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Environmental Issues Essay Paper history assignment help writing services: history assignment help writing services

Environmental Issues

Question 1: What is global warming, and how can it be reduced?


Global warming refers to the gradual rise in the temperature of the atmosphere of the earth associated with the greenhouse effect as a result of the accumulation of chlorofluorocarbon, Carbon (IV) oxide, and other pollutants. There are various ways of preventing global warming, which include using renewable energies such as geothermal, wind, solar, and biogas instead of fossil fuels. We should also enhance sustainable public transportation, hydrogen, and electric mobility to reduce emissions of carbon (IV) oxide, and hence fight global warming. We should also promote sustainable forest and agriculture management by using natural resources and avoiding deforestation (Harvey, 2018).

Question 2: What is the importance of controlling water pollution?


Water pollution refers to contaminating water bodies such as oceans, lakes, and rivers, mainly due to human activities. The primary sources of water pollution are industrial discharge, domestic waste, detergents, fertilizers, pesticides, and insecticides. Other sources of water pollution include factories, refineries, and waste management facilities that release untreated residues and dangerous byproducts to water sources. It is essential to control water pollution to avoid waterborne diseases such as cholera and typhoid, elimination of aquatic animals through eutrophication, which reduces the amount of oxygen for marine life. We should prevent water pollution by treating sewages before disposing them to water bodies and using environment-friendly products that do not pollute the water.

Question 3: Which possible hashtags will you employ to campaign against water pollution and global warming?

Hashtags can be critical in promoting a campaign when used strategically, especially on twitter campaign by the use of hot topics and trends. They help to raise awareness about the primary purpose of the campaign to a broader audience and target a specific audience. The possible hashtags I can use for my campaign are #StopGlobalWarming, #ClimateChange, #SaveWaterBodies, #ClimateJustice, #EnvironmentallyFriendly, #SaveAquaticLife, and #GlobalWarmingisReal. My favorite hashtag is #EnvironmentallyFriendly because it will create awareness on the importance of conserving the water sources and the atmosphere


Question 4: What is the purpose of the campaign?

What is the target audience?

What does the campaign hope to achieve?


Harvey, L. D. (2018). Global Warming. Routledge.


E-cigarettes vs. nicotine replacement therapy (NRT) for smoking cessation university history essay help

Researches have proposed that 5% of the over 55 population have CAD. You are working with a colleague who believes that you should screen at your health center all patients over 65 with the lipid sniff test.. This test has reported a sensitivity of 33 -78% and a specificity of 70 – 93%. Construct two 2×2 tables and calculate the PPV, NPV, for the worse (sensitivity 33%/ specificity 70%) and best case-sensitivity and specificity of this test (sensitivity 78%/ specificity 93%). Please show the equations, your calculations, and place your answers in the tables below. What would you recommend to your colleague about screening for dementia using this test and explain your answer?


NPV       =               d

c + d

=                630 

67 + 630

=             630/ 697

=             0.90


PPV        =                a

a + b

=                 33


=             33/ 303

=             0.119

NPV       =               d

c + d

=                837

22 + 837

=             837/ 859

=             0.97


PPV        =                a

a + b

=                 78

78 + 63

=             78/ 141

=             0.553

Both NPV and PPV are seen to provide clinical relevance to a test. They are crucial because they use the prevalence of a condition to determine the possibility of a test that diagnoses that particular disease. Sensitivity and specificity are important measures in the diagnostic accuracy of a test, but they do not estimate the probability of a disease in an individual patient. PPV and NPV, on the other hand, are estimates of the probability of a disease, but they both vary according to the prevalence of a disease.

“(Routine CT scans for smokers) yielded an estimated 10-year survival rate of more than 90%, researchers said. Currently, about 5% of the 174,000 lung cancer patients diagnosed each year survive for ten years…_.” Efficiently use concept(s) from Welch’s lectures to explain this finding.

This statement shows the possibility of curing patients early of lung cancer and using CT scans to find the disease. The results are astonishing! That a CT scan for smokers can increase the survival rates of lung cancer patients from 5 to 90% is unbelievable, and the question to ask is, does this prove that the scans work?

