Nursing Paper Example on Pneumonia [SOLVED]

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Nursing Paper Example on Pneumonia [SOLVED]

Pneumonia, a pervasive respiratory infection, exacts a substantial toll on global health each year. Its prevalence and potential for severe complications underscore the importance of comprehensive understanding and effective management. This paper endeavors to unravel the intricacies of pneumonia, delving into its diverse array of causes, intricate symptomatology, underlying etiology, pathophysiological mechanisms, diagnostic criteria according to the DSM-5, and contemporary treatment modalities. By illuminating the nuances of this ailment, healthcare professionals can better navigate its complexities, offering timely interventions and personalized care to afflicted individuals. Through heightened awareness, evidence-based practices, and patient-centered education, we can collectively combat pneumonia’s impact, striving towards improved outcomes and reduced morbidity in our communities. (Nursing Paper Example on Pneumonia [SOLVED])

Nursing Paper Example on Pneumonia [SOLVED]

Causes

Pneumonia, a multifaceted respiratory infection, stems from a variety of causative factors, ranging from microbial pathogens to environmental exposures. Bacterial pneumonia, often instigated by Streptococcus pneumoniae, Haemophilus influenzae, or Mycoplasma pneumoniae, constitutes a prevalent subset of cases. These bacteria can infiltrate the lower respiratory tract, leading to localized inflammation and alveolar damage. Similarly, viral pneumonia, triggered by pathogens like respiratory syncytial virus (RSV) or influenza viruses, poses a significant health threat, particularly during seasonal outbreaks.

Additionally, fungal pneumonia, commonly associated with organisms such as Pneumocystis jirovecii in immunocompromised individuals, presents unique challenges in diagnosis and management. Furthermore, aspiration pneumonia arises from the inhalation of foreign substances, including gastric contents or chemical irritants, into the lungs. This condition is frequently observed in individuals with compromised airway protection mechanisms, such as the elderly or those with neurologic impairments.

Environmental factors also play a pivotal role in pneumonia development, with air pollution, overcrowded living conditions, and exposure to tobacco smoke exacerbating respiratory infections. These environmental stressors can compromise respiratory defenses, increase susceptibility to microbial invasion, and exacerbate pulmonary inflammation. Moreover, underlying medical conditions, such as chronic obstructive pulmonary disease (COPD), asthma, or immunodeficiency states, heighten the risk of pneumonia occurrence.

Understanding the diverse array of pneumonia causes is paramount for clinicians in implementing targeted preventive measures and tailored treatment strategies. By addressing both microbial and environmental contributors, healthcare providers can mitigate the burden of pneumonia and enhance respiratory health outcomes for individuals and communities alike. (Nursing Paper Example on Pneumonia [SOLVED])

Signs and Symptoms

Recognizing the signs and symptoms of pneumonia is crucial for timely diagnosis and intervention. While presentation may vary, common manifestations often include fever, cough, and chest pain. Patients may experience a productive cough, producing sputum that can range from clear to yellow or green in color.

Dyspnea, or difficulty breathing, is another hallmark symptom, often accompanied by rapid, shallow respirations. Auscultation of the chest may reveal crackles or wheezes, indicative of underlying lung pathology. Additionally, patients may exhibit systemic symptoms such as fatigue, malaise, and loss of appetite.

In severe cases, pneumonia can lead to cyanosis, a bluish discoloration of the skin and mucous membranes, due to impaired oxygenation. Furthermore, elderly individuals or those with compromised immune systems may present with altered mental status or confusion, highlighting the systemic impact of the infection.

Physical examination findings may include increased tactile fremitus and dullness to percussion over affected lung areas. In children, pneumonia can manifest differently, with symptoms such as grunting, nasal flaring, and retractions indicating respiratory distress.

Complications of pneumonia can arise, particularly in vulnerable populations or when treatment is delayed. These may include pleural effusion, lung abscess formation, or septicemia. Therefore, prompt recognition and management of pneumonia symptoms are paramount to prevent disease progression and mitigate potential complications.

Heightened awareness among healthcare providers and the public regarding the varied presentations of pneumonia can facilitate early detection and intervention, ultimately improving patient outcomes and reducing morbidity associated with this common respiratory infection. (Nursing Paper Example on Pneumonia [SOLVED])

Etiology

The etiology of pneumonia encompasses a complex interplay of host factors, microbial pathogens, and environmental influences. Host susceptibility plays a pivotal role, with certain populations at increased risk of infection. Individuals with underlying medical conditions such as chronic obstructive pulmonary disease (COPD), asthma, or immunodeficiency states are more vulnerable to pneumonia.

Age also influences susceptibility, with extremes of age—infants, elderly individuals, and those with weakened immune systems—being particularly prone to infection. Environmental factors contribute significantly to pneumonia incidence, with exposure to air pollution, tobacco smoke, or overcrowded living conditions increasing the risk of respiratory infections.

Microbial pathogens are diverse and can include bacteria, viruses, fungi, and other microorganisms. Streptococcus pneumoniae remains the leading cause of bacterial pneumonia, while other common bacterial culprits include Haemophilus influenzae and Mycoplasma pneumoniae. Viral pneumonia is often triggered by respiratory viruses such as influenza virus, respiratory syncytial virus (RSV), or adenovirus.

In immunocompromised individuals, opportunistic pathogens like Pneumocystis jirovecii or cytomegalovirus (CMV) may cause pneumonia. Aspiration pneumonia results from the inhalation of foreign substances, including oral or gastric contents, into the lungs. This can occur in individuals with impaired swallowing mechanisms, such as stroke patients or those with neuromuscular disorders.

Understanding the multifactorial etiology of pneumonia is crucial for implementing targeted preventive measures and optimizing treatment strategies. Vaccination against common pathogens, smoking cessation interventions, and environmental modifications to reduce exposure to respiratory irritants are essential preventive measures. By addressing both host susceptibility and environmental factors, healthcare providers can effectively reduce the burden of pneumonia and improve respiratory health outcomes for individuals and communities. (Nursing Paper Example on Pneumonia [SOLVED])

Pathophysiology

The pathophysiology of pneumonia involves a cascade of events triggered by the invasion of microbial pathogens into the lower respiratory tract. Initially, the entry of bacteria, viruses, or fungi into the alveoli initiates an inflammatory response aimed at containing and eliminating the invading microorganisms.

This inflammatory cascade leads to the activation of immune cells, including neutrophils, macrophages, and lymphocytes, which migrate to the site of infection. These immune cells release pro-inflammatory cytokines and chemokines, amplifying the inflammatory response and recruiting additional immune cells to the infected area.

As the infection progresses, the alveolar epithelium becomes damaged, compromising the integrity of the alveolar-capillary barrier. This disruption allows for the leakage of fluid and proteins into the alveolar spaces, contributing to pulmonary consolidation and impaired gas exchange.

Nursing Paper Example on Pneumonia [SOLVED]

Furthermore, the accumulation of inflammatory exudate within the alveoli leads to the formation of consolidated lung tissue, characteristic of pneumonia. This consolidation is often visualized on chest imaging studies such as chest X-rays or computed tomography (CT) scans.

In severe cases, the inflammatory response can extend beyond the alveoli, affecting the surrounding lung parenchyma and leading to interstitial inflammation and fibrosis. Additionally, the release of inflammatory mediators into the systemic circulation can result in systemic manifestations such as fever, malaise, and sepsis.

The pathophysiology of pneumonia culminates in impaired gas exchange, respiratory compromise, and potential complications such as pleural effusion or lung abscess formation. Understanding the intricate interplay between microbial pathogens and host immune responses is essential for guiding therapeutic interventions and improving outcomes in patients with pneumonia. (Nursing Paper Example on Pneumonia [SOLVED])

DSM-5 Diagnosis

Diagnosing pneumonia relies on a combination of clinical evaluation, radiological findings, and laboratory testing, with the DSM-5 criteria providing a standardized framework for classification and diagnosis. According to DSM-5, pneumonia is categorized under the broader classification of respiratory tract infections.

Key diagnostic criteria include the presence of respiratory symptoms such as cough, dyspnea, and chest pain, along with evidence of pulmonary infiltrates on chest imaging studies such as chest X-rays or computed tomography (CT) scans. These infiltrates typically manifest as areas of opacity or consolidation within the lung parenchyma.

Physical examination findings, including auscultatory abnormalities such as crackles or decreased breath sounds, may further support the diagnosis of pneumonia. Additionally, laboratory tests such as complete blood count (CBC) with differential and inflammatory markers like C-reactive protein (CRP) or procalcitonin may aid in assessing the severity and inflammatory response associated with pneumonia.

Microbiological investigations, including sputum culture and sensitivity testing or respiratory pathogen molecular assays, can help identify the underlying etiology of pneumonia and guide targeted antimicrobial therapy. Culturing respiratory specimens allows for the isolation and identification of specific bacterial, viral, or fungal pathogens responsible for the infection.

Furthermore, the DSM-5 emphasizes the importance of considering comorbidities and risk factors that may predispose individuals to pneumonia, such as age, immunocompromised state, or chronic medical conditions like diabetes or heart disease. By integrating clinical, radiological, and laboratory findings within the DSM-5 diagnostic framework, healthcare providers can accurately identify and classify cases of pneumonia, facilitating appropriate management and treatment decisions. (Nursing Paper Example on Pneumonia [SOLVED])

Treatment Regimens and Patient Education

Effective management of pneumonia involves a multifaceted approach aimed at eradicating the underlying infection, alleviating symptoms, and preventing complications. Treatment regimens are tailored based on the suspected or confirmed etiology of pneumonia, severity of illness, and individual patient factors.

For bacterial pneumonia, antibiotics are the mainstay of treatment, with empiric therapy initiated promptly pending culture results. Commonly used antibiotics include macrolides, fluoroquinolones, or beta-lactam antibiotics such as amoxicillin-clavulanate or cephalosporins. The choice of antibiotic is guided by factors such as local antimicrobial resistance patterns, patient allergies, and comorbidities.

In cases of viral pneumonia, supportive care is emphasized, including rest, hydration, and symptomatic relief with antipyretics or analgesics. Antiviral medications may be indicated for specific viral pathogens such as influenza virus or respiratory syncytial virus (RSV), particularly in high-risk individuals or during seasonal outbreaks.

Supplemental oxygen therapy may be necessary for patients with hypoxemia, ensuring adequate tissue oxygenation. Non-invasive ventilation methods such as continuous positive airway pressure (CPAP) or bilevel positive airway pressure (BiPAP) may be utilized in select cases to improve oxygenation and alleviate respiratory distress.

Patient education plays a crucial role in pneumonia management, empowering individuals to actively participate in their care and optimize treatment outcomes. Patients should be educated on the importance of completing prescribed antibiotics as directed, even if symptoms improve, to prevent bacterial resistance and treatment failure.

Additionally, patients should be counseled on the significance of adequate hydration, rest, and nutrition to support the immune system and facilitate recovery. Smoking cessation interventions should be offered to smokers, as tobacco smoke can exacerbate respiratory symptoms and delay healing.

Moreover, patients should be educated on the warning signs of worsening pneumonia, including persistent fever, increasing dyspnea, or worsening cough, prompting prompt medical evaluation. Follow-up appointments should be scheduled to monitor treatment response, ensure resolution of symptoms, and address any lingering concerns or complications.

