Abstract Inadequate educational preparation, professional mentorship, and practicum exposure are significant barriers to optimal palliative care. A deficit was noted in the current curricula that focus on ethical issues rather than on building core competencies that will improve patient outcomes. An end-of-life (EOL) course founded in standardized best practices and...
Introduction Sleep is one of the most important functions which help human body to have some rest and recover essential functions. Sleep deprivation means lack of sleep which influences the main psychological and physiological processes. Kushida (2005) claims: “The deprivation of sleep is the partial or near-complete removal of sleep...
Abstract Patient satisfaction is a direct measure of care quality that offers an insight into a variety of clinical aspects ranging from care effectiveness to the level of empathy. Dissatisfaction with care usually leads to a drop in the level of patients’ trust in their healthcare providers, which also adversely...
The main problem addressed by the practicum project plan is patient safety. It is defined by the absence of preventable harm to individuals who receive emergency or medical care. Relative to this assertion, the World Health Organization (2019) posits that about 25% of patients who seek health services are often...
Executive Summary The topic of the project is hospital-acquired pressure ulcers (HAPUs) in healthcare organizations in the United States. The problem of the project is the alarming prevalence rates of HAPUs in Kings County Hospital Center in comparison with the benchmark set by the New York State Department of Health....
The development of multiple conditions has a significant effect on a patient’s health. In the discussed case, M.K., a 45-year-old female has a history of Type II diabetes mellitus (T2D) and hypertension. Her current diagnosis is chronic bronchitis, as the patient experiences chronic cough with sputum, excessive peripheral edema, nocturia,...
Patient Initials: JB Age: 68 Gender: F Subjective Data Chief Complaint (CC): “Yellow secretions from eyes.” History of Present Illness (HPI): A 68-year-old Caucasian female presents to the office with complaints of yellow discharge from her eyes. The symptoms occurred quickly about 3 days ago, and they continue to progress...
In a nursing home setting, a safety culture should be focused on effective rehabilitation and appropriate transitions among care environments. A set of values and beliefs that is to be applied to challenges and overall organizational management reflects a home’s common understanding of safety. Sollecito and Johnson (2013) state that...
Utilizing the Plan-Do-Study-Act (PDSA) approach to bettering healthcare environments may be possible within any surroundings. An essential part is sustaining its continuity by not stopping at a single rotation through the four steps and preparing for long-run revisions and innovations (DemingInstitute, 2012). As such, highlighting a potential PDSA process improvement...
The procedures used in both preoperative and postoperative care are important aspects of any surgical interventions. The thorough preparation of patients for a certain operation and subsequent monitoring of the progress of recovery are the practices that are utilized in most medical institutions. The benefits of this work are significant...
Introduction The article chosen for critical analysis is Halm et al, 2005, ‘Hospital Nurse Staffing and Patient Mortality, Emotional Exhaustion, and Job Dissatisfaction’, from the Clinical Nurse Specialist. Summary of the Article The article is based on an in-house study at United Hospital in St. Paul Minnesota, similar to the...
Introduction In this paper, I will describe my professional aspirations and the role of my practicum experience in helping to achieve two of my professional objectives. The first one is to evaluate what I need to facilitate a career change from a nursing student to a leadership and management role...
Introduction The nursing profession entails giving care be it physical, biological, or psychological to those with deficiencies in society. Nurses, therefore, need to have a sincere devotion to addressing their patients with compassion. Savings lives and reducing pain are some of the major objectives of nurses. Although the first nurses...
According to World Health Organization (WHO), Autism is a complex set of developmental disorders with appearing in the early years of life mostly in the first 3 years of life. The condition sometimes referred to as autistic disorder describes many interrelating psychological conditions which result in abnormalities in the social...
To control the process of administering treatment to patients and keep the process of meeting their needs continuous, nurses have to engage with the dialogue with inpatients. However, given the broad range of responsibilities that nurses have in the hospital setting, the amount of time and extent of care that...
Today, many debates about the idea of smoking marijuana (cannabis) are raised to identify its positive and negative aspects. According to the investigations offered by the Substance Abuse and Mental Health Services Administration, approximately 24 million Americans aged 12 and older use marijuana regularly, and the increase is still observed....
