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History, Nursing and Medical

History, Nursing and Medical

Week 3 Reply to Discussion Posts Please include references if any Stated whether you agree to the discussion or you want to add something to the discussions. Discussion Post 1: Professor and class, Once the war for Texas independence from Mexico and the annexation of Texas into the United States finally occurred the boundary between Texas and Mexico needed to be determined. The Mexican government says its Nueces River and America says it’s the Rio Grande. Mexico still being upset over losing Texas and much more does not want to lose any more land than it already has. So the Mexican war of 1846 begins. At times wars are necessary. The Mexican war did allow California, New Mexico, Utah, Nevada, and Arizona to become part of the United States through the Treaty of Guadalupe Hidalgo (and a bit of money). Manifest Destiny was coined to say that the United States was destined by God to expand its land spread democracy and capitalism across the United States ( n.d.). Definitely, just a way to make yourself feel better about the things that you need to do during wartimes or just doing what you think is right for your country. Some people were against the war. They thought it was just a way to conquest lands and expand slavery and those were unjust reasons to go to war. So why wouldn’t someone want to think they are doing this because it is God’s doing? This I think reflects America’s hunger for land and power in this time. This war also has brought the topic of slavery out in the open with north versus south and should slavery be permitted in the west. References: Keene, J., Cornell, S., & O’Donnell, E. (2013). Visions of America: A history of the United States. Boston, MA. Pearson (n.d.). Manifest Destiny. Retrieved on 3/11/2018 from (Links to an external site.)Links to an external site. Answer: Discussion Post 2: Professor and class, The Mexican war was started over unclear boundaries. But it’s never just one thing. This was a time in America that full of growth and opportunity, and freedom. Land was considered the most important for status and massing one’s fortune. This was a complicated war that resulted in a win for US, while keeping the issue of slavery on the forefront. Again, political parties were divided, with the Southern Whigs all for the war, while the north was opposed. The treaty of Guadalupe ended the war with the US obtaining 500,000 square miles of land. This was also the first 24-hour news coverage, so to speak, with the telegraph and papers, people were able to keep up with the war in almost real time (Keene, Cornell & O’Donnell, 2013). I’m sure Polk wasn’t the first, and he definitely wasn’t the last, to use GOD as an excuse/reason for his actions. He believed GOD favored the United States, and favored whites over blacks, so his actions to take land from Mexico, and support slavery were, in his eyes at least, not only OK, but heavenly inspired (Peace, n.d.). Keene, J., Cornell, S., & O’Donnell, E. (2013). Visions of America: A history of the United States. Boston, MA. Pearson. Peace, R (n.d.). The United States-Mexican war, 1846-1848. United States foreign policy history and resource guide. Retrieved from http://peacehistory-usfp-org Answer: Discussion Post 3: Professor and class The Mexican War of 1846 took place because there were “exact boundary” discrepancies between the United States and Mexico following the annexation of Texas (O’Donnell et al., 2013). While there was division over whether the war was necessary or not, it provided a great victory for the United States and was the first that America had fought primarily on foreign soil (O’Donnell et al., 2013). Two years later, the war finally came to an end with The Treaty of Guadalupe Hidalgo which settled the border dispute. According to an article titled “The United States-Mexican War, 1846-1848,” the treaty “established Texas at the Rio Grande and California/New Mexico to the US” going on further to add that Article XXI “…committed both nations to peacefully negotiating any future disagreements” (Peace, 2018). As far as God’s plan for all of this to happen, a term had been coined in 1845 by newspaper editor John O’Sullivan, to describe “the essence of this mindset” and that was to basically assume that a greater plan was in the works based on the beliefs “that God himself blessed the growth of the American nation” ( America was to expand and be superior. References: Keene, J., Cornell, S., & O’Donnell, E. (2013). Visions of America: A history of the United States. Boston, MA. Pearson. Manifest Destiny. (n.d.). Retrieved March 12, 2018, from Peace, R. (n.d.). The United States-Mexican War, 1846-1848. Retrieved March 12, 2018, from Answer: Discussion Post 4: Professor and class, Transportation played an important role in the growth of the Americas. Economy was mostly a local system, with goods traded using the barter system. As the market revolution saw farmers having a surplus of goods, transportation helped them trade further, and become more commercially orientated (Keene, Cornell, & O’Donnell, 2013). The transportation revolution was also responsible for isolated regional economies to integrate nationally, helping to determine roles in regional structures and regional income (Kim, 2009). This can be seen in the difference in the northern and southern regions. The north was moving to a free labor economy, using technology to improve efficiency, transportation, and communication. The growth in the south focused mostly on cash crops, still utilizing slave labor The railroad, by being cheaper and more efficient allowed those who previously could not marker their goods to now become involved in trade, boosting individual finances, and the economy. The roads help decrease travel times, giving us the “National road”, the first federally funded road. The steamboats and canals also provided the new faster and cheaper way to transport goods.