For advanced health assessment, To prepare: With the information presented in Chapter 1 of Ball et al. in mind, consider the following: By Day 1 of this week, you will be assigned a new patient profile by your Instructor for this Discussion. Note: Please see the “Course Announcements” section of the classroom for your new patient profile assignment. How would your communication and interview techniques for building a health history differ with each patient? How might you target your questions for building a health history based on the patient’s social determinants of health? What risk assessment instruments would be appropriate to use with each patient, or what questions would you ask each patient to assess his or her health risks? Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration. Select one of the risk assessment instruments presented in Chapter 1 or Chapter 5 of the Seidels Guide to Physical Examination text, or another tool with which you are familiar, related to your selected patient. Develop at least five targeted questions you would ask your selected patient to assess his or her health risks and begin building a health history.
DISCUSSION CASE PATIENT: 21-year-old Filipino college student living in a dorm wanting to know what birth control is: For advanced pharmacology,Post a description of the patient case from your experiences, observations, and/or clinical practice from the last 5 years. Then, describe factors that might have influenced pharmacokinetic and pharmacodynamic processes of the patient you identified. Finally, explain details of the personalized plan of care that you would develop based on influencing factors and patient history in your case. Be specific and provide examples
If the cost of electricity decreased to 8 ¢/kWh, which alternative would be the most cost-effective?
At what electricity cost would the following alternatives just break even? (a) Alternatives 1 and 2, (b) alternatives 1 and 3, (c) alternatives 1 and 4.
Background
Aeration and sludge recirculation have been practiced for many years at municipal and industrial water treatment plants. Aeration is used primarily for the physical removal of gases or volatile compounds, while sludge recirculation can be beneficial for turbidity removal and hardness reduction.
When the advantages of aeration and sludge recirculation in water treatment were first recognized, energy costs were so low that such considerations were seldom of concern in treatment plant design and operation. With the huge increases in electricity cost that have occurred in some localities, however, it became necessary to review the cost-effectiveness of all water treatment processes that consume significant amounts of energy. This study was conducted at a municipal water treatment plant for evaluating the cost-effectiveness of the pre-aeration and sludge recirculation practices.
Information
This study was conducted at a 106 m3/min water treatment plant where, under normal operating circumstances, sludge from the secondary clarifiers is returned to the aerator and subsequently removed in the primary clarifiers. The Figure below (Figure 13–12) is a schematic of the process.
To evaluate the effect of sludge recirculation, the sludge pump was turned off, but aeration was continued. Next, the sludge pump was turned back on, and aeration was discontinued. Finally, both processes were discontinued. Results obtained during the test periods were averaged and compared to the values obtained when both processes were operational.
The results obtained from the four operating modes showed that the hardness decreased by 4.7% when both processes were in operation (i.e., sludge recirculation and aeration). When only sludge was recirculated, the reduction was 3.8%. There was no reduction due to aeration only, or when there was neither aeration nor recirculation. For turbidity, the reduction was 28% when both recirculation and aeration were used. The reduction was 18% when neither aeration nor recirculation was used. The reduction was also 18% when aeration alone was used, which means that aeration alone was of no benefit for turbidity reduction. With sludge recirculation alone, the turbidity reduction was only 6%, meaning that sludge recirculation alone actually resulted in an increase in turbidity—the difference between 18% and 6%.
Since aeration and sludge recirculation did cause readily identifiable effects on treated water quality (some good and others bad), the cost-effectiveness of each process for turbidity and hardness reduction was investigated. The calculations are based on the following data:
Aerator motor = 40 hp
Aerator motor efficiency = 90%
Sludge recirculation motor = 5 hp
Recirculation pump efficiency = 90%
Electricity cost = 9 ¢/kWh (previous analysis)
Lime cost = 7.9 ¢/kg
Lime required = 0.62 mg/L per mg/L hardness
Coagulant cost = 16.5 ¢/kg
Days/month = 30.5
As a first step, the costs associated with aeration and sludge recirculation were calculated. In each case, costs are independent of flow rate.
