writing and rhetoric, nursing theory (watson’s theory),

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1) Minimum 19 pages  (No word count per page)-   Follow the 3 x 3 rule: minimum of three paragraphs per page 

You must strictly comply with the number of paragraphs requested per page.  

The number of words in each paragraph should be similar

         Part 1: minimum 3 pages (Due 24 hours)

         Part 2: minimum 3 pages (Due 24 hours)

         Part 3: minimum 2 pages (Due 18 hours)

         Part 4: minimum 5 pages (Due 48 hours)

         Part 5: minimum 6 pages (Due 48 hours)

Submit 1 document per part

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        The number of words in each paragraph should be similar

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4) Minimum 3 references (APA format) per part not older than 5 years  (Journals, books) (No websites)

Part 1 and 2: Minimum 7 references (APA format) per part not older than 5 years  (Journals, books) (No websites)

Part 4:  Minimum 7 references (APA format) per part not older than 5 years  (Journals, books) (No websites) 

Part 5:  Minimum 7 references (APA format) per part not older than 5 years  (Journals, books) (No websites) 

All references must be consistent with the topic-purpose-focus of the parts. Different references are not allowed 

5) Identify your answer with the numbers, according to the question. Start your answer on the same line, not the next

 Example:

Q 1. Nursing is XXXXX

Q 2. Health is XXXX

Q3. Research is…………………………………………………. (a) The relationship between……… (b) EBI has to

6) You must name the files according to the part you are answering: 

Example:

Part 1.doc 

Part 2.doc

__________________________________________________________________________________

Part 1: Writing and rhetoric

Topic: Deaths caused by school shootings clearly show the need to develop programs to improve students’ mental health.

Deep: Tweets to Reports

Writing: school genre

According to

https://twitter.com/SomeMoreNews/status/1575606631894687744

Pick two claims (facts, statistics, arguments) made in the social media text and

1. What do you find online information (Journals, books…) about the claims selected? (One paragraph)

a. What say two reliable sources per each picked claim that either confirms or disproves that information? 

Following the checklist (Check the file attached)

2. Discuss at least one detail from your source that establishes each of the following:  (One paragraph)

a. Authority

b. Purpose

c. Accuracy and Verifiability

e. Currency and Relevance.  If you can’t establish all four of these criteria, consider using a different source.  

4.  Following the Guiding Questions for Researching Rhetorically 2 file (Check the file attached) answer each question in a paragraph, that is, seven paragraphs

Question 1  (One paragraph)

Question 2  (One paragraph)

Question 3  (One paragraph)

Question 4  (One paragraph)

Question 5  (One paragraph)

Question 6  (One paragraph)

Question 7 (One paragraph)

Part 2: Writing and rhetoric

Topic:   Recognizing sex work would allow women in this industry to unionize and access benefits that workers in other industries have

Deep: Tweets to Reports

Writing: school genre

According to

https://twitter.com/aclu/status/1289212497531228160

Pick two claims (facts, statistics, arguments) made in the social media text and

1. What do you find online information (Journals, books…) about the claims selected? (One paragraph)

a. What say two reliable sources per each picked claim that either confirms or disproves that information? 

Following the checklist (Check the file attached)

2. Discuss at least one detail from your source that establishes each of the following:  (One paragraph)

a. Authority

b. Purpose

c. Accuracy and Verifiability

e. Currency and Relevance.  If you can’t establish all four of these criteria, consider using a different source.  

4.  Following the Guiding Questions for Researching Rhetorically 2 file (Check the file attached) answer each question in a paragraph, that is, seven paragraphs

Question 1  (One paragraph)

Question 2  (One paragraph)

Question 3  (One paragraph)

Question 4  (One paragraph)

Question 5  (One paragraph)

Question 6  (One paragraph)

Question 7 (One paragraph)

Part 3: Nursing theory

Topic: Watson’s theory 

1. Present an overview of the nursing theory (One paragraph)

2. Describe the conceptual model the theory would fall into. (Two paragraphs)

3.  Is it a practice theory, midrange theory, or grand theory? (One paragraph)

a. Explain

4. Explain how the nursing theory incorporates the four metaparadigm concepts.(Two paragraphs: One paragraph for a and b; One paragraph for c and d)

a. Person

b. Health

c. Environment

d. Nursing

Part 4: Pathophysiology

Topic: Schizoaffective Disorders

Disease: schizophrenia

1. According to DSM- 5 (ONLY) explain what Schizoaffective Disorders is (One paragraph)

2. Definition of the disease or disorder  (One paragraph)

3. Stadistic epidemiology of the disease or disorder (One paragraph)

a. Incidence

b. Prevalence

4. Pathogenesis (Four paragraphs)

a. Pathophysiology at the Cellular level (One paragraph)

b. Genetics/genomics (One paragraph)

c. Neurotransmitters (One paragraph)

d. Neurobiology (One paragraph)

5. Clinical features of the disease or disorder (Three paragraphs)

a. History of the patient’s problems (One paragraph)

b. Physical findings (One paragraph)

c. Psychiatric findings (One paragraph)

6. Recommendations (Five paragraphs)

a. Treatment recommendations according to the US clinical guidelines. (One paragraph)

b. Patient education for management and anticipatory guidance.(One paragraph)

c. Non-pharmaceutical (One paragraph)

d. Cultural (One paragraph)

e. Spiritual considerations (One paragraph)

Part 5: Capstone project

Topic: Hyperlipidemia: lifestyle modifications combined with pharmacologic treatment

According to Part 5: Hyperlipidemia (Check file attached)

1. Create a MAP-IT (Check MAP-IT stands) (Five paragraphs)

a. M- Mobilize (One paragraph)

b. A- Asses (One paragraph)

c. P- Plan (One paragraph)

d. I- Implement (One paragraph)

e. T- Track (One paragraph)

2. Framework: Health Belief Model (HBM) (Three paragraphs)

a. Explain the Framework (One paragraph)

 b. Explain how HBM is the most appropriate health promotion/disease prevention theoretical or conceptual model that best serves as the guiding framework for the proposal (Two paragraph)

3. Outcomes (Two paragraphs) 

a. Describe the intended outcomes concurrent with the SMART goal approach 

 4. Detailed Plan (Four paragraphs) 

a. Provide a detailed plan for the evaluation for each outcome. 

5. Barriers / Challenges (Two paragraphs) 

a. Describe possible barriers/challenges to implementing the proposed project (One paragraph)

b. Describe the strategies to address these barriers/challenges(One paragraph) 

6.  Conclusion (Two paragraphs) 

a. Share your insights about this strategy and your expectations regarding achieving your goals.  (One paragraph)

b. Make a comprehensive conclusion summarizing the pap3r and providing a call to action for the nurses. (One paragraph)

4

Deaths caused by school shootings clearly show the need to develop programs to improve students’ mental health.

