Best Writer

• Summarize the clinical problem, significance to nursing, and clinical
practice guideline.
• Clearly state your PICO(T).

Clinical Problem
There has been a prevalent problem among children in the operation room displaying increased anxiety before anesthesia administration. According to Chaurasia et al. (2019), “Anesthetic induction can be one of the most stressful experiences for the child during the perioperative period, with almost 50% of the children showing significant anxiety” (p.1629). Children experience anxiety due to the unknown environment, the absence of their parents, the appearance of needles, and having to be covered with a mask orally. Children tend to feel more anxious, more nervous, and more afraid due to the inability to recognize the medical environment, so since it is an environment that is foreign to them, they look for their dependents. Furthermore, the noncompliance to surgery can postpone the need for surgical repair, anesthesiologists are pressured to turning to sedation medication which should be avoided because it can have on small children’s health. The number one concerning side effect of sedative medication for children is respiratory depression in which the child starts to experience
in decline in the ability to breathe, therefore nonpharmacologic treatment [relaxation techniques] preoperatively is best for reducing anxiety in small children in operation room.
Clinical Question/PICO(T) Development
· Decreasing the stress and anxiety of the child and parents undergoing surgery is extremely important. It could help with the result of the surgery as well as assist with maintaining adequate vitals during surgery. The purpose is to see what interventions could decrease the distress of both the adolescent and guardian prior to surgery compared to those who did not ?

This is a discussion post. 1 is the initial post (2 paragraphs- Dallas, Texas) and the others are responses to two peers , 1 paragraph each

Initial post – question
Locate current or proposed legislation, city rules, or ordinances that have the potential to affect the environment in your area. Summarize the legislation and draw conclusions about the impact legislation will have on environmental practices.
Dallas TEXAS
GUIDELINES
Visit the website of a legislative body that has the ability to create rules, codes, or ordinances that impact the environment. Examples of these types of agencies include: Green Dallas, Fort Worth Environmental Management Department, Texas House of Representatives Committee on Environmental Regulation, U.S. House of Representatives Committee on Natural Resources, U.S. Senate Committee on Environment and Public Works and U.S. Environmental Protection Agency (EPA). Select one piece of legislation (or rule, or ordinance), either proposed or actual, and summarize it for the class. Ideally, you should select legislation that will directly impact your community.

Review the discussion board prior to selecting a proposal or prior to posting your message to the discussion board in order to avoid duplicating resources.
List the title of the legislative bill, rule, or ordinance. Include the title of the legislative body that drafted, proposed, or authorized the legislation.
Summarize the environmental legislation in one or two paragraphs. Identify key concepts included in the legislation.
In your opinion, what is the potential or realized impact of this legislation on the community?
Do you agree or disagree with the legislation? Support your answer.
Your original post should consist of complete sentences and should be at least two complete paragraphs but no more than three paragraphs.

Peer 1 Pena- (already answered the above question) please reply in one paragraph The United States Environmental Protective Agency in 1970 created The Clean Air Act. Under this act, the EPA regulates the Ethylene Oxide emission from the industrial pollutants and monitors the trends through National Air Toxics Trends Stations (NATTS) and the Urban Air Toxics Monitoring Program (UATMP). (EPA, 2022) Recently Texas Comission of Environmental Quality ( TCEQ) argumented against EPA about the toxicity of Ethylene Oxide. According to Vasquez, in his this news article, Houston is considered the “industrial cancer hotspot”. (Vasquez, 2022). The TCEQ, considers that the EPA’s findings are inaccurate and TCEQ claims that Ethylene Oxide emissions are “less harmful”, opposing EPA’s findings.

The issue with the TCEQ’s findings is that if the EPA’s re-categorization of Ethylene Oxide is to their favor, which is stated by them to be much harmful, is that the emissions of Ethylene Oxide would be substantially reduced to protect the habitants around the area. Monetary losses or production rates could be affected by the restrictions that these new findings from the EPA could implicate.

As per Vasquez the Public Citizen researcher Stephanie Thomas, some facilities in Texas ethylene oxide emissions “exceed levels of concern”. (Vasquez, 2022). There is a correlation between lymphoid and breast cancer deaths and ethylene oxide. (Vasquez, 2022). If the TCEQ gets to prove their argument to be correct, which is that the air pollutant is not as toxic as the EPA claims to be, the emissions would not be reduced or restricted. This means highly putting people at risk for cancer associated with ethylene oxide emissions. If the EPA wins this contradictory claim, there will be more protection to the citizens living in the area. The photo in the news article taken by David J. Phillip, portrays a refinery emitting gases, and in the background the buildings of Houston Downtown area. Residents have for years been asking for more protection regarding this same issue.

