Category: Nursing

Environmental Influences ON health of both individuals and communities

Environmental hazards in both the natural and built environment are a growing concern in Brownsburg, Indiana, and affect the health of individuals and the entire population. Such significant physical risks are air pollution caused by vehicle emissions and local industries, which aggravate asthma and COPD among the population. Moreover, it also brings questions about the effects of pesticide exposure, which may affect people with special needs, for instance, children and older adults. If individuals do not have access to parks or safe neighbourhoods to walk, cycle or engage in other forms of physical activity, they lead a lifestyle that is sedentary. They are more susceptible to heart disease, diabetes, and obesity. (Balcetis et al., 2020).

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Such risks call for community-based nursing care, where the nurse cares for people in their communities. Knowledge of clients’ environment and social conditions enables the nurses to give appropriate advice on avoiding contact with contaminated substances, such as wearing a mask or avoiding outdoor activities when there is high air pollution. Furthermore, engaging in public health campaigns that support change in environmental policy in Brownsburg can be a part of nursing practice as it seeks to eliminate the causes of ill health, taking their basis from health promotion contexts at the population level (Iriarte-Roteta et al., 2020) Environmental Influences .

The environmental context will also affect health education regarding personal lifestyle’s role in diminishing risk. Clients at risk because of airborne pollution or lack of physical activity need wellness services, and the nurses can refer them to the relevant community services to enhance their health.

References

Balcetis, E., Cole, S., & Duncan, D. T. (2020). How walkable neighborhoods promote physical activity: Policy implications for development and renewal. 
Policy Insights from the Behavioral and Brain Sciences
, 
7
(2), 173-180.
https://journals.sagepub.com/doi/abs/10.1177/2372732220939135

Iriarte‐Roteta, A., Lopez‐Dicastillo, O., Mujika, A., Ruiz‐Zaldibar, C., Hernantes, N., Bermejo‐Martins, E., & Pumar‐Méndez, M. J. (2020). Nurses’ role in health promotion and prevention: A critical interpretive synthesis. 
Journal of Clinical Nursing
, 
29
(21-22), 3937-3949.
https://onlinelibrary.wiley.com/doi/abs/10.1111/jocn.15441

Merit-Based Incentive Payment System (MIPS) quality and safety

General Instructions

This week, you will discuss how the Merit-Based Incentive Payment System (MIPS) impacts quality and safety.

Include the following sections
:

Application of Course Knowledge
: Answer all questions/criteria with explanations and detail.

Describe one practice area in which MIPS could be used to improve the quality of care related to your anticipated 
future
practice
 setting as a Nurse Practioner. Do not discuss your current practice setting.

Discuss two ways MIPS could positively impact the practice area.

Describe the role of MIPS in supporting the financial viability of healthcare providers and organizations and client health outcomes.

Examine how advanced practice nurses can contribute to the development and refinement of MIPS quality measures to ensure that they are valid, reliable, and meaningful for clients and providers.

 

Practice Area for MIPS Application

In my anticipated future practice as a Nurse Practitioner in the mental health care setting, the Merit-Based Incentive Payment System (MIPS) can be effectively utilized to enhance the quality of care for patients suffering from mental health disorders. By implementing MIPS, mental health practitioners can establish standardized quality measures focusing on critical aspects such as patient engagement, treatment adherence, and overall patient satisfaction (Bond et al., 2022). This structured approach would help monitor the effectiveness of various interventions, reduce stigma, and improve access to mental health services.

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Positive Impacts of MIPS on Mental Health Practice

As a result, MIPS could benefit mental health practice in numerous aspects, mainly patient involvement and data-driven transformations. First, MIPS promotes ensuring patients’ perspectives and views on their outcomes and satisfaction level that may enhance patient involvement in the treatment management procedures. Increased participation improves treatment compliance and positive mental health (Gettel et al., 2022). Second, the data collection and analysis facilitated by MIPS help mental health providers to monitor different indices, including therapeutic outcomes and rates of readmissions to hospital, and thus apply evidence-based treatments that enable the expansion of access to high-quality and safe care. Merit-Based Incentive Payment System (MIPS) quality and safety

Role of MIPS in Financial Viability and Client Health Outcomes

MIPS is indispensable for the sustainability of healthcare providers and organizations and for enhancing clients’ well-being. MIPS also encourages healthcare organizations to improve the quality of services dispensed by increasing reimbursement rates for services provided, creating positive payment shocks for superior participant firms (Gettel et al., 2022). This emphasis on quality care not only keeps the financials of a healthcare organization healthy by eradicating expensive costs like readmission rates, but also preserves the clients’ lives for a sustainable future.

Contribution of Advanced Practice Nurses to MIPS Quality Measures

MIPS quality measures constitute an essential aspect in Devine & Nugent’s model of advanced vision whereby advanced practice nurses (APNs), including Nurse Practitioners, have a central role in developing and fine-tuning MIPS quality measures in terms of their validity, reliability, and meaningfulness. Given the vast experience of clinicians providing mental health services, APNs are in a position to define quality indicators that would effectively capture value and results for patients with mental disorders (Otero et al., 2024). Nurse Practitioners (NPs) can engage different stakeholders within the healthcare system to support their proposed measures, including other health measures related to mental health hurdles (Bond et al., 2022). Merit-Based Incentive Payment System (MIPS) quality and safety Additionally, through sharing their feedback on the current quality measures or standards derived based on their practice encounters, APNs can contribute to sharper calibration of the existing measures, thus embracing the quality metrics that have the potential of improving the quality of care, as well as the experiences patients undergo within the healthcare system.

 

References

Bond, A. M., Schpero, W. L., Casalino, L. P., Zhang, M., & Khullar, D. (2022). Association between individual primary care physician merit-based incentive payment system score and process and patient outcomes measures.
JAMA
,
328
(21), 2136.
https://doi.org/10.1001/jama.2022.20619

Gettel, C. J., Han, C. R., Canavan, M. E., Bernheim, S. M., Drye, E. E., Duseja, R., & Venkatesh, A. K. (2022). The 2018 Merit-based Incentive Payment System: Participation, Performance, and Payment Across Specialties.
Medical Care
,
60
(2), 156–163.
https://doi.org/10.1097/MLR.0000000000001674

Otero, S. P., Diaz, A. L., Hemal, K., Boyd, C. J., Lee, W.-Y., & Karp, N. S. (2024). Merit-Based Incentive Payment System: How Are Plastic Surgeons Performing?
Plastic and Reconstructive Surgery
, 10.1097/PRS.0000000000011455.
https://doi.org/10.1097/PRS.0000000000011455
  Merit-Based Incentive Payment System (MIPS) quality and safety

Pressure Ulcers PICOT Question

Develop a PICOT

In a document of between 700 and 1100 words (3 to 4 pages), identify an evidence-based problem from a clinical setting (such as long-term care, home care, or community agency). Develop a well-written clinical question using the PICOT, PICO, or PIO method (P = Population, I = Implementation, C= Comparison, O = Outcome, T = Time).

In your assignment, be sure to include the following:

• An introduction to the problem, including your personal connection to this problem and a brief summary of relevant background information

• Information about the population who will be affected by the resulting project

• A well-written PICOT/PICO/PIO question, including your rationale for why this is an EBP or QI question

and not a research question

• An assessment of the feasibility of, and potential barriers to, the change you’re proposing

• Identification of the stakeholders involved in the practice change or quality improvement (for example,

the agency from whom you would need permission to complete the project)

A note about the question: Learners sometimes have problems writing an EBP/QI question but write a research question instead. An EBP/QI question should never use the words how or why. Those terms belong in a research question. Your question should acknowledge that evidence already exists. Below are some examples. Instead of asking:

• How does the use of kangaroo care help increase infant weight gain? (a research question)

You will ask:

• Will nurses (P) who attend a class on the practice change of using kangaroo care (I) score higher on a

post-class test than on a pretest given before the class (O)? Pressure Ulcers PICOT Question

Instead of asking: What is the effectiveness of a pressure injury prevention bundle for adult intensive care unit (ICU) patients? (a research question)

You will ask: • In adult intensive care unit (ICU) patients (P), will the implementation of a pressure injury prevention bundle (I) compared to receiving standard pressure injury prevention (C) reduce the incidence of pressure injuries (O) after two months (T)?

