For this assignment, you will:

Select and watch any one film from the list below, or another cross-cultural film of your choice that you can easily access (please ask if you’d like other recommendations; do not select the assigned films – In My Country or Just Mercy – or the film described in the example below – Gran Torino).
Analyze and interpret that film from an intercultural communication research perspective, using at least two relevant theories and/or concepts from the course (paying special attention to chapters 5-10).

The selected concepts should be specific and not too general.

“Nonverbal communication” is too vague to serve as a concept for this paper; instead, focus on a specific aspect of nonverbal communication, like proxemics or chronemics.
“Verbal communication” is too vague, but co-cultural communication theory or code switching would be appropriate course concepts.
“Identity” is too general, but minority identity development is suitable.
“Migration” is general, but a specific type of migrant-host relationship would be appropriate.

Locate and use two scholarly sources (scholarly journal article or scholarly book chapter) – the textbook does not count. The scholarly sources should be related to the selected course concepts – one source per primary course concept. The assigned scholarly readings are also excellent to cite, but they will not count. The point is for you to do research on concepts that interest you, and to use the sources you find to help you develop a deeper understanding of the selected course concepts. If the sources also happen to discuss the film you’re analyzing, that’s great, but do not search for scholarly sources on the film – use keywords to search for scholarly sources on your concepts. You may refer to and cite the textbook and assigned scholarly readings, but those citations will not count towards the two scholarly sources you are assigned to locate and use for the film analysis.
Identify and describe macro-contexts and power relations depicted in the film.
Evaluate how the film reinforces or challenges forces of power and oppression. Make an argument for how these representations could be improved or how they are represented appropriately in the film.
Include in this analysis a brief summary of the selected scholarly source and use the source to support your critical analysis. Focus on the key findings from the source rather than on explaining how the author(s) did their study. We need to know what the findings were from that research and how that helps us better understand the concept in relation to the film. Prioritize paraphrasing and avoid direct quotes from the scholarly source, except for a phrase or two where relevant. Always use APA style for both in text citations as well as reference section at the end.

Key Components to Include
Your paper should include the following components:
1. Introduction
Brief introduction that identifies the film you have chosen and why you think it is important to study it from an intercultural communication perspective. Identify the two course concepts used to analyze the film and explain why they are relevant.
2. Plot
Brief summary of the plot/storyline of the film.
3. Critical Analysis

Taking a critical approach, analyze the film in relation to the two selected course concepts that you believe best explain the intercultural ideas, relationships, and complexities highlighted in the film. The strongest papers connect the concepts to show how they impact each other rather than just talking about two different concepts without relating them to each other in the context of the film.

Example 1: You might write about multicultural identity development and theories of adaptation as depicted in the selected film.
Example 2: You might write about co-cultural communication theory and post-colonialism as depicted in the selected film.
Example 3: You might analyze a migrant’s movement along the U-curve or W-curve models of intercultural adaptation and how a migrant’s changing nonverbal behavior like proxemics and/or kinesics reflects their movement along that curve.
Example 4: You may decide to focus on cultural spaces depicted in the film and their meanings for the characters, and cultural variations in communication style among the characters.
Example 5: You may decide to focus on a type of migrant-host relationship and prejudice represented in the film.

Identify and describe macro-contexts and power relations depicted in the film.
Evaluate how the film reinforces or challenges forces of power and oppression. Make an argument for how these representations could be improved or how they are represented appropriately in the film.
Include in this analysis a brief summary of the selected scholarly sources and use this source to support your critical analysis.

4. Conclusion
Summary of the key points made in your film analysis.
5. References
Reference section with APA style citations for the scholarly source(s) cited in the paper.
Paper Outline
Format your paper as follows:
1. Introduction (~1 paragraph)
2. Plot summary (~1 short paragraph)
3. Critical Analysis

Concept #1

Define the concept in your own words and explain, also in your own words, how it’s been explored in scholarly research using selected scholarly source (~1/2 paragraph)
Explain how concept applied to film, refer to scholarly source again (~1/2 paragraph)
Briefly describe 2-4 scenes or moments where concept can be seen operating in the storyline and/or characters’ relationships (~1 paragraph)
Select one of the aforementioned scenes to analyze in depth and explain how the concept applies, briefly refer to scholarly source (~2-3 paragraphs)

Concept #2  

Define the concept in your own words and explain, also in your own words, how it’s been explored in scholarly research using selected scholarly source (~1/2 paragraph)
Explain how concept applied to film, refer to scholarly source again (~1/2 paragraph)
Briefly describe 2-4 scenes or moments where concept can be seen operating in the storyline and/or characters’ relationships (~1 paragraph)
Select one of the aforementioned scenes to analyze in depth and explain how the concept applies, briefly refer to scholarly source (~2-3 paragraphs)