Internal and external validity are important concepts in training evaluation, as they prove that its results are meaningful and relevant. Threats to validity are the factors that might affect the level of believability of the study outcomes and the extent of their generalization. Internal validity is an important featur as...
The title of the article is good as it suggests the key variables (primary care diabetes, primary care physicians, and nurse practitioners) and the study population (Medicare patients) (Lutfiyya et al., 2016). Similarly, the abstract is clear and it concisely summarizes the main features of the report including aims, background,...
Introduction Gene therapy offers promise to many patients suffering from cardiovascular diseases. Cardiovascular diseases are one of the major reasons for morbidity and mortality globally. Hence, there is always the urgency to obtain alternative solutions, pharmacological or otherwise (Ekhart & Koch; Frazier, Johnson & Sparks 315). In many clinical tests,...
Introduction One of the significant health concerns healthcare facilities are yet to solve is hospital-acquired venous thromboembolism (HA-VTE). It has been estimated that approximately 70% of surgical and 50% of medical patients are affected (Assareh, Chen, Ou, Hillman, & Flabouris, 2016). This negative trend is associated with adverse patient outcomes,...
Introduction Voltage-gated calcium channels belong to a family of calcium channel proteins that are integrated in the membranes of both excitable and non-excitable cells. In many cells an influx of calcium triggers depolarization which can increase excitability. Calcium is a known intracellular messenger which not only plays a role in...
Introduction The purpose of this project is to examine medication adherence related to hydroxyurea-based (HU) therapy in patients with sickle cell disease (SCD). The focus of this project is on determining the outcomes of using pill compliance packaging on HU therapy for SCD patients in the context when non-compliance packaging...
Introduction Healthcare systems and hospitals should evaluate their capabilities and resources in an attempt to identify existing gaps and key areas that require continuous improvement. Such an initiative has the potential to minimize issues in care delivery, including readmissions, increased costs, and sentinel events. Fortunately, numerous ideas and developments are...
Introduction Patient Protection and Affordable Care Act (ACA; the informal name – Obamacare) is a U.S. Federal law signed by President Barack Obama on March 23, 2010. It is the legislative framework for health care reform, which has become one of the largest-scale projects in U.S. history since the mid-1960s....
Socialized Health Care is one of the terms used to describe publicly0-funded healthcare facilities. Critics admit that US healthcare will benefit if the state introduces a socialized healthcare system for all citizens. The main problems that affected Americans are poor healthcare services for low social classes and racial minorities, immigrants,...
This paper highlights interdisciplinary team communication as a tool for improving patient safety. The research topic stems from my practicum experience where I detected poor communication among different interdisciplinary teams. Relative to this assertion, the Australian Commission on Safety and Quality in Health Care (2017) contends that proper communication is...
That the inadequate healthcare system needs a significant and immediate overhaul is undeniable. Health care professionals understand the problems associated with the failing system more so than anyone and are the first to voice their concerns. Americans of all political ideologies agree too many individuals and families are uninsured or...
The debate over Physician-Assisted Suicide (PAS) is complex and contentious. Since ancient times, there have been arguments about the permissibility of suicide, assisted suicide, and physician-assisted suicide. (Kopelman, DeVille, pp 1). The discussions have covered the properly legal, ethical, or professional response of the people who feel that they are...
Introduction Personal health records are a technology that enables patients to access, document, and monitor health-related information. The California Health Care Foundation (CHCF, 2019) notes that PHRs are often confused with patient portals. While connected PHRs may take the form of patient portals, but standalone PHRs are not linked to...
Introduction First, it was medical marijuana; next, it will be alcohol and so on and so forth. The problem the country faces with medical marijuana is similar to the one it faces when the issue of legalizing abortion nationwide or physician-assisted suicide came into view. Both of these areas are...
Abstract The conclusions of this awfully intense and ruthless respiratory syndrome (SARS) in Hong Kong shaped many issues for health support behavior among older citizen with a poor social and financial standing and so. With an alarming situation that this helpless group could be at superior risk of contracting the...