By incorporating patient education into pneumonia management protocols, healthcare providers can enhance treatment adherence, promote self-care practices, and reduce the risk of recurrent infections or complications, ultimately improving patient outcomes and quality of life. (Nursing Paper Example on Pneumonia [SOLVED])

Conclusion

Pneumonia presents a multifaceted challenge, requiring a nuanced understanding of its diverse causes, intricate symptomatology, and optimal treatment approaches. Through an exploration of pneumonia’s etiology, pathophysiology, DSM-5 diagnosis criteria, treatment regimens, and patient education strategies, this paper has shed light on key aspects of pneumonia management. By emphasizing early recognition, appropriate antimicrobial therapy, and supportive care interventions, healthcare providers can effectively mitigate the burden of pneumonia and improve patient outcomes. Moreover, integrating patient education into treatment plans empowers individuals to actively participate in their care, promoting treatment adherence and fostering a conducive environment for recovery. As we continue to unravel the complexities of pneumonia and refine our management strategies, a comprehensive and patient-centered approach remains paramount in addressing this common yet significant respiratory infection. (Nursing Paper Example on Pneumonia [SOLVED])

References

https://www.ncbi.nlm.nih.gov/books/NBK526116/

 
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Network Architecture Security Plan Proposal 2

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Network Architecture Security Plan Proposal 2

(Network Architecture Security Plan Proposal 2)

Table of Contents

Network Architecture Security Plan Proposal 3

Section 1 Introduction. 3

Section 2: Network Architecture. 6

The Network Architecture for JPMorgan Chase & Co. 6

Physical Structures, Major Types of Hardware Used to Connect Computers and Networks Together, and the Way Data Travels Through the Network. 8

Section 3: Managing and Protecting Data. 11

User Access to Computer Resources. 11

Security Profiles. 12

Passwords. 12

Email 13

Internet Access. 13

Antivirus. 14

Backup. 14

System Patches. 15

Remote Access. 15

Intrusion Detection. 15

Section 5: Digital Evidence Controls, Computer Forensic Analysis, and Recovering Files. 16

Preserving Information for Forensic Analysis. 16

Digital Evidence Controls. 17

Computer Forensic Tools for Forensic Analysis and File Recovery. 18

Section 6: Recommendations for Best Practices. 19

Recommendations For Best Practices. 19

Why the Proposal Should be Accepted as Best Practices for the Organization. 21

References. 22

Network Architecture Security Plan Proposal

Section 1: Introduction

Cyber threat protection for any business and its data is a challenging task requiring expertise and well-managed resources. Businesses need a thorough security plan outlining how to protect their network from online threats. Also, the company’s end users want guidance on effectively using mobile platforms, email, the internet, and other network components. However, this approach should not conflict with the business model and should be relatively easy for the personnel to implement (Xu et al., 2022). The network security plan is a strategy that outlines the techniques and policies that will be used to protect the network from unauthorized users and counteract actions that could jeopardize or compromise a system’s security.

Banks are vulnerable to cyber-attacks and require robust network architecture security plans to protect client data and the valuables entrusted to them. JPMorgan Chase collects personal information when clients or customers visit their premises or use their online services, including names, email addresses, mailing addresses, telephone numbers, account numbers, location information, such as zip code, and user name and password for online services. When more personal information is needed for ordinary business purposes, JPMC also collects payment card information, Social Security numbers, driver’s license numbers, and gender, race, nationality, and biometric data (JPMorgan, 2018). The organization also creates personal information for clients in some circumstances, including recordings of customer interactions and account details. Additional information JPMC collects includes device IP address when using online services, operating system and browser type, and information on sites visited and those to be called. (Network Architecture Security Plan Proposal 2)

Network Architecture Security Plan Proposal 2

Moreover, JPMC uses customer data regarding social media usage and credit reporting agencies (JPMorgan, 2018). Often cyber-attacks target this information to access consumer bank accounts and other money storage or transfer avenues. Personal information on location, name, and gender can also be used for malice, including targeted attacks on individuals or stalking. This sensitive information needs protection from unauthorized access, loss, or misuse.

This paper seeks to analyze JPMorgan Chase’s network architecture and develop a network security plan proposal that can help the organization further protect public data from security threats. The JPMorgan Chase Institute takes pride in offering insightful information to decision-makers in government, business, and charitable organizations (JPMorgan Chase & Co, 2022). These disclosures, however, must not come at the expense of client or customer confidentiality. To achieve this, the Institute has implemented stringent security procedures and checks and balances to guarantee that all consumer data remains private and secure (JPMorgan Chase & Co, 2022). Government agencies use of statistical standards and JPMorgan Chase’s collaboration with technology, data privacy, and security specialists who are assisting the enterprise in upholding industry-leading standards have all influenced these measures.

Currently, the enterprise adopts measures as a further commitment to protect public data and ensure privacy and confidentiality, including the Institute’s standards and procedures that mandate that any data it collects and uses for various purposes not contain any personal information about clients. Before accessing client data, the Institute also makes its researchers and employees submit to thorough background investigations and sign binding confidentiality agreements (JPMorgan Chase & Co, 2022). Employees are legally obligated to only utilize the data for authorized purposes and not try to re-identify any clients or individuals reflected in the data. Any publishing derived from Institute data is required only to include aggregate data or data that is not otherwise not reasonably traceable to a specific, identified consumer or business. The information that the JPMC and its staff rely on is kept on a secure server that is only accessible per stringent security guidelines intended to prevent the transfer of information outside of JPMorgan Chase’s systems (JPMorgan Chase & Co, 2022). All JPMorgan Chase Information Technology Risk Management specifications for data monitoring and security are met by its data infrastructure. (Network Architecture Security Plan Proposal 2)

The security plan proposal offers insights into strategies and procedures JPMC can adopt to reinforce or ensure better data protection and promote customer privacy and confidentiality due to the growing hacker threat probing organization networks. The plan seeks to help the enterprise to protect the network infrastructure from unauthorized access, data misuse, destruction, and damaged corporate reputation. The plan will offer recommendations to the enterprise for dealing with suppliers and dependent subcontractors and their access to information classification to ensure data protection. It will also advise additional measures for data protection, data encryption to protect data in transit, authentication approaches, protection policy, digital signatures, random number generation, hash functions, and key and certificate lifecycle management.

Moreover, it will offer procedures for data protection policy review and cookie management procedures that should comply with applicable laws and regulations. Furthermore, the security plan proposal will include recommendations on identity and access management, security configuration procedures, security operations, vulnerability management, and third-party relationship management and access protocols. Generally, this paper aims to describe the JPMC network architecture and offer a plan for managing and protecting data, risk assessment, digital evidence controls, computer forensic analysis, and recovering files, and provide recommendations for best practices.

Section 2: Network Architecture

The Network Architecture for JPMorgan Chase & Co.

JPMorgan Chase & Co is a financial institution in the US in the consumer or commercial banking category. It offers financial services and advice to millions of people and maintains a wide variety of consumer data that needs protection from unauthorized access or illegal use. The bank adopts the client-server network architecture in which people can access information stored in its server via various platforms, including its website and other online services. This architecture allows individuals to access shared files and information, which are centralized, with a backup, from their serving machines like mobile devices and computers, which include the teller computers (Sugandhi, 2023). More than one client has access to resources and services, and there are different servers, including mail, web, and file servers. The client-server relationship is one-to-many because multiple clients can access the services and resources at go. The JPMorgan Chase & Co bank has moved into an almost entirely digital locale, and most clients or users access its resources and information remotely.

Considering the bank serves thousands of customers daily requesting different services and constantly trying to access information and bank services at high speeds through their virtual devices, client-server has been the heart of its banking system because it works effectively and makes it easy to manage information and service delivery centrally. With this architecture, the bank keeps a centralized record of all the information needs, including account information, that can be accessed at the banking center by a teller or from remote devices. Generally, an account holder can check balances, withdraw money, or deposit money. Additional services include financial advice, questing for a loan, servicing a loan, or asking for bank statements. JPMorgan Chase & Co bank network architecture is vast, with multiple serves and databases at the center of the architecture, providing additional functionality to its customers. According to (Sugandhi, 2023), this centralization allows consumers to access resources and services without the need to understand how many servers they are communicating with, increasing the possibility of breaking down the architecture to even pore task-particular nodes and elevating the distribution of the application task and processing to ensure greater performance, reliability, and security.

The servers are under strong server standards that guide the core functionality of the client-server relationship, ensuring it is more static, enabling the bank to upgrade by extending the model into future devices not used before, like mobile banking applications, without the need to redesign the architecture. As the industry and the bank mature, this architecture that allows an extension allows the bank to keep up with new customer demands for increased functionality, performance, security, and flexibility of the banking system. Generally, the client-server architecture has seamlessly transitioned the bank into the digital world of virtual services. (Network Architecture Security Plan Proposal 2)

 

Figure 1: Client-server architecture model used by JP Morgan Chase & Co.

Physical Structures, Major Types of Hardware Used to Connect Computers and Networks Together, and the Way Data Travels Through the Network

Different types of hardware connect the computers and the network in the client-server architecture. The three major interrelated components are workstations, servers, and networking devices. Workstations are also client computers or mobile devices with different operating systems, mostly lacking administrative or security policies, a centralized database, or shared software. Servers hold much information and handle multiple requests, having more memory, hard drive space, and faster speeds (Hill et al., 2017). Servers have multiple roles, acting as the domain controller, mail server, file server, and database server, all running simultaneously. These duties are assigned to different servers to maximize performance and simplify maintenance and backup (Hill et al., 2017). Some networking devices connect computers and the network, including hubs that connect a server or centralized servers to many different workstations, repeaters that help transmit data from one device to the next, and bridges that segment isolated networks.

The primary purpose of adopting the client-server architecture is to speed up data transmission and protect data during transfer. It makes the ban faster and more secure regarding data transfers. In most instances, the interaction begins with a client request to the server through the internet, and it is successful when the server accepts the request and returns the information or data packets the client requested (Hill et al., 2017). Generally, a client sends a request to the Domain Name System (DNS) server, which searchers for the specific server and replies with the details, including the IP address of the server to the client, then the browser sends an HTTP(S) request, if the request is through the web, to the server’s IP address (Hill et al., 2017). A successful and accepted request sees the server send the necessary files, and the browser displays them to the client.

 

Figure 2: Network Connectivity of JPMorgan Chase and Co.

JPMorgan Chase & Co has a data mesh architecture that aligns its data technology to its data product strategy. This data mesh architecture is beneficial as the bank adopts cloud services, enabling data sharing across the institutions while allowing data owners more control and visibility of their data, which increases the ability to manage their data effectively (Jain et al., 2022). The significant advantages of the data mesh are the ability to align the data architecture to the data product strategy, empower the right people or data owners to have more control and make control decisions, enforce control decisions via in-place consumption, and offer cross-enterprise visibility of data usage or consumption. The data mesh makes data available in lakes, and individuals can request the lake-based data via a reporting application (Jain et al., 2022). The bank can audit data flows from the lake to the reporting application, increasing visibility or clarity of the origin of the data in the reports. (Network Architecture Security Plan Proposal 2)

Figure 3: JPMC & Co Data Mesh

Section 3: Managing and Protecting Data

Deploying a network security policy is a critical undertaking to prevent security issues on the network. A network security policy provides guidelines for network access, determines policy enforcement, dictates the organization’s network security environment, and provides how security policies are adopted throughout the network architecture (Valenza et al., 017). Security policies are the organization’s security control on various components of the network architecture, keeping malicious individuals from accessing the network and mitigating risky people within the organization. The first or initial provision of network security policy is regarding access to information, including what information and services are available, to whom, and through what means, and the protection needed. A hierarchy of access permissions ensures that individuals at different levels can only access what they need to operate with. The proposal recommends the following policies for managing and protecting data:

User Access to Computer Resources

It is critical to protect organization computing systems and resources by implementing user access security activities and ensuring users have the right to access the information they need to work with. A user access security policy is needed to control user access to computer resources, ensuring that only authorized users can access particular resources. The acceptable use policy (AUP) stipulates the rules, practices, and constraints users must agree with to access the organization’s network, internet, and other resources (Kirvan, 2022). Employees must sign the AUP before being given permission or a network ID. The AUP provides users with instructions on what they can or cannot do when using the organization’s computers, computing infrastructure, and the internet. Moreso, this applies to tellers and other office employees that have been provided individual computers for use within the organization. It spells out acceptable and unacceptable behavior and will offer the organization legal mechanisms to ensure compliance and repercussions for non-compliance.

Security Profiles

A security profile is attributed to an organization’s overall security program, comprising security determined by the organization’s work and the network facilities in place. It dictates the network, log sources, and domains a user can access (IBM, 2023). Individuals at different access levels will have different security profiles; for instance, administrative users will have a default security profile that provides access to all networks, log sources, and domains. The organization will create more security profiles before adding user accounts to help meet specific access user requirements. The security profiles policy will help configure security profiles at run-time to dictate or control security operations completed in a message flow at run-time. The security profiles policy will help determine authentication and authorization on source identities.

