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7-9 page paper over the following

7-9 page paper over the following.

The book America’s Bitter Pill focuses on the politics surrounding the drafting and implementation of the Affordable Care Act. Author Steven Brill uses the ACA as a means to explore the bitter partisanship, special interest power, and political messaging that has become intertwined in our democracy and the battle for an equitable, efficient healthcare system. It’s Even Worse Than It Looks presents an incisive investigation into the political gridlock that has choked Congressional action for the past few decades. Brookings Institution senior fellow Thomas Mann and American Enterprise Institute (and life-long Republican) scholar Norman Ornstein look at the history of high-stakes, confrontational politicians from Newt Gingrich to Mitch McConnell, and search for the sources of America’s increasing partisanship. Directions: Please address the following questions with three pages allotted for each question (12 point, times new roman, 1 inch margins, double spaced) (so 9 pages total, 1 page for each section). Good answers will use specific examples from the book to support your argument. To ease grading, please structure your essays to match the formatting of the questions below. If you want to note specific passages or notes in the book you should use in text citations e.g. (Brill, p136) or (M&O, p95). The use of in text citations would be a good way to ensure that you do not plagiarize and will show that you are drawing examples from the required reading. You do not need to provide complete citations for the assigned books. If you choose to use any additional sources (which should not be necessary), please use APA citation format. You should work alone on this assignment, though you can discuss the books and questions with other students. Steven Brill describes that in 2007 – 2008, the Senate, while slow in deliberation, was genuinely interested in moving America forward and advancing solutions to America’s health care problems. However, not long after Obama’s election, health care became an extremely polarizing topic. A)Describe some of the policy ideas in health care reform that appeared to be bipartisan – that is, there ought to be supporters among both Republicans and Democrats.B)What changed during the course of the health care debate that led to the bill not getting a single Republican vote? C)Throughout Obama’s presidency, House Republicans voted to repeal or cripple the Affordable Health Care Act (AHCA) dozens of times. And in the 2012, 2014, and 2016 elections, Republicans made this a central promise of their campaigns. Yet once ascending to power in the House, Senate, and Presidency, they were unable to generate sufficient votes to do so. What explains this paradox? 2. Some journalists and scholars (across the political spectrum)[1] have argued that U.S. democracy is on a precipice of totalitarianism, or, at best, “illiberal democracy”. These people point to the failure of democratic institutions; the collapse of institutional norms; the disregard for safeguards such as the electoral college; and the rise of a leader who has little regard for these democratic norms, institutions, and the Constitution. Mann and Ornstein, prior to Trump’s candidacy, highlighted collapsing institutional rules and norms, arguing that U.S. democracy had become dysfunctional. A)Mann and Ornstein describe a collapse of institutional rules and norms in Congress that have contributed to dysfunction in Congress. Discuss 3 rules and norms that have been disrupted over the past decade, and how these would lead to the rise of illiberal democracy. B)Why were these norms disrupted? What was the origin of disruption? Did this just happen? Or was it a calculated strategy? Explain.C)Do you think that American democracy is dying? To what extent does the 2016 election represent a temporary or permanent change in America’s political landscape? What evidence, from the Mann and Ornstein book, supports your perspective? 3) Ornstein and Mann argue that there are a number of major policy issues facing the US: Climate Change; long term debt issues and fiscal (tax) reform; and growing inequality. In America’s Bitter Pill, Brill describes Obama’s political strategy as a search for bipartisanship and compromise to solve a major policy issue (Health Care Coverage & Costs). A)Why did Obama attempt to pursue a strategy of bipartisanship and compromise? What were the consequences of this strategy?B)Considering the political climate that Mann and Ornstein describe, how might these efforts be viewed in the future? What needs to happen to achieve political compromise in the future?C)Discuss 3 major political lessons from the Health Care Reform experience that might help improve the prospects for addressing other major policy issues. [1] See the following essays as examples:
7-9 page paper over the following

Allegany College of Maryland Java Programming Questions.

