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Advanced Levels of Clinical Inquiry and Systematic Reviews

To Prepare:

· Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.

· Develop a PICO(T) question to address the clinical issue of interest you identified in Module 2 for the Assignment. This PICOT question will remain the same for the entire course.

· Use the key words from the PICO(T) question you developed and search at least four different databases in the Walden Library. Identify at least four relevant systematic reviews or other filtered high-level evidence, which includes meta-analyses, critically-appraised topics (evidence syntheses), critically-appraised individual articles (article synopses). The evidence will not necessarily address all the elements of your PICO(T) question, so select the most important concepts to search and find the best evidence available.

· Reflect on the process of creating a PICO(T) question and searching for peer-reviewed research.

The Assignment (Evidence-Based Project)

Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews

Create a 6- to 7-slide PowerPoint presentation in which you do the following:

· Identify and briefly describe your chosen clinical issue of interest.

· Describe how you developed a PICO(T) question focused on your chosen clinical issue of interest.

· Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected.

· Provide APA citations of the four relevant peer-reviewed articles at the systematic-reviews level related to your research question. If there are no systematic review level articles or meta-analysis on your topic, then use the highest level of evidence peer reviewed article.

· Describe the levels of evidence in each of the four peer-reviewed articles you selected, including an explanation of the strengths of using systematic reviews for clinical research. Be specific and provide examples.

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How should nurses assure policy change for advanced practice registered nurses?

Reply to classmate’s discussion ( answers to your peer of 150 words) each reply needs citation and reference independently. Turnitin less 15%.

Classmate 1 post:

The United States has a growing demand for highly skilled and specialized nurses. An aging population, a growth in chronic illnesses, and an increasing emphasis on preventative care drive this demand. Nurses must be able to grow their careers and practice to their full ability to meet this demand. Unfortunately, various barriers prevent nurses from doing so, one of the most significant being policy. Nurses must be able to ensure policy change for advanced practice registered nurses to solve labor shortages in remote places. The Affordable Care Act (ACA) is one strategy to accomplish this. The Affordable Care Act gives financial incentives to nurses.

Nurses can advocate for policy changes in a variety of ways. One approach is to educate decision-makers on the value of advanced practice registered nurses (APRNs). APRNs play a crucial role in providing high-quality care, and policymakers must recognize their value to the healthcare system (Hassmiller, 2022). Another option for nurses to lobby for policy change is to speak out about the importance of APRNs having access to the resources they require to be successful. It includes education and training, as well as adequate remuneration. Nurses can also endeavor to educate the public about the value of APRNs and the need for legislative reform (van Wijk et al., 2022). This objective can be accomplished through social media, community outreach, and other forms of public interaction.

The Affordable Care Act (ACA) has many provisions aimed at addressing rural labour shortages. One section authorizes the establishment of Community Health Centers (CHCs), which will offer primary care services in underprivileged communities. CHCs can help attract and maintain rural health care practitioners by offering debt repayment assistance and other financial incentives. Another ACA provision created the National Health Service Corps (NHSC), which offers medical practitioners scholarships and loan repayment aid if they agree to serve in underprivileged communities. The NHSC also provides loan repayment help to providers who commit to work for at least two years in underserved areas. The Affordable Care Act (ACA) offers financial incentives for medical care providers (Zhang et al., 2020). Increasing the number of graduates from medical institutions, attracting foreign-trained physicians, and implementing contemporary technology are some initiatives to equip the physician workforce to cater to the rising healthcare demand.

The current demand in the United States for highly competent and specialized nurses can only be met if legislative adjustments are adopted to allow nurses to reach their full potential. One technique used to do this is the Affordable Care Act. Financial incentives are provided to healthcare providers under the Affordable Care Act (ACA), which also forms Community Health Centers (CHCs) that might assist attract and retaining rural healthcare practitioners. Nurses may help bring about the policy reforms needed to solve the nursing crisis by educating decision-makers and the general public about the significance of advanced practice registered nurses and the need for legislative reform.

References

Hassmiller, S. B. (2022). How Nurses Can Help to Create a Better Post-Pandemic World. Policy, Politics, & Nursing Practice, 23(1), 3–4.  https://doi.org/10.1177/15271544221075201

van Wijk, M., Lalleman, P. C. B., Cummings, G. G., & Engel, J. (2022). Public Opinion Leadership in Nursing Practice: A Rogerian Concept Analysis. Policy, Politics, & Nursing Practice, 23(1), 67–79.  https://doi.org/10.1177/15271544211071099

Zhang, X., Lin, D., Pforsich, H., & Lin, V. W. (2020). Physician workforce in the United States of America: forecasting nationwide shortages. Human Resources for Health, 18(1).  https://doi.org/10.1186/s12960-020-0448-3

Classmate 2 post:

How should nurses assure policy change for advanced practice registered nurses? What role does the Affordable Care Act (ACA) play in addressing workforce shortages in rural communities?