This can be determined by understanding the survival rate:

In this case, the survival rate is 10-years, which is the proportion of people diagnosed with lung cancer that is still alive after 10 years. Take, for instance, 10,000 people were diagnosed with lung cancer 10 years ago. If 500 of them are still alive today, then the survival rate is 500/10000, which is also 5%, and if 2,000 of them are alive today, the survival rate will be 5,000/ 10,000, giving us 50%. Yet, even if the survival rate increased to 50%, none of the diagnosed patients may live an extra day. The understanding is, some patients are diagnosed early enough, and they may survive more than ten years after the diagnosis. Still, patients who are diagnosed late have zero chances of survival.

See the above forest plot:

Demonstrate your mastery of reading forest plots by explaining each line in detail. What do these results indicate?

The data provided in the above forest plot on the effects of antiplatelet therapy on women with gestational hypertension events were available from five trials and included 1643 participants and 193 events. The overall, compared with the usual care control or placebo groups, the antiplatelet therapy produced a 40% reduction on the odds of the gestational hypertension events, or 0.60; 95% CI, 0.45 – 0.78; P = 0.0033, without evidence of heterogeneity in the results of the individual trials since I2 = 74%, and heterogeneity is = 15.63. According to Clasp (1994), 46 events were recorded of 667 participants in which the risk of gestational hypertension was not altered by antiplatelet agents (0.92; 95% CI, 0.63 – 1.36). For India (1994), however, antiplatelet agents helped reduce the odds of gestational hypertension by 79% (0.21; 95% CI; 0.09 – 0.19). The same case applies to India (1999), where antiplatelet agents reduced the occurrence of gestational hypertension. In Israel (1990), the risk of gestational hypertension was not altered at all by antiplatelet agents, although there was a clear effect in the UK (1992).

E-cigarettes vs. nicotine replacement therapy (NRT) for smoking cessation

The rate of sustained one-year abstinence in the e-cigarette group was 18% while that for the nicotine-replacement group was 10% (RBI 0.83; 95% CI 0.3 to 1.58). The absolute difference existing between the e-cigarette and the nicotine-replacement group is eight percentage points. This results in a number that is needed to treat for an additional person. The results do not change significantly for the four risks. However, abstinence rates are higher in the e-cigarette group than the nicotine-replacement group at all the different time points.

The study also shows that cough and phlegm were higher in the nicotine-replacement group than the e-cigarette group, which is an indication that replacing nicotine had greater health impacts than resorting to e-cigarette. The relative risk for phlegm, however, was higher than that of cough for both groups. It is also evident that the severity of the urge at one week was higher for the NRT group than for the e-cigarette group, and it remained higher even after four weeks. The relapse rates and time to relapse at 52 weeks for subjects with sustained abstinence at four weeks did not record a significant difference between the two groups

What is evident, however, is that the mean difference between the two groups decreased as time increased, although the time provided is a bit limited in helping come up with a conclusive answer. The table also indicates that the participants reported a reduction by at least five cigarettes from the two weeks following their quit date, and an expired carbon monoxide level (<8ppm). There were also reports of no-smoking from two weeks after the quit date and expired carbon monoxide level <8ppm at four weeks.

Demonstrate your understanding of the two principal forms of reasoning. What is the difference between inductive and deductive reasoning? How do you identify which form of reasoning you are implementing? How would this affect patient care?

Two types of reasoning exist, including inductive and deductive reasoning. I understand inductive reasoning as reasoning in which the premises support the conclusion, which is the hypothesis. This means that the conclusion is reasoning that inductive reasoning intends to prove. An example is where Kelvin, a firstborn, believes that all firstborns marry before their siblings. He argues that his cousin, who is a firstborn, married before his siblings, his father married before his younger brothers, and his friend, James, also married before his siblings. This is a generalized conclusion that all older brothers marry before their siblings. Deductive reasoning, on the other, is reasoning where true premises develop a true and valid conclusion. In this case, the conclusion is only true if the premises are true. Deductive reasoning uses general principles to develop a certain conclusion. It is also known as top-down reasoning in that it starts from the general, working its way down to specifics. An example is that “all cars have engines, and I have a car. Therefore, my car has an engine.”