NO PLAGERISMWrite a complete java program that prompts the user for their name and two numbers. The correct j ava methods and parameters must be passed to find the length of the name entered and return “TRUE” if the sum of numbers is even, or FALSE if the sum of numbers is odd:Sample ProgramPlease enter a name and I will tell you the length of the name enteredJohnThen length of the name John is 4 Please enter 2 positive #’s and I will return True if the sum of numbers is even of False if the sum is odd !65 The sum is false
Allegany College of Maryland Java Programming Questions

Conduct an internet search on their respective tax bases (i.e. how much income does each district receive from its residents). Now conduct an internet search of each district’s racial composition. Note any differences in the racial composition of each district and how they correspond to funding for public education.

Wichita State University ? Informed Opinions through Causal Chains Discussion

Wichita State University ? Informed Opinions through Causal Chains Discussion.

Unit 8: Informed Opinions through Causal ChainsWriting Assignment and RubricWriting AssignmentWrite a multi-paragraph essay identifying at least two of your personal or lifestyle choices and explain the positive and/or negative effects they have on the environment. Support your opinion with effective examples showing the impact of your individual actions externally (close to home and/or on a larger scale). Make sure you AVOID logical fallacies, meaning that your connections between causes and consequences are carefully considered and sufficiently proven.Your response should clearly explain and describe at least two personal choices and use details to show how each choice impacts the environment, close to home, out in the world, or both. To do a good job you need to convince the reader that what you have to say, although personal, impacts them in some way. Ultimately, why should your reader care that these choices lead to these consequences? This means each paragraph should include a personal choice, the effects of this choice, and the points that show why this information matters to your reader. You should have at least two body paragraphs, depending on how many personal choices you plan to discuss, an introduction that is attention-grabbing and reveals your argument (your thesis goes here), and a conclusion that offers some memorable final thoughts on the connection between individuals and their environments.In all, you will have at least four paragraphs, depending on the number of personal choices you include. Each paragraph should have a unique link between it and the one that comes after it. The order of these points is up to you, but make sure you have placed each paragraph purposefully and that the body paragraphs show causal relationships (choice causes effect).Remember that you need to write sound arguments, so you can avoid logical fallacies. Refer to the foundation lesson on this topic if you need examples of logical fallacies.The grading rubric below will help you develop your paper.Reading Material…RubricYour essay will be graded using five separate categories: Purpose, Thesis Statement, Supporting Ideas, Paragraph Development, and Grammar & Punctuation. Each of these five categories will be rated as Proficient, Developing, or Needs Improvement.Proficient means that you have met the standards of an effective analysis essay. Developing means you have partially met the standards of an analysis essay, but it needs some revision. Needs Improvement means you did not meet the standards of an analysis essay.Multi-Paragraph Causal EssayProficientDevelopingNeeds ImprovementPurpose(exploring causal relationshipsClearly presents two personal choices and thoroughly analyzes the effects of those choices on the environment.Includes a partial causal analysis, but doesn’t fully develop the claim and/or presents an unoriginal view of the topic.Does not include causal elements or is not fully developed.Thesis StatementClearly presents a thesis statement that is interesting and shows how the essay will progress.Vaguely identifies a functional but uninteresting thesis statement. The overall essay direction is present butinconsistent.Does not include a thesis statement and the essay’s direction is unclear.Supporting Ideas(use of Major and Minor Details)Uses solid examples to support the thesis statement and prove important points; avoids logical fallacies.Partially uses examples as proof; lacks support for some important points; mostly avoids logical fallacies.Does not develop or provide examples to illustrate the claim; argument contains logical fallacies.Paragraph Development (strength of introduction, conclusion, and coherency)Smoothly connects ideas between/within paragraphs in a purposeful manner; introduction and conclusion make interesting, effective statements about the topic.Ideas between/within paragraphs are partially connected or moderately purposeful; introduction and conclusion are present but not effective.Missing connection between ideas; purpose of content is unclear; incomplete introduction and conclusion.Grammar & PunctuationEssay contains appropriate use of semicolons, colons. When used, dates and addresses contain correct commas, and numbers are written correctly.Essay needs further editing and/or contains some problems with semicolons, colons, commas, and/or numbers.Displays little attention to editing or correct usage of semicolons, colons, commas, and/or numbers.
Wichita State University ? Informed Opinions through Causal Chains Discussion

