Write a paper (2,000-2,500 words) in which you apply the concepts of epidemiology and nursing research to a communicable disease. Refer to “Communicable Disease Chain,” “Chain of Infection,” and the CDC website for assistance when completing this assignment.

Communicable Disease Selection

1. Chickenpox
2. Tuberculosis
3. Influenza
4. Mononucleosis
5. Hepatitis B
6. HIV
7. Ebola
8. Measles
9. Polio
10. Influenza

Epidemiology Paper Requirements

1. Describe the chosen communicable disease, including causes, symptoms, mode of transmission, complications, treatment, and the demographic of interest (mortality, morbidity, incidence, and prevalence). Is this a reportable disease? If so, provide details about reporting time, whom to report to, etc.
2. Describe the social determinants of health and explain how those factors contribute to the development of this disease.
3. Discuss the epidemiologic triangle as it relates to the communicable disease you have selected. Include the host factors, agent factors (presence or absence), and environmental factors. Are there any special considerations or notifications for the community, schools, or general population?
4. Explain the role of the community health nurse (case finding, reporting, data collection, data analysis, and follow-up) and why demographic data are necessary to the health of the community.
5. Identify at least one national agency or organization that addresses the communicable disease chosen and describe how the organizations contribute to resolving or reducing the impact of disease.
6. Discuss a global implication of the disease. How is this addressed in other countries or cultures? Is this disease endemic to a particular area? Provide an example.

A minimum of three peer-reviewed or professional references is required.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

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The Discussion Section question is:  

Add a comment pertaining to the effect of workload on coronary blood flow. Please detail our potential to image the ratio of decrease blood flow for  diagnostic value. Add to to the DICUSSION PANNEL for this unit.

Here some example for you :

1- The effect of workload on coronary blood flow and our potential to image the ratio of decrease blood flow for diagnostic value:

According to The Journal of the American Association, coronary blood flow is determined by the rate at which blood flows out of the coronary arteries to other parts of the body. For example, during rest, the amount of blood flows through the coronary arteries is 225 ml per minute which is 4-5% of total cardiac output. During stress, the blood flow is faster and the heart muscle contracts during systole. As a result, during diastole, the cardiac muscle relaxes to allow the flow of blood through the body without any resistance. One significant effect on coronary blood flow is the workload the heart is subjected to during stress. With an increase in stress rate, the heart reacts to pump blood in a faster rate to ensure oxygen is supplied to the rest of the body. When imaging, the vasodilator stress agents are helpful in decreasing the blood flow and relaxing the heart muscle. These pharmacological agents help when measuring the supply to the heart and viewing the heart’s workload.

2- The following is regarding the effect of workload on coronary blood flow and our potential to image the ratio of decrease blood flow for diagnostic value:

The heart is a very smart organ with very smart systems. An auto-regulatory mechanism known as coronary autoregulation is constantly maintaining the interaction of pressure and resistance of coronary blood flow. Decreases in pressure are compensated for by decreases in resistance and conversely, increases in pressure by increases in resistance so that flow remains constant for a give cardiac workload. This regulatory mechanism operates within the range of physiologic arterial pressures but fails during hypotension when flows become strongly dependent on the driving pressure.

For imaging purposes, pharmacological vasodilator stress agents seek to maximally lower the vascular resistance through relaxation of the vascular smooth muscle cell at the level of the microcirculation, thereby uncoupling coronary flow (supply) and myocardial work (demand). With the help of such pharmacological agents, imaging can take place in order for diagnostic purposes.

References

Schelbert H. R. (2010). Anatomy and physiology of coronary blood flow. Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology, 17(4), 545–554. doi:10.1007/s12350-010-9255-x

3- The effect of workload on coronary blood flow and our potential to image the ratio of decrease blood flow for diagnostic value:

Blood flow to the heart mainly occurs during diastole, the great majority of blood flow to the left ventricle occurs during diastole. The diastolic pressure from the aorta propels blood through the coronary circulation. The more coronary blood flow to the left ventricle means the longer time that diastole will last. The right ventricle receives blood equally during both systole and diastole. Diastole lasts for about two thirds of the cardiac cycle. The coronary arties through the myocardium are compressed during ventricular contraction when fibers are thickening and are unable to fill.  The pressure within the left ventricle offers resistance to this flow. Blockage of coronary arteries can reduce coronary blood flow at rest, resulting in a buildup of a clot, and also anything that causes arteries to constrict and not allow the vasodilatation to even improve coronary blood flow.

