Chronic asthma and acute asthma exacerbation are respiratory disorders that affect children and adults. Advanced practice nurses often assist physicians in providing treatment to patients with these disorders. Sometimes, patients require immediate treatment, making it is essential to recognize and distinguish minor asthma symptoms from serious, life-threatening symptoms. Since symptoms and attacks are often induced by a trigger, nurses must also help patients identify their triggers and recommend appropriate management options. Like many other disorders, there are various approaches to treating and managing care for asthmatic patients. Some approaches work better than others, depending on individual patient factors. One method that supports the clinical decision making of drug therapy plans for asthmatic patients is the step-wise approach, which you explore in this Assignment.

To prepare:

• Review “Asthma” in Chapter 27 of the Huether and McCance text. Identify the pathophysiological mechanisms of chronic asthma and acute asthma exacerbation. Consider how these disorders are similar and different.
• Consider drugs used to treat asthmatic patients, including long-term control and quick relief treatment options for patients.
• Think about the impact these drugs might have on patients, including adults and children.
• Review Chapter 25 of the Arcangelo text. Reflect on using the stepwise approach to asthma treatment and management. Consider how stepwise management assists health care providers and patients in gaining and maintaining control of the disease.
• Think about how to educate patients to develop a plan for medication adherence. Consider how the plan might differ based on the patient’s age.

By Day 7

Write a 2- to 3-page paper that addresses the following:

• Describe the pathophysiological mechanisms of chronic asthma and acute asthma exacerbation. Then, explain the changes in the arterial blood-gas patterns during an exacerbation.
• Describe long-term control and quick-relief drugs used to treat asthma in patients.
• Explain the impact these drugs might have on adults and children.
• Explain the stepwise approach to asthma treatment and management and how this approach assists health care providers and patients in gaining and maintaining control of the disease.
• Explain how you would help patients develop a plan for medication adherence, including how the plan might differ based on the patient’s age.

Reminder: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. 

FORENSIC PSYCHOLOGY 44.543
Assignment #1:
Please answer in no more than 3 pages (double-spaced)
A 5 year old boy, whose parents are undergoing a divorce, reports that he was sexually molested by his father. His mother takes him to a psychologist who evaluates him using various techniques, including a clinical interview, Anatomically Correct Dolls and a test she has created: “Detection of Childhood Abuse Test” (DCAT). The psychologist is called to testify in court about her findings.
1) What are the issues related to the validity of using Anatomically Correct Dolls for this purpose? Explain the basis for your opinion (that is, cite the relevant sources).
2) Cite at least one U.S. Supreme Court case (covered in this course) which provides guidance that the Judge could use to decide whether the psychologist can testify about the results from the DCAT? What are the factors which would need to be considered?
3) Aside from the tests administered, what would you want to know about the clinical interview to decide whether the testimony in that area should be considered credible?

Nursing standards of care
You mentioned that the nurse is responsible for being aware and following standards of care. How do you keep informed about the standards of practice that relate to your role?

Your post must be highly organized, thorough and accurate. All posts should include proper grammar and mechanics.

3.Advance the discussion or extend discussions already taking place. Responses must add new information not previously discussed.

4.Pose new possibilities or opinions not previously voiced. Consider new factual information tied with critical thinking. Interesting and current research on the topic.

5.Do not simply summarize another student’s post and agree/disagree. Consider starting out posts with, “A research article I found said, Did you know, 3 things I found interesting were

Posture is something we all sort of don’t pay too much attention to, but is extremely important. I think when we hear the word posture, we think of our mothers correcting our appearance and basically shrugging and not really caring about it. However, posture is something we should practice every day and always make sure we are standing properly. The neutral spine is the most common reference when it comes to speaking about posture terms. It basically means aligning your spine where everything is centered. Your feet are right below your hips, your neck is straight, and your shoulders should be leveled. This posture has so many benefits for our body. There are so many different kinds of posture, such as the military posture were we stand tall and align our joints together. It’s not just our spine/back that contribute to posture. Posture is our whole entire body. The position of the ankles and knees affect the rest our bodies. That is why you see so many athletes having issues with feet, runner’s knee, achilles tendonitis, ect. Having your knee in a position, or your feet in a position for too long, that is not the ordinary posture, affects your body. You see dancers who create too much movement or abrupt movements to their hips end up having hip injuries or needing surgery. Stability is a whole different level of importance. Stability is basically the support we all need. Our muscles are constantly pushing force upon its joints to impart tension and stiffness. According to PTonthenet, these muscles are regulated by a finely tuned nervous system that sends and receives messages from the spinal ligaments and muscle to provide stability framework that is highly capable of tremendous and extremely enduring support. Because of this, our joints in our spine are able to balance for long periods of time without any issue. Posture and stability correlate in so many ways. It makes it very difficult to sustain a great amount of stability if your posture is not correct.

