The Tuskegee Study

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Discussion -08 (two pages)

After reading about the syphilis study at Tuskegee, how do you think participants in the study would have reacted had they been given full disclosure about the research methods prior to the start of the study? When responding to your classmates, discuss possible suggestions for re-creating the study using the current standards used in research with human subjects.

Response one

8-2 Discussion: The Tuskegee Study ( one pages)

The Tuskegee Study of Untreated Syphilis in the Negro Male initiated in 1932 involved 600 black men – 399 infected with syphilis and 201 uninfected subjects who served as a control group. The men in the study were recruited with misleading promises of “special free treatment”, which were actually spinal taps done without anesthesia to study the neurological effects of syphilis (Heintzelman, 2003). Periodic assessments were completed on the patients and they were told they were being treated for “bad blood”, a local term used to describe certain ailments which included anemia, syphilis, and anemia. Physicians involved with this study were told to not treat the men and to follow them to their death. In 1945 Penicillin became the accepted treatment for syphilis but the men in the study were not offered it. In 1972, the first news article was published condemning the Tuskegee Study and an Ad Hoc Advisory Panel was appointed by the Assistant Secretary for Health and Scientific Affairs to review the study. The panel found that there was no evidence that the men were informed of the study or its real purpose as they were not given all the facts to provide informed consent. The advisory panel also found that the men involved in the study were never given the choice of quitting the study, even when penicillin treatment became widely used. The study ended in in October of 1972 as the panel concluded that it was ethically unjustified noting that little information was gained when compared with the risks posed for the participants. In 1974, the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research was created to identify basic principles of research conduct and suggested ways to make sure the principles were followed (“Tuskegee Study and Health Benefit Program – CDC – NCHHSTP,” 2018).

When reading about this study I asked myself how the participants in the study would have reacted had they been given full disclosure about the research methods prior to the study. I think that had the participants known that the physicians would not tell them their diagnosis, refuse to treat them for the debilitating disease, and actively deny some of them treatment most would have not participated. The risk of this study outweighed the benefits of participation. There are many ethical issues with this experiment such as informed consent, withholding treatment known to be effective, protecting the interests of the individual patient, and deciding when to withdraw a patient from the study (Friis & Sellers, 2014). Informed consent, which refers to informing potential research participants about all aspects of the research that might reasonably influence their decision to participate, was the main ethical issue in this study. The men in this study agreed to participate and thought they would be treated but in fact did not receive the proper treatment needed to cure their illness. Another ethical issue is that researchers took advantage of a deprived socioeconomic situation in which the participants had experienced low levels of care. The lives of those black men and their families were mostly ruined after this study as many of them died from complications of syphilis. There has been research that suggests that the ill effects of the Tuskegee Study extend beyond those men and their families to the greater whole of black culture. There is mistrust of physicians and the medical system by black patients who are more likely to believe medical conspiracies. The awareness of the Tuskegee study is exactly what eroded trust as it was identified by researchers as a contributor to health disparities in the first place. The disclosure in 1972 made the system less abusive and led to reforms that established medical ethics and protections for disadvantaged people (Heintzelman, 2003).

References

Friis, R. H., & Sellers, T. A. (2014). Epidemiology for Public Health Practice (5th ed.). Burlington, MA: Jones & Bartlett Learning.

Heintzelman, C. A. (2003). The Tuskegee Syphilis Study and Its Implications for the 21st Century. New Social Worker, 10(4), 4–6. Retrieved fromhttp://ezproxy.snhu.edu/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=sih&AN=11504864&site=eds-live&scope=site

Tuskegee Study and Health Benefit Program – CDC – NCHHSTP. (2018, October 3). Retrieved February 11, 2019, from http://www.cdc.gov/tuskegee/index.html

The Crisis of Credit Visualized video

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BUS670 WK 3 RPLY

 

DQ 1

After viewing The Crisis of Credit Visualized video, respond to each of the following:

1. How could government regulations have prevented or mitigated the credit crisis of 2008? 2. Discuss whether too much governmental regulation of business or too little governmental regulation of business presents the greater danger to:

a. the greater good b. business

Guided Response:  Respond to at least two of your fellow students’ posts in a substantive manner. Some ways to do this include the following, though you may choose a different approach, providing your response is substantive:

Agree or disagree with other students’ positions. Defend your position by using information from the week’s readings.

