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Heart failure (HF) is a common pathology that affects over 6 million adults. The lifetime risk of HF is 1:9 for males and 1:6 for females, and increases greatly in individuals who have experienced prior myocardial infarction (MI). Thus, treatment and prevention of HF are a major priority for most health care professionals, yet poor prevention and care are the most cited reasons for adverse clinical outcomes.

In 2014, the FDA approved the drug Entresto for the management and treatment of HF, finding that it significantly reduced the risk of death from HF-related conditions by 16-20% and was particularly effective at reducing the risk of death for HF patients with reduced left ventricular ejection fraction (LVEF). Entresto is actually a combination of two drugs: sacubitril, which inhibits the enzyme neprilysin, and valsartan, which is an angiotensin II receptor antagonist.

How do these drugs work together to reduce the risk of further heart failure and preserve function? In your response, briefly describe the two signaling pathways that are affected by the drug, how they are affected, and what the body’s overall response to the drug intervention is. How does this benefit patients with HF?

In addition to your own original post, you should respond to at least two other students’ posts, and to any replies to your original post as well. Replies should be substantive, not just a “me too” or “well done” type of comment. Please note that in your response, plagiarism is not allowed. Please do NOT simply cut and paste information from books, journals, websites, or other sources. In addition, direct quotation of sources, regardless of whether or not the source is cited, is not allowed. Please summarize the material and what you have learned in your own words.

WNIOSEK – szczere podziękowania LACOSTE dla wolontariuszy

Koszulka Merci Polo narodziła się z misją wspierania i demonstrowania zaangażowania marki na rzecz wolontariuszy podczas kryzysu COVID-19.

Firma Lacoste wprowadziła na rynek koszulkę „L12.12 Polo Merci”, Wólka Kosowska hurtownia obuwia limitowaną edycję produktu, który łączy ducha wolontariuszy walczących o powstrzymanie epidemii z całego świata. Dochód wygenerowany z tego produktu zostanie zwrócony międzynarodowym stowarzyszeniom partnerskim pierwszej linii, które nadal pracują dzień i noc podczas kryzysu epidemicznego.
 

Od grudnia 2019 roku świat zmaga się z pandemią Covid-19, której towarzyszy bezprecedensowy kryzys społeczno-gospodarczy. Pani Louise Trotter, dyrektor kreatywna Lacoste, zaprojektowała ekskluzywną koszulkę polo z limitowanej edycji o nazwie „L12.12 Polo Merci”. Produkt narodził się z misją wspierania i demonstrowania zaangażowania marki na rzecz wolontariuszy w czasie kryzysu.

Historycznie koszulka polo Lacoste zawsze umieszczała w sercu logo aligatora, co jest również symbolicznym nawiązaniem do wartości Lacoste. Buty Wólka Kosowska Na tej koszulce Merci Polo znak solidarności jest przekazywany przez Lacoste poprzez kształt serca otaczający kultowego krokodyla marki. To serce wyraża szczerą wdzięczność marki dla odważnych, kochających ludzi, którzy poświęcają się, by opiekować się innymi w kryzysie. To wolontariusze z fabryk Lacoste pracują dzień i noc, aby wyprodukować niezbędne maski lub odpornych ludzi na linii frontu. Reprezentują silnego ducha kolektywnego, aby pomóc najbardziej zagrożonym podczas wybuchu epidemii. Cała sprzedaż tej koszulki „L12.12 Polo Merci” zostanie przekazana Fundacji Lacoste, która wesprze działania Federacji Czerwonego Krzyża na całym świecie.

Ta akcja Lacoste jest zgodna z zaangażowaniem marki na rzecz społeczności od początku kryzysu, a także pokazuje chęć wniesienia wkładu we wspólne wysiłki w walce z Covid-19. Od marca, dzięki dobrowolnemu zaangażowaniu pracowników, Lacoste wyprodukowała w swoich fabrykach we Francji i Argentynie ponad 200 000 sztuk masek tkaninowych. Maski te zostały dostarczone do władz lokalnych i miejsc pierwszej linii zapobiegania epidemii.