Aeration cost:
40 hp × 0.75 kW/hp × 0.09 $/kWh × 24 h/day ÷ 0.90 = $72 per day or $2196 per month
Sludge recirculation cost:
5 hp × 0.75 kW/hp × 0.09 $/kWh × 24 h/day ÷ 0.90 = $9 per day or $275 per month
The estimates appear in columns 1 and 2 of the cost summary in Table 13–1 below.
Costs associated with turbidity and hardness removal are a function of the chemical dosage required and the water flow rate. The calculations below are based on a design flow of 53 m3/min.
As stated earlier, there was less turbidity reduction through the primary clarifier without aeration than there was with it (28% vs. 6%). The extra turbidity reaching the flocculators could require further additions of the coagulating chemical. If it is assumed that, as a worst case, these chemical additions would be proportional to the extra turbidity, then 22% more coagulant would be required. Since the average dosage before discontinuation of aeration was 10 mg/L, the incremental chemical cost incurred because of the increased turbidity in the clarifier effluent would be
(10 × 0.22) mg/L × 10–6 kg/mg × 53 m3/min
× 1000 L/m3 × 0.165 $/kg × 60 min/h
× 24 h/day = $27.70/day or $845/month
Similar calculations for the other operating conditions (i.e., aeration only, and neither aeration nor sludge recirculation) reveal that the additional cost for turbidity removal would be $469 per month in each case, as shown in column 5 of Table 13–1 above.
Changes in hardness affect chemical costs by virtue of the direct effect on the amount of lime required for water softening. With aeration and sludge recirculation, the average hardness reduction was 12.1 mg/L (i.e., 258 mg/L × 4.7%). However, with sludge recirculation only, the reduction was 9.8 mg/L, resulting in a difference of 2.3 mg/L attributed to aeration. The extra cost of lime incurred because of the discontinuation of aeration, therefore, was
2.3 mg/L × 0.62 mg/L lime × 10−6 kg/mg
× 53m3/min × 1000 L/m3 × 0.079 $/kg
× 60 min/h × 24 h/day = $8.60/day or
$262/month
When sludge recirculation was discontinued, there was no hardness reduction through the clarifier, so that the extra lime cost would be $1380 per month.
The total savings and total costs associated with changes in plant operating conditions are tabulated in columns 3 and 6 of Table 13–1 above, respectively, with the net savings shown in column 7. Obviously, the optimum condition is represented by “sludge recirculation only.” This condition would result in a net savings of $1089 per month, compared to a net savings of $622 per month when both processes are discontinued and a net cost of $1574 per month for aeration only. Since the calculations made here represent worst-case conditions, the actual savings that resulted from modifying the plant operating procedures were greater than those indicated.
In summary, the commonly applied water treatment practices of sludge recirculation and aeration can significantly affect the removal of some compounds in the primary clarifier. However, increasing energy and chemical costs warrant continued investigations on a case-by-case basis of the cost-effectiveness of such practices
Write a paper (700 words) on what you think should be included in a future reform of the health care system, focusing on financial operating changes that would improve efficiency and provide for improved transparency to the public. Include three to five research/references to support your position.
Prepare this assignment according to the guidelines found in the GCU Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.
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Hydrographics are applied to firearms for aesthetic purposes almost as often as they are for functional ones. This is evident in the many different films available which are purely for looks. Let’s face it, you are unlikely to ever be surrounded by flames and skulls and in need of a firearm which blends into your environment. Consider all the purely aesthetic hydrographics you have seen and then discuss the following.
Do you find there to be any ethical concern with taking a tool such as a firearm and giving it a “designer look” like you would a car, boat, or other “toy”? Why or why not? If you were to offer hydrographic application at your own shop, would you apply these finishes if a customer requested them? Why or why not? Finally, how would you defend your position to a customer who took offense to your view, whatever it is?
In this Discussion Board, you will look at the use of data and factors that support growth essential to student achievement and standards-based teaching and learning.