Post 1 –

ark as Unread Alicia Bearde: Crisis of 2008 Alicia Bearden mail this Author 5/28/2015 12:51:51 PM

 
  In my opinion government regulations could have prevented the 2008 crisis by increasing standards of who was getting home loans and putting stricter limitations on what people could be approved for. There was to much risk taking that could have been avoided. It is

important for banks to hold more capital for cushion in case of losses. The government has our

society’s best interest at heart, and we must pout faith in this. Seaquist (2012) states that “since

1930 the federal government has been steadily increasing and expanding their regulatory

powers over business and individuals through the creation of agencies such s the Federal Trade Commission, Internal Revenue Service, and Food and Drug Administration.”

Although to much or too little government regulation can be dangerous, it is essential

to have a happy medium. I feel that to little government regulation of businesses present

the greater danger. We have already seen that from our history how bad it can be

when there is to little government regulation. Implementing an early warning system of currency crisis is an excellent idea to help maintain the happy medium so that future disaster will not happen.

It is essential for government to regulate businesses to prevent risky and borrowing practices.

Government Regulations are implemented to protect the public and in return also protects businesses from growing out of control. It is so vital to have the happy medium of government regulation because to much would damage businesses and prevent them from

growing and put a major hold on society growing which would lead to great danger

for us as a whole. Research has found that we find that “better governance mitigates

the disruption caused by the bank credit supply shock to firms’ financing and investment activities” (Nguyen, Nguyen, & Yin, 2015).

Nguyen, T., Nguyen, H. (., & Yin, X. (2015). Corporate Governance and Corporate Financing and Investment during the 2007-2008 Financial Crisis. Financial Management (Wiley-Blackwell), 44(1), 115-146. doi:10.1111/fima.12071

Seaquist, G. (2012). Business law for managers.  San Diego, CA: Bridgepoint Education, Inc.

 

 

 

 

ollapse ark as Unread Regulation and the Greater Good Krista Fletcher mail this Author 5/28/2015 8:20:17 PM

 
  After viewing the short video, I believe government regulations could have mitigated the extent of the credit crisis of 2008.  From my understanding, subprime mortgages negatively

affected the economy in large part because of the lack of government regulation.  Although I do not think government regulations could have prevented this crisis, I do believe

regulations could have mitigated the snowball effect that occurred due to the subprime lending practices.

Subprime mortgages are unregulated, high risk investments.  Individual investors, pension funds, and hedge funds are backing the mortgages after the initial mortgage

is passed through the cycle of interested parties (Jarvis, 2009).  Furthermore, hedge funds are not regulated by the Securities and Exchange Commission (SEC) making it a risky investment.

In hindsight, SEC regulation could have identified the risk and potentially prevented or mitigated the credit crisis.  However, too much government regulation of business

presents the danger to business; yet, too little government regulation of business presents an even greater danger to the greater good of society.  In this circumstance,

too little government regulation presents the greater danger.

The credit crisis of 2008 negatively impacted the entire economy due to the lack of regulation (Jarvis, 2009).

Krista Fletcher

Jarvis, J.  (2009).   The crisis of credit visualized  [Video file].  Retrieved from  http://vimeo.com/3261363

Administrative Law and Business

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Administrative Law and Business
Some argue that government needs to increase its regulation of business for the good of society as a whole, while others believe that the marketplace is self-regulating and that government intervention through needless regulation places an unfair, costly burden on businesses in  general and on small businesses in par-ticular. What role do you believe government regulation should play to ensure ethical conduct by businesses? How do different political viewpoints potentially shape the answer to this question?
Guided Response:
Respond to at least two of your fellow students’ posts in a substantive manner. Some ways to do this include the following, though you may choose a different approach, providing your response is substantive:
Agree or disagree with your classmate’s position. Defend your position by using information from the week’s readings or examples from current events.

