Nursing Student’s Perceptions of Rural Healthcare

Nursing Student’s Perceptions of Rural Healthcare In quantitative research, the goal is to establish a relationship between the independent variable and the dependent variable or outcome in a population. Quantitative research designs may be descriptive or experimental. A descriptive design establishes an association between variables. Experimental or quasi-experimental design are used to determine the effectiveness of an intervention, and to provide evidence to guide clinical practice. In this study, a non-experimental descriptive design will be used. The method will be a survey plan utilizing open-ended questionnaires. The theoretical framework of the adaptation model occurs when people react encouragingly to situational changes, and it is the process and outcome of individual and groups who use deliberate reasoning, self-reflection and selection to develop human and environmental assimilation. The key concepts are person, health, environment, and nursing (Jones and Barlett Learning, LLC). A person is a bio-psycho-social being in constant coolaboration with an altering environment, using intuitive and intellectual methods to accomodate (Jones and Barlett Learning, LLC). The model incorporates people as an individual and a group. Person can be a presentation of an individual or group. The person is an adaptive entity whom practices coping skills to manage stressors (AbuShosha, 2012). Health is a component of a person’s existence and isignified as the appearance and aspect of being assimilated. The environment is all situations,contexts, and motivations that affect the transformation and behavior of theindividual. The model includes two sub-sets, the cognitive-emotive, perceptual and informational processing, learning, judgment, and emotion. Nursing is the promotion of acclimation in four manners; biological, self-concept, character function, and interdependence. The regulator sub- set is a prime integration means that reacts through neural, chemical, and endocrine coping channels (AbuShosha, 2012). There are ten adaptation model assumptions: 1) the person is a bio-psycho-social being (Jones and Barlett Learning, LLC). 2) The person is in constant associations with a fluctuating situation. 3) The person uses coping mechanisms, instinctive and learned to cope with a changing domain. 4) wellbeing and scikness are unavoidable characteristics of life. 5) An individual must change in order to react positively to the circumstances. 6) The individual’s adaptation is an event of the provocation that they are subjected. 7) The person’s acculmation situation is such that it comprises an expanse indicating a difference of stimulation that will lead to an affirmative response (Jones and Barlett Learning, LLC). 8) There are four types of adaptation; physiological needs, self- concept, role function, and interdependence (AbuShosha, 2012). 9) Interpersonal associations are a essential segment of the profession of nursing. 10) There is a vital purpose for existence with the defini tive aim of achieving confidence and honor (AbuShosha, 2012). There are also four basic assumptions; 1) people can be reduced to agments for examination and investigation. 2) Nursing is based on cause and effect 3) people’s ethics and opinions should be reviewed and appreciated. 4) A condition of adaption liberates a person’s resources to respond to other incentives (AbuShosha, 2012). The application of this theory in the project is to identify perceptions of nurse practitioner students of clinical rotation in rural and urban healthcare settings. The approach is a quantitative approach using a survey method. The data collection design is snowball approach, which is an application used for collecting research subjects through the association of a primary subject who is used to give names of other people (Tappen, 2011). An advantage for the snowball method is the ability to engage hidden populations. Disadvantages are over sampling of a network of peers can lead to discrimination. The sampling is fifty (50) nurse practitioner students. Concepts used are the four adaptive methods, to create closed ended questions based on the four methods and cognator subsets, to process changes in the environment through cognitive and emotional avenues involve personal perceptions and data processing, learning, judgment, and emotions (AbuShosha, 2012). Instruments used will be surveys given at the end of the clinical rotation. Validity and reliability estimates will be based on two methods; factor analysis to determine if items are theoretically associated show similar link in the answers. Split-half reliability means using two versions of the questions and comparing the results (Etchegaray, 2006). The means to verify the questions will be a scale of (1-5) one to five, and not likely to extremely likely. Reliability is the consistency of the measurement of the survey. This means the item measures the same thing across like responses. Piloting or pre-testing the survey can help check for reliability. Validity is the degree to which the instrument measures what it is proposed to measure, and what is the relationship between information provided and what is desired to know. A scale that measures a concept consistently is viewed as reliable; a scale that measures the proposed concept is viewed as credible (Etchegaray, 2006). The sampling size and criteria for inclusion will be a sampling of fifty (50) students. Inclusion criteria are to have students one year before graduation that live within one hour of a rural area or are willing to drive to a rural setting. Obtaining the sampling group will be through nurse practitioner students known to the developer and referrals from these students. Description of the study and informed consent will be obtained when the student agrees to participate. To obtain permission for the study, the schools in question will be approached through the academic offices and the director of the nurse practitioner programs for permission, through a proposal request. The setting will be rural and urban clinical sites within the northern Kentuckian area that are amenable to the study, where surveys will be distributed after the clinical experience is complete. The preceptors will be informed of the study, and informed consent will be obtained at that time. The sampling strategy is a non-probability sample design using the snowball network or referral sampling method; this is where one starts with known individuals and asks them to refer others with the same concern or interest (Tappen, 2011). The sampling will be divided into two groups, one that shadows a rural nurse practitioner and one that shadows an urban practitioner. The surveys will be distributed to both groups after the clinical rotation is completed and may be faxed or emailed when finished. References AbuShosha, G. . (2012, July). A critical analysis of using Roys adaptation model in nursing research. International Journal of Academic Research, 4(4), 26-31. Retrieved April 8, 2014, from http://www.academia.edu/1775409/A_Critical_Analysis_of_Using_Roys_Adaptation_Model_in_Nursing_Research Etchegaray, J. . (2006, June). Survey research: Be careful where you step. Quality and Safety in Healthcare, 15(3), 154-155. Doi:10.1136/qshc:2005.016659 Jones and Barlett Learning, LLC. (N.d.). Roy Adaptation Model. In Nursing theories:A framework for professional practice (pp. 127-141). Jones and Barlett Learning, LLC. Retrieved April 8, 2014, from http://www.samples.jbpub.com/9781449626013/7376_CH10_masters Tappen, R. (2011). Advanced nursing research: From theory to practice. In R. Tappen, Advanced nursing research: From theory to practice (1 ed., Pp. 75-76). Sudbury, MA: Jones Barlett Learning,LLC. Retrieved March 29, 2014