Instead of asking:

• What is the relationship between self-reported job satisfaction among nurses and turnover intentions? (a research question)

You will ask:

Among nursing staff in a large urban hospital (P), will a decrease in

the patient-to-nurse ratio (I) reduce RN turnover (O) after eight

months (T)?

 

 

Pressure Ulcers PICOT Question

Pressure Ulcers

Pressure injuries, also known as pressure ulcers, are prevalent complications in long-term care facilities because patients are often bedridden and elderly. Pressure injuries have the potential to cause complications such as infections and pain, making the patient spend more days in the hospital and affecting the quality of life. This particular topic is of significance to me because I have firsthand experience working for a long-term care facility, within which I’ve witnessed the Initial onset of pressure injuries in immobile patients even while practicing preventive measures (Mazzucco et al., 2024). Research supports enhanced pressure injury preventive measures like timely turning, nutritional support, and pressure Ulcer Relief Devices, many of which decrease pressure injury occurrence. Yet, deficits in manpower and consequent non-compliance with the disease prevention standards lead to less-than-ideal patient outcomes. This issue supports the general notion that pressure injury prevention needs a more rigorous process.

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Population Affected

The targeted population that will significantly benefit from this project includes elderly patients in long-term care facilities, many of whom are most vulnerable to pressure injuries. They are often bed or chair-bound with underlying medical conditions and other related diseases liable to compromise skin integrity. Other staff include nurses and certified nurse assistant CNAs, who are also charged with implementing preventive measures within the facility (Tsai et al., 2023). The required aim and objective can be directly related to enhancing care practice and the overall health of this population, decreasing new implications, and improving quality of life.

PICOT Question

P
: In elderly patients in long-term care facilities who are at risk of developing pressure injuries,

I
: will the implementation of a comprehensive pressure injury prevention bundle,

C
: compared to standard care practices,

O
: reduce the incidence of pressure injuries,

T
: over six months?

This is an evidence-based practice EBP because it asks for the identification of pressure injury prevention practices that have been evidenced to be valid and that could be used in standard practice. It should not seek new findings that would be true with a research question. Rather, it attempts to assess the applicability of effective interventions in other contexts for particular clinical problems in long-term care. So, there is a rationale for this question because it allows researchers to create easier, faster, and more effective intervention processes for patients. This PICOT question is an EBP question rather than research: It does not ask ‘How’ and ‘Why’ pressure injuries occur. Instead, it builds on trying to organize an intervention that will be proven to enhance the results of patients. Posed questions of the type ‘Will the use of a detailed pressure injury prevention bundle decrease pressure injuries’ to enhance practice regarding the issue by applying the research findings.

Viability Of The Organization Change Proposed and Possible Impediments

The possibility of implementing a pressure injury prevention bundle in a long-term care facility may vary depending on two aspects: staff availability and resources needed and staff engagement in the change process. Another may be a need for more time from the staff since most employ few nurses. Activities, such as repositioning patients, must be done with enough staff to do it continuously. Furthermore, some infrastructures will not afford enhanced pressure-relieving devices, including specially designed mattresses, which would otherwise enhance the intervention. The third hazard is associated with staff education and training, which may be considered a barrier to implementing telemedicine services (Osuagwu et al., 2023) Pressure Ulcers PICOT Question. Since the key aspects of the prevention bundle concern pressure injury prevention techniques such as skin assessment, repositioning schedules, and the use of appropriate gear, all team members need to be trained on the right techniques. Such changes need leadership support, staff training, and the `compliance check’ tool. However, there are barriers to implementing this intervention: leadership and staff. The intervention is feasible if the resources are available. For the project to work effectively, they will need training program funding, enhanced staffing, and cost-reducing gadgets. Moreover, clear communication of change and systematic control of change communication quality can establish protocols that counteract the opposition to change.

Major actors who participate in the process of practice change

Before changing the practice, the individuals outlined below must participate in it. First, the top management or care home will have to endorse the project and provide adequate funds for training the employees and purchasing the equipment. The main stakeholders are nursing staff: registered nurses (RNs) and CNAs because they will be implementing the prevention bundle and must guarantee that each component is being applied (Mazzucco et al., 2024). Co-workers on the front lines directing care must be equipped and prepared throughout the implementation process. Lastly, conversant quality improvement committees, which are found in any facility, should be involved in tracking and evaluating the impact of the intervention. Patients and their families can also be viewed as stakeholders since they will be affected by the results of the project. To promote adherence to preventive measures, families need to be informed about pressure injury prevention and included in the care process.

Conclusion

Because pressure injury prevention is a vexing problem, it is reasonable and imperative to employ a systematic approach to address it, such as creating a pressure injury prevention bundle. Hence, through understanding these best practices and, most importantly, the actual start of this project, the recognition of reduced incidences of pressure injuries has the propensity of positively ‘changing’ patient outcomes, bettering the quality of care offered. Despite barriers like a lack of human resources and other resources, the problem can be solved with good leadership, effective training, and supervision. The stakeholders in this quality improvement plan include the nursing staff, the leadership in the facility, and the patients Pressure Ulcers PICOT Question.

 

 
References

Mazzucco, L., Balbo, V., Zingarelli, E. M., Desilvestri, M., Marchioni, M., Perrero, L., … & Varvello, I. (2024). Treatment of severe pressure ulcers with protein-enriched filtered platelet-rich plasma (PEFPRP): a possible management. 
Frontiers in Bioengineering and Biotechnology
, 
11
, 1279149.
https://doi.org/10.3389/fbioe.2023.1279149

Osuagwu, B., McCaughey, E., & Purcell, M. (2023). A pressure monitoring approach for pressure ulcer prevention. 
BMC Biomedical Engineering
, 
5
(1), 8.
https://link.springer.com/article/10.1186/s42490-023-00074-6

Tsai, Y. J., Lin, C. H., Yen, Y. H., Wu, C. C., Carvajal, C., Molte, N. F., … & Hsieh, C. H. (2023). Risk factors for pressure ulcer recurrence following surgical reconstruction: A cross-sectional retrospective analysis. 
Frontiers in Surgery
, 
10
, 970681.
https://doi.org/10.3389/fsurg.2023.970681
  Pressure Ulcers PICOT Question

Mrs. Collin is a 79 y.o. Caucasian female living in the dementia center in assisted living

Case Study #2

The geriatric population contributes a significant proportion of patients seen in primary care settings. This patient population is unique, given the coexistence of various co-morbidities that present diagnosis and management challenges for most healthcare providers. Among the most common diseases affecting this patient population is dementia. Dementia delineates a significant decline in cognitive abilities affecting an individual’s ability to complete activities of daily living (Kumar et al., 2024). Of the various causes of dementia, Alzheimer’s disease is the most prevalent type of dementia, as it accounts for more than two-thirds of cases of dementia in individuals aged 65 years and above (Kumar et al., 2024). The behavioral and cognitive function decline associated with Alzheimer’s disease makes the disease a management priority in older adults to improve the patient’s and their caregiver’s quality of life. Therefore, this paper will discuss the diagnosis, management, evaluation, follow-up, and educational plan for a case study patient who has Alzheimer’s disease. The paper will also evaluate appropriate health promotion activities for the patient and discuss the ethical-legal issues in the case study that could be anticipated to plague patient management in real-life scenarios.

