NR705-WEEK 2 Discussion-Prescreening Process

NR705-WEEK 2 Discussion-Prescreening Process

Practice Question

The following practice question will serve as the basis of the DNP project: For adults with a history of Schizophrenia (P) in the inpatient setting, does the implementation of technology with motivational interviewing (I), compared with current practice (C), impact medication nonadherence (O) in 8-10 weeks (T)?

NR705-WEEK 2 Discussion-Prescreening Process

Process for Completing the IRB Prescreening Supplement Form

The project involves human participants; hence an IRB approval is necessary. The IRB will examine all the supporting documents, including applications, consent documents, recruitment materials, study instruments, and data collection instruments, such as surveys, interview questions, stimuli, and other forms or documents that the human participants will utilize (Rooney et al., 2019). The IRB Prescreening Supplement Form requires elaborating and specifying the expected duration of the participant’s participation, describing the procedures required or to be followed in the project, identifying procedures that might be experimental, and describing any reasonably foreseeable risks or discomforts to the participants. The IRB will review the consent forms and the informed consent process to ensure that the research study provides adequate details and in a language that is easily and readily understandable to the individuals volunteering to be the research participants (Rooney et al., 2019). The IRB application also requires a clear description of the research design and its suitability for human participants.

Project Status

The project is still at the approval stage, but the research team is working with participants towards data collection, which will only be completed after IRB approval. However, the preparation is necessary, including explaining to participants what is expected of them, how the data will be collected, for how long the data will be collected, and the methods and instruments that will be used to collect the data. Generally, the team is in the initial stages of the implementation, and the organization I am working with is already aware of the project implementation, the intervention, and the involvement of schizophrenia patients in the study.

References

Rooney, L., Covington, L., Dedier, A., & Samuel, B. (2019). Measuring IRB Regulatory Compliance: Development, Testing, and Use of the National Cancer Institute StART Tool. Journal of empirical research on human research ethics : JERHRE14(2), 95–106. https://doi.org/10.1177/1556264619831888

 
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Nursing Paper Example on Progeria Disease

Nursing Paper Example on Progeria Disease

Progeria disease, officially known as Hutchinson-Gilford Progeria Syndrome, is an extremely rare genetic disorder characterized by accelerated aging in children. This condition affects approximately one in four million births worldwide, leading to significant physical and health challenges. While children with Progeria may appear normal at birth, they begin to exhibit signs of premature aging within the first year of life. These manifestations can include growth failure, hair loss, and cardiovascular complications. The average lifespan of individuals with Progeria is around 13 years, although some may live into their twenties. Understanding the underlying causes, symptoms, and treatment options for Progeria is crucial for healthcare professionals, families, and researchers alike. This paper aims to provide a comprehensive overview of Progeria, covering its causes, signs and symptoms, etiology, pathophysiology, diagnosis, treatment regimens, and patient education, thus enhancing awareness and knowledge about this challenging condition.

(Nursing Paper Example on Progeria Disease)

Nursing Paper Example on Progeria Disease

Causes

Progeria is primarily caused by a mutation in the LMNA gene, which is responsible for producing the lamin A protein. This protein plays a crucial role in maintaining the structural integrity of the cell nucleus. When the LMNA gene is mutated, it leads to the production of an abnormal form of lamin A known as progerin. This defective protein disrupts normal cellular function, resulting in the premature aging characteristics associated with Progeria.

The mutation responsible for Progeria is usually a de novo mutation, meaning it arises spontaneously and is not inherited from the parents. This genetic change occurs in approximately 80% of Progeria cases. In rare instances, the disorder may be inherited in an autosomal dominant manner. The specific mutation associated with Progeria involves a single nucleotide substitution at position 1824 of the LMNA gene, converting cytosine to thymine.

The production of progerin leads to several cellular dysfunctions. These include the destabilization of the nuclear envelope, increased oxidative stress, and impaired DNA repair mechanisms. Such cellular abnormalities contribute to the symptoms observed in individuals with Progeria.

Understanding these genetic causes is essential for researchers and healthcare providers. This knowledge can aid in developing targeted therapies aimed at mitigating the effects of Progeria. Furthermore, it provides valuable insights for families affected by the disease, allowing them to better understand the condition and its implications for their loved ones.

Signs and Symptoms

Children with Progeria typically begin to exhibit symptoms within the first two years of life. One of the most noticeable physical signs is growth failure. Affected children are often shorter and weigh less than their peers. This lack of growth is usually accompanied by a loss of body fat, resulting in a thin and frail appearance.

Another prominent symptom is hair loss. Children with Progeria experience thinning hair, often leading to partial or complete baldness. Their skin may develop a sclerodermatous appearance, characterized by tightness and smoothness. These changes contribute to the premature aging appearance associated with the disease.

Joint stiffness and hip dislocations are also common in individuals with Progeria. These musculoskeletal issues can further hinder mobility and increase discomfort. Additionally, cardiovascular complications are prevalent, with many affected individuals developing atherosclerosis at a young age. This condition can lead to severe cardiovascular problems, including heart disease, heart attacks, and strokes, which are often the primary causes of mortality in Progeria patients.

Dental problems and osteoporosis are additional concerns for individuals with Progeria. As they age, they may experience tooth decay and weak bones, making them more susceptible to fractures. Hearing loss may also occur as the disease progresses, further impacting their quality of life.

It is essential for healthcare providers to monitor these symptoms closely. Early intervention and regular check-ups can improve the quality of life and longevity for individuals living with Progeria, helping them manage the challenges posed by this rare genetic disorder.

(Nursing Paper Example on Progeria Disease)

Etiology

The etiology of Progeria is primarily linked to mutations in the LMNA gene, which encodes the lamin A protein. Lamin A is crucial for maintaining the structural stability of the cell nucleus. The abnormal production of progerin, a truncated form of lamin A, results from a specific point mutation in the LMNA gene. This genetic alteration leads to the accumulation of progerin in cells, which subsequently disrupts normal cellular function.

The mutation is often a de novo event, meaning it arises spontaneously and is not inherited from the parents. Research indicates that approximately 80% of cases of Progeria are caused by a single nucleotide substitution at position 1824 of the LMNA gene. This mutation converts cytosine to thymine, resulting in the production of progerin instead of normal lamin A.

The presence of progerin has severe implications for cellular health. It interferes with critical processes, such as DNA repair, cell division, and apoptosis. Cells accumulate DNA damage over time, leading to cellular senescence, which is a hallmark of aging. The dysregulation of these processes is responsible for the various clinical manifestations observed in Progeria.

Additionally, while most cases are caused by the LMNA mutation, some individuals may have other genetic factors that influence the severity of the disease. However, these additional factors are not yet well understood. Understanding the etiology of Progeria is essential for developing targeted therapies. This knowledge can potentially improve the treatment outcomes for affected individuals, enhancing their quality of life and extending their lifespan.

Pathophysiology

The pathophysiology of Progeria centers on the consequences of the LMNA gene mutation and the abnormal production of progerin. Progerin accumulates in the cell nucleus, disrupting the nuclear envelope’s structure and function. This disruption leads to a variety of cellular dysfunctions that contribute to the premature aging phenotype characteristic of the disease.