Conducting Technology Audit
Appendix A1
Business Objectives
Objective Timeframe: one year goals
Profit example: Increase profit by 8%
Products and Services example: Post comparable products list on website
Production example: Begin label making in-house
Customer Satisfaction
Employee Retention
Growth
Change Management
Marketing
New Clients
Quality
Service Level
Donation Level
Community Relations
Research and Development
Innovation
Globalization
Brand Recognition
Corporate Image
Supply Chain
Funding
Information Technology
Training example: Offer Label making training
Instructions for Appendix A (A1 A2): Business Objectives Each organization will have its own business objectives, although many look similar. However, for-profit organizations will likely differ in their objectives than educational entities or non-profits. Business objectives may be written as a verb, “Increase Profit” or “Increase Service Level”, or may only identify the business area, “Profit” or “Service Level” as the goal statements typically define the direction and scope of the activity, ie., “increase profit by 5% in next 12 months”, or “provide all new clients job training classes”. You must identify a minimum of three objectives and at least one goal for each objective for each of the two timeframes identified in Appendix A1 and A2. If your organization uses different timeframes, then you may change the timeframes from the templates to your actual planning phases, but please ensure that you have near term and long term goals. The goals may remain the same or be different in some of the timeframes.
Appendix A2
Business Objectives
Objective Timeframe: Five+ year goals
Profit
Products and Services
Production
Customer Satisfaction
Employee Retention
Growth
Change Management
Marketing
New Clients
Quality
Service Level
Donation Level
Community Relations
Research and Development
Innovation
Globalization example: enter market of one asian and three east african countries
Brand Recognition
Corporate Image
Supply Chain
Funding
Information Technology example: upgrade unsupported legacy systems
Training
Instructions for Appendix A (A1 A2): Business Objectives Use instructions in Appendix A1
Appendix B
Organizational Effectiveness
Twelve Organizational Effectiveness Criteria; adapt as needed Suggested Measures for Evaluating Scoring of Criteria: 1 (less effective, poor) to 5 (very effective, excellent) Issues/explanation of score
Efficiency Revenue per employee-hour Profit per employee-hour Profit per square foot Cost per client served Cost per unit of output Fixed asset utilization rate Revenue multiplier
Productivity Unit volume per employee-hour Unit volume per machine-hour Gross output per employee-hour Gross output per machine-hour No. of clients served per employee-hour No. of billable hours per employee-hour Gross payroll power
Stability Planning and goal setting Extent of routinization No. of layoffs during the period Extent of job rotations Safeguarding assets Alignment of strategy, mission, vision Compliance with established procedures
Innovation R&D expenses as a percentage of net revenue Training as a percentage of net revenue New product development rate No. of new markets entered Willingness to innovate Operational process change frequency Administrative process change frequency
Growth Compounded annual growth rate (revenue) Profit or fund crowd during the period Relative market share change New customer growth New market growth Change in manpower Net change in assets
Evaluative Feedback system utilization Performance management system utilization Task force utilization No. of new initiatives launched Percent of internally generated business ideas Percent of externally generated business ideas Change initiatives launched
Fiscal Health Return on net assets/equity /invested capital Net debt position Free cash flow Liquidity ratios Profitability ratios Expense ratios Fund equity balance
Output Quality Customer satisfaction / loyalty Customer retention rate External review / accreditation Internal quality measures Warranty claims Service errors Response time
Information Management Role ambiguity Integrity of information Timeliness of information No. of staff meetings per month No. of company-wide meetings per year Perceived adequacy of information available Access to procedures, rules, and regulations
Conflict-cohesion Work group cohesion Employee turnover Absenteeism Workplace incivility Commitment Bases of power Violence of conflict
Intra-organizational Instances of ethical breach Results of ethics audits Evidence of workforce training Evidence of monitoring systems Components of organizational justice No. of employee accidents External / internal audits
Extra-organizational Regulatory compliance Ecological footprint change Environmental controls and monitoring Emissions levels (pollutants, noise) External audits Contribution to the larger system Philanthropic activities
