Cancer, Genetics, and Genomics
Rachel comes from a family with a history of breast cancer on her mother’s side. Rachel’s mother died of breast cancer when she was very young. Rachel has two sisters, Lisa and Kristin. Rachel has remained close to Lisa, but she no longer has a relationship with Kristin. At a routine checkup, Rachel is told about the availability of genetic testing for identifying a predisposition to breast cancer. Her doctor recommends the test to Rachel given her family history. Rachel has the genetic testing done and finds that she has a mutated breast cancer 1, early onset (BRCA1) gene. Her doctor tells her she is at high risk for developing breast and ovarian cancer. Rachel’s doctor suggests she ask her sisters to be tested also, so they can take the proper preventative measures. Rachel feels comfortable sharing this information with Lisa, but she has not spoken to Kristin in many years. Rachel tells her doctor that she is not in contact with Kristin and will not make an effort to tell her about BRCA1 and genetic testing. Rachel’s doctor feels confident that she can locate Kristin but worries about breaching patient confidentiality if she goes against Rachel’s wishes.
If you were Rachel’s healthcare provider, what would you do? Provide a rationale for your response. Include the pathological processes associated with breast cancer. What role does the BRCA1 gene contribute to managing the patient’s care? Describe and explain the role of the BRCA1 and breast cancer 2, early onset (BRCA2) gene in contribution as a risk factor for breast cancer. Analyze the risk factors for breast cancer and possible interventions to preventive health management for women and men

This week, you will formulate a concise statement of the problem. (Impact of Lead Exposure)
Most environmental health issues involve a variety of elements with overlapping or distinct causes, stakeholder groups, and solutions. Selecting an important, specific element of the issue is essential when formulating realistic ways to address and improve the environmental issue. This specific aspect of the issue is known as the problem and can be defined in a concise problem statement. The problem statement includes the purpose of the problem-solving effort, defines its scope, and states the specific objective of the problem-solving effort in the form of a question.
The three elements of the statement are—explaining how things should be; identifying a significant gap; and asking a question about one major way to improve the current situation. For example:
The food you purchase should be free from levels of pesticide residues that are hazardous to human health, but many commercially used pesticides have not been tested using newer techniques to detect harm that they may cause during prenatal development or childhood. Should the EPA require that pesticides used on food crops be reevaluated using the new tests to ensure that children are fully protected, and if so, which tests?Employees who work with lead have a right to expect that their health will be protected if their workplace adheres to the OSHA lead standard, but the OSHA lead standard has not been updated since 1978, despite a great deal of new epidemiologic and toxicologic research about lead toxicity. Should the OSHA lead standard be revised, and if so, what should the new provisions be?Consumers often trust that products and services that they purchase are safe unless they are advised otherwise. Recently, nail salons have been the focus of worker safety initiatives because they use hazardous chemicals such as methacrylates, acetates, toluene, and formaldehydes. Are consumers adequately protected from hazardous chemicals when they receive services in nail salons?The process of developing a problem statement is extremely useful because you will choose a defined focus, which will guide the rest of the work leading to a proposed solution to the problem.
For this assignment:
Choose a specific aspect of the topic that you selected last week as your problem. (Impact of Lead Exposure)Define the environmental or occupational problem affecting human populations that you will analyze for your final project.Write your problem statement in 2–3 sentences in a Microsoft Word document. These sentences should be questions that you intend to explore in your research paper.Justify, in 1–2 paragraphs, why you chose to focus your analysis of this multifaceted issue to the specific problem as stated in your problem statement.

The focus of Week 1 has been on the theory-practice-research cycle, quantitative and qualitative research, the levels-of-evidence pyramid and the research question.
Quantitative Research Question
Write a quantitative research question using the PICO(T) model about a health or safety issue observed in the Ironridge or Summerville communities. 
Conduct a search of the literature for the quantitative research question.
Describe the literature search strategies (search terms, databases, filters, search results).
How many randomized, controlled trials (RCTs) did you find compared to other types of studies? What level of evidence does an RCT represent? 
Provide a brief, two to three sentence, summary of one quantitative research study.

Qualitative Research Question
Using the same issue, how would you write a qualitative research question using the P (population), I (abstract concept) from the PICO(T) model. What qualitative research method (Phenomenology, Grounded Theory, Ethnography) would you select? The abstract concept and research method must support each other.

Cite at least ONE SCHOLARLY research reference to support your statements in your initial post and at least ONE SCHOLARLY research reference in your response/s to peers. The scholarly research reference requirement supports the focus of this course–advanced research methods and evidence-based practice and assists in extending your and your peer’s research knowledge.
Melnyk, B. M., & Fineout-Overholt, E. (2015). Evidence-based practice in nursing and healthcare: A guide to best practice (3rd ed.). Retrieved from http://bookshelf.vitalsource.com
• Chapter 1: Making the Case for Evidence-Based Practice and Cultivating a Spirit of Inquiry
• Chapter 2: Asking Compelling Clinical Questions
• Chapter 3: Finding Relevant Evidence to Answer Clinical Questions
• Chapter 4: Critically Appraising Knowledge for Clinical Decision Making
Pearce, P.F., Christian, B. J., Smith, S. L., & Vance, D. E. (2014). Research methods for graduate students: A practical framework to guide teachers and learners. Journal of The American Association of Nurse Practitioners, 26(1), 19-31. Doi: 10.1002/232
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Infant nutrition is critically important, as an infant typically triples his birth weight and increases his length by 50% in the first year of life alone! Without proper nutrition, this stage of enormous growth can be jeopardized. With this in mind, answer the questions below.
What are the energy (kcal) and protein requirements for an infant from age 0-6 months and 6 months to 1 year? How does this compare to your energy and protein intake? You will need to figure out your kcal and protein intake as g/kg/day in order to make this comparison.
The diet of an infant, prior to solid food introduction, consists of either breast milk or formula. When mothers make the choice of what to feed their child during this time, what factors come into play? For example, some cultures may be more accepting of breast feeding than others.
At what point is solid food recommended to be added to an infant’s diet? Nutritionally speaking, why is this? Each infant is different, so how can it be determined when a certain infant is ready for solid foods?
During the first year of life, what are appropriate foods and beverages to serve to an infant? Are there any foods or beverages that should be avoided during this time?

Neurological System Case Study
A 35-year-old male is admitted to a hospital following a minor car accident. He was driving home and fell asleep at the wheel. This is the third accident he has had in the past year. He also falls asleep regularly at work, at the dinner table, at church, and, in fact, anywhere. When he becomes excited or enraged, he suddenly becomes weak and falls. At night, he often has bizarre, terrifying dreams. During these dreams, he feels as if he were paralyzed.
Based on the scenario given above, answer the following questions:
Describe how a nerve impulse is transmitted from one neuron to the next.Compare the structure and functions of the CNS and PNS.What is the probable diagnosis for this man’s condition?What parts of the person’s brain could have been affected?What sleep state do these symptoms resemble?How would an electroencephalogram (EEG) look like during the sleep condition of this patient?What type of treatments (physical or chemical) would you prescribe for the patient?