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Case Summary

The patient was seen at the request of her family to ascertain why the patient could not return to assisted living. The patient is a 79-year-old Caucasian female with Alzheimer’s disease who has been on Donepezil therapy for four years. The patient was transferred to a skilled nursing facility, followed by worsening cognition three days after hospitalization for acute gastroenteritis with dehydration. The patient is pleasant and cooperative, eats 50% of her meals and continent, and requires minor assistance with activities of daily living. On examination, she has adequate skin turgor and normal vital signs, is alert but disoriented with a mini-mental status exam score of 24/30, and is ambulatory with full muscle strength.

Discussion Questions and Answers

Assessment

A thorough history and comprehensive physical examination are required for the diagnosis of Alzheimer’s disease (Kumar et al., 2024). In the assessment of disease progression, like in the case study, it is crucial to have adequate background information on the patient’s baseline at the onset of the disease as a comparison to how the patient is feeling currently. Therefore, I would inquire about the disease’s onset, pattern, tempo, and progression from the patient’s primary caregivers and staff at the assisted living facility. I would be interested to know the changes that took place in the patient’s cognitive features, notably, their memory, behavior, personality, cognitive functions, and functional abilities as they relate to instrumental activities of daily living such as fulfilling their roles at work (Kumar et al., 2024). I would be interested in the patient’s medication history to asses for medications used during the hospitalization that could impair the patient’s cognitive function (Kumar et al., 2024). A thorough social history for alcohol and substance abuse is crucial too to ascertain accelerators of neurocognitive decline (Kumar et al., 2024). Regarding objective data, I would conduct a comprehensive neurological exam to rule out other diseases that could explain the patient’s cognitive decline. Lastly, I would perform a Mini-Cog or Montreal Cognitive Assessment Exam (MOCA) to complete the cognitive neurological exam.

I expect a normal neurological examination in the patient except for anosmia, which is common in Alzheimer’s disease patients as in other conditions such as Parkinson’s disease and traumatic brain injury (Kumar et al., 2024). However, it is also expected to detect the presence of focal neurological derangements such as aphasia, apraxia, primitive reflexes, and frontal release signs in patients with advanced stages of Alzheimer’s disease, such as the patient in the case study (Kumar et al., 2024). Therefore, the goal is to acquire a comprehensive clinical picture of the patient to guide appropriate patient management.

Differential Diagnoses

The differential diagnoses for dementia in the patient include depression, Lewy body, vascular, and frontotemporal dementia. The presence of declining cognitive and behavioral functions in the patient provides evidence to support the diagnoses of the diseases above. The impairment in memory and disorientation in the patient can also be explained by other diseases that should be ruled out, namely alcohol or drug abuse, vitamin B12 deficiency, renal insufficiency, and hypothyroidism (Kumar et al., 2024). Therefore, the diagnostic tests that would be indicated to rule out the differential diagnoses include complete blood count, complete metabolic profile, thyroid function tests, and vitamin 12 levels to rule out systemic diseases Mrs. Collin is a 79 y.o. Caucasian female living in the dementia center in assisted living.

Magnetic resonance imaging (MRI) of the brain, more so volumetric MRI of the brain, is precise and sensitive to diagnosing Alzheimer’s disease. It helps to differentiate the various causes of dementia by demonstrating structural changes that are pathognomic for Alzheimer’s disease, specifically, atrophy of the entorhinal cortex and the media temporal lobe affecting the hippocampus with resultant memory impairment in the patient (Kumar et al., 2024). Other particular tests that could be done include amyloid Positron Emission Tomography (PET), functional MRI, and Single-Photon Emission Computed Tomography (SPECT) to map out affected brain areas in Alzheimer’s disease (Kumar et al., 2024). These tests also help to set the differential diagnoses aside from Alzheimer’s disease.

Clinical Guidelines

Globally, there are fifty-three available clinical practice guidelines on the management of Alzheimer’s disease, fifteen of which were published in 2018 (Monfared et al., 2023). In the United States, the American Academy of Neurology (AAN) offers the leading clinical practice guideline for managing Alzheimer’s disease with over a thousand citations (Monfared et al., 2023). The AAN clinical guideline was developed through panel selection, extensive literature review, and critical clinical trial evidence evaluation (Monfared et al., 2023). The overall recommendation by AAN is the use of cholinesterase inhibitors and memantine for the management of Alzheimer’s disease. The clinical practice guidelines fall short in the screening recommendations for asymptomatic patients, more so utilizing biomarkers testing to screen and diagnose the disease in practice routinely (Monfared et al., 2023). Therefore, advances in developing practical screening guidelines using biomarker testing are required.

Treatment Plan

The progressive nature of the patient’s cognitive impairment in the absence of other diseases, medications, and risk factors to rule in other differential diagnoses makes the diagnosis of moderate Alzheimer’s disease acceptable. Moderate Alzheimer’s disease can effectively be symptomatically managed using memantine (Namenda) alone or in combination with Donepezil (AAR, 2024). Therefore, besides Donepezil, I agree with the patient’s primary care provider that adding Namenda would benefit the patient. Memantine reduces brain damage by inhibiting the excessive levels of glutamate causing overstimulation and hence damage to neurons in the brain (AAR, 2024). The starting dose for memantine for the patient would be 5mg daily for a week, then increase by 5mg weekly until the patient takes 10mg twice daily (Varadharajan et al., 2023). The patient should also receive physical activity and memory and orientation exercises to improve their cognitive function and overall quality of life (AAR, 2024) and enhance their ability to complete activities of daily living.

Health Promotion and Patient Teaching

The patient should be educated on the adverse effects of the new medication, such as dizziness, headaches, high blood pressure, and gastrointestinal discomfort (Varadharajan et al., 2023). The patient and their family members should be educated on the progressive nature of the disease and the anticipated neurocognitive decline that would affect the patient. The lack of a definitive cure for the disease should be tabled early, as well as the presence of alternative drugs to slow the disease progression rate, such as aducanumab and lecanemab, and their side effects (Zhang et al., 2024). The presence of worsening cognitive impairment and the need for around-the-clock skilled nursing care for the patient should be provided to the family members as the rationale why the patient requires skilled nursing care warranting skilled nursing facility admission and hence the inability to take the patient back to the assisted living facility.

The Healthy People 2030 goal for dementia, including Alzheimer’s disease, should be considered for this case goal to improve health and quality of life for people with dementia (Healthy People 2030, n.d.). An initiative to help achieve this Healthy People 2030 goal is reducing preventable hospitalization in older adults with dementia (Healthy People 2030, n.d.). Consequently, providing skilled nursing care for the patient will help boost their overall health and well-being and prevent frequent hospitalization. Further, non-pharmacological therapies such as music therapy, physical exercise, and involvement in various social events help alleviate loneliness in the patient and promote higher quality of life. Therefore, a combination of pharmacological and non-pharmacological interventions would prove effective in edging the patient closer to the ultimate Healthy People 2030 goal for dementia.

Legal-Ethical Consideration

Dementia research has been invaluable in developing effective management strategies to treat the disease. However, the involvement of cognitively impaired patients unable to consent in research presents an ethical-legal challenge for healthcare providers (David et al., 2024). The need for further study and improvement in treatment in practice necessitates appropriate dementia research. Therefore, there is a need for expanded knowledge on dementia research, specifically regarding how to ethically and legally involve dementia patients in research to further interest in the field. Additionally, close interaction with the patient’s caregivers will help to navigate the ethical-legal challenges facing interaction with dementia patients like the patient in the case study.