( If you want to see a beautiful site, come to New Orleans and watch the steamboat go down the Mississippi). The takeaway from this is the transportation revolution changed the way America did business. Less expensive, and faster, it allowed more people to become involved in trades, and it changed the economy. Keene, J., Cornell, S., & O’Donnell, E. (2013). Visions of America: A history of the United States. Boston, MA. Pearson. Kim, S (1998). Economic integration and convergence: U.S. regions 1840-1987. The journal of economic history (58) 3. doi: 10.1017/50022050700021112 Answer: Discussion Post 5: Professor and class, The “market revolution is the term used by historians to describe this transformation, encompassed interrelated developments that revolutionized agriculture, industry, technology, transportation, and communications” (Keene, Cornell & O’Donnell. 2013). America’s transportation revolution greatly contributed to this. With improvements in transportation, this now allows products from farms that previously could not be delivered to certain areas now could be delivered. Roads and turnpikes were being developed which allowed transportation of people and goods to go further, cheaper, faster and more reliable. This network of roads was allowing access to places that were not easy to get to. Many main rivers were ways to get goods from inner lands out to the marketplace but it took a long time and was a large expense because of the one-way system with the flow of the rivers. Once steamboats were invented this changed everything. Upriver travel was possible and increased the sales of river cities. The creation of canals contributed to the financial success of these river cities too. Products would deliver faster and cost less. Next came the railway systems. This was the big wow factor. Large amounts of goods now could be transported from one side of the country to the other in record times. None of this may have happened if the results of the 1824 presidential election had not gone the way it had. There were 4 candidates. 3 of them were Andrew Jackson, John Quincy Adams, and Henry Clay. Clay had an idea and vision of the future of America’s economy. His plan was called The American System. Part of this plan was to have Federal funding to make internal improvements such as roads and canals. At the end of the election, Clay came in 4th place. Jackson won the popular vote and had the most electoral votes but was short in the electoral college majority that he needed to win. In this situation, our constitution says the deciding factor is left to the speaker of the house. Well guess who the speaker of the house is? Henry Clay! Clay knew that Adams supported Clay’s ideas in The American System. So his deciding decision put Adams into office and the beginning of the transportation and market revolution would occur. Reference: Keene, J., Cornell, S., & O’Donnell, E. (2013). Visions of America: A history of the United States. Boston, MA. Pearson Answer: Discussion Post 6: Professor Muir and class, During the nineteenth century, America had become more commercially oriented. Farmers were growing cash crops. Everyone was trying to make some money. The introduction of transportation changed things drastically for the market. Having roads and turnpikes decreased travel times. Sometimes even by half the time! The introduction of steamboats was also a huge change for the market. At one time traveling upriver was once very slow and expensive to do. With using the steamboat to travel from New Orleans to Kentucky as the book states, it cut the time from three to four months down to about a week by 1826 (Keene, Cornell, O’Donnell, 2012). Having canals built also cut travel time and expenses down tremendously. By the year 1840, over 125 million was invested into building canals. They had over $3,300 miles of canals at that time. Around the time of the production of canals, railroads were also being built. Obviously, trains were faster than any other form of transportation. Not only did this facilitate the movement of manufactured goods and people. But communication could be spread faster than ever. More letters could be mailed. Also, advertisements increased due to the improvement of printing. Magazines and newspapers were filled with the latest fashions, which encouraged consumers to buy. Technology changed the way people lived in every way, shape, and form. Everything was faster, bigger, and cheaper. Keene, J., Cornell, S., & O’Donnell, E. (2012). Visions of America: A history of the United States. Boston, MA. Pearson. Answer: Discussion Post 7: Professor and Class, When searching for evidence relevant to my proposed research question the research design that I will expect to find will follow the format of experimental design. Experimental design “studies causality by introducing an intervention to one group (the treatment group) and comparing the outcome to that of another group that has not experienced the intervention (the control group); subjects are randomly assigned to groups” (Houser, 2018 p.145). The treatment group would be patients that have a central venous catheter with catheter hub that is protected by antiseptic impregnated cabs. The control group (that will be used for comparison) would be patients that have central venous catheter with catheter hub that is not protected by antiseptic impregnated caps. Another feature of experimental designs is that subjects will be randomly assigned to each group. Random assignment ensures that the outcome of the study is due to the manipulated variable (application of antiseptic cab) and is not influenced by the makeup of the test groups. The dependent variable of the research project is to identify the effectiveness of antiseptic impregnated cabs in the reduction of catheter line-associated bloodstream infection (CLABSI) for patients with central venous catheters. Convenience sampling involves the selection of subjects that are conveniently available to the researcher, for examples polls or