health insurance when
changing employment. It also increased the confidentiality of
patient information. In 1997, the Balanced Budget Act (BBA)
was enacted to control the growth of Medicare spending. It also
established the State Children’s Health Insurance Program
(SCHIP). ■ 2000: The SCHIP, now known as the Children’s
Health Insurance Program (CHIP), was implemented. ■ 2000:
The Medicare, Medicaid, and SCHIP Benefits Improvement and
Protection Act provided some relief from the BBA by providing
across-the-board program increases. ■ 2003: The Medicare
Prescription Drug, Improvement, and Modernization Act was
passed, which created Medicare Part D, prescription plans for
the elderly. ■ 2006: Massachusetts mandated all state residents
have health insurance by 2009. ■ 2009: President Obama signed
the American Recovery and Reinvestment Act (ARRA), which
protected health coverage for the unemployed by providing a
65% subsidy for COBRA coverage to make the premiums more
affordable. ■ 2010: The ACA was signed into law, making it
illegal for insurance companies to rescind insurance on their
sick beneficiaries. Consumers can also appeal coverage claim
denials by the insurance companies. Insurance companies
cannot impose lifetime limits on essential benefits. ■ 2013: As
of October 1, individuals could buy qualified health benefits
plans from the Health Insurance Marketplaces. If an employer
does not offer insurance, effective 2015, consumers can
purchase it from the federal Health Insurance Marketplace. The
federal government provided states with funding to expand their
Medicaid programs to increase preventive services. MARGIN IS
OFF ■ 2015: The CMS posted its final rule that reduces
8. Medicare payments to hospitals that readmit Medicare patients
within 30 days after discharge. This rule is an attempt to focus
hospital initiatives on quality care
Rubic_Print_FormatCourse CodeClass CodeAssignment
TitleTotal PointsNRS-433VNRS-433V-O506PICOT Question
and Literature Search120.0CriteriaPercentage1: Unsatisfactory
(0.00%)2: Less Than Satisfactory (75.00%)3: Satisfactory
(83.00%)4: Good (94.00%)5: Excellent
(100.00%)CommentsPoints EarnedContent80.0%Summary of
Clinical Issue5.0%A clinical issue is omitted or is not relevant
to nursing practice.A clinical issue is partially presented. It is
unclear how the clinical issue relates to nursing practice.
Significant aspects are missing, or there are inaccuracies.A
clinical issue is summarized. The issue generally relates to
nursing practice.A clinical issue is presented. The issue relates
to nursing practice. Minor detail is needed for clarity.A clinical
issue is thoroughly described. The issue relates to nursing
practice.PICOT Question10.0%A PICOT question is not
included.A PICOT question is provided but is incomplete. The
PICOT question format is used incorrectly.A PICOT question is
provided. The PICOT question format is generally applied.
Some information or revision is needed.A PICOT question is
provided. The PICOT question format is applied accurately.
Some detail is need for support or clarity.A PICOT question is
clearly presented. The PICOT question format is applied
accurately and presents an answerable and researchable
question.APA-Formatted Article Citations With
Permalinks5.0%Article citations and permalinks are
omitted.Article citations and permalinks are presented. There
are significant errors in the APA format. One or more links do
not lead to the intended article.Article citations and permalinks
are presented. Article citations are presented in APA format, but
there are errors.Article citations and permalinks are presented.