References:

Environmental Protection Agency. (n.d.). EPA. Retrieved February 28, 2022, from (Links to an external site.)

Environmental Protection Agency. (n.d.). Ethylene oxide CASRN 75-21-8 | DTXSID0020600 | Iris | US EPA, Ord. EPA. Retrieved February 28, 2022, from (Links to an external site.)

Vasquez, L. (2022, February 22). Texas defends its less protective standard for highly toxic air pollutant during EPA meeting. Houston Public Media. Retrieved February 28, 2022, from (Links to an external site.)

Peer 2 – has already replied . please respond in 1 paragraph lillian
Oil and Natural Gas Production Facilities: National Emission Standards for Hazardous Air Pollutants (NESHAP)

The Environmental Protection Agency (EPA) created The Clean Air Act (CAA) section 112. EPA issued final rules to reduce emissions of hazardous air pollutants (HAPs) from oil and natural gas production facilities as well as natural gas transmission and storage facilities.

I live in West Texas where oil and natural gas are extracted and processed. Emissions from different manufacturing and processing at oil and natural gas industries and natural gas transmission and storage facilities here in West Texas contains air toxins, from benzene, toluene, ethyl benzene, and mixed xylenes, and n-hexane. These are the pollutants known as to cause serious health problems, cancer, birth defects and reproductive problems. Having this rule in place, it will cause positive impact on residents on West Texas reducing too much exposure to these harmful toxins.

References

Environmental Protection Agency. (n.d.). EPA. Retrieved February 28, 2022, from (Links to an external site.) (Links to an external site.)

Environmental Protection Agency. (n.d.). Ethylene oxide CASRN 75-21-8 | DTXSID0020600 | Iris | US EPA, Ord. EPA. Retrieved February 28, 2022, from (Links to an external site.)

Write a paper on what needs to be revised is attached which are the Approaching Competence areas.

I only need to write the answers for question 3 and 4

3. What are two questions in the survey that you think could be described as “bad”
questions using the concepts we talked about in class? What makes them “bad”? How
would you re-write them to improve them?
4. Copy and paste one question found in the survey that uses each of the following scales:
ratio, ordinal, and nominal. There is no descriiption needed; copying and pasting three
questions and labeling which is which is all you need to do in this section

Discuss and analyze 3 studies with template provided. studies must be on postpartum depression.

1. What are the sources and trends in the demand for Instinet products across its lines of business?

(what is their product needed? existing and potentially addressable market, customer switching costs)

2.What is the Regulatory landscape across Instinet Group’s businesses and the outlook for it?

(order of importance, is it biased towards antitrust enforcement or IP-right protection? aggressiveness of customer protection, public relation risks)

3. What has the competition looked like for IB and Instinet? Direct and Indirect

(Incumbents, market share trends, barriers to entry, marketing intensity)

4. What are the characteristics of IB’s and Instinet’s production technology?

(Operating leverage, scalability, investment cycle/intensity)

5. How risky are the IG’s businesses? Think about both systematic risk (i.e. market beta) and idiosyncratic?

(qualitatively and based the past stock returns and valuations of the IG and its competitors. Is there debt capacity?)

6. Is there a unique advantage in the near future for either IB or Instinet to profitably grow market share and/or enjoy better margins and/or invest less to maintain a given cash flow?

Part one: Identify different historical definitions of, causal explanations for, and responses to alcohol abuse
Part two: Apply social learning theory to alcohol abuse
Part three: Analyze the interactional contexts in which alcohol abuse most often occurs

3.) Conduct brief research online and identify an example of a major cyber attack or IT disruption from any cause (Note: Please use a different example than you did in the Week 8 Discussion Forum). Describe who was the aggressor and their motives, or what was the cause, and the impacts of the event. How could this type of disruption or attack be prevented or mitigated in the future? In your assessment, does the creation of the Cybersecurity and Infrastructure Security Agency (CISA) within DHS (see https://www.dhs.gov/cisa/about-cisa) add value to our national cybersecurity program and protect against threats such as the case you described? What more should Pres. Biden do in in terms of urgent measures, policies, strategies or policies for cybersecurity? Support your arguments with specific examples or evidence from authoritative sources.