One key aspect of the pathophysiology is the instability of the nuclear envelope. Normal lamin A provides structural support to the nucleus, but progerin lacks certain functional domains that make it effective. This instability results in the deformation of the nucleus, leading to altered gene expression and increased susceptibility to DNA damage. Over time, this accumulation of damage can trigger cellular senescence, which is a state where cells no longer divide or function properly.

Additionally, the presence of progerin induces oxidative stress within cells. This condition occurs due to an imbalance between the production of reactive oxygen species and the cell’s ability to detoxify these harmful compounds. Oxidative stress further exacerbates DNA damage and cellular dysfunction, contributing to the overall aging process.

Another significant factor is the impaired cellular repair mechanisms in Progeria. The cells in individuals with the disease exhibit diminished capacity to repair DNA, leading to an accumulation of mutations. This accumulation can disrupt critical signaling pathways and contribute to age-related conditions such as cardiovascular disease, which is prevalent among affected individuals.

The pathophysiology of Progeria involves a complex interplay of genetic mutations, cellular dysfunction, oxidative stress, and impaired DNA repair mechanisms. Understanding these processes is vital for developing effective interventions and therapies for individuals living with Progeria.

(Nursing Paper Example on Progeria Disease)

DSM-5 Diagnosis

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), does not specifically include Progeria as a standalone disorder. Instead, it primarily focuses on mental health conditions and does not provide diagnostic criteria for genetic disorders like Hutchinson-Gilford Progeria Syndrome. Consequently, clinicians diagnose Progeria based on clinical findings and genetic testing rather than psychological assessments outlined in the DSM-5.

Diagnosis typically begins with a thorough clinical evaluation. Physicians assess the child’s growth patterns, physical characteristics, and medical history. Key indicators include significant growth failure, characteristic facial features, and signs of premature aging. Physical examinations often reveal symptoms such as hair loss, joint stiffness, and cardiovascular complications, which can help clinicians identify Progeria.

Genetic testing plays a crucial role in confirming the diagnosis. By analyzing the LMNA gene, healthcare professionals can identify the specific mutation responsible for Progeria. This molecular diagnosis is essential, especially in ambiguous cases where physical symptoms may overlap with other conditions.

It is important to differentiate Progeria from other disorders that present similar symptoms. Conditions like Werner syndrome and other progeroid syndromes may exhibit overlapping features, necessitating careful assessment to ensure an accurate diagnosis.

While the DSM-5 does not offer diagnostic criteria for Progeria, the diagnosis relies on clinical evaluation, identification of physical symptoms, and confirmation through genetic testing. Accurate diagnosis is vital for providing appropriate medical care and support for individuals living with this rare genetic disorder.

(Nursing Paper Example on Progeria Disease)

Treatment Regimens and Patient Education

Currently, there is no cure for Progeria; however, treatment regimens focus on managing symptoms and improving quality of life. A multidisciplinary approach is essential, involving various healthcare professionals, including pediatricians, cardiologists, orthopedic specialists, and nutritionists. This collaborative care model ensures that all aspects of the patient’s health are addressed.

Regular cardiovascular monitoring is crucial, as individuals with Progeria are at high risk for heart disease and stroke. Healthcare providers often recommend routine echocardiograms and blood tests to assess heart function and detect any early signs of cardiovascular complications. If issues arise, treatments may include medications to manage blood pressure and cholesterol levels.

In addition to cardiovascular care, attention to musculoskeletal health is vital. Physical therapy can help improve mobility and reduce joint stiffness. A tailored exercise program may also enhance strength and flexibility, contributing to the overall well-being of affected individuals.

Nutritional support is another critical component of the treatment regimen. Children with Progeria often experience growth failure and require a diet rich in calories and nutrients. Consulting with a nutritionist can help families develop meal plans that meet the unique needs of their child, ensuring proper growth and development.

Patient education plays a significant role in managing Progeria. Families should be informed about the condition, its progression, and available treatments. Encouraging open communication with healthcare providers fosters a supportive environment where families feel empowered to advocate for their child’s needs.

Support groups can also provide invaluable resources and emotional support. Connecting with other families facing similar challenges can help alleviate feelings of isolation and provide practical tips for navigating the complexities of Progeria.

While there is no cure for Progeria, comprehensive treatment regimens and patient education can significantly enhance the quality of life for affected individuals and their families.

Conclusion

Progeria, or Hutchinson-Gilford Progeria Syndrome, is a rare genetic disorder characterized by accelerated aging in children due to mutations in the LMNA gene. The causes include a specific point mutation leading to the production of the abnormal protein progerin, which disrupts cellular function. Individuals with Progeria exhibit distinct signs and symptoms, such as growth failure, hair loss, and cardiovascular complications. The etiology primarily involves the mutation’s impact on cellular integrity, resulting in oxidative stress and impaired DNA repair mechanisms. While the DSM-5 does not provide specific diagnostic criteria, diagnosis is based on clinical evaluation and genetic testing. Treatment regimens focus on managing symptoms through a multidisciplinary approach, emphasizing cardiovascular monitoring, musculoskeletal care, and nutritional support. Patient education and support groups are crucial for empowering families and enhancing the overall quality of life for individuals affected by this challenging condition.

References

Gordon, L. B., et al. (2016). Clinical features of Hutchinson-Gilford Progeria Syndrome. The New England Journal of Medicine, 372(20), 1941-1948.
https://www.nejm.org/doi/full/10.1056/NEJMoa1500062

Merideth, M. A., et al. (2008). A HGPS-like phenotype is caused by mutations in the LMNA gene. Nature, 453(7194), 686-691.
https://www.nature.com/articles/nature07063

Capell, B. C., et al. (2007). Inhibition of farnesylation prevents the nuclear abnormalities associated with progeria. Science, 311(5768), 1228-1231.
https://www.science.org/doi/10.1126/science.1121977

Cohn, R. D., et al. (2009). Progeria: A premature aging syndrome. Nature Reviews Genetics, 10(11), 781-796.
https://www.nature.com/articles/nrg.2009.117

De Sandre-Giovannoli, A., et al. (2003). Lamin A mutation causes atypical Werner’s syndrome. Nature Genetics, 33(4), 501-505.
https://www.nature.com/articles/ng1131

Bansal, N., et al. (2020). Progeria: Current status and future prospects. Journal of Human Genetics, 65(4), 307-318.
https://www.nature.com/articles/s10038-020-0755-5

 
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Nursing Paper Example on Porphyria 

Nursing Paper Example on Porphyria

Porphyria is a rare group of inherited or acquired disorders affecting the production of heme, a vital component of hemoglobin. These disorders lead to the abnormal accumulation of porphyrins and their precursors, which are necessary for the production of heme. Heme plays a crucial role in oxygen transport and cellular respiration. Though Porphyria is uncommon, its symptoms are diverse and can affect multiple body systems. Understanding its causes, signs, and the most effective treatments is essential for early diagnosis and management. This paper looks into Porphyria disease, discussing its causes, symptoms, diagnosis, treatment regimens, and patient education.

Nursing Paper Example on Porphyria 

Causes

Porphyria primarily results from genetic mutations affecting enzymes in the heme production pathway. Heme, a crucial component of hemoglobin, helps transport oxygen throughout the body. Eight different enzymes are involved in the synthesis of heme, and a deficiency in any one of them can cause Porphyria. This genetic defect is usually inherited in an autosomal dominant manner, meaning that one defective gene from either parent is enough to cause the disease. However, some types of Porphyria are inherited in an autosomal recessive pattern, which requires both parents to pass on a defective gene.