First article:

https://www.nea.org/advocating-for-change/new-from-nea/uvalde-school-shooting-underscores-urgent-need-mental-health-resources#:~:text=Press%20Releases-,Uvalde%20School%20Shooting%20Underscores%20Urgent%20Need%20for%20Mental%20Health%20Resources,wake%20of%20shootings%20and%20pandemic
.

Second article:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7803479/

The first article, “Uvalde School Shooting Underscores Urgent Need for Mental Health Resources,” is directed towards a general audience of educators and advocates for change (Long, 2022). The second article, “Mental Illness, Mass Shootings, and the Future of Psychiatric Research into American Gun Violence,” is directed toward a scholarly audience of mental health professionals and researchers (Metzl et al., 2021). The purpose of the first article is to raise awareness and advocate for increased mental health resources in schools (Long, 2022), while the second article’s purpose is to provide a review of the literature on the relationship between mental illness and mass shootings and to provide an understanding of gun violence (Metzl et al., 2021). The first article is in the genre of advocacy literature, while the second one is in the genre of research literature.

Summary

Long, C. (2022, May 26). Uvalde school shooting underscores urgent need for mental health resources.
NEA News.

The first article discusses the recent school shooting in Uvalde, Texas, and argues that the shooting highlights the urgent need for increased mental health resources in schools (Long, 2022). The article identifies the extended risks that people of color face by being the target of shootings and the protection they need. Anxiety and sadness are filling students and community members because of the shooting that happened back-to-back (Long, 2022). The article cites statistics on the prevalence of mental health problems among students, the lack of access to mental health services, and the need for increased funding to support mental health programs.

Metzl, J. M., Piemonte, J., & McKay, T. (2021). Mental illness, mass shootings, and the future of psychiatric research into American gun violence. 
Harvard Review of Psychiatry
29(1), 81.

The second article, “Mental Illness, Mass Shootings, and the Future of Psychiatric Research into American Gun Violence, ” reviews the literature on the relationship between mental illness and mass shootings (Metzl et al., 2021). The article argues that there is a complex relationship that exists between mass shootings and mental health problems, and that mental health problems alone cannot be a significant predictor of mass shootings. Researchers should not assume that a diagnosed mental health condition is enough for mass shootings but also focus on social and cultural aspects (Metzl et al., 2021). The article also provides information about the legality and psychological elements of private gun owners and their usage. Additionally, policies to minimize incidences of gun violence should be researched thoroughly.

Both articles show that mental health is a significant issue related to school shootings and that schools need to improve access to mental health resources. The first article builds on the second article’s argument that mental health is a complex issue related to school shootings by providing a specific example of a recent school shooting and highlighting the need for increased mental health resources in schools (Long, 2022). The second article builds on the first article’s argument that even though mental health diagnosis is not enough to result in mass shootings, mental health resources and policies are required to minimize violent events (Metzl et al., 2021).

The first article reveals the increased risk that students’ educators, and community members have toward being victims of mass shootings and how it highlights the urgent need for increased mental health resources in schools (Long, 2022). The second article to be more helpful in helping me understand the topic because it provided a more nuanced understanding of the relationship between mental health and school shootings and was based on proper research resources (Metzl et al., 2021). It was related to how the information was packaged relating mental health, mass shootings, and gun violence and research implications.

The two texts differ in their rhetorical choices based on their audience, purpose, and genre differences. The first article appeals emotionally to its audience by providing testimonials from educators and advocates who have witnessed the impact of the lack of mental health resources in schools. The second article, on the other hand, makes logical appeals to its scholarly audience by providing a review of the literature and recommendations for future research and violence prevention.

Rhetorical choice

The stylistic choices of the first article, such as the use of personal anecdotes, are more effective in raising awareness and advocacy, while the second article’s use of research and statistics is more effective in providing a scholarly analysis of the topic (Khany et al., 2019). These differences shape how these texts can participate in the conversation by appealing to different audiences and serving different purposes. The first article can be used to raise awareness and advocate for increased mental health resources in schools, while the second article can be used to inform future research and violence prevention efforts in the field of mental health.

References

Khany, R., Aliakbari, M., & Mohammadi, S. (2019). A model of rhetorical markers competence in writing academic research articles: a qualitative meta-synthesis. 
Asian-Pacific Journal of Second and Foreign Language Education
4(1), 1-19.
https://doi.org/10.1186/s40862-018-0064-0

Long, C. (2022, May 26). Uvalde school shooting underscores urgent need for mental health resources.
NEA News.

Metzl, J. M., Piemonte, J., & McKay, T. (2021). Mental illness, mass shootings, and the future of psychiatric research into American gun violence. 
Harvard Review of Psychiatry
29(1), 81.

This document was taken from the link http://www.in.gov/gpcpd/2349.htm for better viewing purposes.

Responding to Disability: A Question of Attitude

This questionnaire is designed to stimulate thinking and dialogue. It is not intended to test knowledge of disability or

attitudes toward people with disabilities. As people increasingly find themselves in situations involving people who are

disabled they need to make quick decisions on how to respond. This questionnaire provides an opportunity to think

about situations involving people with disabilities, to respond, and then to consider the various responses more

carefully.

Responding to Disability: A Question of Attitude

Written by Patricia Hague

produced by

Minnesota State Council on Disabilities

208 Metro Square Building

St. Paul, MN 55101

612/296-6785 or

1-800/652-9747

Toll Free Voice and TDD

edited by

Indiana Governors Planning Council for People With Disabilities

Note: I would like to take this opportunity to extend my gratitude to the Center for Education for Non-Traditional

Students for their support during much of the time I was writing this questionnaire. Their encouragement and

thoughtful feedback were valuable in the development of these questions and answers. In particular, I would like to

thank Sandra Gish for her assistance with the development of question number ten. I would especially like to thank

Jerry Bergdahl, Gary TeGrootenhuis, Jeanne-Marie Moore, Kay Stoll and Alice Nelson for teaching me most of what I

know about disabilities and for giving me plenty of opportunities to improve my awareness of and attitudes toward

disabilities. – Patricia Hague

Copyright 1982

Minnesota Council on Disabilities

If interested in reproducing all or part of this booklet, contact the Minnesota State Council on Disabilities, 208

Metro Square, St. Paul, MN 55101, for permission.

(Editors note: With permission, this document has been edited to ensure that it reflects people first language.

Permission has been granted to reproduce this document or any portion thereof so long as proper credit is

given to the author.)

INTRODUCTION

With the recent changes in laws, opportunities, and attitudes, more people with disabilities are moving into the

mainstream, pursuing education, employment, and leisure activities. Yet few of us have had extensive

exposure to people with disabilities. Despite our desires to respond appropriately when we interact with a

person who has a disability, sometimes there is confusion, hesitancy or miscommunication.

This questionnaire is designed to stimulate thinking and dialogue. It is not intended to test your knowledge of

disability or your attitudes toward people with disabilities. Increasingly we find ourselves in situations

involving people who are disabled and we need to make quick decisions on how to respond. We’re not always

sure what response is best. This questionnaire will give you an opportunity to think about situations involving

disabilities, to respond, and then to consider the various responses more carefully.