One can differentiate between the two forms of reasoning by understanding that while deductive refers to the outcomes of a set of conditions, inductive is concerned with determining the probability of an outcome. Yet, it is important to understand that only possible conclusions can be drawn since not all conditions that influence or determine the outcome of a certain situation are known.

In fewer than 100 words, discuss the concepts of Bayesian thinking.

Bayesian thinking takes into consideration not only want the data says but what the expertise says as well. Bayesian thinking is based on the idea that more is known about a physical situation than what is contained in data gathered from a single experiment. It is therefore advisable that decisions are made based on prior information about a certain situation, and new evidence from collected data.

See the above graphic: 02 therapy

“In acutely ill hospitalized patients, an international panel strongly recommends that SpO2 be maintained at no higher than 96% in patients with stroke or M.I., they suggest not starting oxygen therapy for Spo2>90%.”

You are preparing an information session for your staff about this issue. Please use the above graphic to develop a brief bulleted handout in simple language summarizing this information.

The hospital provides supplemental oxygen to patients admitted regardless of oxygen saturation in their blood.
This table shows that too much supplemental oxygen can increase the mortality for patients admitted in hospital,

The patients receiving oxygen therapy should receive peripheral capillary oxygen saturation (SpO2) of less than or equal to 97%.

The target range of peripheral capillary oxygen saturation range of 92% seems to be okay for most patients and 90% for patients who are at risk of respiratory failure. It is always better to use the minimum amount of oxygen possible.
Finally, acutely ill patients and those suffering from myocardial infarction and stroke, oxygen therapy should not go above 90%.
See the graphic below (Poorly diagnostic findings). This is poorly diagnostic findings in community-acquired pneumonia, explain why the same physical exam findings of crackles and decreased breath sounds have poor sensitivity and specificity. Yet, they are considered to have a good likelihood ratio. Please explain each line.

The above diagnosis shows that the Crackles have a sensitivity of 50%, specificity of 81%, LR+ of 2.6, and an LR- of 0.6. The decreased O2 saturation has a sensitivity of 52%, specificity of 80%, LR+ of 2.6, and LR- of 0.6. It also showed that decreased breath sounds had 48% sensitivity, 81% specificity, 2.5 LR+, and 0.6 LR-. The explanation behind the findings of crackles and breathing sounds having poor sensitivity and specificity, and a good likelihood ratio may be first, pneumonia patients with crackles may be sicker than those without, and are therefore likely to be admitted and frequently. Atypical pneumonia, on the other hand, means low sensitivity to crackles as opposed to patients with pneumococcal pneumonia. The second explanation may mean that a pneumonia diagnosis can be missed when crackles are not present, which means a lower rate of admission.


The equity theory of motivation history assignment help is it legit: history assignment help is it legit

Equity Theory


This paper explores the equity theory of motivation, including its past and present application. Equity theory by Adam, an American psychologist, recognizes that apart from salary, and gifts, employees get motivation from fair treatment. The word fairness, in theory, is the treatment of employees about their dedication to the organization. Employees get motivated when they realize that the rewards resonate with the commitment they put, including skills and loyalty towards the organization. However, they also assess whether other workers are doing lesser tasks but with higher pay than theirs, leading to demotivation. The paper also finds that equity theory has maintained its assumption without any update due to its basic construction. The approach applies in therapeutic settings to assess therapy that resonates with patients’ needs and hence raise satisfaction. In Educational settings, Equity theory also guides educators to support student’s needs as opposed to generalization. However, business people use the approach to control employees’ hard work and behaviors by varying rewards in comparison to their practices and hard work.