Article citations are presented in APA format. There are minor
errors.Article citations and permalinks are presented. Article
9. citations are accurately presented in APA format.Relationship
of Articles to the PICOT Question10.0%Three or more articles
do not relate to the PICOT question.At least two articles do not
relate to the PICOT question. The remaining articles provide a
small degree of support for the PICOT question. Different
articles are needed to provide better support for the PICOT
question.At least one articles does not relate to the PICOT
question. The remaining articles provide general support for the
PICOT question. One or two different articles are needed to
provide better support for the PICOT question.Each article
relates to the PICOT question. The articles provide support for
the PICOT question.Each article clearly relates to the PICOT
question. The articles provide strong support for the PICOT
question.Quantitative and Qualitative Articles10.0%Fewer than
six research articles are presented. Four or more articles do not
meet the assignment criteria for a quantitative, qualitative,Six
research articles are presented. Three articles do not meet the
assignment criteria for a quantitative, qualitativeSix research
articles are presented. Two articles do not meet the assignment
criteria for a quantitative, qualitative, or mixed study. Some
ability to identify the type of research design used in a study is
demonstrated.Six research articles are presented. One article
does not meet the assignment criteria for a quantitative,
qualitative, or mixed study. A general ability to identify the
type of research design used in a study is demonstrated.Six
research articles are presented. Each article meets the
assignment criteria for a quantitative, qualitative, or mixed
study. An ability to identify the different types of research
design used in a study is consistently demonstrated.Purpose
Statements5.0%Purpose statements are omitted or are
incomplete overall.Purpose statements are referenced but are
incomplete in some areas.Purpose statements are presented.
There are minor omissions in some areas, or major
inaccuracies.Purpose statements summarized. There are some
minor inaccuracies in some.Purpose statements are accurate and
clearly summarized.Research Questions5.0%Research questions
10. are omitted or are incomplete overall.Research question is
presented for each article. The research question has been
misidentified or misinterpreted for at least two of the articles.
Additional information is needed to fully illustrate the research
question for several of the articles.Research questions are
presented. The research question has been misidentified or
misinterpreted for one of the articles. Some detail is needed to
fully illustrate the research question for one or two
articles.Research questions are presented. Minor detail is
needed for clarity in some areas.Research questions are accurate
and capture the fundamental question posed by the researchers
in each study.Outcome5.0%Research outcomes are omitted or
are incomplete overall.Research outcome is presented for each
article. The research outcome has been misidentified or
misinterpreted for at least two of the articles. Additional
information is needed to fully illustrate the research outcomes
for several of the articles.Research outcomes are presented. The
research outcome has been misidentified or misinterpreted for
one of the articles. Some detail is needed to fully illustrate the
research outcomes for one or two articles.Research outcomes
are presented. Minor detail is needed for clarity in some
areas.Research outcomes are accurate and described in detail for
each article.Setting5.0%The setting is omitted for one or more
of the articles. The setting described for three or more articles
is inaccurate or incomplete.The setting is indicated for each
article. The setting described for two of the articles is
inaccurate or incomplete.The setting is indicated for each
article. The setting described for one article is inaccurate or
incomplete.The setting is indicated for each article. Some detail
is needed to fully illustrate the physical, social, or cultural site
in which the researcher conducted the study.The setting in
which the researcher conducted the study is detailed and
accurate for each article.Sample5.0%The sample is omitted for
one or more of the articles. The sample described for three or
more articles is inaccurate or incomplete.The sample is
indicated for each article. The sample described for at least two
11. of the articles is inaccurate or incomplete.The sample is
indicated for each article. The sample described for one article
is inaccurate or incomplete.The sample is indicated for each
article. Minor detail is needed for accuracy.The sample is
indicated and accurate for each article.Method5.0%Method of
study for one or more articles is omitted. Overall, the methods
of study are incomplete.The method of study is partially
presented for each article. Key information is consistently
omitted. Overall, the methods reported contain inaccuracies.The
method of study for each article is presented. Some key aspects
are missing for one or two articles, or there are some
inaccuracies for the methods reported.A discussion on the
method of study for each article is presented.A thorough
discussion on the method of study for each article is
presented.Key Findings of the Study5.0%Discussion of study
results, including findings and implications for nursing practice,
is incomplete.A summary of the study results includes findings
and implications for nursing practice but lacks relevant details
and explanation. There are some omissions or
inaccuracies.Discussion of study results, including findings and
implications for nursing practice, is generally presented for
each article. Overall, the discussion includes some relevant
details and explanation.Discussion of study results, including
findings and implications for nursing practice, is complete and
includes relevant details and explanation.Discussion of study
results, including findings and implications for nursing practice,
is thorough with relevant details and extensive
explanation.Recommendations of the Researcher5.0%Researcher
recommendations are omitted for one or more of the articles.