Circle of Caring

Using the circle of caring, the patient, their primary caregivers and caretakers, and their family members should be involved in hearing the patient’s voice throughout the patient’s case management. The caregiver who stays with the patient the longest should be the primary focal person to communicate the patient’s needs and wants as they notice changes in their condition. Additionally, the patient’s health proxy or next of kin should be involved to ensure that each care decision is in the patient’s best interest and in keeping with the patient’s care wishes.

Evaluation/Follow-Up Plan

The follow-up visit for the patient should be within two weeks to assess for neurocognitive changes between the time of the last hospital visit and the next visit. A comprehensive neurocognitive examination should be completed as part of the patient’s evaluation in the next visit to ascertain the progression of the disease. The expected changes in the patient by the next hospital visit include improvement in cognitive function, such as orientation and continued competency in completing most of her activities of daily living.

Billing

Lastly, the appropriate billing codes that I would recommend for this patient case are G30.1 for Alzheimer’sAlzheimer’s disease with late onset and G0299 for skilled nursing services by a registered nurse. According to the Healthcare Common Procedure Coding System (HCPCS), the patient is liable for billing under both level I and II provisions for the care provided in the current and next hospital visits.

Conclusion

Finally, Alzheimer’s disease diagnosis and management in the geriatric patient population is challenging. Other medical conditions requiring multiple laboratory tests to rule out the disease could mimic the disease. Imaging to identify the disease is helpful with higher specificity for the disease. However, imaging studies such as the amyloid PET scan are costly. Overall, managing the disease relies on pharmacological and non-pharmacological management to achieve the Healthy People 2030 goal for dementia, which speaks of a better quality of life, health, and well-being for older adults suffering from dementia, such as Alzheimer’s. Therefore, there is a need for healthcare providers to amass adequate knowledge in geriatric nursing and healthcare to effectively identify and treat these older adults with declining cognitive and behavioral functions.

 

References

Alzheimer’s Association Report (AAR) (2024). 2024 Alzheimer’s disease facts and figures.
Alzheimer’s & Dementia
,
20
(5), 3708-3821.
https://doi.org/10.1002/alz.13809

David, C. B. M., Giovane, D. M., Wilson, D., Truman, T., Huntley, D. J., Suleman, M., Keene, R. A., Parker, M., Sharp, J. D., & Malhotra, A. P. (2024). Considerations for legal, ethical, and effective practice in dementia research.
Brain Communications
,
6
(4), fcae211.
https://doi.org/10.1093%2Fbraincomms%2Ffcae211

Healthy People 2030 (n.d.).
Dementias
. Healthy People 2030.
https://health.gov/healthypeople/objectives-and-data/browse-objectives/dementias#:~:text=Healthy%20People%202030%20focuses%20on,memory%2C%20thinking%2C%20and%20behavior
.

Kumar, A., Sidhu, J., Lui, F., & Tsao, W. J. (2024). Alzheimer disease. Treasure Island (FL): StatPearls Publishing.
https://www.ncbi.nlm.nih.gov/books/NBK499922/

Monfared, T. A. A., Phan, N. T. N., Pearson, I., Mauskopf, J., Cho, M., Zhang, Q., & Hampel, H. (2023). A systematic review of clinical practice guidelines for Alzheimer’s disease and strategies for future advancements.
Neurology and Therapy
,
12
(4), 1257-1284.
https://doi.org/10.1007%2Fs40120-023-00504-6

Varadharajan, A., Davis, D. A., Ghosh, A., Jagtap, T., Xavier, A., Menon, J. A., Roy, D., Gandhi, S., & Gregor, T. (2023). Guidelines for pharmacotherapy in Alzheimer’s disease – A primer on FDA-approved drugs.
Journal of Neuroscience in Rural Practice
,
14
(4), 566–573.
https://doi.org/10.25259%2FJNRP_356_2023

Zhang, J., Zhang, Y., Wang, J., Xia, Y., Zhang, J., & Chen, L. (2024). Recent advances in Alzheimer’s disease: Mechanisms, clinical trials, and new drug development strategies.
Signal Transduction and Targeted Therapy
,
9
(211).
https://www.nature.com/articles/s41392-024-01911-3

 

Mrs. Collin is a 79 y.o. Caucasian female living in the dementia center in assisted living

The expected length of the paper is approximately 6-7 pages, which does not include the cover page and reference page(s).

Introduction (including purpose statement)

Case Summary or Synopsis

Include a short (75-100 word) description of the patient in terms of age, sex, race, height, weight, marital status, occupation, social/cultural history, previous hospital admissions, and chief complaints on the current visit. This serves to orient the reader to the case study patient and provides an overview of clinical issues of the patient.

Discussion Questions and Answers

Conclusion

 

In regards to APA format, please use the following as a guide:

Include a cover page (this is not part of the 6-7 page limit)

Include transitions in your paper (i.e., headings or subheadings)

Use in-text references throughout the paper

Use double-spaced 12-point Times New Roman font

Apply appropriate spelling, grammar, and organization

Include a reference list (this is not part of the 6-7 page limit)

Attempt to use primary sources only. That said, you may cite reliable electronic sources (i.e., NCSBN, AANP)

 

Case Study #2:

Mrs. Collin is a 79 y.o. Caucasian female living in the dementia center in assisted living. She was diagnosed with Alzheimer’s disease by her primary care physician about 4 years ago and was started on Donepezil, which appeared to slow progression for a time. Safety concerns resulted in her placement in assisted living about 2 years ago. She recently had gastroenteritis, became dehydrated, and was hospitalized. After a 3-day stay, she was admitted to a skilled nursing facility when the assisted living staff evaluated her in the hospital and saw her cognitive impairment was much worse. Her primary care physician completed the initial exam 4 days ago, and you are asked to see her at the request of the family who does not understand why she could not return to assisted living. You review the physician’s note and he believes her AD has progressed to the moderate stage and is considering adding Namenda to Donepezil therapy.

The nursing staff reports that she appears to be confused but is pleasant and cooperative and has improved since her admission. She is eating about 50% of her meals and continues to need encouragement to drink. She is continent and able to do her activities of daily living with minor assistance. She has no known co-morbidities and is on no other medications.

Physical exam: Patient is alert and disoriented. Her MMSE is 24/30. Patient is pleasant and cooperative. Skin turgor is adequate. Patient is ambulatory with full muscle strength. Vital signs are within normal limits.

Case Study Questions:

What additional subjective and objective data would you gather?

What is the list of differential diagnoses? What additional diagnostic tests would you include to confirm or rule out each condition?

What national guidelines are appropriate to consider?

Based on your assessment and current research, what treatment would you recommend? Do you believe that adding Namenda to her medication regimen at this time should be advised?

What else should you teach your patient and her family?  Are there any Healthy People 2030 objectives that you should consider?

Are there any legal/ethical considerations?

Using the circle of caring, what or who else should be involved to hear the patient’s voice, getting him/her and family involved in the care to reach optinal health?

Mrs. Collin is a 79 y.o. Caucasian female living in the dementia center in assisted living

What is your evaluation/follow-up plan?

What billing codes would you recommend?

 Rubric:

Competency

15 Points

13 Points

 11 Points

0
 
Point

 

Assessment

 

Assessment:

Develops and demonstrates a clear & precise assessment plan supported with scholarly/evidence-based. literature, and includes objective and subjective data.

Assessment:

Develops and demonstrates an assessment plan but not fully supported with scholarly/evidence-based. literature, and may be missing one important piece of data

.

Assessment:

Develops and demonstrates a brief & vague assessment plan while missing important details of the assessment data. supported with minimal professional literature.

No paper submitted or content is missing.

