Tag: Pathophysiology & Pharmacology

  • [Solved] RUA

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    this is my topic: obesity in latino teens 13-19 Cultural age/group please the articles have to be from 2020-2025 no earlier than that APA and only 1 page I have attached everything – [\ \ NR222_RUA_Health_Promotion_Guidelines_V6_002.docx](https://www.sweetstudy.com/files/nr222-rua-health-pro…

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    this is my topic: obesity in latino teens 13-19 Cultural age/group

    please the articles have to be from 2020-2025 no earlier than that

    APA and only 1 page I have attached everything

    – [\
    \
    NR222_RUA_Health_Promotion_Guidelines_V6_002.docx](https://www.sweetstudy.com/files/nr222-rua-health-promotion-guidelines-v6-002-docx-10246465 "NR222_RUA_Health_Promotion_Guidelines_V6_002.docx")

    – 2 years ago

  • [Solved] Write Your Own Problem -S2023

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    Write an original problem that can be solved using the Fundamental Counting Principle. Then solve the problem. Respond to at least 2 of your classmates. – should be at least 200 words/numbers or a combination of both. – Additional readings must be cited, and formatted in the current APA style. – *…

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    Write an original problem that can be solved using the Fundamental Counting Principle. Then solve the problem. Respond to at least 2 of your classmates.

    – should be at least 200 words/numbers or a combination of both.
    – Additional readings must be cited, and formatted in the current APA style.
    – **Price firm** Turnitin report *** NO AI

    – 2 years ago

  • [Solved] help with discussion

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    Please help with the discussion – [\ \ Screenshot2025-04-02at7.57.57AM.png](https://www.sweetstudy.com/files/screenshot2025-04-02at7-57-57am-png "Screenshot2025-04-02at7.57.57AM.png") – 2 years ago

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    Please help with the discussion

    – [\
    \
    Screenshot2025-04-02at7.57.57AM.png](https://www.sweetstudy.com/files/screenshot2025-04-02at7-57-57am-png "Screenshot2025-04-02at7.57.57AM.png")

    – 2 years ago

  • [Solved] Weekly Clinical Experience 3

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    Describe your clinical experience for this week as a nurse practitioner student in a pediatric primary care clinic. – Did you face any challenges, any success? If so, what were they? – Describe the assessment of a patient, detailing the signs and symptoms (S&S), assessment, plan of care, and at leas…

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    Describe your clinical experience for this week as a nurse practitioner student in a pediatric primary care clinic.

    – Did you face any challenges, any success? If so, what were they?
    – Describe the assessment of a patient, detailing the signs and symptoms (S&S), assessment, plan of care, and at least 3 possible differential diagnosis with rationales.
    – Mention the health promotion intervention for this patient.
    – What did you learn from this week's clinical experience that can beneficial for you as an advanced practice nurse?
    – Support your plan of care with the current peer-reviewed research guideline.

    **Submission Instructions:**

    – Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources published within the last five years.
    – In paragraph form, no bullet points.

    – 2 years ago

  • [Solved] Discussion Post

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    In-depth study guidance and analytical solution covering Discussion Post.

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    Full assignment prompt and step-by-step guidance are included in the downloadable solution file.

  • [Solved] DISC4

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    Some commonly followed treatments for Attention Deficit Disorder (ADD) have not been scientifically substantiated, including restricted or modified diets, treatments for allergies, treatment for inner ear problems, treatments for yeast infections, megavitamins, chiropractic adjustment and bone align…

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    Some commonly followed treatments for Attention Deficit Disorder (ADD) have not been scientifically substantiated, including restricted or modified diets, treatments for allergies, treatment for inner ear problems, treatments for yeast infections, megavitamins, chiropractic adjustment and bone alignment, eye training, special-colored glasses, and biofeedback.

    – Discuss four non-pharmacological treatments that you would recommend for a 6 year old child with ADD.
    – Use the US clinical guidelines to support your response

    Your initial post should be at least 500 words, formatted, and cited in current APA style with support from at least 2 academic sources.