The recommendations described for three or more articles are
inaccurate or incomplete.Researcher recommendations are
indicated for each article. The researcher recommendations
described for two of the articles are inaccurate or
incomplete.Researcher recommendations for each article are
presented. Researcher recommendations described for one
article are inaccurate or incomplete.Researcher
12. recommendations for each article are accurately presented.
Minor detail is needed for accuracy.Researcher
recommendations accurate are thoroughly described for each
article.Organization and Effectiveness10.0%Mechanics of
Writing (includes spelling, punctuation, grammar, language
use)10.0%Surface errors are pervasive enough that they impede
communication of meaning. Inappropriate word choice or
sentence construction is used.Frequent and repetitive
mechanical errors distract the reader. Inconsistencies in
language choice (register), sentence structure, or word choice
are present.Some mechanical errors or typos are present, but
they are not overly distracting to the reader. Correct sentence
structure and audience-appropriate language are used.Prose is
largely free of mechanical errors, although a few may be
present. A variety of sentence structures and effective figures of
speech are used.Writer is clearly in command of standard,
written, academic English.Format10.0%Documentation of
Sources (citations, footnotes, references, bibliography, etc., as
appropriate to assignment and style)10.0%Sources are not
documented.Documentation of sources is inconsistent or
incorrect, as appropriate to assignment and style, with numerous
formatting errors.Sources are documented, as appropriate to
assignment and style, although some formatting errors may be
present.Sources are documented, as appropriate to assignment
and style, and format is mostly correct.Sources are completely
and correctly documented, as appropriate to assignment and
style, and format is free of error.Total Weightage100%
As you begin your Literature Review search for the Week 1
assignment, I want to share some information with you to assist
you in knowing the difference. This is very important. The
Week 1 paper, sets the course for Week 2, 3, and 5 papers.
In the Week 1 paper, you will have to find three quantitative
and three qualitative research articles, for a total of six articles.
Week 2 - You will write a Qualitative research critique using 2
of the 3 Qualitative articles from the Week 1 Literature Review
13. Table
Week 3 - You will write a Quantitative research critique using 2
or the 3 Qualitative articles from the Week 1 Literature Review
Table
Week 5 - You will provide a comprehensive document,
Research Critiques, and PICOT Statement Final Draft
So, it is pertinent that you know how to tell the difference
between qualitative and quantitative research. Please review the
image below, it notes the differences between the two methods.
When conducting your search, first begin by reading the
Abstract, esp the Methods and Results. If it a Qualitative study,
then it will state either interviews or direct observations, textual
or visual analysis (eg from books or videos) and interviews
(individual or group). However, the most common methods
used, particularly in healthcare research, are interviews and
focus groups. Qualitative data is recorded and transcribed.
Qualitative data analysis involves review of transcribed data to
identify common themes.
If it is Quantitative design, instruments, surveys, or tools are
used to collect data, typically using a scale such a Likert.
Quantitative data is analyzed statistically often using SPSS
software
Literature Evaluation Table
Student Name: Student Example
Summary of Clinical Issue (200-250 words): Central line
associated infections can happen in the ICU setting and can lead
to poor patient outcomes, longer complicated hospital stays, and
increased cost in hospital stays. Education is a crucial way to
inform frontline staff about how to prevent these infections. The
creation of a bundle of ways for nurses to care for central lines
and incorporating it into their protocols and daily routine can
14. decrease the rate of infections. As a nurse in the ICU, it is
helpful for staff to have direct and clear instructions to make
sure their responsibilities and skills are being performed
according to best practice and per protocol per facility. Nurses
are at the bedside and are frequently interacting with central
lines on a daily basis in the ICU. Making simple changes such
as proper hand hygiene before and after use of a central line can
have a very positive result on the rate of the infection. The Joint
Commission has included central line-associated bloodstream
infections (CLABSIs) in their National Patient Safety Goals. It
is a problem that can cause critical issues for patients and event
result in death. Nurses can have an impact on reducing
CLABSIs by implementing evidence-based interventions, such
as hand hygiene, proper education on central line care, visual
reminders for staff in unit with key points, proper catheter
access protocol, disinfecting caps, dressing changes, and
frequent assessment of the continued need for the central line.