„Koszula „L12.12 Polo Merci” to zobowiązanie marki podczas tego bezprecedensowego kryzysu zdrowotnego. Buty Wólka Kosowska Przemysł modowy może naprawdę, na swój sposób, pokazać działanie i okazać solidarność, aby wspierać i motywować osoby, które dzień i noc umierają do walki z epidemią na linii frontu”.

Pani Louise Trotter, dyrektor kreatywna Lacoste dodała: „Ikoniczny krokodyl Lacoste zamknięty w prostym czerwonym sercu wydaje się być najlepszym sposobem na wyrażenie naszego podziwu. Dla ludzi, którzy pracują nad zapobieganiem chorobom podczas tej pandemii”.

Koszulka „L12.12 Polo Merci” będzie dostępna od 28 maja w Europie i około połowy czerwca w pozostałych częściach świata w wybranych sklepach Lacoste i na stronie internetowej Lacoste.

O FUNDUSZACH LACOSTE
Fundacja Lacoste powstała w 2020 roku, z zadaniem rozwijania i realizacji działań społecznych marki. Wólka Kosowska hurtownia obuwia Fundusz budowany jest już od kilku miesięcy, wszystkie działania ukierunkowane i promowane są na kwestie związane z obecną sytuacją epidemiczną. Gdy kryzys epidemiczny zostanie opanowany, Fundacja Lacoste skoncentruje się na swojej pierwotnej misji: towarzyszeniu młodym ludziom w celu wspólnego tworzenia odpowiedzialnej i bezpiecznej przyszłości poprzez stowarzyszenia, rozwijania zdolności

Utilize a standard ethical decision-making model (provided below) to process and resolve an ethical dilemma case in counseling. Case scenarios are provided below. From these cases, choose one case to process utilizing the model.

Create responses to the 8-step model regarding their specific case. Utilize and cite a minimum of 3 sources. Two of the 3 required sources must be the ACA and NBCC Codes of Ethics, the other source could be a scholarly journal, book, or appropriate website. Utilize proper spelling, grammar, intelligible sentences, and APA format for their intext citations and references.  

Ethical Decision-Making Model by Corey, Corey, Corey & Callahan (2015)

1.  Identify the problem (ethical dilemma).

2.  Identify other potential issues involved.

3.  Identify the relevant ethical guidelines (cite standards from both the ACA and NBCC code of ethics that apply).

4.  Identify the relevant laws and regulations.

5.  Identify the possible consultation sources that could be utilized.

6.  Identify potential courses of action (at least 2 different options).

7.  Identify the consequences of the potential courses of action (for each option in step 7).

8.  Identify the best course of action and why.

The movie Grease is a timeless classic that many people from all walks of life can enjoy. Some of you can relate to all of the awesome songs and some of the situations that are going on in this great movie. High school can be tough, and this movie hits on some of the rough situations that high school kids can endure. Immature boys, foiled relationships, and even a pregnancy scare could all be something you encounter during your days as a teenager. Grease makes this time in life relatable to every age group and introduces us to characters we all know and love.

With that being said, based on Erik Erickson’s Psychosocial Development Theory, in the stages “Intimacy vs. Isolation,” and “Identity vs. Role Confusion,” describe what the individual(s) and groups are experiencing. Be incredibly detailed in your descriptions giving a minimum of 2 examples per person and group.

T-Birds

Kenickie

Rizzo

Sonny

Danny

The Love Birds

Frenchy

Sandy

Rydell High

Pink Ladies

Putzie and Doody

Marty

Jan

                             PLEASE POST EACH DISCUSSION SEPARATELY

Each healthcare organization has its own internal policies related to departmental processes. Having Subject Matter Experts (SMEs) on the selection steering committee is a very important aspect of the process. Hospitals are poor at including SMEs at the executive decision-making level. This is a risk as those who will use the system should have a voice in its selection. Workflow processes can be significantly impacted by the EHR and are poorly evaluated by those who are not end-users.

This article, Barriers to Electronic Health Record System Implementation and Information Systems Resources: A Structured Review, concisely summarizes multiple articles that yielded 57 barriers to the implementation of EHR systems.

