Author: chris

Final thoughts on QI, Lean

You have been introduced to many strategies and techniques of quality improvement based on Lean. For most of you these techniques have been new and understandably challenging to master. Please use this final discussion board to post your opinions on the pros and cons of applying Lean techniques in your career as a health professional. There are no \”right\” or \”wrong\” answers. Some of you may have been transformed into Lean champions with plans to utilize many of these strategies in your career. Others may find that while some of the techniques are useful others do not seem like a good fit for your career path. In addition, there are barriers to using Lean techniques that many of you have noted in your efforts to apply them in your current settings, such as lack of understanding and buy-in from peer professionals. Remember, you do not have to answer all of these questions. Pick the one\’s that are most relevant to you. I am most interested in your engaging in dialog with your classmates on these questions.

What quality improvement and Lean strategies and techniques do you find most useful? Why?

Which quality and lean strategies and techniques did you find least helpful? Why?

Why do you think quality improvement and Lean approaches are important in healthcare reform? What is the importance of quality improvement and Lean in emerging models of integrated care, such as the Patient-Centered Medical Home (PCMH) or Accountable Care Organization (ACO)?

What are the greatest barriers that you have encountered or anticipate in trying to apply quality improvement and Lean techniques? How can you overcome these barriers?

What are effective approaches to introducing quality improvement and Lean to healthcare professionals who do not have training or education in these approaches? What approaches are not likely to be effective?

Do you have any questions for your classmates or instructor about quality improvement and Lean?

Do use at least on citation (reading, web site, etc.) in your initial post.

Enjoy the discussion!

Dr. O\’Donnell

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I\’ve indicated Linguistics as the subject area, with a leaning toward Discourse Analyses and a focus on narrative and context. The paper will use social media from the Egyptian protests of 2011+ as context. You should draw on the provided PDF texts by Ruth Page & Greg Myers as core material. Please also use whatever other sources are appropriate. The paper should be in three sections:
Section 1 – The first section expounds the notion of linearity within specific contexts of social media narrative as a significant factor in building communities of resistance and creating solidarity among community members. Analyses of examples of texts from the Egyptian Revolution protest of 2011+ demonstrate how temporal sequences underpin stories through complex references to time that provide meaning and value for readers. Rather than a chronology framed solely by story content, however, temporarily is also inferred from the discourse and behavioral contexts in which the process of storytelling is embedded. The Revolution texts show how language used to represent temporal sequences tends to prioritize recency and, in turn, construct a sense of social connection through the illusion of co-presence between narrators and readers.
Section 2 – The second section incorporates elements of linearity, as discussed in section 1, into notions of the ways in which teller ship and tell ability of social media texts influence production and reception of narrative identity as part of community building processes. Egyptian Revolution stories exhibit and promote options for multiple teller ship and co-tellership across related or episodic textual units, thereby expanding readership and increasing opportunities for readers to evaluate and assess stories. Such assessment acts to define in- and out-groups through rhetorical resources used to create involvement between narrators and readers. Analyses of linguistic devices used by Revolution authors demonstrate that positive evaluative assessment by narrative participants reinforces narrative identities and ties of solidarity among in-group members.
Section 3 – The final section extrapolates the discussions in prior chapters of linearity, tellership and tellability to explore the concept of authenticity as textual performances produced by Revolution participants. Such performances draw on both on- and offline contexts to shape narrative interactions, which act to confer status and delineate groups identities. Through narrative choices within social media stories, often presented as personal experiences, Revolution narrative participants created personal and group identities that tended to privilege the status of protesters and disavow narrative sources of Egyptian Government authenticity.

critical analysis of Nigeria assets, challenges and strategies to malaria control. Influence of transnational companies, world trade cooperation, NGOs, pharmaceutical companies. The role of intellectual properties, patency and generic medicine. Apply global health model by Huymen and Hilderink ,2005.