Passwords

In a secure network, users need passwords to access network resources. However, the organization must follow the rules regarding passwords or policies it should share with users to dictate password development to ensure a secure and protected network. A password management policy provides the organization’s requirements for acceptable password options and maintenance. The policy guides password creation to maximize password security and minimize password misuse and theft. For this proposal, all passwords should be strong and contain at least eight alphanumeric characters, at least two non-alphabetic characters, and at least three alphabetic characters (Shay et al., 2016). Also, the password should not be a single dictionary, language, slang, dialect, jargon word, or personal information. However, individuals can develop passwords with passphrases that contain three or more dictionary words joined by alphabetic characters. All passwords are private and should not be written or stored online, shared within an email message or any electronic communication, shared with anyone, including other organization personnel, or be the same as those used to access external accounts like online banking. Users should change their passwords at least every six months. Lastly, any passwords suspected of being compromised should be changed promptly. (Network Architecture Security Plan Proposal 2)

Email

Most hackers or malicious users use email conversations to access personal information or have users click on malicious links without suspecting it. An email security policy is needed to govern email use within the organization’s network. The policy provides how the users will interact with email messages to ensure that email messages are secure from unauthorized access (Wilton, 2021). The email security policy requires the organization to use trusted email services like Gmail that include capabilities like regular updates, improved phishing filters, and multi-factor authentication, create effective spam filters, educate users to sport phishing emails and malicious attachments and links, and protect email address by instructing users and employees not to post work email addresses on social media accounts or other public platform and adopt catchall email for customer services and support.

Internet Access

An internet security policy allows the organization to manage internet access and comply with federal, legal, and accreditation rules and requirements on internet and data confidentiality and integrity. The policy dictates that users should not access or use the organization’s internet for personal business, have a valuable purpose for accessing and using the internet, and avoid offensive websites and pornographic content. Additionally, users should not use another individual’s network ID, password, or other identification details to access the internet, establish external network connections, or new network connections to allow communication or unauthorized access to the network without the Security Officer’s approval. Users are also required to avoid transferring identifiable information through the internet.

Antivirus

All users must adhere to the antivirus policy, which requires all users connected to the network or data systems to have antimalware software installed and authorized and qualified IT personnel to conduct a comprehensive analysis of virus threats regularly and evaluate application software for adequacy and sufficiency (Trinity University, 2022). Also, all resources with an antivirus installed need regular updates, and the antivirus selected must scan email, email attachments, web traffic, media, and downloaded files. Infected devices should be disconnected immediately, and the virus should be removed. Users must not install unauthorized software from external networks.

Backup

The backup policy requires all organization data and resources to be backed up as a data protection, disaster recovery, and business continuity plan. The policy also ensures that all organization and user data copies are safe (Savannah State University, 2016). It provides the organization to back up data on the cloud for rapid recovery in case of disruption. The policy dictates what data needs protection, where to store the copies, how often the backup should run, and the time to retain a copy. The policy adopts the 3-2-1 approach that requires the organization to have three backup copies in two locations, one on the cloud and the other in an offsite location. The organization should have an incremental backup that copies the data sets that have changed since the previous backup. (Network Architecture Security Plan Proposal 2)

System Patches

The system patch management policy highlights the processes and approaches that help ensure that hardware and software on the organization’s data are regularly maintained (Jill, 2022). The patching security policy requires patches to be evaluated constantly and responded to promptly, documented and well understood by employees, automated and constantly monitored, and executed according to the vendor tools on a constantly communicated schedule.

Remote Access

Employees and consumers can access data remotely or offsite, which sometimes increases the risk of unauthorized users like hackers and man-in-the-middle accessing the data (Ouaddah et al., 2016). The remote access policy requires individuals accessing the organization’s services remotely, especially employees, to have standardized hardware and software, including firewall and antivirus or antimalware, to adopt data and network encryption standards, use VPN access on network connectivity, and follow information security and confidentiality and email usage policies.

Intrusion Detection

Intrusion detection or prevention and a security monitoring policy are vital in monitoring loggings and observing events to identify security issues and threats. Internet, electronic mail, Local Area Network traffics, and operating system security parameters will be used to monitor intrusions. Intrusion checks will monitor the firewall, automated intrusion detection system, user account, network scanning, system error, application, data backup ad recovery, telephone call, service desk trouble tickets, and network printer logs for any signs of vulnerability (Sam Houston State University, 2022). Every year, the policy requires checking password strengths, unauthorized network devices, unauthorized personal web servers, unsecured sharing of devices, and operating system and software licenses. (Network Architecture Security Plan Proposal 2)

Section 5: Digital Evidence Controls, Computer Forensic Analysis, and Recovering Files

Preserving Information for Forensic Analysis

Digital evidence can be stored and maintained in physical or digital devices. After information collection, it will be moved to physical media for storage and where it can be accessed. The data acquired and the device used for storage are secured until the information is required for forensic analysis. The physical and digital storage systems or a smart management system are integrated to form the evidence management system to be used at the organization. Preservation is required to ensure the legal admissibility of the information stored. The evidence management system will include drive imaging, hash values, and a clear chain of custody (Simon, 2023). Rather than the original information, the company will create images of the evidence that will be used for analysis. The analyst will develop a duplicate of the drive used to store the information to help retain the original evidence for investigation. Investigators can exclusively use the duplicate image rather than the original media.

Hash values will also aid in preserving the evidence or information generated when duplicates or images of the original media are produced. The hash values will help determine the authenticity and integrity of the duplicates as an exact image of the original information. Hash values will help ascertain if the information was altered at any point, which is a vital part of forensic analysis and admitting the evidence in court if necessary (Simon, 2023). Creating new or editing existing files generates new hash values that can only be accessed using special software. The hash values must match the expected values, and if not, they will help confirm that the evidence was altered. A clear chain of custody is vital in digital evidence preservation. The company forensic analyst or investigator will document all media and evidence transfers on the Chain of Custody (CoC) forms and capture signatures and dates after handing off media. The chain-of-custody paperwork will help determine that the image of the digital evidence is or was under known possession from the time the duplicate or image was created (Simon, 2023). A lapse in the chain of custody would allow the company to nullify the legal value or dependability of the image. Generally, the primary purpose of preserving the evidence is to ensure legal admissibility. (Network Architecture Security Plan Proposal 2)

Digital Evidence Controls

JP Morgan Chase works with a cybersecurity forensic investigator whose main role at the company is to watch over the data and find innovative ways to protect the data. Approaches used to control digital evidence include risk reviews and vulnerability analysis that help identify potential threats. The investigator conducts forensic preservation work and preliminary investigations, adopting established standards (JP Morgan Chase Company, n.d.). The investigator also helps identify violations of the JP Morga Chase Code of Conduct and identifies, collects, and preserves the associated digital evidence. The organization, through the investigator, conducts forensically sound collection and analysis of electronic evidence using different tools to enhance security, compliance, and legal processes.

JP Morgan Chase preserves network and host-based digital forensics on Microsoft Windows-based systems and other necessary operating systems like LINUX and adopts standard digital forensic and network monitoring tools to independently plan and carry out forensic support. The organization adopts High-Security Access (HSA) systems for forensic investigations. It conducts an enhanced annual screening of users of the systems, including checking criminal and credit backgrounds (JP Morgan Chase Company, n.d.). Additionally, the organization ensures technology governance, risk, and compliance by regularly validating the effectiveness of the controls, assessing risk annually to ensure the implemented controls can protect the organization’s information, and adopting security policies and procedures to govern receipt, transmission, processing, storage, retrieval, access, and presentation of the information. The principle of least privilege is adopted to grant personnel access to the information. Physical facilities hosting the data are restricted and have detective monitoring controls and controls for hazards like fire and water. (Network Architecture Security Plan Proposal 2)

Computer Forensic Tools for Forensic Analysis and File Recovery

The autopsy/the Sleuth Kit will be used for disk analysis. The tool is recommended for its ease of use, extensibility, speed, and cost-effectiveness. The Sleuth kit is a command-line tool that helps conduct forensic analysis of hard drives and smartphone images. The Autopsy is a GUI-based system using the Sleuth Kit in the background (Kaushik et al., 2020). Its modular and plug-in architecture ensures that the user can easily incorporate additional functionality. Law enforcement agencies and organizations can use this tool to investigate activities or events in a computer, analyze disk images, and recover associated files. The tool can analyze both Windows and LINUX disks. The Volatility tool will also help with memory forensics, incident response, and malware analysis. Often, investigations determine what activities occurred at the time of the incident. Volatility is used to link device, network, file system, and registry artifacts to confirm the list of all running processes, active and closed network connections, running Windows command prompts screenshots and clipboard contents that were in progress at the time of the incident (Mohanta et al., 2020). Investigators will use Volatility to assess processes, check command history, and retrieve files and passwords from the system.

Section 6: Recommendations for Best Practices

Recommendations For Best Practices

The organization must understand the OSI Model, different types of network devices, network defenses, network segregation, proper placement of security devices, network address translation, avoiding disabling personal firewalls, centralized logging, and immediate log analysis as best practices for network security. The organization should comprehend the devices that make up the network in order to build and protect it (Yu et al., 2019). Hubs, switches, routers, bridges, and gateways are the various categories of network devices. Also, the company may protect its network by implementing the right tools and solutions. Firewalls, intrusion detection systems, intrusion prevention systems, network access controls, web filters, proxy servers, anti-DDOS, load balancers, and spam filters are among the most popular and efficient network defenses.

Network segmentation includes dividing the network into zones, which are logical or functional components. For instance, the company might have distinct technical requirements for its sales, technical support, and research zones. It can do this by employing switches, routers, or virtual local area networks (VLANs), which are made by setting up a switch’s ports to act like different networks (Netwrix Corporation, 2022). Segmentation restricts the scope of what could be affected by a compromise to that particular area. In essence, it separates one target into several, giving attackers the option of treating each part as a separate network or compromising one and trying to cross the gap. Neither option is desirable. Since the attacker must breach each section separately, treating each segment as a separate network entail much more work and significantly increases the attacker’s risk of being found. Attempting to jump from a compromised zone to other zones is challenging. The network traffic between the segments can be limited if properly constructed (Netwrix Corporation, 2022). Data classification and data protection also benefit from segmentation. Each segment may be given a different set of data categorization rules, configured to the proper level of security, and after that, monitored.

The company must choose where to put each device as it develops its network segregation strategy. The firewall is the simplest device to install; the company should install a firewall at each network zone intersection (Anwar et al., 2021). A firewall ought to be installed on every section of the network. All current switches and routers have firewalls (Anwar et al., 2021). These features only need to be enabled and properly configured by the company. An anti-DDoS device should also be placed on the perimeter so that the company can thwart DDoS attacks before they spread throughout the network. The company should have a web filter proxy behind the primary firewall that serves the public network.

Another network security best practice is using network address translation. The company can make up for the IPv4 networking address shortage via network address translation (NAT). Private addresses (internal to a specific business) are converted into routable addresses on open networks like the internet through NAT. For instance, NAT is a technique for using a single IP address to link numerous computers to the internet or any other IP network (Netwrix Corporation, 2022). NAT works with firewalls to add an additional layer of protection to an organization’s internal network. The protected networks’ hosts typically have private addresses that allow them to connect with the outside world, but external systems must pass through NAT boxes in order to access internal networks. Additionally, the company can adopt centralized logging and immediate log analysis. The company should keep track of erroneous computer events like logins and other suspicious activity (Netwrix Corporation, 2022). With the aid of this best practice, the business will be able to reconstruct what took place during an attack and take action to enhance its threat detection system and effectively stop attacks in the future. (Network Architecture Security Plan Proposal 2)

Why the Proposal Should be Accepted as Best Practices for the Organization

Financial institutions are a lucrative target for cybercrime and network infiltration because of the money. Individuals working outside and inside the banks will likely take advantage of the many vulnerable links in the network architecture and security chains. JP Morgan is a financial institution that is highly vulnerable to security attacks as hackers and malicious individuals seek to access financial account information. This proposal offers a robust analysis of JP Morgan Chase Network Architecture, data management and protection, risk assessment, digital evidence controls, computer forensic analysis, and file recovery, and recommends best practices to ensure network security. The proposal seeks to help the company be more secure by integrating technology and awareness best practices because more than technology is needed to solve network security issues and the cybercrime problem efficiently and effectively. It provides insights into how the company can ensure consumer and organization data security through data management and protection and risk assessment techniques. Most importantly, it suggests to the organization how to protect itself from insider threats by adopting detection strategies, multi-factor authentication, and other preventative measures like system hardening and monitoring of users and networks. These insights are adequate to convince JP Morgan Chase to accept this proposal. (Network Architecture Security Plan Proposal 2)

References

Anwar, R. W., Abdullah, T., & Pastore, F. (2021). Firewall best practices for securing smart healthcare environment: A review. Applied Sciences, 11(19), 9183.