Post 1
Mark as Unread
Administrative Law and Business
Krista Fletcher 
5/28/2015 8:35:22 PM

Some argue that government needs to increase its regulation of business for the good of society as a whole, while others believe that the marketplace is self-regulating and that government intervention through needless regulation places an unfair, costly burden on businesses generally and small businesses in particular.  Initially, I thought that too much government regulation inhibits and burdens businesses, especially small businesses.  However, after watching the video on the credit crisis of 2008, I think government regulation could have mitigated the extent of damages done to the economy.
The role that I believe government regulation should play to ensure ethical conduct by businesses is to serve as a checks and balances to provide additional oversight.  There should be a balance to ensure businesses are not being smothered by unnecessary and burdensome regulations.  Government regulatory agencies should oversee businesses to protect the rights of consumers.  For example, the Securities and Exchange Commission (SEC) serves to protect investors; maintain fair, orderly, and efficient markets; and facilitate capital formation (www.sec.gov).
Different political viewpoints embrace both ends of the political spectrum in regards to the marketplace.  On the one hand, some believe that government regulation keeps investors and consumers safe from danger.  On the other hand, government regulations can be costly to remain compliant, especially for small businesses.  An individual’s political stance would determine how he or she might feel about government regulation.
Krista Fletcher
Seaquist, G. (2012). Business law for managers.  San Diego, CA: Bridgepoint Education, Inc.
Securities and Exhange Commission (2015). Retrieved from http://www.sec.gov/about/whatwedo.shtml

Post 2
Collapse
Mark as Unread
Administrative Law and Business
Sandra Diniz 
5/29/2015 12:44:38 AM

The government should monitor and supervise businesses closely to ensure that the businesses are functioning in an ethical manner. There should be fines placed of businesses that attempt to monopolize a market or perhaps rules set that will not allow such. Businesses are concerned with their bottom line and they should be concerned with how they are perceived by their customers. If it is reported that a hefty fine was imposed on Blah Blah Inc. for violating anti-trust guide lines, rules, and regulation their public image will be tarnished. For businesses that function in an ethical manner there should be some sort of incentive. Tax breaks would be appealing to any business so using that as an incentive for them to function in an ethical manner. (Breslin, C., The Role of Government in Business Ethics par.3-4).
Because business have political affiliations which would determine how they view government regulating them.  For example those that are concerned about the environment would affiliated with political partners that had some interest in taking care of the planet.
References:
http://smallbusiness.chron.com/role-government-business-ethics-65128.html

Demonstration of Proficiency

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Demonstration of Proficiency

By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

  • Competency 1: Interpret findings from scholarly quantitative, qualitative, and outcomes research articles and studies.
    • Explain why the sources selected should provide the best evidence for the chosen diagnosis.
  • Competency 2: Analyze the relevance and potential effectiveness of evidence when making a decision.
    • Describe the best places to complete research and what types of resources one would want to access to find pertinent information for the diagnosis within the context of a specific health care setting.
  • Competency 4: Plan care based on the best available evidence.
    • Identify five sources of online information (medical journal databases, websites, hospital policy databases, et cetera) that could be used to locate evidence for a clinical diagnosis.
  • Competency 5: Apply professional, scholarly communication strategies to lead practice changes based on evidence.
    • Describe communication strategies to encourage nurses to research the diagnosis, as well as strategies to collaborate with the nurses to access resources.
    • Communicate using writing that is clear, logical, and professional with correct grammar and spelling using current APA style.

Professional Context

As a baccalaureate-prepared nurse, you will be responsible for providing patient-centered, competent care based on current evidence-based best practices. You will be required to do research, analysis, and dissemination of best evidence to stay abreast of these best practices. Understanding where to go to find credible sources and locate evidence, as well as which search terms to use, is the foundation of incorporation of best practices.

Scenario

You are supervising three nurses working on the medical-surgical floor of a local teaching hospital. This hospital is nationally recognized as a leader in education and has a computer lab with an online library where staff has access to medical research databases (that is, CINAHL, PubMed, Medline, and Cochrane library) and online sources of all hospital policies, procedures, and guidelines, and computers at nurse workstations that also have access to these resources. (For this scenario, use the Capella University Library to simulate the hospital’s online library.) You have given the nurses their patient assignments and you have all participated in shift report. A new nurse who just completed orientation and training a week ago approaches you and tells you that one of the assigned patients has a diagnosis he or she is very unfamiliar with. Knowing that patient-centered care based on best practices is imperative to positive patient outcomes, you want to assist this nurse to find research that can be utilized to provide the best care for this patient. Describe how you would communicate with this nurse to encourage him or her to research the diagnosis. Assume you will assist in the quest to locate evidence, then describe where you would go within the facility and what resources you would look for. These resources may include websites, journals, facility policies or guidelines, or any other sources of online information.