    – 2 years ago

  • [Solved] discussion

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    https://www.nso.com/Learning/Artifacts/Legal-Cases/nurse-and-medical-malpractice-case-study-with-risk 1. Did the nurse follow hospital policies? Why or why not? Please explain. 2. Do you think the nurse is the only one who should be responsible for the patients' fall? Please explain. 3. Is there any…

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    https://www.nso.com/Learning/Artifacts/Legal-Cases/nurse-and-medical-malpractice-case-study-with-risk

    1. Did the nurse follow hospital policies?  Why or why not?  Please explain.
    2. Do you think the nurse is the only one who should be responsible for the patients' fall? Please explain.
    3. Is there anything else the nurse could have done, to prevent the patients fall? Please explain.
    4. We know that nurses are advocates for patients and for their safety.  Could the nurse have escalated her concerns about her assignment?  How would the nurse do this? Please explain.
    5.  How do you feel about the nurse being reported to the National Practitioner Data Bank?  need apa style with 2 refernces

    – 2 years ago

  • [Solved] Responses

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    In response to your peers, offer feedback on ways to address their issues. Speak in first person – 2 years ago **files (1)** – ## Responses.docx **## Responses.docx** **Shah Discussion:** **Addressing Staffing Shortages in Outpatient Psychiatry for Underserved Populations** My capstone project will …

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    Assignment Prompt & Instructions

    In response to your peers, offer feedback on ways to address their issues.

    Speak in first person

    – 2 years ago

    **files (1)**

    – ## Responses.docx

    **## Responses.docx**

    **Shah Discussion:**

    **Addressing Staffing Shortages in Outpatient Psychiatry for Underserved Populations**

    My capstone project will focus on addressing staffing shortages in outpatient psychiatric clinics that serve underserved populations, improving patient care, and providing timely access to mental health services.

    Staffing shortages in outpatient psychiatry significantly impact healthcare organizations, especially those serving marginalized urban communities. These shortages contribute to long patient wait times, increased provider burnout, reduced appointment availability, and compromised continuity of care. For organizations committed to equitable access and quality outcomes, resolving workforce challenges is essential to fulfilling their mission and maintaining operational efficiency (American Hospital Association, 2021).

    As of 2023, nearly half of the U.S. population lives in a designated mental health professional shortage area, with urban areas facing distinct challenges due to high demand and uneven provider distribution (National Institute for Health Care Management, 2023). The U.S. faces a projected shortage of 14,000 to 31,000 psychiatrists by 2024, which disproportionately affects outpatient services in underserved communities (Satiani et al., 2023). The American Hospital Association (2021) also notes that behavioral health professional shortages are most pronounced in areas serving historically marginalized populations, making access to care more difficult for vulnerable urban residents.

    While drafting this section, I found it difficult to locate recent, geographically specific data on psychiatric staffing shortages limited to urban outpatient settings. Much of the available literature addresses general mental health workforce issues or includes rural areas, making it challenging to isolate urban trends. Additionally, distinguishing between overall behavioral health shortages and psychiatry-specific data required deeper investigation. These challenges highlight the need for more focused workforce research and the importance of local data to drive targeted solutions.

    **References**

    American Hospital Association. (2021).
    _Fact sheet: Strengthening the health care workforce_.
    [https://www.aha.org/fact-sheets/2021-05-26-fact-sheet-strengthening-health-care-workforce](https://www.aha.org/fact-sheets/2021-05-26-fact-sheet-strengthening-health-care-workforce)

    National Institute for Health Care Management. (2023).
    _The behavioral health care workforce: Shortages and solutions_.
    [https://nihcm.org/publications/the-behavioral-health-care-workforce-shortages-solutions](https://nihcm.org/publications/the-behavioral-health-care-workforce-shortages-solutions)

    Satiani, A., Niedermier, J., Satiani, B., & Svendsen, D. P. (2023). Projected workforce of psychiatrists in the United States: A shortage or surplus?
    _Journal of Psychiatric Research_, 161, 120–127.
    [https://doi.org/10.1016/j.jpsychires.2023.01.012](https://doi.org/10.1016/j.jpsychires.2023.01.012)