For imaging potential of decreased blood flow, pharmacological vasodilator stress agents can be utilized to cause a lower vascular resistance through relaxation of the smooth muscles of the heart during a nuclear stress test. This can lead to measuring the supply and demand of the heart, it is which these pharmacological stress agents that when can possibly use to help increase the potential to image the ratio of decreased blood flow for diagnostic reasons and value.

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Discussion: Urinary Tract Infections

Urinary tract infections (UTIs) are caused by bacteria—most often Escherichia coli. However, certain viruses, fungi, and parasites can also lead to infection. The infection can affect the lower and upper urinary tract, including the urethra, prostate (in males), bladder, ureter, and kidney. Due to the progression of the disease and human anatomy, symptoms present differently among the sexes as well as among age groups. It is important to understand how these factors, as well as others, impact the pathophysiology of UTIs. Advanced practice nurses must have this foundation in order to properly diagnose patients.

                                          To Prepare

Review Chapter 30 in the Huether and McCance text.

Identify the pathophysiology of lower and upper urinary tract infections.      Consider the similarities and differences between the two types of infections.

Select two of the following patient factors: genetics, gender, ethnicity, age, or behavior.

Reflect on how the factors you selected might impact the pathophysiology of the infections, as well as the diagnosis of and treatment for the infections.

Post a description of the pathophysiology of lower and upper urinary tract infections, including their similarities and differences.

Then explain how the factors you selected might impact the pathophysiology of the infections, as well as the diagnosis of and treatment for the infections.

NOTE: This is the link of the book you have to use

https://drive.google.com/file/d/12MGt6z2PicuM1y4rM-SN8rpGD09-Tmkj/view?usp=sharing
https://drive.google.com/file/d/12MGt6z2PicuM1y4rM-SN8rpGD09-Tmkj/view?usp=sharing
Check the documents attached bellow

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Write an APA style (min 600 work) APA style essay detailing “The technologist’s role in acheiving Safe and the highest of Quality, Nuclear Cardiology images”.

here is an example for you

Technologist’s Role in Safe and High-Quality Nuclear Cardiology Images

We as technologists play a very crucial role in safe and high-quality nuclear cardiology images because we are the experts. We are performing tests and images on the heart, which is a very vital and complex muscle within the human body so it only makes sense that our job is to safely perform nuclear cardiology tests on patients while providing accurate and good quality images. Patient safety should always come before quality images, because the patient care should be the technologist’s top priority always. As technologists it is important to focus on the ALARA (as low as reasonably achievable) philosophy and monitoring patient dose. With the combination of both principles there should be a balance between dose and image quality (Watson & Odle, 2013). Therefore, you are considering the patient’s safety in the amount of radiation that they are receiving while also being mindful of what dose will also better serve for a good enough image quality. While maintaining the ALARA philosophy for both the technologist and patient, it is important to explain the entire procedure to the patient and ask them if they have any questions to ensure they fully understood what scan they are about to be taken in for(Watson & Odle, 2013). It is crucial that the technologists inform the patient that their heart will be put under a lot of stress, but there are precautions that are considered beforehand to ensure the risks outweigh the benefits. It is also important to inform them that they have the chance of crashing, but there will always be a crash cart near by and monitored the entire time during the whole study.

