Strategic Consensus Organizing Principles

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Strategic Consensus Organizing Principles

(Strategic Consensus Organizing Principles)

The Strategic Principles of Consensus Organizing

Can you teach people how to be strategic? It’s a question that trainers and teachers often ask as they approach a new training program or a classroom full of eager faces. Thinking strategically and pragmatically is the hallmark of a good consensus organizer. Consensus organizing is based on several key strategic principles that are the fundamental beliefs and values that guide the implementation of the model and its activities. These principles also express the philosophy and the attitude behind the consensus organizing approach. As consensus organizers begin to enter a community, these principles are at the forefront of their minds as their organizing strategy takes shape. This chapter explains these principles and why they are important to consensus organizing.

Table 3.1 summarizes the five core strategic principles of consensus organizing (Consensus Organizing Institute, n.d.).

Table 3.1 Strategic Principles of Consensus Organizing

Strategic Principle Key Strategies Example
Solutions to local problems should come from affected communities.
  • Strategies and objectives are set by the community.
  • Incorporate community’s existing social networks.
  • Analyze and identify individual self-interests and mutual community interests and build relationships based on those interests.
 Residents bring recent crime problems to the attention of the local police and ask for assistance in developing a crime watch program. The local police work with residents to develop a neighborhood watch. Relationships are built between residents and the police.
Pragmatic leadership is present in communities, though not always recognized.
  • Identify trusted, respected, behind-the-scenes leaders.
  • Position leaders to take responsibility for effort.
  • Build leaders’ skills and confidence to succeed.
 An older woman to whom young mothers turn for parenting help.
A teacher who stays after school hours to help his students with their studies.
Self-interest can be harnessed as a motivation for improving the welfare of communities.
  • Analyze and identify the interests of members of external power structure (e.g., government, philanthropy, corporate, social service).
  • Position them to make genuine contributions aligned with their and the community’s interests.
 A local foundation director who has $1 million to improve housing in local distressed neighborhoods, but who does not have relationships with community-based organizations located in those neighborhoods.
If a project achieves its short-term goals without positioning the participants to make even greater gains in the future, then an opportunity has been missed.
  • Position community leaders to take the lead on projects.
  • Use short-term projects to build community’s skills and relationships with power structure to lay the foundation for more comprehensive efforts.
 A neighborhood cleanup that builds relationships among residents and between residents and the city can lead to new opportunities, such as improved code enforcement and the rehab of dilapidated housing in cleanup area.
Building relationships and strategically positioning leaders to make a program work requires time, care, and finesse.
  • Understand and gain trust of leaders of the community and power structure.
  • Break down stereotypes and misperceptions that community and power structure have of one another.
  • Invest the time up front to position leaders of the community and power structure to develop genuine strategic partnerships.

 

 Going to churches, agencies, and community organization meetings, and meeting residents one-on-one in their homes. Attending local housing symposiums, city council meetings, and chamber of commerce meetings, as well as meeting one-on-one with members of the e
 
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Transforming Hospital Organizational Effectiveness

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Transforming Hospital Organizational Effectiveness

(Transforming Hospital Organizational Effectiveness)

Case Study Essay

Read the below case and then write a paper.

you must have a minimum of 3 scholarly sources (peer-reviewed journal articles). Please ensure that you follow standard APA formatting. Your paper must have a title page and a reference page. You must have a minimum of five (5) in-text citations.

During the paper, answer these questions. DO NOT put this in a question and answer format. Make sure there is an introduction and conclusion, and some parts of the questions as headings and subheadings and follow the recommended outline to ensure that all questions are answered.

Respond to the following questions in an essay (3 page minimum).

1. Assemble the diagnostic data into a framework and prepare feedback to the senior administrators of the hospitals. What’s your sense of the organization’s current structure and employee involvement issues?

2. What changes would you recommend? Is a total quality management intervention appropriate here? What alternatives would you propose?

3. Design an implementation plan for your preferred intervention.

Be sure that you describe the most common organization structures used today as well as their strengths and weaknesses.  Describe the employee involvement and how it relates to performance. Consider whether there should be a sociotechnical systems work design.

Selected Cases THE SULLIVAN HOSPITAL SYSTEM

PART I(Transforming Hospital Organizational Effectiveness)

At the Sullivan Hospital System (SHS), CEO Ken Bonnet expressed concern over market share losses to other local hospitals over the past six to nine months and declines in patient satisfaction measures. To him and his senior administrators, the need to revise the SHS organization was clear. It was also clear that such a change would require the enthusiastic participation of all organizational members, including nurses, physicians, and managers.

At SHS, the senior team consisted of the top administrative teams from the two hospitals in the system. Bonnet, CEO of the system and president of the larger of the two hospitals, was joined by Sue Strasburg, president of the smaller hospital. Their two styles were considerably different. Whereas Bonnet was calm, confident, and mild-mannered, Strasburg was assertive, enthusiastic, and energetic. Despite these differences, both administrators demonstrated a willingness to lead the change effort. In addition, each of their direct reports was clearly excited about initiating a change process and was clearly taking whatever initiative Bonnet and Strasburg would allow or empower them to do.

You were contacted by Bonnet to conduct a three-day retreat with the combined management teams and kick off the change process. Based on conversations with administrators from other hospitals and industry conferences, the team believed that the system needed a major overhaul of its Total Quality Management (TQM) process for two primary reasons. First, they believed that an improved patient care process would give physicians a good reason to use the hospital, thus improving market share. Second, although the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) had enacted policies some time ago encouraging hospitals to adopt continuous improvement principles, SHS’s system was sorely behind the times. The team readily agreed that they lacked the adequate skills and knowledge associated with implementing a more sophisticated TQM process. This first meeting was to gather together to hear about how TQM, engagement, and other strategic change processes had advanced and the issues that would need to be addressed if more sophisticated processes were to be implemented. During the meeting, you guided them through several exercises to get the team to examine methods of decision making, how team-based problem solving had advanced, and explored their understanding of the hospital’s current mission, goals, and strategies.

Although you were concerned about starting the process with a workshop that explored a solution rather than understanding the problem, you remembered Roger Harrison’s consulting rule, “Start where your client is at,” and agreed to conduct the workshop. You were assured by Bonnet that the hospital system was committed to making substantive changes and that this was only the first step. In addition, and in support of this commitment, Bonnet told you that he had already agreed in principle to begin a work redesign process in a few of the nursing units at each hospital and had begun to finalize a contract with a large consulting firm to do the work. The workshop was highly praised and you convinced the team to hold off on the work design implementation long enough to conduct a diagnosis of the system.

