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To Prepare:

• Review the Resources and reflect on the evolution of nursing informatics from a science to a nursing specialty.
• Consider your experiences with nurse Informaticists or technology specialists within your healthcare organization.

Post a description of experiences or observations about how nurse informaticists and/or data or technology specialists interact with other professionals within your healthcare organization. Suggest at least one strategy on how these interactions might be improved. Be specific and provide examples. Then, explain the impact you believe the continued evolution of nursing informatics as a specialty and/or the continued emergence of new technologies might have on professional interactions.

It is important to focus on lesbian, gay, bisexual, transgender, and queer (LGBTQ) health, and the healthcare disparities gap that exist in the LGBTQ community.  Health inequities and poor health outcomes among LBGTQ populations are a result of the adversity experienced by gender and sexually minoritized populations.  For instance, the ways in which LGBTQ health is often conceptualized and measured from a deficit-focused framework can have significant implications for health care access and uptake among LGBTQ populations.  LGBTQ health research has an important role to play in shifting the way that LGBTQ health is understood and measured in health policy and practice, which in turn has significant implications for health promotion strategies targeted at keeping LGBTQ populations healthy across the life course (Colpitts, & Gahagan, 2016).  In the Healthy People 2020, LGBT people are for the first time identified as a United States (U.S.) national health priority, with the Institute of Medicine (2011) concluding that insufficient information exists on the health of LGBT people.  One aspect of social justice is to better understand the social, structural, and institutional elements that create differential access to healthcare and health outcomes in this population.  In fact, there is accumulating evidence of health disparities among LGBT older adults, making LGBT older adults an at-risk population (Emlet, C., A. 2016).  

            Colpitts, & Gahagan, (2016) pointed out that the health needs and experiences of LGBTQ populations have generally been rendered invisible in mainstream health care systems and policies.  This is, in part, because LGBTQ health has traditionally been understood through a heteronormative framework whereby the health needs and experiences of LGBTQ populations are assumed to be similar to those of their age-matched heterosexual and/or cisgender peers.  The invisibility of LGBTQ health needs and experiences has significant implications in terms of the provision of evidence-based, culturally competent health care.  The Virginia Transgender Health Initiative Study found that the health care system was the most commonly cited area where transgender individuals experienced discrimination.  Public health policy and programming interventions have traditionally focused on individual-level indicators of health and on reducing the risk for negative health outcomes by changing individual, ‘lifestyle’ behavior such as diet, exercise, and drug and alcohol use.  Existing LGBTQ health research has demonstrated that social stigma, discrimination and victimization experienced by LGBTQ populations may affect uptake rates of preventative health screening programs and health care services.  It is equally important to note that LGBTQ populations may also experience negative determinants of health such as homelessness, social exclusion and poverty at higher rates than their age-matched heterosexual and/or cisgender peers.  Population-based initiatives that facilitate ‘coming out’ without fear of marginalization or violence are central to promoting the health of LGBTQ populations across the life course (Colpitts, & Gahagan, 2016).  Emlet (2016) stated that there are sub-groups within the LGBT older adult population, including those who identify as bisexual, transgender, older than age 80, and living with HIV infections may be at greatest risk for economic insecurity and a subsequent impact on health and healthcare access, which contributes further to health disparities.  Emlet (2016) added that important disparities have been noted between older and younger adults living with HIV infection as well.   It is said that older adults living with HIV are more likely to live alone and be socially isolated than their younger peers.

            LGBTQ health research has a significant role to play in shifting how LGBTQ health is understood and measured, and, more specifically, the ways in which health research evidence is used to inform health policy and practice.  However, given the longstanding focus on the risks for poor health outcomes among LGBTQ populations, including rates of sexually-transmitted infections (STI) and human immunodeficiency virus (HIV) infection, smoking, obesity and depression/suicidal ideation, a conceptual shift toward health-promoting LGBTQ research approaches is warranted.  According to the World Health Organization, health promotion approaches focus on the “…process of enabling people to increase control over, and improve, their health”, which includes “a wide range of social and environmental interventions”.  It is important to note that health promotion recognizes the significance of both modifiable and non-modifiable determinants of health, and emphasizes upstream, preventative approaches, which include the development of healthy public policy, in contrast to deficit-focused approaches (Colpitts, & Gahagan, 2016).