Keywords: Equity Theory, Motivation, Input, Output, Rewards, Satisfaction

Theory Overview

Equity theory, referred to as Adam’s equity theory, is a motivation model that John Stacy Adam, an American behavioral and workplace psychologist, created in 1963 (John & Chiekezie, 2016). Adam developed the theory after realizing that equity and fairness are an essential component of individual motivation. According to the theory, fair treatment of employees leads to motivation and vice versa. Fairness in the theory context is balance in employee input and output and also treatment about other employees and organizations (John & Chiekezie, 2016). The theory considers input as employees’ quantity and quality of contribution to the organization, including skills, loyalty, social skills, and experience. Output, on the other hand, is the employees’ rewards material and non-material, for example, praise and recognition. Employees who get rewards that are proportionate to the input have motivation because of the feeling of fairness. Employees also compare their input and output to those of their colleagues. Demotivation occurs when employees feel that their colleagues are getting more rewards with fewer efforts.

Application of the Theory in the Past and Present

Equity theory application concentrated on the motivation of employees at the begging, later in marketing, and finally went back to capitalize on workplace motivation.  Huppertz et al. (1978) demonstrate that the theory gained application in marketing to motivate customers following Adam’s recommendation that it was applicable in any relationship exchange. The researcher performed research to show find out whether equity theory would apply to attract customers in retail. Findings indicate that customers are sensitive to equity in input and output, which makes it possible to use Adam’s theory as a marketing tool (Huppertz et al., 1978). The cost in which customers for products are inputs while the price and customer service they receive is the output. Where the customers perceive that the cost they pay is too high for the services and price, they perceive inequality and likely to avoid the retailer. However, the relationship is more complex, as Huppertz et al. explain in the research study.

In the present, Adam’s theory has an extensive application in business organizations to motivate employees. However, managers are using the approach to stimulate the right behaviors and hard work. In a research study, Gino and Pierce (2009) found that employees are likely to engage in honest acts when they perceive equity in treatment with high-level workers. Employees, as a result, are using the theory to motivate employees towards the adoption of other behaviors that maintain organizational culture as opposed to directly increasing productivity. However, employees are using the same approach, indirectly stimulating worker performance. John and Chiekezie (2016), in a study, found that fair treatment of employees motivates university employees. Adam’s theory, as a result, has several applications, including motivation for the right behaviors and hard work in organizations in the present.

Current Updates on the Theory

Adam’s equity theory has no received any update since its development due to its general or primary approach to motivation. Recognized the theory as “the explicit and rigorously developed,” and which had sustained prediction of behavior in relationships by 1983 (Cosier & Dalton, 1983, 311). Other theories have built on the equity model, for example, the game theory and indication that it sustains its initial assumption since there is no adjustment before its application.

Application of the Theory in Therapeutic, Educational and Business Settings

In healthcare, psychiatric, and other therapeutic settings, equity theory applies in assessing the right treatment that will increase satisfaction and hence, recovery. Patients accept treatment, and the treatment relates to their needs when it is socially fair. Fairness in the therapeutic setting is the provision of care that resonates with the patient’s needs, both psychological and physiological (Pauly, 2017). Equity in healthcare is also the provision of care that is similar to the one which other groups of people, for example, different ages, gender, and ethnicity receive. The theory, therefore, applies in therapeutic settings to guide the therapist on how to increase satisfaction, which is by offering care that resonates with the patient’s needs without discrimination.

Adam’s theory, on the other hand, applies in an educational setting to identify makers of student’s motivation towards the class. Student’s motivation occurs when they perceive that the teacher is supporting them concerning their contribution. Most students struggle to achieve their needs through different means, like asking questions. As a result, the theory guides educators to assess student’s needs and provide individualized support, which will allow improvement in hard work and maintaining motivation. Equity in education is the provision of support to students according to their needs while avoiding discrimination. The theory thus applies in an educational setting to allow identification of the proper intervention for student’s motivation in their work.

In a business setting, managers and supervisors apply the theory to seek employee motivation for the right behaviors and hard work. Managers cultivate proper behaviors and organizational culture through fairness in treatment (John & Chiekezie, 2016). They can increase output inform of rewards higher compared to the input to push workers towards loyalty, honesty, and other behaviors. However, businesses use the theory to raise motivation towards hard work where an increase in rewards compared to the work input results in increased employee’s efforts.



