Great discussion on HIV & inflammatory bowel disease (IBD). The two major phenotypes of inflammatory bowel disease are ulcerative colitis and Crohn’s disease. IBD is influenced by a complex interplay of genetics and immunologic factors. However, the exact etiology is unknown. Research on IBD includes focus on particular gut proteins and immune cells that are recruited to the gut. Stem cell research is a focus as well. What role does genetics play in the development of these disorders?

 

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Respond to this post with a positive response :

Ask a probing question, substantiated with additional background information, evidence or research.

Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional research.

Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Use  references

EXAMPLE OF A REFERENCE

 If you cannot locate a doi number, this is how the reference should look. 

Quelly, S. B. (2017). Characteristics Associated with School Nurse Childhood Obesity Prevention Practices. Pediatric Nursing, 43(4). Retrieved from https://www.pediatricnursing.net/issues/17julaug/abstr5.html

                                                MAIN POST

Online learning has become more mainstream and is now providing higher education opportunities to those who would not have had access in the past.  Online success comes from planning out your week and then accomplishing it. For me, I set aside time on Monday and Wednesday.  These days are my weekly off days that I set up with my OR director before school started.  Involving my director and manager lets them know what my goals are and how they can help me achieve them.  

Planning/Time Management

When I plan out my “school day”, I start with what time I am waking up, I incorporate breakfast, and dropping the little girl off at VPK, as well as gym time.  My day starts at 0530 and “class” begins around 0730-0745.  Mondays are dedicated to reading and initial discussion post’s.  If I can post a discussion with time to spare I will start thinking of ideas for my response post.  Wednesday’s are dedicated review days and responding to posts.  Thursday and Friday, for me, seem to be review of material and discussion post.  These days tend to be later in the night since I get off at 1900. So, I set aside and hour and a half of “school-time” on those nights.  The main thing to understand about planning and time management with online learning is this; you can’t expect to achieve a goal without preparation.  

Communication/ Technology use

            Temeka Johnson states in the academic guide” Walden offers a very user-friendly environment for the students to stay connected–to get connected and stay connected”.  Communication is so vital for achieving online success.  Walden is connected, they have provided you a way to access information 24-7.  There is the Facebook groups and pages for each class, there is the chat support on the main page of the student portal. Walden has also given you a link for FAQ’s.  In my opinion they have thought about everything.  With everything that Walden offers, the ease of accessing information is due to use of modern technology.  Jeffrey Bodimer states in the academic guide, “I mean, it’s technology, you’re not going to break it. You know, it’s not going bite you. You just simply have to get in and play around with it. Do the pointing, do the clicking. Post something incorrectly. You know, make the mistake. Don’t be afraid of making of making the mistake.”   

Walden University has given us a solid platform to jump from.  The tools of success have been handed to you as well as the instructions on how to use them.  Take the time to plan out future, communicate with your instructors and fellow students, and use the technology provided to make those plans a reality.  

 

 

 

References

Gerr, M. (2018). Walden SRO: Creating a Technology Backup Plan. [online] Academicguides.waldenu.edu. Available at: https://academicguides.waldenu.edu/ld.php?content_id=2828215 [Accessed 3 Dec. 2018].

 

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I need a positive argument  based in this discussion question. Respond to this argument in one or more of the following ways:

Ask a probing question, substantiated with additional background information, evidence or research.

Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional research.

Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Use references

                      My Goals and Walden University Vision and Mission

            In 2011 I graduated from Nursing School.  I knew I wanted work in the Emergency Department.  I had finished my practicum in an ED and was slotted to be hired once I passed my NCLEX.  As life would have it, I wouldn’t be able to take that job until year later.  In the meantime, I toughed it out as a floor nurse, and honed my skills.  I knew that floor nursing was not in my 10-year plan, so I made it a point to get all the experience I could to prepare myself for a career as a nurse. My journey since becoming an RN has been an amazing one.  I have completed Critical Care fellowships, worked beside some of the finest physicians, and now with all my experiences, I need to become a Nurse Practioner.  I am currently working in the Operating Room and have absolutely fallen in love with Orthopedics.  Becoming an Orthopedic Nurse Practioner will allow me to treat patients in clinic as well as assist the surgeon to increase mobility in those requiring surgery.

            I found Walden University during a school fair at my current hospital.  I spoke with a representative who, in my opinion, made the choice very easy.  I did research other online programs, but I always came back to Walden University.  The ability for me to attend a program and still be able to work full time was a must.  I felt like this University had my best interest in mind after reading the School of Nursing’s (SON) vision and mission statement.  The mission statement states “Walden University provides a diverse community of career professionals with the opportunity to transform themselves as scholar-practitioners so that they can effect positive social change.”  (Walden University, 2011a) I feel as though Walden University will assist me to be in control my transformation from Registered Nurse to Nurse Practioner.  