            People who live in poverty are less healthy than those who are financially better off, regardless of whether the benchmark is mortality, the prevalence of acute or chronic diseases, or mental health.  Approximately 26 percent of adults ages 65 and older in the United States live at or below 200 percent of the federal poverty level.  In contrast, in a national, non-representative sample of LGB older adults (ages 50 and older) Fredriksen-Goldsen and colleagues (2012) found nearly a third of the LGB older adults enrolled in the study lived at or below that economic threshold (Emlet, C., A. 2016).  

            In conclusion, while the needs of this population are receiving additional attention at local, state, and national levels, continued advocacy for improving access to care and working to remove disparities are critical.  An emerging concern for many LGBT older adults is competent and compassionate long-term care.  The future of care and compassionate service delivery for these individuals will require us to learn to identify and build from their naturally emerging strengths (such as community identity, mastery, and social support), improve understanding and competence among providers as to the unique needs and historical consequences of this population, and continually work toward fairness and equity for all older adults (Emlet, C., A. 2016).  Many people do not want the LGBTQ community to have anything because of religious beliefs for instance.  We, as a society, have to do our best in order to close the healthcare disparities gap in the LGBTQ community. 

References

Colpitts, E., & Gahagan, J. (2016). The utility of resilience as a conceptual framework for

            understanding and measuring LGBTQ health. International Journal for Equity in

            Health, 15, 1–8. doi.org/10.1186/s12939-016-0349-1

Emlet, C., A. (2016). Social, Economic, and Health Disparities Among LGBT Older

            Adults. Generations: Journal of the American Society on Aging, 40(2), 16.

Thank you for sharing your informative post on the role of the DNP and elaborating on well-defined policies. I appreciate you adding about instilling change and the importance of training and educating staff. Thank you for your post! Embracing changes and the perception of the need for the change by the nurses and staff is important. 

1-Have you seen changes not work? 

2-What can be learned from the scenario when it just didn’t get implemented?

I need to answer these 2 questions separated and use 2 sources no later than 5 years.

Presbycusis refers to the loss of hearing that steadily happens in many people as they age. Loss of hearing is a typical issue related to aging. “Approximately 30-35% of adults 65 years and older suffer from hearing loss. Studies also show that 40 to 50% of individuals 75 years and older suffer from hearing loss” (Purnami et al., 2020, p. 1). “Some of the signs and symptoms of presbycusis are slurred or mumbled speech, conversations that are difficult to comprehend, high pitched sounds such as “th” and “S” which are tough to hear, overly loud sounds and tinnitus” (Zhang et al., 2020, p. 2).Sensorineural hearing misfortune is brought about by issues of the auditory nerve or inner ear. Presbycusis is, for the most part, a sensorineural hearing issue. Steady changes in the inner ear commonly cause this issue. The combined impacts of repeated subjection to everyday construction work or loud traffic sounds, noisy workplaces, devices that make noise, and loud music can lead to sensorineural hearing issues. The sensorineural hearing usually begins because of lost hair cells which are tactile receptors of the inner ear. This hearing loss can also happen due to genetic and aging factors, different ailments, and adverse effects of specific prescriptions like ibuprofen and individual anti-infection agents (Purnami et al., 2020). Presbycusis might be brought about by changes in the blood supply channels towards the ear due to cardiovascular illnesses, hypertension, vascular conditions brought about by diabetes, or other circulatory issues.The hearing loss can be subtle, moderate, or profound. Sometimes, presbycusis may be a conductive hearing problem, which means loss of sound affectability is brought about by variations from the norm of the outer ear and middle ear. The inconsistencies may incorporate the tympanic membrane’s decreased capability, also called the eardrum or diminished capacity of the three small bones found in the ear that convey ripples of sound from the tympanic membrane to the inner ear. The presbycusis differential diagnosis encompasses noise exposure, trauma, perilymph fistula, autoimmune disease, otosclerosis, Meniere disease, metabolic dysfunction, infection, genetically inherited presbycusis, and exposure to ototoxic agents (Cheslock, 2020).Some of the interventions which are available for patients with presbycusis to remove the wax blockage, surgical procedures whereby a doctor can insert tiny tubes that assist in draining the ear if the patient has repeated infections, use of cochlear implants if the patient has a severe hearing impairment, or use of hearing aids if the inner ear is damaged (Zhang et al., 2020).There are three different kinds of retinal and macular diseases. These are:• Stargardt disease is an inherited retinal issue that usually leads to vision loss in children or adults.• Wet macular degeneration is a severe eye disorder causing blurred vision and is caused by unusual leaking blood vessels that leak blood or fluid into the macular.• Dry macular degeneration is the deterioration of the retina whereby a tiny yellow deposit called drusen forms under the retina.