Figure 9.3 (Indicators of Standards-Based Teaching and Learning p.160 in the Text: Getting More Excited About Using Data) lists 15 attributes that were compiled to provide a more complete understanding of standards-based teaching and learning.
Figure 1.2 (Sources of Data, p.11 in the text: Getting More Excited About Using Data) lists 30 different sources of data that are useful in addressing important aspects of teaching and learning.
You have been asked by your building administrator to participate on a task force to identify why the school is seeing two years of declining scores in the area of English Language Arts (ELA) or Math. In the Discussion Board post the following:
Identify if you have chosen to serve on the ELA team or the Math team.
What three to five indicators from Figure 9.3 would you want the team to explore in order to determine why there is a decline in the scores?
Share each indicator chosen from Figure 9.3 and explain why you believe the data source would help the school make improvement decisions to facilitate increased student performance.
Match the appropriate sources of data from Figure 1.2 that would guide the team in determining data points for decision making and planning based upon the three to five indicators you selected from Figure 9.3.
What would the data sources tell you about students, their learning and their instructional needs?
Discussion 5
ffective School-Wide Leadership
Directions
Leadership is not a one size fits all process. Leaders come to their role with different skills, different abilities and different levels of needed growth. In the discussion, you will look at how leadership models matched with personal style, behaviors, and skills are used to build a school-wide culture of leadership in schools. In this Discussion Board you will compare three different leadership philosophies and models. Before starting your Discussion Board posting, complete these three assessments from your textbook:
Your leadership style model (Figure 4.2 p. 93-94)
Your emphasis on task and relationship behaviors survey (Figure 5.2 p.111-112)
Your leadership skills survey (Figure 6.2 p.134-135)
In the Discussion Board, reflect on your results of each survey and discuss how the model and your style, behaviors and skills relate to each. You will share your strengths and weaknesses in style as it relates to each model.
How would you use these surveys?
What would you expect to do with the information to create a school-wide culture?
How would these surveys help you to identify the leaders within the school?
How would you classify the teachers into leadership groups to create a culture of leadership?
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Many business activities generate data that can be thought of as random. An example described in the textbook is the servicing of cars at an oil change shop. Each car entering the shop can be considered an experiment with random outcomes. A variable of interest in this experiment could be the amount of time necessary to service the car. Service time will vary randomly with each car.
We can often capture the most relevant characteristics of a stochastic process with a simple probability distribution model. We can then analyze the model to make predictions and drive decisions. For instance, we could estimate the number of technicians the oil change shop needs to service demand on a Saturday afternoon. Discuss the following:
What is a random variable?
How would you differentiate a discrete from a continuous random variable?
A laptop manufacturing company has implemented a 2-step process to test the quality of each production batch. In the first step, a technician randomly selects 15 laptops from the batch and determines whether they meet specifications. The batch is considered acceptable provided no more than 1 laptop fails to meet specifications. Otherwise, the entire batch must be tested in the second step. Historical data shows that 95% of the laptops produced adhere to specifications. Discuss the following:
What are the 4 characteristics of a binomial experiment?
Can we use a binomial distribution to model this process?
What is the probability that the entire batch unnecessarily has to be tested if in fact 95% of its laptops conform to specifications? (Hint: Use Excel’s =BINOMDIST() function to find the probability.)
What is the probability that the batch is incorrectly accepted if only 75% of its laptops conform to specifications?
Due Day 7
Reply and or respond to at least 2 of your classmates or your faculty member, and/or address the following subjects:
Explain what we mean when we identify “cause and effect”.
How are percentages an important part of determining probability?
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How would you differentiate a discrete from a continuous random variable?
