Computer Science

Managing Contention for Shared Resources on Multicore Processors

1. In order to share several hardware structures, the advanced multicore systems are planned that enables clusters. For example LLCs (last-level caches such as L2 or L3), memory controllers, interconnects and prefetching hardware. In addition, the resource-sharing is advised as the clusters work as memory domains. The shared resources act as a memory pyramid. The threads that are present on cores in the memory domains participate for shared resources in a contention-free atmosphere (Bischof, 2008). In order to understand the function of contention for shared resources and its effects on application and performance, an example is given below. There are four applications Soplex, Sphinx, Gamess, and Namd (Balasubramonian, Jouppi, & Muralimanohar, 2011). These applications are taken from SPEC (Standard Performance Evaluation Corporation) CPU 2006 benchmark suite. This runs parallel on an Intel Quad-Core Xeon system. On three altered schedules, a test would run on group of applications for number of times. Each time two different paring is made that shares memory domain. Moreover, within the same domain the three pairing permutations run these applications (FEDOROVA, BLAGODUROV, & ZHURAVLEV, 2010).

  • Soplex and Sphinx ran in a memory domain, while Gamess and Namd shared another memory domain.
  • Sphinx was paired with Gamess, while Soplex shared a domain with Namd.
  • Sphinx was paired with Namd, while Soplex ran in the same domain with Gamess.

2. The main purpose is the captivity of essence of memory-reuse profiles. This can be done in a very simple metric. After metric was discovered an approximate way is determined while utilizing information present in a thread scheduler. In addition, the memory-reuse profiles are successful at modeling contention mainly due to implementation of two core qualities. These core qualities are sensitiveness and greatness. The sensitiveness of threads describes the issues a thread has to face while sharing cache along with other threads. The greatness in terms of thread sharing means that how much a thread damages other threads while sharing with cache. In fact, major information is captured by the sensitiveness and greatness of threads within memory-reuse profiles. In order to approximated the sensitiveness and greatness while using online performance of information we need to check their bases for modeling cache contention between threads. The information is derived from metrics in memory-reuse profiles in order to achieve sensitiveness and greatness (FEDOROVA, BLAGODUROV, & ZHURAVLEV, 2010).

3. While assessing new models for the cache contentions, following objectives are considered such as, the ability of models for generating contention-free thread schedules. A model is constructed that would help to search for top or to avoid worst schedules. Therefore, these models are assessed on the basis of constructed merit schedules. Pain metric is used to evaluate scheduler that finds top schedule. For instance, consider a system that contains two pairs of core sharing and two caches. Moreover, this model also works boundless with the additional cores per caches. In this scenario, we need to analyze and identify the finest schedule for all the four threads. Likewise, the scheduler will develop permutations of threads available within the system as, all the permutations are exclusive in terms of pairing with each other in memory domain. For example if there are four threads present named as A, B, C and D than the exclusive schedules formed are: (1) {(A,B), (C,D)}; (2) {(A,C), (B,D)}; and (3) {(A,D), (B,C)}. Here the notations (A, B) describe the co-schedulers of threads A and B in similar memory domains. The pain regarding each and every pair is calculated by the scheduler for every schedule such as, {(A, B), (C, D)}. Moreover, the Pain (A, B) and Pain (C, D) is calculated by scheduler with the help of equations that are present formerly. The calculated amount is considered as an initial Pain values that are determined via equations. The lowest values of Pain are considered as the ‘Estimated Best Schedule’ by Scheduler. This Pain metric is developed through actual memory-reuse profiles. This pain metric helps to determine the best schedule. Another method for determining is via approximating the Pain metric using online data. After the best schedule value is determined, the performance is associated with the workload in order to obtain the ‘actual best schedule’ from the ‘estimated best schedule’. For this purpose, the ‘estimated best schedule’ is run over the real hardware and its performance is than associated with the ‘actual best schedule’. By running all the schedules on real hardware we can obtain the best value. Moreover, by running all the possible schedules on hardware may limit the workload as the large number of workloads are consuming at the same time. This is the most direct way to determining the ‘actual best schedule’ (FEDOROVA, BLAGODUROV, & ZHURAVLEV, 2010).