Communication Skills in Nursing

online homework help Share this: Facebook Twitter Reddit LinkedIn WhatsApp Communication is a vital part of the nurses role. Theorists such as Peplau (1952), Rogers (1970) and King (1971) all emphasise therapeutic communication as a primary part of nursing and a major focus of nursing practice. Long (1992) further suggests that communication contains many components including presence, listening, perception, caring, disclosure, acceptance, empathy, authenticity and respect. Stuart and Sundeen (1991, p.127) warn that while communication can facilitate the development of a therapeutic relationship it can also create barriers between clients and colleagues. Within Healthcare, communication may be described as a transitional process that is dynamic and constantly changing (Hargie, Saunders and Dickenson, 1994, p.329). It primarily involves communication between the nurse and the patient. If the interaction is to be meaningful, information should be exchanged; this involves the nurse adopting a planned, holistic approach which eventually forms the basis of a therapeutic relationship. Fielding and Llewelyn (1987) contend that poor communication is the primary cause of complaints by patients. This is supported by Young (1995) who reports that one third of complaints to the Health Service Commissioner were related to communication with nursing staff. Studies by Boore (1979) and Devine and Cook (1983) demonstrate that good communication actually assisted the rate of patient recovery thus reducing hospital admission times. This suggests that good communication skills are cost effective. In this assignment, I have reflected on situations that have taken place during my clinical work experience. These situations have helped to develop and utilise my interpersonal skills, helping to maintain therapeutic relationships with patients. In this instance, I have used Gibbs’ (1988) reflective cycle as the framework for my reflection. Gibbs’ (1988) reflective cycle consists of six stages in nursing practice and learning from the experiences. Description of the situation that arose. Conclusion of what else would I could have done. Action plan is there so I can prepare if the situation rises again. Analysis of the feeling Evaluation of the experience Analysis to make sense of the experience My Reflective Cycle Baird and Winter (2005) illustrate the importance of reflective practice. They state that reflecting will help to generate knowledge and professional practice, increase one’s ability to adapt to new situations, develop self esteem and greater job satisfaction. However, Siviter (2004) explains that reflection is about gaining self confidence, identifying ways to improve, learning from one’s own mistakes and behaviour, looking at other people’s perspectives, being self aware and making future improvements by learning from the past. I have come to realise that it is important for me to improve and build therapeutic relationships with my patients by helping to establish a rapport through trust and mutual understanding, creating the special link between patient and nurse as described by Harkreader and Hogan (2004). Peplau (1952), cited in Harkreader and Hogan (2004), notes that good contact in therapeutic relationships builds trust as well as raising the patient’s self esteem, often leading to the patient’s personal growth. Ruesh (1961), cited in Arnold and Boggs (2007), states that the purpose of therapeutic communication is to improve the patient’s ability to function. Therefore, in order to establish a therapeutic nurse/patient interaction, a nurse must possess certain qualities e.g. caring, sincerity, empathy and trustworthiness (Kathol, 2003) (P.33). These qualities can be expressed by promoting effective communication and relationships by the implementation of interpersonal skills. Johnson (2008) defines interpersonal skills as the ability to communicate effectively. Chitty and Black (2007, p 218) mention that communication is the exchange of information, thoughts and ideas via simultaneous verbal and non verbal communication. They explain that while verbal communication relies on the spoken word, non-verbal communication is just as important, consisting of gestures, postures, facial expressions, plus the tone and level of volume of one’s voice. Thus, my reflection in this assignment is based on the development of therapeutic relationships between the nurse and patient using interpersonal skills. My reflection is about a particular patient, to whom, in order to maintain patient information confidentiality (NMC, 2004), I will refer to as Mr R. It concerns an event which took place when I was working on a surgical ward. Whilst there were male and female wards, female and male surgical patients were encouraged mingle. On this particular day, I noticed that one of the male patients was sitting alone on his bed. This was Mr R., a 64 year old gentleman who had been diagnosed with inoperable cancer of the pancreas, with a life expectancy of 18-24 months. He was unable to control his pain, and whilst some relief could be provided by chemotherapy, Mr R. had a good understanding of his condition and knew that there was no cure available. He was unable to walk by himself and always needed assistance even to stand up or sit down. Because of his mobility problems I offered to get him his cup of tea and I then sat with him as he was lonely. I would now like to discuss the feelings and thoughts I experienced at the time. Before I gave Mr R. his cup of tea, I approached him in a friendly manner and introduced myself; I tried to establish a good rapport with him because I wanted him to feel comfortable with me even though I was not a family member or relative. When I first asked Mr R. if I could get him a cup of tea, he looked at me and replied “I have asked the girl for a cup of tea, I don’t know where she is.” I answered “Well, I will see where she is and if I can’t find her, I will gladly get one for you Mr R”. In doing this, I demonstrated emphatic listening. According to Wold (2004, p 13), emphatic listening is about the willingness to understand the other person, not just judging by appearance. Then I touched MrR.’s