Assignment: Application: Adoption of New Technology Systems
As a nurse, you can have a great impact on the success or failure of the adoption of EHRs. It is important for nurses to understand their role as change agents and the ways they can influence others when addressing the challenges of changing to a drastically different way of doing things.
Everett Rogers, a pioneer in the field of the diffusion of innovations, identified five qualities that determine individual attitudes towards adopting new technology (2003). He theorized that individuals are concerned with:
Relative advantage: The individual adopting the new innovation must see how it will be an improvement over the old way of doing things.
Compatibility with existing values and practices: The adopter must understand how the new innovation aligns with current practices.
Simplicity: The adopter must believe he or she can easily master the new technology; the more difficult learning the new system appears, the greater the resistance that will occur.
Trialability: The adopter should have the opportunity to “play around’ with the new technology and explore its capabilities.
Observable results: The adopter must have evidence that the proposed innovation has been successful in other situations.
Note: You are not required to purchase Rogers’ book or pursue further information regarding his list of five qualities. The information provided here is sufficient to complete this Assignment. The full reference for Rogers’ work is provided below the due date on this page.
For this Assignment, you assume the role of a nurse facilitator in a small hospital in upstate New York. You have been part of a team preparing for the implementation of a new electronic health records system. Decisions as to the program that will be used have been finalized, and you are now tasked with preparing the nurses for the new system. There has been an undercurrent of resistance expressed by nurses, and you must respond to their concerns. You have a meeting scheduled with the nurses 1 week prior to the training on the new EHR system. Consider how you can use the five qualities outlined by Rogers (2003) to assist in preparing the nurses for the upcoming implementation.
To prepare
Review the Learning Resources this week about successful implementations of EHRs.
Consider how you would present the new EHR system to the nurses to win their approval.
Reflect on the five qualities outlined by Rogers. How would addressing each of those areas improve the likelihood of success?
By Day 7 of Week 6
Write a 3- to 5-page paper which includes the following:
Using Rogers’ (2003) theory as a foundation, outline how you would approach the meeting with the nurses. Be specific as to the types of information or activities you could provide to address each area and include how you would respond to resistance.
Analyze the role of nurses as change agents in facilitating the adoption of new technology.

Acknowledgements
It is usual but not compulsory to thank those who
have been of particular help to you in completing the dissertation.
Abstract
This is a short section (maximum one page), which
concisely summarizes the whole of the dissertation;
the main aim of the research, the findings of the
Literature Review, the research methodology
adopted, the findings of your primary research and
the conclusions made. It should be written in the
past tense.
Contents Page
This should be written on a separate page and
should show chapter/section headings and page
numbers. It should include all appendices and be
followed by separate lists of tables and figures if
appropriate.
Introduction
Your introduction should contain your topic clearly
stated and defined, the reason why it is of interest
to you, a clear overall purpose and definitions of all
special and general terms. This chapter should also
end with a clear research question or questi
ons, a list of objectives and a hypothesis or hypotheses if
needed.
Literature Review
This chapter should demonstrate that you have
conducted a thorough and critical investigation of
relevant sources, outlining, comparing and
discussing key ideas, expl
anations, concepts, models
and theories. You should present these ideas in a
systematic, well structured and logical sequence.
You will be expected to use prominent and up to date books and academic journals.
This chapter should end with a statement of the
gap in current knowledge which your research aims to fill.
Methodology
This chapter describes and
assesses the approach you have taken to the data collection process (research philosophy, research strategy, method(s),
validity etc.) For each research qu
estion or hypothesis and objectives you should have a method
for achieving it, making sure that you offer clear
rationales for the decisions that you have made. You
should explicitly describe your chosen method(s)
and any sampling techniques used. It is al
so important to give a brief assessment of other
potential relevant data collection methods and why
you discounted them. Do not describe all data
collection methods. There should be a critique of the
success, or otherwise, of your method(s). Explain
the appropriateness of the data analysis techniques
that you have selected. You must also discuss
validity, reliability and generalisability.
Findings / Results
In this chapter the data generated should be
reported as completely and neutrally as is possible
such that the reader can assess it easily. This is
where you will include such tables and graphs that
will illustrate your findings. This chapter will also
contain verbatim quotes from interviewees, or
sections of narrative account that illustrate periods
of unstructured observation. The purpose of this
chapter is to present the facts. It is not appropriate
in this chapter to begin to offer opinions on the facts.
Analysis / Discussion of Findings
You should present your analysis clearly and logically
and it should be relevant to your research aim,
research question(s), hypothesis (es) and objectives.
Make sure that you relate the findings of your
primary research to your Literature Review. You can
do this by comparison: discussing similarities and
particularly differences. If you think your findings
have confirmed some literature findings, say so and
say why. If you think your findings are at variance
with the literature, say so and say why.
Conclusions/
Recommendations
State the main conclusions of your dissertation.
State explicitly how and to what extent you have met
your aims and objectives / answered your research
question(s) / proved your hypothesis (es) whichever
is appropriate. Your conclusions should follow
logically from your findings and not contain any new material. Recommendations can be made if
appropriate.
Appendices, illustrations etc
Any necessary information should be here, for
example, sampled questionnaires, topic guides, etc.
Each appendix should be lettered (A, B, C etc.) and
should consist of detailed information that is
interesting but not essential to the main thrust of
your findings section.
References
Full references to every source used, presented in
the format of the Harvard System of Referencing.

