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personal reflections in professional nursing practice Homework Solution

personal reflections in professional nursing practice Homework Solution

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week 3 discussion due by 2/11/20 @ 5:00pm EST : Week 3 – Discussion 66 unread replies.99 replies. Your initial discussion thread is due on Day 3 (Thursday) and you have until Day 7 (Monday) to respond to your classmates. Your grade will reflect both the quality of your initial post and the depth of your responses. Refer to the Discussion Forum Grading Rubric under the Settings icon above for guidance on how your discussion will be evaluated. Cardiovascular Disease [WLOs: 1, 2] [CLOs: 1, 2, 3, 4, 5, 6, 7] Prior to beginning work on this discussion, read Chapter 5 in your textbook, the Heart Disease Facts (Links to an external site.) website, and review this week’s Instructor Guidance. Review the risk factors identified in Chapter 5 that are associated with cardiovascular disease. Following the table below, review your assigned topic and address the required components in your initial post. Your initial post must be a minimum of 250 words and use your textbook as a resource. TopicFirst Initial of Last NameChoose one of the four heart conditions listed in section 5.3 of the textbook (e.g., congenital heart disease, hypertension, heart disease, and stroke). Discuss the impact the chosen condition has on the people within the micro-level system (refer to Chapter 1 Section 6 if you need to review the micro-level system).C, F, G, L, M, R, U, XWith Bronfenbrenner’s macro-level system in mind, discuss what you believe to be the most prevalent societal factor that has contributed to the increase in cardiovascular disease (e.g., occupation, environmental factors, food processing, lifestyle behaviors, socioeconomic status, etc.). Give your rationale.A, D, I, J, O, P, S, V, YDiscuss the biopsychosocial and cultural factors that have contributed to an increase in the incidence of cardiovascular disease. Include changes that have occurred only during your lifetime that have contributed to this change.B, E, H, K, N, Q, T, W, Z Guided Response: Respond to two classmates that were assigned to a different topic than your own. Do you agree or disagree with the information in their post? Give your rationale as to why you agree or disagree. What additional factors would you add? Your response should be a minimum of 100 words.

Week 3 – Discussion
66 unread replies.99 replies.
Your initial discussion thread is due on Day 3 (Thursday) and you have until Day 7 (Monday) to respond to your classmates. Your grade will reflect both the quality of your initial post and the depth of your responses. Refer to the Discussion Forum Grading Rubric under the Settings icon above for guidance on how your discussion will be evaluated.

Cardiovascular Disease [WLOs: 1, 2] [CLOs: 1, 2, 3, 4, 5, 6, 7]
Prior to beginning work on this discussion, read Chapter 5 in your textbook, the Heart Disease Facts (Links to an external site.) website, and review this week’s Instructor Guidance.
Review the risk factors identified in Chapter 5 that are associated with cardiovascular disease. Following the table below, review your assigned topic and address the required components in your initial post. Your initial post must be a minimum of 250 words and use your textbook as a resource.
TopicFirst Initial of Last NameChoose one of the four heart conditions listed in section 5.3 of the textbook (e.g., congenital heart disease, hypertension, heart disease, and stroke). Discuss the impact the chosen condition has on the people within the micro-level system (refer to Chapter 1 Section 6 if you need to review the micro-level system).C, F, G, L, M, R, U, XWith Bronfenbrenner’s macro-level system in mind, discuss what you believe to be the most prevalent societal factor that has contributed to the increase in cardiovascular disease (e.g., occupation, environmental factors, food processing, lifestyle behaviors, socioeconomic status, etc.). Give your rationale.A, D, I, J, O, P, S, V, YDiscuss the biopsychosocial and cultural factors that have contributed to an increase in the incidence of cardiovascular disease. Include changes that have occurred only during your lifetime that have contributed to this change.B, E, H, K, N, Q, T, W, Z
Guided Response: Respond to two classmates that were assigned to a different topic than your own. Do you agree or disagree with the information in their post? Give your rationale as to why you agree or disagree. What additional factors would you add? Your response should be a minimum of 100 words.

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presentation due in 24 hours : instructions are attached due in 24 hours apa format presentation   Required Resources Text Piper, T. (2015). Language, learning, and culture: English language learning in today’s schools. Retrieved from https://content.ashford.edu Chapter 1: The Faces of Diversity Chapter 2: Language, Learning, and Culture Articles Deng, F., & Zou, Q. (2016). A study on whether adults’ second language acquisition is easy or not: From the perspective of children’s native language acquisition. (Links to an external site.) Theory and Practice in Language Studies, 6(4), 776-780. doi:10.17507/tpls.0604.15 This article provides information about the unique perspectives of adult learning in an English as a second language classroom and will assist you with your Who Are English Language Learners? discussion and your Understanding the Importance of Language Objectives assignment. Accessibility Statement does not exist. Privacy Policy (Links to an external site.) Himmel, J. (n.d.). Language objectives: The key to effective content area instruction for English learners.  (Links to an external site.)Retrieved from http://www.colorincolorado.org/article/language-objectives-key-effective-content-area-instruction-english-learners This article provides information about using language objectives in an English as a second language classroom and will assist you with the Understanding the Importance of Language Objectives Assignment. Accessibility Statement does not exist. Privacy Policy (Links to an external site.) Lieshoff, S. C., Aguilar, N., McShane, S., Burt, M., Peyton, J. K., Terrill, L., & Van Duzer, C. (2008, March). Practitioner toolkit: Working with adult English language learners. (Links to an external site.) Retrieved from http://www.cal.org/caela/tools/program_development/CombinedFiles1.pdf This document from the Center for Applied Linguistics will help you understand several components of helping adult ELLs learn English. This document will help you on the assignment.

instructions are attached
due in 24 hours
apa format
presentation
 
Required Resources
Text
Piper, T. (2015). Language, learning, and culture: English language learning in today’s schools. Retrieved from https://content.ashford.edu

Chapter 1: The Faces of Diversity
Chapter 2: Language, Learning, and Culture

Articles
Deng, F., & Zou, Q. (2016). A study on whether adults’ second language acquisition is easy or not: From the perspective of children’s native language acquisition. (Links to an external site.) Theory and Practice in Language Studies, 6(4), 776-780. doi:10.17507/tpls.0604.15

This article provides information about the unique perspectives of adult learning in an English as a second language classroom and will assist you with your Who Are English Language Learners? discussion and your Understanding the Importance of Language Objectives assignment.

Accessibility Statement does not exist.

Privacy Policy (Links to an external site.)

Himmel, J. (n.d.). Language objectives: The key to effective content area instruction for English learners.  (Links to an external site.)Retrieved from http://www.colorincolorado.org/article/language-objectives-key-effective-content-area-instruction-english-learners

This article provides information about using language objectives in an English as a second language classroom and will assist you with the Understanding the Importance of Language Objectives Assignment.

Accessibility Statement does not exist.

Privacy Policy (Links to an external site.)

Lieshoff, S. C., Aguilar, N., McShane, S., Burt, M., Peyton, J. K., Terrill, L., & Van Duzer, C. (2008, March). Practitioner toolkit: Working with adult English language learners. (Links to an external site.) Retrieved from http://www.cal.org/caela/tools/program_development/CombinedFiles1.pdf

This document from the Center for Applied Linguistics will help you understand several components of helping adult ELLs learn English. This document will help you on the assignment.