surveys found on the internet. “In other words, this sampling method involves getting participants wherever you can find them and typically wherever is convenient. In convenience sampling no inclusion criteria identified prior to the selection of subjects. All subjects are invited to participate” (Convenience Sampling). One implication of convenience sampling is the introduction of subject selection that is bias. This can lead to under or over representation of a particular group of subjects in the sample. If the subjects for the sample is not chosen at random then there is no representation of the entire population, therefore, the researcher will not be able to make any generalizations about the entire population. Reference Convenience sampling. (n.d.). Retrieved March 12, 2018, from Houser, Janet. Nursing Research: Reading, Using and Creating Evidence, 4th Edition. Jones & Bartlett Learning, 20161214. VitalBook file. Answer: Discussion Post 8: Professor and class, My research question is: during a year-long study would a cardiothoracic post-op surgery patient, at Delray Medical Center, that has co-morbidities and are hemodynamically unstable more likely to end up with a central line associated blood stream infection if the central line is placed in the subclavian vs the jugular vein? Initially after reading the different research designs, I thought that my question would be best suited as a correlation research design. Our text (Houser, 2018) states that a correlation research design “describes the relationship between two variables in a single population or the relationship between a single variable in two population” (p.142). My thinking at first was asking if there was a correlation between CLABSIs and subclavian CVLs, or between CLABSIs and IJ CVLs. However, after re-reading the definition multiple times, I am changing my mind to thinking my question is best categorized as an experimental research design. Our lesson this week (Chamberlain College of Nursing, 2018) teaches us that “an experimental design involves the researcher manipulating variables to determine cause and effect.” I think that my variables would be a subclavian CVL and an IJ CVL. Convenience sampling is the most common sampling method. Our text (Houser, 2018) reminds us “however, selection using convenience methods can introduce bias into the sample” (p.168). If using the convenience sampling with my research question, I would need to eliminate as much bias as possible. We are taught that even if we use a coin to flip to assign subjects to groups, we’re eliminating the bias that comes with assigning ourselves. An article in Statistics in Medicine (2011) tells us that “Utilizing data from convenient populations are usually biased, and likely do not reflect the disease status or impact in the general population.” With that being said, convenience sampling is that–more convenient. For optimal research, I would much rather use a different sampling method. Chamberlain College of Nursing. (2018). NR 439 Week 3: Reading research literature–problems and designs. [Online Lesson]. Downers Grove, IL. DeVry Education Group. Hedt, B. L., & Pagano, M. (2011). Health Indicators: Eliminating bias from convenience sampling estimators. Statistics in Medicine, 30(5), 560–568. (Links to an external site.)Links to an external site. Houser, J. (2018). Nursing Research: Reading, Using and Creating Evidence, 4th Edition. [Bookshelf Online]. Retrieved from Answer: Discussion Post 9: Professor & Class, The clinical issue I chose to address was “(P) For neonates born at Baptist Hospital in the month of March, who are less than 4 days old and had a procedure done on the postpartum floor. (I) Does treating their procedural pain non-pharmacologically vs (C) treating them pharmacologically (O) adequately and effectively treat their pain (T) over a 30 day period?” The research design I chose to assist me in the search for evidence is the Experimental design which are best applied to answer questions about the effectiveness of interventions (Houser, 2018). Using that specific design method would be able to help me in finding the evidence needed to prove that my outcome is indeed effective and why or why not my intervention or comparison intervention is correct. My goal is to find out if whether or not newborns are being adequately treated when it comes to painful procedures. Pain in the neonate has been an issue for some time now where studies believe that babies cant feel pain while others believe they can and should be treated even though they can’t verbally express it. I have had parents also ask me about the treatment for their newborns after procedures such as circumcisions and wonder why they should be giving their child Tylenol which they believe is harmful to newborns. I have worked at a hospital that didn’t give Tylenol after a circumcision and I now work for a hospital that does, so who is right? Convenience sampling while it is the easiest, probably takes the shortest time and is the cheapest to implement, it isn’t fair. How could selecting the thing or person closest and easiest to you be correct, easy yes but not correct. I cant expect to do a study on nurses at my hospital who feel like their nurse-patient ratio is too high but choose to only ask 30 nurses on my mother/baby floor, what about the nurses on med-surg or PACU? We all have a common goal but the way we reach that goal is different on each floor which means we may all have different views. In summary, convenience sampling is a common strategy, but its scientific disadvantages appear to outweigh its practical advantages (Bornstein et al,.2013). Reference Bornstein, M. H., Jager, J., & Putnick, D. L. (2013). Sampling in Developmental Science: Situations, Shortcomings, Solutions, and Standards. Developmental Review : DR, 33(4), 357– 370. Houser, J. (2018). Nursing research: Reading, using, and creating evidence (4th ed.). Sudbury, MA: Jones & Bartlett. Answer:

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