Introduced to a child

When we first are Introduced to a child, we have to assess them to understand which bevel of language we are going to use with them, we would not say to a 6 month old baby, ‘Hello, how are you, what have you been doing today, what would you like for dinner et. We must use lots of facial expressions and soften our tone of voice and use shorter sentences, we tend to speak slower as well so we say ‘Hellos' with a big smile on our face when speaking to a baby. If we are showing a baby something when we are speaking to them we should point also to help them understand what we are saying to them. Rhetorical questions are not real questions as the person asking the question as such, also answer it, so we might say to a baby would you like your nap now, Oh yes you would, you look very tired' or you would like your bottle of milk now, wouldn't you'. It allows us to speak and communicate with a baby or toddler who will not answer our questions but it is a way of us using speech, la nguage and communication on a daily basis, helping to be part of the day and feel involved.Using eye contact and smiling the response it usually positive and received back with a mile or babble. Closed questions should not be used all the time, only when a yes or no answer Is needed, we must ensure we still use all others areas through out the day, we can use a closed questions Like ‘have you finished your lunch' ‘do you need help with your shoes'. Closed question should not be used on babies, but can be used on young even able to shake or nod their head.Sometimes if a child is upset or does not know you (their first settling in), closed questions can be used to help if the child is feeling anxious and does not want to hold a conversation with you, obviously this is something you do not want happening every day and the child should start to speak and say words to you. Open questions prompt a child to give a longer answer and are needed to develop their speech and languag e skills.So asking questions like ‘what shall we do today' ‘what shall we have for lunch'. A child should not give a yes or no answer in open questions, but hopefully will speak up and answer the questions, sometimes you may et a ‘l don't no' answer, but that usually is due to others reasons. Babies will not be able to answer open questions and most of the time only children that feel comfortable with you, so the children that attend you setting for a while and are quite settled.