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Discussion: Discussion: Patient Preferences and Decision Making : Changes in culture and technology have resulted in patient populations that are often well informed and educated, even before consulting or considering a healthcare need delivered by a health professional. Fueled by this, health professionals are increasingly involving patients in treatment decisions. However, this often comes with challenges, as illnesses and treatments can become complex. What has your experience been with patient involvement in treatment or healthcare decisions? In this Discussion, you will share your experiences and consider the impact of patient involvement (or lack of involvement). You will also consider the use of a patient decision aid to inform best practices for patient care and healthcare decision making. To Prepare: Review the Resources and reflect on a time when you experienced a patient being brought into (or not being brought into) a decision regarding their treatment plan. Review the Ottawa Hospital Research Institute’s Decision Aids Inventory at https://decisionaid.ohri.ca/. Choose “For Specific Conditions,” then Browse an alphabetical listing of decision aids by health topic. NOTE: To ensure compliance with HIPAA rules, please DO NOT use the patient’s real name or any information that might identify the patient or organization/practice. By Day 3 of Week 11 Post a brief description of the situation you experienced and explain how incorporating or not incorporating patient preferences and values impacted the outcome of their treatment plan. Be specific and provide examples. Then, explain how including patient preferences and values might impact the trajectory of the situation and how these were reflected in the treatment plan. Finally, explain the value of the patient decision aid you selected and how it might contribute to effective decision making, both in general and in the experience you described. Describe how you might use this decision aid inventory in your professional practice or personal life. By Day 6 of Week 11 Respond to at least two of your colleagues on two different days and offer alternative views on the impact of patient preferences on treatment plans or outcomes, or the potential impact of patient decision aids on situations like the one shared.  Micheals discussion In the clinical or within the hospital setting, the health care industry exposes us to people from all works of life to include variations in culture, belief system and even treatment options. As a charge nurse in an inpatient cancer treatment facility a situation came up where I had the pleasure of managing the care of a woman whose religious affiliation was of the Islamic faith. My female patient’s clinical diagnosis was breast cancer and she opted for a surgical removal of the breast which entailed getting a mastectomy with surgical reconstruction of the breast with a flap using abdominal tissues for a donor site, along with that came a foley catheter to help drain urine and periodic monitoring of the flap and surgery site to rule out complications. Some treatment alternatives as presented by the patient decision aid tool for a breast cancer patient includes; “Have surgery to remove the breast (mastectomy). Have surgery to remove just the cancer from the breast (breast-conserving surgery) followed by radiation treatments.” (Ottawa Hospital Research Institute, 2019)      Given my patient’s cultural background, and her religious affiliation, my client was not comfortable with having a male nurse as her care taker, instead she opted for a female nurse, given this scenario and the need to respect her wishes and cultural differences I had to change the assignment to accommodate her cultural preference with regards to post surgical care and ongoing treatment. I personally believe that granting her desires made the treatment plan go as planned with no added stress or tension on the path to recovery because we offered her treatment and care that was culturally appropriate and in line with her believe system, she was relaxed and receptive to care, this approach helped decrease her anxiety about her care, while she focused on the healing process, other arrangements I made was to inform other charge nurses of this development and to ensure every staff assignment to her room was a female per her request.      The value of the patient decision aid I selected was one that is applicable to my patient alongside care that is consistent with her religious and cultural affiliation, while keeping in mind the need to respect her wishes with regards to post surgical care and treatment options to include considerations for patient modesty and patient self awareness and reflection post surgical removal of her breast. The decision aid I utilized for breast cancer patient, presented with considerations to observe while caring for patients saddled with this type of scenario. “Evidence-based medicine (EBM) and shared decision making (SDM) are both essential to quality health care, yet the interdependence between these 2 approaches is not generally appreciated. Evidence-based medicine should begin and end with the patient: after finding and appraising the evidence and integrating its inferences with their expertise, clinicians attempt a decision that reflects their patient’s values and circumstances.” (Hoffman et. al., 2014)      With respect to my professional practice and or personal life, I would say the decision aid inventory presents with a wealth of information concerning various clinical situations that may arise and carefully thought out interventions that a client might be inclined to use, given the circumstance, the expert opinion and other considerable options that the client can choose from, to enhance their treatment process which will in turn improve their overall prognosis with the view of utilizing best practice options that is tailor made for each patients respective scenario. “Evidence based practice is the integration of patient preferences and values, ethical expertise, and rigorous research to make decisions that lead to improved outcomes for patients and families” (Melnyk, 2018, p219).                                                                                                             References Hoffmann, T. C., Montori, V. M., & Del Mar, C. (2014). The connection between evidence-based medicine and shared decision making. JAMA: Journal of the American Medical Association, 312(13), 1295–1296. https://doi-org.ezp.waldenulibrary.org/10.1001/jama.2014.10186 Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer. The Ottawa Hospital Research Institute. (2019). Patient decision aids. Retrieved from https://decisionaid.ohri.ca/ Laura’s I work in a small rural community hospital, IMCU. As COVID-19 hospitalizations increase, I have more conversations of end of life decisions with patients and families. This week, three-fourths of my patient load COVID + and on high flow oxygen at greater than 50 liters with Fio2 of 50% or more.  My patients were all over 65 years old with multiple comorbidities. Repositioning met with desaturation levels of 70-80%. These patients dip to 80% just when trying to take a few sips of water. When their Spo2 levels drop, they are slow to recover. On my unit, there are discussions on mechanical ventilation and CPR every day. Most of these people have a poor understanding of how CPR will affect them. They don’t want to make decisions on ventilator use. They’re too afraid to make decisions well. In particular, one patient was deteriorating and was declining to make any decisions on code status and intubation. Staff was trying to be proactive with education and a treatment plan of care; conversations were conducted daily, if not more. When the team had conversations with him, he would say he did not want to leave his current IMCU room; he liked his nurses and did not want to go to ICU. This meant he remained a full code and would be intubated at the point of emergency. We ended up changing his care level, transferring him to ICU, where he was immediately intubated. The next day, he was flown to a larger parent hospital. This was done because he was the most stable ICU patient that could be moved as we needed an ICU bed for an incoming patient too unstable to travel. In this case, allowing the patient time to process the information and have preferences in care did not improve decision making. We accepted his choices in care. His condition deteriorated further, and intubation took place later than we would have liked, decreasing his chances of a successful outcome. Had we allowed him more time to decide, his condition could have made him too critical to transport to the parent facility. This delay could have jeopardized another patient (the incoming patient too critical for travel would have had to been flown out). I looked at the decision tree for “Advance Care Planning: Should I receive CPR and life support” (Healthwise.org, 2020). I think the decision tree was well made and thought the personal stories section helped make the choices more relatable. With my knowledge base, a decision tree is an excellent option, but patients’ health literacy will impact their capability to use patient decision aids (PtDA). Few current patient  PtDAs have addressed lower health literacy users’ needs, and the impacts of PtDAs intended to diminish the effect of low health literacy are unknown (McCaffery, et al., 2013). PtDAs can be a beneficial tool for higher health literacy patients, but care needs to be taken with lower health literacy users. I think nurses are educators at heart. We are always in information exchange with our patients. I explain what and why I have to complete an action, the patient asks questions, and again I provide more clarifying information. The doctor leaves the room, and the patient looks to their nurse for a more understandable explanation of the dialogue. Patients need to be informed well so that they can make the best decisions for themselves. Providing education on PtDAs to nurses on how and when to implement sensitive topics would be fitting (Pyl & Menard, 2012). Patients need to learn on their own timeline. We need to offer opportunities for PtDA use but not be pushy. We need to assess the patient’s readiness to learn. The patient I spoke of may have benefited from a PtDA before becoming too ill. Once someone is on my unit, they likely would be too ill and fatigued to use this type of tool without family assistance. Advanced directive PtDAs could be introduced at PCP offices very effectively as the best time to make these types of decisions are when you are healthy and can think clearly. In my own practice, PtDAs would need to be submitted to the facility for approval. Speaking to the unit coordinator would be the first step. In my personal life, I think a decision tree would be helpful. Nurses tend to put off self-care. Using a tree might make some nurses, myself included, become more proactive in their health. References Healthwise.org. (2020). Advance Care Planning: Should I Receive CPR and Life Support? Retrieved from Healthwise.org: https://www.healthwise.net/ohridecisionaid/Content/StdDocument.aspx?DOCHWID=tu2951 McCaffery, K., Holmes-Rovner, M., Smith, S., Rovner, D., Nutbeam, D., Clayman, M. L., . . . Sheridan, S. L. (2013, Nov). Addressing health literacy in patient decision aids. BMC Medical Informatics Decision Making, 13(s10). doi:10.1186/1472-6947-13-S2-S10 Pyl, N., & Menard, P. (2012). Evaluation of Nurses’ Perceptions on Providing Patient Decision Support with Cardiopulmonary Resuscitation. International Scholarly Research Network, 2012. doi:10.5402/2012/591541

Changes in culture and technology have resulted in patient populations that are often well informed and educated, even before consulting or considering a healthcare need delivered by a health professional. Fueled by this, health professionals are increasingly involving patients in treatment decisions. However, this often comes with challenges, as illnesses and treatments can become complex.
What has your experience been with patient involvement in treatment or healthcare decisions?
In this Discussion, you will share your experiences and consider the impact of patient involvement (or lack of involvement). You will also consider the use of a patient decision aid to inform best practices for patient care and healthcare decision making.
To Prepare:

Review the Resources and reflect on a time when you experienced a patient being brought into (or not being brought into) a decision regarding their treatment plan.
Review the Ottawa Hospital Research Institute’s Decision Aids Inventory at https://decisionaid.ohri.ca/.

Choose “For Specific Conditions,” then Browse an alphabetical listing of decision aids by health topic.

NOTE: To ensure compliance with HIPAA rules, please DO NOT use the patient’s real name or any information that might identify the patient or organization/practice.