As a nurse in the ICU, I want to establish a central line care
bundle using evidence-based research that can reduce CLABSIs
and improve patient outcomes.
PICOT Question: Does the implementation and use of a central
line care bundle compared to a non-standardized routine reduce
the rate of central line blood stream infections (CLABSIs) in
adult ICU patients during their hospital stay?
In _______(P), what is the effect of _______(I) on ______(O)
compared with _______(C) within ________ (T)?
In Adult Intensive Care Unit patients, what is the effect of
central line care bundle on central line blood stream infections
(CLABSIs) compared with non-standardized routine care during
the hospital stay.
Criteria
Article 1
Article 2
15. Article 3
APA-Formatted Article Citation with Permalink
Scheck McAlearney, A., & Hefner, J. L. (2014). Facilitating
central line-associated bloodstream infection prevention: A
qualitative study comparing perspectives of infection control
professionals and frontline staff. American Journal of Infection
Control, 42(10), S216–S222. doi:
https://doi.org/10.1016/j.ajic.2014.04.006
Scheck, M. A. A., Hefner, J. L., Robbins, J., Harrison, M. I., &
Garman, A. (2015). Preventing central line-associated
bloodstream infections: a qualitative study of management
practices. Infection Control Hospital Epidemiology, 36(5), 557–
563. doi: 10.1017/ice.2015.27
Damschroder, L. J., Banaszak-Holl, J., Kowalski, C. P., Forman,
J., Saint, S., & Krein, S. L. (2009). The role of the "champion"
in infection prevention: results from a multisite qualitative
study. BMJ Quality and Safety, 18(6). doi:
http://dx.doi.org/10.1136/qshc.2009.034199
How Does the Article Relate to the PICOT Question?
Reiterates how frontline staff are responsible for delivering
direct and ongoing care for central lines. It helps discuss the
different perspectives about challenges of central-line
associated bloodstream infection prevention program successes.
It discusses how management and hospital-level differences can
affect the outcome of patients who have central line-associated
bloodstream infections. It gives me more of an idea of how my
hospital performs due to their level of performing. I can
recognize these barriers to help implement change to reduce
infection rates.
It explores types and numbers of champions who lead efforts to
implement best practices to prevent infections. It gives me ideas
16. on how to implement practices to prevent CLABSIs and the
characteristics is takes to promote change and improve patient
outcomes.
Quantitative, Qualitative (How do you know?)
Correct Qualitative- it describes quality and characteristics of
frontline staff through observation and interviews
Correct Qualitative- it interviews people and receives their
nonnumeric data through descriptive characteristics.
Correct Qualitative- it gathers data about characteristics of
people and observes behaviors not numeric type of data.
Purpose Statement
Infection control professionals play a critical role in
implementing and managing healthcare-associated infection
reduction interventions, whereas frontline staff are responsible
for delivering direct and ongoing patient care.
To identify factors that may explain hospital-level differences
in outcomes of programs to prevent central line-associated
bloodstream infections.
Although 20% or more of healthcare-associated infections can
be prevented, many hospitals have not implemented practices
known to reduce infections. We explored the types and numbers
of champions who lead efforts to implement best practices to
prevent hospital-acquired infection in US hospitals.
Research Question
To determine if ICPs and frontline staff have different
perspectives about the facilitators and challenges of central-line
associated bloodstream infection prevention program success.
How can management practices reflect CLABSI rates and what
can be implemented to streamline the reduction rate of
CLABSIs with appropriate and effective central line care.
Observing how champions can promote and create change
regarding CLABSIs or other hospital acquired infections/
Outcome
Study shows the need to include nurses in the implementation of
infection control initiatives. Frontline staff contribute a critical
real-world perspective that may facilitate the success of patient
17. safety interventions.