4. The reason of contention in multicore systems is discussed in this answer. A number of experiments are performed in order to determine the main cause of contention on multicore systems. Initially, the degree of contention is measured, separated and divided into several kinds of shared resources for instance, Cache, Memory Controller, Front-side bus and Prefetching Hardware (Das, Thankachan, & Debnath, 2011). The detailed arrangement related to the experiments is defined in this study. At first stage we need to focus on the contention for the shared cache. This removes the cache while competing with the threads from cache lines. However, this is not considered as the main reason for performance degradation in the multicore systems. The main reason that is involved in performance degradation in shared resources includes

  • Front-side bus
  • Perfecting resources
  • Memory controller

It is very difficult to describe the limitations and there effects on contention for prefetching hardware. The influence of prefetching reveals the combined effect of all the three factors and hardware itself. In this experiment the longstanding of memory-reuse model that is constructed for model cache contention are not effective. Furthermore, the model contention other than shared cache if applied in a real system did not prove efficient performance in the presence of other kinds of contention. On the contrary, the cache-miss rate is an outstanding analyst for contention for the memory controller, Prefetching hardware and front-side bus (FEDOROVA, BLAGODUROV, & ZHURAVLEV, 2010). Along with the Milc application, each and every application is co-schedule in order to create contention. The memory controller along with front-side bus would engaged by the cache missing applications. This would not damage the applications that are present in hardware. The high LLC miss rate in an application will destructively use prefetching hardware. This is due to the cache that is requested by the data counted via cache misses. Thus, for heavy usage regarding prefetching hardware a high miss rate is an excellent indicator (FEDOROVA, BLAGODUROV, & ZHURAVLEV, 2010).


Balasubramonian, R., Jouppi, N. P., & Muralimanohar, N. (2011). Multi-core cache hierarchies Morgan & Claypool.

Bischof, C. (2008). Parallel computing: Architectures, algorithms, and applications Ios PressInc.

Das, V. V., Thankachan, N., & Debnath, N. C. (2011). Advances in power electronics and instrumentation engineering: Second international conference, PEIE 2011, nagpur, maharashtra, india, april 21-22, 2011. proceedings Springer.

FEDOROVA, A., BLAGODUROV, S., & ZHURAVLEV, S. (2010). Managing contention for shared resources on multicore processors. Communications of the ACM, 53(2), 49-57.


Week 7: Developmental Psychologist Jean Piaget

Jean Piaget (1896-1980) was a scholar from a very young age, publishing his first scientific article, which documented the behavior of an albino sparrow, at the age of 10 (Shaffer & Kipp, 2009, p. 53). Piaget’s youthful interests in the behavior of animals ultimately led him to pursue a degree in zoology. However, he was also interested in epistemology, and this led him to psychology (p. 53). It was this that him a position working with children in order to help develop the world’s first IQ test (p. 53). Piaget realized that the young children he was working with consistently gave him the same kinds of wrong answers to particular questions, and this led him, in time, to the developmental stage theory for which he is most famous (p. 53).

Piaget’s four-stage theory of development is by far his best-known achievement. The first stage is the sensorimotor stage, which lasts from birth to about two years of age: during this period, the infant learns through the use of its senses and its motor reflexes (Jardine, 2006, pp. 51-53; Vialle, Lysaght & Vernikina, 2000, pp. 20-21). The infant’s key achievement in this period is the attainment of object permanence: the realization that an object does not cease to exist when it leaves the infant’s sight, nor does it come into existence when it enters the infant’s sight (Vialle et al., 2000, p. 20). Although infants are reflex-driven at the beginning of this stage, by the end they are not only much more coordinated, but also much more goal-directed (Shaffer & Kipp, 2009, p. 55; Vialle et al., 2000, pp. 20-21).

In the preoperational stage, roughly ages 2-7 years, the young child’s language abilities become a source of tremendous self-expression, gaining great symbolic abilities and attributes. Where the sensorimotor stage is the stage of reflexes and physical actions, the preoperational stage is a deeply symbolic stage: as the young child’s vocabulary grows, often at a prodigious rate, so too does their capacity for symbolic thinking (Jardine, 2006, p. 54; Vialle et al., 2000, pp. 21-22). However, children in this stage are deeply egocentric: they cannot understand that others view the world from a different perspective than they do (Jardine, 2006, p. 54). They also have difficulty understanding conservation of matter, i.e. that a given quantity of water does not change simply because it has been poured into a taller, narrower glass (Vialle et al., 2000, p. 22).