Justify the impact of the expense of human capital on the selection of an EHR. 

Include the following aspects in the discussion:

• Use Chapter 9 from the text (Strategic Planning, Project Management, and Health Information Technology Selection) and any other outside resources you find helpful
• Select two functions in the project management process that must be considered during the EHR selection activity.
• Explain the importance of assessing the internal and external environments during the planning process.
• Discuss the value of strategic planning in health information technology (HIT), and explain why it is important.
• Provide your personal perspective on what the role of the SME in the HIT section process should be

REPLY TO 2 OF MY CLASSMATES DISCUSSION TO THE ABOVE QUESTIONS AND EXPLAIN WHY YOU AGREE. MINIMUM OF 150 WORDS EACH

                                               CLASSMATE POST 1

A team must consider two functions in the project management process: planning and execution. The planning phase outlines every task of the project. The managers establish deadlines for each assignment and the professional responsible for finishing it. They also finalize the budget, which dictates the equipment and time needed to accomplish their goals without wasting resources. Executing the project involves working on the assigned tasks and monitoring the project’s progress. Challenges may occur during this stage, and managers modify their objectives as needed, requiring additional approval from supervisors or stakeholders (Sipes, 2016).

According to Dennis (2019), Strategic planning is critical for healthcare organizations to succeed internally and externally. Understanding how your company functions is the key to creating an effective strategic plan for the entire healthcare system. Sometimes you need to look at the chain of command of your organization. Deciding your company’s goals and setting a path to achieve these goals motivates your staff at every level to succeed with you. It’s easy for organizations at every level to become confused as to what’s going on. Your employees and investors want to ensure that your organization will have a long-lasting approach (Dennis, 2019). They want to know where your company is headed and the steps to get there. Good planning in healthcare management can help you establish precision and enhance communication. Your strategic plan should handle the key issues, your organization’s vision and goals, and the steps to get there. As a result, your employees and stakeholders will have improved confidence and faith in your organization.

SME is a person who has clear and relevant knowledge about how Healthcare IT software should be used in their day-to-day job. They are essential components of both implementation projects as well as ongoing support of healthcare software products. A Subject Matter Expert in Healthcare IT gives support and advocacy for the end-users of clinical software (Rostek, 2012). This is a big deal in Healthcare because the SME bridges the gap between technical staff who are sometimes not very clinically minded, and clinical staff who may lack technical skills.

According to Rostek, 2012, Some of the tasks that an SME helps with are:

Assisting with reviewing of new software

Finding gaps in performance that need to be addressed

Finding and documenting current and proposed operations

Communicating resolutions back to their co-workers

Functioning as a Super User to deliver support for co-workers

References

Dennis C. Strategic planning—a health system operational perspective. J Hosp Management Health Policy 2019;3:32.

Rostek, Katarzyna, 2012. “The reference model of competitiveness factors for SME medical sector,” Economic Modelling, Elsevier, vol. 29(5), pages 2039-2048.

Sipes, C. (2016). Project management for the advanced practice nurse. New York: Springer.

 Introduction and EHR Selection

Each healthcare organization has its own internal policies related to departmental processes. Having Subject Matter Experts (SMEs) on the selection steering committee is a very important aspect of the process. Hospitals are poor at including SMEs at the executive decision-making level. This is a risk as those who will use the system should have a voice in its selection. Workflow processes can be significantly impacted by the EHR and are poorly evaluated by those who are not end-users.

This article, Barriers to Electronic Health Record System Implementation and Information Systems Resources: A Structured Review, concisely summarizes multiple articles that yielded 57 barriers to the implementation of EHR systems.

Justify the impact of the expense of human capital on the selection of an EHR. 