Nurses participate in policymaking as healthcare professionals, which is critical for improving service, protecting patient safety, increasing healthcare outcomes, and facilitating access to excellent health care. Advanced registered nurses are particularly suited to play a significant role in healthcare policy formation. Advanced registered nurses have an impact on health policy at several levels, particularly organizational, regional, and national levels. They use their leadership abilities to drive shifts in policy at both levels. Advanced registered nurses impact policy at these levels by introducing advocacy skills to the management and advocating collaborative governance mechanisms in their organization (Arabi et al., 2014). They may, for example, lobby fellow caregivers to optimize staffing numbers, emphasize professional growth, and guarantee an appropriate provision of safety gear. Through these channels, nurses encourage a safe working environment in order to safeguard both patients and staff from injuries and other hazards.

By taking on leadership roles in healthcare and addressing policy issues with state authorities, registered nurses may influence policy. This may be achieved through enrolling in formal political education programs, participating in local government organizations and councils, or even campaigning for local office. Additionally For example, by engaging in lobbying and using their voting privileges. Specialized training Registered nurses may also do this by joining organizations for professionals, many of which include lobbyists who can raise concerns about nursing with authority or political figures (BARZEGAR SAFARI et al., 2020). They may also become members of state nursing organizations, in which they can fight for unrestricted practice rights, or join state nursing associations, where they have the chance to promote professional autonomy (BARZEGAR SAFARI et al., 2020). Nurses may also promote policy change by campaigning for elected office; if elected, they will have the ability to directly address concerns with the Legislature or the Presidency.

The Affordable Care Act is a critical component in the effort to alleviate labor force shortages. This is made easier by the availability of financial support to support rural communities in attracting and retaining clinical staff and also by the creation of a national office of rural healthcare reform to aid in coordinating and improving medical coverage in remote regions (Kominski et al., 2017). Both of these measures are aimed at making it easier for rural residents to receive medical treatment. It is possible that the ACA can help alleviate the nursing labor shortage by investing in education and training initiatives that will assist in the expansion of the proportion of healthcare practitioners working in rural regions (Kominski et al., 2017). This is accomplished by providing financial aid to remote healthcare professionals in order to assist them in the recruitment and retention of staff members. The Affordable Care Act (ACA) contributes to an increase in the number of nurses actively working in the field, which in turn helps alleviate any labor shortages that may exist in the field.

References

Arabi, A., Rafii, F., Cheraghi, M. A., & Ghiyasvandian, S. (2014). Nurses’ policy influence: A concept analysis. Iranian journal of nursing and midwifery research, 19(3), 315–322.

BARZEGAR SAFARI, M., BAHADORI, M., & ALIMOHAMMADZADEH, K. (2020). The Related Factors of Nurses’ Participation and Perceived Benefits and Barriers in Health Policy Making. Journal of Nursing Research, Publish Ahead of Print. https://doi.org/10.1097/jnr.0000000000000385

Kominski, G. F., Nonzee, N. J., & Sorensen, A. (2017). The Affordable Care Act’s Impacts on Access to Insurance and Health Care for Low-Income Populations. Annual Review of Public Health, 38(1), 489–505.  https://doi.org/10.1146/annurev-publhealth-031816-044555

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Create a working advanced statement outline

accomplish the following tasks: 3 pages

1. Create an overall thesis. Consult You, Writing! on pp. 31-36. 

2. Create a working advanced statement outline. Consult You, Writing! on pp. 37-46

3. Write two different introductory paragraphs. Decide also which introduction you like the best. Why? Remember the introduction should grab the reader’s attention. Since it is a narrative, the thesis may be implied or explicit. Traditionally, a thesis should be the last sentence of your first paragraph, but for now, you are still in the invention and drafting stage. Therefore, do not worry so much about getting it right. 

Requirements:

  • Submit the thesis, outline and two introductory paragraphs as a DOCX file (Microsoft Word default). If using another word processing program, click “Save As” for your document and choose 

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SACR-4150. Advanced Seminar in Culture, Power, and Globalization

A critical and substantive examination of culture in a global context, including cultural practices, political economy and culture, culture and representation and culture and identity. Topics may include: material culture, commodities and cultural products; colonialism; globalization; ideas of place and time; transnational networks. (Prerequisites: SACR-3910 or SACR-3560 or SACR-3730; SACR-3900 or SACR-3080 and semester 7 or higher standing, or consent of instructor.)