For each question, pick the answer that you feel is best. When you have answered all 14 questions, turn to the

answer section that follows. In the answer section you will find discussion regarding each of the various

responses. When you are done, discuss this questionnaire with others. Ultimately in any human interaction

there are not “right” or “wrong” answers.

This document was taken from the link http://www.in.gov/gpcpd/2349.htm for better viewing purposes.

RESPONDING TO DISABILITY:

A QUESTION OF ATTITUDE

Question Section

1. You are in a grocery store with your children when a man in an electric wheelchair enters. Your

children ask in loud voices: “Why is that man sitting down?” Then they go over to him and ask:

“What’s wrong with you?” Your response should be:

a) try as discreetly as possible to get your children away from the man and to tell them

it’s not polite to talk like that.

b) explain to your children that the man has a disability and, if they want to know

more, ask if he would mind briefly telling your children what that means.

c) go to the man and apologize for your children’s behavior while encouraging the

children to come with you and to leave the man alone.

2. You see a woman with a disability struggling to get a package off of the floor and into her lap. You

approach her and ask if she would like some assistance. She snaps angrily at you, saying that she can

get it herself without your help. You conclude that:

a) you should not have offered to help her.

b) people who are disabled do not want assistance unless they ask for it.

c) you have just met a person in a bad mood.

d) all of the above.

3. Which of the following positions has not been filled by a person who is legally blind?

a) photographer

b) airplane pilot

c) chemistry professor

d) all of the above

4. You are talking to a woman with a severe speech impairment. You have asked the woman to repeat

herself in order to understand what she is saying. The person has repeated one phrase five times and

you still don’t understand it. You should:

a) give up and go on, assuming you will get the meaning from the context of the rest

of the conversation.

b) ask again and again to have the sentence repeated, until you do understand it.

c) ask the woman to spell the word, or use an alternate word or phrase.

d) get someone else who understands the woman better to serve as an interpreter.

e) make a joke about the situation and laugh at your inability to understand the

woman.

5. Because of your background with organizing church events, you are asked to serve on a committee

that will be organizing a local telethon fund raiser similar to the Jerry Lewis telethon for the Muscular

Dystrophy Association. The proceeds of your local telethon will be donated to the local Association

for Retarded Citizens. After agreeing to serve on the committee, you remember that you have a

neighbor who has been treated for mental illness and who occasionally gives talks about mental

illness. You should:

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This document was taken from the link http://www.in.gov/gpcpd/2349.htm for better viewing purposes.

a) ask your neighbor if he would be interested in helping with the telethon so that you

have consumers involved in raising the money for an organization that benefits them.

b) ask your neighbor if he would share some of his experiences with mental illness

with you so that you will be more knowledgeable and sensitive when dealing with the

people affiliated with the Association for Retarded Citizens.

c) neither of the above.

d) both a and b above.

6. You are talking to a person who is deaf through a sign language interpreter. At the end of the

conversation, you decide to talk to the interpreter. As you begin talking, the interpreter continues to

sign. You stop him, saying, “You don’t have to sign this.” However, the interpreter continues to sign

everything you say. At this point you should:

a) tell the person who is deaf you are having a private conversation with the interpreter

and that you have asked him not to sign.

b) ask the person who is deaf for permission to ask a question of the interpreter; then

ask the interpreter if he will have free time to talk to you later.

c) continue talking, but position yourself so that you block the person who is deaf’s

view of the interpreter.

d) politely draw the interpreter away from the person and explain that you meant your

conversation to be private.

e) lightly touch or hold the interpreter’s hand so that he will realize that you don’t want

the conversation interpreted.

7. A person with a hearing impairment who is a good lip reader will be able to see the following

percentage of spoken sounds by watching the lips of a speaker.

a) 80% – 90%

b) 40% – 50%

c) 35% or less

8. You are teaching a freshman college class in which there is one student with a disability. This

student is working very hard and doing the best she can. However, even her best work is only “D”

quality. She is very eager to do well. You are afraid that if you give her a “D” she will get

discouraged and give up. It is time for mid-term grades; you should:

a) give her a “D” and ask her if she would like to make an appointment to discuss

ways of improving.

b) give her a “C” because she is doing well if you take into account the educational

barriers she is facing.

c) talk to her and encourage her to drop the class and enroll in an easier program of

study.

9. Which of the following has not been heard of?

a) a clinical psychologist who is totally deaf.

b) a medical doctor who is quadriplegic.

c) a person with no arms who is a barber.

d) a biomedical engineer who can barely read or write due to severe dyslexia.

e) all of the above.

f) none of the above.

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This document was taken from the link http://www.in.gov/gpcpd/2349.htm for better viewing purposes.

10. You are in a restaurant and you notice two people who are deaf communicating silently in sign

language. When a waitress goes to their table, one person gives his order out loud, but his voice is

strange, hard to understand, and too loud for the quiet restaurant. The second person does not speak,

but points to items on the menu. You conclude that:

a) the first person is only deaf while the second person is deaf-mute.

b) the first person is mentally retarded as well as deaf.

c) the first person has better speech than the second and speaks for both of them.

d) some people who are deaf like to use their voices, others can speak, but prefer to

communicate silently.

11. Your child watches an old movie on TV. At the end of the movie a couple who are in love and

have been engaged to be married tearfully break their engagement because the man has had an

accident and is now quadriplegic. Your child doesn’t fully understand why the couple had to break

the engagement. You explain that:

a) because of the accident the man would not be able to be a father and would not be

able to be a husband to the woman.

b) because of the accident the man won’t be able to lead a normal life and will need to

live in an institution where he can be taken care of.

c) you’re not sure why the movie ended that way; you think they could have gotten

married and had a fine life.

d) some movies are old and reflect inaccurate information and assumptions, i.e., that a

man with a disability couldn’t support a wife; that a wife needs to be supported; and

that people with disabilities don’t have sexual needs.

e) both a and b above.

f) both c and d above.

12. The DuPont company has conducted studies of its employees with disabilities over a period of 25

years. Which of the following statements do you think most accurately reflects the results of these

studies?

a) employees with disabilities ranked higher than others in safety, job duties and

attendance.

b) employees with disabilities ranked the same as other employees in areas of safety,

job duties and attendance.

c) in comparison to other employees, employees with disabilities ranked slightly

higher on safety, the same on job duties, and slightly lower on attendance.

d) in comparison to other employees, employees with disabilities ranked slightly

lower on safety and job duties but higher on attendance.

e) employees with disabilities ranked almost as high as other employees in the areas of

safety, job duties and attendance.