A main theme that differentiated higher from lower performing
hospitals was as distinctive framing of the goal of “getting to
zero” infections. Although all sites reported this goal, at the
higher performing sites the goal was explicitly stated, widely
embraced, and aggressively pursued; in contrast, at the lower-
performing hospitals the goal was more of an aspiration and not
embraced as part of the strategy to prevent infections.
The types and numbers of champions varied with the type of
practice implemented and effectiveness of champions was
affected by the quality of organizational networks. For practices
that require significant behavioral changes, however, a coalition
of champions may be needed.
Setting
(Where did the study take place?)
8 various sites in Ohio with approval of the Institutional Review
board of Ohio State University
Eight US hospitals that had participated in the federally funded
On the CUSP-Stop BSI initiatives.
14 hospitals from all over the US were sent surveys, telephone
interviews, sit down interviews, and some on-site visits.
Sample
Across the 8 sites in the study, they interviewed 194 key
informants with different jobs and roles in the hospitals. Among
these informants were 50 frontline nurses, and 26 ICPs. They
focused on the comments from these 76 informants because
their roles in the organizations are relevant to their research
question focusing on the perspectives of ICPS and frontline
staff.
194 interviewees including administrative leaders, clinical
leaders, professional staff, and frontline physicians and nurses.
Survey responses were used to select a stratified purposive
sample of 14 hospitals for in-depth semistructured telephone
interviews. These hospitals were selected for their potential to
further our understanding of organizational barriers and
facilitators in implementing infection prevention practices.
18. Method
They conducted interviews at 8 hospitals that participated in the
Agency for Healthcare Research and Quality CLABSI
prevention initiative called {On the CUSP: Stop BSI.” They
analyzed interview data from 50 frontline nurses and 26 ICPs to
identify common themes related to program facilitators and
challenges. Interviews lasted 30-60 minutes, and the majority
were conducted with at least 2 interviewers.
Extensive qualitative case study comparing higher and lower
performing hospitals on the basis of reduction in the rate of
central line-associated bloodstream infections. In-depth
interviews were transcribed verbatim and analyzed to determine
whether emergent themes differentiated higher from lower
performing hospitals.
Qualitative analyses were conducted within a multisite,
sequential mixed methods study of infection prevention
practices in Veteran Affairs and no-Veteran Affairs hospitals in
the USA. The first phase included telephone interviews
conducted in 2005-2006 with 38 individuals at 14 purposively
selected hospitals. The second phase used findings from phase 1
to select six hospitals for site visits and interviews with another
48 individuals in 2006-2007.
Key Findings of the Study
Identified 4 facilitators of the CLABSI program success:
education, leadership, data, and consistency. We also identified
3 common challenges: lack of resources, competing priorities,
and physician resistance. However, the perspectives of ICPs and
frontline nurses differed. Whereas ICPs tended to focus on
general descriptions, frontline staff noted program specifics and
often discussed concrete examples.
Five additional management practices were nearly exclusively
present in the higher-performing hospitals: 1) top-level
commitment, 2) physician-nurse alignment, 3) systematic
education, 4) meaningful use of data, and 5) rewards and
recognition. They present these strategies for prevention of
healthcare-associated infection as a management “bundle” with
19. corresponding suggestion for implementation.
It was possible for a single well-placed champion to implement
a new technology, but more than one champion was needed
when an improvement required people to change behaviors.
Although the behavioral change itself was often more
complicated than changing technology because behavioral
changes required interprofessional coalitions working together.
Recommendations of the Researcher
Their results suggest ICPs need to take into account the
perspectives of staff nurses when implementing infection
control and broader quality improvement initiatives. Further,
the deliberate inclusion of frontline staff in the implementation
of these programs may be critical to program success.
Adding a management practice bundle may provide critical
guidance to physicians, clinical managers, and hospital leaders
as they work to prevent CLABSIs.
Merely appointing champions is ineffective; rather, successful
champions tended to be intrinsically motivated and enthusiastic
about the practices they promoted. Create enthusiasm about the
topic because champions can implement change within their
own sphere of influence.