Macro-Contexts and Evaluation

Identify and describe macro-contexts and power relations depicted in the film and how they relate to the selected concepts. (~1-2 paragraphs)
Evaluate how the film reinforces or challenges forces of power and oppression. Make an argument for how these representations could be improved or how they are represented appropriately in the film. (~1-2 paragraphs)

4. Conclusion (~1 paragraph)
5. References
Additional Details
The paper should be 1500-1800 words in length with 1-inch margins on all sides and 12-point, Times font and submitted as a Word document. Your paper should be written in the first person. Keep in mind that grammar and spelling count – proofread and spellcheck your work before submitting it. Late papers will not be accepted and will earn 0 points.
List of Recommended Films
(if you are on campus, some of these films are available as DVDs at the library)

Mississippi Masala (1991) 
Rabbit Proof Fence (2002) – available on Amazon Video, Hulu, 
Hotel Rwanda (2004) – available on Amazon Video,
Arranged (2007) – available on Netflix; YouTube; 
Cairo Time (2009) – available on Netflix, Hulu
Buen Día, Ramon (2013) – available on Netflix
A Borrowed Identity (2014) – available on Netflix
The Hundred-Foot Journey (2014) – available on Amazon Video; 
Viva (2015) – available on Netflix
Front Cover (2015) – available on Netflix, Amazon Video
The African Doctor (2016) – available on Netflix
The Big Sick (2017) – available on Amazon Video; 
Crazy Rich Asians (2018) – available on Amazon Video; 
BlacKkKlansmen (2018) – available on Amazon Video
The Farewell (2019) – available on Amazon Video

Example
Plot Summary
The film Gran Torino (2008) tells the story of a surly, old, white American veteran, Walt Kowalski, who lives in a Detroit neighborhood that is experiencing demographic changes. Many of his fellow white, American neighbors have either passed away or moved, and Hmong immigrant/refugee families have been moving in, much to Walt’s displeasure. Throughout the film, though, Walt develops a close friendship with his two teenage neighbors – siblings Sue and Thao Vang Lor.
Concepts Addressed in Film
Some conceptual areas addressed in the film are the individualism-collectivism value orientation, cross-cultural facework, prejudice, ethnocentrism, language (via racial slurs) and their shifting meaning throughout the film, gender dynamics, and cultural spaces.
What Next?
To write the paper, I would –

Select two or three of these concepts, e.g. facework, cultural spaces and/or racial slurs;
Identify specific scenes where these topics are illustrated among the characters and use those to scenes to analyze how the concepts apply and play out in those scenes;
Articulate the connections between the concepts to demonstrate how they relate to each other in the context of the film;
Locate two scholarly sources that address each of my two primary conceptual areas to help deepen my analysis of the film;
Since I am taking a critical approach, I also want to identify macro-contexts (in this case, military history, political contexts, socio-economic, immigration policies, among others) that shape the relationships depicted in the film; and finally
Evaluate how the film does with representing these topics – does it reinforce and/or resist stereotypes, and how could these depictions be improved? For example, I would critique the film for its perpetuation of the white-savior trope (the false notion that people of color need white people to save them) rather than telling a story where people of color have agency.