Diagnostics/ Differential diagnoses

 

Diagnostics & Differential diagnoses:

Clearly describes all appropriate diagnostic tests (including sensitivity and specificity).  Thoroughly describes all relevant differential diagnoses and rationales.

Diagnostics & Differential diagnoses:

Describes all appropriate diagnostics but lacks a discussion of specificity and sensitivity for each diagnostic. Describes differential diagnoses and some rationales but omits one that should be considered

Diagnostics & Differential diagnoses:

Simply lists some diagnostics but does not discuss specificity, or sensitivity.  Describe differential diagnoses but omits more than one that should be considered and rationales.

No paper submitted or content is missing.

 

Treatment plan

Treatment plan:

Develops a clearly written set of orders inclusive of all essential elements in a treatment plan with supporting scholarly/evidence-based literature and guidelines.

Treatment plan:

Develops a clear set of written orders but omits an important order for the diagnosis, and not fully supported with scholarly/evidence-based literature and guidelines.

Treatment plan:

Develops and provides a brief set of orders for the treatment plan with more than one omission and supported with minimal professional literature.

No paper submitted or content is missing.

Evaluation/follow-up plan

Evaluation/follow-up plan:

Develops and demonstrates a clear & precise evaluation/follow-up plan for the next office visit inclusive of data and target outcomes that will need to be reviewed.

 

Evaluation/follow-up plan:

Discusses a general plan for follow-up but does not describe predictive changes and when follow-up should occur or why.

Evaluation/follow-up plan:

Describe a generalized follow- up plan that applies to all patients not the specific case.

No paper submitted or content is missing.

 

Competency

15
 
Points

14 Points

12 Points

 
0
 
Point

 

Clinical Guidelines

Thoroughly describes all relevant practice guidelines.  Clearly defines and delineates the levels of evidence that support the guidelines.

Describes relevant practice guidelines and/or describes levels of evidence to support guidelines but does not do both.

Describes a brief & vague treatment plan but lists no guidelines and does not level evidence.

No paper submitted or content is missing.

 

Health promotion/ Teaching

Develops and demonstrates a clear & precise description of the Healthy People 2030 goals and specifically relates one goal to current case.

Develops and demonstrates a clear & precise educational plan for the patient and family.

Develops a Health Promotion plan and/or discusses Healthy People 2030 and the relation to the case.

Educational topics are described but no plan is developed for the patient and family

Describes Health Promotion but does not relate back to the case.

A general educational plan is shared but is not specific to the current case. Mrs. Collin is a 79 y.o. Caucasian female living in the dementia center in assisted living

No paper submitted or content is missing.

 Competency

5 Points

4 Points

3 Points

 0 Points

 

Billing

Discusses all levels of billing that apply to the case and the most appropriate level for first visit and one follow up visit.

Discusses only the billing level that the APN may utilize without rationalization and the differences in initial and follow -up

Discusses billing levels but provides inaccurate levels or rationalization.

No paper submitted or content is missing.

 

Grammar, spelling, and punctuation

APA

There are no errors in grammar, spelling, and punctuation.

The paper meets APA format guidelines.

There are a few minor errors in grammar, spelling, and punctuation that do not detract from the meaning.

There are minor APA format errors.

There are major errors in grammar, spelling, and punctuation that do not reflect scholarly writing.

There are significant errors in format

No paper submitted.

Total Points Possible = 100

Purpose

The purpose of this assignment is to identify and respond to ethical dilemmas in the healthcare setting. This assignment will allow for the discovery of ethical principles and supports the professional formation of the nurse practitioner practice role.

General Instructions

Complete the Addressing Ethical Dilemmas Assignment by following the steps below.

Download the Week 6 Addressing Ethical Dilemmas PowerPoint templateLinks to an external site.
. Use of this template is required. If the template is not used, a 10% deduction will be applied. See the rubric.

Follow current APA grammar, spelling, word usage, and punctuation rules consistent with formal, scholarly writing.

Use at least 3 scholarly sources to substantiate the information presented.

Correctly cite and reference information from scholarly sources.

Include the following sections
 (detailed criteria listed below and in the grading rubric)

Title Slide

Include your name and session.

Introduction (1 slide)

Identify the purpose of the presentation.

Advanced Nursing Role (1-2 slides)

Explain three ways advanced practice nurses can contribute to the resolution of ethical dilemmas in healthcare.

Provide an in-text citation from one scholarly source to support your writing.

Description of an Ethical Dilemma (2-4 slides)

Describe an ethical dilemma from the literature or your nursing practice. You may reuse the information you wrote for this week’s Collaboration Café.

Identify the stakeholders.

Describe how the situation impacts stakeholders.

Ethical Analysis (2-4 slides)

Analyze the ethical principles in the conflict.

Discuss which provisions of the American Nurses Association Code of Ethics apply.

Provide an in-text citation from one scholarly source to support your writing.

Recommendations (1-3 slides)

Provide at least three recommendations for resolving the ethical dilemma.

Provide an in-text citation from one scholarly source to support your writing.

Conclusion (1 slide)

Summarize the key points of the presentation.

References

Create references in APA format. You may use bullets. Hanging indents are not required.

Use at least 3 scholarly sources.

Ensure each reference has a matching citation.

Presentation

The slides are professional in appearance and tone.

Slide information is succinct and presented with bulleted points.

A minimum of 18-point font is used and appropriate for audience reading.

 The presentation has 8-15 slides (excluding title and reference slides).

 Title and Reference slides are included.

Industrialization, Imperialism, and America’s Entry Into WWI

In preparation for the initial post, consider two (2) of the minority groups during 1880–1914:  Women’s rights activists African Americans Immigrants from southern and eastern Europe Child workers Great Plain IndiansThen, in one (1) to two (2) paragraphs, address one (1) of the following:   Explain the socio-economic status and challenges of your minority groups at the turn of the century. Evaluate how the Industrial Revolution affected your chosen minority groups. Analyze how the Progressives brought reform to your selected minority groups. Do you find that the Progressives successfully made government responsive and improved the conditions of your chosen minority group?

 

Industrialization, Imperialism, and America’s Entry Into WWI

In the late 19
th
century and early 20th centuries, diverse factors, including industrialization and social reforms, impacted different minority groups in the US, including women rights activists, African Americans, immigrants from the South, and child workers. According to Williams et al. (2010), African Americans were freed from slavery and hence experienced a diverse, daunting socio-economic landscape. For example, the enactment of Jim Crow laws resulted in racial segregation and discrimination. This resulted in the majority of African Americans being relegated to second-class Americans.

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African Americans disproportionately experienced heightened poverty levels as they could only access low-paying and menial jobs on farms and as domestic workers. On the other hand, while it opened new opportunities for urban centers, the Industrial Revolution had minimal economic impact on most African Americans. African Americans often found themselves excluded from skilled labor and inequality discrimination during hiring. Industrialization, Imperialism, and America’s Entry Into WWI.

The Industrial Revolution had a mixed impact on African Americans. On the one hand, while it offered a path for migration from rural to urban for industrial jobs, it also expounded on the existing racial dissemination. The influx of European immigrants relegated the Africans to the bottom of the economic and social ladders. On the other hand, the Industrial Revolution resulted in the growth of cities, ghettos, and slums, the latter of which were found in African American concentrations (Williams et al., 2010). The slums and ghettos summed up segregated environments, which, in turn, were short of adequate housing, education facilities, and sanitation, which resulted in exacerbating the challenges faced by African Americans.