You may choose the diagnosis for the patient in this scenario. Choose something you would find interesting to research or that applies to a clinical problem you would be interested in addressing. Create a list of at least five sources that could be used to find evidence, with the best source listed first, and explain why the sources you chose are best to find evidence for the diagnosis you chose and the clinical scenario. You are only evaluating the sources of evidence (database, website, policy database or website, et cetera). You are not actually completing a search and selecting evidence. Consider the following examples: a nursing journal in CINAHL may not be the best source of evidence for information on how to administer medications through a central-venous catheter, whereas a hospital policy database found on a website may not be the best source of information on caring for a patient with a rare chromosomal abnormality.

Preparation

To help ensure you are prepared to complete this assessment, review the following resources related to the Capella library. These resources will provide you an overview of the types of tools, resources, and guides available in the library. This may be useful in forming a better understanding of the library to apply to the hypothetical situation laid out in the scenario of this assessment.

  • BSN Program Library Research Guide.
  • Evidence-Based Practice in Nursing & Health Sciences.
  • Databases A-Z: Nursing & Health Sciences.
  • Get Critical Search Skills.

Remember, it is also appropriate to look toward databases and resources outside of the Capella library, such as organizational policies, professional organizations, and government health care resources.

Instructions

The purpose of this assessment is to understand where to find evidence that can be applied to clinical scenarios and to learn effective communication and collaboration with clinical staff during the process of evidence location. As a baccalaureate-prepared nurse, you will not only use research for self-improvement in your clinical role, but you will also serve as a mentor to supervised nursing staff. Therefore, you will need to be able to communicate and collaborate effectively to guide them toward resources to find research, as well as support them through the initial evidence location process. In doing so, nurses can gain access to evidence that can be analyzed and utilized to stay current on best practices. This allows them to provide safe, patient-centered care and improve patient outcomes.

For this assessment:

  • Describe your role as a baccalaureate-prepared nurse supervising clinical staff nurses with regard to communication and collaboration in locating evidence for application to a nursing practice scenario.
  • Compile a list of five online databases or other online sources (that is, websites, journals, facility policies or guidelines, et cetera) that can be used to research evidence to apply to this scenario and describe to which of these you would direct a nurse colleague to search for evidence.
  • Describe where you might go in the clinical setting to complete this research and how you would access the desired, relevant research within research databases or other online sources.

Be sure to address the following in this assessment, which correspond to the grading criteria in the scoring guide. Please study the scoring guide carefully so that you will know what is needed for a distinguished score.

  • Describe communication strategies to encourage nurses to research the diagnosis, as well as strategies to collaborate with the nurses to access resources.
  • Describe the best places to complete research and what types of resources you would want to access to find pertinent information for the diagnosis within the context of a specific health care setting.
  • Identify five sources of online information (medical journal databases, websites, hospital policy databases, et cetera) that could be used to locate evidence for a clinical diagnosis.
  • Explain why the sources of online information selected should provide the best evidence for the chosen diagnosis.
  • Communicate using writing that is clear, logical, and professional with correct grammar and spelling using current APA style.

Note: While you are not selecting and evaluating specific evidence to help with the clinical diagnosis, you should still be citing the literature and best practices to support your description of your communication and collaboration approach. Additionally, it is appropriate to cite best practices related to EBP and evaluating databases to support your explanation as to why you selected the five sources of online information that you did.

Submission Requirements

Your assessment should meet the following requirements:

  • Length of submission: 1–2 pages (not including the reference page) informal description of communication, collaboration, and evidence location process, including a list of databases or other sources with description of why they are appropriate for clinical scenario diagnosis (that is, something that would be useable in professional practice for other nurses). Be sure to include an APA-formatted reference page at the end of your submission.
  • Number of references: Cite a minimum of three sources of scholarly or professional evidence that supports your findings and considerations. Resources should be no more than five years old.
  • APA formatting: References and citations are formatted according to current APA style.