Monthly Archives: April 2017
Case study Assignment: Improving Public Health Informatics
Consider the following business case study on Improving Public Health Informatics. As a competent project
manager working for a consulting company, the Program manager has called you in for advice on the current
project communication plan. Please bear in mind that you are acting independently, and as an experienced
PM write a report on the following points:
1. Report your assessment of the current project communication plan.
2. Compare your assessment with sound project management practices.
3. Recommend a communication plan for future project involving stakeholders from different
sectors
4. Justify your recommendation
Case Study: Improving Public Health Informatics
An economic analysis of an article
You are required to produce an essay on “An economic analysis of an article.”
There are three articles available on GA503/MA503 Moodle shell in the folder
named “Articles for the Individual Assignment”
Select one of the articles.
Critically analyse the article you have chosen using the microeconomics
concepts you have learnt in weeks 1- 4 and produce your economic analysis in
the form of an essay.
You are required to use appropriate economics terminology, concepts, models
and diagrams.
You are expected to carry out further research.
Consider the following structure and marking breakdown for you essay.
Prepared by Indika Karunanayake, GA503 Unit Coordinator 2
Cover page: (2 marks)
Attach a cover page from word and provide the following information.
o Student name and ID
o Unit code and name
o Assignment name
o Assignment due date
o Lecturer name
o Campus
Paragraph 1: (7 marks)
Provide an introduction for your essay
Paragraph 2: (10 marks)
Provide a demand and supply analysis.
For your analysis consider the following points.
o Identify the market.
o Identify and discuss the effect of any factors discussed in the
article related to the market you have identified that affect
either shift in demand curve or supply curve or both curves.
o Discuss the effect of each of the factors you have identified
above on the initial equilibrium.
Paragraph 3: (10 marks)
Price elasticity of demand analysis.
o Assume the price elasticity of demand for the market.
o Discuss the consequence on the revenue of the above market
when the price of the product changes.
Paragraph 4: (10 marks)
Externality analysis.
o Identify any externality related to the market and discuss the
effect of the externality on the market.
o Provide suggestions to promote the positive externality
and/or to reduce the negative externality if you have
identified.
paragraph 5: (7 marks)
Provide a summary for your essay
Topic: Week 2 Discussion – Traits and behaviors
Order Description
Traits and Behaviors
According to recent research discussed in Daft (2015, p. 55), different traits and behavioral styles are better suited to different types of leadership roles.
• Identify one or more key traits and behavioral styles needed for one (1) of the following leadership roles: operational, collaborative or advisory.
• Is a leader’s style fixed or can leaders successfully move among these roles? Support your response with an example.
Required Text: Daft, R. L. (2015). The Leadership experience (6th ed.). Mason, OH: SouthWestern. ISBN: 978-1435462854
Topic: Review Task
Order Description
review your partner’s new paragraph from the Paragraph Task and offer constructive
feedback for revision
In reviewing your partner’s paragraph, you should consider the following with regards
to their chosen rhetorical situation for the new paragraph:
• Paragraph type and structure
• Sentence variety, order, and structure
• Use of rhetorical appeals
• Incorporation of research
• Grammar and punctuation
• Tone and voice
• Word choice, including use of jargon and definitions
• Flow and transition
You will then reflect on the peer review process, including:
• How your application of style and method considers the rhetorical situation of a
peer review
• The strategies, techniques, and/or resources you have used to provide feedback to
your partner
• Your experience with the peer review process
Topic: A reflective essay
Order Description
Must be completed in 2200-2500 words (excluding the reference list) and is worth 60 marks.
The Assessment 2 paper should predominantly be written in narrative form but you may prefer to list specific
learning goals and objectives.
The word limits show the minimum and maximum word count (excluding the reference list). Each 100
words or part thereof beyond the upper or lower limit will incur a 5% (3 marks) penalty.
In Assessment 2, you are asked to develop an academic paper that demonstrates how you will draw on your strengths and capabilities to successfully progress from being a student nurse to a graduate nurse.
Your written work in Assessment 2 will provide you with a basis for updating or enhancing your own Professional Portfolio, such as in relation to critical reflections on and self-assessment of your professional practice, and undertaking continuing professional development.