The progressive era was denoted by an increase in activism both politically and on social grounds. These were aimed at establishing solutions to counter the problems of organization and industrialization. While the activities advocated for justice and racial equality, racial attitudes and political realities already existed. For example, the NAACP became the leading organization advocating racial equality via public advocacy and legal challenges. The NAACP sought to bring down the Jim Crow system, but progress was slow, and multiple obstacles were faced (Library of Congress, 2014) Industrialization, Imperialism, and America’s Entry Into WWI.

While the progressive era marked some advances regarding civil rights for African Americans, the Jim Crow system and the legacy of slavery continued to pose a notable challenge. The Industrial Revolution, on the one side, offered opportunities for African Americans and reinforced racial inequalities and hierarchies. The activists’ input, despite being limited, provided the foundations for future struggles for racial justice in the country.

 

References

Library of Congress. (2014).
The Segregation Era (1900–1939) – The Civil Rights Act of 1964: A Long Struggle for Freedom | Exhibitions – Library of Congress
. Library of Congress; Library of Congress.
https://www.loc.gov/exhibits/civil-rights-act/segregation-era.html

Williams, D. R., Mohammed, S. A., Leavell, J., & Collins, C. (2010). Race, socio-economic status, and health: complexities, ongoing challenges, and research opportunities. 
Annals of the New York Academy of Sciences
, 
1186
, 69–101.
https://doi.org/10.1111/j.1749-6632.2009.05339.x
  Industrialization, Imperialism, and America’s Entry Into WWI

The New Deal Essay

For the initial post, pick two (2) of the following (any program and/or act of the New Deal).  Reflecting over the weekly reading and lesson video The New Deal Coalition (also linked in the Required Resources), address the following for your selections:

 

Consider workers, immigrants, and African Americans. Explain how minorities were represented by the New Deal.

Analyze to what extent you think that the New Deal effectively ended the Great Depression and restored the economy.

 

Programs – The New Deal Essay

Civilian Conservation Corp (CCC)

Public Works Administration (PWA)

Civil Works Administration (CWA)

Works Progress Administration (WPA)

Farm Security Administration (FSA)

 

Acts – The New Deal Essay

Emergency Banking Relief Act

Economy Act

Agricultural Adjustment Act (AAA)

Tennessee Valley Authority Act (TVA)

National Employment System Act (Wagner-Peyser Act)

Home Owners Loan Act

National Industrial Recovery Act (NIA)

Glass-Steagall Act (Banking Act)

Securities & Exchange Act

Emergency Relief Appropriation Act

Resettlement Administration (RA)

Rural Electrification Administration (REA)

National Labor Relations Act (Wagner Act)

Social Security Act

Fair Labor Standards Act (FLSA)

 

The New Deal Essay

The New Deal

The New Deal was identified as a host of programs or legislations enacted during President Roosevelt’s era. These laws and programs were a response to the great depression, which had a weighty impact on Americans. According to Schlesinger (2003), while the programs and legislation were focused on addressing the evident economic crisis, they diversely affected different groups, i.e., minorities. This paper explores the impact of the Civilian Conservation Corps (CCC) and the National Labor Relations Act or Wagner Act on African Americans, immigrants, and workers during the New Deal period.

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The CCC was a program developed to offer jobs to young men. It was a relief program that successfully employed millions of young men to work in natural resources projects, i.e., national parks, soil erosion prevention, and conservation of natural resources (Katznelson, 2013). However, the inclusivity for minorities was limited. Like many programs developed during the New Deal, programs experienced racial segregation as African Americans faced inequality dissemination and limited opportunities for advancement (Schlesinger, 2003). Despite the discrimination of minority groups, the CCC program offered economic relief as the majority of young men had some income, hence an improvement in individual livelihoods. But in a larger view, the program was a failure to address the systematic disparities, i.e., racial disparities in their American community.

On the other hand, passed in 1935, the Wagner Act was legislation to protect workers’ rights via labor unions. This was a landmark moment for labor movements in the US. Regarding the representation of minorities, the ACT had a profound impact on workers, including immigrants and African Americans (Katznelson, 2013). This is because the Act allowed them to join unions that advocated for better pay and working conditions. However, some unions limited the inclusion of African Americans. In terms of effectiveness, the Wagner Act strengthened the country’s labor positions, as through unions, workers could secure improved pay and working conditions, which boosted the workers’ economic status (Schlesinger, 2003). However, despite improving worker-related issues, the legislation had limited success in alleviating ethnic and racial inequalities.

Including the explored new deals above, the new deal policies offered a notable relief to the American economy and for workers who could find work and address economic hardships from the Great Depression. However, the news deals didn’t fully end the depression and systematic discrimination that minority groups faced. In summary, while the New Deal offered a new dawn to millions of people, the success was uneven, such as not meeting the needs of minorities and inequalities.

 

References

Katznelson, I. (2013). Fear itself: The New Deal and the origins of our time.
Labor: Studies in Working-Class History of the Americas
, 10(3), 61–78.

Schlesinger, A. M. (2003).
The coming of the New Deal, 1933-1935
. Houghton Mifflin.

WW II – Treaty of Versailles and fascist, militarist, and imperialist policies

In preparation for the initial post, consider two (2) of the following historical events:

Treaty of Versailles

Rise of fascism, militarism, and imperialism

Failure of the League of Nations

Hitler and the Nazi Party

The Lend-Lease Act

Japanese expansion and the bombing of Pearl Harbor

Then, in one (1) to two (2) paragraphs, address one (1) of the following:

Assess if the United States’ foreign policy during the 1930s helped to promote World War II. Could the United States have prevented the outbreak of World War II? If so, how? If not, why not?

Explain if the United States, despite neutrality, aided the Allies against the Axis powers.

Analyze if using atomic (nuclear) weapons to defeat enemies in war is a setback for democracy (President Truman’s decision to drop the atomic bomb on Japan).

 

WW II – Treaty of Versailles and fascist, militarist, and imperialist policies

WWII

There are two historical events which are most directly associated with the beginning of the Second World War. The Treaty of Versailles and fascist, militarist, and imperialist policies. This document was not only signed in 1919 after the WWI in order to determine peace, but also put several bounded measures on Germany from economical, territorial and even military aspects (Birk & Groß, 2015). The terms of the treaty were completely humiliating for the German people mainly because they had to pay reparations, where most of the factories were seized, and the territory was reduced thus paving way for dictator Adolf Hitler. For a number of Germans, the treaty was seen as a profound shame, and it is here that Hitler found fertile ground for his fascism, and the sort of nationalism, militarism, and eugenics he portrayed.

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At the same time, the further growth of fascism, militarism and imperialism began in Germany in 1920-1930s. In Italy, Benito Mussolini seized power and put into practice fascism. In Japan militaristic leaders went for imperialism in east Asia. These movements were essentially characterized by hatred of democracy, liberalism and internationalism and in their place, they espoused authoritarianism and imperialism respectively (Parfitt, 2018). Germany and Japan both aimed at the restoration of their nations and lieutenant challenging post-World War I international relations Governed by the Treaty of Versailles and the League of nations. WW II – Treaty of Versailles and fascist, militarist, and imperialist policies

The contrast between the Treaty of Versailles and the rise of fascism, militarism, and imperialism lies in their nature of the treaty that was a feeble effort at making peace. On the other hand, fascism and militarism as ideologies aimed at challenging the status quo (Roubinek, 2019). However, both were connected, for the lack of a stable peace as offered by the treaty led to rise of these ideologies that culminated into more instability.

American foreign policy was isolated in the 1930s during the Great Depression when the country had its own problems to solve. The Neutrality Acts of this year were intended to avoid the entanglement of the U.S in European struggles. But this neutrality contributed to the emergence of all conditions for the second World War, as the US did not take the first actions regarding fascist powers’ aggressive actions (Woods, 2021). Failure to give even starker sponsorship to the League of Nations or to negotiate in the initial phase of aggression by the Germany, Italy and Japan, America allowed these countries to go bolder, which led to the outbreak of war.