By Day 3 of Week 11
Post a brief description of the situation you experienced and explain how incorporating or not incorporating patient preferences and values impacted the outcome of their treatment plan. Be specific and provide examples. Then, explain how including patient preferences and values might impact the trajectory of the situation and how these were reflected in the treatment plan. Finally, explain the value of the patient decision aid you selected and how it might contribute to effective decision making, both in general and in the experience you described. Describe how you might use this decision aid inventory in your professional practice or personal life.
By Day 6 of Week 11
Respond to at least two of your colleagues on two different days and offer alternative views on the impact of patient preferences on treatment plans or outcomes, or the potential impact of patient decision aids on situations like the one shared. 
Micheals discussion
In the clinical or within the hospital setting, the health care industry exposes us to people from all works of life to include variations in culture, belief system and even treatment options. As a charge nurse in an inpatient cancer treatment facility a situation came up where I had the pleasure of managing the care of a woman whose religious affiliation was of the Islamic faith. My female patient’s clinical diagnosis was breast cancer and she opted for a surgical removal of the breast which entailed getting a mastectomy with surgical reconstruction of the breast with a flap using abdominal tissues for a donor site, along with that came a foley catheter to help drain urine and periodic monitoring of the flap and surgery site to rule out complications. Some treatment alternatives as presented by the patient decision aid tool for a breast cancer patient includes; “Have surgery to remove the breast (mastectomy). Have surgery to remove just the cancer from the breast (breast-conserving surgery) followed by radiation treatments.” (Ottawa Hospital Research Institute, 2019)
     Given my patient’s cultural background, and her religious affiliation, my client was not comfortable with having a male nurse as her care taker, instead she opted for a female nurse, given this scenario and the need to respect her wishes and cultural differences I had to change the assignment to accommodate her cultural preference with regards to post surgical care and ongoing treatment. I personally believe that granting her desires made the treatment plan go as planned with no added stress or tension on the path to recovery because we offered her treatment and care that was culturally appropriate and in line with her believe system, she was relaxed and receptive to care, this approach helped decrease her anxiety about her care, while she focused on the healing process, other arrangements I made was to inform other charge nurses of this development and to ensure every staff assignment to her room was a female per her request.
     The value of the patient decision aid I selected was one that is applicable to my patient alongside care that is consistent with her religious and cultural affiliation, while keeping in mind the need to respect her wishes with regards to post surgical care and treatment options to include considerations for patient modesty and patient self awareness and reflection post surgical removal of her breast. The decision aid I utilized for breast cancer patient, presented with considerations to observe while caring for patients saddled with this type of scenario. “Evidence-based medicine (EBM) and shared decision making (SDM) are both essential to quality health care, yet the interdependence between these 2 approaches is not generally appreciated. Evidence-based medicine should begin and end with the patient: after finding and appraising the evidence and integrating its inferences with their expertise, clinicians attempt a decision that reflects their patient’s values and circumstances.” (Hoffman et. al., 2014)
     With respect to my professional practice and or personal life, I would say the decision aid inventory presents with a wealth of information concerning various clinical situations that may arise and carefully thought out interventions that a client might be inclined to use, given the circumstance, the expert opinion and other considerable options that the client can choose from, to enhance their treatment process which will in turn improve their overall prognosis with the view of utilizing best practice options that is tailor made for each patients respective scenario. “Evidence based practice is the integration of patient preferences and values, ethical expertise, and rigorous research to make decisions that lead to improved outcomes for patients and families” (Melnyk, 2018, p219).
                                                                                                            References
Hoffmann, T. C., Montori, V. M., & Del Mar, C. (2014). The connection between evidence-based medicine and shared decision making. JAMA: Journal of the American Medical Association, 312(13), 1295–1296. https://doi-org.ezp.waldenulibrary.org/10.1001/jama.2014.10186
Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.
The Ottawa Hospital Research Institute. (2019). Patient decision aids. Retrieved from https://decisionaid.ohri.ca/
Laura’s
I work in a small rural community hospital, IMCU. As COVID-19 hospitalizations increase, I have more conversations of end of life decisions with patients and families. This week, three-fourths of my patient load COVID + and on high flow oxygen at greater than 50 liters with Fio2 of 50% or more.  My patients were all over 65 years old with multiple comorbidities. Repositioning met with desaturation levels of 70-80%. These patients dip to 80% just when trying to take a few sips of water. When their Spo2 levels drop, they are slow to recover. On my unit, there are discussions on mechanical ventilation and CPR every day. Most of these people have a poor understanding of how CPR will affect them. They don’t want to make decisions on ventilator use. They’re too afraid to make decisions well.
In particular, one patient was deteriorating and was declining to make any decisions on code status and intubation. Staff was trying to be proactive with education and a treatment plan of care; conversations were conducted daily, if not more. When the team had conversations with him, he would say he did not want to leave his current IMCU room; he liked his nurses and did not want to go to ICU. This meant he remained a full code and would be intubated at the point of emergency. We ended up changing his care level, transferring him to ICU, where he was immediately intubated. The next day, he was flown to a larger parent hospital. This was done because he was the most stable ICU patient that could be moved as we needed an ICU bed for an incoming patient too unstable to travel.
In this case, allowing the patient time to process the information and have preferences in care did not improve decision making. We accepted his choices in care. His condition deteriorated further, and intubation took place later than we would have liked, decreasing his chances of a successful outcome. Had we allowed him more time to decide, his condition could have made him too critical to transport to the parent facility. This delay could have jeopardized another patient (the incoming patient too critical for travel would have had to been flown out).
I looked at the decision tree for “Advance Care Planning: Should I receive CPR and life support” (Healthwise.org, 2020). I think the decision tree was well made and thought the personal stories section helped make the choices more relatable. With my knowledge base, a decision tree is an excellent option, but patients’ health literacy will impact their capability to use patient decision aids (PtDA). Few current patient  PtDAs have addressed lower health literacy users’ needs, and the impacts of PtDAs intended to diminish the effect of low health literacy are unknown (McCaffery, et al., 2013). PtDAs can be a beneficial tool for higher health literacy patients, but care needs to be taken with lower health literacy users.
I think nurses are educators at heart. We are always in information exchange with our patients. I explain what and why I have to complete an action, the patient asks questions, and again I provide more clarifying information. The doctor leaves the room, and the patient looks to their nurse for a more understandable explanation of the dialogue. Patients need to be informed well so that they can make the best decisions for themselves. Providing education on PtDAs to nurses on how and when to implement sensitive topics would be fitting (Pyl & Menard, 2012). Patients need to learn on their own timeline. We need to offer opportunities for PtDA use but not be pushy. We need to assess the patient’s readiness to learn.
The patient I spoke of may have benefited from a PtDA before becoming too ill. Once someone is on my unit, they likely would be too ill and fatigued to use this type of tool without family assistance. Advanced directive PtDAs could be introduced at PCP offices very effectively as the best time to make these types of decisions are when you are healthy and can think clearly. In my own practice, PtDAs would need to be submitted to the facility for approval. Speaking to the unit coordinator would be the first step. In my personal life, I think a decision tree would be helpful. Nurses tend to put off self-care. Using a tree might make some nurses, myself included, become more proactive in their health.
References
Healthwise.org. (2020). Advance Care Planning: Should I Receive CPR and Life Support? Retrieved from Healthwise.org: https://www.healthwise.net/ohridecisionaid/Content/StdDocument.aspx?DOCHWID=tu2951
McCaffery, K., Holmes-Rovner, M., Smith, S., Rovner, D., Nutbeam, D., Clayman, M. L., . . . Sheridan, S. L. (2013, Nov). Addressing health literacy in patient decision aids. BMC Medical Informatics Decision Making, 13(s10). doi:10.1186/1472-6947-13-S2-S10
Pyl, N., & Menard, P. (2012). Evaluation of Nurses’ Perceptions on Providing Patient Decision Support with Cardiopulmonary Resuscitation. International Scholarly Research Network, 2012. doi:10.5402/2012/591541

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BRAINSTORM ASSIGNMENT DUE IN 24 HOURS : THE INSTRUCTIONS ARE ATTACHED “BRAINSTORM” – DUE IN 24 HOURS –  Required Resources Text Piper, T. (2015). Language, learning, and culture: English language learning in today’s schools. Retrieved from https://content.ashford.edu Chapter 1: The Faces of Diversity Chapter 2: Language, Learning, and Culture Articles Deng, F., & Zou, Q. (2016). A study on whether adults’ second language acquisition is easy or not: From the perspective of children’s native language acquisition. (Links to an external site.) Theory and Practice in Language Studies, 6(4), 776-780. doi:10.17507/tpls.0604.15 This article provides information about the unique perspectives of adult learning in an English as a second language classroom and will assist you with your Who Are English Language Learners? discussion and your Understanding the Importance of Language Objectives assignment. Accessibility Statement does not exist. Privacy Policy (Links to an external site.) Himmel, J. (n.d.). Language objectives: The key to effective content area instruction for English learners.  (Links to an external site.)Retrieved from http://www.colorincolorado.org/article/language-objectives-key-effective-content-area-instruction-english-learners This article provides information about using language objectives in an English as a second language classroom and will assist you with the Understanding the Importance of Language Objectives Assignment. Accessibility Statement does not exist. Privacy Policy (Links to an external site.) Lieshoff, S. C., Aguilar, N., McShane, S., Burt, M., Peyton, J. K., Terrill, L., & Van Duzer, C. (2008, March). Practitioner toolkit: Working with adult English language learners. (Links to an external site.) Retrieved from http://www.cal.org/caela/tools/program_development/CombinedFiles1.pdf This document from the Center for Applied Linguistics will help you understand several components of helping adult ELLs learn English. This document will help you on the assignment.

THE INSTRUCTIONS ARE ATTACHED “BRAINSTORM” – DUE IN 24 HOURS – 
Required Resources
Text
Piper, T. (2015). Language, learning, and culture: English language learning in today’s schools. Retrieved from https://content.ashford.edu

Chapter 1: The Faces of Diversity
Chapter 2: Language, Learning, and Culture

Articles
Deng, F., & Zou, Q. (2016). A study on whether adults’ second language acquisition is easy or not: From the perspective of children’s native language acquisition. (Links to an external site.) Theory and Practice in Language Studies, 6(4), 776-780. doi:10.17507/tpls.0604.15

This article provides information about the unique perspectives of adult learning in an English as a second language classroom and will assist you with your Who Are English Language Learners? discussion and your Understanding the Importance of Language Objectives assignment.

Accessibility Statement does not exist.

Privacy Policy (Links to an external site.)

Himmel, J. (n.d.). Language objectives: The key to effective content area instruction for English learners.  (Links to an external site.)Retrieved from http://www.colorincolorado.org/article/language-objectives-key-effective-content-area-instruction-english-learners

This article provides information about using language objectives in an English as a second language classroom and will assist you with the Understanding the Importance of Language Objectives Assignment.

Accessibility Statement does not exist.

Privacy Policy (Links to an external site.)

Lieshoff, S. C., Aguilar, N., McShane, S., Burt, M., Peyton, J. K., Terrill, L., & Van Duzer, C. (2008, March). Practitioner toolkit: Working with adult English language learners. (Links to an external site.) Retrieved from http://www.cal.org/caela/tools/program_development/CombinedFiles1.pdf

This document from the Center for Applied Linguistics will help you understand several components of helping adult ELLs learn English. This document will help you on the assignment.