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SACR-4600. Advanced Seminar in Constructions of Deviance

This course explores theory and research concerned with constructions of deviant behavior and social issues. It involves the application of constructionist theory to a variety of behaviours and issues including the role of moral entrepreneurs, symbolic crusades and the medicalization on deviance. Substantive topics will vary by instructor. (Prerequisites: SACR-2600, SACR-3910 or SACR-3730 or SACR-3560; SACR-3900 or SACR-3080 and semester 7 or higher standing; at least one 3000-level course from the 300 level criminology course selection, or consent of instructor.)

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SACR 4620. Advanced Seminar in Policing, Security, and Surveillance

This course explores theory and research about 21st Century developments in policing, security, and surveillance. Topics may cover intelligence-gathering, pre-crime, fusion centres, social media policing, body-worn cameras, artificial intelligence/predictive policing, and big data surveillance by public and private agencies. (Prerequisites: SACR 2600; 2620; SACR 3820 or SACR 3680 or SACR 3730; SACR 3910 or SACR 3080, and semester 7 or higher standing; or higher.)

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SACR-4640. Advanced Seminar in Sociology of Law

An investigation of theory and research in the sociology of law. Topics may include the social construction of law, the legal profession, law and social change, legal consciousness, law as governance, legal avoidance, moral regulation, and popular representations of law. Criminal and other forms of law will be discussed in relation to these topics. Focus of the course will vary by instructor. (Prerequisites: SACR-3910 or SACR-3730 or SACR-3560; SACR-3900 or SACR-3080 and semester 7 or higher standing; at least one 3000-level course from the 3000 level criminology course selection; or consent of instructor.)

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Special Topics in Health & Society – Obesity: Causes, Consequences, and Solutions 
Instructor: N. Spence

According to the World Health Organization, over 1.9 billion adults and 340 million children and adolescents are obese. Obesity is a significant issue in society, with a wide range of causes, consequences, and potential solutions. Using a multidisciplinary approach, including social science, public health, medicine, and the humanities, we will critically examine the history of obesity and research evidence to date across a host of issues: individual factors related to lifestyle and behavior, as well as biological influences; physical and mental health; stigma, inequality, and discrimination; socioeconomic costs; and the role of the social determinants of health. A thorough analysis of the responses by key social institutions, including medicine, the economic system, and government, will be conducted. Finally, the challenges faced by regions beyond Western society will be reviewed. 

SOCD01H3S: Advanced Seminar in Culture and Cities:  The Sociology of the Neighbourhood
Instructor: F. Calderon Figueroa

From the ancient town to the modern megalopolis, the neighbourhood is one of the oldest forms of human association. Despite dramatic transformations in cities, politics, economies, and culture, neighbourhoods remain central and consequential foci of social life.  Neighbors socialize frequently with one another, and neighborhoods often provide the physical basis for face-to-face interactions in cities where much of life proceeds anonymously in crowds or virtually online.  Neighborhoods are frequently the units of governmental administration, the targets of urban policy, the basis of civic activism, and the arenas of heated political conflict. The neighbourhood in which one grows up and lives has tremendous consequences for one’s life chances and outlook, from health to income to political attitudes and beyond. 

This course will closely examine from a number of perspectives the nature, functions, consequences, and causes of neighbourhoods, paying special attention to the ways in which neighbourhoods are changing and enduring in contemporary post-industrial societies. 

Toronto has often been called a “city of neighbourhoods,” and we will use Toronto as our living laboratory.  In addition to close reading of key texts, students will engage in ongoing field assignments in neighbourhoods across Toronto and its suburbs.  Students will work in teams to examine a neighbourhood via multiple techniques―they will triangulate quantitative, qualitative and spatial data analysis.  They will learn to collate government statistics from the census with online business data to produce statistical mappings of the neighbourhood, and compare it to others.  They will compile media stories, histories,  literary documents, music lyrics, and more to analyze the cultural representation of a neighbourhood.  They will engage in multiple structured personal field observations to observe the street life and activity patterns that characterize the neighbourhood.  Interviews with community leaders and ‘old-timers’ will reveal neighbourhood history and changing perceptions of its character.  Digital photos will provide material both for mapping patterns (e.g. in colour schemes or signage) and for visual comparisons across neighbourhoods (in e.g. architectural style).  