 

References

Birk, E., & Groß, G. P. (2015). From Versailles via Paris to Moscow: Strategic options and perspectives of the German Empire with a view to National Power Policy (Part 2). 
Security and Defence Quarterly
, 
6
(1), 65-85.

Parfitt, R. (2018). Fascism, Imperialism and International Law: An Arch Met a Motorway and the Rest is History… 
Leiden Journal of International Law
, 
31
(3), 509-538. doi:10.1017/S0922156518000304

Roubinek, E. S. (2019). From a Nazi imperialism to a fascist imperialism: Transnational nationalisms and the creation of a “New Europe”. In 
German-occupied Europe in the Second World War
 (pp. 101-117). Routledge. 1st Edition

Woods, R. B. (2021). 
The Roosevelt Foreign-Policy Establishment and the” Good Neighbor”: The United States and Argentina, 1941–1945
. University Press of Kansas.

Integrating Self-Leadership and Policy Advocacy for Positive Health Outcomes

Application of Course Knowledge

The knowledge gained throughout the course has been of significant importance to understanding self-leadership and policy advocacy within the field of healthcare and for nursing leadership. Through the analysis of self-leadership, I have realized that the regulation of emotions and motivation is crucial to stress and team management (Harari et al., 2021). Moreover, the calculated examination of obesity as the key problem of public health revealed the importance of the research-based practice for dismantling inequalities in access to health services and fighting for improved health within communities.

Concept Impact

Of all the concepts captured in this presentation, both emotional intelligence and policy engagement were particularly notable. Self-regulation is important in stressful settings found in healthcare facilities where accurate decisions have to be made. Learning how to change policies and practice advocacy for population health in the obesity case study has expanded my view of nursing beyond just client care, stressing that it’s significant to be involved in the formulation of approaches and policies that have an effect on population health (Cardel et al., 2022).

Program Outcome 5

Tutor-Marked Assignment & Learning Activities Some of the learning activities and assignments in the course have directly supported the achievement of Program Outcome 5, it focusses on using collaborative and compassionate nursing methods to promote favorable health outcomes. In solving problems of clients who are obese, among others, I have come to understand how to undertake research and come up with evidence in order to improve the health of the community, thereby countering the role of nursing in community health promotion (Warr et al., 2021). Integrating Self-Leadership and Policy Advocacy for Positive Health Outcomes

AACN Essentials Competency 10.3

The choice of the AACN Essentials Competency 10.3 has become beneficial to developing leadership skills as a result of this focus. In particular, I have learnt how to assess the results of purposeful change, for instance, in the spheres of leadership and policy and emotional intelligence. They have equipped me to lead during emergencies so that my leadership is informed by research, fairness, and equality.

 

References

Cardel, M. I., Newsome, F. A., Pearl, R. L., Ross, K. M., Dillard, J. R., Miller, D. R., … & Balantekin, K. N. (2022). Patient-centered care for obesity: how health care providers can treat obesity while actively addressing weight stigma and eating disorder risk. 
Journal of the Academy of Nutrition and Dietetics
, 
122
(6), 1089-1098.
https://www.sciencedirect.com/science/article/am/pii/S2212267222000077

Harari, M. B., Williams, E. A., Castro, S. L., & Brant, K. K. (2021). Self‐leadership: A meta‐analysis of over two decades of research. 
Journal of Occupational and Organizational Psychology
, 
94
(4), 890-923.
https://bpspsychub.onlinelibrary.wiley.com/doi/abs/10.1111/joop.12365

Warr, W., Aveyard, P., Albury, C., Nicholson, B., Tudor, K., Hobbs, R., … & Ziebland, S. (2021). A systematic review and thematic synthesis of qualitative studies exploring GPs’ and nurses’ perspectives on discussing weight with patients with overweight and obesity in primary care. 
Obesity Reviews
, 
22
(4), e13151.
https://onlinelibrary.wiley.com/doi/abs/10.1111/obr.13151
   Integrating Self-Leadership and Policy Advocacy for Positive Health Outcomes

The Rise of Information Age – Science and Technology Essay – HIST 405 American History

The Rise of Information Age – Science and Technology

Your name

Chamberlain University

HIST 405 American History

Professor Name

Date

The Rise of Information Age – Science and Technology

The 20th century is considered to be the century of science and technology especially in the USA where great advancements made during this period changed the present world in terms of space research, medical facilities and computing. From the period of reaching President Kennedy’s target of taking a man to the moon to technology advancement created by cold war competition, USA became a world power in scientific development. The main focus of this paper will be dedicated to the technical and political challenges of the NASA, innovative technological issues of the Cold War, biotechnology as well as development of the contemporary medicine, computing and internet grounding.

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Technical and Political Dilemmas Faced by NASA in Meeting Kennedy’s Goal

When President John F. Kennedy declared in 1961 that the United States intends to take a man to the Moon before the end of the decade, NASA had to overcome numerous technical and political problems to accomplish this huge task. The technical issues were focused on major problems of scientific and engineering nature that had to be solved (Logsdon, 2011). NASA needed technologies that were out of this world and did not exist. The technologies that could successfully launch the Saturn V rocket far enough into the space to allow the astronauts to travel to that last little bit to get to the Moon. This contest also involved designing a craft that would take astronauts to the Moon and back, safely land on the lunar surface and leave. The space exploration and travel subjected humanity to major challenges such as space navigation, management of the life support systems and the actual physical manner in which the lunar module was to land on the moon’s surface. The Rise of Information Age – Science and Technology Essay – HIST 405 American History.

Politically, NASA came under much pressure because by the time it was formed, the Soviet Union had already embarked on space exploration having put the first artificial satellite in orbit and sending the first man (Yuri Gaggarin) to space. The political importance of showing American’s superiority to the Soviets added to the pressure on NASA. Anything could be considered a national shame, and therefore, the project was not only a scientific one, but also a major political gamble (Lambright, 2010). A truly effective collaboration with politicians on the one hand and internal engineers and scientists on the other, as well as the struggle for support within the Congress, all of was based on the interactions between different governmental bodies and NASA. President Kennedy’s spirited vision was not to bring a new style of living in space. Instead, it was all about the Cold War power game to demonstrate American technology superiority and gain an added advantage (Lambright, 2010).

Technological Advances in Space Exploration and Military Initiatives During the Cold War

The conflict of the Cold War led to very rapid technological development especially in space and defense technologies. The superpowers conducted science for war because both the United States and Soviet Union spent significant portions of their resources on research & development to support their global struggle (MacDonald, 2017). The most dramatic technological advancements of the technological phase of space exploration were the space race that led to the Apollo Moon landings and produced important advancements in rocket propulsion, satellite communication, and material science. All these inventions had a civil space use as well as military purpose.

In the period of the Cold War, military innovations included ICBMs, nuclear submarines and stealth aircraft which required technology (Moltz, 2019). This has made the rocketry innovations that further moved spacecraft to also create missiles that can deliver nuclear warheads at long ranges. Also, it is pertinent to note that official global positioning system (GPS), also known as global positioning satellite, which was invented to help military at this period was one of the most important technological advancements of the period that was later used for public use.

Space exploration was inseparable from military rivalry since both the US and the USSR aimed at proving their tech supremacy. The physical achievement of the Apollo 11 mission in 1969 was a splendid technological feat, which helped maintain the military might position of United States during the Cold War (Moltz, 2019). Aside from geopolitical perspective, the scientific information in the concept of finding out about space also contributed to future technological advancement in telecommunication, meteorology, and remote sensing.