4.) Considering the concept of the “cybersecurity triad” including intergovernmental relations, public-private relations, and cybersecurity citizens, and the incremental approach to cybersecurity proposed by Harknett and Stever, what approach or measures do you believe are actually required to really engage and prepare all three legs of that triad? Who must lead that effort, and who or what constitutes the “weak link” in cybersecurity? Do previous or historical government measures in response to the nuclear technology revolution during the Cold War have enduring relevance or offer any lessons for cybersecurity today, or was that too long ago or too different in nature or scope to have any value today? Support your arguments with specific examples or evidence.

O‌‍‍‍‌‍‍‌‌‌‍‌‍‍‍‍‌‍‌‌verview: In this 3-4 double-spaced page analytical synthesis (1500-1800 words), you will analyze inequality through the lens of Bourdieu’s capital using the texts we have read and discussed this semester. Rather than explain each author’s individual argument, you will find common themes in the texts that help you explain how economic, cultural, and social capital, and social class reproduction contribute to inequality. You will group the authors accordingly, make claims about how their ideas about inequality relate to Bourdieu’s capital, make connections, highlight similarities, and support your claims by synthesizing the authors’ arguments. Rationale: The ability to synthesize information is important in academic writing; rarely is there one perspective, one voice, or one answer to an issue. Synthesis skills are necessary for producing a literature review. Literature reviews have different purposes. Often the purpose is to discuss the significance of the topic and broad areas of agreement or controversy (e.g., the status quo) to carve out a gap that an author will fill in that same text. But other times, the purpose is for an expert to synthesize scholarship on a big topic (like inequality) so others can see connections outside of their specialized field. And these often point to remaining questions or avenues of inquiry. In your analytical synthesis, you will develop both your synthesizing and analytical skills. As we have seen with our discussion of the Onion Model in class, analyzing means breaking up something into its parts and seeing them through the lens of disciplinary knowledge. Throughout the first weeks of the semester, we have used the disciplinary knowledge/framework of Bourdieu’s capital to tease out the various authors’ arguments about inequality. Your job now is to use the concept of capital as the organizing principle of your analytical synthesis. The ability to analyze using a disciplinary framework is an important skill to have. The analytical synthesis and the problem analysis assignments in this course will prepare you for the kinds of tasks you will be expected to do in many of your course. Process: You may start by re-reading the texts and reviewing your notes about how the arguments made by the authors we read connect to Bourdieu’s capital. You should also review the discussion questions on canvas and your own and your classmates’ answers, the power point slides, and the google docs we have used in our class discussions. You will then group the authors’ ideas in terms of how they relate to economic, cultural, social capital, and social class reproduction. Using the authors’ ideas, you will make a claim about how capital and social class reproduction help to explain inequality. Throughout each paragraph, you will support your claims with evidence from the authors. To get you started early with your writing, you will write your analytical synthesis in three stages: Synthesis in-progress draft 1: Here you will synthesize the arguments of the authors we have read thus far during the semester. We won’t be done with all our readings on inequality by then, but it is important to start identifying which authors�‌‍‍‍‌‍‍‌‌‌‍‌‍‍‍‍‌‍‌‌�� ideas relate to the different kinds of capital and social class reproduction, and to get started early with your writing. Synthesis in-progress draft 2: By this time, we will be done with all the readings on inequality, and you will be able to add the new authors to your on-going draft and continue to work on revisions of your synthesis in-progress draft 1. You will submit this as a draft and get feedback from your professor. Synthesis final draft: After you have received feedback on your full draft, you will work on revisions and submit your final draft. Audience: You should imagine that you are writing your analytical synthesis for an audience that is interested in inequality but that has NOT read the texts from our course. This means that you must make clear claims, precisely define and effectively use the terminology used by the authors, and provide relevant from the authors to support your claims. The Parts: In your introduction, begin by introducing the significance of the topic of inequality using shared context with your audience. Shared context refers to something the audience knows and can relate to before you delve into inequality and capital. Be sure to convince your readers from the outset of the significance of the issue you are exploring—in other words, why should they care about inequality? Then preview your main argument and your supporting claims about how economic, cultural, and social capital, and social class reproduction contribute to inequality. Your claims in your body paragraphs will relate to how the different forms of capital contribute to inequality. But note that you don’t necessarily have to have a separate paragraph to discuss social class reproduction. You may discuss social class reproduction in connection to the different forms of capital. Use PEEL to organize your paragraphs: Point, elaboration, evidence, and link. Start each major body paragraph with a topic sentence in which you make a claim (your point) about inequality using one form of capital or social class reproduction. Remember that a claim is a statement that needs to be defended and supported. Then explain the big picture idea of the claim (your elaboration) and provide evidence from the authors that have something to say about your claim. Use evidence in the form of paraphrases or relevant quotes from the authors. When you present evidence, you need to show how the evidence helps to support the claim you are making in this paragraph (this is your link). You will need to demonstrate how the different authors add something to your understanding of the claim so that it becomes stronger than the perspective of any single author. Although there will be some differences among individual authors’ perspectives, emphasize what they have in common. Stay focused! Make sure that your paragraph is only about one topic and not multiple topics! In your conclusion, you will need to re-iterate the major points made in your synthesis and discuss wider implications by considering how, for example, the ideas presented may help you understand a specific case of inequality, or how you see inequality impacting your immediate context, or how you think inequali‌‍‍‍‌‍‍‌‌‌‍‌‍‍‍‍‌‍‌‌ty will play out in the future.