Instructions for Appendix B: Organizational Effectiveness There are several methods of evaluating organizational effectiveness, and for this project we will be using a goal focused method. This template uses 12 universal effectiveness criteria as identified by Wesley A. Martz (Martz, Wesley A., “Evaluating Organizational Effectiveness” (2008). Dissertations. 793. http://scholarworks.wmich.edu/dissertations/793). You may adapt these criteria for your own organization. The effectiveness criteria you use should be clear, concise, measurable, and tied to organizational performance. The suggested measures offer some ideas as to how that criteria can be measured. Organizations should define what makes the criteria poor or excellent so that the measures are evaluated as consistently as possible. As you fill out this checklist for your organization, see if you can get help from executives in your organization. Evaluate a minimum of three organizational effectiveness criteria for your organization, providing your description of how that criteria is being measured, your score, and a one to two sentence explanation of your score.
Appendix C
Department Effectiveness
Department Evaluation Score: 1 (less effective) to 5 (very effective) Issues/explanation of score
Executive
Finance
Production
Distribution/Transportation
Administration
Information Technology
Sales
Marketing
Customer Service
Human Resources
Training
Facilities
Maintenance
Logistics
Quality
Accounting
Documentation
Research & Development
Legal
Contracts/Procurement
Operations
Public Relations/Public Affairs
Test and Evaluation
Recruiting
Instructions for Appendix C: Department Effectiveness Organizations have different departments that support their business functions. Often business functions may be combined within a single department that represents several functions, such as Sales & Marketing, or Distribution & Logistics, or Finance & Accounting. Select two departments from your organization and perform your assessment of their effectiveness. You should explain your evaluation with one or two sentences that describe how the department is effective or ineffective in meeting business goals or where potential weaknesses have been uncovered.
Appendix D
TECHNOLOGY INVENTORY
Technology/ Business System Function Supplier/ Inventory System Financial/ Transactional System Compensation Sales and Marketing System Office Administration System Production System Research and Technology Management System Quality and Auditing System Training System Knowledge Management System Employee Communication System Documentation System Management Decision Making
Hardware example: Mobile credit card
Software Programs example: In-house accounting tool developed in Cobalt
Enterprise Systems example: SAP for timekeeping example: SAP for transfer to corporate HQ
e-business
Databases example: Inventory database
Security example: Common access cards (PKI enabled) example: none
People example: Marketing has their own IT
Networks:
Local Area Network
Wide Area Network
Internet Connectivity
Instructions for Appendix D: Technology Inventory Provide an inventory of the technology and tools currently used in your organization. Identify what business function they provide. In some instances, you may find that one tool provides capability to several business functions, such as enterprise systems for financial bookkeeping, timekeeping, and inventory. In other instances, you may find that a single business function is managed by using multiple pieces of technology, including software programs, databases, networks, and hand-held tools. For example, inventory systems may depend on hand-held scanners, supplier databases, transportation networks, and in-house inventory optimization programs. Provide detail for those business processes that you feel are most critical to your organization’s performance.
Appendix E
INFORMATION TECHNOLOGY ASSESSMENT
Business Information System Specific Functions Performed Gap in capability to meet needs Inefficiencies or Redundancies Customer Complaints Potential Vulnerabilities (now and future) IT effectiveness score – 1 (least) to 5 (most) Explanation/ Comment/ Issues
Inventory System
Financial System
Compensation System
Sales and Marketing System example: Online ordering; Facebook; email marketing; customer database example: For last two years, we’ve missed our sales target. example: New customers must be added manually to customer database example: Customers not able to access online ordering during peak hrs example: Access problem will become worse if we make more products available online example: 2
Office Administration System
Production System
Research and Technology System
Quality and Auditing System
Training System
Employee Training System
Knowledge Management System example: 3
Employee Communication System
Local Area Network
Wide Area Network
Internet Connectivity
Documentation System
Instructions for Appendix E: Information Technology Assessment This Information Technology assessment template is significant to the technology audit as it is the foundation of your IT needs assessment. As you think about the business functions in your organization identified in Appendix D, you will now evaluate how well the existing IT infrastructure supports each business function. The business functions listed in the template are fairly standard and should capture most of the functions that IT services in your organization. Again, provide your score along with an explanation of how IT could be used more effectively in support of that business function. After filling out the template, you will write a detailed description (one to two paragraphs) that address where existing technologies are not meeting the business needs, where customer support is not being met, where there are ineffiencies or redundancies, and where potential vulnerabilities exist.