Another thing to keep in mind as a technologist for patient safety is to constantly meet their needs. A lot of patients coming into the cardiology department do not have good hearts, and that is why we perform our studies to further gather more information on their heart related problems. If a patient does not want to have the study done, the technologist can not force the patient to undergo the study. However, it is strongly encouraged to ensure the patient that the study would be in their best interest in the long run to enable an accurate diagnosis and possible treatment due to the images that were taken. Once safety concerns are addressed, it is important to ensure good imaging protocols to ensure the best diagnosis. To ensure the most accurate protocol is performed, it is important to have close communication between the referring physician and all technologists who are performing the test (DiPuey et al., 2012). All tests are patient specific, so obtaining and understanding the patient’s medical history can be important when deciding what is best for the patient. For example, and exercise stress test is preferred rather than administering a pharmacological stressor but sometimes a patient is physically unable to perform exercise. However, it has been found that pharmacological stressors can enhance nuclear cardiology by providing a more flexible and broader accessibility for SPECT procedures. With the pharmacological stress agents, it is important to know the contraindications of all also, as we the technologist are responsible for that. It is clearly indicative that a patient centered approach will improve the overall diagnostic and prognostic performance of MPI (DePuey et al., 2012). It is super important to understand what the patient is experiencing to ensure they receive the correct protocol that is given or considered. Through good radiation safety practice, strong communication, and a good understanding of medical history the technologist should always be pristine all the way around when it comes to patient safety. Quality patient care leads to quality images because it is all patient specific when dealing with the heart, and within nuclear cardiology.

References

DePuey, G., Mahmarian, J., Miller, T., Einstein, A., Hansen, C., Holly , T., . . . Wann, S. (2012).  Patient-Centered Imaging. ASNC Practice Statement, 1-31.

Watson , L., & Odle, T. (2013). Patient Safety and Quality in Medical Imaging: The Radiologic    Technologist’s Role. Retrieved from American Society of Radiologic Technologists :  https://www.asrt.org/docs/default  source/research/whitepapers/asrt13_patientsafetyqltywhitepaper.pdf?sfvrsn=a119f22f_12

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This assignment provides the opportunity for the student to continue development of a MSN EBP scholarly project that started with the identification of a nursing concern and PICOT/PICo question from Week 2. The focus of this assignment is to discuss the research-based literature support for the selected concern, identify an appropriate research design, explain the sampling method, and discuss implementation through the use of a change model.

Course Outcome:

This assignment enables the student to meet the following course outcome:

CO 1. Integrate evidence-based practice and research to support advancement of holistic nursing care in diverse healthcare settings. (PO 1)

CO 2. Integrate knowledge related to evidence-based practice and person-centered care to improve healthcare. (PO 2, 5)

CO #4. Develop knowledge related to research and evidence-based practice as a basis for designing and critiquing research studies. (PO 1, 2, 3, 5)

CO #5. Analyze research findings and evidence-based practice to advance holistic nursing care initiatives that promote positive healthcare outcomes. (PO 1, 2, 5)

Due Date Sunday 11:59 PM MT at the end of Week Five

Students are given the opportunity to request an extension on assignments for emergent situations. Supporting documentation must be submitted to the assigned faculty. If the student’s request is not approved, the assignment is graded and a late penalty is applied as follows:

• Monday = 10% of total possible point reduction
• Tuesday = 20% of total possible point reduction
• Wednesday = 30% of total possible point reduction

If the student’s request is approved, the student will be informed of the revised due date. Should the student fail to meet the revised due date, the assignment is graded and a late penalty is applied as follows:

• Monday = 10% of total possible point reduction
• Tuesday = 20% of total possible point reduction
• Wednesday = 30% of total possible point reduction

Total Points Possible: 250 points

Requirements

Description of the Assignment: This continues the development of a MSN EBP scholarly project by requiring the student to identify the additional elements of the process. The required elements are noted to be:

• Research Literature Support (NOTE: Ten research-based references related to PICOT/PICo question are required)
• Research Approach and Design
• Sampling
• Intervention

Criteria for Content

1. Research Literature Support: In this section, comprehensive research literature support for the identified nursing concern and PCIOT/PICo question is to be provided. A minimum of ten (10) research-based references are required. The use of a systematic research review article as a reference is NOT allowed. All research studies are to be consistent with the selected concern and PICOT/PICo question. The PICOT/PICOT question is restated before presenting the research literature support. For each research-based reference the following information is to be discussed:

