Reply 1In clinical research, statistically significant study outcomes are frequently regarded as clinically significant. Clinical significance represents the study’s influence on clinical practice, whereas statistical significance demonstrates the study’s trustworthiness. According to Ranganathan et. al, (2015), the “clinical significance” of a finding in clinical practice is determined by its consequences for current practice, with treatment effect size being one of the most significant variables driving treatment decisions. Statistical significance is heavily influenced by the sample size of a study; with large sample sizes, even minor treatment effects (which are clinically insignificant) can appear statistically significant; as a result, the reader must carefully consider whether this “significance” is clinically meaningful. Overall survival was compared in 569 patients with advanced pancreatic cancer who were randomly assigned to receive erlotinib with gemcitabine vs gemcitabine alone, according to a research published in the Journal of Clinical Oncology. The erlotinib plus gemcitabine arm had a “significantly” longer median survival (6.24 months vs. 5.91 months, P = 0.038). The P = 0.038 indicates that there is only a 3.8 percent probability that the observed difference between the groups happened by chance (less than the conventional cut-off of 5%), making it statistically significant. In this case, the “treatment effect” or difference in median survival between 6.24 and 5.91 months – a mere 10 days, which most oncologists would agree is a clinically irrelevant “improvement” in outcomes, especially when considering the added toxicity and costs associated with the combination – is the clinical relevance of this “positive” study.Statistical significance must always be established before clinical significance can be assessed in evidence-based research. Clinical significance, on the other hand, is generally a subjective assessment that cannot be determined by a single experience test. By ensuring that the result is statistically significant, I may leverage clinical significance to support good results in my project outcome. This is because the vast majority of statistically significant discoveries have therapeutic implications.ReferenceRanganathan, P., Pramesh, C. S., & Buyse, M. (2015). Common pitfalls in statistical analysis: Clinical versus statistical significance. Perspectives in clinical research, 6(3), 169–170. https://doi.org/10.4103/2229-3485.159943Reply 2t Sapio 1 postsRe: Topic 8 DQ 2To successfully implement evidence-based practice, it is important to understand and interpret research. In this regard, it is important to understand the difference between statistical significance and clinical significance. Statistical significance refers to when a relationship between variable is accurate and not random or caused by luck. It is used to determine the reliability of findings. In this regard, statistical significance as a parameter in evidence-based practice shows the extent or the likelihood that finding from research is true and does not occur by a chance (Heavey, 2015).Clinical significance is essentially a subjective interpretation of research findings as meaningful for patient under care, and therefore likely to influence the behaviour of healthcare provider (Heavey, 2015). A clinically significant result occurs when medical experts believe that the finding is considerable enough to be medically crucial and hence be applied as a guide in provision of care to patients.In evidence-based research practice, statistical significance must always be determined before determination of clinical significance. However, clinical significance is usually a subjective evaluation and cannot be established by a single experiential test. I can use clinical significance to support positive outcomes in my project outcome by ensuring that the result is statistically significant. This is because majority of statistically significant findings normally have clinical significance.ReferencesHeavey, E.(2015). Differentiating statistical significance and clinical significance. American Nurse Today, 10(5): 26-28. Retrieved from https://www.brockport.edu/daily_eagle/doc/2015-04/item_8038_7659.pdf

 
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Minimum of 750 words with at least 2 peer review reference in 7th edition APA style.Refer to “The Medical H and P” and “How to Create a Differential Diagnosis” videos in this topic. Discuss your observations. What questions did the videos raise for further exploration? Explain what else would you have added to the examination and patient interaction activities.Watch “The Medical H and P (Part 1 of 2),” by Strong Medicine (2013), located on the YouTube website.URL:https://www.youtube.com/watch?v=0BfkBC34U38Watch “The Medical H and P (Part 2 of 2),” by Strong Medicine (2013), located on the YouTube website.URL:https://www.youtube.com/watch?v=OnAOcZOqlMQWatch “How to Create a Differential Diagnosis (Part 1 of 3),” by Strong Medicine (2013), located on the YouTube website.URL:https://www.youtube.com/watch?v=qKrLPY_8Cyk-Watch “How to Create a Differential Diagnosis (Part 2 of 3),” by Strong Medicine (2013), located on the YouTube website.URL:https://www.youtube.com/watch?v=iEbonwYPNVkWatch “How to Create a Differential Diagnosis (Part 3 of 3),” by Strong Medicine (2013), located on the YouTube website.URL:https://www.youtube.com/watch?v=n48zY7GLqc0