    **Chantel Duscussion:**

    Hello Class,

    My proposal aims to reduce acute myocardial infarction (AMI) readmissions at Rush University Medical Center, where according to CMS the 30-day readmission rate of 14.2% slightly exceeds the national average of 13.7%, to improve patient outcomes and reduce hospital costs. This data highlights the need for enhanced discharge planning, patient education, and follow-up care. This topic is essential because high readmission rates not only indicate potential gaps in patient care but also lead to financial penalties and lower hospital performance ratings. Research shows that AMI readmissions account for one-fifth of all 30-day hospital readmissions, with survivors facing a higher risk of recurrent cardiac events such as MI, heart failure, arrhythmias, and sudden cardiac death, leading to increased hospitalizations. According to Sana et al. 2023, “The financial burden of readmissions for AMI to the healthcare system is estimated to be over 1 billion US dollars (USD) annually. Hospital readmission rates have thus become an important focus to improve patient care, outcomes and healthcare economics” (p. 2). According to the CMS, hospitals with excessive AMI readmissions face reduced reimbursements, impacting overall financial stability.

    One challenge in drafting this section is effectively integrating clinical data with best practices to propose evidence-based interventions. Additionally, identifying the most impactful strategies such as remote patient monitoring, medication adherence programs, or improved care coordination requires careful consideration of feasibility and resource allocation.

    **References**

    Centers for Medicare and Medicaid Services (2024, October 30).
    _Rush University Medical Center_. Www.Medicare.gov.
    [https://www.medicare.gov/care-compare/details/hospital/140119?id=a40d03c6-742d-4d85-87fd-9b7dbcbe3b02&city=Chicago&state=IL&zipcode=](https://www.medicare.gov/care-compare/details/hospital/140119?id=a40d03c6-742d-4d85-87fd-9b7dbcbe3b02&city=Chicago&state=IL&zipcode=)

    Sana, M., Kumi, D., Park, D., Asemota, I., DeAngelo, S., Yilmaz, M., Hammo, H., Shaka, H., & Vij, A. (2023). Impact of Hospital Readmissions Reduction Program Policy on 30-Day and 90-Day Readmissions in Patients with Acute Myocardial Infarction: A 10-Year Trend from the National Readmissions Database.
    _Current Problems in Cardiology_,
    _48_(7), 101696.
    [https://doi.org/10.1016/j.cpcardiol.2023.101696](https://doi.org/10.1016/j.cpcardiol.2023.101696)

    **## Responses.docx**

    **Shah Discussion:**

    **Addressing Staffing Shortages in Outpatient Psychiatry for Underserved Populations**

    My capstone project will focus on addressing staffing shortages in outpatient psychiatric clinics that serve underserved populations, improving patient care, and providing timely access to mental health services.

    Staffing shortages in outpatient psychiatry significantly impact healthcare organizations, especially those serving marginalized urban communities. These shortages contribute to long patient wait times, increased provider burnout, reduced appointment availability, and compromised continuity of care. For organizations committed to equitable access and quality outcomes, resolving workforce challenges is essential to fulfilling their mission and maintaining operational efficiency (American Hospital Association, 2021).

    As of 2023, nearly half of the U.S. population lives in a designated mental health professional shortage area, with urban areas facing distinct challenges due to high demand and uneven provider distribution (National Institute for Health Care Management, 2023). The U.S. faces a projected shortage of 14,000 to 31,000 psychiatrists by 2024, which disproportionately affects outpatient services in underserved communities (Satiani et al., 2023). The American Hospital Association (2021) also notes that behavioral health professional shortages are most pronounced in areas serving historically marginalized populations, making access to care more difficult for vulnerable urban residents.

    While drafting this section, I found it difficult to locate recent, geographically specific data on psychiatric staffing shortages limited to urban outpatient settings. Much of the available literature addresses general mental health workforce issues or includes rural areas, making it challenging to isolate urban trends. Additionally, distinguishing between overall behavioral health shortages and psychiatry-specific data required deeper investigation. These challenges highlight the need for more focused workforce research and the importance of local data to drive targeted solutions.

    **References**

    American Hospital Association. (2021).
    _Fact sheet: Strengthening the health care workforce_.
    [https://www.aha.org/fact-sheets/2021-05-26-fact-sheet-strengthening-health-care-workforce](https://www.aha.org/fact-sheets/2021-05-26-fact-sheet-strengthening-health-care-workforce)

    National Institute for Health Care Management. (2023).
    _The behavioral health care workforce: Shortages and solutions_.
    [https://nihcm.org/publications/the-behavioral-health-care-workforce-shortages-solutions](https://nihcm.org/publications/the-behavioral-health-care-workforce-shortages-solutions)