Incorporation of Social Change

            Everyday our society experiences change whether swift or gradual.  I want to promote positive social change by integrating Walden University’s views with my own.  “Positive social change results in the improvement of human and social conditions.” (Walden 2011b, para.1) I want to be part of that change, I want to be part of the improvement, I want to use my knowledge and experience to help improve the way we live together as human beings.  I feel like Walden University will provide me with the tools needed to make this vision a reality.  

References

Walden University. (2011a). About the school. Retrieved from               

http://www.waldenu.edu/Colleges-and-Schools/College-of-Health-Sciences/15863.htm

Walden University. (2011b). Vision, mission, and goals. Retrieved from 

http://catalog.waldenu.edu/content.php?catoid=21&navoid=2450

 

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Respond to this post with a positive response :

Ask a probing question, substantiated with additional background information, evidence or research.

Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional research.

Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Use at least 3 references

                                       Health care Challenges in Africa

        Africa faces a burden of communicable and non-communicable diseases. On March 23, 2014, the World Health Organization (WHO) reported cases of Ebola Virus Disease in the forested rural area of Southeastern Guinea. A research done by Olu, Petu, Ovberedio & Muhongerwa, 2017 states that the 2014/2015 Ebola Virus Disease (EVD) outbreak in West Africa infected more than 28,000 persons out of which 11,000 died. At the height of this outbreak, a considerable load of cases and their contacts overwhelmed the response capacity of the principally affected countries namely Guinea, Liberia, and Sierra Leone. When this outbreak happened, the affected states didn’t have experience or tools to identify cases and limit the spread of the disease rapidly. Cost-effective interventions and medical access would have reduced the number of people infected during the epidemic/outbreak, but coverage is too low due to the health care system. These challenges relate to the leadership in Africa countries, health workforce, and medical products.

Challenges and the way forward

      All countries suffer from problems of coordination among hospitals and community-based services (Knickman & Knover, 2015, Chapter 4). One challenge is accessing, which is still the greatest challenge to health delivery in Africa. Fewer than 50% of Africans have access to modern health care facilities. Many African countries spend less than 10% of their GDP on healthcare. Secondly, shortages of trained health care professionals from Africa because many of them prefer to live in places like the United States and Europe. There is also the increase in communicable and non-communicable disease such as AIDS, malaria, hypertension, which are increasing in the middle-class and the poor increases.  I think the government is responsible for ensuring that everyone has access to healthcare. However, I don’t believe that healthcare is a public good that is the sole responsibility of the government in Africa. There should be an opportunity for entrepreneurs to enter the health delivery space in Africa to provide healthcare to the middle class and the working poor.  African Counties need to embrace technology to close health care gap and private-public partnership in the health care system. In 2007, Becton, Dickinson, and Company (BD) and the US President’s Emergency Plan for AIDS Relief (PEPFAR) entered into a public-private sector partnership focused on laboratory-system strengthening in sub-Saharan Africa (Cohen, 2016). This partnership is now known as “Labs for Life” was formed to help the people in low resource countries in Africa living with AIDS access to antiretroviral therapy.

According to Hader (2016),

Public-private partnerships (PPPs) align public and private needs around mutual goals to move vital projects forward. When PPPs work to strengthen the critical link in the healthcare system, such as laboratory networks, as demonstrated in this supplement by authors from the International Laboratory Branch at the Centers for Disease Control and Prevention (CDC), in-country officials from the respective CDC and Ministries of Health, implementing partners, and Becton, Dickinson, and Company (BD), they significantly change the landscape of healthcare and patient outcomes.

 

     Cognizant of the challenges mentioned above, the 46 Ministers of Health from the African Region adopted and signed the Ouagadougou Declaration that proposes ways of addressing health system challenges. The Ouagadougou Declaration urges Member States to update their national health policies and plans according to the primary health care (PHC) approach; promote inter-sectorial collaboration and public-private partnership to address broad determinants of health; improve health workforce production and retention; set up mechanisms for increasing availability and accessibility of essential medicines, health technologies and infrastructure; strengthen health information systems; develop and implement strategic health financing policies and plans; promote health awareness and build behavioral change capacities among communities.