Following the retreat, your diagnosis of the SHS organization employed a variety of data collection activities including interviews with senior managers from both hospitals as well as a sampling of middle managers and staff (for example, nurses, ancillary professionals, and environmental services providers). Questions about the hospital’s mission garnered the most consensus and passion. There was almost unanimous commitment to the breadth of services provided and the values that played a prominent role in the delivery of those services by a Catholic-sponsored health care organization, such as SHS. A mission and values statement was clearly posted throughout the hospital and many of the items in that statement were repeated almost verbatim in the interviews.

From there, however, answers about the organization’s purpose and objectives became more diverse. With respect to goals and objectives, different stakeholder groups saw them differently. Senior administrators were fairly clear about the goals listed in the strategic plan. These goals included increasing measurements of patient satisfaction, decreasing the amount of overtime, and increasing market share. However, among middle managers and supervisors, there was little awareness of hospital goals or how people influenced their accomplishment. A question about the hospital’s overall direction or how the goals were being achieved yielded a clear split in people’s perceptions. Some believed the hospital achieved its objectives through its designation as the area’s primary trauma center. They noted that if someone’s life were in danger, the best chance of survival was to go to SHS. The problem, respondents joked, was that “after we save their life, we tend to forget about them.” Many, however, held beliefs that could be labeled “low cost.” That is, objectives were achieved by squeezing out every penny of cost no matter how that impacted patient care.

Opinions about the policies governing the hospital’s operation supported a general belief that the organization was too centralized. People felt little empowerment to make decisions. There also were a number of financial policies that were seen as dictated from the corporate office, where “shared services” existed, including finance, marketing, information systems, and purchasing. Further, several policies limited a manager’s ability to spend money, especially if it wasn’t allocated in budgets.

In addition to the managerial sample, a variety of individual contributors and supervisors were interviewed either individually or in small groups to determine the status and characteristics of different organization design factors. The organization’s policy and procedure manuals, annual reports, organization charts, and other archival information were also reviewed. This data collection effort revealed the following organization design features:

(Transforming Hospital Organizational Effectiveness)

· • The hospitals’ structures were more bureaucratic than organic. Each hospital had a functional structure with a chief executive officer and from two to five direct reports. Both hospitals had directors of nursing services and professional services. The larger hospital had additional directors in special projects, pastoral care, and other staff functions that worked with both hospitals. Traditional staff functions, such as finance, procurement, human resources, and information services, were centralized at the corporate office. There were a number of formal policies regarding spending, patient care, and so on.

· • The basic work design of the hospitals could be characterized as traditional. Tasks were narrowly defined (janitor, CCU nurse, admissions clerk, and so on). Further, despite the high levels of required interdependency and complexity involved in patient care, most jobs were individually based. That is, job descriptions detailed the skills, knowledge, and activities required of a particular position. Whenever any two departments needed to coordinate their activities, the work was controlled by standard operating procedures, formal paperwork, and tradition.

· • Information and control systems were old and inflexible. From the staff’s perspective, and to some extent even middle management’s, little, if any, operational information (that is, about costs, productivity, or levels of patient satisfaction) was shared. Cost information in terms of budgeted versus actual spending was available to middle managers and their annual performance reviews were keyed to meeting budgeted targets. Unfortunately, managers knew the information in the system was grossly inaccurate. They felt helpless in affecting change, since the system was centralized in the corporate office. As a result, they devised elaborate methods for getting the “right” numbers from the system or duplicated the system by keeping their own records.

· • Human resource systems, also centralized in the corporate office, were relatively generic. Internal job postings were updated weekly (there was a shortage of nurses at the time). There was little in the way of formal training opportunities beyond the required, technical educational requirements to maintain currency and certification. Reward systems consisted mainly of a merit-based pay system that awarded raises according to annual performance appraisal results. Raises over the previous few years, however, had barely kept pace with the cost of living. There also were various informal recognition systems administered by individual managers.

PART II(Transforming Hospital Organizational Effectiveness)

This diagnostic data was discussed and debated among the senior team. A steering committee composed of physicians, managers, nurses, and other leaders from both hospitals was convened, and creating a vision for the system and the change effort became one of their first tasks.

The steering committee spent hours poring over vision statements from other organizations, discussing words and phrases that described what they thought would be an exciting outcome from interacting with the hospital, and trying to satisfy their own needs for something unique and creative. When the first draft of a statement emerged, they spent several months sharing and discussing it with a variety of stakeholders. To their dismay, the initial version was roundly rejected by almost everyone as boring, unimaginative, or unreal. The group discussed the input gathered during these discussions and set about the task of revising the vision. After several additional iterations and a lot of wordsmithing, a new and more powerful vision statement began to emerge. The centerpiece of the vision was the belief that the organization should work in such a way that the patient felt like they were the “center of attention.” Such an orientation to the vision became a powerful rallying point since many of the hospitals’ management teams readily understood that there was an existing perception of poor service that needed to be turned around.

The three months spent working and adapting the vision statement was well worth it. As it was presented to people in small meetings and workshops, each word and phrase took on special meaning to organizational members and generated commitment to change.

 
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Health Insurance Case Scenarios

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Health Insurance Case Scenarios

(Health Insurance Case Scenarios)

Health Insurance Basic Questions

1. Mrs. Washington was involved in a traffic accident. She saw Dr. Grace because of pain in her right knee. She explained that this pain was the result of her knee hitting the dashboard on impact. Mrs. Washington has a history of arthritis in both of her knees. Dr. Grace listed her diagnosis from this visit as bilateral degenerative joint disease. What are the consequences of this diagnosis on Mrs. Washington’s case?

2. Anthony is 17 years of age and attending college in Maine. One day while skiing, he broke his leg and was taken to the emergency room of the local hospital. When filling out the necessary paperwork, whom should Anthony name as the party responsible for the charges incurred?

3. Mrs. Cassidy called her physician’s office complaining that her insurance company was billed twice for her office visit on November 19. Carole pulled Mrs. Cassidy’s file and verified that this was true. She apologized for the error and assured Mrs. Cassidy that she would correct this error. What steps should be taken to avoid duplicate billing

4. Mrs. Ellison called her doctor’s office and spoke with Lorraine about a bill from her recent visit. Mrs. Ellison has been Dr. Johnson’s patient for many years, although prior to her recent visit it had been some time since she saw Dr. Johnson. Mrs. Ellison was sure that there was a billing error because she was billed for a new patient visit. How should Lorraine handle this patient’s inquiry

5. Allison was working at the reception desk during a department staff meeting. She normally worked in medical records and therefore had an understanding of the importance of patient confidentiality. When a caseworker from a workers’ compensation case arrived and asked to discuss a patient’s case with the physician, Allison explained that she would need a signed release form from the patient before that was possible. Did Allison handle this situation correctly?