In the concrete operational stage, approximately 7 to 11 or 12 years, young children again pass tremendous developmental milestones. Their egocentric thinking gives way to the recognition that in fact, other people do experience the world from very different perspectives than they do (Shaffer & Kipp, 2009, p. 55). Unlike in the preoperational stage, children in this stage are capable of looking through appearances and not being fooled: for example, conservation of matter is now something they take for granted. Their social skills are much better, particularly their abilities to discern others’ motives, and all in all their thinking is much more logical (p. 55). But there is one final stage left, and that is the formal operational stage: in this stage, the adolescent and then the young adult gains the full powers of abstract thinking. For the first time in their development, the young person can generate a complete hypothesis and test it. They can also evaluate their own thinking, reflecting on their thoughts (Shaffer & Kipp, 2009, p. 55; Vialle et al., 2000, p. 23).

Piaget’s theory has lost ground since the 1960s. Researchers now believe Piaget consistently underestimated the capabilities of children, particularly the problem-solving abilities of infants, preschoolers, and grade-schoolers (Shaffer & Kipp, 2009, p. 56). In fact, some of the ostensible limitations of young children’s thinking that he identified can be surmounted if more care is taken to present them with problems with which they are familiar (p. 56). However, Piaget’s work remains tremendously important: his developmental stage theory was tremendously influential on later theorists, and it still contains important and acknowledged insights. Piaget’s greatest legacy is easily the way that he invited us to look at development.


Jardine, D.W. (2006). Piaget & education. New York: Peter Lang Publishing.

Shaffer, D.R., & Kipp, K. (2009). Developmental psychology: Childhood & adolescence (8th ed.). Belmont, CA: Wadsworth.

Vialle, W., Lysaght, P., & Verenikina, I. (2000). Handbook on child development. Tuggerah, NSW: Social Science Press.





Apple Computer, Inc

Founded in 1997, Apple designs, manufactures, and markets a range of products including mobile communication devices, personal computers, portable digital music players, software, and other hardware products. The company’s products and services include Macintosh (“Mac”) computers, iPhone, iPad, iPod, Apple TV, iOS and Mac OS X operating systems, iCloud, and iTunes store. As of September 24, 2011, the company had a total of 245 U.S. retail stores and 112 international retail stores. The company opened 40 new retail stores last year out of which 28 were international markets (Apple Inc.).
Apple is probably the only technology company that remains highly profitable despite maintaining tight control over both the hardware and software. The company refuses to license its products even if it means sacrificing potential increase in market share. Apple has a very loyal customer base who do not mind premium prices for Apple’s products because Apple outcompetes its competitors in terms of product quality, design, innovative features, and ease of use. Instead of volume, Apple competes on the basis of product and service differentiation.
Medicine and Health

Barriers to Medication Compliance with Bipolar Patients

Table of Contents

Introduction.. 3

Research Question. 5

Theoretical Basis for Study…………………………………………………………………………………. 6

Significance of Study. 6

Literature Review… 8

Medication Compliance. 8

Factors Affecting Compliance. 10

Issues in Non-Compliance. 12

Methodology.. 14

Research Design. 14

Sample. 15

Procedure. 15

Human Subject Issues……………………………………………………………………………………….. 15

Findings. 17

Discussion.. 20

Limitations. 22

Conclusions. 23

Implications for Clinical Practice. 23

References. 25


Barriers to Medication Compliance with Bipolar Patients


Bipolar disorder (BPD) is a serious disease that afflicts approximately six million Americans. Two types of BPD are recognized, BPD type I (BPD-I), which is the more severe form of the condition including at least one manic or mixed manic/depressive episode, and BPD-type II (BPD-II) in which the manic episodes are more moderate or hypomanic; the level of depressive symptoms may be as severe as in BPD-I, however (Puri & Gilmore, 2011). BPD-II is closely associated with a prevalence of anxiety disorders, and longer or more frequent depressive phases (Puri & Gilmore, 2011).