Criteria
Article 4
Article 5
Article 6
APA-Formatted Article Citation with Permalink
Atilla, A., Doganay, Z., Kefeli Celik, H., Tomak, L., Gunal, O.,
& Kilic, S. S. (2016). Central line-associated bloodstream
infections in the intensive care unit: importance of the care
bundle. Korean Journal of Anesthesiology, 69(6), 599–603. doi:
10.4097/kjae.2016.69.6.599
Berenholtz, S. M., Lubomski, L. H., Weeks, K., & Goeschel, C.
A. (2014). Eliminating Central-Line Associated Bloodstream
20. Infections: A National Patient Safety Imperative. Infection
Control and Hospital Epidemiology, 35(1), 55–62. doi:
https://doi.org/10.1086/674384
Guerin, K., Rains, K., & Bessesen, M. (2010). Reduction in
central-line associated bloodstream infections by
implementation of a postinsertion care bundle. American
Journal of Infection Control, 38(6), 430–433. Doi:
https://doi.org/10.1016/j.ajic.2010.03.007
How Does the Article Relate to the PICOT Question?
Explains the importance and efficacy of a care bundle for
preventing central line-associated blood stream infections in the
Intensive Care Unit. Also reinforces why central lines should be
assessed daily if they are essentially needed for care.
It shows how the implementation of the “On the CUSP: Stop
BSI” program with uniform and appropriate central line care
can reduce the rate of CLABSIs.
Studied how a post insertion bundle was effective in decreasing
rates of infection. It also gives ideas of what post insertion
interventions help prevent infections for nursing care.
Quantitative, Qualitative (How do you know?)
Correct Quantitative- it evaluates numbers that result in
measurable data
Correct Quantitative- it evaluates using numbers and concludes
with measurable data
Correct Quantitative- they did measurable methods to gather
data and evaluated using numbers.
Purpose Statement
The importance and efficacy of a care bundle for preventing
central line-associated bloodstream infections and infections
complications related to placing a central venous catheter in the
patients in the intensive care unit.
Several studies demonstrating that central line-associated
bloodstream infections are preventable prompted a national
21. initiative to reduce the incidence of these infections.
Central line-associated bloodstream infections cause substantial
morbidity and incur excess costs. The use of a central line
insertion and postinsertion bundle has been shown to reduce the
incidence of CLABSI.
Research Question
What is the effect of a central line care bundle in association
with central line-associated bloodstream infections in the ICU.
How can implementing a national program help decrease the
rates of CLABSIs.
Post insertion bundles need to be consistent and uniform to be
effective.
Outcome
The catherization duration was longer and femoral access was
more frequently observed in patients with CLABSIs. CLABSI
rates decreased with use of the care bundle.
The overall mean CLABSI rate significantly decreased from
1.96 cases per 1000 catheter-days at baseline to 1.15 at 16-18
months after implementation.
During the preintervention period, there were 4415 documented
catheter-days and 25 CLABSIs, for an incidence density of 5.7
CLABSIs per 1000 catheter-days. After implementation of the
interventions, there were 2825 catheter-days and 3 CLABSIs,
for an incidence density of 1.1 per 1000 catheter-days.
Setting
(Where did the study take place?)
In a medical ICU and a surgical ICU
Adult ICU patients in a total of 44 states, the District of
Columbia, and Puerto Rico. Collectively more than 1000
hospitals and 1800 hospital units participated
DVAMC-Denver is a university-affiliated acute care teaching
hospital which includes a 10-bed medical intensive care unit
and a 13-bed surgical intensive care unit.
Sample
In total, 114 patients who had CVCs placed in a 22-bed medical
ICU and a 12-bed surgical ICU from July 2013 to June 2014
22. were enrolled.
Adult ICU patients in a total of 44 states, the District of
Columbia, and Puerto Rico. Collectively more than 1000
hospitals and 1800 hospital units participated
All ICU patients in both the medical and surgical ICU from
October 1, 2006 to September 30, 2009 with a preintervention
and a postintervention study completed.