6. Jamie is reviewing Mr. Murphy’s medical file to process his insurance claim. She has difficulty reading the doctor’s notes, but rather than flag the file to check with the doctor, Jamie makes an educated guess and completes the insurance form. What are some possible consequences of Jamie’s actions?

 
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Navigating Ethics in Healthcare

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Navigating Ethics in Healthcare

(Navigating Ethics in Healthcare)

HEALTHCARE ETHICS

ASSIGNMENT 2

HA570-1: Critique the need for and role of ethics in the American healthcare environment.

Instructions:

As you have learned, differences exist between morality, ethics, and the law. Morality refers to an individual‘s moral compass or belief system based on their individual perspective. Ethics refers to the standard of action that should be performed, irregardless of an individual‘s perspective, opinion, or ideology. Law simply refers to any legal requirements involved.

In an ethical dilemma, varying perspectives exist. Oftentimes, these perspectives include the patient, provider, caregiver, family member, or staff member. Every person has a unique perspective and it is these unique experiences that form our belief system. As a future leader in healthcare administration, it is important to identify and understand how these varying perspectives act as a foundation for individual morality and influence our decisions. Likewise, it is also important to understand that despite personal morality, providers are required to abide by the ethical standards present in the field.

In this unit, you will explore the differences between morality and ethics by examining a scenario and its implications from varying perspectives. By the end of this unit, you will be able to proficiently discuss the need for and role of ethics in the American healthcare environment.

To begin, select one (1) of the following stories from your textbook from which to address the assignment requirements:

· The Story of the Harvey Family and the Interprofessional Care Team (p. 3)

· The Story of Pat Jackson, the Interprofessional Care Team, and Mr. Sanchez (p. 29)

· The Story of Bill Boyd and Kate Lindy (p. 53)

· The Story of Elizabeth Kim, Max Diaz, Melinda Diaz, and Michael Meary (p. 73)

· The Story of Michael Halloran and Amrou Croteau (p. 106)

In a 5-7 page paper (excluding title page and reference list), address the following:

· Summarize the story briefly providing the ethical dilemma and parties involved.

· Discuss the varying perspectives from the parties involved. Be sure to discuss potential reasoning for the varied perspectives. Please note that you may need to include fictitious information to complete this.

· Discuss ethical standards relevant to the unique scenario.

· Identify possible personal moral convictions which may influence the direction of the story.

· Foreshadow potential events in the story of what could happen if ethical standards did not exist.

Report your findings noting the following standards:

· Current APA formatting (e.g. title page, citations, conclusion, reference page, etc.) should be used.

· Proper grammar, spelling, and punctuation are expected.

· Plagiarism, self-plagiarism, unoriginal work, and unattributed content is not permitted and will result in action pursuant to the University’s Plagiarism Policy and Procedures.

Navigating Ethics in Healthcare

HA570-2: Assess national regulations regarding confidentiality and ethical considerations of confidentiality laws.

Instructions:

As you have learned, regulations and laws exist to protect patient privacy and uphold confidentiality. Especially in a technological advanced setting, such as healthcare, maintaining these standards can prove challenging as a result of new, ethical issues not previously experienced. As a future leader in healthcare administration, it is important to understand national regulations relative to confidentiality, privacy, and informed consent.

In this unit, you will compare ethical issues of confidentiality by examining a scenario and its implications of various regulations and laws. By the end of this unit, you will be able to assess national regulations regarding confidentiality and ethical considerations of confidentiality laws.

To begin, select one (1) of the following stories from your textbook from which to address the assignment requirements:

· The Story of Twyla Roberts and Mary Louis (p. 203)

· The Story of Beth Tottle, Mrs. Uwilla, and the Uwilla Family (p. 229)

· The Story of Jack Burns and Cecelia Langer (p. 250)

· The Story of Meg Perkins and Helen Williams (p. 279)

In a 5-7 page paper (excluding title page and reference list), address the following:

· Summarize the story briefly providing the ethical dilemma and parties involved.

· Discuss the varying perspectives from the parties involved. Be sure to discuss potential reasoning for the varied perspectives. Please note that you may need to include fictitious information to complete this.

· Discuss ethical standards relevant to the unique scenario.

· Identify national regulations and laws pertinent to the story.

· Using the six-step process, explain a practical, ethical solution to your story.

Report your findings noting the following standards:

· Current APA formatting (e.g. title page, citations, conclusion, reference page, etc.) should be used.

· Proper grammar, spelling, and punctuation are expected.

· Plagiarism, self-plagiarism, unoriginal work, and unattributed content is not permitted and will result in action pursuant to the University’s Plagiarism Policy and Procedures.

Navigating Ethics in Healthcare

3: Evaluate other healthcare industry regulations that protect patients and providers and best practices for assuring that they are followed.

Instructions:

As you have learned, the role of the ethical professional in the healthcare field requires conscious decision-making and consideration for all parties involved. As a future leader in healthcare administration, it is important to understand various industry regulations that protect patients and providers in an effort to make an appropriate decision with a caring response.

In this unit, you will use the six-step process to work through an ethical issue in healthcare to make an appropriate, caring response. By the end of this unit, you will be able to identify various healthcare industry regulations that protect patients and providers. Likewise, as a result, you will be able to discuss the proper moral limits of intervention.

To begin, select one (1) of the following stories from your textbook from which to address the assignment requirements:

· The Story of Mitch Rice, Gail Campis, the Belangers, and the Botched Home Visit (p. 123)

· The Story of Maureen Gudonis and Isaias Echevarria (p. 153)

· The Story of Simon Kapinsky and the Interprofessional Ethics Subcommittee to Implement a Green Health Plan (p. 179)

In a 5-7 page paper (excluding title page and reference list), address the following:

· Summarize the story briefly providing the ethical dilemma and parties involved.

· Discuss three healthcare rules, regulations, or laws relevant to the story (in additional to national laws, you will need to research industry-specific regulations based on your story selection).

· Thoroughly discuss each phase of the six-step process relative to your story selection.

· Recommend an appropriate, caring response that aligns with industry-specific regulations and ethical standards.