BPD is a serious illness, and frequently is found in patients with other psychiatric disorders such as substance abuse, anxiety, ADHD, eating disorders, and others (Sansone & Sansone, 2011). Other issues are that BPD patients are at substantially higher risk of suicide (both attempts and completions) than patients with other psychiatric disorders, with as many as one in five attempting suicide at least once in their lifetime, and untreated BPD patients have a suicide rate twenty to thirty times higher than in the general population (Sansone & Sansone, 2011). Thus, BPD may be the most lethal of all psychiatric disorders (Sansone & Sansone, 2011).

Diagnosing BPD is challenging because it primarily presents in the depressive part of the cycle and thus is often mistaken for simple depression (Baldessarini et al, 2010).  Some distinguishing characteristics of BPD are that it is almost equally prevalent in males as females; it often appears in adolescence or early adult years particularly in cases with a family history of mood disorders (Baldessarini et al., 2010). BPD-I appears at younger ages than BPD-II, and BPD-II generally appears at younger ages than depression (Baldessarini et al., 2010).  BPD also has a high recurrence rates, with substantial mood shifts about once or twice a year typically, and, in some patients, even more rapid cycling of four or more episodes a year  (Baldessarini et al., 2010). As a result of these and other difficulties, it is often five to ten years after initial symptoms before correct diagnosis and treatment is begun  (Baldessarini et al., 2010).

However, the treatment of BPD is controversial. Guidelines suggest that treating BPD patients solely with an antidepressant is not a good idea because it may induce a manic state—yet multiple studies offer evidence exists that fluoxetine in depressed BPD-II patients is actually reasonably effective on at least a short-term basis for depressed phases (Sansone & Sansone, 2011). The treatment for the manic episodes in BPD patients is equally controversial, with antipsychotics and lithium being notorious for their side effects.  Common side effects, including weight gain, increases the risk formedical complications such as hypertension, hyperlipidemia, diabetes, asthma, and joint pain (Sansone & Sansone, 2011).  Given the current epidemic of obesity in this country, weight gain associated with their BPD treatment regimens, reported in about 30% of BPD patients, is itself a serious problem, with nearly one in five developing hyperlipidemia and 8.6% developing diabetes (Baldessarini, Perry & Pike, 2008). Psychiatrists note that critically needed improvements in available treatments including the need for better mood stabilization, medications that do not lead to weight gain, and better treatment for depression that does not respond to current treatments (Baldessarini, Perry & Pike, 2008).

A diagnosis of BPD can be expensive for the patient and third-party payers. Hassan and Lage (2009) report that caregiving costs associated with BPD are nearly $5 billion a year, while lost productivity within the family as a result of relapses was $6.2 billion a year (Hassan & Lage, 2009). Thus, controlling relapses via medication is important for BPD patients. The medications used to treat BPD can be expensive. Many of the newer BPD medications are brand-name rather than generic, making them more expensive. In addition, some BPD medications such as some of the antipsychotics also require regular laboratory tests as part of the dosage monitoring process, making them even more expensive for patients (Sansone & Sanson, 2011).  Qiu, Fu, Liu, and Chirstiensen (2010), however, investigated the actual annual medical expenses of BPD patients in one state (North Carolina) using Medicaid data. They found that prescribing atypical antipsychotic medications alone had higher medication costs, but lower overall medical care costs than those receiving only a mood stabilizer, making the overall cost of those two options approximately equivalent. The most expensive treatment option from a third-party payer perspective was that of combining antipsychotic medications with a mood stabilizer (Qiu et al., 2010).

Patients report that the greatest frustrations of having BPD are mood swings, depression, the need to take medication daily, the stigma of being “mentally ill,” difficulty with interpersonal relationships, and medication side effects (Baldessarini, Perry & Pike, 2008). The result of these frustrations with their condition can lead some patients to be non-compliant with their treatment program.

Research Question

The questions raised by these issues regarding BPD result in some serious treatment questions, specifically:

What reasons do patients cite for not being compliant with their BPD medication regimens?

The objective behind this research question is to better understand noncompliance from the patient’s perspective, and thus have an understanding of what interventions may be most useful in improving patient compliance. The approach that will be taken is one of a qualitative study to determine patient rationales for their noncompliance. The issue is of particular importance in an advanced nursing practice since understanding why patients do not comply with their medications directly impacts providing quality patient care. If nurses can better understand the rationales patients have for not taking their medications, strategies can be developed to overcome these barriers to proper compliance with the patients’ medication regimens.