Pauly, B. M., Shahram, S. Z., Dang, P. T., Marcellus, L., & MacDonald, M. (2017). Health equity talk: understandings of health equity among health leaders. AIMS Public Health, 4(5), 490.

John, O. & Chiekezie O. (2016). Equity theory of motivation and work performance in selected South East universities. Reiko International Journal of Business and Finance, 8(4).

Cosier, R. A., & Dalton, D. R. (1983). Equity theory and time: A reformulation. Academy of management review, 8(2), 311-319.

Gino, F., & Pierce, L. (2009). Dishonesty in the name of equity. Psychological science, 20(9), 1153-1160.

Huppertz, J. W., Arenson, S. J., & Evans, R. H. (1978). An application of equity theory to buyer-seller exchange situations. Journal of marketing research, 15(2), 250-260.

Sun, K. (2016). The Power of Perks: Equity Theory and Job Satisfaction in Silicon Valley. Scripps Senior Theses. Paper 846. Retrieved from

Ward, P. R. (2018). The relevance of equity in health care for primary care: creating and sustaining a’fair go, for a fair innings’. Quality in Primary Care, 17(1).


Ethical Dilemma Case Study Analysis history assignment help is it legit

Ethical Dilemma Case Study Analysis

Ethical dilemmas are common in the field of medical practice brought about by the issues arising from different aspects of practice. These dilemmas happen when one gets faced with two right decisions and finds it challenging as to which one of the two to choose (American Nurses Association, 2011). This paper seeks to provide a demonstration of the principles of ethics in when one gets faced with conflict in choosing between two right options, identify the stakeholders and their perspectives regarding the dilemma, the resolution option and the rationale behind the option, the implementation plan and the consideration of methods of evaluation, and a discussion of the potential impact of moral distress on the decision-makers.

Bad Blood Ethical Dilemma

Right versus Right

The dilemma that has been presented in the scenario, in this case, is a right versus right dilemma because of the reasons below. Closing the department of emergency in the hospital as stipulated is right because it would help the organization save costs and avoid losing money, which could possibly result in the closure of the healthcare organization (Westrick, 2014). However, it is also right that choosing not to close the department of emergency would benefit the organization as most admissions happen to come through it and it will also save the members of the community the time they will have to travel for almost an hour to get to another hospital when an emergency arises within that time. Both options are right, with one being for the organization and another for the welfare of the community.

Ethical Principles in Conflict

The principles of ethics are essential in helping the CEO making decisions that are logical and also understanding the consequences of the decision she makes concerning the matter. The principles of ethics that arise in this case include the principle of justice whereby the CEO will be faced with a dilemma of making a decision that is just when both options are right (American Nurses Association, 2011). Another principle of ethics in a conflict that gets brought out is the principle of beneficence where the CEO will be faced with the conflict where he is required to do good for others, in this case, a conflict arises because choosing one option would hurt those affected by the other.

Dilemma Stakeholders

There are several stakeholders that are affected by the dilemma in this case and hold different perspectives with regard to the dilemma. The first stakeholders are the management of the organization who believe that closing the department of emergency during the said hours would help the organization save more and avoid closure. The patients and community members are also stakeholders, whose perspective will be that closing the emergency ED will be an infringement of their right to receive care (Agency for Healthcare Research and Quality, 1998). It will be challenging for them because diving for fifty minutes could be a long time to help a patient that needs urgent care. While the perspective of the CFO is that the closure of the organization during the said hours will save the organization a lot of costs, the effect on the community will be significant in the event of emergencies as driving for a long distance to seek care could endanger the life of the patient. While every stakeholder caught up in a dilemma has a perspective they know is right, the right decision of each of them when implemented has a negative effect on the other stakeholder. They are all important, which makes the CEOs process of making the decision challenging.

Options for Resolution

There are several options that present themselves in soling the ethical dilemma presented in the case scenario above. The CEO makes the decision on an ethical basis, and the options available for resolving the dilemma are as follows.