Hill, J.D., Kruth, A. R, Salisbury, J., & Varga, S. (2017). Software architecture in banking: A comparative paper on the effectiveness of different software architectures within a financial banking system. https://www.rose-hulman.edu/class/csse/csse477/handouts_377/HillTermPaper_FINAL.pdf

IBM. (2023). Security profiles. https://www.ibm.com/docs/en/qsip/7.4?topic=management-security-profiles

Jain, A., Person, G., Conroy, P., & Shankar, N. (2022, May 5). How JPMorgan chase built a data mesh architecture to drive significant value to enhance their enterprise data platform. Amazon Web Services. https://aws.amazon.com/big-data/how-jpmorgan-chase-built-a-data-mesh-architecture-to-drive-significant-value-to-enhance-their-enterprise-data-platform/

Jill, S. (2022). Patch management policy. https://www.cde.state.co.us/dataprivacyandsecurity/patchmanagementpolicy

JP Morgan Chase Company. (n.d.). Cybersecurity Forensic Investigator. https://www.wayup.com/i-Financial-Services-j-JP-Morgan-Chase-Company-827769314821227/

JP Morgan Chase Company. (n.d.). JPMorgan Chase & Co. Minimum Control Requirements. https://www.jpmorganchase.com/content/dam/jpmc/jpmorgan-chase-and-co/documents/supplier-minimum-control-requirements.pdf

JPMorgan Chase & Co. (2022). JPMorgan Chase & Co. Minimum Control Requirements. https://www.jpmorganchase.com/content/dam/jpmc/jpmorgan-chase-and-co/documents/supplier-minimum-control-requirements.pdf

JPMorgan Chase & Co. (2022, March 29). Data Privacy Protocols. https://www.jpmorganchase.com/institute/about/data-privacy-protocols

JPMorgan. (2018, May 21). Private Policy. https://www.jpmorgan.com/privacy

Kaushik, K., Tanwar, R., & Awasthi, A. K. (2020). Security tools. In Information Security and Optimization (pp. 181-188). Chapman and Hall/CRC.

Kirvan, P. (2022). Acceptable use policy (ATP). https://www.techtarget.com/whatis/definition/acceptable-use-policy-AUP

Mohanta, A., Saldanha, A., Mohanta, A., & Saldanha, A. (2020). Memory Forensics with Volatility. Malware Analysis and Detection Engineering: A Comprehensive Approach to Detect and Analyze Modern Malware, 433-476.

Netwrix Corporation. (2022). Network security best practices. https://www.netwrix.com/network_security_best_practices.html

Sam Houston State University. (2022). Intrusion Detection/Prevention and Security Monitoring Policy: IT-23. https://www.shsu.edu/intranet/policies/information_technology_policies/documents/IT-23IntrusionDetectionSecurityMonitoringPolicy.pdf

Ouaddah, A., Abou Elkalam, A., & Ait Ouahman, A. (2016). FairAccess: a new Blockchain‐based access control framework for the Internet of Things. Security and communication networks, 9(18), 5943-5964.

Savannah State University. (2016, July 1). Information Technology Security Plan Backup Policy (10.13). https://www.savannahstate.edu/computer-services/docs/policies-2017/10_13%20Backup%20Policy.pdf

Shay, R., Komanduri, S., Durity, A. L., Huh, P., Mazurek, M. L., Segreti, S. M., … & Cranor, L. F. (2016). Designing password policies for strength and usability. ACM Transactions on Information and System Security (TISSEC), 18(4), 1-34.

Simon, M. (2023). Methods to preserve digital evidence for computer forensics. https://www.criticalinsight.com/resources/news/article/3-methods-to-preserve-digital-evidence-for-computer-forensics

Sugandhi, A. (2023). Client Server Architecture: Components, Types, Benefits. https://www.knowledgehut.com/cloud-computing/client-server-architecture

Trinity University. (2022, June 16). Antivirus policy. https://policies.trinity.edu/a2e92e93-3e56-45ac-b237-da061062f925.pdf?v=mM8K9Ed4AUOdCX0xEXykCQ2/

Valenza, F., Su, T., Spinoso, S., Lioy, A., Sisto, R., & Vallini, M. (2017). A formal approach for network security policy validation. J. Wirel. Mob. Networks Ubiquitous Comput. Dependable Appl., 8(1), 79-100.

Wilton, L. (2021). How to secure email in your business with an email security policy. https://carbidesecure.com/resources/how-to-secure-email-in-your-business-with-an-email-security-policy/

Xu, J., Sun, F., & Chen, Q. (2022). Network security. An Introduction to the Smart Court System-of-Systems Engineering Project of China (pp. 343-384). Singapore: Springer Nature Singapore.

Yu, Q., Ren, J., Fu, Y., Li, Y., & Zhang, W. (2019). Cybertwin: An origin of next generation network architecture. IEEE Wireless Communications, 26(6), 111-117.

 
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Section 6: Recommendations for Best Practices

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Part 2: Section 6: Recommendations for Best Practices

Recommendations For Best Practices

The organization must understand the OSI Model, different types of network devices, network defenses, network segregation, proper placement of security devices, network address translation, avoiding disabling personal firewalls, centralized logging, and immediate log analysis as best practices for network security. The organization should comprehend the devices that make up the network in order to build and protect it (Yu et al., 2019). Hubs, switches, routers, bridges, and gateways are the various categories of network devices. Also, the company may protect its network by implementing the right tools and solutions. Firewalls, intrusion detection systems, intrusion prevention systems, network access controls, web filters, proxy servers, anti-DDOS, load balancers, and spam filters are among the most popular and efficient network defenses. (Section 6: Recommendations for Best Practices)

Network segmentation includes dividing the network into zones, which are logical or functional components. For instance, the company might have distinct technical requirements for its sales, technical support, and research zones. It can do this by employing switches, routers, or virtual local area networks (VLANs), which are made by setting up a switch’s ports to act like different networks (Netwrix Corporation, 2022). Segmentation restricts the scope of what could be affected by a compromise to that particular area. In essence, it separates one target into several, giving attackers the option of treating each part as a separate network or compromising one and trying to cross the gap. Neither option is desirable. Since the attacker must breach each section separately, treating each segment as a separate network entail much more work and significantly increases the attacker’s risk of being found. Attempting to jump from a compromised zone to other zones is challenging. The network traffic between the segments can be limited if properly constructed (Netwrix Corporation, 2022). Data classification and data protection also benefit from segmentation. Each segment may be given a different set of data categorization rules, configured to the proper level of security, and after that, monitored. (Section 6: Recommendations for Best Practices)

Section 6: Recommendations for Best Practices

The company must choose where to put each device as it develops its network segregation strategy. The firewall is the simplest device to install; the company should install a firewall at each network zone intersection (Anwar et al., 2021). A firewall ought to be installed on every section of the network. All current switches and routers have firewalls (Anwar et al., 2021). These features only need to be enabled and properly configured by the company. An anti-DDoS device should also be placed on the perimeter so that the company can thwart DDoS attacks before they spread throughout the network. The company should have a web filter proxy behind the primary firewall that serves the public network. (Section 6: Recommendations for Best Practices)

Another network security best practice is using network address translation. The company can make up for the IPv4 networking address shortage via network address translation (NAT). Private addresses (internal to a specific business) are converted into routable addresses on open networks like the internet through NAT. For instance, NAT is a technique for using a single IP address to link numerous computers to the internet or any other IP network (Netwrix Corporation, 2022). NAT works with firewalls to add an additional layer of protection to an organization’s internal network. The protected networks’ hosts typically have private addresses that allow them to connect with the outside world, but external systems must pass through NAT boxes in order to access internal networks. Additionally, the company can adopt centralized logging and immediate log analysis. The company should keep track of erroneous computer events like logins and other suspicious activity (Netwrix Corporation, 2022). With the aid of this best practice, the business will be able to reconstruct what took place during an attack and take action to enhance its threat detection system and effectively stop attacks in the future. (Section 6: Recommendations for Best Practices)

Why the Proposal Should be Accepted as Best Practices for the Organization

Financial institutions are a lucrative target for cybercrime and network infiltration because of the money. Individuals working outside and inside the banks will likely take advantage of the many vulnerable links in the network architecture and security chains. JP Morgan is a financial institution that is highly vulnerable to security attacks as hackers and malicious individuals seek to access financial account information. This proposal offers a robust analysis of JP Morgan Chase Network Architecture, data management and protection, risk assessment, digital evidence controls, computer forensic analysis, and file recovery, and recommends best practices to ensure network security. The proposal seeks to help the company be more secure by integrating technology and awareness best practices because more than technology is needed to solve network security issues and the cybercrime problem efficiently and effectively. It provides insights into how the company can ensure consumer and organization data security through data management and protection and risk assessment techniques. Most importantly, it suggests to the organization how to protect itself from insider threats by adopting detection strategies, multi-factor authentication, and other preventative measures like system hardening and monitoring of users and networks. These insights are adequate to convince JP Morgan Chase to accept this proposal. (Section 6: Recommendations for Best Practices)

Section 6: Recommendations for Best Practices

Refences

Anwar, R. W., Abdullah, T., & Pastore, F. (2021). Firewall best practices for securing smart healthcare environment: A review. Applied Sciences, 11(19), 9183.

Netwrix Corporation. (2022). Network security best practices. https://www.netwrix.com/network_security_best_practices.html

Yu, Q., Ren, J., Fu, Y., Li, Y., & Zhang, W. (2019). Cybertwin: An origin of next generation network architecture. IEEE Wireless Communications, 26(6), 111-117.

 
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Nursing Paper Example on the Plague [SOLVED]

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Nursing Paper Example on the Plague [SOLVED]

Plague, often associated with medieval times, continues to pose a threat in the modern era. This infectious disease, caused by the bacterium Yersinia pestis, has left an indelible mark on human history, sparking pandemics and claiming millions of lives. In this paper, we delve into the causes, signs, symptoms, etiology, pathophysiology, DSM-5 diagnosis, treatment regimens, and patient education surrounding the plague, aiming to provide a comprehensive understanding of this formidable illness. Despite advancements in medicine and public health, outbreaks of plague still occur, reminding us of the persistent threat posed by infectious diseases and the importance of ongoing research, surveillance, and preparedness. By unraveling the complexities of plague and its impact on human health, we can better equip ourselves to confront and mitigate the risks associated with this ancient scourge in the modern world. (Nursing Paper Example on the Plague [SOLVED])

Nursing Paper Example on the Plague [SOLVED]

Causes

Plague, caused by the bacterium Yersinia pestis, is primarily transmitted to humans through the bite of infected fleas, commonly found on rodents such as rats. The bacterium can also be transmitted through direct contact with bodily fluids or tissues of infected animals, posing a risk to individuals who handle or come into close contact with infected animals, such as hunters or veterinarians. Additionally, human-to-human transmission of plague can occur, particularly in cases of pneumonic plague, where the bacterium is spread via respiratory droplets from infected individuals.

The complex life cycle of Yersinia pestis involves both a mammalian host, typically rodents, and an insect vector, such as fleas. Within the flea vector, the bacterium can multiply and form biofilms, facilitating its transmission to susceptible hosts through subsequent flea bites. Factors such as overcrowding, poor sanitation, and ecological disruptions can exacerbate the spread of plague by increasing human contact with infected animals or fleas.

Historically, plague pandemics have been associated with significant morbidity and mortality, shaping human history and influencing socio-economic and political dynamics. The infamous Black Death of the 14th century, believed to be caused by Yersinia pestis, decimated populations across Europe, Asia, and Africa, resulting in widespread panic, social upheaval, and economic turmoil. Despite advances in medical knowledge and technology, outbreaks of plague continue to occur in various parts of the world, underscoring the ongoing threat posed by this ancient disease and the importance of vigilance, surveillance, and public health interventions to prevent and control its spread. (Nursing Paper Example on the Plague [SOLVED])

Signs and Symptoms

The clinical presentation of plague can vary depending on the route of transmission and the organs affected. The disease manifests in three main forms: bubonic, septicemic, and pneumonic plague. Bubonic plague, the most common form, typically presents with the sudden onset of fever, chills, headache, and malaise. One of the hallmark signs of bubonic plague is the development of painful, swollen lymph nodes, known as buboes, particularly in the groin, armpit, or neck regions. These buboes are often tender to the touch and may become fluctuant as the disease progresses.

Septicemic plague occurs when Yersinia pestis proliferates in the bloodstream, leading to systemic illness and potential organ failure. Patients with septicemic plague may experience symptoms such as fever, chills, weakness, abdominal pain, vomiting, and diarrhea. The skin may also exhibit purpura, petechiae, or ecchymoses due to disseminated intravascular coagulation (DIC), a severe complication of septicemia.