13. Which of the following disabilities prevent a person from getting a driver’s license?

a) deafness

b) learning disability

c) quadriplegia

d) blindness

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This document was taken from the link http://www.in.gov/gpcpd/2349.htm for better viewing purposes.

e) epilepsy.

f) a and d above

g) all of the above

14. After explaining a complex point, you turn to your coworkers and say, “Do you see what I

mean?” As soon as the words are out of your mouth, you wonder if it was inappropriate to use that

phrase since one of the people you are talking to is blind. At this point you should:

a) apologize for choosing an inappropriate phrase and continue with the conversation,

avoiding all future use of such phrases.

b) continue with the conversation without commenting on having used the word “see”

so as not to embarrass your coworker, but make a note to yourself to avoid using the

word “see” around a person who is blind again.

c) continue talking as you always do, not worrying about whether or not you use

words like “see”, “walk” or “hear” around people with disabilities.

d) ask your coworker who is blind if you should avoid using the word “see” when you

are in conversations with him in the future.

Scroll Down for Answers and Discussion

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This document was taken from the link http://www.in.gov/gpcpd/2349.htm for better viewing purposes.

RESPONDING TO DISABILITY:

A QUESTION OF ATTITUDE

Answer Section

1. b) explain to your children that the man has a disability and, if they want to know more, ask him if

he would mind briefly telling your children what that means.

The curiosity of children about disability is natural and should not be discouraged or

apologized for. Much of our discomfort with disabilities as adults is a result of having been

trained as children to avoid people with disabilities, not to look at them and not to talk to

them. The only way for children to learn to interact naturally and comfortably with people

who are disabled is for them to ask honest questions and receive honest answers.

However, you should also be sensitive to the desires of the person who is disabled. Many

people would be quite willing to talk with your children briefly. In fact, many would be

especially pleased to see a parent who encourages children to interact with them naturally.

However, not all people with disabilities would be willing to talk with your children and even

those who are willing will not always have the time or inclination. Therefore, you should not

be surprised if you are rebuffed upon occasion when choosing this response.

You may consider contacting local organizations of people with disabilities to ask if there are

awareness programs that you and/or your children could attend in order to increase your

exposure to and knowledge of disabilities. This would decrease the likelihood that your

children would be so surprised and curious when they encounter a person with a disability.

2. c) you have just met a person in a bad mood.
People with disabilities are as varied in personality, mood and temperament as other people.

You cannot learn a set of rules “for dealing with people with disabilities,” follow them

faithfully, and expect never to offend a person with a disability. In this case, you just met

someone who either does not like to be offered assistance or someone who happened to be in

a bad mood for receiving assistance at that particular moment. However, that does not mean

that you were in error by offering assistance. Do not assume from one experience that all

people with disabilities would prefer that you not offer assistance. Many would be grateful for

the offer. Some would think that you are rude or insensitive if you don’t offer to help. You

won’t know until you ask.

Although there are no rules to follow to ensure that you won’t offend, there are some

guidelines that will decrease the chances of offending. First, when you see a person who looks

like they could use assistance, ask them if they would like assistance. Don’t assume from one

experience that all people with disabilities would refuse help. If they do indicate that they

would like assistance, ask them what you can do for them and how they would like it done.

Again, don’t assume you know what they want done, or the best way of doing it. This is

particularly true of any personal assistance you may offer (e.g., help with putting on a coat).

When you think a person with a disability needs assistance, offer it as you would offer

assistance to anyone. There is no need to be overly helpful, cautious, patronizing, or

sympathetic because the person is disabled. Your offer may be received with gratitude, turned

down politely, or sometimes, perceived as an insult.

This document was taken from the link http://www.in.gov/gpcpd/2349.htm for better viewing purposes.

3. b) airplane pilot

I have never found a reference to an airplane pilot who is blind. This does not mean that a

person who is blind absolutely couldn’t fly a plane, nor that it has never happened. But to the

best of my knowledge it hasn’t happened yet.

George Covington, a professional photographer who is blind, has written a photography

manual for individuals with impaired vision, Let Your Camera Do the Seeing (published by

the Council of Citizens with Low Vision, 1211 Connecticut Avenue N.W., Suite 506,

Washington, D.C. 20036). People with severely impaired vision can use photography as a tool

by studying greatly enlarged copies of their pictures.

People who are blind have pursued chemistry, biology, engineering and a vast array of other

sciences. You will find references to such scientists, including chemistry professors, in the

Resource Directory of Handicapped Scientists, compiled by J. Alsford Owens, M. Ross

Redden and J. Welsh Brown (AAAS Publication No. 78-13, 1978, Office of Opportunities in

Science, 1776 Massachusetts Avenue N.W., Washington, D.C. 20036).

4. c) ask the woman to spell the word, or use an alternate word or phrase.

The only option that really is not good is to go on with the conversation without having

understood what was being said. Most (not all) people with speech impairments are used to

having to repeat themselves and would rather try to help you understand than have you

pretend you understand when you don’t. Remember that you are probably more frustrated and

embarrassed by the process than the person with the speech impairment. You will look more

foolish if you give an inappropriate answer because you pretended to understand than if you

ask the person to repeat over and over, to use an alternate phrase, to spell, or to do whatever is

necessary so that the two of you can continue genuinely sharing in dialogue.

If neither of the above options work, you may want to resort to option d–asking someone else

to interpret–or option e–making a joke. Asking someone else to interpret can be useful if

there is someone available who can understand the person better than you can. However, it is

not good to rely consistently on an interpreter rather than learning to relax and understand the

person yourself. You should also not use an interpreter simply because you are in too much of

a rush to take the time to understand the person yourself.

Making a joke is useful if you are talking with someone with whom you have good rapport. A

joke might help relax both of you, therefore easing the communication. However, a joke may

also offend. It depends both on your ability to make appropriate jokes and the other person’s

ability to laugh at jokes. The key here is that the joke is as much on your inability to

understand as it is on the other person’s inability to convey the message clearly. You have a

mutual problem.

5. c) neither of the above.

The idea of having consumers involved in organizing the telethon is a good one, as is the idea

of talking to a consumer so that you will be more informed. However, your neighbor in this

scenario is mentally ill and the fund raiser is designed to benefit people who are mentally

retarded. Mental illness is frequently and inappropriately confused with mental retardation.

People with mental illness have emotional problems and may experience inability to cope

with the problems and stresses of life. This is not caused by their intelligence or their capacity

to learn. People with a variety of intellectual capacities can experience mental illness. On the

other hand, people who are mentally retarded develop at a below average rate and experience

This document was taken from the link http://www.in.gov/gpcpd/2349.htm for better viewing purposes.

unusual difficulty in learning, they learn more slowly than others. Although a person who is

retarded is not necessarily mentally ill they, like anyone else, may become emotionally

disturbed.

Consumers with disabilities should be involved in developing services, programs and fund

raisers that affect them. Too often programs are developed in a patronizing way for people

with disabilities and end up perpetuating dependency and stereotypes. People with disabilities

have many strengths that should be drawn on and enhanced. Although the public may be

responsive to donating money for “those poor, helpless people,” society as a whole will

benefit more if the theme of fund raisers is one of investing in the capabilities of people rather

than one of taking care of the helpless.