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14 RESPONSES DUE IN 14 HOURS : 14 PEER RESPONSES DUE IN 16 HOURS – EACH SET OF 2 HAS ITS OWN INSTRUCTIONS  please label responses according to discussion title    Leading Groups, Facilitating Groups, and Reading People SHEMAIAH’S POST: Nonverbal communication refers to the nonverbal processes we undergo as we relay information to others. Nonverbal communication is a very important aspect of the group setting. Nonverbal communication is uncontrolled and trumps verbal communication (Adams, K., & Galanes, G, 2017, p.71-72). In the group setting, individuals communicate even if one says nothing. Often, the nonverbal communication signals one displays are what take precedence over what is spoken aloud. For example, if someone in the group scrunches up one’s face in reaction to trying an unfamiliar dish, it will be perceived that the food is distasteful even if the individual declares it to be delicious. One way to communicate nonverbally is the usage of proxemics. Proxemics refers to the amount of space an individual keeps between themselves and others (Adams, K., & Galanes, G, 2017, p.74). I think that proximity can both help and harm relationships with others because it may be comfortable to some but can cause discomfort for others. Facial expressions are one of the most noticeable elements of nonverbal communication. I think that facial expressions can cause more harm than because, it can cause others to gain the wrong impression. In addition to this, facial expressions can send messages that can be misinterpreted. I think that eye contact is one of the most misconstrued nonverbal elements. Although eye contact is acceptable, this element can be harmful when one takes into consideration the cultures of others. While interacting within the group setting, it of the greatest significance that communication is effective. Communication can single handedly cause a group to experience success or lead to its ultimate failure. In order to facilitate a group effectively, communication must be ongoing. In addition to this, roles must be distributed to ensure that each group member is sharing the workload (Adams, K., & Galanes, G, 2017, p.96). Most importantly, in order to facilitate a group effectively, the leader should address conflict appropriately and in a timely fashion to avoid groupthink (Adams, K., & Galanes, G, 2017, p.182). The most ineffective form of leadership is a leader who leads with a laissez-faire attitude. Laissez-Faire leaders assume the role of being equal with all group members and are not typically interested in leadership responsibilities (Adams, K., & Galanes, G, 2017, p.71-72). On the other hand, the most effective form of leadership is a leader who is democratic. An example of a democratic leader is my pastor. Although my pastor must make many decisions without the input of the congregation, he often allows church members to submit their input concerning church related operations. My pastor genuinely values our input and considers what will benefit most of the church when opposing ideas are presented.   Kagan is an engagement based program that has been implemented in schools worldwide. Spencer Kagan developed this program to increase student engagement and to create a world in which individuals value the input of others by sharing and gaining information from others. This program is researched based and is available for professionals worldwide. Using this program will allow individuals to access the tools needed to grow as a facilitator in both the small and large group setting. Adams, K., & Galanes, G. (2017). Communicating in groups: application and skills (10th ed.). New York, NY: McGraw-Hill TAMMY’S POST: Effective facilitation in a consumer group and any group In the case of consumers, it is essential to grasp and maintain attention. We may all hear, but active listening is essential. We send information but it is equally important to receive information -feedback. We may need to move about, change our tone, and even change the details of how and what we present. The key to succeeding as we do this is knowing the audience we encounter. In order to gain the attention of an audience, a facilitator must engage the emotional response. One must elicit time and space for thoughts, desires, and opinions. Although not every piece of mind will be implemented into a project, the value of being seen and heard can establish the rapport necessary to thrive. For instance, you may have heard someone say, “It is not for me, but I have heard…” or “If this was X, Y, or Z, then I may consider…” When a person or group is not heard that is when attention or care leaves with them. Nonverbal communication and body language Body language and gestures convey what is not said and are often more seen and heard than what is not being said. Be awake and attentive. Being sluggish and slumped over sends a poor image. Be appropriately toned. Do not yell in a library, nor whisper in a stadium. Pay attention if an audience is gravitating toward you. Sometimes, the simple responses can tell us a lot. Is a person squinting? Adjust the screen projector. Are they rolling their eyes? Add some humor or questions as this engages audiences and groups. Non-verbal cues and body language are like pictures in that they are worth a million words, so the saying goes. Least and most effective leadership styles exampling Transformative leadership is ideal, in my opinion. It is selfless, and inspiration for the greater good of all, or otherwise most as ethical principles and philosophies would concur. It means to bring no harm but also go beyond the limb to help someone else grow. (Adams & Galanes, 2017, p. 258) Although I agree with the trade and exchange of transactional leadership, I think the transformative superior engages and pumps others’ enthusiasm. There is also the approach for the better good. While the best fit does not always fit a few, the principle is moral and ethical in genuinely looking for a seamless and beneficial. An example used is Dr. Martin Luther King, Jr. for his charismatic leading style. King saw pain and desired to bring love. He spoke in compassion. His will was to do good and reflect on character, not color. It is a toss-up of these two leaderships because compromising and collaborating are and give and take necessary. Give and take is like send and receive. Least favorable in leading others is one that does not lead at all but rather with a distributive concept as an approach manipulates and sometimes coerces (Adams & Galanes, 2017, p. 260)  Dictating or push each other around; in such cases of power and control and a power struggle, no one wins. No person should necessarily Groupthink or be as distributed leadership indicates become a possession to another in a hierarchy. I feel there is no specific leader in this category, but instead, I see this more in communist and cult ideals. Many that come to mind are Stalin or Manson, extremists.  Resources to grow as facilitators of groups Some of the best resources to facilitate groups are growing communication and learning styles. Facilitation and cohesion in doing so can be encouraged and fostered through an assortment of courses. Interpersonal and intercultural are ideal for a foundation. Three ways of communicating nonverbally and explain how this communication is harmful or helpful in your relationship with human services consumers This question is challenging because my position mostly interacts electronically – by Notice of Action (NOA). Our correspondence is literal legal jargon and policy implemented with statutes following this federal provision or that state exception, so it is dry. It can come across as insensitive or demanding. I personalize my notices of action with a “Congratulations on your new baby!” Being human opposed to, “Federal law prohibits and state addendums requirements…section 1.22.3456(A).”I think this personalization shows that I see the family as an asset and of value. Even a sincere and heartfelt, “This is a difficult time. We understand how tolling the pandemic has proven to be. Know, we are working to process in your favor to meet your family’s needs.” Introduction and conclusion with a salutation and well wishes can set a kind tone. Lastly, I invite the client to call with questions or concerns and leave directives in my narratives. It is a deep jolt to feel forgotten or just another case number. Specific verbiage is also reassuring, leaving a voice message apologizing and then reiterating the discussion without disclosure, which can also be done on written fomrats. It sends a loud message that I cared enough to listen. References Adams, K., & Galanes, G. (2017). Communicating in groups: Application and skills (10th ed.). New York, NY: McGraw-Hill. eISBN-13: 9781259983283 Who Are English Language Learners? Guided Response: Review several of your classmates’ posts, and compare the information to what you wrote. Discuss what information is new and what is already known. What information surprises you? Respond to at least two of your classmates, and provide recommendations to extend their thinking. For distinguished peer responses, respond with a minimum of five sentences that add to the conversation and, refrain from evaluative posts (i.e., You did a good job.). MELISSA’S POST: Who Are English Language Learners?                English language learners are students and adults who are learning how to speak English as a second language. English Language Learners mostly come from non-English speaking homes or backgrounds and may have come into the United States after they were born, however, most children in the schools in the United States have been born in this country, but still, come from non-English speaking households. These students require modified and specialized instructions in both their academics and learning the English Language.                The four domains of language are listening, speaking, reading, and writing. Listening and reading are receptive and observable, it is how we learn and process information whereas, Speaking and writing are productive and are how we express or communicate the information we have learned. To be proficient in each domain I have broken down the 4 domains below: · Listening: Being proficient in listening means that you have developed a skill set that has enabled you to be able to give your full attention to the speaker, interprets to gain an understanding of what the speaker has said, and is able to engage the speaker throughout the conversation. As well as, to evaluate the spoken language in a variety of different situations. · Speaking: Being proficient in speaking means that you can engage in oral communication in different situations and with different audiences. You will be able to use the proper words in context, understanding the proper definitions, pronunciations, timing, and the use of proper syllables. · Reading: Being proficient in reading means that you can process and understand the written language. Being able to identify and evaluate text, symbols, and the written language with fluency. · Writing: To be proficient in writing means that the writer can engage in written and oral communication and transfer that onto paper using the correct meaning in their text. The writer can write to several different audiences and situations. Culture shock and other circumstances can affect the child’s ability to learn because the child is not feeling comfortable in their new environment. Being in shock hinders the child’s ability to learn because they are anxious, fearful, and insecure of their surroundings, those people around them, and the new culture they are in. If the child does not know how to communicate in their new environment, they become quiet and withdrawn. They do not understand how to ask for help or who to trust to get help from. All these issues will affect the child and their ability to learn. Therefore, it is imperative that we make the child feel as welcome as possible. Learning the child’s culture, some language, how to say their name, etc. will help the child to gain trust in you as their teacher and help to make the child feel more comfortable, thus enhancing their ability to learn. References: Deng, F., & Zou, Q. (2016). A study on whether adults’ second language acquisition is easy or not: From the perspective of children’s native language acquisition. (Links to an external site.) Theory and Practice in Language Studies, 6(4), 776-780. doi:10.17507/tpls.0604.15 Himmel, J. (n.d.). Language objectives: The key to effective content area instruction for English learners.  (Links to an external site.)Retrieved from http://www.colorincolorado.org/article/language-objectives-key-effective-content-area-instruction-english-learners (Links to an external site.) Lieshoff, S. C., Aguilar, N., McShane, S., Burt, M., Peyton, J. K., Terrill, L., & Van Duzer, C. (2008, March). Practitioner toolkit: Working with adult English language learners. (Links to an external site.) Retrieved from http://www.cal.org/caela/tools/program_development/CombinedFiles1.pdf Piper, T. (2015). Language, learning, and culture: English language learning in today’s schools. Retrieved from https://content.ashford.edu · Chapter 1: The Faces of Diversity · Chapter 2: Language, Learning, and Culture FELECIA’S POST: K-12 According to our textbook, “Language, Learning, and Culture” (Piper, 2015), ELL are students who are not born in United States and are between ages of 3-12. Other qualifications are they speak their Native Language (first) and English as their second or may not speak English at all. Also may have difficulties in writing, reading, speaking, and over understanding the English Language. However, there is a program in schools (elementary to high school) for students who may have difficulties with the following previous listed. This program is called ESL, English as a Second Language. ESL  is a program of techniques, methodology and special curriculum designed to teach ELL students English language skills, which may include listening, speaking, reading, writing, study skills, content vocabulary, and cultural orientation. ESL instruction is usually in English with little use of native language. (U.S department of Education, 2020) In order for students to succeed in school they must be competent in these four domains/ skills, reading, writing, listening, and speaking. Reading is skill that all children need and is taught from the early ages.  Children who are ELL have acquire reading skills simultaneously with listening and speaking  because they have attend public school in early years. As for ELL who have not, this may harder but also have to learn the three domains simultaneously, but some will benefit from having the foundation of literacy in another language.  (Piper, 2015) Writing means communication, more of social skill. ELLs, writing is easier and more purposeful if it is fully integrated into other language activities and with the broader curriculum. There are five stages of learning how to write, prewrite phrase/ brainstorming, draft phrase/ rough draft, revision phrase, editing phrase, and publishing. Also, writing needs to be link with other language sources because if not it would make it harder to learn. It is important to focus on oral language first, but for all learners it is sometimes necessary to concentrate on helping them develop comprehension and speaking ability before embarking on the journey to literacy. (Piper, 2015) Listening is foundational all language skills.  It plays role in reading as well. For ELL, listening may be hard because they are listening to different language that not their own. Listening comprehension entails a complex network of cognitive processes. These processes involve the listener calling upon both linguistic and nonlinguistic knowledge. Linguistic knowledge includes information about the relevant sounds in a language (the phonemes), how they go together to form words, word identification and meaning, sentence structure, and discourse structure. Nonlinguistic knowledge refers to the real-world information and experience. (Piper, 2015) Speaking  is the only skill that actually advances underlying proficiency in the language, it is nonetheless true that to be able to communicate in the language, learners have to be able to speak. With ELLs, if their pronunciation is good and they speak fluently with appropriate vocabulary, we usually judge them to be proficient. (Piper, 2015)  Culture shock is the stress that people experience when they are immersed in a new and unfamiliar environment. For ELL, is learning something new, a different language and everything that comes with it. They are facing culture adaptions, between the school/ community and country. A ELL student may act out in class for number of reasons because one this something new and they do not understand what is going on. Two stress of learning new language and culture ways tends to be stressful especially if it is their first time here. Creating an environment in which all ELLs and, indeed, all children are comfortable requires sensitivity to these cultural elements. (Piper, 2015) To lessen the stress of an ELL, teachers should include their culture and other elements to assist with learning and adapting to new environment.  Piper, T. (2015). Language, learning, and culture: English language learning in today’s schools. Retrieved from https://content.ashford.edu U.S department of Education https://www2.ed.gov/about/offices/list/ocr/ell/glossary.html Discussion – Reader Response comment on the posts of two classmates DILLON’S POST: In this weeks lectures and reading assignments, I learned the basics of  writing many different essays; those being compare and contrast essays, analogy, division and classification essays, and definition essays. For this weeks essay i believe I will go with the compare and contrast essay. The division and classification essay, I didn’t fully understand. It seemed to resemble the compare and contrast essays alot. BRIDGET’S POST: In this week’s lesson I learned about several different types of  essays.  I learned about comparing, contrasting, analogy, definition, division and classification.  The compare/contrasting essay looks at a subject from two different points of view.  Comparing is finding the similarities and contrasting is finding the differences.  An analogy essay is telling about something unfamiliar by comparing it with something similar.  A definition essay means you put something in a general category and then add characteristics that distinguish it from others.  Lastly is the division/classification essay.  The division is a way of separating something something into parts and the classification is when we put something into groups that share characteristics.   While reading this week’s lesson, I didn’t really understand how to write the defining essay.  The example was confusing.  When I was reading about the different types of essays this week, I thought about which one I wanted to use for my assignment.  At this point, I’m still confused about what will be the best fit for me, but I’m working on it.   Discussion – It’s Classified comment on the posts of two classmates  ALYVIA’S POST: There are 2 types of thinkers in life  The way people think defines what type of person they are in life. There are two ways of thinking in life which include Positive thinking and Negative thinking. Many people are either classified as one or the other.  1. Positive thinking. People who have a positive mind set tend to be the happiest. These types of people look for the good out of every situation. They typically believe everything happens for a reason and to not sweat the small things in life. Positive people tend to believe anything is possible. They create/conquer their own dream life goals. They are go getters and never settle for less. When walking in a room full of people, their positive energy feeds off on others.  2. Negative thinking. People who have a negative mind set tend to have dark things going on internally or externally. These types of people will pull you down to their level to make sure you feel that dark energy they feel. They typically can drain other energies down. They always think of the worst things that can happen before taking time to see the good. These types of thinkers are always having the worst karma coming back to them from the universe. They always blame others for their problems. Nothing works out in their favor and the negative thinking continues. It is always good to be a positive thinker although we all have tendencies of negative thoughts. The type of attitude you portray to the universe is what you will get back. So with that being said, being a positive thinker in any situation rather than a negative thinker because it will lead you to a better and happier life.  DILLON’S POST: The two types of different people Ive choose to write about are lazy people, and productive people. Although I feel that i may fall in both categories from time to time, there are many things that separate the two. 1. Productive people have many things in common. I feel that productive people start off their day early and get the most out of it. another thing is acting and executing the things you need to do at that moment and not putting it off till later. I feel that productive people also plan out their days and make a list of the things that need to be accomplished day to day.  2. Lazy individuals usually sleep in most days, put off important tasks that need attention, and don’t plan ahead for anything. Pretty much the complete opposite of productive. Discussion – It’s a Slang Thang comment on the posts of two classmates BRIDGET’S POST: As a mother of three, I often hear my children use slang.  While many are common enough that most people wouldn’t pay much attention, there are a few that are just so off the wall that I find myself shaking my head in wonder.  One phrase that my two teenage sons use all the time is “bet”.  This word refers to the phrase, “bet me I won’t (or can’t) do something”.  For example, one day I took my boys to the park and my middle child wanted to play basketball.  So, while he was playing, he looked and me and said, “Mom, you think I can make this shot from here?”.  When I replied that I didn’t know, his immediate response was “bet”.  I find both boys using this term all the time.  “Think I won’t win this game?  Bet!”.   KYLEIGH’S POST: Throughout my 19 years of existence, slang has played a major impact on my everyday life. In my younger years, the word “fierce” was one I used to describe myself when I was really feeling it. As I matured, I referred to myself as a “savage”, this word held many meanings for me, but the most important one was when I used this word to describe my character. The word “savage” meant that my character made me a strong independent 14-year-old. However, now that I am grown and have seen the world, my favorite slang phrase is, “sauce up.” This phrase means to simply do. It is a word that implements actions. Although this phrase may not be common, it is used in my everyday life. Below this paragraph, I have listed a few examples that will hopefully bring more clarity. EXAMPLES: ” I am about sauce up some eggs for breakfast.” “Let’s sauce up a game night.” “Sauce me the salt, please.” “Saucing up some dinner tonight.” “Sauce me some dance moves.” Although these are just a few examples, rest assured the word “sauce” is used in my everyday life.  Discussion – Birds of a Feather comment on the posts of two classmates  ALYVIA’S POST: I can say my dad is my hero. I had a difficult childhood growing up. It was my dad, my mom, my older sister and myself living together. The difficulty did not come from a set of divorced parents it was simply because of the health issues my mom and sister struggled with. My mom is disabled and my sister has been struggling with a past traumatic brain injury since 08’. With that being said my dad had to step up and do way more than a normal dad would have to do in a family. When my sister had her accident, that is when my mom became very ill. Not only that, my dad’s own business hit the fan and he lost a lot of money. He had many hospital bills, personal bills, and family bills he had to pay for. He struggled because it was only him having to deal with that. Him having to not only take care of his sick family and myself, he had to continue to work hard to build his business back up. I can say my dad is a very ambitious person who works hard everyday to provide for my family no matter what the situation is. He has not only done his job as a father but has taken the mother role of my own mother in the things she could not do. I look up to him in that way. Growing up and watching everything my dad has done has inspired me to go get what I need to succeed in life. He showed me how life can be difficult and how to handle those situations in the right way. He is a very passionate person and I can relate to that. My dad is very smart and can accomplish a task without thinking hard about it. He works better underpressure rather than myself. Although I am smart, I suffer from Dyslexia which leads me to work a little bit harder and more organized than he does. Overall, he is now a very successful man. I strive to get where he is or even further than he is today! KYLEIGH’S POST: Over the years, I have considered several people as heroes in my life. In fact, a few examples would be my mom, Mitt Romeny, and even Ben Carson. However, when I think about the one I resonate with the most, Taylor Swift is the one that comes to mind. Although we share many similarities, we also differ in quite a few ways.    Taylor Swift and I are similar in how we both were on the bleachers, and lost the boy we loved to the girl in a short skirt. However, we differed in the fact that she was in high school when this happened, and I was in middle school. Another way we are similar is our love for music. Taylor Swift and I both have a very diverse taste in music and change our tastes often. Despite our love for country music, we both share a similar enjoyment of pop culture. However, we differ in the fact that she gets paid millions for her music taste whereas I just get the simple pleasure of paying 9.99 a month to enjoy my tunes on apple music. We also share the same love for Grey’s Anatomy, but unlike mine, her favorite character is Meredith, and mine will always be Christina. Another similarity is our love for the Jonas Brothers, yet despite our mutual feelings, she dated one of them, and I just had the privilege of singing “burning love’ while watching them on a TV screen. As one can see Taylor Swift and I share many similarities, but it is our differences that make us human. Discussion – Apples to Aardvarks comment on the posts of two classmates ALYVIA’S POST: Has anything annoyed you so much you wanted to scream? I can answer that myself. As humans we come across people and things that drive us crazy!! A good example would be my sisters. Some days I can not stand being around them. It could be the smallest things they say or do that aggravate me. The slow screeching noise from the chalkboard and the continuous aggravation I feel from my sisters, gives off a feeling or pain that hurts to even listen.  BRIDGET’S POST: Children are like sponges.  They soak up everything that goes on or that is said around them.  They can also absorb your energy as well.  To be honest, they can zap your energy, but that’s a subject for a different day.  My daughter, who is almost eight, is very active and never stops going.  I hear my named called repeatedly, all time time.  I’ve never stopped to count, but it feels like she’s calling me half a million times a day on average.  Most of the time it is to tell me that just popped into her mind and it absolutely had to be told at that particular moment in time.  Waiting is not an option and patience is obviously not a virtue in eight-year-olds.  I assume that her haste is because she will have forgotten what she wanted to say thirty seconds from when she planned to say it.  Of course, telling me from afar is also not an option.  I have to be physically present in the same room and looking her in the eye for the news to count.  So, when I repeatedly hear “mom, Mom, MOM!”, I have to get up, go to where she is at that moment in time, and see what she needs.  Hence the sponge aspect.  Not only is she soaking up my conversations, my experiences and my attitude, she is also soaking up my energy by having to run to she what she wants every few seconds.