• -Purpose of the research study
• -Research approach that was used
• -Data collection methods used
• -Results of the research study
• -One strength of the research study
• -One limitation of the research study.
• 2. Research Approach and Design: In this section, the student will identify the research approach that he/she plans on using for the EBP project as being either quantitative or qualitative. In addition, if the selected approach is quantitative, the student needs to identify if the design is experimental, quasi-experimental, or descriptive. If the selected approach is qualitative, the student needs to identify if the design is phenomenological, ethnography, grounded theory, or historical. A description of the selected design is to be provided as well as rationale for its selection. In addition one advantage and one disadvantage to the selected design is to be identified and discussed. Required content includes:
• -Identification of the research approach that the student plans on using as either quantitative or qualitative
• -Identification of selected quantitative research design by indicating if the design is experimental, quasi-experimental, or   descriptive
• -Identification of the selected qualitative design by indicating if the design is phenomenological, ethnography, grounded theory,  or historical
• -Description of the selected design
• -Rationale for the selected design
• -Identification of one advantage of the selected design
• -Identification of one disadvantage of the selected design
• -Provide scholarly reference(s) to support information about the selected research approach/design
• 3. Sampling: In this section, the student will identify the sampling method to be used in order to obtain the necessary participants for the proposed EBP project. Discussion of participants’ rights as research subjects is also included. Required content includes:
• -Describe the target population
• -Identify the sampling method as being either probability or nonprobability
• -Provide a complete description of the sampling procedure including:
  • Sample size
  • Inclusion criteria
  • Exclusion criteria
• -Identify one advantage to the selected sampling procedure
• -Identify one disadvantage to the selected sampling procedure
• -Explain how participants’ rights will be protected including confidentiality, anonymity, protection from harm, and informed consent
• -Provide scholarly reference(s) to support information about the selected sampling method
• 4. Proposed Implementation with a change model: In this section, the student will apply the PDSA Change Model as the method to implement the proposed EBP practice solution/change. The required content includes:
• -Describe the PDSA Change Model
• -Explain why this change model is best suited for implementation of your evidence-based nursing practice solution/change
• -Apply each step of the PDSA Change Model to implementing the proposed practice solution/change
• -Explain how to overcome one barrier to the use of the EBP results from this project
• -Explain how an environment that supports EBP can be fostered in your future practice setting
• -Include a scholarly reference(s) for the PDSA Change Model

Preparing the Assignment

Criteria for Format and Special Instructions

1. The additional sections to the proposal are not to exceed 15 (fifteen) pages. Be sure that all literature review articles are on your reference page. Points will be lost for not meeting these length requirements.
2. Title page, running head, body of paper, headings, and reference page(s) must follow APA guidelines as found in the 6th edition of the manual.
3. Required textbook for this course, dictionary and Chamberlain College of Nursing lesson information may NOTbe used as scholarly references for this assignment. For additional assistance regarding scholarly nursing references, please see the Library Guide. Be aware that information from .com, .edu, and library websites may be incorrect and should be avoided. Please contact your faculty member for guidance concerning the acceptability of a website as a scholarly source. References are current – within a 5-year time frame unless a valid rationale is provided and the instructor has approved the use of the older reference.
4. This assignment is the required submission to Turn It In™ (TII) for NR 505. To prepare for the final submission, students are encouraged to submit their assignments early. A similarity score of 24% or less is required for the final submission. Any other level of similarity index requires the student to revise the assignment before the due date and time. To allow sufficient time for revision, early submission of the assignment to TurnItIn™ is highly encouraged. The final submission will be graded by faculty. If the final TurnItIn™ report indicates that plagiarism has occurred, the Academic Integrity policy will be followed. Similarity scores of 25% or higher result in the implementation of the Academic Integrity Policy located in the Chamberlain College of Nursing Student Handbook.

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The practice of health care providers at all levels brings you into contact with people from a variety of faiths. This calls for knowledge and understanding of a diversity of faith expressions; for the purpose of this course, the focus will be on the Christian worldview.

Based on “Case Study: End of Life Decisions,” the Christian worldview, and the worldview questions presented in the required topic study materials you will complete an ethical analysis of George’s situation and his decision from the perspective of the Christian worldview.