    Satiani, A., Niedermier, J., Satiani, B., & Svendsen, D. P. (2023). Projected workforce of psychiatrists in the United States: A shortage or surplus?
    _Journal of Psychiatric Research_, 161, 120–127.
    [https://doi.org/10.1016/j.jpsychires.2023.01.012](https://doi.org/10.1016/j.jpsychires.2023.01.012)

    **Chantel Duscussion:**

    Hello Class,

    My proposal aims to reduce acute myocardial infarction (AMI) readmissions at Rush University Medical Center, where according to CMS the 30-day readmission rate of 14.2% slightly exceeds the national average of 13.7%, to improve patient outcomes and reduce hospital costs. This data highlights the need for enhanced discharge planning, patient education, and follow-up care. This topic is essential because high readmission rates not only indicate potential gaps in patient care but also lead to financial penalties and lower hospital performance ratings. Research shows that AMI readmissions account for one-fifth of all 30-day hospital readmissions, with survivors facing a higher risk of recurrent cardiac events such as MI, heart failure, arrhythmias, and sudden cardiac death, leading to increased hospitalizations. According to Sana et al. 2023, “The financial burden of readmissions for AMI to the healthcare system is estimated to be over 1 billion US dollars (USD) annually. Hospital readmission rates have thus become an important focus to improve patient care, outcomes and healthcare economics” (p. 2). According to the CMS, hospitals with excessive AMI readmissions face reduced reimbursements, impacting overall financial stability.

    One challenge in drafting this section is effectively integrating clinical data with best practices to propose evidence-based interventions. Additionally, identifying the most impactful strategies such as remote patient monitoring, medication adherence programs, or improved care coordination requires careful consideration of feasibility and resource allocation.

    **References**

    Centers for Medicare and Medicaid Services (2024, October 30).
    _Rush University Medical Center_. Www.Medicare.gov.
    [https://www.medicare.gov/care-compare/details/hospital/140119?id=a40d03c6-742d-4d85-87fd-9b7dbcbe3b02&city=Chicago&state=IL&zipcode=](https://www.medicare.gov/care-compare/details/hospital/140119?id=a40d03c6-742d-4d85-87fd-9b7dbcbe3b02&city=Chicago&state=IL&zipcode=)

    Sana, M., Kumi, D., Park, D., Asemota, I., DeAngelo, S., Yilmaz, M., Hammo, H., Shaka, H., & Vij, A. (2023). Impact of Hospital Readmissions Reduction Program Policy on 30-Day and 90-Day Readmissions in Patients with Acute Myocardial Infarction: A 10-Year Trend from the National Readmissions Database.
    _Current Problems in Cardiology_,
    _48_(7), 101696.
    [https://doi.org/10.1016/j.cpcardiol.2023.101696](https://doi.org/10.1016/j.cpcardiol.2023.101696)

  • [Solved] Budgeting Spreadsheet

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    – 2 years ago **files (1)** – ## Budgetingspeadsheetdirections.docx **## Budgetingspeadsheetdirections.docx** Please let me know if you have access to the spreadsheet Download and complete the [Budget Plan Template (Excel)Links to an external site.](https://courseapps.onlinenursing.baylor.edu/media/…

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    Assignment Prompt & Instructions

    – 2 years ago

    **files (1)**

    – ## Budgetingspeadsheetdirections.docx

    **## Budgetingspeadsheetdirections.docx**

    Please let me know if you have access to the spreadsheet

    Download and complete the
    [Budget Plan Template (Excel)Links to an external site.](https://courseapps.onlinenursing.baylor.edu/media/NUR6316/week13/docs/new_budget_template_rev_spring24.xlsx).

    On the spreadsheet, make sure to include the answers to the questions at the top. You will then provide a description or rationale for each income and expense line item. For example, salaries are listed as a line item. In the description column, you need to provide how you got to the total amount for salaries: e.g., [3 RNs x $65 per hour x 2080 hours per year] + [one PCT x $16 per hour x 2080 hours].

    **PLEASE NOTE:** Your ROI should be between 0-100%. It may be slightly negative if you are choosing to do something that is vital to patient safety. Your ROI may be somewhat over 100% if your expenses were significantly smaller than your cost-savings/avoidance. However, if your ROI is well over 100%, then review LINE 40 in your spreadsheet. Most projects will not eliminate all occurrences. This number in LINE 40 should not be zero. If you have questions, please contact with your faculty.