Summary

        Efficient health interventions are available to help with the health care problems in Africa. Unfortunately, health systems are too weak to adequately and equitably deliver those interventions to people who need them. As nurses, we need to reach out to the health care teams and organizations in Africa to speak up for the population. Join International health organizations and write letters to the policymakers in countries in Africa. Let our voice be heard through international media to help curtail this problem. We need to make it a global problem and advocate for this population so they can have good health care and access to medical care by involving policymakers and legislators in their respective countries.

 

                                                        References

Cohen, G. (2016). Role of Public-Private Partnerships in Meeting Healthcare Challenges in Africa: A Perspective From the Private Sector. The Journal Of Infectious Diseases, 213 Suppl 2, S33. https://doi-org.ezp.waldenulibrary.org/10.1093/infdis/jiv578

Ebola: 2014 Outbreak in West Africa. (2014). Congressional Research Service: Report, Retrieved from https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=edb&AN=98496602&site=eds-live&scope=site

Hader, S. L. (2016). Role of Public-Private Partnerships in Meeting Healthcare Challenges in Africa: A Perspective From the Public Sector. The Journal Of Infectious Diseases, 213 Suppl 2, S34. https://doi-org.ezp.waldenulibrary.org/10.1093/infdis/jiv575

Knickman, J. R., & Knover, A. R. (2015). Health Care Delivery in the United States (11th ed.). New York, NY: Springer Publishing Company

Olu, O., Petu, A., Ovberedjo, M., & Muhongerwa, D. (2017). South-South cooperation in Africa: experiences, challenges and a call for concerted action. Pan African Medical Journal , 28 , 1-7. https://doi-org.ezp.waldenulibrary.org/10.11604/pamj.2017.28.40.12201

The Ouagadougou Declaration. (2002). Africa News Service. Retrieved from https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=edsgov&AN=edsgcl.89001532&site=eds-live&scope=site

World Health Organization: Strengthening health systems to improve health outcomes: World Health Organization’s framework for action Geneva. Retrieved from http://www.wpro.who.int/health_services/strategic_plan_strengthening_health_system

 

 

 

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Respond to the post bellow, using one or more of the following approaches:

Ask a probing question, substantiated with additional background information, and evidence.

Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

Offer and support an alternative perspective using readings from  the classroom or from your own review of the literature in the Walden  Library.

Validate an idea with your own experience and additional sources.

Make a suggestion based on additional evidence drawn from the readings or after synthesizing multiple postings.

 

                                        

                                      Data Collection 

Data  collection methods vary greatly depending on the research question and  the type of participants, regardless of chosen methodology, data  collection must be rigorously executed to produce high-quality data.  Similarly, instruments to collect data must provide accurate, concise,  and provide quantifiable data from which clinical meaning can be  extrapolated and subsequently applied to effect improvements in  practice. In this case, research aims to assess patient satisfaction,  from the patient’s perspective. Polit & Beck (2017), report that  structured self-report instruments are widely used by nurse researchers,  and are typically formatted as either questionnaires or interviews.  Surveys provide several advantages. In comparison to interviews, they  are cost-effective, maintain the anonymity of respondents, mitigate  interviewer bias, and can be easily administered using computer  technology. Disadvantages to surveys include low response rates;  typically around 50%, exclusion of certain populations such as the  elderly and children, questions may lack depth, or be ambiguous or  confusing causing respondents to skip them altogether (Polit & Beck,  2017)

Survey Instrument 

Low  response rate remains a primary barrier in survey administration and  efficacy. However, when surveys are personally distributed in a  particular setting, in this case, the primary care clinic, response  rates are significantly higher. Moreover, the personal nature of a  survey tool being directly distributed to respondents has a positive  effect on participants (Polit & Beck, 2017). Keough and Tanabe  (2011) contend that although the data collected through surveys is not  as scientific as data obtained through experimentation, it is  nonetheless important and informs nursing practice. Because the clinic  is interested specifically interested in understanding the patients’  point of view, I assert that a self-report survey tool should be  designed using a Likert-type rating scale. The range of responses  available to the participants provides greater insight compared to a  simple closed-ended question. Moreover, rating scales are easy to  complete and are also efficient. However, because people may  misunderstand the concept of the Likert Scale, instructions and  statements should be clear and concise (Polit & Beck, 2017).

Sampling Methodology and Participant Selection

             I would employ a consecutive sampling methodology; this includes  recruiting all accessible and eligible participants over a  pre-determined time-period (Polit & Beck, 2017). There is no  specific formula for sample size. Martínez-Mesa, Bastos, Bonamigo, and  Duquia (2014) assert that sample size can be thought of in tiers. The  largest tier represents the entire population; in this case, 10,000  patients. The target population is the portion of the total population  who are of interest to the study. In this case, we would exclude very  small children or patients who are cognitively impaired. Finally, the  study population includes those who will be included in the research  (Martínez-Mesa, Bastos, Bonamigo, & Duquia, 2014). 

