Epidemiology is the study of the distribution and determinants of disease in human population. To determine if a new drug is beneficial for treating a disease, a randomized controlled trial, which is an interventional study, is the gold standard of epidemiologic design. In environmental epidemiology, however, “observational” studies are the main source of epidemiologic data, i.e., people are exposed through the course of their lives rather than through an experiment.
Your textbook provides examples of observational studies addressing environmental health topics. Today, epidemiologic studies are commonly published in journals devoted to environmental health as well as in medical, public health, and other types of journals.
Articles from major journals are indexed by the National Library of Medicine in a database known as Medline, which you can search by typing the word “PubMed” into your search engine.
The PubMed site permits you to find journal articles addressing specific topics. If you are not familiar with searching PubMed, you can refer to the tutorials present on the PubMed site. You can also ask South University Online Library support staff to assist you.
Click here to learn some basic guidelines for searching PubMed.
For this assignment:
Do a PubMed search with one of these epidemiologic search terms that represent observational study methods—”cohort” or “case-control.”Link the epidemiologic term you chose using AND with the environmental health term—pollution.Further specify your search with a term for the overall source of pollution such as air, water, waste, workplace, occupational, industry, mining, etc.An example search strategy is—cohort [TI] AND pollution AND air.Another example search strategy is—(case-control [TI] OR “case control” [TI]) AND pollution AND water.The articles you retrieve may have a great deal of technical information about statistics and may present a seemingly overwhelming amount of data in the results section. For this assignment, concentrate on the study abstract, found in PubMed, and the portion of the methods section, which describes how the people who were evaluated were selected for study in the full-text version of the article.Prepare a 2- to 3-page report in a Microsoft Word document addressing the following points:Retrieve the full text of an article using the above search strategy that addresses human health (not wildlife or ecosystems). Choose an original research study, not a review article that is an example of a cohort or case-control observational epidemiologic study concerning environmental health.List the PubMed identifier (PMID) number from PubMed at the beginning of your paper so that the instructor can easily retrieve the article and review it (for example, PMID: 14769642).Describe the study that you located with your PubMed search, including the number of people studied, where they were located, and the pollutant. This information will probably be in the title and abstract of the study.Describe the main study question or hypothesis addressed by the study. For example, “Is well-water arsenic exposure higher among people with bladder cancer compared to people without bladder cancer?”List how the studied individuals were selected. In most cases, this will be succinctly described in the methods section of the article.Summarize the findings as noted in the study’s abstract.Describe the importance of the study’s findings to human health.Provide a title page that includes the title of this assignment, your name, the section of the course in which you are enrolled, and the date.Include the full bibliographic citation of the article chosen and other appropriate references.

In Part 2 of your Project, you will develop a work breakdown structure (WBS) that must be accomplished in order to complete the Casino Medical Center project. Use the Team Project Scenario document in this week’s Learning Resources to help define your deliverables. (SEE ATTACHED FILE FOR TEAM PROJECT SCENARIO)
Begin by deciding, with your team, the approach to developing a work breakdown structure you wish to use (WE WILL USE THE TABULAR BREAKDOWN STRUCTURE). This approach will guide your process and the final design of the WBS. Your team will identify project deliverables that need to be accomplished to achieve the project’s goals. For each deliverable, relevant subtasks or activities must be identified (the work that needs to be done). Using these activities, you create a WBS. This WBS will be the basis for creating a project plan and schedule in Microsoft Project.
You and your team are not expected to know all of the deliverables and sub-activities that need to occur, but you should be able to use your combined experience, knowledge, and research to identify many of the necessary deliverables and supporting activities. Be sure to utilize course resources, as these resources should provide information on what to include in this part of the Team Project.
As you and your team address the discussion question below, you will be able to write and submit
a 2- to 3-page team paper that summarizes the group’s work and that includes WBS diagrams of at least five high-level deliverables.
Deliverables to consider in defining the activities and tasks for the hypothetical project are included here. Your team will identify the unique deliverables for your project. Use specific names for the deliverables that reflect the project’s purpose.
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What is meant by an impulse purchase? Why is it important?