Pneumonic plague, the most severe and rapidly progressing form, affects the lungs and can develop as a primary infection or secondary to bubonic or septicemic plague. Patients with pneumonic plague typically present with symptoms such as fever, cough, dyspnea, chest pain, and hemoptysis. Radiographic findings may include patchy or lobar consolidation, pleural effusion, and pneumothorax. Unlike bubonic plague, which requires flea bites for transmission, pneumonic plague can be transmitted directly from person to person via respiratory droplets, posing a significant risk of person-to-person spread and potential outbreaks. Early recognition and treatment of pneumonic plague are critical to prevent complications such as respiratory failure, septicemia, and death. (Nursing Paper Example on the Plague [SOLVED])

Etiology

The etiology of plague is primarily attributed to the bacterium Yersinia pestis, a Gram-negative coccobacillus belonging to the family Enterobacteriaceae. Yersinia pestis possesses several virulence factors that contribute to its pathogenicity and ability to cause disease in humans. One key virulence factor is the plasminogen activator protease (Pla), which facilitates the dissemination of the bacterium from the site of inoculation and contributes to the evasion of host immune responses.

Another crucial virulence factor is the type III secretion system (T3SS), a complex molecular machinery that enables Yersinia pestis to inject effector proteins directly into host cells, modulating host cell signaling pathways and facilitating bacterial survival and replication. The T3SS is essential for the establishment of infection and the development of the characteristic buboes seen in bubonic plague.

Yersinia pestis also produces a variety of toxins, including the Yersinia outer proteins (Yops) and the pesticin toxin, which contribute to tissue damage, inflammation, and immune evasion. These toxins play a significant role in the pathogenesis of plague by disrupting host cell function, inducing apoptosis, and suppressing the host immune response.

Genetic studies have revealed that Yersinia pestis evolved from the less virulent bacterium Yersinia pseudotuberculosis through a series of genetic changes, including the acquisition of plasmids encoding key virulence factors such as the Yersinia virulence plasmid (pYV) and the plasmid for the F1 antigen (pFra). These genetic adaptations have enabled Yersinia pestis to colonize and persist in its flea vector and mammalian hosts, leading to its emergence as a highly successful and deadly human pathogen.

Understanding the etiology of plague is essential for developing effective prevention and control strategies, including the development of vaccines, antimicrobial therapies, and vector control measures aimed at reducing the transmission of Yersinia pestis and mitigating the impact of plague outbreaks on human health. (Nursing Paper Example on the Plague [SOLVED])

Pathophysiology

The pathophysiology of plague involves a complex interplay between the bacterium Yersinia pestis and the host immune system, leading to the characteristic clinical manifestations of the disease. Following transmission to a human host, Yersinia pestis undergoes rapid multiplication at the site of entry, typically the skin or mucous membranes, leading to local inflammation and the formation of buboes in bubonic plague.

The bacterium expresses a variety of surface antigens and virulence factors that enable it to evade the host immune response and proliferate within host tissues. One key mechanism by which Yersinia pestis evades host defenses is through the production of a capsule composed of the F1 antigen, which inhibits phagocytosis by neutrophils and macrophages, allowing the bacterium to survive and replicate within host cells.

Yersinia pestis also produces a range of toxins, including the Yersinia outer proteins (Yops) and the pesticin toxin, which contribute to tissue damage, inflammation, and immune evasion. These toxins disrupt host cell function, induce apoptosis, and modulate host cell signaling pathways, promoting bacterial survival and dissemination.

In bubonic plague, the infection is localized to the regional lymph nodes draining the site of inoculation, leading to the characteristic swelling and tenderness associated with buboes. As the infection progresses, Yersinia pestis can disseminate via the lymphatic and bloodstream to other organs, causing systemic illness and septicemia.

In pneumonic plague, the bacterium infects the lungs, leading to severe inflammation, tissue damage, and respiratory compromise. Pneumonic plague can develop as a primary infection or secondary to bubonic or septicemic plague and is characterized by symptoms such as fever, cough, dyspnea, and hemoptysis. Without prompt treatment, pneumonic plague can rapidly progress to respiratory failure, septicemia, and death, highlighting the importance of early recognition and intervention in managing this life-threatening form of the disease. (Nursing Paper Example on the Plague [SOLVED])

DSM-5 Diagnosis

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), does not include specific diagnostic criteria for plague, as it is an infectious disease rather than a mental health disorder. However, the diagnosis of plague is typically based on clinical symptoms, laboratory tests, and epidemiological factors.

Clinical symptoms of plague can vary depending on the form of the disease and may include fever, chills, headache, malaise, lymphadenopathy, and respiratory symptoms such as cough and dyspnea. The presence of characteristic buboes, particularly in the inguinal, axillary, or cervical regions, is often a key diagnostic feature of bubonic plague.

Laboratory tests are essential for confirming the diagnosis of plague and may include blood cultures, polymerase chain reaction (PCR) assays, serological tests for specific antibodies, and histopathological examination of tissue samples. Blood cultures and PCR assays can detect the presence of Yersinia pestis in blood or tissue specimens, providing definitive evidence of infection.

Epidemiological factors, such as exposure to infected animals or regions with known plague outbreaks, can also aid in the diagnosis of plague. A thorough history of travel, occupational exposure, and contact with potentially infected individuals or animals is essential for identifying individuals at risk of plague and guiding diagnostic testing and treatment decisions.

Given the potentially rapid progression and severity of plague, prompt diagnosis and treatment are crucial for preventing complications and reducing mortality. Healthcare providers should maintain a high index of suspicion for plague, particularly in individuals with compatible symptoms and risk factors, and promptly initiate appropriate diagnostic testing and treatment to mitigate the spread of the disease and optimize patient outcomes. (Nursing Paper Example on the Plague [SOLVED])

Treatment Regimens and Patient Education

The management of plague involves a combination of antimicrobial therapy, supportive care, and public health measures aimed at preventing further transmission of the disease. Early diagnosis and prompt initiation of treatment are crucial for improving patient outcomes and reducing the spread of plague within communities.

Antimicrobial therapy is the cornerstone of treatment for plague and should be initiated as soon as the diagnosis is suspected or confirmed. Antibiotics such as streptomycin, gentamicin, or fluoroquinolones are the preferred agents for treating plague due to their bactericidal activity against Yersinia pestis. These antibiotics should be administered intravenously or intramuscularly for a duration of 10 to 14 days, depending on the severity of the infection and the patient’s response to treatment.

In addition to antimicrobial therapy, supportive care is essential for managing complications and promoting recovery in patients with plague. Supportive measures may include fluid resuscitation to maintain hydration, pain management for symptomatic relief, and respiratory support for patients with severe pneumonic plague. Close monitoring of vital signs, fluid balance, and organ function is necessary to detect and manage complications such as septic shock, respiratory failure, and multi-organ dysfunction.

Patient education plays a crucial role in preventing the spread of plague and reducing the risk of future outbreaks. Patients should be educated about the importance of flea control and avoidance of contact with potentially infected animals, particularly rodents such as rats and prairie dogs, which are common reservoirs for Yersinia pestis. Simple measures such as keeping living spaces clean, storing food in rodent-proof containers, and using insect repellents can help reduce the risk of flea bites and transmission of plague to humans.

Additionally, patients should be instructed on the early recognition of plague symptoms and the importance of seeking medical attention promptly if they develop fever, chills, headache, lymphadenopathy, or respiratory symptoms suggestive of plague. Healthcare providers should also educate patients about the need for compliance with antibiotic therapy and the potential side effects and drug interactions associated with antimicrobial agents used to treat plague.

Public health measures such as surveillance, contact tracing, and community-based interventions are essential for preventing outbreaks and controlling the spread of plague within affected areas. Collaboration between healthcare providers, public health agencies, and community stakeholders is necessary to implement effective prevention and control strategies and minimize the impact of plague on human health and well-being. (Nursing Paper Example on the Plague [SOLVED])

Conclusion

The management of plague necessitates a multifaceted approach encompassing antimicrobial therapy, supportive care, and comprehensive public health interventions. Early diagnosis and prompt initiation of appropriate treatment are vital for improving patient outcomes and limiting the spread of the disease within communities. Through the use of antibiotics such as streptomycin, gentamicin, or fluoroquinolones, along with supportive measures like fluid resuscitation and respiratory support, patients can receive effective care to combat the infection. Furthermore, patient education regarding flea control, avoidance of infected animals, and recognition of plague symptoms is essential for preventing future outbreaks and minimizing the impact of the disease on public health. By implementing rigorous surveillance, contact tracing, and community-based interventions, healthcare providers and public health agencies can work together to mitigate the spread of plague and protect the health and well-being of individuals and communities worldwide. (Nursing Paper Example on the Plague [SOLVED])

References

https://www.ncbi.nlm.nih.gov/books/NBK549855/

 
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Bipolar Disorder Depressed 2

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Bipolar Disorder Depressed

Depression in people with bipolar illness (BD) poses significant clinical difficulties. Depression, the most common psychopathology even in BD that has been treated, is linked to excess morbidity, mortality from co-occurring general medical illnesses, and a high risk of suicide. Risks for cardiovascular disease, metabolic syndrome, diabetes, and other medical conditions, as well as the accompanying mortality rates, are many times higher in BD than in the general population or those with other psychiatric conditions (Baldessarini et al., 2020). The likelihood of suicide among people with BD is 20 times higher than the rate for the general population and is higher than the rate for those with other severe psychiatric conditions. In BD, hospitalization, time spent depressed, and mixed and depressive phases are all highly linked to suicide. (Bipolar Disorder Depressed 2)

Bipolar Disorder Depressed 2

Signs And Symptoms

Patients with BD frequently fear, try to avoid, report, and seek therapeutic assistance for depression. On the other hand, they might not regard little improvements in mood, vigor, activity, or libido as clinically significant hypomanic symptoms and might even enjoy such states (Barney, 2022). Diagnostic ambiguity is pervasive early in the illness and the absence of corroborating information from a family member or close friend. Initially undiagnosed, bipolar disorder (BD) is characterized by recurrent bouts of mania or hypomania that alternate with depressive episodes (Barney, 2022). Bipolar disorder’s depression phase can cause people to feel down, anxious, or empty, have little to no energy, feel like they cannot enjoy anything, sleep too little or too much, struggle to get out of bed, eat too little or too much, struggle to concentrate or remember things, struggle to make decisions, and even consider suicide or death. People may experience some or all of these symptoms. Bipolar disorder patients can experience extreme sadness and high energy levels (Barney, 2022). Those who experience depression for an extended period, often at least two weeks, are more likely to be in the depressive phase of BD. Patients may experience these episodes infrequently or frequently each year. (Bipolar Disorder Depressed 2)

Pharmacological Treatments

Pharmacological treatment for bipolar disorder depressed includes FDA-approved drugs such as olanzapine and fluoxetine (OFC), quetiapine, lurasidone, cariprazine, and lumateperone. Other common BD-D treatments include classic mood stabilizers and antipsychotics (Yalin & Young, 2020). The first medication that the US FDA expressly approved to treat BD-D was OFC. While treating BD-D, lurasidone is taken alone or in conjunction with lithium or valproate. Cariprazine lessens the symptoms of depression. Recently, lumateperone was licensed for treating depression in either BD-I or BD-II disorder as a monotherapy or as an additional therapy with lithium or valproate. Lithium is beneficial in the short-term management of mood and prevention of mania, and it may be especially effective in a subset of patients (Yalin & Young, 2020). Asenapine, risperidone, clozapine, aripiprazole, and ziprasidone have not received FDA approval. (Bipolar Disorder Depressed 2)

Nonpharmacological Treatments

Common nonpharmacological treatments for BD-D are electroconvulsive therapy and cognitive-behavioral therapy. Electroconvulsive therapy (ECT) delivers a rapid clinical reaction and can be utilized in urgent clinical conditions, including suicidal behaviors, severe psychosis or catatonia (Levenberg & Cordner, 2022). Patients with BD-D typically notice improvement after seven ECT sessions, while the number of sessions required varies considerably. There is a relatively minimal probability of negative side effects with psychotherapy. Pharmaceutical therapy is supplemented by cognitive behavioral therapy (CBT). CBT has been linked to decreased BD-D relapse rates and improved depressive symptoms. (Bipolar Disorder Depressed 2)

Appropriate Community Resources and Referrals

NAMI and NAMI Affiliates provide people with information about various community resources and support on an individual and family level. For questions concerning bipolar disorder and available resources, contact the NAMI HelpLine at 1-800-950-NAMI (6264) or info@nami.org. The Depression and Bipolar Support Alliance (DBSA) is a national nonprofit that assists people with depression and bipolar mood disorders. The group also provides a support system for parents of kids who have pediatric mood disorders. Assistance is provided through local chapter meetings and online tools like educational videos, discussion forums, and support groups. The American Academy of Child and Adolescent Psychiatry (AACAP) is a prestigious nonprofit group of doctors and other mental health specialists committed to assisting kids, teenagers, and families experiencing mental, behavioral, or developmental issues. The AACAP offers information for parents on its website, including a link to a local pediatric and adolescent psychiatrist. (Bipolar Disorder Depressed 2)

References

Baldessarini, R. J., Vázquez, G. H., & Tondo, L. (2020). Bipolar depression: a major unsolved challenge. International journal of bipolar disorders, 8(1), 1. https://doi.org/10.1186/s40345-019-0160-1

Barney, A. (2022). Depression in Bipolar Disorder: What You Can Do.https://www.webmd.com/bipolar-disorder/guide/depression-symptoms

Levenberg, K., & Cordner, Z. A. (2022). Bipolar depression: a review of treatment options. General Psychiatry, 35(4).