Discuss how case management approach can be differently utilized based on counseling specialties (e.g., mental health, addiction and clinical rehabilitation) peer1 ElaineAs it is mentioned in our lecture, the whole concept of case management as a process is to assist multiple-need clients. (Kim, n.d.). Depending on what the client’s needs are will be how a case manager will approach the situation. In my undergrad program, I was always told that a case manager wore many hats. By being a case manager, we need to be culturally sensitive, anticipatory, flexible, pragmatic, client-driven and driven by the client’s needs, community-based, and lastly, involve advocacy. Case management should offer the client a single point contact with the social services and health systems. For example, applying case management to substance abuse treatment involves preparing a client for community-based treatment and living within their community. As a case manager, we can ensure a smooth transition and help by removing any obstacles being in the way of timely admission within the community-based programs (Comprehensive Case Management for Substance Abuse Treatment, 2012). Another example is mental health case managers. Case managers for mental health clients, develop treatment plans that are properly targeted at the patient’s needs. This involves a thorough assessment of the client’s personal needs, psychological triggers, and strengths. Last example is case management in clinical rehabilitation. A case manager in clinical rehabilitation can conduct outreach and case finding, provide assessment and ongoing reassessments, assist in goal planning (client life area goals), make referral to needed resources, monitor referrals, provision of therapeutic activities central to model, and helps develop informal support systems (Comprehensive Case Management for Substance Abuse Treatment, 2012). Kim, J.H. (n.d.) Introduction to Case Management, Definition & Philosophy, Role and Functions of Case Manager. [Transcript]. Texas Tech University Health Sciences Center. Substance Abuse and Mental Health Services Administration. Comprehensive Case Management for Substance Abuse Treatment. Treatment Improvement Protocol (TIP) Series, No. 27. HHS Publication NO. (SMA) 12-4215 Rockville, MD: Author, 2012 Peer 2 KristenDifferent needs require different levels of case management intervention in a client’s life. Mental health comes in several various forms and severities. Some counseling is more intensive and all-encompassing regarding someone’s life. Other forms of counseling regarding mental health may involve minimal contact; it just depends on the client and how much intervention they require for their health. Individuals struggling with addiction may and usually do require a much more hands-on and intensive approach or ‘intensive case management’ where the ‘clients are at high risk for rehospitalization or for behavior that poses a danger to themselves or other people’ (Summers,2009). Clinical rehabilitation follows the similar ebb and flow of whatever suits accordingly to the client at hand. The case management approach follows guidelines, however, that are similar in different counseling specialties. There are goals to be met for meetings surrounding the approach taken regarding the client’s specific needs and even plans for themselves. This can be a range of many vast things since there are so many different specialized areas in counseling. Usually, a primary goal involved in the case management approach is what services the client will be provided and choose to receive according to their own life, determined by both the client and the counselor. Plans made can and usually do change. However, a dream, to begin with, is always necessary as a baseline. There will often be collaborating with others involved in the client’s life; this can also look very different carrying across the different types of specialized counseling fields.Summers, N. (2009). Fundamentals of Case Mangaement Practice Skills for the Human Services (5th ed.). Harrisburg: Cengage Learning. Peer 3 ShannonSorry, I am late posting forum #3, my kiddos have a stomach bug, so to say life has been pretty eventful the last 48-72 hours, would be an understatement. Hoping they are on the mend, as they are sleeping. As for the question, how can a case management approach be differently utilized based on counseling specialties (e.g., mental health, addiction and clinical rehabilitation)?In our text, the heart of “case management is a process for assessing the individual’s total situation and addressing the needs and problems found in that assessment. ” (Summers, 2016. p. 1.). When keeping this in mind, case management by nature differs from person to person and need by need. When looking at the levels of case management, a case manager can take an administrative role, coordinate resources, intensive case management, or targeted. Where these levels might change agency to agency, the premise behind them will stay the same, it is the level of care provided by the case manager (Summers, 2016. p. 381.). When looking at how a case manager’s approach may differ based on counseling specialties, I think you have to go back to the individual that is in need of care. If a case manager is faced with an individual that is addicted to drugs, who is self-medicating for anxiety, the case manager will need to treat the substance abuse first, but figure out how to work to solve the anxiety, in hopes of this individual making the desired recovery. If the case manager has a client who is blind, isolated, and depressed, the case manager will need to evaluate the individual’s life and see what services are needed, and it will likely be a combination of rehabilitation counseling as well as mental health counseling. If an individual has just had a baby and is finding herself sad and losing hope, but has all her basic needs met, the case manager will likely work with a mental health counselor to help treat the sadness and potential postpartum depression. A case manager’s role will differ by need and scope. What works with one individual, will not work with another and it is the case manager’s role in the patient’s care to look at a patient’s situation holistically and determine the best avenue to meet the patient’s needs. There may be times the case manager will have to change paths to achieve the desired outcome for a patient working with the providers. ReferenceSummers, N. (2016). Fundamentals of case management practice: Skills for the human services. In Fundamentals of case management practice: skills for the human services (pp. 1). Cengage Learning. Peer 4 DawnDiscuss how case management approach can be differently utilized based on counseling specialties (e.g., mental health, addiction and clinical rehabilitation)While case managers should be skilled listeners who are attentive to the needs of clients, there are additional skills that may be effective depending on the counseling specialty. The specific needs of the client can dictate the case manager’s approach and change with the target population. One example is the Assertive Community Treatment model, which may look different depending on the client and issue being addressed. The highlights of this model are establishing relationships with clients, providing services in the home or community, helping clients find success in daily life, advocacy, a team approach, long-term commitment, and frequent contact. Often used in the treatment of people with severe mental illness, ACT substantially reduces psychiatric hospital use, increases housing stability, and moderately improves symptoms and subjective quality of life (Bond et al., 2001). In addition, ACT is highly successful in engaging patients in treatment. Case managers may have the additional burden of advocating for clients with insurance companies.This same model could also be utilized by a vocational rehabilitation counselor in the treatment of people with disabilities, but would likely not be as successful without a focused vocational component. Although having a team of professional help would be beneficial, vocational rehabilitation clients generally need more help with goal setting, job skills, advocacy with employers, skill-building, and access to resources. The ACT model would not address all these aspects of treatment but could provide some limited assistance. Counselors should make informed decisions about the selection of treatment models to maximize the use of time, funds, and resources for clients. Another example is clients recovering from addiction who may also benefit from an ACT approach. Clients would not be expected to solely seek services at a treatment facility but might receive in-home intervention by members of the treatment team. Getting a recovering client back to a treatment facility after relapse can be a huge hurdle. The ACT approach might be a game-changer if it means clients in need of help are identified earlier and suffering could be alleviated. As a mental health counselor and educator, I personally find great value and reward in utilizing a strengths-based approach to treatment planning. This approach places value on the skills, knowledge, and potential of clients and takes the focus off the challenges. The emphasis on the positives may help promote optimism and hope and enhance well-being. Teaching clients to use strengths to supplements challenges, and how to use resources to ensure success are the hallmarks of this model which can be applied to a variety of approaches for substance abuse, use with high-risk youth, treatment of behavioral issues, and social work. Personally, I think clients should grow confident and independent in treatment. Counselors need to have a variety of tools and approaches available for different clients and situations.