shoulders, kept talking and raised my tone a little because I was unsure of his reaction. At the same time, I used body language to communicate the action of drinking. I paused and repeated my actions, but this time I used some simple words which I though Mr R. would understand. Mr R. looked at me and nodded his head. As I was giving him his cup of tea, I maintained eye contact as I didn’t want him to feel shy or embarrassed. Fortunately, using body language helped me to communicate with this gentleman. At the time I was worried that he would be unable to understand me since English is not my first language but I was able to communicate effectively with him by verbal and non-verbal means, using appropriate gestures and facial expressions. Body language and facial expressions are referred to as a non-verbal communication (Funnell et al. 2005 p.443). I kept thinking that I needed to improve my English in order for him to better understand and interpret my actions. I thought of the language barrier that could break verbal communication. Castledine (2002, p.923) mentions that the language barrier arises when individuals come from different social backgrounds or use slang or colloquial phrases in conversation. Luckily, when dealing with Mr R. the particular gestures and facial expressions I used helped him to understand that I was offering him assistance. The eye contact I maintained helped show my willingness to help him; it gave him reassurance and encouraged him to place his confidence in me. This is supported by Caris-Verhallen et al (1999) who mention that direct eye contact expresses a sense of interest in the other person and provides another form of communication. In my dealings with Mr R., I tried to communicate in the best and appropriate way possible in order to make him feel comfortable; as a result he placed his trust in me and was more co-operative. Evaluation In evaluating my actions, I feel that I behaved correctly since my actions gave Mr R. both the assistance he needed and provided him with some company. I was able to successfully develop the nurse-patient relationship. Although McCabe (2004, p-44) would describe this as task centred communication – one of the key components missing in communication by nurses – I feel that the situation involved both good patient and task centred communication. I feel that I treated Mr R. with empathy because he was unable to perform certain tasks himself due to his mobility problems and was now refusing chemotherapy. It was my duty to make sure he was comfortable and felt supported and reassured. My involvement in the nurse-patient relationship was not restricted to task centred communication but included a patient centred approach using basic techniques to provide warmth and empathy toward the patient. I found that I was able to improve my non-verbal communication skills in my dealings with Mr R. When he first mentioned having chemotherapy, he volunteered very little information, thus demonstrating the role of non-verbal communication. Caris-Verhallen et al (1999, p.809) state that the role of non-verbal communication becomes important when communicating with elderly people with incurable cancer (Hollman et al 2005, p.31) There are a number of effective ways to maximise communication with people, for example, by trying to gain the person’s attention before speaking – this makes one more visible and helps to prevent the person from feeling intimidated or under any kind of pressure; the use of sensitive touch can also make them feel more comfortable. I feel that the interaction with Mr R. had been beneficial to me in that it helped me to learn how to adapt my communication skills both verbally and non-verbally. I used body language to its full effect since the language barrier made verbal communication with Mr.R. difficult. I used simple sentences that Mr R. could easily understand in order to encourage his participation. Wold (2004, p.76) mention that gestures are a specific type of non-verbal communication intended to express ideas; they are useful for people who have limited verbal communication skills. I also used facial expressions to help encourage him to have chemotherapy treatment which might not cure his problem but would give him some relief and make him feel healthier. Facial expressions are the most expressive means of non-verbal communication but are also limited to certain cultural and age barriers (Wold 2004 p.76). My facial expressions were intended to encourage Mr R. to reconsider his decision with regard to chemotherapy treatment. Whilst I could not go into all the details about his treatment, I was able to advise him to complete his treatment in order to alleviate his symptoms. Analysis In order to analyse the situation, I aim to evaluate the important communication skills that enabled me to provide the best level of nursing care for Mr R. My dealings with Mr R. involved interpersonal communication i.e. communication between two people (Funnell et al 2005, p-438).I realised that non-verbal communication did help me considerably in providing Mr R. with appropriate nursing care even though he could only understand a few of the words I was speaking. I did notice that one of the problems that occurred with this style of communication was the language barrier but despite this I continued by using appropriate communication techniques to aid the conversation. Although it was quite difficult at first, the use of non verbal communication skills helped encourage him to speak and also allowed him to understand me. The situation showed me that Mr R. was able to respond when I asked him the question without me having to wait for an answer he was unable to give. Funnell et al (2005, p 438) point out that communication occurs when a person responds to the message received and assigns a meaning to it. Mr R. had indicated his agreement by nodding his head. Delaune and Ladner (2002, P-191) explain that this channel is one of the key components of communication techniques and processes, being used as a medium to send out messages. In addition Mr R. also gave me feedback by showing that he was able to understand the messages being conveyed by my body language, facial expression and