ReferencesCheslock, M. (2020). Presbycusis. PubMed. https://pubmed.ncbi.nlm.nih.gov/32644646/. (Links to an external site.)Purnami, N., Mulyaningsih, E. F., Ahadiah, T. H., Utomo, B., & Smith, A. (2020). Score of Hearing Handicap Inventory for the Elderly (HHIE) Compared to Whisper Test on Presbycusis. Indian Journal of Otolaryngology and Head & Neck Surgery, 1–5. https://doi.org/10.1007/s12070-020-01997-5  (Links to an external site.)Zhang, W., Yu, Z., & Ruan, Q. (2020). Presbycusis-Related Tinnitus and Cognitive Impairment: Gender Differences and Common Mechanisms. Multiple Chronic Conditions – Overview and Management of Chronic Disease Clusters. https://doi.org/10.5772/intechopen.90956 (Links to an external site.).Hearing Eye Age-Related Diseases, discussion board week 5.docx

REPLY 2

Hearing and Eye Age-Related Diseases

Over the past years, hearing and age-related diseases have been a threat to human lives and are a rising difficulty for most health professionals. In society, the widespread of low vision and hearing problems have increased continuously with age among all the racial and ethnic categories. Similarly, age-related and hearing diseases are expensive and, therefore, a menace to the aged’s potentiality to live singly. In the 2013 Eye and Hearing Prevalence Research Group report, it was revealed that the hearing and age-related diseases double each year; also, one among the 28 American adults above 40 years are associated with eye and hearing diseases (Teutsch & Rechel, 2012). As such, the focus of this essay is threefold: To define presbycusis and identify its signs and symptoms, etiology, and differential diagnosis. To create three interventions-education measures with a patient with presbycusis and lastly, to list, define, and elaborate on three different retinal and macular diseases age-related.

Presbycusis, its Signs and Symptoms, Etiology, and Diagnosis

Presbycusis refers to the loss of hearing, which frequently takes place in aged individuals. The disorder mostly limits the hearing of high pitched sounds. For instance, the aged find it challenging to hear closer sounds of birds’ chirping or ringing of a phone.  The symptoms include the address of other individuals seeming slurred, the challenge in hearing and telling high pitch sounds, difficulty in understanding conversations, the occurrence of tinnitus, and particular sounds seeming or overloud or irritating (Teutsch & Rechel, (2012). Presbycusis’ diagnosis and etiology reveal that the disorders cause it regarding the inner or auditory nerve. The changes in the significant year as an individual gets older cause the disorder. The disorder can also be caused by overloud sounds such as traffic, equipment, or music. Additionally, it can be caused by the changes in the blood supply in the body due to the conditions of heart diseases or high blood pressure. 

Interventions-Education Measures of a Patient with Presbycusis

There are various interventions prescribed for hearing disorders. In surgical intervention, there is the implant of the cochlear. The implant process involves a multiplex electronic device that acts as a replacement of the internal ear cochlea. The process is essentials in enabling the patients to understand the sound and speech wave. Secondly is the management intervention. The intervention involves the devices of the hearing aids and aural rehabilitation. The hearing aid is essential in helping advance the hearing of the aged. In pharmaceuticals intervention, includes the transcription of pharmaceutical drugs such as Tankan, eblesen, and antioxidant therapy. The drugs are essential in the treatment of the hearing disorder. 

Retinal and Macular Diseases Age-Related

There are different retinal and macular diseases related to age. Firstly is the dry Age-Related Macular Degeneration (AMD). It is a condition that involves the macula layers getting continually thinner and defunctioning of their functionality. In its initial stages, the color of the macula changes, and tiny drusen are seen, which leads to the deterioration of the retina.  In wet AMD, newly advanced blood vessels implant in the choroid layer just next to the retina. It is also called choroidal neovascularization. The newly created vessels are usually weak leading to the leaking of fluids, lipids, and blood, which gets into the retina, causing scar tissue formation, which stops the functionality of the retina cells (O’Keefe-McCarthy, 2009). Lastly, the Stargardt is also another type of macular degeneration, majorly caused by a recessive gene in individuals. 