Include the following aspects in the discussion:

• Use Chapter 9 from the text (Strategic Planning, Project Management, and Health Information Technology Selection) and any other outside resources you find helpful
• Select two functions in the project management process must be considered during the EHR selection activity.
• Explain the importance of assessing the internal and external environments during the planning process.
• Discuss the value of strategic planning in health information technology (HIT), and explain why it is important.
• Provide your personal perspective on what the role of the SME in the HIT section process should be

REPLY TO 2 OF MY CLASSMATES DISCUSSION TO THE ABOVE QUESTIONS AND EXPLAIN WHY YOU AGREE. MINIMUM OF 150 WORDS EACH

                                               CLASSMATE POST 2

The two functions in selection of Electronic Health Records (EHR) I have selected to discuss include 1. Ease of use and 2. Implementation and training process. Through my years of practice in the healthcare profession, the number 1 barrier I have faced in regards to EHR is processes that actually make the flow of patient care more difficult. An example of this I have faced in the past is documenting patient information that does not flow in a systematic fashion or allowing for not allowing for the  expansion of clinical data. Ensuring that staff have been properly trained to use EHR is also necessary for success.  Adequate training time and ensuring that those on the front line of use have the opportunities to voice concerns is also of great importance. “A recommendation for training is to complete a user skills assessment and training needs before implementation. A user skills assessment evaluates the healthcare worker’s basic computer literacy and skills”( Aguirre et al.,2019).  Front line care providers must also see the need for change and improvement through the use of EHR. Without thoses using these new systems on board for the implementation, success can be a challenge. “Independent of the EHR adoption level, we found that the work environment is highly associated with nurses’ ratings of the usefulness of EHR systems, and most importantly that the quality of the work environment may determine the extent to which comprehensive EHR systems have their intended impact on quality and safety” (Kutney-lee., 2019). In my current practice as a case manager , administration is implementing a new rounding format and documentation system for reporting between the team.  One thing I have noticed is that as soon as the direct training for the changes has stopped, the entire disciplinary team reverts back to old ways of practicing.  The reason is clear that those on the front lines were not included in the implementation of the new processes and that the new format is not practical . This new system has actually made our practice more challenging. “One of the leading reasons for poor outcomes following EHR adoption may be the lack of consideration for how the system will interface with end-users and the existing organizational structure” (Kutney-lee., 2019). In closing, I can recognize the benefit of EHR and the value it can bring to overall patient care.  I believe that as future leaders, APNs need to be on the forefront of development to ensure the appropriateness of new systems. 

                                                                           Reference

Aguirre, R. R., Suarez, O., Fuentes, M., & Sanchez-Gonzalez, M. A. (2019). Electronic Health Record Implementation: A Review of Resources and Tools. Cureus, 11(9), e5649. https://doi.org/10.7759/cureus.5649

Kutney-Lee, A., Sloane, D. M., Bowles, K. H., Burns, L. R., & Aiken, L. H. (2019). Electronic Health Record Adoption and Nurse Reports of Usability and Quality of Care: The Role of Work Environment. Applied clinical informatics, 10(1), 129–139. https://doi.org/10.1055/s-0039-1678551

ASSIGNMENT 3 

REL3851.E1 Family Relations

Read Balswick, Fifth Edition, Part 3 (Parenting and Beyond, chapters 6-10). Answer the following questions.

Follow the same format and instructions as on Assignment 1.  Note that some answers must be longer than others.

1. Summarize what the authors say about the process of relationship empowerment as they begin chapter 6. Pages 111-114 

2. Explain the difference between discipline and punishment. Pages 116-117

3. Discuss the four styles of instrumental parent leadership. Pages 118-119

4. Assess and explain the styles of socioemotional parenting. Pages 120-123

5. Summarize then evaluate what the authors call a biblical model of parenting. Pages 125-128

6. Explain the objective of chapter three. Pages 130-131

7. In two or three sentences each, summarize the following:

a. Psychoanalytic Theory, page 133

b. Erikson’s Neopsychoanalytic Theory, page 135

c. Cognitive Structural Theories, page 136

d. Cognitive Development Theory, pages 136-138

e. Object Relations Theory, pages 138-139

f.  Social Learning Theory, pages 140-141

g. Sociocultural Theory, page 141-142

h. Social Ecology, page 142-143 

8. Summarize the authors’ critique of these theories. Pages 143

9. Concerning internal tension, how do the authors see sin as a human condition? Pages 143-144

10. Explain why and how the church is valuable as an extended family. Pages 145-146

11. In a couple of sentences each, summarize the various key elements of facilitating healthy growth of children. Pages 146-153