    Review a
    [faculty example of a completed spreadsheet.Links to an external site.](https://courseapps.onlinenursing.baylor.edu/media/NUR6316/week13/docs/FACULTY_Example_new_budget_template_rev_fall24.xlsx)

    **Narrative Portion Instructions**

    Please submit a word document for the narrative portion that should include a paragraph summarizing the income (whether the project is a cost savings, cost avoidance, or new source of revenue, and the rationale for that determination), the expenses, discussing the ROI, and a concluding statement.

    Your summary paragraph should include:

    · The purpose of the project and the financial ask. Why is this project important and what, or how much, are you requesting?

    · Whether the project will result in a new source of revenue, cost savings, or cost avoidance. Provide a few straightforward sentences to support your determination. For example, “This project is aimed at reducing central line infections. If we reduce infections by 25%, the organizations will have a cost avoidance of $XX, XXX.” Provide a source to back up your statement. "Smith (2019), Jones & Wong (2017), and Kelly & Washington (2015) conclude that similar projects have resulted in infection rate decreases of 28% and found a positive financial benefit to the organization of X amount.”

    **Example Summary:**“The total expenses for the first year of the new program are projected to be $500,000. This projected amount is within the range of what other organizations have spent on their implementations of similar projects. One-half of the expenses are for employee salaries, and the other major expenses are related to the purchase of new technology. Even accounting for depreciation, the expenses in the second year are expected to decrease by 20%, as the new technology has a life span of five years.”

    Please Let me know if your able to access the spreadsheet Thank you! Based in Florida.

    | | | |
    | — | — | — |
    | **Budget Rubric Sp 2024** |
    | **Criteria** | **Ratings** | **Pts** |
    | **Introduction** | **2 to >1 pts**<br>**Meets Criterion**<br>Includes name, project, location, outcomes<br>**1 to >0 pts**<br>**Partially Meets Criterion**<br>Does not include one or more of the introduction components | **/ 2 pts** |
    | **Personnel Expenses** | **30 to >29 pts**<br>**Meets Criterion**<br>Includes reasonable expenses for personnel for planning (10 points), training (10 points), and implementation (10 points) (at launch and for first year)<br>**29 to >0 pts**<br>**Partially Meets Criterion**<br>Does not include reasonable or logical expenses for planning, training, and/or implementation (at launch and for first year) | **/ 30 pts** |
    | **Supplies and Other Expenses** | **20 to >19 pts**<br>**Meets Criterion**<br>Includes reasonable expenses for implementation of project and costs for first year<br>**19 to >0 pts**<br>**Partially Meets Criterion**<br>Does not include reasonable expenses for implementation of project and costs for first year | **/ 20 pts** |
    | **Rationales** | **20 to >19 pts**<br>**Meets Criterion**<br>Includes logical rationales for each expense<br>**19 to >0 pts**<br>**Partially Meets Criterion**<br>Does not include logical rationales for each expense | **/ 20 pts** |
    | **ROI** | **18 to >17 pts**<br>**Meets Criterion**<br>Accurately calculates ROI based on logical and realistic project outcomes<br>**17 to >0 pts**<br>**Partially Meets Criterion**<br>Does not accurately calculate ROI based on logical and realistic project outcomes | **/ 18 pts** |
    | **Summary**<br>**view longer description** | **10 to >9 pts**<br>**Full Marks**<br>Adequately addresses all points of the required narrative summary.<br>**9 to >0 pts**<br>**Partial Marks**<br>Does not adequately address all of the required points of the narrative summary, or did not complete a summary. | **/ 10 pts** |
    | **Total Points: 0** |

    **## Budgetingspeadsheetdirections.docx**

    Please let me know if you have access to the spreadsheet

    Download and complete the
    [Budget Plan Template (Excel)Links to an external site.](https://courseapps.onlinenursing.baylor.edu/media/NUR6316/week13/docs/new_budget_template_rev_spring24.xlsx).

    On the spreadsheet, make sure to include the answers to the questions at the top. You will then provide a description or rationale for each income and expense line item. For example, salaries are listed as a line item. In the description column, you need to provide how you got to the total amount for salaries: e.g., [3 RNs x $65 per hour x 2080 hours per year] + [one PCT x $16 per hour x 2080 hours].