You should therefore encourage the participation of consumers in organizing services and

benefits that affect them. Don’t assume, however, that all people with disabilities are

interested in or affected by any one service or benefit and don’t assume that a person with one

disability will automatically be interested in helping with a program designed for people with

a different disability.

6. b) ask the person who is deaf for permission to ask a question of the interpreter; then ask the

interpreter if he will have free time to talk to you later.
When on duty, a sign language interpreter’s professional responsibility is to translate

communication, without editing or interjecting personal comments. The interpreter in this

situation is therefore bound to interpret your comments and cannot engage in personal

conversations particularly ones that exclude the person who is deaf. Even more important,

however, is the point that to talk in front of a person who is deaf without translating the

conversation is the same as whispering in front of a hearing person: it is rude, whether or not

the conversation pertains to them. We all like to know what is going on around us, even if we

are not being addressed directly.

On the other hand, occasions do arise when you desire to talk personally with the interpreter.

In this case, you should first request permission from the person who is deaf to address the

interpreter directly. It is courteous to do this since the interpreter is on duty. You should then

proceed just as you would if you wanted to ask one member of a group of hearing people for a

convenient opportunity to speak privately. However, don’t be surprised if the interpreter still

signs your question and his response.

Essentially, when communicating in situations involving a sign language interpreter, you will

do best if you simply talk with the person who is deaf as you would anyone else. You should

not address the interpreter, but rather the person who is deaf. If you say to the interpreter,

“Would you please tell Sue that…” the interpreter will probably turn to Sue and sign, “Would

you please tell Sue that…” Instead, you should look directly at the person who is deaf and say,

“Sue, I want to tell you that…” The interpreter will sign for you while the person who is deaf

watches both you and the interpreter, thus gaining a full understanding of the conversation.

7. c) 35% or less
Estimates as to the percentage of speech that is visible on the lips is 35% at the very highest.

Some sounds are not visible on the lips; others are indistinguishable sounds (i.e., compare

kiss, sis, and hiss, mother and brother, man, ban and pan). Therefore, even those people with

the best skills in lip reading will be unable to distinguish many words. In these instances

meaning is often gathered from context, but much of the content of a communication may be

This document was taken from the link http://www.in.gov/gpcpd/2349.htm for better viewing purposes.

missed. Poor enunciation, moustaches, cigarettes or a tendency to turn ones back to an

audience will complicate comprehension further.

For many people who become deaf prior to age 6 or so, English is a second language. Their

first language is often American Sign Language (ASL), a language with a linguistic structure

different from that of English. Many deaf people have mastered the English language as well

as ASL. Others have not. Those that haven’t may have limited skills in reading or writing

English that are not reflective of their actual level of intelligence or achievement. The range

of English language competency varies among people who are deaf just as it varies among

hearing people.

Despite difficulties, do not hesitate to attempt to communicate with someone with a hearing

impairment. Speak normally without exaggerating your lip movements; people are trained to

read normal mouth movements. If you have difficulty with the lip reading, you may use

gestures, facial expressions, pantomime, pen and paper, interpreters, or all of the above. You

may feel strange at first, but your efforts will be appreciated. A sincere attempt to

communicate generally meets with success.

Whenever you know that you will be meeting with a person who is deaf, or whenever you are

arranging a public meeting or event, do as much as possible to arrange for a certified sign

language interpreter to be present (unless the person who is deaf makes a different request).

Some cities have agencies that facilitate contact and scheduling with interpreters. To assist

you in locating the agency closest to you, contact your local Office of Vocational

Rehabilitation.

8. a) give her a “D” and ask her if she would like to make an appointment to discuss ways of

improving.
It is both dishonest and patronizing to give a person with a disability a better grade than he or

she has earned. In their demand for reasonable accommodation, people with disabilities and

their advocates are not requesting special favors or relaxed standards. If a student is not

competing adequately in a given situation, the situation needs to be explored honestly.

The person may be doing poorly because of the presence of artificial barriers that can be

modified or eliminated. For example, this student may be doing poorly because of a lack of

access to critical classroom material (i.e., an inaccessible reserve reading room, a lecture

course that is not interpreted in sign language, books that have not yet been put on cassette

tape or made into braille, testing procedures that have not been modified). Giving a better

grade than deserved, or encouraging the student to try an easier course, would remove her

from this learning situation before the situation had been explored. In some cases you might

never discover that her poor performance may lie not in her disability or in her aptitude, but in

artificial but overlooked educational barriers that could be modified. By making modifications

that eliminate competitive disadvantages, student performance often can improve without

sacrificing standards or granting special or unfair privileges.

On the other hand, this student may be doing poorly because she was not adequately prepared

for college level work. Rather than passing the student on, you should give her honest

feedback and help prepare her for the reality that sooner or later she may need to do some

remedial work. If other professors are passing this student on, giving her better grades than

she deserves, she may choose not to believe you. However, at some point she will need to

This document was taken from the link http://www.in.gov/gpcpd/2349.htm for better viewing purposes.

come to grips with the reality of her performance level. The sooner this occurs, the easier it

will be to remedy.

Finally, this student may be doing poorly because she is not college material. If she really

wants to continue with college, despite feedback that she may not succeed, she should be

allowed to try. All of us learn as much from our failures as from our successes. People with

disabilities have often been sheltered from failure and have thus missed valuable learning

opportunities. Students with disabilities should not be set up for failure, but they should not be

treated as exceptionally fragile either. We all have a “right to fail.”

9. c) a person with no arms who is a barber
Although I have never heard of a barber who has no arms, after seeing the film “A Day in the

Life of Bonnie Consolo,” I do believe that if a person with no arms wanted to become a

barber it would be possible (available from Barr Films, P.O. Box 5667, Pasadena, CA 91107–

16 minute, 16mm color film). The attitudes of potential clients would present far more

difficulties than the mechanics of using one’s feet to do the job. In the film Bonnie Consolo

trims her son’s hair, bakes homemade bread slices tomatoes, writes checks and drives her car

all with her feet.

You can find the names and addresses of clinical psychologists who are deaf, medical doctors

who are quadriplegics and many other scientists who are disabled by consulting the Resource

Directory of Handicapped Scientists compiled and edited by Janette Alsford Owens, Martha

Ross Redden, and Janet Welsh Brown (AAAS Publication No. 78-13, 1978, Office of

Opportunities in Science, American Association for the Advancement of Science, 1776

Massachusetts Avenue N.W., Washington, D.C. 20036).

A little research can uncover endless examples of people with disabilities who have

accomplished extraordinary things. While opening ourselves to recognizing the potential of

people with disabilities it is also important to avoid creating new “super-crip” expectations or

assumptions that all people with disabilities are courageous, determined or talented.People

with disabilities are as varied as other people: some are exceptional, many are ordinary. Not

all talented people with disabilities will choose to pursue professional careers or succeed

when they do.