14 PEER RESPONSES DUE IN 16 HOURS – EACH SET OF 2 HAS ITS OWN INSTRUCTIONS 
please label responses according to discussion title
  
Leading Groups, Facilitating Groups, and Reading People
SHEMAIAH’S POST:
Nonverbal communication refers to the nonverbal processes we undergo as we relay information to others. Nonverbal communication is a very important aspect of the group setting. Nonverbal communication is uncontrolled and trumps verbal communication (Adams, K., & Galanes, G, 2017, p.71-72). In the group setting, individuals communicate even if one says nothing. Often, the nonverbal communication signals one displays are what take precedence over what is spoken aloud. For example, if someone in the group scrunches up one’s face in reaction to trying an unfamiliar dish, it will be perceived that the food is distasteful even if the individual declares it to be delicious. One way to communicate nonverbally is the usage of proxemics. Proxemics refers to the amount of space an individual keeps between themselves and others (Adams, K., & Galanes, G, 2017, p.74). I think that proximity can both help and harm relationships with others because it may be comfortable to some but can cause discomfort for others. Facial expressions are one of the most noticeable elements of nonverbal communication. I think that facial expressions can cause more harm than because, it can cause others to gain the wrong impression. In addition to this, facial expressions can send messages that can be misinterpreted. I think that eye contact is one of the most misconstrued nonverbal elements. Although eye contact is acceptable, this element can be harmful when one takes into consideration the cultures of others.
While interacting within the group setting, it of the greatest significance that communication is effective. Communication can single handedly cause a group to experience success or lead to its ultimate failure. In order to facilitate a group effectively, communication must be ongoing. In addition to this, roles must be distributed to ensure that each group member is sharing the workload (Adams, K., & Galanes, G, 2017, p.96). Most importantly, in order to facilitate a group effectively, the leader should address conflict appropriately and in a timely fashion to avoid groupthink (Adams, K., & Galanes, G, 2017, p.182).
The most ineffective form of leadership is a leader who leads with a laissez-faire attitude. Laissez-Faire leaders assume the role of being equal with all group members and are not typically interested in leadership responsibilities (Adams, K., & Galanes, G, 2017, p.71-72). On the other hand, the most effective form of leadership is a leader who is democratic. An example of a democratic leader is my pastor. Although my pastor must make many decisions without the input of the congregation, he often allows church members to submit their input concerning church related operations. My pastor genuinely values our input and considers what will benefit most of the church when opposing ideas are presented.  
Kagan is an engagement based program that has been implemented in schools worldwide. Spencer Kagan developed this program to increase student engagement and to create a world in which individuals value the input of others by sharing and gaining information from others. This program is researched based and is available for professionals worldwide. Using this program will allow individuals to access the tools needed to grow as a facilitator in both the small and large group setting.
Adams, K., & Galanes, G. (2017). Communicating in groups: application and skills (10th ed.). New York, NY: McGraw-Hill
TAMMY’S POST:
Effective facilitation in a consumer group and any group
In the case of consumers, it is essential to grasp and maintain attention. We may all hear, but active listening is essential. We send information but it is equally important to receive information -feedback. We may need to move about, change our tone, and even change the details of how and what we present. The key to succeeding as we do this is knowing the audience we encounter. In order to gain the attention of an audience, a facilitator must engage the emotional response. One must elicit time and space for thoughts, desires, and opinions. Although not every piece of mind will be implemented into a project, the value of being seen and heard can establish the rapport necessary to thrive. For instance, you may have heard someone say, “It is not for me, but I have heard…” or “If this was X, Y, or Z, then I may consider…” When a person or group is not heard that is when attention or care leaves with them.
Nonverbal communication and body language
Body language and gestures convey what is not said and are often more seen and heard than what is not being said. Be awake and attentive. Being sluggish and slumped over sends a poor image. Be appropriately toned. Do not yell in a library, nor whisper in a stadium. Pay attention if an audience is gravitating toward you. Sometimes, the simple responses can tell us a lot. Is a person squinting? Adjust the screen projector. Are they rolling their eyes? Add some humor or questions as this engages audiences and groups. Non-verbal cues and body language are like pictures in that they are worth a million words, so the saying goes.
Least and most effective leadership styles exampling
Transformative leadership is ideal, in my opinion. It is selfless, and inspiration for the greater good of all, or otherwise most as ethical principles and philosophies would concur. It means to bring no harm but also go beyond the limb to help someone else grow. (Adams & Galanes, 2017, p. 258) Although I agree with the trade and exchange of transactional leadership, I think the transformative superior engages and pumps others’ enthusiasm. There is also the approach for the better good. While the best fit does not always fit a few, the principle is moral and ethical in genuinely looking for a seamless and beneficial. An example used is Dr. Martin Luther King, Jr. for his charismatic leading style. King saw pain and desired to bring love. He spoke in compassion. His will was to do good and reflect on character, not color. It is a toss-up of these two leaderships because compromising and collaborating are and give and take necessary. Give and take is like send and receive.
Least favorable in leading others is one that does not lead at all but rather with a distributive concept as an approach manipulates and sometimes coerces (Adams & Galanes, 2017, p. 260)  Dictating or push each other around; in such cases of power and control and a power struggle, no one wins. No person should necessarily Groupthink or be as distributed leadership indicates become a possession to another in a hierarchy. I feel there is no specific leader in this category, but instead, I see this more in communist and cult ideals. Many that come to mind are Stalin or Manson, extremists. 
Resources to grow as facilitators of groups
Some of the best resources to facilitate groups are growing communication and learning styles. Facilitation and cohesion in doing so can be encouraged and fostered through an assortment of courses. Interpersonal and intercultural are ideal for a foundation.
Three ways of communicating nonverbally and explain how this communication is harmful or helpful in your relationship with human services consumers
This question is challenging because my position mostly interacts electronically – by Notice of Action (NOA). Our correspondence is literal legal jargon and policy implemented with statutes following this federal provision or that state exception, so it is dry. It can come across as insensitive or demanding. I personalize my notices of action with a “Congratulations on your new baby!” Being human opposed to, “Federal law prohibits and state addendums requirements…section 1.22.3456(A).”I think this personalization shows that I see the family as an asset and of value. Even a sincere and heartfelt, “This is a difficult time. We understand how tolling the pandemic has proven to be. Know, we are working to process in your favor to meet your family’s needs.” Introduction and conclusion with a salutation and well wishes can set a kind tone. Lastly, I invite the client to call with questions or concerns and leave directives in my narratives. It is a deep jolt to feel forgotten or just another case number. Specific verbiage is also reassuring, leaving a voice message apologizing and then reiterating the discussion without disclosure, which can also be done on written fomrats. It sends a loud message that I cared enough to listen.
References
Adams, K., & Galanes, G. (2017). Communicating in groups: Application and skills (10th ed.). New York, NY: McGraw-Hill. eISBN-13: 9781259983283
Who Are English Language Learners?
Guided Response: Review several of your classmates’ posts, and compare the information to what you wrote. Discuss what information is new and what is already known. What information surprises you? Respond to at least two of your classmates, and provide recommendations to extend their thinking. For distinguished peer responses, respond with a minimum of five sentences that add to the conversation and, refrain from evaluative posts (i.e., You did a good job.).
MELISSA’S POST:
Who Are English Language Learners?
               English language learners are students and adults who are learning how to speak English as a second language. English Language Learners mostly come from non-English speaking homes or backgrounds and may have come into the United States after they were born, however, most children in the schools in the United States have been born in this country, but still, come from non-English speaking households. These students require modified and specialized instructions in both their academics and learning the English Language.
               The four domains of language are listening, speaking, reading, and writing. Listening and reading are receptive and observable, it is how we learn and process information whereas, Speaking and writing are productive and are how we express or communicate the information we have learned. To be proficient in each domain I have broken down the 4 domains below:
· Listening: Being proficient in listening means that you have developed a skill set that has enabled you to be able to give your full attention to the speaker, interprets to gain an understanding of what the speaker has said, and is able to engage the speaker throughout the conversation. As well as, to evaluate the spoken language in a variety of different situations.
· Speaking: Being proficient in speaking means that you can engage in oral communication in different situations and with different audiences. You will be able to use the proper words in context, understanding the proper definitions, pronunciations, timing, and the use of proper syllables.
· Reading: Being proficient in reading means that you can process and understand the written language. Being able to identify and evaluate text, symbols, and the written language with fluency.
· Writing: To be proficient in writing means that the writer can engage in written and oral communication and transfer that onto paper using the correct meaning in their text. The writer can write to several different audiences and situations.
Culture shock and other circumstances can affect the child’s ability to learn because the child is not feeling comfortable in their new environment. Being in shock hinders the child’s ability to learn because they are anxious, fearful, and insecure of their surroundings, those people around them, and the new culture they are in. If the child does not know how to communicate in their new environment, they become quiet and withdrawn. They do not understand how to ask for help or who to trust to get help from. All these issues will affect the child and their ability to learn. Therefore, it is imperative that we make the child feel as welcome as possible. Learning the child’s culture, some language, how to say their name, etc. will help the child to gain trust in you as their teacher and help to make the child feel more comfortable, thus enhancing their ability to learn.
References:
Deng, F., & Zou, Q. (2016). A study on whether adults’ second language acquisition is easy or not: From the perspective of children’s native language acquisition. (Links to an external site.) Theory and Practice in Language Studies, 6(4), 776-780. doi:10.17507/tpls.0604.15
Himmel, J. (n.d.). Language objectives: The key to effective content area instruction for English learners.  (Links to an external site.)Retrieved from http://www.colorincolorado.org/article/language-objectives-key-effective-content-area-instruction-english-learners (Links to an external site.)
Lieshoff, S. C., Aguilar, N., McShane, S., Burt, M., Peyton, J. K., Terrill, L., & Van Duzer, C. (2008, March). Practitioner toolkit: Working with adult English language learners. (Links to an external site.) Retrieved from http://www.cal.org/caela/tools/program_development/CombinedFiles1.pdf
Piper, T. (2015). Language, learning, and culture: English language learning in today’s schools. Retrieved from https://content.ashford.edu
· Chapter 1: The Faces of Diversity
· Chapter 2: Language, Learning, and Culture
FELECIA’S POST:
K-12
According to our textbook, “Language, Learning, and Culture” (Piper, 2015), ELL are students who are not born in United States and are between ages of 3-12. Other qualifications are they speak their Native Language (first) and English as their second or may not speak English at all. Also may have difficulties in writing, reading, speaking, and over understanding the English Language. However, there is a program in schools (elementary to high school) for students who may have difficulties with the following previous listed. This program is called ESL, English as a Second Language. ESL  is a program of techniques, methodology and special curriculum designed to teach ELL students English language skills, which may include listening, speaking, reading, writing, study skills, content vocabulary, and cultural orientation. ESL instruction is usually in English with little use of native language. (U.S department of Education, 2020)