eye contact. The channels of communication I used can therefore be classed as both visual and auditory. Delaune and Ladner (2002 p.191) state that feedback occurs when the sender receives information after the receiver reacts to the message, however Chitty and Black (2007, p.218) define feedback as a response to a message. In this particular situation, I was the sender who conveyed the message to Mr R. and Mr R. was the receiver who agreed to talk about his chemotherapy treatment and allowed me to assist. Consequently I feel that my dealings with Mr R. involved the 5 key components of communication outlined by Delaune and Ladner (2002, p.191) i.e. senders, message, channel, receiver and feedback. Reflecting on this event allowed me to explore how communication skills play a key role in the nurse and patient relationship in the delivery of patient-focussed care. Whilst I was trying to assist Mr R. when he was attempting to walk, I realised that he needed time to adapt to the changes in his activities of daily living. I was also considering ways of successful and effective communication to ensure a good nursing outcome. I concluded that it was vital to establish a rapport with Mr R. to encourage him to participate in the exchange both verbally and non-verbally. This might then give him the confidence to communicate effectively with the other staff nurses; this might later prevent him from being neglected due to his age or his inability to understand the information given to him about his treatment and the benefits of that treatment. I have set out an action plan of clinical practice for future reference. If there were patients who needed help with feeding or with other procedures, I would ensure that I was well prepared to deal patients who weren’t able to communicate properly. This is because, as a nurse, it is my role to ensure that patients are provided with the best possible care. To achieve this, I need to be able to communicate effectively with patients in different situations and with patients who have differing needs. I need to communicate effectively as it is important to know what patients need most during there stay on the ward under my supervision. Whilst I have a lot of experience in this field of practice, communication remains a fundamental part of the nursing process which needs to be developed in nurse-patient relationships. Wood (2006, p.13) states that communication is the key to unlock the foundation of relationships. Good communication is essential if one is to get to know a patient’s individual health status (Walsh, 2005, p.30). Active learning can also help to identify the existence of barriers to communication when interacting with patients. Active learning means listening without making judgements; I always try to listen to patients’ opinions or complaints since this gives me the opportunity to see the patients’ perspective (Arnold, 2007, p.201). On the other hand, it is crucial to avoid the barriers that occur in communication with the patients and be able to detect language barriers. This can be done by questioning patients about their health and by asking them if they need help in their daily activities. I set about overcoming such barriers by asking open-ended questions and interrupting when necessary to seek additional facts (Funnell et al, 2005, p.453). Walsh (2005, p.31) also points out that stereotyping and making assumptions about patients, by making judgements on first impressions and a lack of awareness of communication skills are the main barriers to good communication. I must not judge patients by making assumptions on my first impression but should go out of my way to make the patient feel valued as an individual. I should respect each patient’s fundamental values, beliefs, culture, and individual means of communication (Heath, 300, p.27). I should be able to know how to establish a rapport with each patient. Cellini (1998, p.49) suggests a number of ways in which this can be achieved, including making oneself visible to the patient, anticipating patients’ needs, being reliable, listening effectively; all these factors will give me guidelines to improve my communication skills. Another important factor to include in my action plan is the need to take into account any disabilities patients may have such as poor hearing, visual impairment or mental disability. This could help give the patient some control and allow them to make the best use of body language. Once I know that a patient has some form of disability, I will be able to prepare a course of action in advance, deciding on the most appropriate and effective means of communication. Heath (2000, p.28) mentions that communicating with patients who have an impairment requires a particular and certain type of skill and consideration. Nazarko (2004, p.9) suggests that one should not repeat oneself if the patient is unable to understand but rather try to rephrase what one is saying in terms they can understand e.g. try speaking a little more slowly when communicating with disabled people or the hard of hearing. Hearing problems are the most common disability amongst adults due to the ageing process (Schofield. 2002, p.21). In summary, my action plan will show how to establish a good rapport with the patient, by recognising what affects the patients’ ability to communicate well and how to avoid barriers to effective communication in the future. Conclusion In conclusion, I have outlined the reasons behind my choosing Gibbs’ (1988) reflective cycle as the framework of my reflection and have discussed the importance of reflection in nursing practice. I feel I have discussed each stage of the cycle, outlining my ability to develop therapeutic relationship by using interpersonal skills in my dealings with one particular patient. I feel that most parts of the reflective cycle (Gibbs 1988) can be applied to the situation on which I have reflected. Without the model of structured reflection I do not feel I would have had the confidence to consider the situation in any depth (Graham cited in Johns 1997 a, p.91-92) and I fear reflection would have been remained at a descriptive level. I have been able to apply the situation to theory; as Boud Keogh