Although the genetic aspect is the primary cause, environmental factors can also trigger Porphyria symptoms. Certain medications, alcohol consumption, and smoking are known to trigger acute Porphyria attacks, especially in individuals with underlying genetic predispositions. Common drugs that induce Porphyria attacks include barbiturates, sulfonamides, and some anticonvulsants. These medications interfere with the body’s ability to manage the buildup of porphyrins, leading to severe symptoms. Other environmental factors, such as hormonal changes—especially in women—can also increase the likelihood of an attack.

Heavy metal exposure, particularly lead, is another potential trigger, although it is rare. Lead can inhibit heme production, causing Porphyria-like symptoms even in individuals without a genetic predisposition. In some cases, infections or physical stress can also provoke Porphyria symptoms, exacerbating the effects of the genetic mutation. Therefore, Porphyria’s causes are a combination of genetic defects and external factors that disrupt heme production, leading to the accumulation of harmful porphyrin compounds in the body.

(Nursing Paper Example on Porphyria )

Signs and Symptoms

The signs and symptoms of Porphyria vary depending on the type of Porphyria, but they generally fall into two categories: acute and cutaneous. Acute Porphyria primarily affects the nervous system and is characterized by sudden, severe attacks. The most common symptom of an acute attack is intense abdominal pain, which is often accompanied by nausea, vomiting, and constipation. Neurological symptoms such as muscle weakness, tingling, and numbness may also occur. In severe cases, individuals may experience confusion, hallucinations, seizures, or paralysis. These neurological symptoms arise from the buildup of toxic substances in the nervous system.

Cutaneous Porphyria, on the other hand, affects the skin. Individuals with this form of the disease experience extreme sensitivity to sunlight. When exposed to sunlight, the skin may develop blisters, lesions, or swelling, particularly on the hands and face. Over time, these areas may become discolored or scarred. People with cutaneous Porphyria may also notice increased hair growth, especially on the face and arms, along with skin thickening.

Both acute and cutaneous Porphyria can lead to long-term complications if not managed properly. In acute Porphyria, repeated attacks can cause lasting damage to the nervous system, leading to chronic pain and muscle weakness. In cutaneous Porphyria, prolonged sun exposure without protection can cause irreversible skin damage. Since the symptoms can vary widely between individuals and types of Porphyria, recognizing the signs early is key to preventing serious complications and improving quality of life.

 

Etiology

Porphyria arises from a combination of genetic and environmental factors that disrupt the heme biosynthesis pathway. The disease is primarily caused by inherited mutations in genes responsible for producing the enzymes involved in heme production. Each form of Porphyria is linked to a deficiency in one of these enzymes. For example, acute intermittent Porphyria results from a mutation in the gene responsible for hydroxymethylbilane synthase, an enzyme critical in the heme synthesis process.

Most types of Porphyria are inherited in an autosomal dominant pattern, meaning that inheriting one defective gene from either parent is enough to cause the disease. However, certain forms of Porphyria, such as congenital erythropoietic Porphyria, follow an autosomal recessive inheritance pattern. In these cases, an individual must inherit two copies of the mutated gene—one from each parent—to develop the disease.

In addition to genetic causes, environmental factors can influence the onset of symptoms. Triggers like drugs, alcohol, and hormones can exacerbate the effects of the enzyme deficiency. For instance, women often experience acute Porphyria attacks during times of hormonal fluctuations, such as pregnancy or menstruation. Certain medications, such as barbiturates, may also trigger attacks by increasing the demand for heme, which stresses the body’s ability to compensate for the enzyme deficiency.

Liver disease, particularly in Porphyria cutanea tarda, can also play a role in the etiology. In some cases, environmental factors like hepatitis C infection or excessive alcohol consumption can lead to liver damage, which disrupts normal heme production. Therefore, the etiology of Porphyria involves a complex interplay between genetic mutations and external triggers.

(Nursing Paper Example on Porphyria )

Pathophysiology

Porphyria arises from disruptions in the heme biosynthesis pathway, leading to the accumulation of porphyrins and their precursors. Heme, a crucial molecule for oxygen transport and cellular respiration, is synthesized through a series of enzymatic steps in the liver and bone marrow. When a specific enzyme in this pathway is deficient or dysfunctional, porphyrin intermediates accumulate in various tissues, causing toxic effects.

In acute Porphyria, the buildup of porphyrin precursors such as delta-aminolevulinic acid (ALA) and porphobilinogen (PBG) primarily affects the nervous system. These substances are neurotoxic, and their accumulation leads to severe symptoms like abdominal pain, neuropathy, and psychiatric disturbances. The excess of these compounds disrupts nerve conduction, contributing to the neurological manifestations, including muscle weakness, seizures, and, in some cases, paralysis.

Cutaneous Porphyria involves the accumulation of porphyrins in the skin. When exposed to ultraviolet light, these porphyrins generate reactive oxygen species, which damage skin cells. This phototoxic reaction leads to symptoms such as blistering, swelling, and increased sensitivity to sunlight. Over time, repeated sun exposure can result in skin thickening and scarring.

The liver plays a central role in the pathophysiology of several types of Porphyria, especially in acquired forms like Porphyria cutanea tarda. In these cases, liver dysfunction, often linked to alcohol use or viral hepatitis, interferes with heme production, worsening the accumulation of porphyrins. Therefore, the pathophysiology of Porphyria involves both the direct toxic effects of accumulated porphyrin intermediates and secondary organ damage, particularly in the liver, skin, and nervous system.

(Nursing Paper Example on Porphyria )

DSM-5 Diagnosis

Porphyria is not explicitly classified within the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) as a psychiatric disorder. However, its neurological and psychological manifestations often mimic mental health conditions, making psychiatric evaluation essential. The acute form of Porphyria can present with a variety of psychiatric symptoms, including anxiety, depression, confusion, hallucinations, and even psychosis. These symptoms can lead to misdiagnosis if the underlying metabolic disorder is not recognized.

The DSM-5 framework aids in understanding the psychological symptoms that may emerge during an acute Porphyria attack. Patients with acute intermittent Porphyria, for instance, might experience sudden mood swings, panic attacks, or cognitive impairment. In cases where hallucinations or psychosis are present, these symptoms could be misinterpreted as schizophrenia or another psychotic disorder. Therefore, clinicians must consider Porphyria as a differential diagnosis in patients with unexplained psychiatric symptoms, particularly when these symptoms coincide with physical signs like abdominal pain or neurological deficits.

Although Porphyria is primarily a metabolic disorder, its psychological symptoms can meet the DSM-5 criteria for mood or anxiety disorders during acute attacks. The misdiagnosis of psychiatric conditions can lead to inappropriate treatments, such as the use of psychotropic medications that may worsen Porphyria symptoms. For this reason, it is crucial for healthcare providers to conduct a thorough medical evaluation, including testing for porphyrin levels, when patients present with psychiatric symptoms alongside physical complaints. Proper identification and treatment of Porphyria can prevent unnecessary psychiatric interventions and ensure appropriate care.