In conclusion, hearing and age-related eye disorder is a significant issue that needs various recommendations. Presbycusis is a hearing disorder that occurs in older adults. Its symptoms are associated with the difficulty of understanding the sound waves. The intervention measures for a patient with Presbycusis include management intervention, surgical intervention, and pharmaceutical intervention. The retinal and macular diseases age-related include the wet AMD, Stargardt, and the dry AMD.

References

O’Keefe-McCarthy, S. (2009). Technologically-mediated nursing care: The impact on moral agency. Nursing Ethics, 16(6), 76-796.

Teutsch, S., & Rechel, B. (2012). Ethics of resource allocation and rationing medical care in a time of fiscal restraint: US and Europe. Public Health Reviews, 34(1), 1-10.

All replies must be constructive and use literature where possible

Your assignment will be graded according to the grading rubric.

200 words each reply

Please see attachment

Review your problem or issue and the cultural assessment. Consider how the findings connect to your topic and intervention for your capstone change project. Write a list of three to five objectives for your proposed intervention. Below each objective, provide a one or two sentence rationale.

After writing your objectives, provide a rationale for how your proposed project and objectives advocate for autonomy and social justice for individuals and diverse populations.

What types of advocacy exist for nurses today?  Certainly we can see how there are many ways and different groups to advocate for as a nurse. 

Definition of Advocate:

1. Defends or promotes the rights of others.
2. Changes systems to meet the needs of others.
3. Empowers and promotes self-determination in others.
4. Promotes autonomy of diverse cultures.
5. Ensures respect, equality, and dignity for others.
6. Cares for the humanness of all.

Instructions:

1. Examine the term advocate as defined above, and think of how advocacy can be demonstrated in everyday practice.
2. Select at least three (3) of the factors that make up the definition and give a very specific explanation of how you or someone you know has demonstrated they were/are an advocate. 
3. Your paper should be:
   • Typed according to APA style for margins, formatting and spacing standards
   • Typed into a Microsoft Word document 

The dissemination of EBP results serves multiple important roles. Sharing results makes the case for your decisions. It also adds to the body of knowledge, which creates opportunities for future practitioners. By presenting results, you also become an advocate for EBP, creating a culture within your organization or beyond that informs, educates, and promotes the effective use of EBP.

To Prepare:

• Review the final PowerPoint presentation you submitted in Module 5, and make any necessary changes based on the feedback you have received and on lessons you have learned throughout the course.
• Consider the best method of disseminating the results of your presentation to an audience.

To Complete:

Create a 5-minute, 5- to 6-slide narrated PowerPoint presentation of your Evidence-Based Project.

• Be sure to incorporate any feedback or changes from your presentation submission in Module 5.
• Explain how you would disseminate the results of your project to an audience. Provide a rationale for why you selected this dissemination strategy.

Submit Part 6, your revised PowerPoint presentation of your Evidence-Based Project.

see attachments.

 Please follow the instruction below for this assignment

ZERO PLAGIARISM

3 PAGES

FIVE REFERENCES

In your role, you must understand group processes and stages of formation, as this will help you develop groups and determine an individual’s appropriateness for group therapy. Whether you are at the beginning stages of group formation or facilitating a session for a developed group, it is important to consider factors that may influence individual client progress. For this Assignment, as you examine the video Group Therapy: A Live Demonstration in this week’s Learning Resources, consider the group’s processes, stages of formation, and other factors that might impact the effectiveness of group therapy for clients.

Learning Objectives

Students will:

• Analyze group processes and stages of formation
• Analyze curative factors of groups
• Analyze the impact of curative factors on client progress
• Recommend strategies for managing intragroup conflict

To prepare:

• Review this week’s Learning Resources and reflect on the insights they provide on group processes.
• View the media, Group Therapy: A Live Demonstration, and consider the group dynamics.

The Assignment

In a 2- to 3-page paper, address the following:

• Explain the group’s processes and stage of formation.
• Explain curative factors that occurred in the group. Include how these factors might impact client progress.
• Explain intragroup conflict that occurred and recommend strategies for managing the conflict. Support your recommendations with evidence-based literature.