Please reply with 100-150 each DQ. Thank you Casey:Falls in the elderly are a common occurrence for chief complaints of this population upon presentation to the emergency department. Furthermore, falls in the elderly are an often occurrence during their visit to the emergency department. These issues combined, place them at an increased risk of mortality and adverse events s/p their ED visit. Additionally, especially with the pandemic, emergency departments are overwhelmed and inundated, therefore, any chance to decrease the number of potential ED visits, can be appreciated. In my PICOT statement, I seek to find if adding tools during triage in the emergency room could potentially alert the staff that certain patients are at an increased risk. This would be in addition to the current standards. There have been several tools used to identify patients who are at risk for falls/frailty, however, none were developed specific to the emergency department (Galvin, et al, 2017, pg. 180). The ISAR (Identification of Seniors at Risk) was developed to assist in identifying the risk of elderly patients (greater than or age of 65) who could be subject to, “future adverse outcomes including functional decline, unplanned hospitalization or ED visit (Galvin, et al., 2017, pg. 180). As a nurse manager, it is my responsibility to ensure the tools that are needed for the frontline staff to identify this population and place the proper precautions to prevent falls. A lot of factors come into play from an administration standpoint. Patient safety, quality improvement, and risk management, just to name a few. It is my hope that using the ISAR tool will improve the identification of this vulnerable population and thereby increase the resources needed upon initial presentation to the emergency department. PICOT: In geriatric adult patients who present to the ED with a chief complaint of falls or injury related to falls (P) does implementing the ISAR (Identification of Seniors at Risk) screening tool (I) when added to the current fall risk standards (C) indicate a higher level of fall risk, thus subsequent emergency department visits, or further injuries (O) for a period of 30 days(T)?References:Galvin, R., Gilleit, Y., Wallace, E., Cousins, G., Bolmer, M., Rainer, T., Smith, S. M., & Fahey, T. (2017). Adverse outcomes in older adults attending emergency departments: a systematic review and meta-analysis of the Identification of Seniors At Risk (ISAR) screening tool. Age and Ageing, 46(2), 179.Devin:PICOT: In adult smokers with MI (P), does the use of mHealth technologies for smoking cessation, in addition to standard treatment (I), compared to standard treatment alone (C), lead to increased quit attempts and abstinence rates and reduced number of cigarettes per day (O) in 6 to 12 months (T)? Rates of cigarette smoking in the United States have reduced dramatically over the past several decades, to about 14% in 2019 (Cornelius, et al., 2020); despite this fact, more preventable disease and death in the United States is attributable to cigarette smoking than to any other cause, with a mortality rate of about 448,865 in 2014 (Ma, et al., 2018). Additionally, smoking rates among certain populations, namely, those with mental illness (MI), have been largely resistant to the same decline, with disproportionately higher rates of tobacco use compared to the general population (Lipari & Van Horn, 2017). Despite the desire of adult smokers with MI to quit (Tulloch, et al., 2016), they have a lower likelihood of cessation compared to those without MI (Lipari & Van Horn, 2017), even with the availability of standard evidence based treatments for smoking cessation (e.g., varenicline or bupropion, nicotine replacement therapy, behavioral support/counseling). In the digital age, mobile health (mHealth) technologies for smoking cessation may help achieve improved smoking cessation rates, including higher quit and abstinence rates and lower rates of cigarettes per day (CPD), among adult smokers with MI. The dramatic decline in tobacco use is considered one of the greatest public health achievements of the twentieth century (Centers for Disease Control and Prevention, 1999). However, vulnerable and overlooked populations, such as those with MI, need continued research, attention, and more targeted interventions to enjoy the same success. As a future advanced public health nurse, I will undoubtedly be involved in community outreach and prevention programs, likely including tobacco cessation, particularly for those most vulnerable to tobacco-related disparities. The proposal supports those with MI by zeroing in on the needs of this specific population, including social support, distraction from cravings, and self-esteem building, to boost smoking cessation rates in this vulnerable population (Gowarty, et al., 2020; Klein, et al., 2019). Additionally, the selected