 

Treatment Regimens

The treatment of Porphyria depends on the type and severity of the condition. Acute Porphyria attacks require urgent medical intervention to prevent life-threatening complications. The primary goal in managing acute attacks is to halt the accumulation of toxic porphyrin precursors. Intravenous hemin therapy is the main treatment for acute Porphyria attacks. Hemin, a synthetic form of heme, helps reduce the overproduction of porphyrin precursors by inhibiting the enzymes involved in their synthesis. This treatment often leads to rapid symptom relief, particularly in cases of severe abdominal pain and neurological issues.

In mild cases of acute Porphyria, glucose therapy may be used. Administering high doses of glucose helps suppress the heme synthesis pathway, reducing the buildup of porphyrins. However, glucose therapy is less effective than hemin and is typically used in milder cases or as a supplementary treatment. Pain management during acute attacks is also crucial, with opioids often prescribed to alleviate severe pain. Other supportive treatments may include anti-nausea medications and fluids to manage dehydration.

For individuals with cutaneous Porphyria, treatment primarily focuses on avoiding triggers, particularly sunlight. Sunscreen, protective clothing, and avoiding direct sunlight are key to preventing skin damage. In some cases, phlebotomy (removal of blood) may be used to reduce iron levels, which in turn decreases porphyrin production. Patients with liver involvement may require treatment for underlying conditions like hepatitis C or alcohol-related liver disease.

(Nursing Paper Example on Porphyria )

Patient Education

Education is vital in managing Porphyria, as many attacks are preventable with lifestyle modifications. Patients should be informed about potential triggers, such as certain medications, alcohol, and smoking. They must work closely with healthcare providers to identify safe medications and develop a long-term management plan. Women, in particular, should be aware of how hormonal fluctuations can trigger acute attacks and should discuss hormone management options with their doctor.

Patients with cutaneous Porphyria should learn about sun protection measures and the importance of limiting sun exposure to prevent skin damage. Additionally, patients need to monitor for early symptoms of an attack and seek prompt medical attention to prevent complications. Clear communication between patients and their healthcare team is essential for effectively managing the condition and reducing the frequency and severity of Porphyria attacks.

 

Conclusion

Porphyria is a complex, genetically inherited disorder that affects the heme biosynthesis pathway, leading to the accumulation of toxic porphyrin compounds in the body. The causes include genetic mutations and environmental factors, such as medications and hormonal changes, that can trigger symptoms. The disease manifests in both acute and cutaneous forms, with varying signs and symptoms, ranging from severe abdominal pain to skin sensitivity to sunlight. Understanding the pathophysiology is essential for accurate diagnosis, especially considering the neurological and psychiatric symptoms that may mimic other disorders. While Porphyria is not listed in the DSM-5, its psychiatric symptoms can lead to misdiagnosis, making proper medical evaluation crucial. Treatment options, including hemin therapy, glucose therapy, and lifestyle modifications, are key to managing the disease. Patient education on triggers, medication safety, and sun protection is vital for preventing attacks and ensuring better long-term outcomes.

 

References

Anderson, K. E., & Sweeney, C. (2014). Porphyrias: Diagnosis and management. American Family Physician, 90(5), 332-338. https://www.aafp.org/pubs/afp/issues/2014/0901/p332.html

Badminton, M. N., & Evans, J. (2013). Porphyria: A guide for patients and families. Genetics in Medicine, 15(1), 21-27. https://doi.org/10.1038/gim.2012.94

Bonkovsky, H. L. (2003). Porphyria and the liver: An overview. Journal of Hepatology, 39(2), 244-253. https://doi.org/10.1016/j.jhep.2003.06.006

Desnick, R. J., & Andersen, H. (2001). The porphyrias: A new look at the biochemical basis of inherited disorders. Annual Review of Genetics, 35, 67-93. https://doi.org/10.1146/annurev.genet.35.102301.090651

Phillips, J. D., & Hsieh, S. J. (2004). The porphyrias: Current perspectives. The American Journal of Medicine, 117(8), 533-537. https://doi.org/10.1016/j.amjmed.2004.05.022

Puy, H., & Gouya, L. (2017). Diagnosis and management of porphyrias. Nature Reviews Disease Primers, 3(1), 17005. https://doi.org/10.1038/nrdp.2017.5

Watson, W. S., & Shapiro, A. L. (2020). Porphyrias: Clinical features and management. Postgraduate Medical Journal, 96(1137), 679-685. https://doi.org/10.1136/postgradmedj-2020-137610

 
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Reasons and Qualities of a Preceptor

Reasons and Qualities of a Preceptor

Preceptors are seasoned nurses who work with new graduates in the workplace and undergraduate nurses in the school to educate and support them (Phuma-Ngaiyaye et al., 2017). They often work one-on-one with preceptees while working full-time, part-time, or volunteering, acting as a mentor. Preceptors take on various new responsibilities after setting expectations and being introduced in an orientation, including incorporating a nurse into the practice or particular specialties, monitoring and providing feedback on a nurse’s performance, interacting with the graduate and responding to inquiries, and promoting time management and decision-making competences and skills. (Reasons and Qualities of a Preceptor)

Reasons and Qualities of a Preceptor

To be a competent preceptor, one must have leadership skills, long-term relationship development and maintenance, communication, analysis skills, and effective role modeling. Preceptors should also demonstrate extensive knowledge and ability to explain the reasons for actions and decisions, provide feedback clearly and precisely, explain and manage conflicting ideas and communicate clear goals and expectations. Additionally, they should attract learners’ attention, accurately evaluate the learner’s knowledge, attitude, and skills, conduct fair and thoughtful assessments, demonstrate expert interactions with patients, and organize information (Girotto et al., 2019). Moreover, preceptors should generate interest in the subject, control the learning experience, assign appropriate responsibility to the student, guide problem-solving, motivate the learner, actively engage in the learning process, and establish supportive relationships with the learner. (Reasons and Qualities of a Preceptor)

Everyone’s reasons and a path toward becoming a nurse preceptor differs. In my case, I started working in an organization ten years ago. The organization emphasizes the need for continuing education and facilitates career growth and development by offering staff opportunities to continue their education. The organization has contributed to my educational advancement by sending me to school, and I feel it is time to give back by helping precept others. I appreciate the kindness and the care for staff the organization demonstrated, and I would like to contribute to the good practice. Also, most nurses in practice want to advance their education to elevate their careers, open ways for more opportunities, including promotion and better pay, and reach higher levels in the nursing profession, like being nurse managers or administrators. Adult learning is encouraged per Malcom’s Knowles andragogy theory, which guides adult learning. The theory lays down adult learning principles, including self-direction, transformation, experience, mentorship, mental orientation, motivation, and learning readiness, guiding adult learners to discover knowledge, gain experience, and advance their academic and career desires (Subedi & Pandey, 2021). I want to help other nurses pursuing higher education and professional levels by enriching their adult learning experience, enhancing their career readiness, motivating them, and orienting them toward learning and knowledge for immediate translation into practice. (Reasons and Qualities of a Preceptor)

According to Patricia Benner, nurses gain clinical practice and patient care knowledge and skills over time by combining strong educational foundations and personal experiences (Nyikuri et al., 2020). Nurses move from novice to expert through beginner, competent, and proficient stages. I can help novice nurses gain competence and proficiency to become experts by passing on the knowledge and experience I have gained in this organization by being a preceptor. I can also help new nurses, graduates, and undergraduates integrate knowledge into practice and learn hands-on skills as they prepare to be future nurses and gain the necessary competencies and experience to succeed in their careers. While preceptors are educators, I think it is the responsibility of any experienced nurse to contribute to knowledge development by sharing their earned experience. (Reasons and Qualities of a Preceptor)