Report your findings noting the following standards:

· Current APA formatting (e.g. title page, citations, conclusion, reference page, etc.) should be used.

· Proper grammar, spelling, and punctuation are expected.

· Plagiarism, self-plagiarism, unoriginal work, and unattributed content is not permitted and will result in action pursuant to the University’s Plagiarism Policy and Procedures.

Navigating Ethics in Healthcare

4: Analyze the effect ethics has on day-to-day operations as well as long-term policy and procedure in a healthcare environment.

Instructions:

As you have learned, the population segment aged 65 and older is rapidly aging in the United States. As a result, new ethical challenges are emerging in the field, specifically in long-term care (i.e. skilled nursing facilities including those with post-surgical short-term rehabilitation services).

One area of concern is the challenge of providing adequate healthcare services to a growing (and aging) population with limited resources. This dilemma is expected to increase as the population continues to increase. As a result, the demand for medical services increases; however, with finite healthcare resources, providing services to everyone who requires care is not possible.

This will present a unique challenge for nursing home administrators because they are responsible to ensure that resident needs (including receiving healthcare services) are being met. Determining who should receive the necessary care that is available will be an interdisciplinary challenge indeed.

Scholars have posited a variety of allocation methods; however, these principles have not been without controversy. One of the most recent principles introduced is the Complete Lives System. This method is unique, because unlike its predecessors that relied on a unilateral perspective, the Complete Lives Systems takes a multi-allocation system approach.

In this unit, you will combine your previous knowledge obtained throughout the course and apply clinical reasoning to evaluate moral action and its relevance to ethical-decision making in long-term care. Using ethical decision-making, you will determine the best method of allocating limited medical resources to a growing and aging population. By the end of this unit, you will be able to analyze the effect ethics has on day-to-day operations as well as long-term policy and procedure in a healthcare environment.

Navigating Ethics in Healthcare

Read the following articles from our library:

· Krütli, P., Rosemann, T., Törnblom, K. Y., & Smieszek, T. (2016). How to fairly allocate scarce medical resources: Ethical argumentation under scrutiny by health professionals and lay people. Plos ONE, 11(7), 1-18. doi:10.1371/journal.pone.0159086

· Persad, G., Wertheimer, A., & Emanuel, E. J. (2009). Department of Ethics: Principles for allocation of scarce medical interventions. The Lancet, 373, 423-431. doi:10.1016/S0140-6736(09)60137-9

Please review the following resources and using specific information from these resources, your course materials, and additional research, address the tasks posed below.

Three individuals in town require a hip surgery, followed by extensive rehabilitative therapy. Physical and occupational therapy will be provided at the skilled nursing facility where the individual will reside until able to return home. Below are details of each individual.

· Donna Mueller is a 58-year old disabled widow with no children. She spent her career as a homemaker and taking care of her husband. Donna requires surgery after falling at home while washing windows. Prior to the accident, Donna was relatively independent, although a stroke a few years prior left her partially paralyzed. She lives alone and has minimal company over.

· Steve McDonald is 40-year old unemployed musician. He has a teenage son who lives with the son’s mother in a neighboring town. At the age of 19, Steve left college to pursue a career as a drummer. For the past two decades, Steve has worked odd jobs while pursuing his dream. Although his perseverance has not landed him national attention, he has performed with a few, known bands in the area. Recently, while exiting stage left from a nightclub performance, Steve tripped over the dark stairs and fractured his hip, ultimately leaving him unemployed as he is currently unable to perform.

· Chris Snider is a 73-year old entrepreneur and business owner. Never married, Chris spent his career in the fast-pace, produce or perish industry of nanotechnology where he employs over 5,000 workers ranging from maintenance technicians to senior research engineers. Chris requires surgery after being innocently hit with a runaway golf cart on the back 9 with his visiting, foreign affiliates. Chris was completely independent prior to the accident. He lives alone; however, his business requires travel.

In a 6-8 page paper (excluding title page and reference list), address the following:

· Considering the aging population and existing challenges, discuss the potential role of allocation principles in the American healthcare system.

· Discuss the potential implications these principles have on the aging population (consider potential violations of federal antidiscrimination laws and ethical principles about fair treatment).

· Based on the Complete Lives System, discuss which individual would most likely receive the surgery.

· Based on your moral compass, ethical standards, and healthcare laws, discuss which individual you would recommend for surgery.

· Recommend the one allocation principle you would prefer as the primary medical intervention for a growing (and aging) population.

Report your findings noting the following standards:

· Current APA formatting (e.g. title page, citations, conclusion, reference page, etc.) should be used.

· Proper grammar, spelling, and punctuation are expected.

· Plagiarism, self-plagiarism, unoriginal work, and unattributed content is not permitted and will result in action pursuant to the University’s Plagiarism Policy and Procedures. 

 
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Clinical Procedure Coding Practice

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Clinical Procedure Coding Practice

(Clinical Procedure Coding Practice)

ICD-PCS Coding

M132 Module 02 Coding Assignment

Find the correct code and explain your rationale for each case study below.

1. Case Study:

PREOPERATIVE DIAGNOSIS:

1. Gangrene right foot.

POSTOPERATIVE DIAGNOSIS:

1. Gangrene right foot.

OPERATION:

1. Right below the knee amputation.

ANESTHESIA: General LMA.

PROCEDURE: The patient was brought to the operative suite where a general LMA anesthesia was induced.

A Foley catheter was inserted. The right foot was s secluded in an isolation bag and the right lower extremity circumferentially prepped and draped in its entirety. Beginning on the right side the skin was marked with a marking pen 4 fingerbreadths below the tibial tuberosity anteriorly with a long posterior flap. The skin was incised circumferentially and the anterior musculature sharply divided exposing the tibia The tibia was cleaned with a periosteal elevator and then transected with the Stryker saw. The fibula was exposed and transected with the bone cutter and the amputation completed by sharply incising the posterior musculature. Bleeding vessels were ligated with 2-0 silk Ligature. There appeared to be adequate bleeding at this level for primary healing. The tibia was then cleaned with a bone rasp and the fibula with a rongeur. The wound was irrigated and ultimately closed without significant tension utilizing interrupted 2-0 vicryl sutures for reapproximation of the fascia and skin staples for reapproximation of the skin.

The right side was dressed with sterile gauze fluff dressings and a Kerlix roll. Estimated blood loss throughout the procedure was approximately 150 mL. The patient received one unit intraoperatively of packed cells because of preoperative anemia. She was transported in stable condition to the recovery room.