In order for students to succeed in school they must be competent in these four domains/ skills, reading, writing, listening, and speaking. Reading is skill that all children need and is taught from the early ages.  Children who are ELL have acquire reading skills simultaneously with listening and speaking  because they have attend public school in early years. As for ELL who have not, this may harder but also have to learn the three domains simultaneously, but some will benefit from having the foundation of literacy in another language.  (Piper, 2015)
Writing means communication, more of social skill. ELLs, writing is easier and more purposeful if it is fully integrated into other language activities and with the broader curriculum. There are five stages of learning how to write, prewrite phrase/ brainstorming, draft phrase/ rough draft, revision phrase, editing phrase, and publishing. Also, writing needs to be link with other language sources because if not it would make it harder to learn. It is important to focus on oral language first, but for all learners it is sometimes necessary to concentrate on helping them develop comprehension and speaking ability before embarking on the journey to literacy. (Piper, 2015)
Listening is foundational all language skills.  It plays role in reading as well. For ELL, listening may be hard because they are listening to different language that not their own. Listening comprehension entails a complex network of cognitive processes. These processes involve the listener calling upon both linguistic and nonlinguistic knowledge. Linguistic knowledge includes information about the relevant sounds in a language (the phonemes), how they go together to form words, word identification and meaning, sentence structure, and discourse structure. Nonlinguistic knowledge refers to the real-world information and experience. (Piper, 2015)
Speaking  is the only skill that actually advances underlying proficiency in the language, it is nonetheless true that to be able to communicate in the language, learners have to be able to speak. With ELLs, if their pronunciation is good and they speak fluently with appropriate vocabulary, we usually judge them to be proficient. (Piper, 2015) 
Culture shock is the stress that people experience when they are immersed in a new and unfamiliar environment. For ELL, is learning something new, a different language and everything that comes with it. They are facing culture adaptions, between the school/ community and country. A ELL student may act out in class for number of reasons because one this something new and they do not understand what is going on. Two stress of learning new language and culture ways tends to be stressful especially if it is their first time here. Creating an environment in which all ELLs and, indeed, all children are comfortable requires sensitivity to these cultural elements. (Piper, 2015) To lessen the stress of an ELL, teachers should include their culture and other elements to assist with learning and adapting to new environment. 
Piper, T. (2015). Language, learning, and culture: English language learning in today’s schools. Retrieved from https://content.ashford.edu
U.S department of Education https://www2.ed.gov/about/offices/list/ocr/ell/glossary.html
Discussion – Reader Response
comment on the posts of two classmates
DILLON’S POST:
In this weeks lectures and reading assignments, I learned the basics of  writing many different essays; those being compare and contrast essays, analogy, division and classification essays, and definition essays. For this weeks essay i believe I will go with the compare and contrast essay. The division and classification essay, I didn’t fully understand. It seemed to resemble the compare and contrast essays alot.
BRIDGET’S POST:
In this week’s lesson I learned about several different types of  essays.  I learned about comparing, contrasting, analogy, definition, division and classification.  The compare/contrasting essay looks at a subject from two different points of view.  Comparing is finding the similarities and contrasting is finding the differences.  An analogy essay is telling about something unfamiliar by comparing it with something similar.  A definition essay means you put something in a general category and then add characteristics that distinguish it from others.  Lastly is the division/classification essay.  The division is a way of separating something something into parts and the classification is when we put something into groups that share characteristics.  
While reading this week’s lesson, I didn’t really understand how to write the defining essay.  The example was confusing.  When I was reading about the different types of essays this week, I thought about which one I wanted to use for my assignment.  At this point, I’m still confused about what will be the best fit for me, but I’m working on it.  
Discussion – It’s Classified
comment on the posts of two classmates 
ALYVIA’S POST:
There are 2 types of thinkers in life 
The way people think defines what type of person they are in life. There are two ways of thinking in life which include Positive thinking and Negative thinking. Many people are either classified as one or the other. 
1. Positive thinking. People who have a positive mind set tend to be the happiest. These types of people look for the good out of every situation. They typically believe everything happens for a reason and to not sweat the small things in life. Positive people tend to believe anything is possible. They create/conquer their own dream life goals. They are go getters and never settle for less. When walking in a room full of people, their positive energy feeds off on others. 
2. Negative thinking. People who have a negative mind set tend to have dark things going on internally or externally. These types of people will pull you down to their level to make sure you feel that dark energy they feel. They typically can drain other energies down. They always think of the worst things that can happen before taking time to see the good. These types of thinkers are always having the worst karma coming back to them from the universe. They always blame others for their problems. Nothing works out in their favor and the negative thinking continues.
It is always good to be a positive thinker although we all have tendencies of negative thoughts. The type of attitude you portray to the universe is what you will get back. So with that being said, being a positive thinker in any situation rather than a negative thinker because it will lead you to a better and happier life. 
DILLON’S POST:
The two types of different people Ive choose to write about are lazy people, and productive people. Although I feel that i may fall in both categories from time to time, there are many things that separate the two.
1. Productive people have many things in common. I feel that productive people start off their day early and get the most out of it. another thing is acting and executing the things you need to do at that moment and not putting it off till later. I feel that productive people also plan out their days and make a list of the things that need to be accomplished day to day. 
2. Lazy individuals usually sleep in most days, put off important tasks that need attention, and don’t plan ahead for anything. Pretty much the complete opposite of productive.
Discussion – It’s a Slang Thang
comment on the posts of two classmates
BRIDGET’S POST:
As a mother of three, I often hear my children use slang.  While many are common enough that most people wouldn’t pay much attention, there are a few that are just so off the wall that I find myself shaking my head in wonder.  One phrase that my two teenage sons use all the time is “bet”.  This word refers to the phrase, “bet me I won’t (or can’t) do something”.  For example, one day I took my boys to the park and my middle child wanted to play basketball.  So, while he was playing, he looked and me and said, “Mom, you think I can make this shot from here?”.  When I replied that I didn’t know, his immediate response was “bet”.  I find both boys using this term all the time.  “Think I won’t win this game?  Bet!”.  
KYLEIGH’S POST:
Throughout my 19 years of existence, slang has played a major impact on my everyday life. In my younger years, the word “fierce” was one I used to describe myself when I was really feeling it. As I matured, I referred to myself as a “savage”, this word held many meanings for me, but the most important one was when I used this word to describe my character. The word “savage” meant that my character made me a strong independent 14-year-old. However, now that I am grown and have seen the world, my favorite slang phrase is, “sauce up.” This phrase means to simply do. It is a word that implements actions. Although this phrase may not be common, it is used in my everyday life. Below this paragraph, I have listed a few examples that will hopefully bring more clarity.
EXAMPLES:
” I am about sauce up some eggs for breakfast.”
“Let’s sauce up a game night.”
“Sauce me the salt, please.”
“Saucing up some dinner tonight.”
“Sauce me some dance moves.”
Although these are just a few examples, rest assured the word “sauce” is used in my everyday life. 
Discussion – Birds of a Feather
comment on the posts of two classmates 
ALYVIA’S POST:
I can say my dad is my hero. I had a difficult childhood growing up. It was my dad, my mom, my older sister and myself living together. The difficulty did not come from a set of divorced parents it was simply because of the health issues my mom and sister struggled with. My mom is disabled and my sister has been struggling with a past traumatic brain injury since 08’. With that being said my dad had to step up and do way more than a normal dad would have to do in a family. When my sister had her accident, that is when my mom became very ill. Not only that, my dad’s own business hit the fan and he lost a lot of money. He had many hospital bills, personal bills, and family bills he had to pay for. He struggled because it was only him having to deal with that. Him having to not only take care of his sick family and myself, he had to continue to work hard to build his business back up. I can say my dad is a very ambitious person who works hard everyday to provide for my family no matter what the situation is. He has not only done his job as a father but has taken the mother role of my own mother in the things she could not do. I look up to him in that way. Growing up and watching everything my dad has done has inspired me to go get what I need to succeed in life. He showed me how life can be difficult and how to handle those situations in the right way. He is a very passionate person and I can relate to that. My dad is very smart and can accomplish a task without thinking hard about it. He works better underpressure rather than myself. Although I am smart, I suffer from Dyslexia which leads me to work a little bit harder and more organized than he does. Overall, he is now a very successful man. I strive to get where he is or even further than he is today!
KYLEIGH’S POST:
Over the years, I have considered several people as heroes in my life. In fact, a few examples would be my mom, Mitt Romeny, and even Ben Carson. However, when I think about the one I resonate with the most, Taylor Swift is the one that comes to mind. Although we share many similarities, we also differ in quite a few ways.
   Taylor Swift and I are similar in how we both were on the bleachers, and lost the boy we loved to the girl in a short skirt. However, we differed in the fact that she was in high school when this happened, and I was in middle school. Another way we are similar is our love for music. Taylor Swift and I both have a very diverse taste in music and change our tastes often. Despite our love for country music, we both share a similar enjoyment of pop culture. However, we differ in the fact that she gets paid millions for her music taste whereas I just get the simple pleasure of paying 9.99 a month to enjoy my tunes on apple music. We also share the same love for Grey’s Anatomy, but unlike mine, her favorite character is Meredith, and mine will always be Christina. Another similarity is our love for the Jonas Brothers, yet despite our mutual feelings, she dated one of them, and I just had the privilege of singing “burning love’ while watching them on a TV screen. As one can see Taylor Swift and I share many similarities, but it is our differences that make us human.
Discussion – Apples to Aardvarks
comment on the posts of two classmates
ALYVIA’S POST:
Has anything annoyed you so much you wanted to scream? I can answer that myself. As humans we come across people and things that drive us crazy!! A good example would be my sisters. Some days I can not stand being around them. It could be the smallest things they say or do that aggravate me. The slow screeching noise from the chalkboard and the continuous aggravation I feel from my sisters, gives off a feeling or pain that hurts to even listen. 
BRIDGET’S POST:
Children are like sponges.  They soak up everything that goes on or that is said around them.  They can also absorb your energy as well.  To be honest, they can zap your energy, but that’s a subject for a different day.  My daughter, who is almost eight, is very active and never stops going.  I hear my named called repeatedly, all time time.  I’ve never stopped to count, but it feels like she’s calling me half a million times a day on average.  Most of the time it is to tell me that just popped into her mind and it absolutely had to be told at that particular moment in time.  Waiting is not an option and patience is obviously not a virtue in eight-year-olds.  I assume that her haste is because she will have forgotten what she wanted to say thirty seconds from when she planned to say it.  Of course, telling me from afar is also not an option.  I have to be physically present in the same room and looking her in the eye for the news to count.  So, when I repeatedly hear “mom, Mom, MOM!”, I have to get up, go to where she is at that moment in time, and see what she needs.  Hence the sponge aspect.  Not only is she soaking up my conversations, my experiences and my attitude, she is also soaking up my energy by having to run to she what she wants every few seconds.