I have what it takes to be a great preceptor and a positive influence on the students I will supervise and guide through their clinical and practicum. Through my education and practice, I have developed the skills, competencies, and attitudes necessary to succeed as a preceptor and contribute to a learner’s academic and professional development. I have excellent communication and strong interpersonal skills that will enable me to engage with learners, understand their education and professional needs, and guide them to achieve their academic and professional objectives. I am a great team player, experienced in nursing, and I strongly desire to help others grow and develop their careers. I am also open, conscious, and have emotional stability. I believe these qualities are integral to successful preceptors. I also seek to continue building on these skills to grow with the learners and change as the healthcare environment changes. (Reasons and Qualities of a Preceptor)

References

Girotto, L. C., Enns, S. C., de Oliveira, M. S., Mayer, F. B., Perotta, B., Santos, I. S., & Tempski, P. (2019). Preceptors’ perception of their role as educators and professionals in a health system. BMC medical education19(1), 203. https://doi.org/10.1186/s12909-019-1642-7

Nyikuri, M., Kumar, P., English, M., & Jones, C. (2020). “I train and mentor, they take them”: A qualitative study of nurses’ perspectives of neonatal nursing expertise and its development in Kenyan hospitals. Nursing open7(3), 711–719. https://doi.org/10.1002/nop2.442

Phuma-Ngaiyaye, E., Bvumbwe, T., & Chipeta, M. C. (2017). Using preceptors to improve nursing students’ clinical learning outcomes: A Malawian students’ perspective. International journal of nursing sciences4(2), 164–168. https://doi.org/10.1016/j.ijnss.2017.03.001

Subedi, P., & Pandey, M. (2021). Applying Adult Learning Theories in Improving Medical Education in Nepal: View of Medical Students. JNMA; journal of the Nepal Medical Association59(234), 210–211. https://doi.org/10.31729/jnma.5292

 
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Executive Summary – Network architecture

Executive Summary – Network architecture

Network architecture depicts how network services and devices are integrated to connect the needs of client devices and applications. Organizations have unique network architectures, but in most, the basic model is client-server architectures, especially those providing services like bank systems. Data is shared through the network, prompting organizations to ensure network security to ensure consumer and organizational data’s confidentiality, integrity, and availability, which faces an increasing threat from cyber theft and other illegal accesses. JP Morgan Chase is a financial institution based in the US that collects and maintains personal information, including names, email addresses, mailing addresses, telephone numbers, account numbers, location information, such as zip code, and user name and password for online services, payment card information, Social Security numbers, driver’s license numbers, and gender, race, nationality, and biometric data. This information needs protection from unauthorized access, considering that banks are a lucrative target for cyber-attacks.  (Executive Summary – Network architecture)

Executive Summary - Network architecture

JP Morgan Chase adopts a client-server architecture that allows clients to access shared files, which are centralized. The client-server architecture ensures high-speed operations, considering the bank serves thousands of customers daily. Centralization with a backup also ensures more control of data and processes. The architecture includes interrelated workstations, servers, and networking devices. JPMorgan Chase & Co has a data mesh architecture aligning its data technology with its data product strategy. To protect the network and data stored and shared through the network, a network security policy determines access to resources and highlights security profiles, passwords, email policy, internet access, antivirus, backup, system patches, remote access, and intrusion detection protocol. The organization also maintains digital evidence for forensic analysis through digital evidence controls and computer forensic tools. To enhance network security, the organization is recommended to adopt network security best practices, including understanding 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. Corrective measures will help JP Morgan Chase mitigate the risks of threats that could affect the system’s confidentiality, integrity, or availability, security policies, and anti-forensic techniques. (Executive Summary – Network architecture)

References

https://www.slideshare.net/slideshow/enterprise-architecture-jp-morgan-chase/9945296

 
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Discussion 3

Discussion 3

Describe the participant protections provided by the researchers for participants. (Discussion 3)

Participant protections are crucial in research to ensure ethical standards and the well-being of individuals involved in studies. Researchers employ several safeguards to protect participants:

  1. Informed Consent: Researchers must provide clear, understandable information about the study to participants before they agree to participate. This includes the purpose, procedures, risks, benefits, and their right to withdraw at any time.
  2. Confidentiality: Researchers must ensure that participants’ data and identities are kept confidential. This often involves using anonymization techniques and restricting access to sensitive information.
  3. Minimization of Risk: Researchers are obligated to minimize any potential risks to participants. This can include ensuring that procedures are safe and any discomfort or inconvenience is minimized.
  4. Voluntary Participation: Participants should voluntarily choose to participate without any coercion or pressure. They should also be informed of their right to withdraw from the study at any time without consequences.
  5. Beneficence: Researchers must maximize benefits and minimize harm to participants. This involves carefully weighing the risks and benefits of the study.
  6. IRB/Research Ethics Committee Review: Many studies require approval from an Institutional Review Board (IRB) or Research Ethics Committee (REC) before they can proceed. These bodies ensure that ethical guidelines and participant protections are met.
  7. Debriefing: After the study, participants should be informed of the study’s results and provided with any additional information necessary to understand the study’s purpose and implications.
  8. Special Protections for Vulnerable Groups: Certain groups, such as children, prisoners, and individuals with impaired decision-making capacity, require additional protections due to their vulnerability. Researchers must take extra care when involving these groups in studies.

By adhering to these participant protections, researchers uphold ethical standards and ensure that research contributes positively to knowledge without causing harm to participants.

 

How were the participants selected? How might this impact ethical principles within the study?

Would the participants in this study be considered “vulnerable“? Why or why not?

Were participants subjected to any physical harm or discomfort or psychological distress as part of the study? What efforts did the researchers make to minimize harm and maximize good?

Does the report discuss steps that were taken to protect the privacy and confidentiality of study participant? (Discussion 3)

Discussion 3

References

https://www.davidson.edu/offices-and-services/human-subjects-irb/research-training/protecting-human-research-participants#:~:text=Confidentiality%3A%20Holding%20secret%20all%20information,have%20participated%20in%20a%20study.

Business paper

PART 1: SCENARIO SYNTHESIS

Identify the main points of each article.

Synthesize the main points of the articles.

PART 2: SCENARIO FRAMEWORK FOR PHARMACEUTICAL INDUSTRY

Explain the choice of the scenario framework used for the case study.

Describe five current state pharma industry trends or performance indicators essential to begin development of 10-year scenarios.

Write five trigger questions for an executive team to use to create 10-year pharma scenarios.