To  optimize response rates, and to increase validity and reliability, the  survey will be administered in quarterly increments over a year.  Therefore, the target population will be all 10,000 patients. Of the  target population, it would be reasonable to assume that some patients  will not want to fill out the questionnaire and that others will be  excluded. The study population will aim to include 7,500 patients. All  eligible participants will be asked to fill out a paper and pencil,  self-administered, survey when they check into the clinic for an  appointment. This will allow adequate time for participants to complete  the survey before seeing their provider. Results will be calculated  every quarter and once at the end of the year for comparison. This  schedule will facilitate detection of variations in patient satisfaction  throughout the year, and help to identify specific variables such as  inadequate staffing that contributed to the results.   

Survey Questions 

Participants  will be asked to rate declarative statements using will be using the  Likert rating scale. A bipolar continuum will assess varying degrees of  satisfaction to the statements regarding patient satisfaction. The  participants will be asked to rate the following items:

1.) 1. Convenience of office hours: 

o Excellent

o Very Good 

o Good

o Fair

o Poor 

2.) 2. Ease of making an appointment:

o Excellent

o Very Good 

o Good

o Fair

o Poor 

3.) 3.  Promptness in seeing your provider:

o Excellent

o Very Good 

o Good

o Fair

o Poor 

4.) 4. Friendliness of staff:

o Excellent

o Very Good 

o Good

o Fair

o Poor 

5.) 5.  Clarity of medical instructions provided:

o Excellent

o Very Good 

o Good

o Fair

o Poor 

6.) 6.  Overall comfort of the office:

o Excellent

o Very Good 

o Good

o Fair

o Poor 

7.) 7. Help provided understanding insurance coverage:

o Excellent

o Very Good 

o Good

o Fair

o Poor 

8.) 8. Answers provided to address questions:

• Excellent 
• Very Good  
• Good 
• Fair 
• Poor  

9. My overall satisfaction is:

• Excellent 
• Very Good  
• Good 
• Fair 
• Poor  

10. Likeliness to recommend the clinic to others:

• Excellent 
• Very Good  
• Good 
• Fair 
• Poor 

The  statements are brief, clear, and each statement identifies just one  issue. The rating scale is reflective of satisfaction rather than  agreement or importance. 

Reliability and Validity 

With  regard to validity, it is important to consider the content of the  survey. Items should be relevant, comprehensive, and balanced (Polit  & Beck, 2017). I believe the statements chosen address the  components of content validity. Internal validity of the survey tool is  enhanced through content validity and further enhanced by the anonymous  nature of the self-administered survey tool provided by office  personnel. The external validity is strengthened by the size of the  study population, and the quarterly implementation which provides data  for comparison. The quarterly administration schedule will also provide  statistical validity. 

Reliability  concerns consistency over time (Polit & Beck, 2017). This can be  challenging when measuring patient satisfaction. Patients may be more or  less satisfied from day to day. Test reliability occurs with the  “administration of the same measure to the same people on two occasions”  (Polit & Beck, p. 303, 2017). Internal consistency occurs when the  same person provides the same results (Polit & Beck, 2017). Because  participants will visit the clinic multiple times during the year, they  will fill out the survey more than once, thereby strengthening test  reliability and internal consistency. If a sample is homogenous,  reliability is decreased (Polit & Beck, 2017). This survey will be  administered to a diverse group, increasing reliability. Because patient  satisfaction is an essential quality metric, its importance should not  be underestimated. The utilization of a self-administered survey tool on  a rolling quarterly basis is cost-effective and reliable.  

References 

Keough, V., & Tanabe, P. (2011). Survey research: An effective design for conducting nursing Research. Journal of Nursing Regulation,1(4),  37-44. Retrieved from  https://class.waldenu.edu/bbcswebdav/institution/USW1/201950_27/MS_NURS/NURS_5052/readings/USW1_NURS_5052_Keough  2011.pdf.

Martínez-Mesa,  J., González-Chica, D. A., Bastos, J. L., Bonamigo, R. R., &  Duquia, R. P. (2014). Sample size: how many participants do I need in my  research?. Anais brasileiros de dermatologia, 89(4), 609–615. doi:10.1590/abd1806-4841.20143705

Polit, D. F., & Beck, C. T. (2017). Nursing research generating and assessing evidence for nursing practice. Philadelphia: Wolters Kluwer.

 

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