2. Case Study:(Clinical Procedure Coding Practice)

PROCEDURE: Open reduction and internal fixation of bilateral tibial plateau fractures.

INDICATIONS: This 23-year old was involved in a serious accident and sustained bilateral tibial plateau fractures

DESCRIPTION OF OPERATION: The patient was brought to the operating room and placed on the operating room table in the supine position. General anesthesia was induced, and after this both lower extremities were prepped and draped in the usual sterile fashion. Attention was first directed towards the left tibial plateau. A standard lateral procedure to reduce the lateral tibial plateau fracture was performed. After a submeniscal arthrotomy was performed, the joint was visualized via the lateral approach. The posterolateral fragments were reduced and the lateral tibial plateau was elevated, restoring the articular surface. K-wires were placed to provisionally hold this reduction. C-arm fluoroscopy was used to confirm good reduction of the joint surface. Next, a 6-hole lateral plateau locking plate from the Stryker sets was selected. This locking plate was advanced down the tibial shaft. Screws were placed to secre the plate to the bone. Four screws were placed in the distal shaft fragments and 4 locking screws in the proximal fragment. A kickstand screw was also placed in the locking mode. After all screws were placed, x-rays exhibited good reduction of the fracture, as well as good placement of all hardware. Next, the wound was thoroughly irrigated with normal saline. The meniscal arthrotomy was closed with the 0 PDS suture, including the capsule. Next, the IT band was closed with 0 Vicryl suture, followed by 2-0 Vicryl sutures for the skin and staples. Attention was then directed toward the right tibial plateau. A similar procedure was performed on the right side. Then, the lateral approach to the lateral tibial plateau was performed, exposing the fracture. The incision was approximately 4 cm on the right side. A 6-hole LISS plate was advanced down the tibial shaft. Four screws were placed in the distal fragments followed by four screws in the locking mode and proximal metaphyseal fragment. Excellent fixation was obtained. The C-arm fluoroscopy was used to confirm excellent reduction of the fracture on both the AP and lateral fluoroscopic images. Next, the wound was thoroughly irrigated and closed in layers. Sterile dressings were applied All wounds were dressed with sterile dressing and the patient was placed into knee immobilizers. The patient was then awakened from anesthesia, and transferred to recovery. The patient will be nonweightbearing for approximately three months on bilateral lower extremities. The patient will receive DVT prophylaxis during this time.

3. Case Study:(Clinical Procedure Coding Practice)

PREOPERATIVE DIAGNOSES:

1. Pelvic pain.

2. History of previous pelvic surgery and ovarian cyst.

POSTOPERATIVE DIAGNOSES:

1. Pelvic pain.

2. History of previous pelvic surgery and ovarian cyst.

OPERATION PERFORMED: Laparoscopic adhesiolysis.

SURGEON: Susan Smith, MD

ANESTHESIA: General endotracheal.

ESTIMATED BLOOD LOSS: Less than 10 mL.

URINE OUTPUT: 70 mL.

IV FLUIDS: 750 mL.

DESCRIPTION OF OPERATION: After informed consent was obtained, the patient was taken to the operating room. She was placed in the dorsal supine position and general anesthesia was induced and prepped and draped in the usual sterile fashion. A Foley catheter was placed to gravity and speculum was placed in the posterior and anterior vagina and the cervix was grasped with a single-toothed tenaculum. A Hulka clamp was then inserted through the cervix into the uterus for uterine manipulations and the tenaculum was removed and attention was then turned to the abdomen.

A supraumbilical incision was made with a scalpel and elevated up with towel clamps. A long Veress needle was then placed and CO2 gas was used to insufflate the abdomen and pelvis. A 10-12 trocar and sleeve were then placed and confirmed via the laparoscope. The dense greater omental adhesions to the anterior abdominal wall were noted immediately. At this time, we were not able to see into the pelvic region. A second 5 mm trocar and sleeve were placed in the left mid quadrant under direct visualization. The ligature device was then placed developing a plane between the omentum and the anterior abdominal wall.

The adhesiolysis took place and it took approximately 25 minutes to release all of the omental adhesions from the anterior abdominal wall. We were then able to visualize the pelvis and a blunt probe was placed through the port. The ovary was visualized and photos were taken with no evidence of any ovarian cyst or ovarian pathology or of pelvic endometriosis. The uterus also appeared normal and the left tube and ovary were surgically absent. The appendix was easily visualized and noted to be noninflamed, normal in appearance, and there were no adhesions in the right lower quadrant. The upper abdominal exam was unremarkable. The procedure was terminated at this time. The ports were removed. CO2 gas was allowed to escape. The incisions were closed with 4-0 Vicryl suture. The Hulka clamp was removed. The vagina was noted to be hemostatic. The patient’s anesthesia was awakened from anesthesia, the Foley catheter was removed, and she was taken in stable condition to the recovery room.

 
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Ethical Conduct

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Ethical Conduct

(Ethical Conduct) Discuss nursing ethics based on the case study.

Ethical Conduct

Nursing Ethics in the Context of a Case Study

Nursing ethics is crucial in ensuring that patient care aligns with moral principles. A recent case study highlights the importance of ethical considerations in nursing. In this case, a nurse faced a dilemma when a terminally ill patient requested assistance in ending their life. This situation presents various ethical challenges, requiring a thorough understanding of nursing ethics to navigate effectively.

Respect for Autonomy

Firstly, respect for autonomy is a fundamental ethical principle in nursing. Autonomy refers to the patient’s right to make decisions about their own health care. In the case study, the patient expressed a clear desire to end their suffering through euthanasia. Therefore, the nurse must respect this wish while considering legal and professional boundaries. To support the patient’s autonomy, the nurse should ensure the patient fully understands their options and the potential consequences of their decision. (Ethical Conduct)

Beneficence and Non-Maleficence

Beneficence and non-maleficence are also critical in nursing ethics. Beneficence involves promoting the patient’s well-being, while non-maleficence means avoiding harm. In the case study, the nurse faces a conflict between these principles. Assisting the patient in ending their life may be seen as promoting well-being by alleviating suffering. However, it also involves causing harm. The nurse must carefully weigh these principles to determine the best course of action.