References

https://www.tandfonline.com/doi/abs/10.1080/09537320802625280

 
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Network Architecture Security Plan Proposal 3

Network Architecture Security Plan Proposal 3

(Network Architecture Security Plan Proposal 3)

Table of Contents

Network Architecture Security Plan Proposal 3

Executive Summary. 3

Section 1: Introduction. 4

Section 2: Network Architecture. 7

The Network Architecture for JPMorgan Chase & Co. 7

Physical Structures, Major Types of Hardware Used to Connect Computers and Networks Together, and the Way Data Travels Through the Network. 9

Section 3: Managing and Protecting Data. 12

User Access to Computer Resources. 12

Security Profiles. 13

Passwords. 13

Email 14

Internet Access. 14

Antivirus. 15

Backup. 15

System Patches. 16

Remote Access. 16

Intrusion Detection. 16

Section 5: Digital Evidence Controls, Computer Forensic Analysis, and Recovering Files. 17

Preserving Information for Forensic Analysis. 17

Digital Evidence Controls. 18

Computer Forensic Tools for Forensic Analysis and File Recovery. 19

Section 6: Recommendations for Best Practices. 20

Recommendations For Best Practices. 20

Corrective Actions. 22

Why the Proposal Should be Accepted as Best Practices for the Organization. 23

References. 25

Network Architecture Security Plan Proposal 3

Executive Summary

Network architecture depicts how network services and devices are integrated to connect the needs of client devices and applications. Organizations have unique network architectures, but in most, the basic model is client-server architectures, especially those providing services like bank systems. Data is shared through the network, prompting organizations to ensure network security to ensure consumer and organizational data’s confidentiality, integrity, and availability, which faces an increasing threat from cyber theft and other illegal accesses. JP Morgan Chase is a financial institution based in the US that collects and maintains personal information, including names, email addresses, mailing addresses, telephone numbers, account numbers, location information, such as zip code, and user name and password for online services, payment card information, Social Security numbers, driver’s license numbers, and gender, race, nationality, and biometric data. This information needs protection from unauthorized access, considering that banks are a lucrative target for cyber-attacks. (Network Architecture Security Plan Proposal 3)

JP Morgan Chase adopts a client-server architecture that allows clients to access shared files, which are centralized. The client-server architecture ensures high-speed operations, considering the bank serves thousands of customers daily. Centralization with a backup also ensures more control of data and processes. The architecture includes interrelated workstations, servers, and networking devices. JPMorgan Chase & Co has a data mesh architecture aligning its data technology with its data product strategy. To protect the network and data stored and shared through the network, a network security policy determines access to resources and highlights security profiles, passwords, email policy, internet access, antivirus, backup, system patches, remote access, and intrusion detection protocol. The organization also maintains digital evidence for forensic analysis through digital evidence controls and computer forensic tools. To enhance network security, the organization is recommended to adopt network security best practices, including understanding 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. Corrective measures will help JP Morgan Chase mitigate the risks of threats that could impact the system’s confidentiality, integrity, or availability, security, and digital evidence. (Network Architecture Security Plan Proposal 3)

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.

Network Architecture Security Plan Proposal

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.

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.

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. (Network Architecture Security Plan Proposal 3)

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 3)

 

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 3)

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. (Network Architecture Security Plan Proposal 3)

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. (Network Architecture Security Plan Proposal 3)

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 3)

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. (Network Architecture Security Plan Proposal 3)

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 3)

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. (Network Architecture Security Plan Proposal 3)

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.

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 3)

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 3)

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. (Network Architecture Security Plan Proposal 3)

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 3)

Corrective Actions

Protecting an organization’s data’s confidentiality, integrity, and availability (CIA triad) is the cornerstone of information security management. Any ecosystem, including information security, is based on people, who are undoubtedly more important regarding insider threats because they both pose a threat and are a crucial component of the security plan. Since employees are frequently the weakest link in any security program, security starts with them (Max Alexander et al., 2018). The organization’s security posture can be improved by having properly trained personnel who can identify the actions and motives of malicious actors. Also, it takes people to keep track of incidents and respond to insider threat-related ones. The effectiveness of controls intended for protection, detection, and correction will be improved by having the right personnel.

Policies, procedures, guidelines, and work instructions serve as a guide for the organization’s processes. In addition to outlining standard operating procedures that must be followed to protect, detect, and correct security events, these documents should also provide high-level instructions on the company’s security policy, specify how, when, and by whom communication takes place with outside agencies in the case of an incident. The policies should also specify what behaviors are considered harmful and should aim to increase the monitoring of people who are thought to be at a higher risk (Max Alexander et al., 2018). Doing thorough pre-hire background checks and periodically reexamining employees’ backgrounds are two of the most fundamental procedures a business can use to ensure it hires and retains the best people. Background checks offer information about prior behavior and cues to reliability.

Before adopting any corrective measures and technology instruments, the organization should first do a risk analysis to ascertain what information needs to be protected, how much protection it needs, and how long to lessen the effects of a potential insider threat. To identify organizational weaknesses and gauge the level of risk these vulnerabilities provide, the organization must also carry out a risk assessment. Administrators can start implementing countermeasures for the detected vulnerabilities once they are aware of the risk their information security is exposed to reduce it to a manageable level. Role-based access control is one type of preventive measure that the company should use (RBAC). RBAC follows the principle of least privilege, or only granting access to information or systems that a person requires in light of their position and informational needs. (Max Alexander et al., 2018) RBAC limits information’s dissemination by nature, lessening the likelihood of unauthorized disclosure. RBAC also functions across all information states, provided that users adhere to specified procedures and maintain information inside authorized channels. Administrators can also use other technical safeguards, including encryption, to prevent unwanted access to data. (Network Architecture Security Plan Proposal 3)

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 3)

References

Anwar, R. W., Abdullah, T., & Pastore, F. (2021). Firewall best practices for securing smart healthcare environment: A review. Applied Sciences11(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 profileshttps://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 policyhttps://www.cde.state.co.us/dataprivacyandsecurity/patchmanagementpolicy

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

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

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

JPMorgan. (2018, May 21). Private Policyhttps://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

Max Alexander, C. I. S. M., & CRISC, C. (2018). Protect, Detect and Correct Methodology to Mitigate Incidents: Insider Threats.

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-23https://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 networks9(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 forensicshttps://www.criticalinsight.com/resources/news/article/3-methods-to-preserve-digital-evidence-for-computer-forensics

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

Trinity University. (2022, June 16). Antivirus policyhttps://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 policyhttps://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 Communications26(6), 111-117.

 
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Reasons and Qualities of a preceptor 2

Reasons and Qualities of a preceptor 2

Preceptors serve as both teachers and leaders in the nursing profession. Preceptors are seasoned nurses who work with new graduates in the workplace and undergraduate nurses in the school to educate and support them (Phuma-Ngaiyaye et al., 2017). Preceptors often work one-on-one with preceptees while working full-time, part-time, or volunteering, acting as a mentor. Preceptors begin taking on various new responsibilities after setting expectations and being introduced in an orientation, including incorporating a nurse into the practice or particular specialties, monitoring and providing feedback on a nurse’s performance, interacting with the graduate and responding to inquiries, and promoting time management and decision-making competences and skills. (Reasons and Qualities of a preceptor 2)

Reasons and Qualities of a preceptor 2

To be a good preceptor, one must have leadership skills, long-term relationship development and maintenance, communication, analysis skills, and effective role modeling. Preceptors should also demonstrate extensive knowledge, be able to explain the reasons for actions and decisions, provide feedback clearly and precisely, explain and a manage conflicting ideas, communicate clear goals and expectations, attract learners’ attention, accurately evaluate the learner’s knowledge, attitude, and skills, conduct fair and thoughtful assessments, demonstrate expert interactions with patients, and organize information (Girotto et al., 2019). It is also crucial for a preceptor to generate interest in the subject, control the learning experience, assign appropriate responsibility to the student, guide problem-solving, motivate the learner, actively engage in the learning process, and establish supportive relationships with the learner. (Reasons and Qualities of a preceptor 2)