problem is amenable to a research-based intervention due to the desire of smokers with MI to quit smoking and their need for further assistance in doing so beyond standard treatment (Tulloch, et al., 2016), as well as the acceptability, usability, and feasibility of mHealth interventions for smoking cessation among smokers with MI, and their generally positive attitudes toward such interventions (Klein, et al., 2019; Gowarty, et al., 2020). Not only is the proposal amenable to research, but further research is also vital to determine which design features and styles within an mHealth intervention would be most useful for the population in question, in order to provide the greatest benefit.References:Cornelius, M.E., Wang, T.W., Jamal, A., Loretan, C.G., & Neff, L.J. (2020, November 19). Tobacco product use among adults — United States, 2019. Morbidity and Mortality Weekly Report, 69, 1736–1742. Centers for Disease Control and Prevention. http://dx.doi.org/10.15585/mmwr.mm6946a4Centers for Disease Control and Prevention. (1999). Ten great public health achievements – United States, 1900-1999. Morbidity and Mortality Weekly Report, 48, 12, 241-243. https://www.cdc.gov/mmwr/preview/mmwrhtml/00056796.htmIsabel:In adult patients with diabetes (P) does provide support such as a personalized health coach program (I) when compared to other interventions (C), lead to improved HbA1C levels (O) over the course of one year (T)? The intervention I am proposing is one that adds to the current standard of care for diabetes self-management education programs in which a peer, registered nurse, or trained person in the field of diabetes coaches the patient in education, health diet choices and medication adherence. The anticipated outcomes would be to see a decrease in HbA1c over a course of time with an increase in self-managing their chronic condition such as diabetes. The intervention supports the diabetic population in that it is attempting new interventions to help Americans control their diabetes. The American Diabetes Association reports that just over 1 in 10 Americas have diabetes– approximately 34.2 million people. Also, that new diabetes cases were higher among non-Hispanic blacks and people of Hispanic origin than non-Hispanic Asians and non-Hispanic whites (Centers for Disease Control and Prevention, 2020). The setting I work within is a busy inpatient hospital that serves a metropolitan community of approx. 350,000. The role I currently occupy is one of a staff nurse and provide beside patient care within the Emergency Department. In the E.R. there are several times where we must assume care for admitted patients and serve as a “floor nurse” as well. IN summary, very fluid-like in the ER as far as a role is assumed, but will always involve providing excellent care to our patients. In adult patients with Diabetes, does providing support such as a personalized health coach program, when compared to other interventions, lead to improved HbA1C levels over the course of one year? A recent study done by Pirbaglou et al. (2018), evaluated the impact of Personal Health Coach (PHC) programs on glycemic management and related psychological outcomes. Randomized controlled trials (RCT) published between January 1990 and September 2017 focused on the effectiveness of PHC interventions in adults with T2DM. Pirbaglou et al. found that relevant study information from individual trials (eg, design, sample characteristics, intervention structure, control group characteristics, disease management outcomes) were extracted and assessed by three reviewers’ using a prespecified format. Meta-analyses of 22 selected publications showed PHC interventions favorably impact HbA1c levels in studies with follow-ups. It is important to note that pharmaceutical, lifestyle-based, and psychoeducational approaches are not mutually exclusive. All can be, theoretically, combined in optimal proportions. It does not seem productive to further assess them competitively, as it is appropriate now to attempt, document, and compare optimal integrations. Certainly, PHC would seem to be an important component of optimally integrated approaches as seen in the study where PHC was offered in combination with a structured dietary program (ie, protein-rich meal replacement). In summary, this study provided useful data but note that PHC will be better served in combination with other structured dietary programs. ReferencesCenters for Disease Control and Prevention. (2020). National Diabetes Statistics Report, 2020. Retrieved from https://www.cdc.gov/diabetes/pdfs/data/statistics/…Pirbaglou, M., Katz, J., Motamed, M., Pludwinsk, I. S., Walker, K., & Ritvo, P. (2018). Personal Health Coaching as a Type 2 Diabetes Mellitus Self-Management Strategy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. American Journal of Health Promotion, 32(7), 1613-1626. doi:10.1177/0890117118758234