Describe the nursing care delivery model used at your current or previous employer. Would you utilize this model at SLMC? Discuss current interprofessional collaboration and how you would encourage collaborative efforts. Does the model support the person-centred nursing framework by McCormack and McCance (2017)? Explain your rationale for choosing to use or not use the person-centred nursing framework. Please refer back to the 2017 PCNF overview presented below. Patient-Centered Care: A Person-Centred Care Model Revisited Caring continues to be a central concept in nursing; however, the context for caring is transforming, resulting in conceptual and theoretical advancements related to the evolving healthcare practice settings. McCormack and McCance originally developed a Person-Centred Nursing (PCN) Framework in 2006 and updated it in 2010 that can be applied to practice in complex healthcare systems (McCormack & McCance, 2006; McCormack & McCance, 2017). The PCN Framework provides a standard of care for practice and is a multidimensional process that places emphasis on the person as the center of care delivery (McCance, McCormack, & Dewing, 2011). The PCN Framework fosters outcomes related to therapeutic relationships through respecting individuals as persons and partners in care. The Person-Centred Care Nursing Framework consists of four constructs: prerequisites, the care environment, person-centred processes, and outcomes (McCance et al., 2011). To deliver effective care, one must work from the outer circle first to the core. McCormack, B. & McCance, T. (2017)Prerequisites focus on the attributes of the nurses and include being professionally competent, having developed interpersonal skills, being committed to the job, being able to demonstrate clarity of beliefs and values, and knowing self. The care environment focuses on the context in which care is delivered and includes appropriate skill mix, systems that facilitate shared decision making, effective staff relationships, organizational systems that are supportive, the sharing of power, the potential for innovation and risk taking, and the physical environment. Person-centred processes focus on delivering care through a range of activities and include working with a patient’s beliefs and values to overcome this gap between the concept and the reality of person-centred care we have developed the Person-Centred Nursing Framework…engagement, having sympathetic presence, sharing decision making, and providing holistic care. Outcomes, the central component of the Framework, are the results of effective, person-centred nursing and include: satisfaction with care, involvement in care, feeling of well-being, and creating a therapeutic environment. (McCance, McCormack, & Dewing, 2011).
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Part 1( attachment 1) In the Discussion Board you will review the work from Danielson’s and create strategies that would be used to monitor teacher quality and effectiveness. You will develop a plan for supporting teachers’ growth and development, as well as monitoring their professional practice for improvement.
Use the Danielson Framework (downloaded at the completion of the learning activity) and identify two standards for quality and two standards for effectiveness that you will create a monitoring plan for. Break down and discuss two strategies you, as a leader, would use to monitor quality and two strategies you would use to monitor effectiveness.
Using these identified strategies, how would you then develop a plan to support the growth and development of a colleague for quality and for effectiveness?
What process would you use to monitor and support the professional practice (observations, checklists, coaching, professional development), and over what period of time would?
Part 2 (link for Part 2) ( https://www2.ed.gov/about/contacts/state/index.html )
Monitoring Strategies
Discussion Overview
As an instructional leader, you will spend time preparing, observing, and reflecting on both teacher quality and effectiveness.
Review your own school district’s teacher performance monitoring tool and one other local or state monitoring tool, (you can use the state contact map to locate school districts). Compare the two district’s monitoring tools and strategies that are used to monitor teacher effectiveness and quality. Look at their commonalities and differences, and share what is similar and what is unique to each.
Describe how they monitor quality and what tools/methods they use. Describe how they monitor effectiveness and what tools/methods they use. In conclusion to this discussion, share one thing you would add in order to increase the ability of the instructional leader to monitor quality and share one thing you would add to monitor effectiveness. Justify each of your answers.
Please Read each activity They are to go on Separate pages Please label them
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Identify a use case where you would be interested in applying a machine learning algorithm-Write a hypothesisstatement and the steps you would take to choose and decide on the correct technique (only based on today’s lecture)-Provide a reason for your choice
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Discuss the organizational structure that you, as the nurse administrator for SLMC, believe would be most appropriate. Use a specific organizational theory to support your decision and discuss how this structure may impact the organization’s outcomes. There is no word count for threaded discussions and there is only one discussion per week. This is different from what you are used to in your core courses. Please see discussion guidelines and rubric below
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