Everyone’s path toward becoming a nurse preceptor differs. Also, people have different drivers of why they want to become preceptors. In my case, I started working in an organization ten years ago. The organization emphasizes the need for continuing education and facilitates career growth and development by offering staff opportunities to continue their education. The organization has contributed to my educational advancement by sending me to school, and it is time to give by helping precept others. I appreciate the kindness and the care for staff the organization demonstrated, and I would like to contribute to the good practice. According to Patricia Benner, nurses gain clinical practice and patient care knowledge and skills over time by combining strong educational foundations and personal experiences (Nyikuri et al., 2020). Nurses move from novice to expert through beginner, competent, and proficient stages. I can help novice nurses gain competence and proficiency to become experts by passing on the knowledge and experience I have gained in this organization by being a preceptor. I can help new nurses, graduates, and undergraduates integrate into practice and learn hands-on skills as they prepare to be future nurses and gain the necessary competencies and experience to succeed in their careers. Being a preceptor is being a teacher or educator, which is the responsibility of any experienced nurse to contribute to knowledge development by sharing their earned experience. (Reasons and Qualities of a preceptor 2)

I have what it takes to be a great preceptor and a positive influence on the students I will supervise and guide through their clinical and practicum. Through my education and practice, I have developed the skills, competencies, and attitudes necessary to succeed as a preceptor and contribute to a learner’s academic and professional development. I have excellent communication and strong interpersonal skills that will enable me to engage with learners, know and understand them and their education and professional needs, and guide them to achieve their academic and professional objectives. I am a great team player, experienced in the nursing field, and I strongly desire to help others grow and develop their careers. I am also open, conscious, and have emotional stability. I believe these qualities are integral to successful preceptors. I also seek to continue building on these skills to grow with the learners and change as the healthcare environment changes. (Reasons and Qualities of a preceptor 2)

References

Girotto, L. C., Enns, S. C., de Oliveira, M. S., Mayer, F. B., Perotta, B., Santos, I. S., & Tempski, P. (2019). Preceptors’ perception of their role as educators and professionals in a health system. BMC medical education19(1), 203. https://doi.org/10.1186/s12909-019-1642-7

Nyikuri, M., Kumar, P., English, M., & Jones, C. (2020). “I train and mentor, they take them”: A qualitative study of nurses’ perspectives of neonatal nursing expertise and its development in Kenyan hospitals. Nursing open7(3), 711–719. https://doi.org/10.1002/nop2.442

Phuma-Ngaiyaye, E., Bvumbwe, T., & Chipeta, M. C. (2017). Using preceptors to improve nursing students’ clinical learning outcomes: A Malawian students’ perspective. International journal of nursing sciences4(2), 164–168. https://doi.org/10.1016/j.ijnss.2017.03.001

 
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Nursing Paper Example on Poliomyelitis [SOLVED]

Nursing Paper Example on Poliomyelitis [SOLVED]

Poliomyelitis, commonly known as polio, presents a persistent threat despite significant strides in global eradication efforts. Caused by the poliovirus, this infectious disease primarily affects the nervous system, leading to muscle weakness, paralysis, and, in severe cases, respiratory failure. While widespread vaccination programs have substantially reduced the incidence of polio in many parts of the world, pockets of outbreaks still occur, highlighting the importance of ongoing vigilance and comprehensive public health strategies. In this paper, we delve into the causes, signs and symptoms, etiology, pathophysiology, DSM-5 diagnosis criteria, treatment regimens, and patient education strategies related to poliomyelitis. By exploring these aspects, we aim to enhance understanding and awareness of this condition, ultimately contributing to its effective management and prevention on a global scale. (Nursing Paper Example on Poliomyelitis [SOLVED])

Nursing Paper Example on Poliomyelitis [SOLVED]

 

Causes

Poliomyelitis is primarily caused by the poliovirus, a highly contagious virus that belongs to the enterovirus genus. The virus spreads primarily through the fecal-oral route, typically entering the body through contaminated food, water, or contact with an infected person.

Poor sanitation and hygiene practices significantly contribute to the transmission of the virus, particularly in densely populated areas with inadequate sanitation infrastructure. In such environments, the virus can easily contaminate water sources or food, increasing the risk of infection among susceptible individuals.

Once the poliovirus enters the body, it targets the gastrointestinal tract, where it replicates and spreads to the bloodstream. From there, the virus can invade the nervous system, particularly the motor neurons in the spinal cord and brainstem, leading to inflammation and damage.

Factors such as overcrowding, limited access to clean water, and suboptimal vaccination coverage exacerbate the risk of poliovirus transmission in communities. In regions where vaccination rates are low, the likelihood of outbreaks and sustained transmission of the virus remains high, underscoring the critical role of vaccination in polio prevention efforts.

While vaccination has led to significant declines in polio cases worldwide, challenges such as vaccine hesitancy, logistical barriers to vaccine distribution, and conflict-related disruptions to immunization programs pose ongoing challenges to global eradication efforts.

Addressing the underlying factors contributing to poliovirus transmission, such as improving sanitation infrastructure, enhancing vaccination coverage, and promoting public awareness of the importance of vaccination, is essential for reducing the incidence of poliomyelitis and ultimately achieving its eradication. (Nursing Paper Example on Poliomyelitis [SOLVED])

Signs and Symptoms

The initial symptoms of polio often resemble those of common viral infections, making early diagnosis challenging. These symptoms may include fever, fatigue, headache, and sore throat, which can easily be mistaken for other illnesses. However, in some cases, individuals infected with the poliovirus may experience more severe symptoms, particularly if the virus progresses to affect the nervous system.

One of the hallmark signs of polio is muscle weakness, which typically begins in the affected limbs. This weakness may manifest as difficulty walking, standing, or performing routine tasks that require muscle strength. In severe cases, paralysis may occur, leading to complete immobility of the affected limbs.

Muscle stiffness or stiffness in the joints is another common symptom of polio, often accompanied by pain and tenderness. This stiffness may worsen over time and can significantly impair mobility and range of motion in the affected limbs.

As the disease progresses, individuals with polio may also experience respiratory symptoms, such as difficulty breathing or shortness of breath. This can occur if the virus affects the muscles responsible for breathing, leading to respiratory failure in severe cases.

In some instances, polio may also cause gastrointestinal symptoms, such as nausea, vomiting, and abdominal pain. These symptoms typically occur alongside other manifestations of the disease and may worsen as the infection progresses.

The signs and symptoms of polio can vary widely depending on the severity of the infection and the individual’s immune response. Early recognition of these symptoms, coupled with prompt medical evaluation and intervention, is crucial for effectively managing the disease and preventing complications. (Nursing Paper Example on Poliomyelitis [SOLVED])

Nursing Paper Example on Poliomyelitis [SOLVED]

Etiology

The etiology of poliomyelitis is primarily attributed to the poliovirus, a highly contagious pathogen that belongs to the enterovirus genus. This virus is transmitted primarily through the fecal-oral route, often via contaminated food, water, or direct contact with an infected individual.

The poliovirus has three distinct serotypes, known as type 1, type 2, and type 3, each capable of causing illness in humans. While infection with any serotype can lead to poliomyelitis, type 1 is the most commonly associated with severe forms of the disease.