Pain Management, Palliative Care, Metabolic, Endocrine, Genetic, and Chronic Conditions and Management Plans II

Pain Management, Palliative Care, Metabolic, Endocrine, Genetic, and Chronic Conditions and Management Plans II. I’m studying for my Health & Medical class and need an explanation.

Pick one Topic:
Precocious puberty
Pediatric obesity
Growth hormone deficiency
Constitutional growth delay
Adrenal Insufficiency
Type 1 diabetes
Type 2 diabetes
Inborn errors of metabolism
Trisomy 21
Trisomy 18
Turner syndrome
Fragile X syndrome
Klinefelter syndrome
Fever in children
Pain in children


Physical exam findings
Differential diagnoses and rationale
Management plan to include diagnostic testing, medications if applicable, follow-up plans and referrals if needed

Initial posts must contain at least 3 evidence based references, be in APA 6th edition format and contain at least 200 words
Pain Management, Palliative Care, Metabolic, Endocrine, Genetic, and Chronic Conditions and Management Plans II

CIS 109 SU Management Information Systems & Computer Programming Discussion

CIS 109 SU Management Information Systems & Computer Programming Discussion.

This week was all about programming. We looked at several types of programming. Watch the video, Why Programing is Important | Mark | Jack | Bill Gates Tips About Programing, where major influencers of the digital world talk about learning to program. They also share their experiences of the importance of learning to program. Choose one of the people interviewed in the video that inspired you. Do some Internet research or use Basic Search: Strayer University Online Library to learn some more about them and share it with the class.Answer this question: Why is it important for you as a business professional in your chosen field to know how to program?Be sure to respond to at least two of your classmates’ posts.
CIS 109 SU Management Information Systems & Computer Programming Discussion