    **PLEASE NOTE:** Your ROI should be between 0-100%. It may be slightly negative if you are choosing to do something that is vital to patient safety. Your ROI may be somewhat over 100% if your expenses were significantly smaller than your cost-savings/avoidance. However, if your ROI is well over 100%, then review LINE 40 in your spreadsheet. Most projects will not eliminate all occurrences. This number in LINE 40 should not be zero. If you have questions, please contact with your faculty.

    Review a
    [faculty example of a completed spreadsheet.Links to an external site.](https://courseapps.onlinenursing.baylor.edu/media/NUR6316/week13/docs/FACULTY_Example_new_budget_template_rev_fall24.xlsx)

    **Narrative Portion Instructions**

    Please submit a word document for the narrative portion that should include a paragraph summarizing the income (whether the project is a cost savings, cost avoidance, or new source of revenue, and the rationale for that determination), the expenses, discussing the ROI, and a concluding statement.

    Your summary paragraph should include:

    · The purpose of the project and the financial ask. Why is this project important and what, or how much, are you requesting?

    · Whether the project will result in a new source of revenue, cost savings, or cost avoidance. Provide a few straightforward sentences to support your determination. For example, “This project is aimed at reducing central line infections. If we reduce infections by 25%, the organizations will have a cost avoidance of $XX, XXX.” Provide a source to back up your statement. "Smith (2019), Jones & Wong (2017), and Kelly & Washington (2015) conclude that similar projects have resulted in infection rate decreases of 28% and found a positive financial benefit to the organization of X amount.”

    **Example Summary:**“The total expenses for the first year of the new program are projected to be $500,000. This projected amount is within the range of what other organizations have spent on their implementations of similar projects. One-half of the expenses are for employee salaries, and the other major expenses are related to the purchase of new technology. Even accounting for depreciation, the expenses in the second year are expected to decrease by 20%, as the new technology has a life span of five years.”

    Please Let me know if your able to access the spreadsheet Thank you! Based in Florida.

    | | | |
    | — | — | — |
    | **Budget Rubric Sp 2024** |
    | **Criteria** | **Ratings** | **Pts** |
    | **Introduction** | **2 to >1 pts**<br>**Meets Criterion**<br>Includes name, project, location, outcomes<br>**1 to >0 pts**<br>**Partially Meets Criterion**<br>Does not include one or more of the introduction components | **/ 2 pts** |
    | **Personnel Expenses** | **30 to >29 pts**<br>**Meets Criterion**<br>Includes reasonable expenses for personnel for planning (10 points), training (10 points), and implementation (10 points) (at launch and for first year)<br>**29 to >0 pts**<br>**Partially Meets Criterion**<br>Does not include reasonable or logical expenses for planning, training, and/or implementation (at launch and for first year) | **/ 30 pts** |
    | **Supplies and Other Expenses** | **20 to >19 pts**<br>**Meets Criterion**<br>Includes reasonable expenses for implementation of project and costs for first year<br>**19 to >0 pts**<br>**Partially Meets Criterion**<br>Does not include reasonable expenses for implementation of project and costs for first year | **/ 20 pts** |
    | **Rationales** | **20 to >19 pts**<br>**Meets Criterion**<br>Includes logical rationales for each expense<br>**19 to >0 pts**<br>**Partially Meets Criterion**<br>Does not include logical rationales for each expense | **/ 20 pts** |
    | **ROI** | **18 to >17 pts**<br>**Meets Criterion**<br>Accurately calculates ROI based on logical and realistic project outcomes<br>**17 to >0 pts**<br>**Partially Meets Criterion**<br>Does not accurately calculate ROI based on logical and realistic project outcomes | **/ 18 pts** |
    | **Summary**<br>**view longer description** | **10 to >9 pts**<br>**Full Marks**<br>Adequately addresses all points of the required narrative summary.<br>**9 to >0 pts**<br>**Partial Marks**<br>Does not adequately address all of the required points of the narrative summary, or did not complete a summary. | **/ 10 pts** |
    | **Total Points: 0** |

  • [Solved] 514m3d

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    In-depth study guidance and analytical solution covering 514m3d.

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    Assignment Prompt & Instructions

    Full assignment prompt and step-by-step guidance are included in the downloadable solution file.