Option One

The first option the CEO has is to allow the closure of the department for the hours that have been suggested in the report by the CFO. The ethical basis for this particular decision is that to ensure that the organization stays open and keeps providing healthcare services to the community, it is necessary for the proposal by the CFO to be implemented until the organization gains stability for the department of emergency to start operating around the clock again.

Option Two

The second option the CEO has is to not allow the closure of the department of emergency during the hours stipulated by in the report by the CFO. The department of emergency should remain open because emergency situations can be life-threatening, and driving for almost an hour could fail to save a patient that needs urgent attention. The ethical basis for his decision is that closing the emergency department will be hindrance the community’s right to access care at all times (Agency for Healthcare Research and Quality, 1998). This would be a major risk to the organization as its continuance of operations with low finances could lead to further losses and potential bankruptcy.

Option Three

The third option the CEO has is to keep the emergency department open and find another means of saving costs for the organization. For example, the organization could implement a program for educating the patients on how to manage certain conditions while at home to help reduce return visits to the emergency department. The reduction in return visits will help the organization save costs and time that would be spent attending to patients whose conditions can be managed in the home environment. The ethical basis of this decision will be to allow the continuance of the provision of care in the emergency department while at the same time-saving costs for the organization to ensure that it stays operational.

Option Selected with Rationale

The option that the CEO found to be most effective in solving the ethical dilemma of the three options that have presented is the third option which is about letting the department of emergency stay open but implement a solution that would help in reducing the return visits to the department of emergency to minimize the cases of emergency to be addressed thus saving the organization time and costs of care provision. The rationale behind this option is that none of the stakeholders involved in the dilemma will be affected negatively (Baker, 1997). All the stakeholders stand to benefit from this option in that the quality of care will be improved for the patients. The nurses will find it easier to carry out their duties due to the reduced workload, and the organization’s financial position will be improved with the costs saved from the reduction in emergency department visits brought About by the education program. This option will solve the dilemma as the decision the CEO arrives at is one that benefits all the parties involved, and it gets made without bias.

Option Selected Implementation Plan

The plan for the implementation of the education program, as presented in the third option, will be as follows. The organization will implement ways through which the nurses will be able to engage in educating patients on self-management after they get discharged from the hospital to help reduce emergency department return visits. While treating the patients, the nurses can also engage in equipping the patients with understanding, knowledge, and preparedness for self- management of their conditions, especially those that are long term (American Nurses Association, 2015). The education of patients can also be implemented by the use of interventions that would provide patients with access to information. The use of the current technologies can help in ensuring that information about their specific conditions and how to manage them gets easily accessed by patients. The organization will also implement the electronic medical record-keeping to enhance access to patient data (Cable News Network (CNN), 2010).  Educating patients on how to access and use the electronic medical records systems will improve their access to their medical history information for them to understand how to self-manage their conditions and to know when to and when to not go to the emergency department.

Moral Distress Considerations

In making a decision concerning the moral dilemma, the decision-makers are likely to experience moral distress that arises from the challenge in determining what the right option is (Gray, B.H., & Herbert, 2006). Moral distress can have several potential impacts, including the fact that the decision-makers can end up feeling powerless about the decisions they have made that get associated with depreciation in their sense of well-being. They end up feeling frustrated, angry, and guilty about their view on what is ethically proper in the ethical dilemma they are faced with. They end up feeling guilty about choosing a decision that affected the other parties negatively.


The ethical dilemma, in this case, is brought out in the fact that the CEO is faced with two decisions, both of which are right. The decision is with regard to whether or not to allow the closure of the department of emergency for the purpose of saving costs of care for the organization. She has to make a decision on how to ethically solve the dilemma. This dilemma is potentially brought about by the increase in the visits to the department of emergency in the hospital brought about by the lack of knowledge ion self-management. This is because most of the ER visits are return visits by patients who have healthcare issues that can be solved without necessarily going back to the hospital. Patient education is a significant step in minimizing the chances of such an ethical dilemma arising in the future.




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