Legal and Professional Considerations

Legal and professional considerations also play a significant role in nursing ethics. The nurse must adhere to the laws and regulations governing their practice. In many jurisdictions, euthanasia is illegal, and assisting a patient in ending their life could result in severe legal consequences. Moreover, professional codes of ethics, such as the American Nurses Association’s Code of Ethics, provide guidelines for nurses. These codes often emphasize the importance of preserving life and prohibit actions that intentionally cause death. Thus, the nurse must balance ethical principles with legal and professional obligations. (Ethical Conduct)

Communication and Compassion

Effective communication and compassion are essential in addressing ethical dilemmas. The nurse should engage in open, honest conversations with the patient and their family. This approach helps to understand their perspectives and provide emotional support. By listening to the patient’s concerns and explaining the ethical and legal constraints, the nurse can build trust and provide compassionate care. Additionally, involving other healthcare professionals, such as physicians and ethicists, can offer valuable insights and support in decision-making.

Ethical Decision-Making Frameworks

Applying ethical decision-making frameworks can guide nurses in resolving complex ethical dilemmas. One such framework is the Four-Box Method, which considers medical indications, patient preferences, quality of life, and contextual features. By systematically evaluating these factors, the nurse can make a well-informed decision. In the case study, this approach could help balance the patient’s desire for euthanasia with the ethical, legal, and professional considerations involved.

Conclusion

Nursing ethics require a careful balance of respecting patient autonomy, promoting well-being, avoiding harm, and adhering to legal and professional standards. In the presented case study, the nurse faces a challenging ethical dilemma when a terminally ill patient requests assistance in ending their life. By applying ethical principles, effective communication, and decision-making frameworks, the nurse can navigate this complex situation. This approach ensures that patient care remains compassionate, ethical, and legally compliant.

References

https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/code-of-ethics-for-nurses/

 
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Forensic Analysis and Drug Classification

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Forensic Analysis and Drug Classification

(Forensic Analysis and Drug Classification)

Respond to one of the following:

Option 1: Differentiate between organic and inorganic analysis.  Differentiate between qualitative and quantitative measurement

Option 2: Gas chromatography is one of the basic analysis procedures for the crime lab.  Describe this process and the theory upon which it is based.

Option 3: Describe the Mass Spectrometry process.

Option 4: Describe the X-ray diffraction process.

Option 5: Our text describes five types of microscopes commonly used in forensic analysis.  List them and briefly describe the function of each.

Option 6: Below is a series of twenty-three questions about drugs or drug use. For your original posting, answer one of these questions that has not been answered by anyone else as yet by identifying which question you are answering by number.  There should be enough questions that each of you can answer a separate one.

Following are descriptions of behavior that are characteristic among users of certain classes of drugs. For each description, indicate the class of drug (narcotics, stimulants, and so forth) for which the behavior is most characteristic.

1. slurred speech, slow reaction time, impaired judgment, reduced coordination
2. intense emotional responses, anxiety, altered sensory perceptions
3. alertness, feelings of strength and confidence, rapid speech and movement, decreased appetite
4. drowsiness, intense feelings of well-being, relief from pain

Following are descriptions of behavior that are characteristic among users of certain classes of drugs. Name at least one drug that produces the described effects.

5. slurred speech, slow reaction time, impaired judgment, reduced coordination
6. intense emotional responses, anxiety, altered sensory perceptions
7. alertness, feelings of strength and confidence, rapid speech and movement, decreased appetite
8. drowsiness, intense feelings of well-being, relief from pain

Following are descriptions of hypothetical drugs. According to the Controlled Substances Act, under which drug schedule would each substance be classified?

9. This drug has a high potential for psychological dependence, it currently has accepted medical uses in the United States, and the distributor is not required to report to the U. S. Drug Enforcement Administration.
10. This drug has medical use in the United States, is not limited by manufacturing quotas, and may be exported without a permit.
11. This drug must be stored in a vault or safe, requires separate records keeping, and may be distributed with a prescription.
12. This drug may not be imported or exported without a permit, is subject to manufacturing quotas, and currently has no medical use in the United States.

The figure on page 143 shows a chromatogram of a known mixture of barbiturates. Based on the figure, answer one of the following questions.

13, Which barbiturate detected by the chromatogram had the longest retention time?
14. Which barbiturate had the shortest retention time?
15. What is the approximate retention time of amobarbital?

Do you like having multiple choices from which to select a response, or do you prefer everyone answering the same question? GB

 
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OSHA Inspection Legal Procedures

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OSHA Inspection Legal Procedures

(OSHA Inspection Legal Procedures)

OSH 3525, Legal Aspects of Safety and Health 1

Course Learning Outcomes for Unit IV Upon completion of this unit, students should be able to:

6. Outline employer rights and responsibilities following an OSHA inspection. 6.1 Discuss an employer’s options to contest OSHA citations and penalties.

Reading Assignment OSHA’s Field Operations Manual (FOM): Chapter 7: Post-Citation Procedures and Abatement Verification Occupational Safety and Health Administration. (2011). Field Operations Manual. Retrieved from

https://www.osha.gov/OshDoc/Directive_pdf/CPL_02-00-159.pdf

Unit Lesson When an Occupational Safety and Health Administration (OSHA) inspection results in citations and penalties, employers can react in many different ways, including disbelief, anger, and confusion about what is required. However, there are some specific requirements that all employers must follow, and some options that are available under the Act. Employees also have some rights after the inspection is complete and citations and penalties have been issued. Many discussions about what can be done after an inspection has been completed are limited to employers, and the rights of employees are not considered.

The OSHA inspection process is supposed to be transparent to employees. This means that the employer has to post any citations that were issued by OSHA. The citations must be posted in the location where the violation(s) occurred, or nearby, and must remain posted for at least 3 days or until the violation(s) have been abated, whichever is longer. Some employers mistakenly believe that they do not have to post the citation notice if they are going to contest the citations. This belief is incorrect. The citation notice must be posted whether the employer is going to contest the citations or not. These posting requirements are specified in 29 CFR 1903.16. Employers can be further cited and penalized if they fail to post a copy of the original citations. Additionally, any abatement certification documents, abatement plans, progress reports, and a notice of informal conference made by the employer to OSHA

concerning the citations must be posted so employees can see the responses. The Act provides both employers and employees with certain rights after the completion of an inspection. These rights are designed to ensure that both the employer and employee have the ability to contest citations and penalties that they believe are unfair. There are several processes available ranging from informal discussions to formal legal proceedings. The employer may decide to simply accept and abate all the citations and pay the proposed penalties. If the

UNIT IV STUDY GUIDE

(OSHA Inspection Legal Procedures)

Employer Rights and Responsibilities after an OSHA Inspection

(US Dept. of Labor, 2011)