Theoretical Basis for Study


Project Management 1

Project Selection

For the capstone project I am looking at three different implementations for the Enterprise Resource Planning (ERP) projects in a manufacturing environment.  Each project is similar in nature in regard to the end state but there are varying implementations for each.  The framework for the projects would still follow the project management lifecycle outlined in the Project Management Book of Knowledge (Project Management Institute).


Who Did Airport Security before TSA and how Airport Security Changed Since 9/11


This research takes a qualitative look at how airport security and safety have changed since the creation of TSA.  The author will also do a detailed analysis of security procedures prior to and post 9/11.  The United States airline industry has undergone several changes within recent years.  There have been many problems that have impacted airline travel and safety include the threat of another terrorist attack. There is a great deal of public opinion regarding problems with TSA security procedures and checks that have directly affected the safeness of airlines.  In addition, the new technologies and aggressive tactics have done little to curb individuals from getting back security checkpoints with dangerous materials on them. Studies have shown the level of impact of TSA in airlines today.  This paper will examine if airports are safer since the creation of 9/11 compared to security procedures prior to TSA.


Leadership: Ineffective Communicators in an Organizational Setting

Leadership Problem

The leadership does not communicate with the employees during assigned projects.  The upper management determines the times, dates, deadlines and tools needed to complete projects.  The leadership needs to get back to the basics learning different management techniques and enter some type of management training program.  Leadership is leadership.  Without question leaders need to practice and use different leader tools and techniques from their kit bag depending on the environment, task, personnel, context and the local politics on the ground – this is situational leadership or leadership in context.   The company has a responsibility to ensure the leadership receives the fundamental training to succeed. However, the manager is accountable for the management style they choose. But at its core – leadership is leadership – the fundamentals are universal (Longo & Doty, 2012).


Capstone Project: Hypertension and Type 2 Diabetes in Hispanic Adults


Throughout many population groups, patients are at a severe risk of chronic illness when they possess poor nutritional and exercise habits, both of which contribute to this risk in different ways. It is important to recognize the many disparities that exist in some populations due to differences in culture, language, education, knowledge, access to care, and other barriers that prevent them from achieving optimal health and wellbeing within their communities. It is important and necessary to develop a strategic approach that will be used to improve the understanding of different populations and their risk of chronic illnesses as attributed to poor nutrition and limited exercise. These efforts are instrumental in shaping outcomes for these individuals and their care and treatment plans. It is imperative to consider the different challenges associated with these elements and to determine how to improve the understanding of chronic illness within this population. The disparities that exist must be addressed in the development of an effective protocol to accommodate the needs of this population groups in different settings. The following discussion will address the issues related to an increased risk of hypertension and type 2 diabetes in the adult Hispanic population between the ages of 18-39. This discussion will demonstrate the impact of culture and language barriers, as well as other challenges that this population faces in their efforts to maintain positive health and wellbeing, and the issues that must be addressed to support this population and its exposure to chronic illness and limitations in obtaining adequate access to healthcare services.


Sexuality and Intimacy in Cancer Patients

The concept of sexuality is often obscure and hard to comprehend. There have been several definitions of Sexuality over time and it is clear that Sexuality includes intimacy and not merely the mechanics of the sexual act (Cleary & Hegarty, 2011). It is a concept that is multi-dimensional in nature and encompasses relationships, sexual functioning and an individual’s self concept. Additionally, sexuality and intimacy does not pertain to individuals with partners but can also be of significance to single people. Problems with sexual health and intimacy can occur to anyone, even individuals leading normal lives but this can be more pronounced in people who have chronic illnesses. Cancer, in particular, can undoubtedly affect not just an individual’s physical well-being but can also have a strong impact on an individual’s psychological and sexual well-being.