Scenario
You are practicing on an acute care unit in a local hospital. During your recent shifts, you identified a practice problem that you would like to see changed. After discussing the issue with your direct supervisor and the Director of Nursing, they have asked that you research the current literature and propose an evidence-based practice solution to the identified practice problem.

Instructions
From your work or clinical experience, identify a potential practice problem and formulate an evidence-based practice question. Prepare a proposal for an evidence-based practice solution that includes the following.

Describe a potential practice problem
Formulate an evidence-based practice question
Locate and review two current, peer-reviewed, research articles that address the identified clinical problem
Appraise research findings
Propose an evidence-based practice solution

RUBRIC

A – 4 – Mastery
Clearly stated, detailed descriiption of a potential practice problem, including background, relevancy, and significance.
A – 4 – Mastery
Clearly stated, detailed descriiption of the formulated evidence-based practice question utilizing PICO(T) format.
A – 4 – Mastery
Clearly stated, detailed summary of four current, peer-reviewed, research articles that address the identified clinical problem, including: research articles less than 5 years old, peer-reviewed, and include at least two quantitative and two qualitative study.
A – 4 – Mastery
Clearly stated, detailed appraisal of the research findings including a detailed summary identifying at least three strengths and three limitations of the relevant research.
A – 4 – Mastery
Clearly stated, detailed descriiption of a proposal for an evidence-based practice solution that includes support for the recommendation with current literature.
A – 4 – Mastery
Formal style reflected throughout poster proposal, including no spelling, grammar, or APA format errors present.

PICO is a mnemonic device used in nursing that helps a person remember the components of a well focused clinical question. It is a strategy used in the first step of Evidence Based Practice (EBP) to assess and ask when researching to formulate a searchable clinical question by helping to develop key terms.

P

Patient, Population, or Problem

What are the most important characteristics of the patient; include the primary problem, disease, or co-existing conditions.

I

Intervention

What do you want to do for the patient? Prescribe a drug, order a test or surgery?

C

Comparison

Are you trying to decide between two drugs, a drug, no medication/placebo or diagnostic tests? You do not always have to have a specific comparison.

O

Outcome

What do you hope to accomplish, measure, improve for the patient? What are you trying to do to affect the patient positively?

PICO Search Strategy Example Case:

Patient A is receiving chemotherapy and to manage the moderate nausea and vomiting the doctor has given them prochlorperazin. The patient calls the nurse line and tells you that they have read that ginger is just as effective as the prochlorperazin and is wondering if this is true.

P

Patient, Population, or Problem

Patient receiving chemotherapy and is experiencing moderate nausea and vomiting.

I

Intervention

Use of ginger

C

Comparison

Effective as procholorperazin

O

Outcome

Reduce the moderate nausea and vomiting

Formulated Question:

In patients receiving chemotherapy who are experiencing moderate nausea and vomiting is the use of ginger as effective as prochlorperazin in reducing it?