Combining all of this together across teams will produce a deep and rich understanding of various neighbourhood forms and experiences, providing students with living material to test and extend the ideas of the authors we will read in class.

SOCD05H3: Advanced Seminar in Criminology and Sociology of Law
Instructor: J. Doherty
This course offers an in-depth examination of selected topics in criminology and the sociology of law. Students will be responsible for conducting a presentation on and leading a discussion of one weekly reading during the course. A list of journal articles will be provided on select topics in criminology including corrections, justice, and policing, and the sociology of law for students to choose from on the first day of class. In addition to the major presentation, students will be required to complete an annotated bibliography and research paper on a subject related to criminology and the sociology of law. 

SOCD15H3: Advanced Seminar in Critical Migration Studies
Instructor: M. Sarkar
According to global estimates, nearly three quarters of migrants move for work. While we tend to think of migration as voluntary and migrants as ‘free’, rational actors, this upper level undergraduate seminar in historical sociology explores the connections between migration/mobility of people and labour, with particular focus on historical and contemporary forms of constrain/unfreedom/coercion that define human mobility and work experiences across the world. 

SOCD44H3S: Advanced Seminar on Issues in Contemporary Sociology
Instructor: J. Hannigan
The thematic focus of this course is the Sociology of the Arctic. With the substantial impact that climate change is having on the Circumpolar North, contemporary issues relating to the changing lifestyles and relationships of indigenous peoples, competition for land and resources, and the growth of a “Global Arctic” are of increasing sociological importance.

SOCD20H3: Advanced Seminar: Social Change and Gender Relations in Chinese Societies
Instructor: P.C. Hsiung
This seminar examines the transformation and perpetuation of gender relations in contemporary Chinese societies. It pays specific attention to gender politics at the micro level and structural changes at the macro level. It engages students in scholarly debates on gender relations and social change in the Chinese societies. By providing guidance and feedback, the instructor helps students acquire substantive knowledge on the subject area and develop transferable, research-based skills. Upon completion of the seminar, students are expected to (1) understand how specific claims are made and substantiated; (2) examine how scholarly research is conducted; and (3) apply such understandings to explore a research question through library research, data analysis, literature review, and presentation of your findings and direction of future inquiry.

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Registered nurses (RNs) and advanced practice registered nurses (APRNs) play a vital role in healthcare delivery.

Respond to the two following post

APA format

2 scholarly References within the last two years for each post

Plagiarism free, Turnitin report

Chloe C

Discusion # 1

Top of Form

Opportunities

Nursing plays a role in changing health policy on multiple levels: conduct quality improvement projects on the job, attend local meetings to share their expertise and advice and write to their political representatives to advise them on critical health-related issues. Registered Nurses and Advanced Practice Registered Nurses are in a great position to advocate for policy development because they spend so much time with patients to know the specific needs of the communities they serve. (Regis College, n.d.).

 Challenges

Nurses often must move out of their comfort zone to advocate for health policy changes, and this process can be very time-consuming. Some have no interest in politics and policy-making and lack educational preparedness. Some have found a lack of resources and mentorship from exemplary nurse leaders. 

           Joining nursing organizations is essential for nurses to enhance individual advocacy efforts. These groups provide resources and strategize more effectively to bring nursing perspectives to health policy decision-makers. Nursing organizations can monitor public policy, offer ways for their members to learn about health policy, and serve as a resource for reliable information related to policy issues and policymakers. (Abood, n.d.).

 Strategies 

As nurses, these opportunities to participate in policy-making can be communicated in the employment setting through word of mouth directly to coworkers or nursing-led education classes about the subject. Also, social media is a great way to reach, educate, advocate, and communicate with a specific target audience on a larger scale in this day and age. (Anders, 2021).

Andrikia W

Discussion post #2

Top of Form

Registered nurses (RNs) and advanced practice registered nurses (APRNs) play a vital role in healthcare delivery. As RNs and APRNs, we must become actively involved and continue to be the voice and advocate for our patients and community. We can become involved by meeting with local legislators and community leaders to address the problems we are facing with health care. Also, joining an organization such as American Nurses Association is a way for nurses to become actively involved in the policy-making process. In addition to lobbying on issues that directly affect the nursing profession, ANA takes bold stances on issues important to its members. ANA has taken firm positions on a range of issues including Medicare reform, the importance of safe nurse staffing, workplace violence, whistleblower protections for health care workers, and adequate reimbursement for health care services (ANA, n.d.). Social media is a key platform for nurses to be advocates. For example, Facebook has a variety of distinct groups designated for RNs and APRNs. It is a resourceful tool to utilize to network and get information to the public. Another strategy in increasing participation and bringing awareness to politics and policymaking is providing nurses with efficient information regarding health policies. For example, I did not have a lot of knowledge about healthcare policy making until taking this course. Surprisingly, this information is not provided or taught in undergraduate courses. If the information is introduced at an early stage in nurses’ careers, then they will be more actively engaged.