Nursing-Capstone: Prevalence of Obesity Among Children and Adolescents


Part 1


  • Problem
  • Purpose
  • Goals
  • Intended Outcome
  • Project Relationships
  • Consistency with roles of nursing

Part 11

Review of Literature

  • Background
  • Recent findings

Part 111

Key Stakeholders and Communication Points

  • Identifying Key Stake Holders
  • Communication Points
  • Persuasive Arguments
  • Anticipated Challenges
  • Proposed Solutions
  • Theory



Part 1V

Operationalization of Project

  • Strategic Plan
  • Estimated Planning Process Time Line
  • Infrastructural Road Map
  • Design, Resources, Budget, and Personnel


Part V

Outcome and Evaluation

  • Implementation Review
  • Conclusion
IT Management

Implementing Microsoft Windows Terminal Services and Remote Apps in a Branch Data Center Environment of a Small Financial Institution

Table of Contents

Review of Other Work. 1

Rationale and Systems Analysis. 6

Project Goals and Objectives. 10

Project Development:. 14

Project Deliverables. 14

Demonstrated Competencies:. 16

Competency Matrix. 17

References. 21

Additional Deliverables. 24


List of Tables

Table 1: Project Timeline with Milestones 30

Table 2: Demonstrated Competency Matrix. 32

Table 3: IT Competency Matrix. 33


List of Figures

Figure 1: Adirondack Bank 17 Branch Locations 2

Figure 2: Schematic of New Server Configuration. 24


Capstone Introduction

The seemingly spontaneous growth and rapid dissemination of current mobile technologies seems to have coincided with the worst global financial crisis (GFC) in history, which has grown progressively worse since its onset in August of 2007 and has had a profoundly dramatic effect on millions of businesses as well as business owners around the world (Swagel, 2009).  Bringing the failure of financial giants such the Lehman Brothers, Fannie Mae, and Freddie Mac, this GFC has made billions of people more cautious with their money and forever changed the demands on the banking indutry (Swagel, 2009).  The grip of the worst GFC on record has made people more anxious about entrusting their financial security to banks when so many have failed and mobile technology has provided the answer with new ways for people to monitor and manage their money through an explosion of mobile applications (Apps) that enables wireless devices to become mobile banking centers (Kellerman, 2002; Swagel, 2009).   Conctricted financial markets have made the already competitive financial markets so much more aggressive, which can also be  accredited to the precipitous spread of technological conveniences such as mobile banking and many financial centres, both small and large, have been required to adapt the  means for their customers to access their sensitive financial information securely while on the go using an online connection with their computing device or smart phone (Kellerman, 2002).  The dawning of the digital age ensured that the majority of businesses are computerized, but in the modern business age,  a smaller financial institution such as Adirondack Bank (AB) must have the right server configuration in order to support the mobile financial financial services today’s customer demands.


Central Illinois Endoscopy Center

The Central Illinois Endoscopy Center (CIEC) is the largest freestanding endoscopy center.   They have proudly managed to maintain 95% satisfaction rate for their customers.  American Society for Gastrointestinal Endoscopy (ASGE) has recognized this facility for providing quality in endoscopy.  They were honored by ASGE by following the guidelines for quality assurance, endoscopy reprocessing, privileging, and CDC infection control guidelines as well as completely specific training for safety and quality in endoscopy.  With all the success this facility has encountered, they have committed to move forward with Healthy People 2020 with the specific focus being on their staff and employees. This health promotion program will benefit not only the center, but will ensure that every patient continues to get the best care they possibly can.

The Central Illinois Endoscopy Center has committed to participate in the Healthy People 2020 by focusing on the staff and employees.  The goals of this center are to prevent, reduce, and ultimately eliminate healthcare-association infections (HAIs); and to promote the health and safety of people at work through prevention and early intervention.  This is what is considered to be controllable areas.  HAIs are infections that patients get as a result of being treated for other conditions.  The infections obtained from medical care can be deadly.  Also focusing on promoting health and safety of their employees through prevention is essential as well.  Committing to not only employees health but the patients will enable Central Illinois Endoscopy Center to remain on top.

CIEC has definite internal needs to maintain the high standards and expectations they have set for themselves.  This is not done by setting the bar and expecting everything to go as planned.  A large portion of the success that this center has found is based on their employees. The company has certain standards already in place to help in promoting the new goals set.  Currently they require and supply the employees to take an annual TB skin test.  They also provide annual flu shots as a preventative measure.  In the event that an employee refuses to take the flu shot or has an allergy to it, they are required to wear a mask at all times while at work.  Hand sanitizer is available in all patient, procedure, scope room, and all desk areas. The director does random checks to verify proper compliance of hygiene.  Health insurance is available for everyone in the company.