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PICOT Formulation : Abbade et al. (2016), states that the PICOT format is generally applicable to comparative studies or studies of association between exposure and outcome.  In breaking down this week’s assignment we will first look at the elements of each provided PICOT question.  The first question: P: Children 5-19 years old I: Use of motivation interviews during well-child visits to influence BMI, quality of life, and daily physical activity C: Practice as usual compared to motivational interviews during well-child visits O: The use of motivation interviews to influence BMI improvement, quality of life, and daily physical activity T: 8-10-week period In identifying key search terms for the first PICOT question, I would focus on motivational interviews, well-child visits, BMI, quality of life, physical activity, and an 8-10-week timeframe. In further investigating the first PICOT question, a research-based intervention that was being addressed was the use of motivational interviews.  Borrello et al. (2015), describe motivational interviewing as a collaborative, goal-oriented style of communication with particular attention to the language of change. It is designed to strengthen personal motivation for and commitment to a specific goal by eliciting and exploring the person’s own reasons for change within an atmosphere of acceptance and compassion.  The quantifiable outcomes were that those patients who received motivational interviews at their visit showed to have decreased BMI, improved/increased physical activity, and overall improved quality of life. This group of researchers used a meta-synthesis to quantify the research findings with the inclusion of six articles.  The use of anthropometric measures, the Motivational Interviewing Treatment Integrity (MITI) scale, and pre-and post-measurement data.  In the review of the research, I do not feel as though an eight to ten-week timeframe is long enough to measure true raw data of implementing the suggested intervention because maintained BMI decrease, improved physical activity, and quality of life need more time to be assessed. Eight to ten weeks does not allow time for life factors, such as finance, access, patient contact, and measurable outcomes.  One positive attribute is that there were pre and post interaction but follow-up and additional conversations/interviews need to be had at the 12-week mark, six-month mark and annual mark need to be addressed, to truly elicit valid outcomes. One of the biggest factors regarding weight is “relapse” or falling back into old patterns or habits and the value of the initial motivational interview could be lost. In the review of a secondary study that utilized randomized controlled trials, the timeframe of eight to ten weeks was not enough time to truly evaluate the effects of motivational interviews to improve BMI, physical activity and quality of life.  Three months was the time frame that this group utilized.  Luque et al. (2018), found that positive effects of a motivational interview on BMI and other obesity-related behavior outcomes. In the second PICOT question: P: Adult critical care patients I: Implementing research-based skincare integrity bundle C: Implementing research-based skincare integrity bundle compared to standard care practice influencing hospital-acquired pressure injuries O: Affect on the incidence of hospital-acquired pressure injures T:8-10-week period In identifying key search terms for the second PICOT question, I would focus on research-based skincare integrity bundle, adult critical care patients, current incidence with current standard care practice, and 8-10-week timeframe. In further investigation of PICOT question two, the research-based evidence was to evaluate the use of a multifaceted approach aimed at improving equipment, digital documentation and education on risk assessment, prevention, and treatment strategies regarding pressure injuries.  Goodman et al. (2018), reports a pressure injury as a localized injury and/or underlying tissue, usually over a bony prominence, resulting from sustained pressure (including pressure associated with shear).   The quantifiable outcome that this research group identified was that in-spite of all research applied they found despite multiple quality improvement initiatives, suggesting critically ill patients represent a unique challenge for reducing hospital-acquired pressure injuries (HAPI) for these patients at our institution (Goodman et al., 2018).  This group of researchers implemented a quality improvement initiative.  In this initiative, they sought to assess, available equipment, education, and digital documentation and utilized project champions to promote changes and evoke support.  Data was collected through the use of the International Pressure Ulcer/Injury Prevalence (IPUP) Survey and a Plan-Do-Study-Act (PDSA) methodology.  Although I do feel as though eight to ten weeks would be a quantifiably adequate amount of time to assess this patient group, this group of researchers evaluated the data over a year’s time. The biggest contingency, that would have an effect is the patient length of stay (LOS) in the critical care setting.  In today’s time, patients’ LOS is a measure that is taken into heavy consideration, and therefore evaluating the use of the addressed measures in the PICOT question could potentially yield short-term results but on the long-term scale, results show variability.  In considering implementing the research there are several things to be considered to allow this intervention to effective, these include, LOS, staffing ratios, patient condition, quality of care, intervention adjuncts, patient age, availability of funding to support this continued initiative.  Although patient benefit should be at the forefront of positive outcomes, sometimes budget is the key indicator in hindrance to yield effective outcomes. Overall, the use of the PICOT question can frame effective and quantifiable research outcomes, when seeking to elicit specific results.  As a DNP scholar effectively implementing a practice change, utilization of a quality PICOT question can potentially yield results that will evoke a positive change in healthcare changes, that will overall improve the healthcare paradigm as a whole. Abbade, L. P., Wang, M., Sriganesh, K., Mbuagbaw, L., & Thabane, L. (2016). Framing of research question using the PICOT format in randomised controlled trials of venous ulcer disease: A protocol for a systematic survey of the literature. BMJ Open, 6(11), e013175. https://doi.org/10.1136/bmjopen-2016-013175 (Links to an external site.) Borrello, M., Pietrabissa, G., Ceccarini, M., Manzoni, G. M., & Castelnuovo, G. (2015). Motivational interviewing in childhood obesity treatment. Frontiers in Psychology, 6. https://doi.org/10.3389/fpsyg.2015.01732 (Links to an external site.) Goodman, L., Khemani, E., Cacao, F., Yoon, J., Burkoski, V., Jarrett, S., Collins, B., & Hall, T. N. T. (2018). A comparison of hospital-acquired pressure injuries in intensive care and non-intensive care units: a multifaceted quality improvement initiative. BMJ Open Quality, 7(4), e000425. https://doi.org/10.1136/bmjoq-2018-000425 (Links to an external site.) Luque, V., Feliu, A., Escribano, J., Ferré, N., Flores, G., Monné, R., Gutiérrez-Marín, D., Guillen, N., Muñoz-Hernando, J., Zaragoza-Jordana, M., Gispert-Llauradó, M., Rubio-Torrents, C., Núñez-Roig, M., Alcázar, M., Ferré, R., Basora, J., Hsu, P., Alegret-Basora, C., Arasa, F., Venables, M., Singh, P., Closa-Monasterolo, R. (2019). The Obemat2.0 Study: A Clinical Trial of a Motivational Intervention for Childhood Obesity Treatment. Nutrients, 11(2), 419. https://doi.org/10.3390/nu11020419 I need a comment for this discussion board and use 3 sources no later than 5 years and at least 2 paragraphs.