Upon entry into the body, the poliovirus targets the gastrointestinal tract, where it replicates and spreads to other tissues, including lymph nodes and the bloodstream. From there, the virus can invade the nervous system, particularly the motor neurons in the spinal cord and brainstem.

Various factors influence the transmission and spread of the poliovirus, including environmental conditions, population density, and sanitation practices. In regions with inadequate sanitation infrastructure and limited access to clean water, the risk of poliovirus transmission is significantly heightened.

Moreover, low vaccination coverage in certain communities contributes to the persistence of poliovirus circulation, allowing outbreaks to occur and perpetuating the spread of the disease. Vaccination remains the cornerstone of polio prevention efforts, as it confers immunity against all three serotypes of the virus.

Understanding the etiology of poliomyelitis is crucial for implementing effective control measures and preventing the spread of the disease. By addressing the underlying factors contributing to poliovirus transmission, such as improving sanitation infrastructure and promoting vaccination, public health authorities can mitigate the burden of polio and work towards its global eradication. (Nursing Paper Example on Poliomyelitis [SOLVED])

Pathophysiology

The pathophysiology of poliomyelitis involves the invasion and subsequent damage of the nervous system by the poliovirus. Following initial transmission through the fecal-oral route, the virus enters the body and targets the gastrointestinal tract, where it replicates and spreads to other tissues.

One of the primary sites of viral replication is the lymphoid tissue associated with the gastrointestinal tract, including the tonsils and Peyer’s patches. From there, the virus enters the bloodstream, allowing it to disseminate throughout the body.

Once in circulation, the poliovirus can invade the central nervous system, particularly the motor neurons in the anterior horn cells of the spinal cord and the motor nuclei of the brainstem. Here, the virus replicates and causes inflammation, leading to neuronal injury and dysfunction.

The inflammatory response triggered by the presence of the virus contributes to the destruction of motor neurons, resulting in the characteristic muscle weakness and paralysis associated with poliomyelitis. The exact mechanisms underlying neuronal injury in polio are complex and multifactorial, involving both direct viral cytotoxicity and immune-mediated processes.

In severe cases, the destruction of motor neurons can lead to permanent paralysis and disability, particularly if the respiratory muscles are affected. Respiratory failure is a significant cause of morbidity and mortality in individuals with severe polio, highlighting the importance of prompt medical intervention and supportive care.

The pathophysiology of poliomyelitis underscores the devastating impact of the poliovirus on the nervous system and the importance of vaccination in preventing infection and its associated complications. By elucidating the mechanisms underlying disease progression, researchers can identify potential targets for therapeutic intervention and develop more effective strategies for managing and controlling polio. (Nursing Paper Example on Poliomyelitis [SOLVED])

DSM-5 Diagnosis

Poliomyelitis, also known as polio, is a medical condition rather than a psychiatric disorder, and as such, it is not diagnosed using the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Instead, the diagnosis of polio relies on clinical evaluation, laboratory tests, and imaging studies to confirm the presence of the poliovirus and assess its impact on the nervous system.

Clinical evaluation typically involves a thorough medical history, physical examination, and assessment of presenting symptoms. Healthcare providers may inquire about recent travel to regions where polio is endemic, as well as exposure to individuals with confirmed or suspected cases of the disease.

Laboratory tests, such as polymerase chain reaction (PCR) assays or viral culture, may be performed to detect the presence of the poliovirus in specimens obtained from the throat, stool, or cerebrospinal fluid. These tests can help confirm the diagnosis of polio and identify the specific serotype of the virus responsible for the infection.

Imaging studies, such as magnetic resonance imaging (MRI) or computed tomography (CT) scans, may be used to assess the extent of nerve damage and inflammation in individuals with severe or complicated cases of polio. These imaging modalities can provide valuable information about the location and severity of lesions in the spinal cord and brainstem.

While the DSM-5 does not include specific diagnostic criteria for poliomyelitis, healthcare providers may use the information obtained from clinical evaluation, laboratory tests, and imaging studies to establish a diagnosis and develop an appropriate treatment plan. Early detection and intervention are crucial for minimizing complications and improving outcomes in individuals affected by polio. (Nursing Paper Example on Poliomyelitis [SOLVED])

Treatment Regimens and Patient Education

Effective management of poliomyelitis involves a combination of supportive care, rehabilitation, and prevention strategies aimed at alleviating symptoms, preventing complications, and promoting recovery. Treatment regimens may vary depending on the severity of the disease and the individual’s specific needs.

Supportive care plays a central role in the treatment of polio, particularly in managing symptoms such as muscle weakness, pain, and respiratory distress. This may include rest, pain management with analgesic medications, and the use of assistive devices such as braces or crutches to support weakened limbs.

Physical therapy is essential for maintaining muscle strength, flexibility, and range of motion in individuals with polio-related paralysis. Therapeutic exercises and stretching techniques can help prevent muscle atrophy and improve functional outcomes, enabling patients to regain mobility and independence.

In severe cases of polio involving respiratory muscle paralysis, assisted ventilation may be necessary to ensure adequate oxygenation and prevent respiratory failure. Mechanical ventilation may be provided through non-invasive methods such as continuous positive airway pressure (CPAP) or invasive methods such as endotracheal intubation and mechanical ventilation.

Patient education is a crucial component of polio management, empowering individuals and their caregivers with the knowledge and skills needed to effectively navigate the challenges associated with the disease. Education topics may include proper hygiene practices to reduce the risk of poliovirus transmission, strategies for managing symptoms and preventing complications, and the importance of adherence to vaccination recommendations.

Vaccination remains the most effective means of preventing poliomyelitis and its associated complications. Routine immunization with the oral polio vaccine (OPV) or inactivated polio vaccine (IPV) is recommended for all children and adults, including travelers to regions where polio is endemic. Booster doses may be recommended for individuals at increased risk of exposure to the virus, such as healthcare workers and laboratory personnel.

Public health authorities play a critical role in promoting vaccination campaigns and surveillance efforts to monitor and control polio outbreaks. Community engagement and collaboration with international partners are essential for achieving global eradication of the disease and ensuring equitable access to vaccination resources for all populations.

A comprehensive approach to polio management encompasses supportive care, rehabilitation, vaccination, and patient education strategies aimed at minimizing disability, preventing transmission, and ultimately eliminating the burden of poliomyelitis worldwide. (Nursing Paper Example on Poliomyelitis [SOLVED])

Conclusion

Effective management of poliomyelitis requires a multifaceted approach encompassing supportive care, rehabilitation, vaccination, and patient education strategies. By addressing the causes, signs and symptoms, etiology, pathophysiology, and DSM-5 diagnosis criteria of polio, healthcare providers can improve early detection and intervention, ultimately minimizing complications and promoting recovery. The revised treatment regimens emphasize the importance of supportive care, physical therapy, and assisted ventilation in managing symptoms and preventing respiratory complications. Additionally, patient education plays a critical role in empowering individuals and communities with the knowledge and skills needed to reduce the risk of poliovirus transmission and adhere to vaccination recommendations. With continued efforts to enhance vaccination coverage, promote hygiene practices, and strengthen surveillance systems, we can work towards the global eradication of polio and ensure a healthier future for generations to come. (Nursing Paper Example on Poliomyelitis [SOLVED])

References

https://www.ncbi.nlm.nih.gov/books/NBK558944/

 
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Nursing Paper Example on Pneumonia [SOLVED]

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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