Public Health Ethics and Laws Case Study HomeworkDr. Naof Faiz Al-AnsaryCase Title: Reducing Sudden Infant Death Syndrome in a Culturally Diverse Society: The New Zealand Cot Death Study and National Cot Death Prevention ProgramSudden Infant Death Syndrome (SIDS) involves the death of apparently healthy sleeping infants, usually within the first year of life. It is a diagnosis of exclusion, that is, it denotes an unknown cause of death (Willinger et al. 1991; American Academy of Pediatrics 2011). It is also known as cot or crib death and is classified as a form of Sudden Death in Infancy (SUDI). Unlike many public health issues, SIDS unites clinical and forensic considerations, as this finding of cause of death can determine attribution of criminal (and moral) responsibility. Police collect evidence and coroners assess the circumstances of the death and release judgments. This is the method by which a SIDS death is determined. Context heightens the ethical significance of SIDS diagnosis, research, and prevention. In 1991, when the New Zealand Cot Death Study (NZCDS) commenced, New Zealand’s rate of SIDS was high by international standards at 4 deaths per 1,000 live births (Mitchell et al. 1997) compared, for example, to the Netherlands (1.3/1,000 in 1989) (de Jonge et al. 1989) and Hong Kong (0.3/1,000 in 1986–1987) (Lee et al. 1989). Within New Zealand, SIDS deaths occurred in the indigenous Māori population at twice the rate of the non-Māori population (Mitchell et al. 1994). The reason for this significant disparity was not well understood.The NZCDS was the first national case-control study designed to identify risk factors for SIDS. By comparing infants whose deaths were attributed to SIDS with a representative sampleof live births, within a year, the NZCDS had identified a number of risk factors. The study confirmed an association between increased risk of SIDS and lower socioeconomic status, along with a range of associated maternal factors, including fewer years of education, younger age at first pregnancy, greater number of previous pregnancies, and lower attendance at prenatal classes (Mitchell et al. 1991). The NZCDS selected three risk factors to address among this range of findings: lack of breast-feeding, maternal smoking, and placing infants to sleep in a prone position (Mitchell et al. 1991). The ensuing national prevention campaign focused on publicizing these risks, which parents were seen as able to influence. These were categorized as ‘modifiable risk factors.’ Many parents changed their practices in response to the campaign (Cowan 2010). Abandonment of the prone sleeping position was the most readily and widely adopted measure and is credited with delivering the largest proportion of the national reduction in SIDS rates (Mitchell et al. 1997). Factors that were less susceptible to parental alteration were classified as ‘non-modifiable risk factors.’ Non-modifiable factors included the baby’s sex, the mother’s age, and the family’s socioeconomic status.Analysis of the second year’s data revealed another risk factor: bed-sharing (Mitchell et al. 1992). Bed-sharing was categorized as a modifiable risk factor, and parents were advised to avoid sleeping on the same surface as their baby or allowing others (for instance, other children) to do so. The study’s findings were immediately fed into the prevention campaign. Communicating with parents about this particular risk factor became more problematic than initially anticipated. The difficulties partly reflected a developing understanding about the subtle nature of bed-sharing risk. While early messages counselled against all bed-sharing, subsequent findings prompted adjustments (Cowan 2010). Now bed-sharing is not viewed as a significant risk unless coupled with maternal smoking or with the baby’s bedmate being intoxicated orexcessively tired. Other factors such as the baby’s age, the site, and duration of bed-sharing have also been identified as affecting the magnitude of risk. These considerations make it difficult to summarize the risk in a way that is scientifically sound and that parents can easily understand. Also, the prevention campaign took place against a backdrop of numerous changes in prevailing thought since the 1950s about the causes of SIDS. These changes were associated with changing advice about parental practices, which created uncertainty within families about which advice should be followed. The cultural significance attributed to bed-sharing meant that there were different reactions among groups to advice not to bed-share. While bed-sharing is not traditional among New Zealand European (Pākehā) families, it is firmly rooted inMāori and Polynesian child-rearing practices (Tipene-Leach et al. 2000). In these communities, bed- s haring is seen as positive and beneficial, promoting bonding between mother and child and enabling mothers to comfort and care for their child (Abel et al. 2001; Tipene-Leach et al. 2000).The message that bed-sharing is risky had serious implications, then, for Māori and Polynesian child-rearing practices. The early years of the SIDS prevention campaign succeeded in reducing the rate of SIDS, but the tenor of the anti-bed-sharing message alienated many, particularly indigenous Māori, consequently turning whānau (wider family networks) away from SIDS prevention messages altogether. Some interpreted the campaign as blaming Māori for infant deaths. After an infant death, the involvement of police, pathologists, and a coroner’s court compounds overtones of culpability, intensifying the guilt and grief associated with the loss of a child (Clarke and McCreanor 2006). Several years after the ongoing SIDS prevention campaign was launched, rates of SIDS among Māori remained disproportionately high. In 2009, the rate of SIDS for Māori was 1.5 per 1,000 live births, compared with 0.6/1,000 for Pacific Peoples, and0.3/1,000 for Other, including Pākehā (Ministry of Health 2012). Several modifiable risk factors for SIDS, including maternal smoking and bed-sharing are more prevalent in the Māori community. Māori parents less frequently attend prenatal classes than non-Māori parents. Along with the modifiable factors, many non-modifiable factors are more likely to apply to Māori families, including lower socioeconomic status, younger age of mother at first pregnancy, greater number of pregnancies, and fewer years of education. These contributors to rates of SIDS among Māori do not receive the same level of scrutiny in the media as modifiable parental practices, and prevention campaigns continue to focus upon altering parental practices. A sense of injustice and a perception that the state lacks a true commitment to addressing the societal factors underpinning SIDS prevails in parts of the Māori community. The prevention campaign’s focus upon discouraging bed-sharing contributes to the community’s sense that the campaign undermines rather than supports traditional Māori practices. In particular, the coronial process— the investigations into the cause of death, the invasive process of autopsy, and the slow return of the body to whānau— cannot easily accommodate the deep-felt need of whānau to complete the traditional Tangihanga process, the spiritual rituals and burial proceedings following a death. Nor is the high profile of the bed-sharing risk matched by a commitment to tackle other risk factors, which may require more resources. Some have therefore called for examination of the process by which risk factors are categorized as modifiable or non-modifiable. The government has committed substantial resources to culturally appropriate SIDS prevention for Māori and Polynesian families and is conducting trials of appropriate supports for families to bed-share safely (Tipene-Leach 2010).Meanwhile, criminal proceedings against Māori parent s relating to the deaths of their infants while co-sleeping continue to receive media attention (R v Tukiwaho 2012; APNZ 2013).No wonder, then, that the strong sense of parental responsibility for SIDS deaths, where bed- sharing is a factor, remains. Although inequities underwrite the high exposure of Māori families to both modifiable and non-modifiable risk factors, both government-funded health promotion and media coverage of SIDS remain focused on parental practice.Following high-profile media coverage of the greater burden of SIDS among Māori, new funding is available for a SIDS prevention campaign to reduce SIDS in Māori and Polynesian families. Part of this funding is reserved for the generation of new guidelines acceptable to Māori. There is also an opportunity to brief the Minister of Health and the Minister of Social Development about measures that can reduce rates of SIDS deaths among Māori infants. Discussion QuestionsPlease submit your typed responses via e-mail prior to class on Wednesday November 28 and be prepared to discuss your answers in class.1. Evidence suggests that several factors affect the magnitude of risk and that bed-sharing in the absence of these factors does not significantly increase the risk of SIDS. But the interplay of risks can be complex and difficult to communicate effectively in a national campaign. Can a definitive “no bed-sharing” message be defended, on ethical grounds, if it causes less confusion but overstates the risk to some groups? What are the most important ethical considerations here?2. What weight should be attributed to the cultural significance of bed-sharing when generating guidelines, and why? Should risks that relate to culturally significant parental practices, such as bed-sharing, be treated differently from risks relating to practices that are not held to be culturally significant?