10. d) some people who are deaf like to use their voices; others can speak, but may prefer to

communicate silently.
People with deafness have voices; they are not mute. The loss of vocal production can occur

in anyone, but it is a separate disability and is not automatically associated with deafness.

Terms such as deaf-mute or deaf and dumb reflect the inaccurate thinking of an era when few

people were given opportunities to learn how to use their voices. People who are deaf have

impaired hearing, but their impaired hearing has nothing to do with the quality of their

intelligence, their vocal cords, or their eyesight.

Learning to use one’s voice to speak effectively requires time, effort, and concentration, and is

especially difficult for people who lost their hearing in infancy. Some people who are deaf

choose to use their voices regularly. Others decide that this is not the best option for them.

Not all deaf people who choose to use their voices will sound like hearing people when they

talk. Hearing people monitor the volume, tone and expression of their speech by listening to

their own voice when speaking. People who are deaf cannot do this and thus sometimes have

voices that sound strange or unusual to others. Occasionally a person who is deaf’s speech

This document was taken from the link http://www.in.gov/gpcpd/2349.htm for better viewing purposes.

may sound similar to the speech of a person who is retarded or the speech of a person from a

foreign country. However, it is not accurate to assume anything about a person’s intelligence

or abilities by the sound of that person’s voice or by that person’s decision not to use his or her

voice. In this case, the person who is pointing to items on the menu is effectively “speaking”

for himself, even though he is not using a voice to do so.

11. f) you’re not sure why the movie ended that way; you think they could have gotten married

and had a fine life; and some movies are old and reflect inaccurate information and

assumptions, i.e., that a man with a disability couldn’t support a wife; that a wife needs to be

supported; and that people with disabilities don’t have sexual needs.

Two common myths are that people with disabilities don’t have sexual desires or abilities and

that they can’t be parents. First, whether or not a person with a disability can biologically

parent a child varies from disability to disability and person to person. Many people with

disabilities can have biological children, For the others an inability to have biological children

certainly does not preclude one from being a successful parent. More and more frequently

people with disabilities are having children, adopting children, and winning custody of

children. The sexual needs and desires of people with disabilities are not different than those

of other people. The ability to “perform” sexually varies depending on the disability and the

person. In general, sexual performance is less impaired than is often assumed.

Of greater significance is the realm of relationships and sexuality which goes far beyond the

ability to perform specific sex acts. Using definitions of sexuality and sexual needs accepted

by the field of sex therapy one would find very little that would be seriously affected by the

presence of disability. Many people with disabilities lead sexually satisfying lives and are

equally able to satisfy the sexual needs of their partners. And, of course people with

disabilities do not need to look only toward other people with disabilities in their search for a

partner. A popular movie which portrays these issues accurately and sensitively is Coming

Home starring Jane Fonda and John Voight.

12. c) in comparison to other employees, employees with disabilities ranked slightly higher on

safety, the same on job duties, and slightly lower on attendance.
DuPont collected new data in 1981; this data confirmed the results found in earlier studies.

Supervisors at DuPont were asked to rate their employees with disabilities and a matching

sample of other employees in the areas of safety, performance of job duties and attendance.

Ninety-six percent of the employees with disabilities were rated average or above average by

their supervisors in the area of safety whereas only 92 percent of the other employees were

rated average or above average in safety. Supervisors rated 92 percent of employees with

disabilities average or above on performance of job duties in comparison with 91 percent of

others. In the area of attendance, 85 percent of employees with disabilities were rated average

or above while 91 percent of other employees were rated average or above. You can receive a

copy of DuPont’s report on this study, Equal To the Task by contacting: E.I. du Pont de

Nemours and Company, Public Affairs Department, 8084 DuPont Building, Wilmington, DE

19898.

This confirms what employers across the country have already learned: people with

disabilities placed in appropriate jobs are just as reliable, productive and safe as other

employees. As with anyone, some workers will be better than others. The central point is that

This document was taken from the link http://www.in.gov/gpcpd/2349.htm for better viewing purposes.

a person’s disability is not related to whether or not that particular person will make a good

employee.

13. d) blindness

As far as I know, people who are blind cannot get driver’s licenses. However, many people

who are blind have taken cross country bicycle trips. I have even heard a report that in

Sweden people who are blind drive trucks in restricted settings by using earphones. I haven’t

been able to verify this report. (Editors note: there are adaptive devices using magnification

which enable people with certain types of vision impairments to drive)

People who are deaf can and do drive cars. Although hearing people usually rely on their

hearing for driving cues, hearing is certainly not necessary. A hearing person driving in

summer with the windows up and radio on is no different from a person who is deaf. Having a

learning disability does not preclude a person from driving a car. People with learning

disabilities have normal intelligence, eyesight and hearing, but have trouble learning in the

way others do because of difficulties in understanding or using spoken or written language or

performing mathematical operations. Many people with learn- ing disabilities learn to drive

successfully; others don’t. The extent to which a learning disability interferes with the ability

to drive varies from person to person since there are many types of learning disabilities. Some

people with learning disabilities may need to take longer to learn how to drive and to relax

while driving. Each person needs to find the compensation techniques and learning style that

works best.

People with quadriplegia, people with no arms and even people with severe cerebral palsy are

able to drive with the use of adaptive technology. Technology has developed to the point that

almost anyone with the desire and with the access to sufficient funds to purchase the hand or

foot controls best for them can drive their own vehicle.

Epilepsy is a condition that can very often be controlled through medication. Laws vary from

state to state but generally after one year without a seizure and with a doctor’s signature, a

person with epilepsy can get a regular driver’s license. Sometimes states also require the

license to be renewed more frequently than the standard time period so as to check to be sure

the person’s seizures are still under control.

14. c) continue talking as you always do, not worrying about whether or not you use words like

“see,” “walk,” or “hear” around people with disabilities.
All languages have expressions with meanings different from a literal translation. Phrases like

“do you see what I mean” or “I hear what you are saying” do not literally refer to seeing or

hearing. Because of this, people with disabilities tend to use these phrases as much as others.

A person who is blind can “see what you mean” because the phrase really means “do you

understand my point; am I being clear?”

A person who uses a wheelchair can “take a walk around the park” because that phrase refers

to moving around on a stroll more than it refers to the actual process of placing one foot in

front of another. Sometimes a person who uses a wheelchair may prefer to use the phrase

“take a wheel around the park.” However, it would be inappropriate to carefully monitor your

speech to eliminate use of any words or phrases such as this. That would tend to produce an

unnatural stiffness and awkwardness in your speech. Relaxing and talking naturally when you

are with people who are disabled is essential to acceptance of disabilities and people who

This document was taken from the link http://www.in.gov/gpcpd/2349.htm for better viewing purposes.

have disabilities. Being overly conscious of disability can cause discomfort and awkwardness

on everyone’s part.