These goals set are obtainable by maintaining the standards already in place.  According to an article in The Association for Professionals in Infection Control and Epidemiology, Inc., and the Society for Healthcare Epidemiology of America, they set the basics for success with eliminating HAIs.  “On the basis of lessons from recent successes, we propose that the elimination of HAIs will require constant action and vigilance (1) to promote adherence to evidence-based practices through partnering, educating, implementing, and investing; (2) to increase sustainability through the alignment of financial incentives and reinvestment in successful strategies; (3) to fill knowledge gaps to respond to emerging threats through basic, translational, and epidemiological research; and (4) to collect data to target prevention efforts and to measure progress. These efforts must be underpinned by sufficient investment” (Cardo et al., 2010).

A key point that was made was vigilance.  This is an essential step in gaining control of HAIs.  Education and implementation is a big part as well.  How well CIEC rolls out a plan to their employees and follows up with the success of it.  These goals have to be clear and measurable for it to be successful.  With less expense and cost associated with HAIs, these funds can be turned into incentives and overall profit.  And finally collect data on what took place in the event of an HAI.  This will be a way to record and measure progress but also a tool to measure the programs overall success.

When focusing on promoting health and safety of their employees through prevention Central Illinois Endoscopy Center has to reassess their current plan.  An article in the Journal of Occupational Environmental Medicine they show how Johnson & Johnson address this area.

“To engage employees in the program, Johnson & Johnson offered a $500 medical benefit plan credit to program participants. Employees were invited to participate in a voluntary HRA, including biometric screening; if they accepted the invitation, they became eligible for the medical benefit credit. The screening determined if the employees were potentially at “high risk”; if so, they were then referred to the PTC “high risk” program” (Goetzel et al., 2008).  Being given an incentive created an environment for more employees to willingly participate.

Safety programs are in place for all employees to protect themselves and the patients that they service daily.  Encouraging healthy personal choices will carry over and ultimately benefit the company.  Mandating flu shots and TB testing is not extensive enough for preventative measures.  This is where Johnson & Johnson made incentives for voluntary participation in biometric screening.  To prevent what can be prevented prior to it getting to a higher or more complicated level.  Safety is also important.  CIEC complies with all state, federal, and individual standards set to prevent unnecessary cost and potential harm. By Central Illinois Endoscopy Center committing to participate in Healthy People 2020 and getting their employees involved this program will be successful.


Cardo, Denise; Penelope H. Dennehy; Paul Halverson; Neil Fishman; Mel Kohn; Cathryn            Murphy; & Richard Whitely. (2010) Moving Toward Elimination of Healthcare-    Associated Infections: A Call to Action.  The Association for Professionals in Infection    Control and Epidemiology, Inc., and the Society for Healthcare Epidemiology of           America.

Goetzel, Ron Z.; Ronald J. Ozminkowski; Jennifer A. Bruno; Kathleen R. Rutter; Fikry Isaac; &             Shaohun Wang. (2008) The Long-Term Impact of Johnson & Johnson’s Health &      Wellness Program on Employee Health Risks.  Journal of Occupational Environmental                Medicine 44:417–424.





Demonstrating Achievement of Core Competencies for the Registered Nurse

My experiences and success in the nursing profession to date have been very beneficial in my efforts to support patients and their wellbeing. I believe that nursing is my vocation and my career path and is what I am most passionate about in my life. I have experienced many rough challenges in my personal life and have discovered that I am most comfortable and spiritually aligned with nursing and with my patients. At this stage of my career, I am committed to completing my education and achieving optimal success and achievement as an OR nurse. My family has been instrumental in supporting this decision and my professional vocation and I am grateful for their love, guidance, and continued support in this challenging yet highly rewarding journey down my career path.


Heart Failure Hospital Readmission


  1. Summary of Heart Failure

Heart failure constitutes is one of the most significant and serious ailments to afflict human beings.  Heart failure, also known as called congestive heart failure, is the inability of the heart to perform its primary function of supplying blood to meet the body’s demand for nutrients and oxygen.  Symptoms of heart failure include, but are not limited to, shortness of breath, swelling in the extremities, and aerobic and anaerobic exercise intolerance. In most cases it is associated with the elderly and research shows that it is prevalent in the developed countries; it is, for example, the number one killer of men and women in the United States (NHLBI 2011).