Provide a 1,500-2,000-word ethical analysis while answering the following questions:

1. How would George interpret his suffering in light of the Christian narrative, with an emphasis on the fallenness of the world?
2. How would George interpret his suffering in light of the Christian narrative, with an emphasis on the hope of resurrection?
3. As George contemplates life with amyotrophic lateral sclerosis (ALS), how would the Christian worldview inform his view about the value of his life as a person?
4. What sorts of values and considerations would the Christian worldview focus on in deliberating about whether or not George should opt for euthanasia?
5. Given the above, what options would be morally justified in the Christian worldview for George and why?
6. Based on your worldview, what decision would you make if you were in George’s situation?

Remember to support your responses with the topic study materials.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

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Discussion: Developing a Culture of Evidence-Based Practice

As your EBP skills grow, you may be called upon to share your expertise with others. While EBP practice is often conducted with unique outcomes in mind, EBP practitioners who share their results can both add to the general body of knowledge and serve as an advocate for the application of EBP.

In this Discussion, you will explore strategies for disseminating EBP within your organization, community, or industry.

To Prepare:

· Review the Resources and reflect on the various strategies presented throughout the course that may be helpful in disseminating effective and widely cited EBP.

o This may include: unit-level or organizational-level presentations, poster presentations, and podium presentations at organizational, local, regional, state, and national levels, as well as publication in peer-reviewed journals.

· Reflect on which type of dissemination strategy you might use to communicate EBP.

Post at least two dissemination strategies you would be most inclined to use and explain why. Explain which dissemination strategies you would be least inclined to use and explain why. Identify at least two barriers you might encounter when using the dissemination strategies you are most inclined to use. Be specific and provide examples. Explain how you might overcome the barriers you identified.

Assignment: Evidence-Based Capstone Project, Part 6: Disseminating Results

The dissemination of EBP results serves multiple important roles. Sharing results makes the case for your decisions. It also adds to the body of knowledge, which creates opportunities for future practitioners. By presenting results, you also become an advocate for EBP, creating a culture within your organization or beyond that informs, educates, and promotes the effective use of EBP.

To Prepare:

· Review the final PowerPoint presentation you submitted in Module 5, and make any necessary changes based on the feedback you have received and on lessons you have learned throughout the course.

· Consider the best method of disseminating the results of your presentation to an audience.

To Complete:

Create a 5-minute, 5- to 6-slide narrated PowerPoint presentation of your Evidence-Based Project.

· Be sure to incorporate any feedback or changes from your presentation submission in Module 5.

· Explain how you would disseminate the results of your project to an audience. Provide a rationale for why you selected this dissemination strategy.

Submit Part 6, your revised PowerPoint presentation of your Evidence-Based Project.

Resources to use below:

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.

• Chapter 10, “The Role of      Outcomes on Evidence-based Quality Improvement and enhancing and      Evaluating Practice Changes” (pp. 293–312)
• Chapter 12, “Leadership      Strategies for Creating and Sustaining Evidence-based Practice      Organizations” (pp. 328–343)
• Chapter 14, “Models to Guide Implementation      and Sustainability of Evidence-based Practice” (pp. 378–427)

Gallagher-Ford, L., Fineout-Overholt, E., Melnyk, B. M., & Stillwell, S. B. (2011). Evidence-based practice, step by step: Implementing an evidence-based practice change. American Journal of Nursing, 111(3), 54–60. doi:10.1097/10.1097/01.NAJ.0000395243.14347.7e. Retrieved from https://journals.lww.com/ajnonline/Fulltext/2011/03000/Evidence_Based_Practice,_Step_by_Step_.31.aspx 

Newhouse, R. P., Dearholt, S., Poe, S., Pugh, L. C., & White, K. M. (2007). Organizational change strategies for evidence-based practice. Journal of Nursing Administration, 37(12), 552–557. doi:0.1097/01.NNA.0000302384.91366.8f. Retrieved from http://downloads.lww.com/wolterskluwer_vitalstream_com/journal_library/nna_00020443_2007_37_12_552.pdf