Yalin, N., & Young, A. H. (2020). Pharmacological Treatment of Bipolar Depression: What are the Current and Emerging Options?. Neuropsychiatric disease and treatment, 16, 1459–1472. https://doi.org/10.2147/NDT.S245166

 
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Letter of Analysis 2

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Letter of Analysis 2

(Letter of Analysis 2)

Dear Student,

I went through your classical argument and identified the following:

Reflection

You have written a paper on the importance of communication in clinical practice, the consequences of poor communication, and strategies that can be adopted to enhance communication among interdisciplinary teams. Communication is critical in care coordination and general healthcare delivery and is integral to accomplishing patient care objectives. There is a direct link between communication and healthcare outcomes, increasing the need to adopt evidence-based strategies, including a standardized checklist, participating in simulation-based training, and providing education on the communication process you shared to improve the effectiveness of interdisciplinary teams. (Letter of Analysis 2)

Letter of Analysis 2

Praise

Thesis

Your thesis is focused and well developed throughout the paper. The essay focuses on the importance of communication in the clinical environment and the consequence of communication failure. The thesis highlights the problem statement indicating that not all members are involved in communication currently, the interventions to enhance communication, including using a standardized checklist, participating in simulation-based training, and providing education on the communication process to every member, and the outcome, which is improved communication among interdisciplinary team members. These thesis elements are sustained throughout the paper, with supported information from current, peer-reviewed studies. You did well in this section, and you achieved your stated purpose. (Letter of Analysis 2)

Idea Development

I was also impressed with your idea development corresponding to the thesis. Your reasoning is clear and logical, and every statement and point developed or argument brought forward is well-thought and convincing. Regarding idea development, I am convinced you did a proper job, which helped sustain the thesis elements throughout the paper and deliver a compelling argument. (Letter of Analysis 2)

Recommendations

However, I have concerns about some elements of writing that you need to improve to become a better academic writer. You have a proper idea development, but your rhetorical arrangement, paragraph organization, and transitions within the paragraphs need improvement. (Letter of Analysis 2)

Organization/Rhetoric Arrangement

Although the ideas are well developed, the organization is flawed and sometimes fails to support the focus and unify the ideas in your essay. The organization contains gaps that, if addressed, would make the essay more aesthetic and free-flowing. Notably, the heading levels do not follow the APA style. The level one headings in a classical argument are the introduction, background, body (argument), opposition, refutation, and conclusion. I am more interested in the body section of the paper. Based on your thesis and main ideas, the interventions shared are subtopics within the body section and should be developed as level two headings rather than level one. Also, it is vital to use heading levels provided in word to specify level one and level two headers. (Letter of Analysis 2)

Paragraph Organization and Transition

Additionally, your paragraph organization and transition within the paragraphs are a major concern. Often, a paragraph has a topic sentence, evidence, critical thinking, and a transition, meaning that a paragraph requires at least four sentences. Some paragraphs have less than four sentences and do not follow the basic paragraph model. For instance, paragraphs one and two have three sentences. Paragraph four has two sentences, while paragraph nine has three sentences. Your paragraphs should follow the basic model to be more convincing and make your essay more robust. Also, you mention research studies in some paragraphs without in-text citations, such as in paragraphs one, three, and five. Your refutation paragraph is not evidence supported. Notably, most of your citations are indicated at the end of the paragraph instead of within the paragraph and at the end of the evidence sentence (s). Proper citations would make your work more credible and reliable. (Letter of Analysis 2)

Strategies for Improvement

Based on these concerns, I would advise that your review essay structuring or rhetoric organization and paragraph structuring and transition notes provided by the instructors.

Organization and Rhetoric Arrangement

To improve essay structure:

  1. The Paragraph Shuffle: Create a set of index cards, with one card for each paragraph in your essay. Write one idea per index card. If you have multiple ideas in each paragraph, write the second (and third, etc.) idea on a separate card. Now, shuffle the cards. Inspect the order. Try rearranging the cards to deliver your focus, ideas, and overall message more effectively.
  2. Color the Categories: Use a highlighter to separate your ideas into categories. Use one color highlighter to mark all your sentences within one category in your essay. Use a different color to code the second category, etc. Now organize your essay into matching colors/categories (Letter of Analysis 2)

Paragraph Organization and Transition

To improve paragraph structuring and transition within paragraphs, I recommend:

  1. Basic Paragraph Model: Use this paragraph model to ensure your body paragraphs are developed and organized so that readers can clearly understand the relationship between your ideas and the progression of your thoughts.
    1. Topic Sentence: States the main idea of this paragraph and shows how it supports the thesis
    2. Evidence: Expert opinion, example, fact, statistical, or logical argument
    3. Critical Thinking: Analyzes, synthesizes, and/or evaluates the evidence
    4. Transition: Make a connection between the main idea of this paragraph, the paper’s thesis statement, and the next paragraph’s main point.
  2. Transition Test: Q & A
    1. Look at the last sentence of your body paragraph.
    2. Write three questions about your main idea. Begin each question with how, why, or what.
    3. Now look at the first sentence of the following paragraph–does it answer or respond to any of those implied questions? If not…
    4. Write the answer to the question…
    5. That answer may fit the first sentence of your paragraph that already exists.
    6. OR! You may need to create another new paragraph.

Generally, the argument is thought-provoking and encouraging and puts forward a genuine concern in the healthcare environment, impacting the effectiveness of interdisciplinary teams and patient health outcomes. Your essay/academic writing level is recommendable in terms of thesis development, sustaining the thesis throughout the paper, and idea development.  (Letter of Analysis 2)

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3990376/#:~:text=Good%20communication%20between%20nurses%20and,demonstrating%20courtesy%2C%20kindness%20and%20sincerity.

 
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Letter of Analysis 3

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Letter of Analysis 3

Letter of Analysis 3

Dear Student, (Letter of Analysis 3)

I went through your classical argument and identified the following:

Praise

Your thesis or focus of the paper is clear and well developed, and sustained throughout the paper. The essay focuses on the importance of communication in the clinical environment and the consequence of communication failure. The thesis highlights the problem statement indicating that not all members are involved in communication currently, the interventions to enhance communication, including using a standardized checklist, participating in simulation-based training, and providing education on the communication process to every member, and the outcome, which is improved communication among interdisciplinary team members. These thesis elements are sustained throughout the paper, with supported information from current, peer-reviewed studies. You did well in this section, and you achieved your stated purpose. I was also impressed with your idea development corresponding to the thesis. Your reasoning is clear and logical, and every statement and point developed or argument brought forward is well-thought and convincing. Regarding idea development, I am convinced you did a proper job, which helped sustain the thesis elements throughout the paper and deliver a compelling argument. (Letter of Analysis 3)

Recommendations

However, I have concerns about some elements of writing that you need to improve to become a better academic writer. Your thesis and idea development is proper, but your organization or rhetorical arrangement, paragraph organization, and transitions within the paragraphs need improvement. Although the ideas are well developed, the organization is flawed and sometimes fails to support the focus and unify the ideas in your essay. The organization contains gaps that, if addressed, would make the essay more aesthetic and free-flowing. Notably, the organization does not attend to the APA style regarding heading levels. The level one headings in a classical argument are the introduction, background, body (argument), opposition, refutation, and conclusion. I am more interested in the body section of the paper. Based on your thesis and main ideas, the interventions shared are subtopics within the body section and should be developed as level two headings rather than level one. Also, it is vital to use heading levels provided in word to specify level one and level two headers. (Letter of Analysis 3)

Your paragraph organization and transition within the paragraphs are a major concern. Often, a paragraph has a topic sentence, evidence, critical thinking, and a transition, meaning that a paragraph requires at least four sentences. Some paragraphs have less than four sentences and do not follow the basic paragraph model. For instance, paragraphs one and two have three sentences. Paragraph four has two sentences. Paragraph nine has three sentences. Your paragraphs should follow the basic model to be more convincing and make your essay more robust. Also, you mention research studies in some paragraphs without in-text citations, for instance, in paragraphs one, three, and five. Your refutation paragraph is not evidence supported. Notably, most of your citations are indicated at the end of the paragraph instead of within the paragraph and at the end of the evidence sentence (s). Proper citations would make your work more credible and reliable. (Letter of Analysis 3)

Strategies for Improvement

Based on these concerns, I would advise that your review essay structuring or rhetoric organization and paragraph structuring and transition notes provided by the instructors. To improve essay structure:

  1. The Paragraph Shuffle: Create a set of index cards, with one card for each paragraph in your essay. Write one idea per index card.  If you have more than one idea in each paragraph, write the second (and third, etc.) idea on a separate card.  Now, shuffle the cards.  Inspect the order.  Try rearranging the cards to deliver your focus, ideas and overall message more effectively.
  2. Color The Categories: Use a highlighter to separate your ideas into categories. Use one color highlighter to mark all of your sentences dealing with one category in your essay. Use a different color to code the second category, etc. Now organize your essay into matching colors/categories (Letter of Analysis 3)

To improve paragraph structuring and transition within paragraphs, I recommend:

  1. Basic Paragraph Model: Use this paragraph model to make sure your body paragraphs are developed and organized so that readers can clearly understand the relationship between your ideas and the progression of your thoughts.
    1. Topic Sentence: states the main idea of this paragraph and shows how it supports the thesis
    2. Evidence: expert opinion, example, fact, statistical, or logical argument
    3. Critical Thinking: analyzes, synthesizes and/or evaluates the evidence
    4. Transition: makes a connection between the main idea of this paragraph, the thesis statement of the paper, and the main point of the next paragraph. (Letter of Analysis 3)
  2. Transition Test: or Q & A
    1. Look at the last sentence of your body paragraph.
    2. Write three questions about your main idea. Begin each question with how, why, or what.
    3. Now look at the first sentence of the following paragraph–does it answer or respond to any one of those implied questions? If not…
    4. Write the answer to the question…
    5. That answer may fit as the first sentence of your paragraph that already exists.
    6. OR! You may need to create another new paragraph. (Letter of Analysis 3)

References

https://www.academia.edu/6911544/THESIS_WRITING_GUIDE

 
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Communication is Key

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Communication is Key

Teamwork is an essential component of providing quality care for patients. Being a part of a team means using different tools to best interact with other members of the health care team. Members of the health care team often work in different departments, have different leadership, and receive different levels of education on how to interact as a team. A recent review of reports collected by the Joint Commission reveal the startling statistic that over 70 percent of sentinel events share a common root cause; communication failures of the team. (Communication is Key)

Currently, members of the health care team consist of many different people, with various roles, who receive various training on working together. If members of a very important team aren’t able to communicate with each other, the potential for poor patient outcomes rises.  Since communication education currently does not involve all members of the team, utilizing a standard checklist, participating in simulation based training, and providing education of communication processes to all team members can promote better communication amongst interdisciplinary members of the team. (Communication is Key)

Communication is Key

Background

Recently, the Institute for Safe Medication Practices (ISMP) published an article citing the most common reasons for medication errors.  In that list, communication failures surrounding verbal/oral orders was listed as the 4th highest reason for errors.  This article was posted in January of 2020, less than 3 years ago.  For many years, the existence of the electronic medical record and tools, such as checklists, have been available to use, yet not all members of the team utilize resources that could potentially entrance communication, thus leading to better care. (Communication is Key)

The growing number of literature available suggests that poor communication (especially between physician and primary nurse) is a significant contributor to negative patient outcomes. In one study, highlighting the ICU, poor collaborative communication between the nurse and physician boasted a 1.8 percent increase in length of stay (Zwarenstein & Reeves, 2002).