Need to create a question and answer around the question \”Why do people get married?\” in 1500 words or less. Must also include an annotated bibliography for the 5 sources/ref\’s that were used, including (i) full ref details,(ii) explanation of topic or theme, (iii) explanation of main argument, (iv)statement about the methods or approach the author uses to make the argument,(v) a conclusions that states what this item will contribute to the essay, Feel free to get in touch if you have any questions.

Discuss the effectiveness of both cognitive behavioral therapy (CBT) and interpersonal psychotherapy (IPT) for depression in children and adolescents. Critically review the evidence and consider the implications for the child and adolescent mental health services population.

In the beginning, please briefly talk about depression disorder and how this disorder is effect the child and adolescent population.

Then, briefly talk about what is CBT and how to use CBT to treat depressed children and adolescents. Then, please talk about the effectiveness (what is working or what is not working and why? Also can be understand as the advantages and disadvantages) of using CBT in depressive children and adolescents. Please write this part in details. For example, if you are giving one advantage about using CBT in depressive children and adolescents’ population, please give specific evidences from journals about why this is an advantage; and please cite clear and carefully in the essay (every time when making a statement, and when its not a personal opinion, please cite it. There isn’t a thing called over-citing).
Different journals may have different opinions on those advantages and disadvantages. For example, some advantages in article A may appear as disadvantages in article B. If there are such situations in the journals, please talk about them as a type of critique. Other critiques on articles, treatments and studies may also be covered in this essay.

Similar things will happen in the IPT sections, briefly talk about what is IPT and how to use IPT to treat depressive children and adolescents. Then, the effectiveness (what’s working and what’s not? or advantages and disadvantages) about using IPT in child and adolescent depressive population. Great details and evidences should also be used here. Critiques about different opinions on adv. and disadv. may also be covered in this part of the essay, too.

In the two treatments, there may be some aspects that CBT is doing poorly on, but appearing as a strong part in IPT, or vise versa. Please talk about those parts in the essay as well.

While writing the paper, please keep in mind that using CBT and IPT to treat children and adolescents population may be different with using these interventions to treat adults due to limited cognitive development on children and adolescents population. Then, how should these intervention be adopted into young age population.

Additional files will be uploaded, but may not cover all the aspects; so, please run additional research (please do not heavily dependent on Wikipedia, if doing additional research). In the additional files, some of the papers may also mention about pharmacotherapy, but this paper will only focus on psychosocial treatments for depression in children and adolescents.

This project will be a survey of Chinese English high school teachers to find out how they use or adapt materials and their attitudes about teaching reading. The purpose of this project is to find out Chinese English teachers’ attitude and knowledge about teaching reading,
to find out how Chinese English teachers use and adapt materials in their reading teaching,and to find out difficulties and strategies they have faced and used in their teaching.

Order Description

Readings
Article: Dickerson, F. B. (1998). Strategies that foster empowerment. Cognitive and Behavioral Practice, 5(2), 255–275.
Retrieved from the Walden Library using the ScienceDirect Health Sciences Subject Collection database.