For this assessment, you will develop a Word document or an online resource repository of at least 12 annotated professional or scholarly resources that you consider critical for the audience of your safety improvement plan, pertaining to medication administration, to understand or implement to ensure the success of the plan.
Communication in the health care environment consists of an information-sharing experience whether through oral or written messages (Chard, Makary, 2015). As health care organizations and nurses strive to create a culture of safety and quality care, the importance of interprofessional collaboration, the development of tool kits, and the use of wikis become more relevant and vital. In addition to the dissemination of information and evidence-based findings and the development of tool kits, continuous support for and availability of such resources are critical. Among the most popular methods to promote ongoing dialogue and information sharing are blogs, wikis, websites, and social media. Nurses know how to support people in time of need or crisis and how to support one another in the workplace; wikis in particular enable nurses to continue that support beyond the work environment. Here they can be free to share their unique perspectives, educate others, and promote health care wellness at local and global levels (Kaminski, 2016).
You are encouraged to complete the Determining the Relevance and Usefulness of Resources activity prior to developing the repository. This activity will help you determine which resources or research will be most relevant to address a particular need. This may be useful as you consider how to explain the purpose and relevance of the resources you are assembling for your tool kit. The activity is for your own practice and self-assessment, and demonstrates course engagement.
Demonstration of Proficiency
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