Standardized Checklist

Communication is Key

The use of a standardized checklist for communication amongst team members is one that is already utilized in both the field of aviation and health care. Checklists are often found in high stakes areas, where missing a step could be critical to the overall mission, or patient care goal. In one high stakes setting, post anesthesia care unit (PACU), a communication tool was implemented by the bedside nursing team. The PACU was experiencing a drop in information from the operating room to the PACU, leaving the nursing team with a feeling of lack of information. Bedside nurses were getting report from a member of the anesthesia team but, not the surgical team, again leaving the team responsible for assessing the patient with no communication of what to expect or even what they did. (Communication is Key)

The PACU nursing team enacted a simple bedside checklist to standardize information that would be useful for any patient visiting the PACU. This allowed for the information to be given in a quick, concise method. This checklist was adopted by the nursing team and then provided to the surgical and anesthesia teams to circulate. A copy of the checklist was laminated and kept in each bay, for quick reference. Although patient outcomes were not able to be quantified from this method, the PACU council conducted an audit after 30 days and reported a perceived better handoff from surgery. PACU nurses reported less distractions in report and felt that they obtained better assessment data about their patient (Sapikowski, et al 2022).

Simulation Based Training

Currently, hospital staff are provided education in a traditional method.  Staff complete mandatory training, utilizing computer based, self paced/study modules. Providers and members alike all have to work together in real time yet, are trained in a siloed, isolated environment. In one recent study, a review of different education provided to all members of an intensive care team; perceived communcication improvement amongst the members was shown upon review of a simulation based training tool. Team members were able to role play difficult patient care scenarios and were instructed to provide feedback in real time. Members were given roles to play and a mediator led the training. (Communication is Key)

Evaluation of this was completed by utilizing a pre and post survey of perceived communication improvement.  Of note, this study involved not only nurses and physicians but, chaplains, social workers, and techs as well. Amongst nursing, perceived communication was improved surrounding nurse to nurse communication. No physicians returned the request for post survey information, leaving many questions to be unanswered (Fettig et all, 2022).

Education for All

Transitioning from the previous section, education provided for all members of the health care team could be considered to improve communication amongst the health care team. Members of the team work in a variety or roles, yet don’t all receive training or even know what type of training the other party has. One study done in the ICU setting revealed that current interventions surrounding collaborative communication are not being provided or encouraged (Boyle & Koshinda, 2004). This is a stepping stone to start the conversation with senior leadership on how improvements surrounding interdisciplinary collaboration and collaborative education can lead to better patient outcomes. (Communication is Key)

Barriers

Barriers cited have included logistical challenges to getting an interdisciplinary team together.  Scheduling challenges and location of departments were cited by both the nursing and ancillary teams that participated in the simulation based training mentioned previously. Costs associated with enacting sweeping changes to the current education program is a factor to implementation.

Refutation

Logistical challenges will always be a factor that provides limitations on gathering a large team together in one location. However, simulation based training or training in general doesn’t have to be in person. We learned over the course of the pandemic that almost anything can be done virtually. There is opportunity to think outside of traditional educational offerings and get creative. Costs associated is also a factor that could be calculated with a return on investment over time, seeing the date (or numbers) may help influence key stakeholders of the value of their investment. (Communication is Key)

Conclusion

            Working as a team means communicating, sharing, and providing all the members with all the information needed to be set for success. In the health care setting, high stakes can mean high tensions, leading to an environment of lack of communication and collaboration.  As evidenced by the studies cited, having a standard checklist, providing simiulation based training, and ensuring all team members have access to education, perceived communication enhancement amongst team members has been shown.  All leading towards the goal of providing the best patient care we can. (Communication is Key)

References

Hospital: 2023 national patient safety goals. The Joint Commission. (n.d.). Retrieved March 19, 2023, from https://www.jointcommission.org/standards/national-patient-safety-goals/hospital-national-patient-safety-goals/

Fettig, L., Tang, Q., Newton, E., Rosario, R., Matthias, M. S., & Torke, A. M. (2022). A Communication Skills Training Workshop to Improve ICU Team Relational Coordination about Goals of Care: A Pilot Study. The American journal of hospice & palliative care, 39(10), 1157–1164. https://doi.org/10.1177/10499091211069994

Sapikowski, L., Bullock, K., Walsh, J., & Alexander, C. (2022). Implementation of a PACU pause in a Pediatric Post Anesthesia Care Unit. Journal of PeriAnesthesia Nursing, 37(4). https://doi.org/10.1016/j.jopan.2022.05.032

ISMP publishes top 10 list of medication errors and hazards covered in newsletter. Institute For

Safe Medication Practices. (2020, January 17). Retrieved March 19, 2023, from

https://www.ismp.org/news/ismp-publishes-top-10-list-medication-errors-and-hazards-

covered-newsletter

 
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Consumer Health Information Website Analysis Paper

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Consumer Health Information Website Analysis Paper

(Consumer Health Information Website Analysis Paper)

The world is in an information age as consumers seek more information to understand products, including health products. Concurrently, more information is available about health on multiple online sources, readily available to everyone with internet access. However, the credibility of the information varies because most people present as health experts on their websites, providing health information and advice without supporting evidence or authority (NIH, 2023). Most websites are for sale, and only a few provide authentic and evidence-based information for educational purposes. This paper addresses diabetes mellitus and analyzes a website offering information on diabetes mellitus, including its authority, credibility, and adequacy.

Consumer Health Information Website Analysis Paper

Diabetes Mellitus

Diabetes mellitus is a metabolic illness that involves abnormally high glucose levels. It is a chronic disease occurring due to impaired insulin secretion, resistance to insulin peripheral actions, or both (Xu et al., 2018). Diabetes mellitus significantly impacts the quality of life and can damage other body organs and systems, making individuals disabled and living with multiple health complications like retinopathy, nephropathy, and neuropathy (Liu et al., 2020). Diabetes increases the risk of macrovascular complications two to four times, making an individual more susceptible to cardiovascular diseases. (Consumer Health Information Website Analysis Paper)

Diabetes mellitus is classified into type 1 diabetes, type 2 diabetes mellitus, and gestational diabetes. Type 1 diabetes is marked by autoimmune damage of insulin-producing beta cells in the pancreas, resulting in insulin deficiency (Sapra & Bhandari, 2022). It can develop at any stage of life but is more common among children and adolescents. Type 2 diabetes mellitus accounts for 90% of all diabetes mellitus cases, and its etiology is linked to insulin resistance (Sapra & Bhandari, 2022). Type 2 diabetes mellitus is more common among adults, particularly those above 45 years old, although cases are increasing among children and young adults due to sedentary lifestyles and calorie-dense foods. Gestational diabetes occurs during pregnancy due to hyperglycemia (Sapra & Bhandari, 2022). Risk factors include age, ethnicity, family history of diabetes, physical inactivity, obesity, and smoking. (Consumer Health Information Website Analysis Paper)

Consumer Health Information Website Analysis Paper

Website Description and Analysis

The American Diabetes Association (ADA) website provides information, services, and support to ensure a life free of diabetes and associated burdens or consequences. The organization’s mission is to prevent and cure diabetes and enhance people’s lives (ADA, n.d.). The organization owning the website fund research towards diabetes prevention, cure, and management, delivers associated services to American communities, offers objective and credible information, and gives voice to those facing denied rights due to diabetes.

Overall, the web pages are well arranged with working buttons to navigate the website from one page to another. The pages are visible at the top of the websites, and the reader can easily go to the webpage they are interested in. It is easy to find information. The website provides previews for the various elements and a “Learn More” or “Get Started” button that directs the reader to more information about a particular topic. The website is not text-dense and easy to read. If the reader requires more information, they can click the “Learn More” or “Get Started” button. The colors contrast perfectly, and the fonts are large enough, making reading easy. The website looks professional. The only issue is the pop-ups about donating that come up every time the website is refreshed or opened again. (Consumer Health Information Website Analysis Paper)

The American Diabetes Association sponsors the websites. It has memberships who donate to the websites, but anyone is open to donating. The website is updated annually, but it can be more frequent when new information, evidence, or regulatory changes are made, and it has to incorporate them (ADA, n.d.). The website was created in 1995. It was last updated as recently as December last year. The website does not state whether the content is medical advice or not. All Americans comprise the intended audience because it provides information to prevent, treat, cure, and manage diabetes. It also specifically targets medical professionals, community groups, and students with the latest diabetes research and treatment and general information to enhance awareness, knowledge, and attitudes regarding diabetes prevention, cure, and management (ADA, n.d.). The information presented is appropriate for the general public and people of all ages and ethnicities. (Consumer Health Information Website Analysis Paper)

Information Credibility

Authority

Behind the American Diabetes Association, which sponsors the website, is a network of over 565,000 volunteers, including their families and caregivers and a professional society of over 12,000 healthcare professionals and 250 staff members (ADA, n.d.). Professionals working with ADA have the expertise and authority to publish information on the websites in various forms, including panel discussions and research. ADA network of professionals offers exclusive education, career development, engagement resources, and other information and education materials for the diverse audience of the general public and healthcare professionals (ADA, n.d.). The website publishes journals providing necessary research information related to diabetes. Readers can access multiple abstracts, which also include the authors’ information and the various institutions they are affiliated with. Many are affiliated with universities and medical institutions, and some are members of the ADA research community, giving them credibility to conduct research and publish information on the website. The website does not offer a place to contact the authors, but it has a center for information where readers can leave or post their inquiries. (Consumer Health Information Website Analysis Paper)

Bias

The website’s authors are multiple, and most publications are new updates on diabetes and research journals. There are publications on general health information, including food and nutrition, weight loss criteria, health and wellness, and diabetes care products, without mentioned authors, only the date when they were last updated (ADA, n.d.). The website is professional and does not indicate any form of bias in the information published. The publications are not promoting any products but offer information to help people prevent, cure, and manage diabetes, including information on lifestyle choices that enhance the quality of life.

Supporting Evidence

ADA website is a professional one with various types of publications. Some publications provide general information on various topics without reference lists indicating supporting evidence. On the other hand, there are journals or research publications available as abstracts for the general public, but full articles can be accessed only by members (ADA, n.d.). The journals have a complete list of works cited, referencing credible and authoritative sources. The information presented as research publications is valid and supported by evidence. The website is committed to providing objective information, and its purpose is clear. The information posted on the website includes peer-reviewed and scholarly articles which are credible, reliable, and valid sources of information in terms of accuracy. The publications providing general information are consistent with the wide knowledge of diabetes. Readers can click on multiple links directing them to additional, valuable resources with minimum effort, although it is easier for members who can access full publications. (Consumer Health Information Website Analysis Paper)

Adequacy

The website is educative, providing informative publications in different forms, including statistics, research publications, education guides on healthy living, and additional tools, products, and resources the audience can access to learn more about diabetes prevention, treatment, and management (ADA, n.d.). The educational information is adequate, and the audience does not have to go elsewhere to get answers about topics presented on the websites. The consumer can access general information on the various web pages and gain more information by accessing multiple research journals published on the website. The information targets every individual, and the level of information sophistication, especially on publications providing general information on diabetes, is elementary to ease understanding and provide uncomplicated data. More technical and advanced information is provided in the research journals. The website communicates its clear purpose through its mission and vision statements, and the information published on it corresponds with its purpose. The website is intended to educate the general public on diabetes. (Consumer Health Information Website Analysis Paper)

References

American Diabetes Association (ADA). (n.d.). Diabetes. https://diabetes.org/

Liu, J., Ren, Z. H., Qiang, H., Wu, J., Shen, M., Zhang, L., & Lyu, J. (2020). Trends in the incidence of diabetes mellitus: results from the Global Burden of Disease Study 2017 and implications for diabetes mellitus prevention. BMC public health, 20(1), 1415. https://doi.org/10.1186/s12889-020-09502-x

National Institute on Aging (NIH). (2023, January 12). How To Find Reliable Health Information Online. https://www.nia.nih.gov/health/how-find-reliable-health-information-online

Sapra, A., & Bhandari, P. (2022). Diabetes mellitus. In: StatPearls [Internet]. StatPearls Publishing.