Employer chooses this option, they must complete the abatement prior to the abatement date specified in the Notice of Citations and Penalties and pay the penalty(ies). 29 CFR 1903.20 provides a process for both employers and employees (or their representative) to request an informal conference with the area director, or their representative. An employee may desire to have an informal conference because they believe their safety or health concerns were not adequately addressed by the OSHA inspection. An employer may desire the informal conference because they believe the citations and penalties were too harsh, because they do not understand some part of the citation or penalty, or to highlight some additional information about their health and safety program(s) to the area director that they believe may mitigate the severity of the citations and penalties. In some cases, the area director may agree to reduce the severity and/or amount of the penalty(ies). If this occurs, an informal settlement agreement may be reached and further litigation avoided.​

It should be noted that employees, or their representatives have the right to participate in any informal conference. This is the reason a notice of an informal conference must be posted in or near the area where citations occurred. Many health and safety experts recommend that an employer always request an informal conference after citations and penalties are issued. Employers must remember that the informal conference does not delay the 15 working days that the employer has to file a notice of contest. Therefore, the employer must schedule the informal conference early enough to allow time to file a Notice of Contest, if necessary. If the employer does not file a Notice to Contest within 15 working days, the citation becomes a final order. This means that the area director can no longer change the seriousness of citations or the penalties because they have become final orders.​

The ability of the employer or employee to formally contest citations, penalties, and abatement dates is extremely important for ensuring due process is provided. The contest process means the employer or employee does not have to accept the views of the compliance officer(s) and the area director without any ability to defend themselves or challenge what is perceived as an inadequate or over reactive response to an employee complaint. An employer or employee does not have to contest every citation and penalty. In fact, in most cases, only a portion of the citations and penalties are challenged. Once a formal notice to contest is filed, the case is in litigation and the area director cannot take any additional actions until the case is heard by an administrative law judge (ALJ) assigned to the case.​

There are many federal agencies that use ALJs. The ALJs that hear contested OSHA citations are from the Occupational Safety and Health Review Commission (OSHRC). The OSHRC was created along with OSHA after the Act was passed. It should be noted that the OSHRC is an independent organization, separate from OSHA and the Department of Labor. This separation was by design to make sure there is no undue influence over the OSHRC. This helps ensure the hearings are impartial. We will study the OSHRC and ALJs in more detail in Units VI and VII.​

The Citation and Notification of Penalty document will specify state abatement dates for each citation. The dates are set by the compliance officer performing the inspection based on his/her best estimate of the time required to complete the abatement. Employers have the right to formally petition for an extended abatement date if they believe they will not be able to meet the original date. 29CFR 1903.1 contains specific requirements for filing a Petition for Modification of Abatement Date (PMA).​

The final document OSHA requires for citations is abatement certification. Abatement certification is required for all citations that have become final orders, except “quick-fix” items that were corrected during the inspection. 29CFR 1903.19 contains specific requirements for abatement certifications. The regulation includes some more extensive documentation for more serious violations. The Citation and Notification of Penalty will typically specify which violations require additional certification. The area director may require an abatement plan to be submitted for some violations, especially if the abatement is complicated or may take an extended period of time. The area director may also require the abatement plan to include interim measures to protect employees during the extended abatement process. If an abatement plan is required, the employer may be required to periodically submit progress reports.

OSH 3525, Legal Aspects of Safety and Health 3

(OSHA Inspection Legal Procedures)

UNIT x STUDY GUIDE

Title

References Missling, T. (2011, July 28). US Department of Labor [Digital image]. Retrieved from https://flic.kr/p/afYuLP Occupational Safety and Health Administration. (n.d.). Purpose and scope, 29 CFR § 1903.1. Retrieved from

https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=9605 Occupational Safety and Health Administration. (n.d.). Posting of citations, 29 CFR § 1903.16. Retrieved from

https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=9621 Occupational Safety and Health Administration. (n.d.). Abatement verification, 29 CFR § 1903.19. Retrieved

from https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=9624

Occupational Safety and Health Administration. (n.d.). Informal conferences, 29 CFR § 1903.20. Retrieved

from https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=9628

Occupational Safety and Health Administration. (2011). Field Operations Manual. Retrieved from

https://www.osha.gov/OshDoc/Directive_pdf/CPL_02-00-159.pdf

Suggested Reading If you are interested in learning more about inspections and abatement, review the resources below: Occupational Safety and Health Administration. (n.d.). All about Occupational Safety and Health

Administration. Retrieved from https://www.osha.gov/archive/Publications/osha2056.html Occupational Safety and Health Administration. (n.d.). Employer rights and responsibilities following a federal

OSHA inspection. Retrieved from https://www.osha.gov/Publications/osha3000.pdf Occupational Safety and Health Administration. (n.d.). OSHA inspections. Retrieved from

https://www.osha.gov/Publications/osha2098.html Occupational Safety and Health Administration. (n.d.). OSHA’s abatement verification regulation. Retrieved

from https://www.osha.gov/Publications/Abate/abate.html Occupational Safety and Health Administration. (n.d.). Petitions for modification of abatement date. Retrieved

from https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=9619

Learning Activities (Non-Graded) OSHA has a hierarchy of controls that must be used for abatement of hazardous conditions. You can view OSHA’s Hierarchy of Controls at the website below: https://www.osha.gov/dte/grant_materials/fy10/sh-20839-10/hierarchy_of_controls.pdf Review the Hierarchy of Controls, and summarize the different types of abatement techniques that would fit into each category.

 
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Comparative Analysis of Energy

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Comparative Analysis of Energy

(Comparative Analysis of Energy)

Name:

 Date:

 Instructor’s Name:

 Assignment: SCIE211 Phase 4 Lab Report

 Title: Comparative Analysis of Energy

 Instructions: You will write a 1-page lab report using the scientific method.

When your lab report is complete, post it in Submitted Assignment files.

 Part I: Using the lab animation, fill in the data table below to gather your data, and use it to help you generate your hypothesis, outcomes, and analysis.