Melnyk, B. M. (2012). Achieving a high-reliability organization through implementation of the ARCC model for systemwide sustainability of evidence-based practice. Nursing Administration Quarterly, 36(2), 127–135. doi:10.1097/NAQ.0b013e318249fb6a

Melnyk, B. M., Fineout-Overholt, E., Gallagher-Ford, L., & Stillwell, S. B. (2011). Evidence-based practice, step by step: Sustaining evidence-based practice through organizational policies and an innovative model. American Journal of Nursing, 111(9), 57–60. doi:10.1097/01.NAJ.0000405063.97774.0e. Retrieved from https://www.nursingcenter.com/nursingcenter_redesign/media/EBP/AJNseries/Sustaining.pdf

Melnyk, B. M., Fineout-Overholt, E., Giggleman, M., & Choy, K. (2017). A test of the ARCC© model improves implementation of evidence-based practice, healthcare culture, and patient outcomes. Worldviews on Evidence-Based Nursing, 14(1), 5–9. doi:10.1111/wvn.12188. Retrieved from https://sigmapubs.onlinelibrary.wiley.com/doi/abs/10.1111/wvn.12188

Melnyk, B. M., Fineout-Overholt, E., Gallagher-Ford, L., & Stillwell, S. B. (2011). Evidence-based practice, step by step: Sustaining evidence-based practice through organizational policies and an innovative model. American Journal of Nursing, 111(9), 57–60. doi:10.1097/01.NAJ.0000405063.97774.0e. Retrieved from https://journals.lww.com/ajnonline/Fulltext/2011/09000/Evidence_Based_Practice,_Step_by_Step__Sustaining.27.aspx

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Develop and Concept Map, using the form provided, on the following patient. Include Diagnostic data and medical orders that you expect to be ordered on the patient.

T.J., a 30-year-old African American client, is in his last year of law school and is clerking for a prestigious law firm. He and his fiancé plan to marry as soon as he graduates. During the last week he has had four dizzy spells and a headache at the base of his skull upon awakening for the last 2 days. His father has a history of hypertension, so T.J. is aware that his symptoms may indicate high blood pressure. On his way home from work, T.J. stops by the clinic and asks the nurse to check his blood pressure. The nursing assessment yields the following data.

Subjective data: States he has had four dizzy spells and has awakened with a headache in the occipital lobe the last two mornings. T.J. has 1 glass of wine at lunch and 2-3 beers in the evening to relax from the tension of school and work. Most of his meals are at fast-food establishments and have a high fat content. T.J. does not smoke. He used to jog 4 mornings a week but quit when he started clerking. He has had nocturia for the last 3 weeks. He is not taking any medication. T.J. states he is concerned about having hypertension because he does not want to take medication.

Objective data: T 98.6°F(37°C), AP 78 beats/min, R 16 breaths/min, BP 142/92 mm Hg, Wt 190 lbs (optimum weight 160). No edema noted in hands, feet, or legs

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TOPIC —   Pressure Ulcers and the Vulnerable Elderly Population at Mary Manning Walsh

II. Community Assessment A. What resources exist within the systems of this community? Consider health and social services, educational services, safety, religion, and politics, among others. i. Be sure to identify resources at the local level. What influences these resources? Why are they considered social determinants of health? ii. Include resources at the regional level. How are the influences on these resources different than the influences on resources at the local level? Justify your reasoning. iii. How are healthcare resources in both the local and regional areas around this community influenced by healthcare policy? Provide support for your answer. iv. Are the healthcare resources in this community different according to the varying demographics? Why or why not? Be sure to support your answer using research or data. B. Analyze the community based on data collected from reliable resources. For example, you might utilize data from the Centers for Disease Control and Prevention, the Community Health Status Indicators website, or even recent census data. i. What are the strengths and weaknesses of the community that would be integral in the formulation of a community health strategy? Support your answer with data and research. ii. What barriers have been identified that may impact successful implementation of that strategy? Support your answer with data and research. iii. What areas of opportunity exist for improving the health of the community? Support your answer with data and research

For additional details, please refer to the MILESTONE TWO GUIDELINES AND RUBRIC.

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