Competency 1: Analyze the elements of a successful quality improvement initiative.

Analyze usefulness of resources for role group responsible for implementing quality and safety improvements with medication administration.

Competency 2: Analyze factors that lead to patient safety risks.

Analyze the value of resources to reduce patient safety risk or improve quality with medication administration.

Competency 3: Identify organizational interventions to promote patient safety.

Identify necessary resources to support the implementation and sustainability of a safety improvement initiative focusing on medication administration.

Competency 5: Apply professional, scholarly, evidence-based strategies to communicate in a manner that supports safe and effective patient care.

Present compelling reasons and relevant situations for resource tool kit to be used by its target audience.
Communicate in a clear, logically structured, and professional manner, using current APA style and formatting.

References
Chard, R., Makary, M. A. (2015). Transfer-of-care communication: Nursing best practices. AORN Journal, 102(4), 329-342.
Kaminski, J. (2016). Why all nurses can/should be authors. Canadian Journal of Nursing Informatics, 11(4), 1-7.
Professional Context
Nurses are often asked to implement processes, concepts, or practices – sometimes with little preparatory communication or education. One way to encourage sustainability of quality and process improvements is to assemble an accessible, user-friendly tool kit for knowledge and process documentation. Creating a resource repository or tool kit is also an excellent way to follow up an educational or in-service session, as it can help to reinforce attendees’ new knowledge as well as the understanding of its value. By practicing creating a simple online tool kit, you can develop valuable technology skills to improve your competence and efficacy. This technology is easy to use, and resources are available to guide you.
Scenario
For this assessment, consider taking one of these two approaches:

Build on the work done in your first three assessments and create an online tool kit or resource repository that will help the audience of your in-service understand the research behind your safety improvement plan pertaining to medication administration and put the plan into action.
Locate a safety improvement plan (your current organization, the Institution for Healthcare Improvement, or a publicly available safety improvement initiative) pertaining to medication administration and create an online tool kit or resource repository that will help an audience understand the research behind the safety improvement plan and how to put the plan into action.

Preparation
Google Sites is recommended for this assessment – the tools are free to use and should offer you a blend of flexibility and simplicity as you create your online tool kit. Please note that this requires a Google account; use your Gmail or GoogleDocs login, or create an account following the directions under the “Create Account” menu.
Refer to the following links to help you get started with Google Sites:

G Suite Learning Center. (n.d.). Get started with Sites. Retrieved from https://gsuite.google.com/learning-center/products…
Google. (n.d.). ;Google Sites. Retrieved from https://sites.google.com
Google. (n.d.). ;Sites help. Retrieved from https://support.google.com/sites/?hl=en#topic=

Instructions
Using Google Sites, assemble an online resource tool kit containing at least 12 annotated resources that you consider critical to the success of your safety improvement initiative. These resources should enable nurses and others to implement and maintain the safety improvement you have developed.
It is recommended that you focus on the 3 or 4 most critical categories or themes with respect to your safety improvement initiative pertaining to medication administration. For example, for an ;initiative that concerns improving workplace safety for practitioners, you might choose broad themes such as general organizational safety and quality best practices; environmental safety and quality risks; individual strategies to improve personal and team safety; and process best practices for reporting and improving environmental safety issues.
Following the recommended scheme, you would collect 3 resources on average for each of the 4 categories focusing on safety with medication administration. Each resource listing should include ;the following:

An APA-formatted citation of the resource with a working link.
A description of the information, skills, or tools provided by the resource.
A brief explanation of how the resource can help nurses better understand or implement the safety improvement initiative pertaining to medication administration.
A description of how nurses can use this resource and when its use may be appropriate.

Remember that you must make your site public so that your faculty can access it. Check out the Google Sites resources for more information.
Here is an example entry:

Merret, A., Thomas, P., Stephens, A., ;Moghabghab, R., Gruneir, M. (2011). A collaborative approach to fall prevention. Canadian Nurse, 107(8), 24-29. Retrieved from www.canadian-nurse.com/articles/issues/2011/octobe…

This article presents the Geriatric Emergency Management-Falls Intervention Team (GEM-FIT) project. It shows how a collaborative nurse lead project can be implemented and used to improve collaboration and interdisciplinary teamwork, as well as improve the delivery of health care services. This resource is likely more useful to nurses as a resource for strategies and models for assembling and participating in an interdisciplinary team than for specific fall-prevention strategies. It is suggested that this resource be reviewed prior to creating an interdisciplinary team for a collaborative project in a health care setting.

Additionally, be sure that your plan addresses the following, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so you understand what is needed for a distinguished score.

Identify necessary resources to support the implementation and continued sustainability of a safety improvement initiative pertaining to medication administration.
Analyze the usefulness of resources to the role group responsible for implementing quality and safety improvements focusing on medication administration.
Analyze the value of resources to reduce patient safety risk related to medication administration.
Present compelling reasons and relevant situations for use of resource tool kit by its target audience.
Communicate in a clear, logically structured, and professional manner that applies current APA style and formatting.

Example Assessment: You may use the following example to give you an idea of what a Proficient or higher rating on the scoring guide would look like but keep in mind that your tool kit will focus on promoting safety with medication administration. Note that you do not have to submit your bibliography in addition to the Google Site; the example bibliography is merely for your reference.

Assessment 4 Example [PDF].

To submit your online tool kit assessment, paste the link to your Google Site in the assessment submission box.
Example Google Site: You may use the example Google Site, Resources for Safety and Improvement Measures in Geropsychiatric Care, to give you an idea of what a Proficient or higher rating on the scoring guide would look like for this assessment but keep in mind that your tool kit will focus on promoting safety with medication administration.
Note: If you experience technical or other challenges in completing this assessment, please contact your faculty member.