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Case Study 2: Wrongful Death by Howard Carpenter on Behalf of Wilma Carpenter, Deceased
People Involved in Case:
Mrs. Wilma Carpenter — patient, deceased
Mr. Howard Carpenter — husband and plaintiff in wrongful death suit
Mrs. Scale, RN, MS — nursing supervisor
Elizabeth Adelman, RN — recovery room nurse
Richard Washington, MD — orthopedic surgeon
Judy Gouda, RN, NP
Joseph Alsoff, LPN — post-surgical unit nurse
Kelly Wheeler, RN — post-surgical unit nurse
David Casler, LRT
Susan Post, JD — risk manager
Amy Green — quality assurance
Michael Parks, RN, MS, CNS — education coordinator
Caring Memorial Hospital
Facts:
The plaintiff, Mrs. Carpenter, was a 55-year-old woman who underwent a total hip replacement at Caring Memorial Hospital. The physician was Richard Washington, MD. Dr. Washington is an orthopedic surgeon. His nurse practitioner is Judy Gouda, RN, NP. Dr. Washington reviewed the consent with Mrs. Carpenter prior to surgery. Joseph Alsoff, LPN, witnessed the consent and Mr. Carpenter was present. Joseph does not remember the doctor ever mentioning that death could be a result of the surgery. The recovery room nurse is Elizabeth Adelman, RN. The respiratory therapist is David Casler, LRT. The nurse on the post-surgical unit was Kelly Wheeler, RN. The supervising nurse was Mrs. Scale, RN, MS.
The patient had an epidural catheter for a post-operative pain management following an episode of hypotension in the recovery room which was treated with Ephedrine. Judy Gouda made rounds on the patient in the recovery room after the hypotensive event and vital signs were stable. The patient, Mrs. Carpenter, was placed on a medical surgical nursing unit with the epidural. The nurse, Kelly, was assigned to the patient and had not worked on that unit before, but had worked in post-acute critical care units. The nurse’s assignment was to provide patient care on the entire floor for that shift. There was also an LPN, Joseph, on the unit. It was a busy day on the unit. Mrs. Carpenter was not the only post-operative patient.
Kelly assessed the plaintiff upon admission, checked the IVs, asked if the patient was in pain, noted that the patient was responsive and understood where she was, and was stable. She then left to care for other patients.
The licensed practical nurse, Joseph Alcoff, had been working on the unit for several years. It had been rumored that Joseph was an alcoholic. There was no evidence that he had been drinking on the unit. Approximately an hour after the patient arrived on the unit, she was unable to tolerate respiratory therapy that was ordered and she became nauseated and vomited. David Casler administered the respiratory therapy. According to Kelly, the registered nurse, 10 minutes after the vomiting episode, Joseph Alcoff, the LPN, found the patient blue and unresponsive and called a code. Joseph is the only person other than the physician that carries his own liability insurance. The hospital also has malpractice insurance.
The code team responded, along with Kelly, the registered nurse. Mrs. Carpenter was intubated and cardiac resuscitation was initiated. The patient responded to resuscitative efforts and she was transferred to the intensive care unit. Subsequently, Mrs. Carpenter did not do well, was unresponsive, and declared brain dead and taken off the respirator. She did not have a DNR in place.
There is a conflict in testimony between Joseph the LPN and Kelly the RN. Joseph indicated that Kelly found the plaintiff to be unresponsive after the vomiting episode and called the code. The record is not clear as to when the vital signs and epidural site were assessed. Kelly said she did a motor and sensory level assessment and they were fine — it is not charted though. The time elapsed between the vomiting episode and finding the patient is in dispute. The final diagnosis was anoxia encephalopathy due to the time lapse between CPR being initiated. The patient was eventually extubated, breathed independently for a period of time, and then subsequently expired.
The vital signs ordered by the physician were hourly. The hypotensive episode in the recovery room had not been reported to the registered nurse.
The risk manager is Susan Post, JD, who works in collaboration with the quality assurance director Amy Green. Amy had noted when doing chart reviews over the last 3 months prior to this incident that the vital signs taken in the recovery room were not charted, not done, or not reported to the units. She was in the process of collecting data from the different units on this observation. She also noted a pattern of using float nurses to several postoperative units. Prior to this incident, the clinical nurse specialist, Michael Parks, RN, MS, CNS, was consulting with Susan Post and Amy Green about the status of staff education on these units and what types of resources and training was needed.

A customer has placed an order for 30 000 first aid kitsA customer has placed an order for 30,000 first-aid kits that must be delivered within 20 business days. The kits are to be assembled on the four-workstation line shown below and in kanban quantities equal to 1 hour of demand. The workstations are manned a total of 7.5 hours per day.
a. What is the overall line utilization?
b. What is the bottleneck operation?
c. How many kits must be started at workstation A each hour in order to deliver the required quantities from workstation D? What is the overall process yield for the line?
d. What is the takt time for this customer’s order?
A customer has placed an order for 30 000 first aid kits