Xu, G., Liu, B., Sun, Y., Du, Y., Snetselaar, L. G., Hu, F. B., & Bao, W. (2018). Prevalence of diagnosed type 1 and type 2 diabetes among US adults in 2016 and 2017: population based study. BMJ (Clinical research ed.), 362, k1497. https://doi.org/10.1136/bmj.k1497

 
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Analyzing Liability

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Analyzing Liability

The purpose of this analysis is to examine a complaint letter from CapraTek employee Thomas Lee. It will identify potential legal liabilities based on U.S. laws relevant to the complaint letter. It will discuss the potential harm to the company, employees, and workplace culture if the complaint goes unattended. Furthermore, this analysis will identify preventative measures to avoid legal liability for the company and suggest viable legal defenses if the company is required to defend this complaint, including the specifics of this complaint letter. Finally, this analysis will address the ethical principles and implications of the complaint letter. (Analyzing Liability)

Summary of the Complaint

The complaint letter is by Mr. Thomas Lee about his disappointment with the company for failing to ensure a secure workplace for individuals from all backgrounds and nationalities. Mr. Lee is an American of Chinese origin who complains of racial discrimination at the workplace following the accusation that he brought COVID-19 to the workplace because he is Chinese. The employee presented a verbal complaint to the supervisor, who failed to listen to him and questioned Mr. Lee’s customs and beliefs. Mr. Lee says the workplace is hostile and intimidating, and he has received threats from other employees who have singled him out for allegations of spreading the virus on the basis of his origin and ethnicity, sending him negative messages through texts, emails, social media and telephone. Mr. Lee continues to point out that several people have died after exposure to Covid-19, insisting the company’s judgment and preparedness was the primary reason.

Furthermore, another letter by Karen Small, a security guard, confirms the allegation. She points out that she probably acquired the virus from Mr. Lee, who the company allowed into the premise, hence the disease spread. Mr. Lee is an American Citizen who has lived in Alabama and cannot contemplate why he is being singled out for spreading the virus merely because he is Chinese. Mr. Lee says the company has done nothing to address the situation and lacks leadership, which encourages the behavior. He is considering a lawsuit if the issue is not dealt with. (Analyzing Liability)

Associated U.S. laws or regulations and how they are relevant to the identified liability

First Mr. Lee complains of racial discrimination at the workplace, which Title VII of the Civil Rights Act of 1964 addresses. This Act makes it illegal to discriminate against people on the mere basis of their color, race, religion, national origin, or sex. For example, Hahn et al. (2018) provide that this Act is fundamental in ensuring racial and ethnic equity and eliminating discriminatory behavior, implying the Act corresponds to the identified liability of preventing racial discrimination based on color, race, gender, or nationality. The law protects all employees from retaliation if they decide to forward a claim on discrimination at the workplace. (Analyzing Liability)

Mr. Lee also points out that most people acquired and were exposed to the virus because of the company’s lapse in judgment and preparedness, addressed by the Occupational Safety and Health Act of 1970. The Act requires employers to keep the workplace free from hazardous conditions, stressing employees’ rights to information regarding the dangers in their job. For example, in Michaels & Wagner (2020), employers are legally required to offer an environment that protects employees from COVID-19 per OSHA provisions. Michaels & Wagner (2020) argue that only employers can make the workplace safe by enforcing OSHA guidelines, and a failure to do so is considered a non-adherence and non-compliance. This scenario implies that the OSHA is relevant to the identified liability of keeping employees safe from Covid-19 at the workplace. The law also protects employees from being punished if they decide to exercise their rights per OSHA.

The potential harm to the company, its employees, and its workplace culture that could result from a lawsuit emanating from the selected complaint

Suppose the company is found liable for non-compliance with Title VII. In that case, it could face penalties for intentional discrimination, enforced as either compensatory or punitive damage up to a maximum provided by the Title VII of the Civil Rights Act of 1964 according to the number of employees in the company. The company would have to pay either back pay, compensatory damages, or punitive damages. For instance, in Lund (2020), the case, titled Bostock v. Claton County, involves the Supreme Court upholding non-discrimination based on race and sex, against which an employer is liable and faces paying compensatory damages. This case implies that if the company is found liable under the interpretation of Title VII of the Civil Rights Act, it would have to pay compensatory damages to Mr. Lee. (Analyzing Liability)

Analyzing Liability

Confirming liability would affect other employees, especially those of other nationalities, who have experienced the same and may also choose to forward their case. This liability would label the workplace as toxic, discriminatory, and lacking diversity. Suppose the company is found liable under OSHA for failing to protect its employees from Covid-19 exposure. In that case, it could face penalties based on the type of violation, ranging between $15,625 and $156,259 per violation. In this case, dealing with litigations for OSHA non-compliance will be costly for the company. For instance, Sadeh et al. (2022) address the cost impact of Covid-19 OSHA citations and specify that fines for non-compliance and regulatory violations significantly impact a company. If the company is found liable, it means that the company would also be liable for all other Covid-19-related cases, amounting to millions of dollars in fines and compensatory damages that would be detrimental to the company’s finances. It would also mean the work environment is unsafe, and the company cannot protect its most valuable resource, leading to a demoralized workforce. (Analyzing Liability)

Realistic preventative measures that could have avoided legal liability

The company must promote workplace diversity by developing and enforcing anti-harassment and anti-discrimination policies that condemn discrimination based on race, color, gender, ability or disability, sexual orientation, and other identifiers to protect employees from bullying and harassment. Cross-cultural or cultural sensitivity training and education would be necessary to ensure a discrimination-free environment. For example, Shepherd (2019) offers evidence supporting cross-cultural training, including diversity training, anti-racism raining, and micro-aggression training, effectiveness in enhancing cultural competence, safety, humility, and intelligence, which are integral in ensuring a workplace free from discrimination, harassment, and intimidation.

The training would include all employees because there are allegations of lapse in conduct and professionalism among low-level employees and supervisors. It would ensure that all employees respect cultural and racial differences, act professionally in conduct and speech, refuse to instigate, participate, or condone discrimination and harassment, and avoid race-based or culturally offensive acts, including humor and pranks (Shepherd, 2019). Systematic factors contribute to discrimination, harassment, and retaliation in the workplace. Therefore, the company should develop an effective internal complaints procedure and address such issues internally to avoid legal liability. These procedures, coupled with dispute resolution systems, can help prevent discrimination and harassment, as provided by Dobbin and Kalev (2020), who offer guidelines for making discrimination and harassment systems better. (Analyzing Liability)

Individuals and departments that would need to be involved in the proposed measures

Mr. Lee complained of harassment daily, from a fellow security guard to the supervisor. This case implies a lack of cultural sensitivity and awareness across employees of all levels. Therefore, all employees, including supervisors and managers, will be involved in the proposed measures, particularly the cross-cultural or cultural sensitivity training, and education. The Human Resources Department will be involved because it is responsible for outlining disciplinary action policies and procedures to respond to actions or behavior that violate the company’s policies. It will help formulate and enforce anti-harassment and anti-discrimination policies and formalize the internal complaints procedure to orient all employees on the code of discipline.

Viable legal defenses the company could assert in a litigation context to defeat the complainant’s claims

The complainant must prove that he experienced racial discrimination at the workplace. It appears to be a serious case because the allegations are confirmed by other complaints, implying that employees think Mr. Lee spread the virus under the company’s watch. The company would also have to prove beyond doubt that Mr. Lee did not experience racial discrimination or that if he did, it was unintentional because only intentional racial discrimination is ruled as non-compliance. The company can also counter the claim by stating a lack of substantial evidence indicating that Mr. Lee experienced racial discrimination. The company has to show current policies that protect employees from racial discrimination and how it enforces these policies to respond to complaints. If the company proves that Mr. Lee indeed brought the virus to the workplace, it can avoid legal liability. In the interview transcript, interviewees provide that the company developed safety rules and measures per CDC to protect employees from Covid-19 exposure. It has to prove this claim with substantial evidence to avoid legal liability, given that other complaint letters point to the lapse of judgment and preparedness as the primary cause of over 70% of infections and several wrongful deaths. Lastly, the company has to convince the jury that employees acquired the virus outside the workplace, which is beyond the employer’s control, to avoid legal liability. (Analyzing Liability)

Ethical implications of the scenario and measures that address ethical issues

Harassment and discrimination are among the most significant ethical issues companies like Capra Tek face today, especially due to the increased workforce diversities and individual differences. Harassment and discrimination occurring at the workplace can be catastrophic to companies like Capra Tek financially and reputationally. Racial discrimination and harassment in the workplace are perceived as ethical failures due to cultures or practices of disrespect, unfairness, and harm (Elias & Paradies, 2021). It violates human rights due to an unjustified distinction created by the nature of the work environment or policy failures. Racial discrimination negatively impacts the work environment and the company at large. Employees harassed and singled out by other employees, including managers and supervisors, feel unheard and unprotected by the company. As a result, it creates a toxic environment, forming divides between employees that are detrimental to the company. Employees of other racial and ethnic minorities or nationalities fear engaging or collaborating meaningfully when the company does not protect them from harassment and discrimination. It would mean increased absenteeism, turnover, poor performance, loss of income and litigation, and damaged relationships with other companies that employ an anti-racist or anti-discrimination approach. If the case is forwarded to the US Equal Employment Opportunity Commission (EEOC), it would have legal ramifications for the company, which is undesirable and harmful to the company’s reputation.

It is paramount companies like Capra Tek consider robust measures to curb ethical issues like racial discrimination and harassment. The company should be aware of the primary ethical principles that guide professional conduct, including justice and fairness, respect of persons, responsibility, and protection from harm. The company should also be aware of the anti-discrimination laws and regulations like Title VII of the Civil Rights Act of 1964 that protect employee from unjust treatment in the workplace. Additionally, companies like Capra Tek can adopt the ILPA Industry Code of Conduct Guidelines that provides all individuals to be treated equally in an organization, and a company should not tolerate discrimination based on age, gender, race, religion, sexual orientation, family status, disability, marital status, or political beliefs (Institutional Limited Partners Association, 2018).

The company is faced with enforcing these ethical principles, anti-harassment and discrimination laws, and the code of conduct guidelines as measures to ensure ethical practice in the workplace. To curb discrimination and racism, protect employees from bullying and harassment, and promote a diverse and inclusive environment where employees respect each other’s differences, the company should apply ethical decision-making or preventive measure framework. The Ethical Work Climate 2.0 theory by Weber and Opoku-Dakwa (2022) presents an ethical framework for Capra Tek. Adopting this model would help establish an ethical workplace, setting up the company to successfully address employee complaints, assess legal liability, and promote ethical decision-making (Weber & Opoku-Dakwa, 2022). The model sets the antecedents that shape the expectations for ethical behavior within the company and fosters employees’ ability to implement benevolent and principled climates, which help foster organizational commitment, job satisfaction, performance, well-being, and ethical behavior.  (Analyzing Liability)

References

Dobbin, F., & Kalev, A. (2020). Making discrimination and harassment complaint systems better. WHAT WORKS? 24.

Elias, A., & Paradies, Y. (2021). The Costs of Institutional Racism and its Ethical Implications for Healthcare. Journal of bioethical inquiry, 18(1), 45–58. https://doi.org/10.1007/s11673-020-10073-0

Hahn, R. A., Truman, B. I., & Williams, D. R. (2018). Civil rights as determinants of public health and racial and ethnic health equity: health care, education, employment, and housing in the United States. SSM-population health, 4, 17-24.

Institutional Limited Partners Association. (2018). Code of conduct: harassment, discrimination and workplace violence: Guidelines for the private equity ecosystem.

Lund, N. (2020). Unleashed and Unbound: Living Textualism in Bostock v. Clayton County. Clayton County (July 14, 2020). Federalist Society Review, 21, 20-15.

Michaels, D., & Wagner, G. R. (2020). Occupational Safety and Health Administration (OSHA) and worker safety during the COVID-19 pandemic. Jama, 324(14), 1389-1390.

Sadeh, H., Mirarchi, C., Shahbodaghlou, F., & Pavan, A. (2022). Predicting the trends and cost impact of COVID-19 OSHA citations on US construction contractors using machine learning and simulation. Engineering, Construction, and Architectural Management (ahead-of-print).

Shepherd, S. M. (2019). Cultural awareness workshops: limitations and practical consequences. BMC Medical Education, 19(1), 1-10.

Weber, J., & Opoku-Dakwa, A. (2022). Ethical Work Climate 2.0: A Normative Reformulation of Victor and Cullen’s 1988 Framework. Journal of Business Ethics, 1-18.

 
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