Abbade et al. (2016), states that the PICOT format is generally applicable to comparative studies or studies of association between exposure and outcome.  In breaking down this week’s assignment we will first look at the elements of each provided PICOT question.  The first question:

P: Children 5-19 years old
I: Use of motivation interviews during well-child visits to influence BMI, quality of life, and daily physical activity
C: Practice as usual compared to motivational interviews during well-child visits
O: The use of motivation interviews to influence BMI improvement, quality of life, and daily physical activity
T: 8-10-week period

In identifying key search terms for the first PICOT question, I would focus on motivational interviews, well-child visits, BMI, quality of life, physical activity, and an 8-10-week timeframe.
In further investigating the first PICOT question, a research-based intervention that was being addressed was the use of motivational interviews.  Borrello et al. (2015), describe motivational interviewing as a collaborative, goal-oriented style of communication with particular attention to the language of change. It is designed to strengthen personal motivation for and commitment to a specific goal by eliciting and exploring the person’s own reasons for change within an atmosphere of acceptance and compassion.  The quantifiable outcomes were that those patients who received motivational interviews at their visit showed to have decreased BMI, improved/increased physical activity, and overall improved quality of life. This group of researchers used a meta-synthesis to quantify the research findings with the inclusion of six articles.  The use of anthropometric measures, the Motivational Interviewing Treatment Integrity (MITI) scale, and pre-and post-measurement data.  In the review of the research, I do not feel as though an eight to ten-week timeframe is long enough to measure true raw data of implementing the suggested intervention because maintained BMI decrease, improved physical activity, and quality of life need more time to be assessed. Eight to ten weeks does not allow time for life factors, such as finance, access, patient contact, and measurable outcomes.  One positive attribute is that there were pre and post interaction but follow-up and additional conversations/interviews need to be had at the 12-week mark, six-month mark and annual mark need to be addressed, to truly elicit valid outcomes. One of the biggest factors regarding weight is “relapse” or falling back into old patterns or habits and the value of the initial motivational interview could be lost.
In the review of a secondary study that utilized randomized controlled trials, the timeframe of eight to ten weeks was not enough time to truly evaluate the effects of motivational interviews to improve BMI, physical activity and quality of life.  Three months was the time frame that this group utilized.  Luque et al. (2018), found that positive effects of a motivational interview on BMI and other obesity-related behavior outcomes.
In the second PICOT question:

P: Adult critical care patients
I: Implementing research-based skincare integrity bundle
C: Implementing research-based skincare integrity bundle compared to standard care practice influencing hospital-acquired pressure injuries
O: Affect on the incidence of hospital-acquired pressure injures
T:8-10-week period

In identifying key search terms for the second PICOT question, I would focus on research-based skincare integrity bundle, adult critical care patients, current incidence with current standard care practice, and 8-10-week timeframe.
In further investigation of PICOT question two, the research-based evidence was to evaluate the use of a multifaceted approach aimed at improving equipment, digital documentation and education on risk assessment, prevention, and treatment strategies regarding pressure injuries.  Goodman et al. (2018), reports a pressure injury as a localized injury and/or underlying tissue, usually over a bony prominence, resulting from sustained pressure (including pressure associated with shear).   The quantifiable outcome that this research group identified was that in-spite of all research applied they found despite multiple quality improvement initiatives, suggesting critically ill patients represent a unique challenge for reducing hospital-acquired pressure injuries (HAPI) for these patients at our institution (Goodman et al., 2018).  This group of researchers implemented a quality improvement initiative.  In this initiative, they sought to assess, available equipment, education, and digital documentation and utilized project champions to promote changes and evoke support.  Data was collected through the use of the International Pressure Ulcer/Injury Prevalence (IPUP) Survey and a Plan-Do-Study-Act (PDSA) methodology.  Although I do feel as though eight to ten weeks would be a quantifiably adequate amount of time to assess this patient group, this group of researchers evaluated the data over a year’s time. The biggest contingency, that would have an effect is the patient length of stay (LOS) in the critical care setting.  In today’s time, patients’ LOS is a measure that is taken into heavy consideration, and therefore evaluating the use of the addressed measures in the PICOT question could potentially yield short-term results but on the long-term scale, results show variability.  In considering implementing the research there are several things to be considered to allow this intervention to effective, these include, LOS, staffing ratios, patient condition, quality of care, intervention adjuncts, patient age, availability of funding to support this continued initiative.  Although patient benefit should be at the forefront of positive outcomes, sometimes budget is the key indicator in hindrance to yield effective outcomes.
Overall, the use of the PICOT question can frame effective and quantifiable research outcomes, when seeking to elicit specific results.  As a DNP scholar effectively implementing a practice change, utilization of a quality PICOT question can potentially yield results that will evoke a positive change in healthcare changes, that will overall improve the healthcare paradigm as a whole.
Abbade, L. P., Wang, M., Sriganesh, K., Mbuagbaw, L., & Thabane, L. (2016). Framing of research question using the PICOT format in randomised controlled trials of venous ulcer disease: A protocol for a systematic survey of the literature. BMJ Open, 6(11), e013175. https://doi.org/10.1136/bmjopen-2016-013175 (Links to an external site.)
Borrello, M., Pietrabissa, G., Ceccarini, M., Manzoni, G. M., & Castelnuovo, G. (2015). Motivational interviewing in childhood obesity treatment. Frontiers in Psychology, 6. https://doi.org/10.3389/fpsyg.2015.01732 (Links to an external site.)
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I need a comment for this discussion board and use 3 sources no later than 5 years and at least 2 paragraphs.

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