 
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scatter -plot

 
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It is one of the most cliché of clichés, but it nevertheless rings true: The only constant is change. As a nursing professional, you are no doubt aware that success in the healthcare field requires the ability to adapt to change, as the pace of change in healthcare may be without rival.As a professional, you will be called upon to share expertise, inform, educate, and advocate. Your efforts in these areas can help lead others through change. In this Assignment, you will propose a change within your organization and present a comprehensive plan to implement the change you propose.To Prepare:Review the Resources and identify one change that you believe is called for in your organization/workplace.This may be a change necessary to effectively address one or more of the issues you addressed in the Workplace Environment Assessment you submitted in Module 4. It may also be a change in response to something not addressed in your previous efforts. It may be beneficial to discuss your ideas with your organizational leadership and/or colleagues to help identify and vet these ideas.Reflect on how you might implement this change and how you might communicate this change to organizational leadership.The Assignment (5-6-minute PowerPoint presentation):Change Implementation and Management PlanCreate a narrated PowerPoint presentation of 5 or 6 slides with video that presents a comprehensive plan to implement the change you propose.Your presentation should be 5–6 minutes in length and should include a video with you as presenter.Your Change Implementation and Management Plan should include the following:An executive summary of the issues that are currently affecting your organization/workplace (This can include the work you completed in your Workplace Environment Assessment previously submitted, if relevant.)A description of the change being proposedJustifications for the change, including why addressing it will have a positive impact on your organization/workplaceDetails about the type and scope of the proposed changeIdentification of the stakeholders impacted by the changeIdentification of a change management team (by title/role)A plan for communicating the change you proposeA description of risk mitigation plans you would recommend to address the risks anticipated by the change you propose.5 references

 
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Generally speaking, bioethics helps determine what is responsible by considering four key principles: autonomy, beneficence, nonmaleficence, and justice. The principle of autonomy is about respecting people and their free will. Beneficence and nonmaleficence are two sides of the same coin: doing what is helpful, and not doing what is harmful. Justice, in this context, has to do with being fair in giving out both benefits and risks.Using your own words, answer the following questions:1. How these models relate to one another varies with each circumstance?2. In your personal opinion which model may be the most important?Models:1.  Ethics of Care Model2.  Narrative Ethics Model3. Complementary/Alternative Medicine (CAM)Requeriments:1. Use APA format.2. Utilize more than three references to answer the questions.3. Your answers must be at least 2 paragraphs to each question.

 
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BACKGROUNDThe client is a 34-year-old Pakistani female who moved to the United States in her late teens/early 20s. She is currently in an “arranged” marriage (her husband was selected for her since she was 9 years old). She presents to your office today following a 21 day hospitalization for what was diagnosed as “brief psychotic disorder.” She was given this diagnosis as her symptoms have persisted for less than 1 month.Prior to admission, she was reporting visions of Allah, and over the course of a week, she believed that she was the prophet Mohammad. She believed that she would deliver the world from sin. Her husband became concerned about her behavior to the point that he was afraid of leaving their 4 children with her. One evening, she was “out of control” which resulted in his calling the police and her subsequent admission to an inpatient psych unit.During today’s assessment, she appears quite calm, and insists that the entire incident was “blown out of proportion.” She denies that she believed herself to be the prophet Mohammad and states that her husband was just out to get her because he never loved her and wanted an “American wife” instead of her. She tells you that she knows this because the television is telling her so.She currently weighs 140 lbs, and is 5’ 5”SUBJECTIVEClient reports that her mood is “good.” She denies auditory/visual hallucinations, but believes that the television does talk to her. She believes that Allah sends her messages through the TV. At times throughout the clinical interview, she becomes hostile towards the PMHNP, but then calms down.You reviewed her hospital records and find that she has been medically worked up by a physician who reported her to be in overall good health. Lab studies were all within normal limits.Client admits that she stopped taking her Risperdal about a week after she got out of the hospital because she thinks her husband is going to poison her so that he can marry an American woman.MENTAL STATUS EXAMThe client is alert, oriented to person, place, time, and event. She is dressed appropriately for the weather and time of year. She demonstrates no noteworthy mannerisms, gestures, or tics. Her speech is slow and at times, interrupted by periods of silence. Self-reported mood is euthymic. Affect constricted. Although the client denies visual or auditory hallucinations, she appears to be “listening” to something. Delusional and paranoid thought processes as described, above. Insight and judgment are impaired. She is currently denying suicidal or homicidal ideation.The PMHNP administers the PANSS which reveals the following scores:-40 for the positive symptoms scale-20 for the negative symptom scale-60 for general psychopathology scaleDiagnosis: Schizophrenia, paranoid typeAt each decision point stop to complete the following:Decision #1Which decision did you select?Why did you select this decision? Support your response with evidence and references to the Learning Resources.What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?Decision #2Why did you select this decision? Support your response with evidence and references to the Learning Resources.What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?Decision #3Why did you select this decision? Support your response with evidence and references to the Learning Resources.What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?