12. How is family spirituality involved in the moral and faith development of a child? Pages 155-158

13. Comment on the authors’ (Jack and Judy) open statements about personal struggles with family beliefs. Pages 162-166. 

14. Explain why adolescence is a time of identity crisis. Pages 167-171

15. Why is midlife a time of crisis? Pages 171-173 

16. What do the authors see as significant about the interaction of adolescence and midlife? Pages 174-178

17. Explain the launching stage of family life, and summarize the four key transition tasks in the launching stage?  Pages 180-183

18. Summarize in a paragraph the challenges of the post-launching stage. Pages 183-197

Note briefly explain in 70-100words, page might not be accurate. 

2 complete paragraphs.

 In this forum, tell us about a recent moral decision that you have made. Then, analyze your thought process, implicit assumptions, and any outside influences that could be behind your decision.  Use Kohlberg’s Stage Theory of Moral Development for the analysis of your thought process.  Sometimes, it seems like we just act out of instinct or conscience, but when we look, we can usually see what we were thinking.  Try to make your thinking process visible.   

2-3 pages nothing less

Your Special Project for Lesson 7 is called “Through the Ringer” You will use the moral theories discussed in chapter 9.  Read the dilemma described below.  Then, respond to each of the numbered prompts, based on the dilemma.  

Scenario:

It is Week 7 of the early 8-week fall term. You are taking 3 courses so that you can get back on track after a rough spring term. It’s 10PM and you stayed up all night yesterday studying for your chemistry ex am, but you realize you misread the calendar: the final deadline for Es say 3 in your English Composition 1 course is in 2 hours. You know that Es say 3 is worth almost 30% of your final grade, and getting a 0 means you are no longer passing the course. You have worked hard all term, and you cannot afford to fail the course because this is your third attempt, and you are already on academic probation. Your instructor’s syllabus that they do not accept late work for Es say 3 because of the time limits of the end of the term. You know that your instructor won’t see their email for at least another 12 hours.

Your classmate told you about a website where you can download an es say from another student who has taken the same class at the same college; all you have to do to gain access to the materials is create an account and upload 5 different course materials to your own account. Time is running out, and you have to decide what to do.

Questions:

1. What is the moral issue at stake here?

2. Explain how you would handle the situation if you subscribed to ethical subjectivism  and why you reached that decision  

3. Explain how you would handle the situation if you subscribed to cultural relativism  and why you reached that decision  

4. Explain how you would handle the situation if you subscribed to utilitarianism  and why you reached that decision  

5. Explain how you would handle the situation if you subscribed to deontological ethics  and why you reached that decision  

6. Explain how you would handle the situation if you subscribed to rights-based ethics  and why you reached that decision  

7. Finally, after running the situation through the various moral theories, explain how you would personally handle the situation.  To which moral theory does your decision most adhere?

 Follow the instructions below to participate in the discussion.

1. Review the ways to build cooperation and decrease resistance in the adolescent client suggested in the reading, “10 ways to build cooperation and decrease resistance”. 
2. Of the ten suggestions, choose the two you consider the most critical.
3. Post your choices and give a short rationale for each.  

I need help with this

 Susan Glaspell’s play “Trifles” (pgs. 693-703)
1. Title Implications: Explain what the word “trifles” means. Do you think it is a
fitting title?
2. Symbolic Setting.  
                Where is the murder site/ farmhouse located?
B.  Inside the house:
List two things that let the audience “feel” how literally cold it is:
3. List three significant details that are evidence of a poorly kept kitchen:  
4.  Thumbnail Sketch: Make a comment about each of the characters (one sentence)
    A.  Attorney Henderson_________________________________________________
    B.  Sheriff Peters ______________________________________________________
    C.  Mr. Hale __________________________________________________________
    D.  Mrs. Peters ________________________________________________________
    E.  Mrs. Hale _________________________________________________________
5.  List two “put down” comments the men make against women:

6.  Why does Mrs. Hale get upset with the men talking about Mrs.Wright?  

7.  Why do you think the women hide the dead bird?