The Role of Civilian Science in Biotechnology and Medical Research

From the mid to late 20th century, civilian science started to be appointed to this position, different from the military push of the Cold War era. The National Institutes of Health (NIH) and other agencies of the federal government invested in research that would later pay off in genetics, pharma and health care technologies (Corbett et al., 2023). Thus, there was a significant change which was mainly due to a growing understanding of the possibility to enhance public health and quality of life through scientific research.

Among these, the most popular and most dynamically developed in civilian science was biotechnology after DNA structure discovery in 1953. These advancements in the biotechnology revolution included the genetically modified organisms (GMOs), Gene therapy and the direct to the patient, ailment matching medicine (Egbe, 2018). The federal government was involved in funding and also in regulating such research and thanks to them that many scientists have been able to find other treatment and technologies which form the basis of most advanced medical treatment today.

Furthermore, medical research not only concerns a society’s health, but also turned into an economic sector as well. The strengthening of this connection between the National University of Singapore and biotechnology companies contributed to the economic success of the health care and pharmaceutical areas through the development of the industry (Inshakova et al., 2021). Self-generated by civilians and backed by government funding, it made the United States the world’s hub of biotechnology ranging from agriculture to medicine industry.

Technological Advances in the 20th Century and Their Impact on Medicine and Computing

The advancements of the twentieth century further revolutionized the field of medicine in addition to computers as well the advances in the internet. The biggest medical advancement that science was able to bring is the introduction of antibiotics that dramatically changed the way people fought infectious diseases. New technologies like the simple X-rays, CT scan, and MRI machines put into use helped the doctors diagnose and treat diseases or conditions which previously could not even be seen (Pesapane et al., 2018). Vaccines, anesthetics, and surgeries were also crucial in transforming healthcare, thus improving life and life expectancy.

Along with this medical advancement came computers and informatics which are becoming mandatory in research and healthcare fields. The first computer, which includes the ENIAC built during the 1940s, created the basis of the modern computers and the internet at the end of 20
th
century, the development of personal computer, software technology and networking enabled medical records, online consulting, and computer aided diagnosis systems (Campbell-Kelly et al., 2023). The internet, which was first conceived as an option for military usage as a means of communication, expanded into a vehicle for conveying knowledge across nations, and thus affecting both medicine and science The Rise of Information Age – Science and Technology Essay – HIST 405 American History.

These advances also facilitated the emergence of large-scale medical research capable of using data analysis based on the use of computer systems. For example, the human genome project which was successfully completed in 2003 undergone a computational ability developed in 20th century (Pesapane et al., 2018). This program was the beginning of PHR and gave a new understanding of the genetic foundations of diseases as well as opening the way to individualized treatment.

The United States as a Scientifically Oriented Society

At the end of the 20th century, American society was ranked as one of the most scientifically advanced societies globally. Such a shift was enabled by a large-scale investment into scientific research, growth of the research university model, and strong research culture. Federal government’s support for rethinking on scientific research came through organizations like NASA, National Institute of Health (NIH), and National Science Foundation (NSF) (Lerner et al., 2021). For example, these organizations offered grant to scientists and institutions through the pursuance of many fields including outer Space exploration and Biotechnology among others.

The U.S education system also signed up to the scientific orientation of United States. Every American university turned into one of the world’s leading institutions for scientific research, drawing talent from across the world. Almost all the technological advances of the Information age such as the internet, GPS, and biotechnology were fostered by tripartite collaborations between academic, government, and private sector. Moreover, post-World War II America, the emergence of the Silicon Valley and the concept of new age technology industry put the United States on the scientific map of the world (Routh, 2017). Digital and software giants like Apple, Microsoft, and Google revolutionized computing and communication, and made America the technology capital of the world. This environment of scientific research and technological advancement fostered a society of research and technology innovation and advancement, putting the United States at forefront of science and technology.

Conclusion

In a recap, the technical and the political problems that NASA locked to in the 1960s together with the Cold War technology helped create one period of quick growth that modified both military and the civilian science. In the end of the twentieth century, the bio and medical techs along with computer technologies prepared the setup for today’s scientific society in which the United States had a leading role.

References – The Rise of Information Age – Science and Technology Essay – HIST 405 American History

Campbell-Kelly, M., Aspray, W. F., Yost, J. R., Tinn, H., & Díaz, G. C. (2023). 
Computer: A history of the information machine
. Routledge.

Corbett, P. S., Janssen, V., Lund, J. M., Pfannestiel, T., Vickery, P., & Waskiewicz, S. (2023, July 6).
U.S. History
. OpenStax, OER Commons. Retrieved January 2, 2024, from
https://openstax.org/details/books/us-history

Egbe, N. (2018). BIOTECHNOLOGY REVOLUTION AND POTENTIAL MILITARY APPLICATIONS. 
Academy Journal of Science and Engineering
, 
12
(1), 73-85.

Inshakova, A. O., Baltutite, I. V., Epifanov, A. E., & Abesalashvili, M. Z. (2021). Biotechnology as a type of converged technologies in industry 4.0 and a source of increased danger in civil law of The Russian Federation. In 
Modern Global Economic System: Evolutional Development vs. Revolutionary Leap 11
 (pp. 1558-1567). Springer International Publishing. https://doi.org/10.1007/978-3-030-69415-9_172

Lambright, W. H. (2010). Exploring space: NASA at 50 and beyond. 
Public Administration Review
, 
70
(1), 151-157.
https://doi.org/10.1111/j.1540-6210.2009.02119.x

Lerner, R. M., Fisher, C. B., & Weinberg, R. A. (2021). Toward a science for and of the people: Promoting civil society through the application of developmental science. In 
Individuals as Producers of Their Own Development
 (pp. 175-190). Routledge. 1st Edition

Logsdon, J. M. (2011). John F. Kennedy’s Space Legacy and Its Lessons for Today. 
Issues in Science and Technology
, 
27
(3), 29-34.
https://www.jstor.org/stable/43315485

MacDonald, A. C. (2017). 
The long space age: The economic origins of space exploration from Colonial America to the Cold War
. Yale University Press.

Moltz, J. C. (2019). The changing dynamics of twenty-first-century space power. 
Journal of Strategic Security
, 
12
(1), 15-43.
https://www.jstor.org/stable/26623076

Pesapane, F., Codari, M., & Sardanelli, F. (2018). Artificial intelligence in medical imaging: threat or opportunity? Radiologists again at the forefront of innovation in medicine. 
European radiology experimental
, 
2
, 1-10.
https://doi.org/10.1186/s41747-018-0061-6

Routh, D. K. (2017). 
The first new nation: The United States in historical and comparative perspective
. Routledge.

 

The Rise of Information Age – Science and Technology Essay – HIST 405 American History

[Please delete all instructions once you have completed this case study. Length: 4-5 double-spaced pages. Use a minimum of one (1) documented example from your US History OpenStax course text
and four (4) scholarly sources
from the Chamberlain Library. Remember, sources for this case study are found under the
Leganto Source List
for a total of five (5) sources. Add in-text citations and end references, and double-space the writing once completed. The course text has already been added to the references, but please add your additional scholarly source to the list.]

Introduction

Describe the technical and political dilemmas experienced by the National Aeronautics and Space Administration (NASA) in its efforts to meet Kennedy’s goal of putting an astronaut on the Moon before the end of the 1960s.

Assess technological advances during the Cold War in space exploration and military initiatives.

Differentiate how civilian science led to the prominence of biotechnology and other medical research from the government.

Examine how the technological advances in the 20th century revolutionized medical science and opened the way for computers and the internet.

Distinguish how the United States during the 20th century became one of the most scientifically oriented societies in the world today.

Conclusion

The Rise of Information Age – Science and Technology Essay – HIST 405 American History