Appendix F
RISK ASSESSMENT
Business Risks Likelihood of occurrence: 1 (less likely) to 5 (very likely) Consequence or Severity of occurrence: 1 (less severe) to 5 (very severe) Risk Rating: low, medium, or high Current mitigation in place Comments
example: Supplier delays example: 4 example: 4 example: High example: Second source for batteries has been found. Sales department is offering incentives for customers to stay while we work the problems. Need automatic alerts and better ordering system to prevent shortages. example: Inventory system did not identify issue with batteries until it began affecting the production line. Key customers have threatened to switch vendors if we can’t deliver product on time. Lack of batteries is slowing production facilities.
example: Loss of key personnel
example: Quality assurance problems
example: External attack on information systems
example: Denial of service to customers
example: New competitors
Instructions for Appendix F: Risk Assessment Use the information that you gathered in Appendix E and identify where you have found BUSINESS RISKS while reviewing the business functions and their IT capabilities. Identify at least 10 business risks and then assess them in terms of how likely they are to occur. Using the risk definitions in Appendix G, first assign a LIKELIHOOD score to the risk. Second, assess how great the impact or consequence would be if the risk occurred and assign a CONSEQUENCE score to the risk. Then use these two numbers to identify the RISK RATING using the risk matrix in Appendix G. Enter the risk rating into the table along with any notes on mitigation strategies that are in place that will help to decrease the likelihood or consequence of the risk. Feel free to record any notes that will help you communicate your evaluations.
Appendix G
RISK DEFINITIONS RISK MATRIX Consequence of Occurence
Likelihood of Occurrence Rating 1 2 3 4 5 Risk Rating
Near Certain (90%) 5 Likelihood of Occurance 5 LOW MEDIUM HIGH HIGH HIGH
Likely (70%) 4 4 LOW MEDIUM MEDIUM HIGH HIGH HIGH
Moderate (50%) 3 3 LOW LOW MEDIUM HIGH HIGH MEDIUM
Unlikely (30%) 2 2 LOW LOW LOW MEDIUM MEDIUM LOW
Rare (10%) 1 1 LOW LOW LOW MEDIUM MEDIUM
Consequence of Occurrence Rating
Catastrophic (Project extended or risk of being cancelled) 5
Major (Delays of up to 50% of schedule or increase of up to 50% of cost) 4
Moderate (reduction to performance has moderate impact on performance objectives) 3
Minor (reduction in performance can be tolerated with little impact) 2
Insignificant (minimal to no impact to performance or schedule) 1
Instructions for Appendix G: Risk Matrix The risk matrix above provides a way to assign a risk rating by considering both likelihood and consequence .
Appendix H
Emerging Technology Assessment Template
Opportunities / Benefits Emerging Technology 1 Emerging Technology 2
Improves efficiency High Low
Improves competitiveness
Improves customer satisfaction Medium
Increases market segment
Employee benefits Medium
Eliminates obsolete system
Standardizes processes across business units Medium
Provides shared information to departments
….others
Concerns/Risks
Ease of Use Low
Cost (upfront) Medium
Cost (ongoing) Low
Training Low
Maturity Medium
Security High
Interoperability Low
….others
Instructions for Appendix H: Emerging Technology Assessment Template For the Emerging Technology template, assess the opportunities and benefits you see for your organization based on the information you found for two new technologies. Some categories to consider when evaluating the benefits are provided although you may add others to the list. If the technology you are considering does not provide that opportunity you can write in N/A for not applicable. Also note the concerns or risks of implementing this technology in your organization. Think of these concerns specific to your organization and what might hold your organization back from seriously considering your recommendations.
Appendix I
Implementation Plan for Emergent Technology 1
What’s the plan? What needs to be done? Who is responsible for managing this piece? What is length of overall task?
Staffing Changes
Facility Changes
Training Required
Life cycle support strategy
Procurement method
Overall Schedule/timeframe
Initial Cost
Operating Cost
Implementation Plan for Emergent Technology 2
What’s the plan? What needs to be done? Who is responsible for managing this piece? What is length of overall task?
Staffing Changes
Facility Changes
Training Required
Life cycle support strategy
Procurement method
Overall Schedule/timeframe
Initial Cost
Operating Cost
Instructions for Implementation Plan for Emerging Technologies Both implementation plans should capture the major considerations and factors regarding implementation of the new technology in your organization. This is where you present the overall idea of the new technology and at a very high level, you address how, when, how much, and by whom, in regards to the implementation in your organization. You will need to fill out the template for each of the two emerging technologies you chose.