Nurses are not always granted the opportunity to voice their concerns. The International Nursing Review article identifies a lack of support, resources, and time for nurses to do so in their workplaces, and too often nurses lack confidence and skills in policymaking and do not understand the differences or connections between policy and politics (Health Stream, 2021). However, nurses should not allow negativity or lack of support from legislators to discourage them from becoming involved. Instead, nurses should fight back and have adequate evidence-based practice to support the topic of concern. Nursing organizations allow nurses to band together and support one another in policy implementation. Nurses can create healthcare change and should become involved in the policy process and learn about upcoming issues. As a component of professional nursing, active participation in the policy process is essential in the formulation of policies designed to provide quality health care at sustainable costs to all individuals (Milstead & Short, 2019).

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Good modeling capability of advanced powertrain control systems within the Matlab/Simulink environment

 Coursework Assessment Brief: Report (80%)FileThe purpose of this assessment is to enable students to demonstrate a number of skills that have been developed within the Module, in particular:
• Good modeling capability of advanced powertrain control systems within the Matlab/Simulink environment
• An appreciation of advanced propulsion and emission control strategies available to the automotive engineer
• How best to specify and implement the chosen designs in order to optimize performance benefits.
This will be achieved by writing a structured report (around 4000 words). Unless specified, the manuscript will report individual work.
The report will contain three parts:
1. A review of advanced hybrid powertrains, their control strategies and how they may be implemented at particular speed and load points
2. The design and implementation of a realistic series or parallel hybrid powertrain.
3. The comparison of various idle speed control strategies
The part 2 (powertrain model) should:
• illustrate the mode based/rule based control of the power flow, in matlab/simulink
• use of an operating point optimizing fuel consumption or the efficiency of the ICE, using Ricardo Wave or justifications.
• follow the WLTP drive cycle
• reflective analysis of the results
The part 3 (Idle speed control) should:
• Discuss a ICE implementation using Ricardo Wave (group work)
• Illustrate the control via ignition timing (one member of the group work)
• Illustrate the control via the intake valve timing and regulation of the air mass rate flow (one member of the group work)
•
• Illustrate the control via the bypass valve and regulation of the air mass rate flow (one member of the group work)
• Illustrate the control via the throttle and regulation of the air mass rate flow (one member of the group work)
• Compare and discuss the control methods and a reflective analysis of the results
Note that it is required that the individual work (for each control strategy) has to be clearly identified in the report

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Good modeling capability of advanced powertrain control systems within the Matlab/Simulink environment

Coursework Assessment Brief: Report (80%)File
The purpose of this assessment is to enable students to demonstrate a number of skills that have been developed within the Module, in particular:
• Good modeling capability of advanced powertrain control systems within the Matlab/Simulink environment
• An appreciation of advanced propulsion and emission control strategies available to the automotive engineer
• How best to specify and implement the chosen designs in order to optimize performance benefits.
This will be achieved by writing a structured report (around 4000 words). Unless specified, the manuscript will report individual work.
The report will contain three parts:
1. A review of advanced hybrid powertrains, their control strategies and how they may be implemented at particular speed and load points
2. The design and implementation of a realistic series or parallel hybrid powertrain.
3. The comparison of various idle speed control strategies
The part 2 (powertrain model) should:
• illustrate the mode based/rule based control of the power flow, in matlab/simulink
• use of an operating point optimizing fuel consumption or the efficiency of the ICE, using Ricardo Wave or justifications.
• follow the WLTP drive cycle
• reflective analysis of the results
The part 3 (Idle speed control) should:
• Discuss a ICE implementation using Ricardo Wave (group work)
• Illustrate the control via ignition timing (one member of the group work)
• Illustrate the control via the intake valve timing and regulation of the air mass rate flow (one member of the group work)
•
• Illustrate the control via the bypass valve and regulation of the air mass rate flow (one member of the group work)
• Illustrate the control via the throttle and regulation of the air mass rate flow (one member of the group work)
• Compare and discuss the control methods and a reflective analysis of the results
Note that it is required that the individual work (for each control strategy) has to be clearly identified in the report


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Good modeling capability of advanced powertrain control systems within the Matlab/Simulink environment

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