You will need to critically reflect on how you will address and manage up to six (6) key challenges that you are likely to encounter in transitioning to graduate practice. In particular, you are asked to describe how you intend to address and manage the key challenges you are likely to experience in relation to:
a. Applying for a position as a Registered Nurse, including attending and succeeding in a job interview
b. Successfully completing your first 6 months of practice as a first year Registered Nurse.
While a scholarly work is expected, this assessment is substantially reflective, so the appropriate use of the first person is acceptable. Ensure your paper commences with a suitable introduction and ends with a suitable conclusion.
The following general guidelines for the presentation of the written papers must be observed.
Presentation:
•?Use Word (.doc or .docx format) – do not submit in PDF
•?A Times New Roman font size ‘12’
•?Double line spacing on A4 clear paper
•?A left margin of 2.5 cm on each page
•?All pages need to include a footer with your Student ID number and the page number.
Structure:
•?Presented professionally in an academic style
•?The paper must be expressed clearly and succinctly with correct grammatical expression and spelling
•?Use a variety of credible sources to support the discussion, analysis and debate (it is expected that
students use database searches to obtain recent, refereed manuscripts)
•?Adhere to the presentation requirements described specifically for each assessment activity
•?APA (6th ed.) referencing style must be used.
Topic: Assessing the SWOT of the Peer to Peer(P2P) lending industry, An economic perspective
Order Description
Assessing the Strength, Weaknesses, Opportunities and Threats of the Peer-¬to-Peer (P2P) lending industry, An economic perspective.
I.finance is newly created fintech company looking to expand its operations. To aid its expansion it is seeking a suitably qualified organisation to provide an economic appraisal of the industry. In particular, it is seeking information regarding:
? Evidence of segmentation of the P2P sector in Australia
? Degree of Market competition by segment of the P2P sector in Australia.
Your task:
The report must not exceed 900 words.
Hints:
? Begin by summarising the main points from each topic.
? Be sure that you have clearly demonstrated each of these main points.
? Ensure your quote/report has a professional look.
? Consider using IBIS world reports.
? Search key terms on Google as well as Google Scholar.
Topic: Defensive Developmentalism
Order Description
Discuss your understanding of why defensive developmentalism, as practiced by the Ottoman Empire, Egypt, and Persia was unsuccessful? Could these three Middle Eastern nations have done anything different to make it work? Explain.
Topic: Arnold, R. Douglass. 1990. The Logic of Congressional Action. Yale University Press.
Order Description
Arnold, R. Douglass. 1990. The Logic of Congressional Action. Yale University Press.
My paper needs to be 5 pages long. I have attached the rubric.
Book reviews should not only tell what a book is about, but also whether it achieves the goals that the author presents. In this way a book review goes beyond the scope of a typical book report and provides a critical reaction to the book in addition to a summary. Book reviews should include a short introduction, summary of the book’s content (about three-four pages), and an evaluation of the book (two-four pages). The evaluation section should describe the major presuppositions and implications of the book as well as the strengths and weaknesses of the author’s argument.
Topic: environmental policies
Order Description
if you were in charge of our nation’s environmental policies, would you implement all of the principles of deep ecology? Or just some of them?Other regulations fall on industry for air pollution or waste generated. Automobiles are a good example of regulating big industry. There is a minimum miles per gallon each vehicle has to achieve.
Topic: Drug abuse and failure of acute drug intervention
Order Description
his manuscript is an interesting case report, but should be revised.