Although it is not necessary to stiffly screen out use of any idioms with physical references

when talking to people with disabilities, it is useful to examine the labels we use when

referring to people with disabilities to identify potentially inaccurate assumptions underlying

such labels. People who are deaf have been referred to as “deaf-mute” or as “deaf and dumb;”

people who use wheelchairs have been referred to as “invalids;” people who are retarded have

been referred to as “poor things” and “vegetables.” These phrases are inaccurate and reflect

the stereotypical thinking of a time when little was known about disabilities and the

capabilities of people with disabilities. Besides eliminating use of inaccurate labels, it is also

appropriate to eliminate use of phrases that undercut a person’s dignity. Referring to a person

with a disability as “wheelchair bound” or a “cripple” is neither accurate or respectful.

In short, some changes do need to occur in our use of language. However, it is not necessary

to bend over backwards, becoming self-conscious and stiffly avoiding use of common idioms.

Speak naturally and ask what phrase is most appropriate if you are unsure.

Guiding Questions for Researching Rhetorically 2

Below I’ve provided you with some questions to help you with your answer. Please 
do not answer in bulleted form. Use the questions below to help you write your response.

Guiding Questions for Researching Rhetorically 2

1. Analyze the genre, purpose, and audience of the text you’ve chosen.

· Where is this text published or made public?

· Who is the specific intended audience? What is the purpose of this text?

2. Rhetorically analyze the text you’ve chosen:

· What stylistic choices do they make?

· What content choices? What choices regarding images, layout, etc?

· How do such choices relate to their rhetorical purpose/s?

· How are they trying to affect change, attract participants, etc.?

3. Based on the social media post(s) you’re analyzing,

· How does this social media platform seem to impact the rhetorical aspects of this text?

· In other words, how does the fact that this text is on social media impact the way that this text engages with its audience and/or achieves its purpose?

· How does this compare to the other texts you discussed in Researching Rhetorically 1? 

4. How does the message in this text align or not align with the texts about your topic? 

· In other words, what are some connections you notice between this social media text and the ones you analyzed in Researching Rhetorically 1?

5. How does this source use evidence?

· Is it reliable? Why or why not?

· What kind of information is given? 

6. How does this source participate in a larger conversation with the other sources you looked at? 

7. What did you learn from this source that you did not know from the previous sources?

· Did you learn something new about your movement or organization?

· In what ways does this source build on or contradict the other sources?

· How does the genre/medium affect the source’s argument?

MAP-IT stands

Creation of a health promotion initiative to improve health indicators for “your health problem”. This activity is focusing on your creativity, analysis of facts, organization and leadership qualities. Be concise but comprehensive in your ideas.

MAP-IT stands for:

M Mobilize

A Asses

P Plan

I Implement

T Track

Using MAP-IT framework briefly determine how you may:

1. Mobilize resources and stakeholders to take care of the selected health problem in your community, determining mission and vision of the resulted coalition, defining partners, their roles and meeting plans.

2. Asses the problem, including a realistic long-term goal, how you may collect data to determine your needs and priorities logically organized

3. Plan objectives and steps to achieve them. Consider opportunities for interventions with broad reach and impact. How may you measure your progress? What is expected to change, by how much, and by when? Choose objectives that are challenging yet realistic.

4. Implement. Create a detailed work plan that includes concrete action steps assigned to specific people with clear deadlines and/or timelines. Share responsibilities across coalition members but consider having a single point of contact to manage the process to ensure that things get done. Check in with coalition members by using the Coalition Self-Assessment to see if your process is running smoothly. Develop a simple communication plan. Use kick-off events, activities, or campus meetings to showcase your coalition’s accomplishments.

5. Track. Plan regular evaluations to measure and track your progress over time. Evaluations can help your coalition determine if your plan has been effective in achieving your goals. Be mindful of limitations of self-reported data, data quality, data validity, and reliability. Partnering with a statistician or researcher at your institution can help you conduct a quality evaluation. You can use these basic formulas to calculate baseline, target, and achieved rates for your selected health outcomes.

2

Hyperlipidemia: lifestyle modifications combined with pharmacologic treatment

Hyperlipidemia, also referred to as dyslipidemia, is a condition that occurs when fats are deposited in the arteries increasing the risk of blockage. Hyperlipidemia is a major health issue among Hispanic females, which increases the risk of cardiovascular diseases in this patient population (Lamar et al., 2020). Current evidence indicates that the national prevalence of hyperlipidemia among U.S. adults is 11.3% (MacDonald, 2022). About 27.3% of the population in Miami-Dade County has high cholesterol (Miami-Dade Matters, 2019). This project aims to identify the effectiveness of combining lifestyle modifications with pharmacology treatment in improving cholesterol levels in mid-aged female Hispanics with hyperlipidemia diagnosis.

Hyperlipidemia: lifestyle modifications combined with pharmacologic treatment

Population

Hispanics are among the ethnic groups at the highest risk of developing hyperlipidemia. Middle-aged Hispanic females are at risk of hyperlipidemia due to various risk factors. Evidence from research indicates that the prevalence of hyperlipidemia is high across all Hispanics, but some groups within the population are more affected such as women. Various factors make women more vulnerable to hyperlipidemia which makes it interesting to focus on the mid-age female population.


Social determinants

The social determinants of health that predispose Hispanic females to hyperlipidemia include individuals’ socioeconomic status, household income, level of education, access to healthy foods, employment, and gender. Socioeconomic status is closely related to other factors such as the level of household income and education level. Individuals of lower socioeconomic status are more likely to have lower education levels, lower household income, and poor access to healthy foods, which could influence their health outcomes (Hudson et al., 2020).


Risk factors

Several risk factors predispose Hispanic females to hyperlipidemia such as high body mass index (BMI), obesity, older age, female gender, low physical activity level, alcohol use, and diabetes (Lamar et al., 2020). The risk of hyperlipidemia is higher in individuals with high BMI, advanced age, and those that are physically inactive due to an increase in weight. Lamar et al. (2020) indicated that women were more affected by hyperlipidemia compared to men, particularly those who are older, obese, and those with underlying conditions such as diabetes. Females are more likely to be obese and physically inactive.

Literature review

Ramírez et al. (2020) conducted a study and wrote an article titled “Prevalence of hyperlipidemia and its associated factors in university students in Colombia.” The purpose of the study was to establish how prevalent hyperlipidemia was and the factors associated with its development. The authors used studied 361 students. They used a sociodemographic survey method in their descriptive cross-sectional study. The researchers established that the prevalence rate was 33.8%, and the risk factors included male sex and alcohol consumption. The limitations identified included the lack of data on participants’ glucose levels, height, and weight. 