Article: Jonikas, J. A., Kiosk, S., Grey, D. D., Hamilton, M. M., McNulty, J., & Cook, J. A. (2010). Cultural competency in peer-run programs: Results of a web survey and implications for future practice. Psychiatric Rehabilitation Journal, 34(2), 121–129.
Retrieved from the Walden Library using the Academic Search Complete database.

Article: Lefley, H. P. (2009). A psychoeducational support group for serious mental illness. Journal for Specialists in Group Work, 34(4), 369–381.
Retrieved from the Walden Library using the SocINDEX with Full Text database.

Article: Maulik, P. K., Eaton, W. W., & Bradshaw, C. P. (2009). The role of social network and support in mental health service use: Findings from the Baltimore ECA study. Psychiatric Services, 60(9), 1222–1229.
Retrieved from the Walden Library using the SocINDEX with Full Text database.

Article: Perron, B. (2002). Online support for caregivers of people with a mental illness. Psychiatric Rehabilitation Journal, 26(1), 70–77.
Retrieved from the Walden Library using the Academic Search Complete database.

Article: Schutt, R. K., & Rogers, E. S. (2009). Empowerment and peer support: Structure and a process of self-help in a consumer-run center for individuals with mental illness. Journal of Community Psychology, 37(6), 697–710.
Retrieved from the Walden Library using the SocINDEX with Full Text database.

Each week of this course highlights the importance of involving clients in their own case management processes. The above quote by Carl Rogers further explains just why client involvement is so crucial. As clients work to assess personal needs and wants, they can also help to identify the ways in which their communities fail to provide them with necessary opportunities for growth. Once these types of resource “gaps” are identified, case managers can begin to advocate for new opportunities. Case managers can enlist knowledgeable and well-connected people within the community to create opportunities for clients in need. Imagine, for example, that a client is new to using food stamps. A case manager might choose to contact a local grocery store to set up times before or after store hours to educate the client on how to find the best deals and to help the client feel comfortable with using food stamps to pay for purchases. Slowly building client confidence and relationships with grocery store employees will help to further empower the client during shopping trips.

Resources that are created change according to the specific needs and wants of each client. This week, you assess the resource gaps that might be present in your community.
You also propose additional resources needed to address your virtual clients’ needs.

To Prepare for this Assignment:

Review the article, “The Role of Social Network and Support in Mental Health Service Use: Findings From the Baltimore ECA Study.” Consider the implications of social support networks for individuals’ use of mental and medical health services.

Review the article, “Online Support for Caregivers of People With a Mental Illness.” Focus on the finding about effects of participation in the self-help group.

Review the research you conducted during Week 4, in which you located resources and agencies in your community to find assistance for your clients.
Review the media titled Creating Resources.
Consider the strengths and weaknesses of your community’s offerings for your clients.

Think about how you might assist your clients by creating or empowering them to create resources to benefit themselves and others who might encounter similar challenges.

**********The Assignment (1–2 pages)

Describe three resources that are missing or inadequate in your community to meet your virtual clients’ needs.

Propose three types of resources to address your virtual clients’ needs.

****Please use required resources and please reference the clients when possible.

Thank you for all of your knowledge and hard work.
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Answer the two following questions in essay form. Each answer should be ~400 words in length total of ~800 words 400 for each question. You should refer only to the enclosed readings in answering the questions and indicate page numbers in parentheses for any direct citations. You are not required to submit a list of works cited.
1) On p.169 of his article “From Homophobia and Heterosexism to Heteronormativity”, Gust Yep articulates the effects of what he calls “soul murder” and “internalized homophobia”. Compare and contrast Yep’s description of the micro-level effects of heteronormativity with Jeffrey Week’s definition of social constructivism on p.22 of his interview called “The Social Construction of Sexuality”. What does each author say about the notions of agency and choice in the development of an individual’s sexual identity?
2) Consider the article “One is Not Born a Woman” by Monique Wittig alongside Adrienne Rich’s article “Compulsory Heterosexuality and Lesbian Existence”. Both authors offer arguments in favor of a political understanding of lesbian identity, and suggest that lesbianism is a liberatory practice for women. Despite these common threads, the two authors differ in their understandings of the categories of gender. Compare and contrast each author’s perspective, using examples from the texts to support your response.
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