Air Quality and Climate Change as Integrated Policy – 1

Environmental policies largely influence the way humans interact with the environment. Policies targeting air quality, namely the Clean Air Act, have been effective in lowering the emissions of pollutants; however climate change is still something that concerns some scientists, citizens, and policymakers. As such, the need for further progress is necessary. In order to make such progress policymakers may need to develop air quality and climate change policies through an integrative approach. Doing this, however, does not come without political, social, and scientific obstacles.Although there are obstacles to recognizing integrative approaches for policymaking, air quality and climate change may be addressed simultaneously, less costly, and more effectively by using such an approach. Air quality and climate change are interrelated and, as such, policies should be developed through an integrative approach. The federal government’s approach to climate change policy has included o nly voluntary measures thus far. This conservative approach has failed to address climate change effectively (Dale, 2011).Policy making is both time- and cost-extensive. Therefore addressing air quality and climate change separately prolongs the policymaking process and increases the costs associated with that process. As greenhouse gas emissions affect air quality and climate change, an integrative approach to developing policies may result in timelier, less cost extensive policies that better address both issues. Air quality and climate change are interrelated, thus policies that address both issues simultaneously may provide better health, economic, and environmental benefits.Air quality and climate change are influenced by common air pollutants. As such, focusing on one pollutant to improve air quality may increase or decrease other pollutants that affect climate change (Thambiran & Diab, 2011). The complex interaction between air quality and climate change makes it nearly impos sible to create a win-win situation. If a policy addresses air quality, but the impacts of the policy on climate change is overlooked, the desired benefits may vanish.Air quality management emission standards are designed to decrease anthropogenic sources of air pollutants, and it is expected that the emission decreases will lead to better air quality. Such policies are aimed at improving air quality, assuming that climate will remain constant. But scientists suggest future climate change is likely to impact meteorological factors that affect air quality, thus making it necessary to consider air quality and climate change to avoid unexpected outcomes (Thambiran & Diab, 2011).An integrative approach to air quality and climate change policy making may generate better health, economic, and environmental benefits. The benefits of an integrative approach to air quality and climate change may seem obvious, but realizing such an approach does not come without political, social, and scienti fic obstacles. Politicians hold differing views about how to manage air quality and climate change. Not all politicians believe that climate change is an issue, despite scientific evidence, but most agree that air quality is an issue.Socially, citizens are divided much like politicians, but often rely on the media for information about the reality of climate change. To further complicate the issue, scientists are in disagreement about the validity of climate change. In every layer of society, agendas and motivations heavily influence the support or opposition to a given piece of legislation. The many political, social, and scientific obstacles come as a result of such a controversial issue, which makes it difficult to develop an integrative approach to air quality and climate change.Maintaining a fragmented approach to air quality and to climate change causes problems for everyone. As with any successful system, all parts must function properly and simultaneously in order to achieve maximum performance. Fragmented is defined as existing or functioning as though broken into separate parts; disorganized; disunified (IAC Companies, 2012). Maintaining a fragmented approach to air quality has delivered successes, but a united effort is necessary to ensure everyone is equally protected from air pollutants.Climate change, however, cannot be maintained with a fragmented approach. Global uniformity is imperative to mitigate climate change, and if cannot be addressed globally, it cannot be managed at all. Attempts locally will not provide adequate results, thus anything less than a global effort creates a problem. Because air quality and climate change are interconnected, maintaining a fragmented approach to either issue creates problems for everyone. Policies that target individual behaviors can be effective in addressing climate change and air quality.Incentives provided by local, state, and government actors are good examples of how policies influencing individual be havior can help mitigate climate change. Individuals are beginning to voluntarily change behaviors that contribute to poor air quality and climate change. These changes are making a difference, so it is rational to believe that policies targeting individual behaviors will effectively address air quality and climate change. Air quality and climate change policies should be developed through an integrative approach.The benefits of this approach include saving money and providing timelier, more effective results. Political, social, and scientific obstacles must be dealt with to realize an integrative approach to managing air quality and climate change. Fragmented approaches to air quality and climate change pose problems for everyone. Voluntary measures being taken by individuals are yielding positive results. It is therefore rational to develop policies that target individual behaviors.Although there are obstacles to recognizing integrative approaches for policymaking, air quality and climate change may be addressed simultaneously, less costly, and more effectively by using such an approach. Reference Dale, L. (2011). Environmental Policy. San Diego: Bridgepoint Education, Inc. IAC Companies. (2012). Retrieved from Dictionary. com, LLC: http://dictionary. reference. com/ Thambiran, T. , & Diab, R. D. (2011). The case for integrated air quality and climate change policies. Elsevier Environmental Science & Policy, 1008-1017.

Essay on Assignment2 - 613 Words

Question 1 In SQL, specify the following queries on the database specified in Figure 1 below using the concept of nested queries and the concepts described in chapter 5. a. Retrieve the names of all employees who work in the department that has the employee with the highest salary among all employees. SELECT fname, minit, lname FROM employee WHERE dno =(SELECT dno FROM employee WHERE salary= (SELECT MAX(Salary) FROM employee)); b. Retrieve the names of all employees whose supervisor’s supervisor has 888665555 for SSN. SELECT fname, minit, lname FROM employee WHERE Super_ssn IN (SELECT ssn FROM employee WHERE Super_ssn= 888665555); c. Retrieve the names of employees who make at least $10,000 more than the employee who is paid†¦show more content†¦Consultants also work on many problems at any given time. For each type of problem there is one consultant who is considered the expert on this problem. A consultant can be an expert on many different types of problems. Assuming constraints are not exact Question 4 Create an ER diagram for the following case. Write your assumptions about any missing information: You want to track information about 10 departments in your company. Each department has a unique name, is located on a specific floor and has a phone number. Within each department there is a department head and a range of additional employees. For all employees we want to track their name, who their boss is, their salary as well as the unique employee number each had assigned to them when they started the company. Each employee also has a set of skills. You need to track this set of skills so you can locate employees with the right skill set to be part of various cross department project teams. You need to also track information about all of the projects that are under taken by these various departments. Each project has a unique id, a name, a start date, and at least 3 employees on it. 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