1. There is not the paragraph of introduction
2. You have to revise the manuscript for english language and you have to use the scientific medical terms in the case summary
3. Recently clinical study reported the benefits of CT angiography/CT perfusion imaging in cases of drug abuse like cocaine. This type of imaging differentiates multifocal vasospasm-induced hy- poperfusion/ischemia from focal thromboembolic ischemia/infarct, allowing for appropriate medical management in the crucial hyperacute time period (see Mehta SV, Gluncic V, Iqbal SM, Frank J, Ansari SA. Role of perfusion imaging in differentiating multifocal vasospasm-related ischemia versus thromboembolic stroke in a setting of cocaine abuse. J Stroke Cerebrovascular Diseases : Official J Natl Stroke Association. 2012; 21(8): 904 e3-6 and Siniscalchi A, Bonci A, Mercuri NB, De Siena A, De Sarro G, Malferrari G, Diana M, Gallelli L. Cocaine dependence and stroke: pathogenesis and management Curr Neurovasc Res. 2015;12(2):163-72). The authors need to discuss this point
4. There is insufficient evidence to evaluate the clinical utility of screening tests for drug abuse in primary care settings, including toxicology tests of blood or urine, or the use of standardized questionnaires to screen for drug use or misuse. However, it is reasonable to screen young patients, particularly men, for drug use when they present with cryptogenic stroke, please discuss and add this point in the discussion.
5. Caution should be exercised before using thrombolytic agents in patients drug abuse users due to the higher risk of intracranial bleeding (Siniscalchi A, Sztajzel R, Bonci A, Malferrari G, De Sarro G, Gallelli L. Editorial: Cocaine and Cerebral Small Vessel: Is it a Negative Factor for Intravenous Thrombolysis? Curr Vasc Pharmacol. 2016 Feb 4. [Epub ahead of print])
This is the article Drug abuse and failure of acute stroke intervention
Faisal Al-Abbas, Aisha Aldowaihi, Hala Abdulhadi, Hosam Al-Jehani
Corresponding Author:
Acute stroke interventional therapy is becoming increasingly utilized in acute ischemic cerebrovascular accidents. This is boosted by the recent line of evidence via several well-conducted prospective randomized collectively showing a significant improvement in outcomes without a major therapy-induced morbidity or mortality.
With the significant and concerning increase in smoking and stroke risk factors in a relatively younger adults, the utilization of such effective therapies becomes of paramount importance.
Several factors have been described as to the reason for failure of acute stroke intervention. They could be patient related, clot related, or material related. We describe a patient in whom the failure of thrombectomy was related to drug abuse induced vasospasm resulting in middle cerebral artery occlusion.
Case summary:
32 year old otherwise healthy male presented to our emergency department at 10:00AM with acute onset of left sided weakness that started about an hour earlier. He was confused and had a smell of alcohol and was found to have dense hemipligea involving the face with a visual field cut. NIHSS was calculated as .16…. Denoting a large stroke. Code stroke was activated an the patient was found to have a right dense MCA sign on computerized tomography with no evidence of hemorrhage (figure). No contraindications to IV t-PA was found so the patient started receiving the bolts at 11:15 AM.
The patient was monitored for 30 minutes, and since there was no improvement in his deficits, he was shifted to the Angio suite around 12:00 PM.
The initial run of the right MCA showed M1 occlusion with no collateralized flow from ACA nor PCA. In addition, a wide-neck 3mm aneurysm was found in the Pcom with somewhat irregular wall. Accordingly, we deferred the use of IA-tPA in fear of hemorrhagic complications and the approach was for mechanical treatment. We deployed revive stent (Codman Jhinson and Johnson) through a 5F distal access catheter (Sophia). We perform 2 passes wth the stent retrieval, 7-minute each, yielding good size clots each time (figure). At this stage, we opted for mechanical distrubtion by the distal access catheter using wire disruption and suction. Consequently, a third and final pass with the stent retriever was done, with the distal tip of the stent well into the origin of M2. Clots were also retrieved but no recanalization was achieved. At this stage, we shifted our attention to the aneurysm, but as were preparing the patient became more confused and agitated, with unexplained hemodynamics instability for which he was incubated, and stabilized and shifts to the intensive care unit. A repeat CT was obtained showing no interval changes from the initial one. Shortly after arrival to the ICU, the toxicology screen revealed alcohol, cannabis and amphetamine intoxication. That was, at least in part, the explanation for the so the patient was started on milrinome as a vasodilator therapy for the vasospasm. The patient was started also on withdrawal measures by our psychiatry colleagues. He regained a grade 3/5 in his upper limb and 4/5 in his lower limb and was discharged to rehab as well as with close follow up with addiction medicine.