Method
A care bundle was implemented from July 2013 to June 2014 in
a medical and surgical ICU. Data were divided into three
periods and a post intervention period. A care bundle consisting
of optimal hand hygiene, skin antisepsis with chlorhexidine
(2%) allowing the skin to dry, maximal barrier precautions for
inserting a catheter, choice of optimal insertion site, prompt
catheter removal and daily evaluation of the need for the CVC
was introduced.
They conducted a collaborative cohort study to evaluate the
impact of the national “On the CUSP: Stop BSI” program on
CLABSI rates among participating adult intensive care units.
The program goal as to achieve a unit-level mean CLABSI rate
of less than 1 case per 1000 catheter days using standardized
definitions from the National Healthcare Safety Network.
Multilevel Poisson regression modeling compared infection
rates before, during, and up to 18 months after the intervention
was implemented.
Surveillance for CLABSI was conducted by trained infection
preventionists using National Health Safety Network case
definitions and device-day measurement methods. During the
intervention period, nursing staff used a postinsertion care
bundle consisting of daily inspection of the insertion site; site
care if the dressing was wet, soiled, or had not been changed for
7 days; documentation of ongoing need for the catheter; proper
application of a chlorohexidine gluconate-impregnated sponge
at the insertion site; performance of hand hygiene before
handling the intravenous system; and application of an alcohol
scrub to the infusion hub for 15 seconds before each entry.
23. Key Findings of the Study
Infection rate increased when catheters remained in place longer
than needed, when healthcare workers did not follow the care
bundle practices, and when the catheter was placed via a
femoral route. During first 6 months, there were difficulty
complying with care bundle practices improved with regular
coordination meetings.
Coincident with the implementation of the national “On the
CUSP: Stop BSI” program was a significant and sustained
decrease in CLABSIs among a large and diverse cohort of ICUs,
demonstrating an overall 43% decrease and suggesting the
majority of ICUs in the US can achieve additional reductions in
the CLABSI rates
Findings demonstrate that implementation of a CVC
postinsertion care bundle was associated with a significant
reduction in CLABSIs. This study demonstrates that
interventions developed by front-line nursing staff can be a
highly effective response to a problem.
Recommendations of the Researcher
Use of all barrier precautions and removal of catheters when
they are no longer needed are essential to decrease the CLABSI
rate.
Have well-defined, evidence-based interventions. Build a solid
implementation structure and project plan. Collect and use
timely, accurate, and actionable data to improve performance.
Tailor national program for local and unit audiences. Evolves
project strategies and emphases over time.
Staff education and reinforcement of proper CVC care after
insertion, along with careful cleaning of the hub before access,
might reduce the incidence of infection.
7
24. Literature Evaluation Table
Student Name:
Summary of Clinical Issue (200-250 words):
PICOT Question:
Criteria
Article 1
Article 2
Article 3
APA-Formatted Article Citation with Permalink
How Does the Article Relate to the PICOT Question?
Quantitative, Qualitative (How do you know?)
Purpose Statement
Research Question
Outcome
Setting
25. (Where did the study take place?)
Sample
Method
Key Findings of the Study
Recommendations of the Researcher
Criteria
Article 4
Article 5
Article 6
APA-Formatted Article Citation with Permalink
How Does the Article Relate to the PICOT Question?
Quantitative, Qualitative (How do you know?)
27. 2
Title
ABC/123 Version X
1
Health Care Timeline
HCS/235 Version 10
1University of Phoenix Material
Health Care Timeline
Complete the following timeline.
Select seven events that have helped shape health care as it is
today. Write a 50- to 150-word summary per event that
discusses the event and its effect on the health care industry. An
example has been provided for you.
Health Care Throughout the Years
Date
Event and Significance
1870-1889
Employers began to provide employee health care. Companies
in several industries, including mining, lumber, and railroads,
developed group industrial clinics with plans that prepaid
doctors a fixed monthly fee to provide medical care to
employees for industrial accidents and common illnesses.