 
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writing a sample to be able to make my own assig

 
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PLEASE FORMAT PAPER ACCORDING TO 7TH EDITION APA FORMAT

 
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Nurses use Quality Indicators (QIs) for several purposes. QIs highlight potential quality concerns, identify areas that need further study and investigation, and track changes over time. The Agency for Healthcare Research and Quality (AHRQ) QIs include Prevention Quality Indicators, Inpatient Quality Indicators, Patient Safety Indicators, and Pediatric Quality Indicators (Agency for Healthcare Research and Quality, n.d.). You will use these quality indicators within your Assignment.Use the Walden Writing Center guidelines titled “Writing a Paper” and “Scholarly Writing: Overview” to do the following:· Draft a 2- to 3-page paper describing your selected QI in general, and then describe how this QI has the potential to improve the quality, safety, and outcomes of your patients and their families.· Describe the current data available and leadership’s goal for improvement.· Draft a solution using 2 sources from professional and scholarly literature to support your proposal.· Use the 2000/3000 AWE Level Assignment Template in the resources for this week to complete your Assignment.· Use in-text citations to support your paper. Use essay-level writing skills, including the use of transitional material and organizational frames.

 
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The nursing profession is both practice-based, referring to the evidence-based practice that we’ve been discussing the last couple weeks and theory based (Younas and Quennell, 2019). The theory part of nursing focuses on the nurses values and beliefs about the human body and the health of it. According to Younas and Quennell, the nursing theory focuses on seeking which approaches to patient care would be best for that individual patient. Essentially it is gathering information from definitions and concepts and making assumptions using both the deductive reasoning and inductive reasoning methods (Nursing Theories, 2020). Younas and Quennell say that nursing theories are just as important as using evidence-based practice (2019). Using theory, evidence-based practice, and research all together can contribute to high knowledge development (Younas and Quennell, 2019). Nursing Theories says that the conceptual model theory is a more abstract way about looking at certain situations; it is a reference used to guide general nursing practice that consists of the patient, the environment, the nurse, and the health of the patient (2020).Johnson’s Theory 1968 is a theory that focuses on a patient’s ability to adapt to their new-found-out illness. It looks at different stressors that may or may not cause the patient to not be able to adapt. The goal of this theory is to help maintain and control our patient’s stress level so they can more easily cope with and recover from their illness (Nursing Theories, 2020).An example of Johnson’s Theory- say a person just found out they had cancer (of any sort). Finding this out would be incredibly stressful in many ways, depending on the type of cancer, how long that person has, how old they are, etc. Say this person found out they have Stage 4 pancreatic cancer and they are 50 years old. This would be devastating news for anyone. Using Johnson’s Theory, we can help provide our patient with resources they need in order to decrease their stress level and be able to cope with this new-found news. We can assist them with an advanced directive, a living will, get them into a support group, get their affairs in line for when they pass, have them meet with the chaplain, etc.Pls always try to support post before writing .its a discussion forum.thanks 200-250 words.

 
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