Discussion:
Acute ischemic stroke is a devastating life altering event. The approved use IV t-PA in 1995 revolutionized therapy(1), yet proved ineffective in the face of major vessel occlusion and some stubborn fibrin clots. The expanded time for IV t-PA and IA t-PA pushed the field forward. The introduction of interventional therapy with clot aspiration and mechanical disruption and most recently mechanical stent retrieval revolutionized ischemic stroke care.
This could not come at a better time as we face younger patients with ischemic strokes than previously perceived owing to more prevalence of stroke risk factors especially smoking among teenagers and young adults from both genders.
Substance abuse have been described for many years as a direct source of multitude of vascular deraingements affecting the proper functioning of the cerebrovascular units in defferant form might produce strokes by direct effects on the cerebral circulation, including elevated blood pressure, vasculitis, and cerebral vasospasm(2) (Table1)(3). This could lead to either ischemic or hemorrhagic strokes or both. In any type in manifests with, these patients pose a multi-tiered risk to the health care process.
The team needs to be notified as early as possible for contact precautions and sharps handling or invasive procedures performed on or around the patient. Specific substances require special regimens and could be reversed if known to improve the overall homeostasis of the patient. The after stroke care would potentially be complicated if the patient suffers a withdrawal and this becomes a delicate balance between the need for monitoring in a neurocritical care/stroke unit versus in a psychiatry ward in case the patients become agitated and combative posing risk of bodily harm to themselves, near by patients, and caring team.
Our patients was positive for alcohol, cannabis and amphetamine. These could have contributed to.presentation and progression The vasospasm observed on the angiogram could have potentially been treated with an intra-arterial vasodilator therapy in conjunction with mechanical thrombectomy. Further more, the procedure induced vasospasm could potentially be amileorated by using arterial dilators, although this is yet to be proven.
the identification of the intoxication promted a change of theraputic strategy towards the releive of vasospasm by the use of the MNH protocol(4) to booset the collaterals and minimize the size of the final infarction. that emphazise the need for maintining a reasonable index of suspecion in such patients to avoid missing their inciting factors in a way that will lead to significant potenitally reversible addd morbidity and in some case mortality.
comprehensive care model will dictate that an added layer of after care must be provided to these patients. After the acute care is concluded and besides the stroke secondary prevention protocols, these patients need significant and structured counselling in order to prevent another catastrophe in the future, affecting or ending the lives of these mostly young and productive members of society.in addition, vascular monitoring modalities are important such in our ptient in whom a 3 mm aneurysm is found “incidentally”. These should be monitored closly especially when the patient is at high risk for relapse or noncompliance with thesubstance abuse rehab.
in conclusion, Vasospasm induced MCA occlusion must be identified in a timly fashion to provide procedural and peri-procedural adjuncts to stroke therpay that will improve their outcome of the acute event and improve their outlook into the future.
SO AS implication
1- Young adult presented e stroke symptom we need to rule out drug abuse clinically and laboratory.
2- Take in consideration of the systematic effect of drug abuse on management mainly the cardiopulmonary effect
3- Addimg on routine workup of these cases MRA and black vessel imaging for identify the thrombus, vasospasm and vasculitis
4- Bypass the iv-tpa and going direct for angiosuite for thrombectomy and vasospasm management
5- Consider general anesthesia and intubation for these procedure
6- Using vascular dilator (nimodipine) e saline for all cases
Reference
1-Hacke W, Kaste M, Fieschi C, Toni D, Lesaffre E, von Kummer R, et al. Intravenous thrombolysis with recombinant tissue plasminogen activator for acute hemispheric stroke. The European Cooperative Acute Stroke Study (ECASS). JAMA. 1995 Oct 4. 274(13):1017-25
2- http://archpsyc.jamanetwork.com/article.aspx?articleid=210017&resultclick=1
3- Benita Tamrazi, MD, and Jeevak Almast, MD Your Brain on Drugs: Imaging of Drug-related Changes in the Central Nervous System May-June 2012 Volume 32, Issue 3
4-Tarabini Fraticelli et al Milrinone for Vasopasm After Subarachnoid Hemorrhage ???????