In another study, Rodriguez et al. (2017) conducted a study called “High Cholesterol Awareness, Treatment, and Control Among Hispanic/Latinos: Results From the Hispanic Community Health Study/Study of Latinos” this study focused on identifying the factors that facilitate awareness in Hispanic patients with high cholesterol. This quantitative study focused on populations from 18 to 74 years of age, of which only 29.5% were undergoing treatment; specifically, the younger patients did not have treatment due to a lack of interest. However, the older patients participated in comprehensive treatments that included medications and healthy lifestyles. The patients who followed the comprehensive treatment in detail showed an improvement of 64%, achieving control of the pathology and demonstrating greater awareness about the disease and the treatment. Likewise, they identified that Cuban and South American people sought less attention for cholesterol control than patients of Puerto Rican and Dominican origin. Finally, this study identified a relationship between age and origin of birth with the follow-up of a comprehensive treatment since other patients with a lower rate of effectiveness in reducing cholesterol did not follow a treatment or a pharmacological treatment but did not include healthy lifestyles.

The study done by Risica et al. (2021) conducted a study called “Clinical outcomes of a community clinic-based lifestyle change program for prevention and management of metabolic syndrome: Results of the ‘Vida Sana/Healthy Life’ program.” In this study, the authors identified that Hispanic populations are more likely to develop cardiovascular diseases. In developing an eight-week program in a community care center for Spanish speakers, the authors performed clinical examinations and physical examinations as entry indicators. Also, they evaluated the knowledge that patients had about healthy habits for the control of cardiovascular diseases, specially high cholesterol, is the leading cause of to development of serious pathologies. The population included women and men of Hispanic origin between 18 and 70; those who showed insufficient knowledge about healthy habits had worse cholesterol results. Finally, the program improved the knowledge of healthy habits, causing a weight reduction and improvement in clinical examinations and physical examinations, demonstrating that the intervention in healthy habits is an essential factor for the control of cardiovascular pathologies and improving the quality of patient life.

Fernandez (2021) was interested in identifying which factors predispose the Latino population to suffer from non-communicable diseases such as heart disease and how these factors increase the health disparity between Hispanic and American populations. In this study, the author identified obesity as the first factor due to inadequate diets that increased plasma cholesterol and triglyceride levels, predisposing patients to developing Dyslipidemia, including hyperlipidemia. Patients with cardiometabolic risk usually start pharmacological treatment to control signs and symptoms. However, the Latino population tends to resist making lifestyle changes and adopting healthy health behaviors, such as healthy eating and physical activity. For the author, the lack of weight control, diet, and physical activity is the leading cause of the high prevalence of metabolic and cardiac diseases in the population. Therefore, the author suggests that healthy behaviors should be promoted among the Hispanic population in a preventive way to reduce weight, control eating, and encourage physical activity since, unlike other diseases, Dyslipidemia is preventable from lifestyles. Healthy.

           The article by Mohsen et al. (2020) was titled “Effectiveness of lifestyle modification on lipid profile for patients with hyperlipidemia.” The authors aimed at examining how lifestyle modification affects the lipid profiles of patients with hyperlipidemia. The study sample included 100 participants. A quasi-experimental design was used in the study. The findings indicated that there were significant differences in the improvement of cholesterol level, triglyceride, and blood pressure levels between the patients that received the lifestyle intervention and those that did not. The study limitation was the small sample size.  

           Vincent et al. (2019) conducted a study and created an article titled “Meta-regression analysis of the effects of dietary cholesterol intake on LDL and HDL cholesterol.” The purpose of the study was to determine how does respond to changes in the intake of cholesterol and markers for lipoprotein-cholesterol in patients at risk of cardiovascular disease. The authors extracted data from 55 publications with 2652 participants. They conducted a meta-regression analysis of data extracted from randomized trials involving dietary interventions. The authors established that there was a positive association between dietary cholesterol and changes in the concentration of LDL cholesterol. The limitations of the study findings include the uncertainty in the practical implications of the findings due to the limitations in the methods used.


Strengths and weaknesses

           The major strengths of the articles were that all of them were relevant to the topic as each study focused on hyperlipidemia. All the studies revealed that lifestyle modification can be effective in improving cholesterol levels in patients with hyperlipidemia. The studies were published in peer-reviewed journals which enhances the credibility of the evidence provided. All the studies were current. The conclusions made were consistent with the results and statistical data provided in the articles. The weakness identified among the studies is that the results obtained from each study respond to a specific population; although it can be applied and verified in other populations, the results closed to specific communities can make it challenging to apply to other populations with more significant limitations for the researchers.

Proposal

           Based on the evidence obtained from the literature review, the problem of high cholesterol can be addressed through a combination of lifestyle modification and medications involving diet and exercise (Mohsen et al., 2020). Lifestyle modification can be recommended for mid-age Hispanic females with hyperlipidemia to reduce their cholesterol levels. The intervention will aim at reducing the fats that have already accumulated in the body and also prevent fat accumulation from dietary intake. The lifestyle modifications will be combined with medications to enhance the effectiveness of the medications in controlling hyperlipidemia. 

The resources required to implement the intervention include brochures with information about healthy diets and appropriate exercises, medications for controlling hyperlipidemia, and meeting rooms in which patients will be educated about the intervention. The professionals involved will include nurses, physicians, pharmacists, and dietitians. The nurses will educate patients about the program; physicians will conduct assessments to establish that the patients meet hyperlipidemia diagnoses; pharmacists will prescribe medications, while the dietitians will educate the patients about healthy diets. 

           Nurses can be effective in an advanced role as they have the training and skills required to perform advanced practice roles such as evaluating and managing patients, leadership, and patient education. The advanced role allows a nurse to make autonomous and complex care decisions. Nurses can use their expert knowledge and clinical capacities to meet the primary care needs of patients and can provide some of the care services provided by physicians, and other professionals in the interdisciplinary care team (Woo et al., 2017). The implementation of the intervention would take 15 weeks, after which it will be evaluated to determine whether the expected outcomes were achieved. The expected outcome is a reduction in the cholesterol level, which is critical in the treatment and management of hyperlipidemia.


References

Fernandez M. L. (2021). Lifestyle Factors and Genetic Variants Associated to Health Disparities in the Hispanic Population. Nutrients, 13(7), 2189.
https://doi.org/10.3390/nu13072189 Hudson, S. E., Feigenbaum, M. S., Patil, N., Ding, E., Ewing, A., & Trilk, J. L. (2020). Screening and socioeconomic associations of dyslipidemia in young adults.
BMC Public Health, 20(1), 1-9. https://doi.org/10.1186/s12889-019-8099-9

Lamar, M., Durazo-Arvizu, R. A., Rodriguez, C. J., Kaplan, R. C., Perera, M. J., Cai, J., Espinoza Giacinto, R. A., González, H. M., & Daviglus, M. L. (2020). Associations of lipid levels and cognition: findings from the hispanic community health study/study of latinos.
Journal of the International Neuropsychological Society: JINS, 26(3), 251–262.
https://doi.org/10.1017/S1355617719001000

MacDonald, T. (2022). Prevalence of High Cholesterol Among the Adult U.S. Population: NHANES 2013–2018. 
Current Developments in Nutrition
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