Energy Source Fuel (Coal)/Uranium Needed (tons) CO2 Emissions
(tons)		 Sulfur Dioxide and Other Emissions (tons) Radioactivity mSv (millisievert) Solid Waste (tons) Accidents
Coal
Nuclear

Part II: Write a 1-page lab report using the following scientific method sections:

  • Purpose
    • State the purpose of the lab.
  • Introduction
    • This is an investigation of what is currently known about the question being asked. Use background information from credible references to write a short summary about concepts in the lab. List and cite references in APA style.
  • Hypothesis/Predicted Outcome
    • A hypothesis is an educated guess. Based on what you have learned and written about in the Introduction, state what you expect to be the results of the lab procedures.
  • Methods
    • Summarize the procedures that you used in the lab. The Methods section should also state clearly how data (numbers) were collected during the lab; this will be reported in the Results/Outcome section.
  • Results/Outcome
    • Provide here any results or data that were generated while doing the lab procedure.
  • Discussion/Analysis
    • In this section, state clearly whether you obtained the expected results, and if the outcome was as expected.
    • Note: You can use the lab data to help you discuss the results and what you learned.

Provide references in APA format. This includes a reference list and in-text citations for references used in the Introduction section.

Give your paper a title and number, and identify each section as specified above. Although the hypothesis will be a 1-sentence answer, the other sections will need to be paragraphs to adequately explain your experiment.

When your lab report is complete, post it in Submitted Assignment files.

 
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Fundamentals of Epidemiology Knowledge

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Fundamentals of Epidemiology Knowledge

(Fundamentals of Epidemiology Knowledge)

Question 1 .

The first step in any epidemiological investigation is to ____.

Answer

understand causation establish risk factors track trends and determine if particular diseases are increasing or decreasing in the population describe the population demographically by age, race, sex, education, and other relevant indicators

Question 2 .

One of the important concepts from the Nuremberg Code is that of ____, which means that the subject understands the scope of the study and can make an informed decision to participate.

Answer

informed consent voluntary consent beneficence primary agent

Question 3 .

A disease or condition that affects a greater than expected (normal) number of individuals within a population, community, or region at the same time is referred to as an ____.

Answer

epidemic endemic outbreak epidemic threshold

Question 4 .

The normal occurrence of a disease or condition common to persons within a localized area is known as a(n) ____.

Answer

transmission pandemic endemic epidemic

Question 5 .

Reproductive health studies ____.

Answer

the role of genetics in disease development the occurrence and risk factors for disease such as cancer, heart disease, and diabetes that are slow to develop but span many years the distribution and risk factors for injuries, either accidental or intentional normal reproductive processes and problems that can occur including infertility, birth defects, and low birth weight

Question 6 .

The course of a disease, if left untreated, is referred to as ____.

Answer

transmission control measure natural history geographic pattern

Question 7 .

Physical, biological, social, cultural, and behaviors that influence health are known as ____.

Answer

risk factors health-related states agents determinants

Question 8 .

James Lind (1716-1794) observed the effect of time, place, weather, and diet on the spread of disease by ____.

Answer

comparing sick persons to well persons applying the germ theory to public health introducing randomization when conducting clinical trials applying the germ theory to hygiene practices

QUestion 9

The aspect of consistency means that ____.

Answer

an increasing amount of exposure increases the risk the association should be compatible with existing theory and knowledge the association is consistent when results are repeated in studies in different settings using different methods the findings agree with currently accepted understanding of pathological processes

QUestion 10

The modern epidemiologic triangle includes groups of populations, causative factors, and ____.

Answer

alternate explanations risk factors results coherence

Question 11

For chronic diseases, the time between exposure and symptoms is called the ____ period, which can range from a few months to many years.

Answer

latency incubation temporal plausibility

Question 12

Risk factors or exposures that we think might affect the outcome are known as ____.

Answer

indirect causes direct causes dependent variables independent variables

QUestion 13

Identifying diseases prior to the clinical stage means that prevention efforts can begin immediately. Because the disease is already present, this is an example of ____ prevention.

Answer

primary secondary tertiary quaternary

QUestion 14 The time between infection and clinical disease is referred to as a(n) ____.

Answer

a plausible period temporal period incubation period latency period

Question 15 .

A proportion measured over a period of time is known as a ____.

Answer

period prevalence prevalence proportion point prevalence rate

Question 16

The representation of a numerator as a fraction of a denominator is known as a(n) ____.

Answer

proportion rate incidence rate specific rate

Question 17 .

Prevalence equals ____.

Answer

incidence times duration of disease incidence divided by duration of disease incidence plus duration of disease incidence divided by duration of disease times 100

Question 18 .

While many people are used to hearing proportions represented as a percentage, many population samples in epidemiology are often presented per ____.

Answer

1,000 10,000 100,000 1,000,000

.Question 19 .

By definition, the disease or condition used to identify a case is determined by the ____.

Answer

hypothesis conclusion prevalence incidence

Question 20 .

A person in the population or study group identified as having the particular disease, health disorder, or condition under investigation is known as a ____.

Answer

person time case suspect case proportion

QUestion 21:

The number of new cases of disease in a specified time (usually one year) divided by the population “at-risk” to develop the disease is known as ____.

Answer

prevalence proportion incidence rate contingency case severity

Question 22 .

The number of existing cases of disease divided by the population is known as ____.

Answer

crude rate person time incidence rate prevalence proportion

Question 23 .

If a bacterium carries several resistance genes, it is called a ____.

Answer

multidrug resistant drug or super-drug multidrug resistant bacterium or superbug resistant bacterium or streptococcus bacterium killer bacterium or deadly bacterium

.Question 24 .

The disease carrier of most concern is known as a(n) ____, which is an infected person who never gets clinically ill, but can transmit the etiologic agent to others.

Answer

healthy or passive carrier pregnant carrier convalescent carrier active carrier

Question 25 .

____ is the transmission of a disease from mother to child during pregnancy or delivery.

Answer

Horizontal transmission Vertical transmission Lateral transmission Polar transmission

Question 26

There is ____ in the overall crude death rate in the United States from the year 1900 until 1996.

Answer

a definite increase a slight decrease hardly any change a clear decline

Question 27 .

The probability of death due to infectious disease in sub-Saharan Africa is ____%, but only ____% in developed countries, such as the United States.

Answer

22; 1.1 35; 10 66; 11 50; 22

Question 28 .

One of the most important emerging problems with the control of infectious diseases has to do with ____.Answer

deadly parasitic infections antibiotic resistant viral infections antibiotic resistant bacterial infections vaccine resistant viral infections

Question 29 .

A(n) ____ is an infected individual capable of transmitting disease during and after clinical disease.

Answer

convalescent carrier passive carrier active carrier inactive carrier

Question 30 . ____ is the transmission of a disease from person to person, and may be directly from one person to another, or indirectly from one person through an intermediate item to another person.

Answer

Horizontal transmission Vertical transmission Quick transmission Polar transmission

 
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