The American Surgeon General has been warning people about the hazards of first hand and second-hand smoking but it seems that these warnings, studies, and polls do not affect smokers. They continue to fight for their right to smoke in public places and feel that their rights have been trampled...
Introduction Nursing care for patients with end-stage dementia is one of the most complicated issues in nursing practice which requires special skills and knowledge of a nurse. Complex societal factors also have influenced the need for a comprehensive approach to chronic disabling conditions. End-stage dementia caused by brain damage is...
The electronic medical record (EMR) is at the forefront of medical technology. Numerous companies are making it available, and physician groups and hospitals are investigating the potential benefits it can provide. The push to get there has now entered the political arena, with candidates from both parties proclaiming how the...
Today, United States is facing many health-related problems like breast cancer, cardiovascular diseases, cancer, and others. Among these, obesity is one of the most serious health problems facing the youth of United States and evidence shows that the problem is getting worse. Childhood obesity represents a threat to the health...
Introduction Medicaid is a program that is designed to meet the needs of poor individuals and families who have limited resources. It is essentially an entitlement program that is funded through the collaboration of the states and the government. (Agency for health care administration, n.p.) Medicaid which was established on...
Patient Protection and Affordable Care Act (PPACA), more commonly known as Obamacare, is major legislation passed in 2010 by President Barack Obama and the Democratic Party. Since the day of its passage, it has been a matter of controversy for various reasons. On the one hand, it is a considerable...
Introduction The emergency department room sometimes called the emergency room (ER), emergency ward (EW), accident & emergency (A&E) section or known as casualty department is a hospital or primary care department that provides initial treatment to patients with a broad range of illnesses and injuries, some of which may be...
Abstract Epidemiology is the study of patterns of disease and injury in human populations and the application of the study to control health problems. Epidemiology focuses on identifying the distribution, determinants and the frequency of the disease within a population. It is the study of human health in populations, studying...
Introduction Although it is definitely true that we are all going to die, some of us will die sooner rather than later – our life chances are closely connected to our social and economic state of affairs, which are insolvably allied to influences of behaviour and intergenerational by constructive and...
One might survive any natural disaster or catastrophe. However, the key role in the fight against it is proper preparation and awareness of actions to be taken in case of an emergency. For instance, one should be informed about the steps that need to be taken beforehand, including making adequate...
Introduction Health is a state of good functioning and the balance on the spiritual, social, mental, emotional, perceptional and physical level. Absolutely it is seen that nobody is perfectly healthy because since childhood all kind of childhood diseases and even the small imperfections are visible; a perfect health will result...
Introductory Elements The quality of diabetes management in primary care remains a critical question in many countries. In their study conducted in the United States, Lutfiyya et al. (2017) examine the presence of differences in care related to the type of provider. In general, the paper’s title adequately represents its...
Introduction Patient education is an essential aspect of contemporary care and disease management that can improve the outcomes of treatment. This element is especially crucial in the context of chronic conditions that require continuous monitoring and adherence to the recommendations of medical professionals. This paper aims to outline an issue...
Introduction Although the organizational values promoted at TUH can be defined as sensible and patient-oriented, the lack of tools for implementing proper care and maintaining control over the well-being of inpatients creates a rather unsettling situation. The specified issues cause a rise in the length of stay, which entails additional...
Background Betty M. Neuman was an American researcher specialized in nursing, clinical psychology, and mental and public health. She was born in 1924 in Ohio, in a family of a farmer and a housewife. After graduation from high school, she completed a nursing program in the hospital of Ohio in...
Introduction Evidence-based medical practice allows to facilitate the decision-making process and improve patients’ health outcomes by using the best available information from high-quality clinical research. Despite the effectiveness of this approach, many medical institutions in the United States have not embraced it yet. The purpose of this paper is to...
The cognitive and emotional development of children is a unique and intricate process that demands careful consideration to understand the challenges that it entails and the opportunities that it contains. Since the phenomenon of childhood development is not homogenous and includes a sequence of changes that affect a child on...
Introduction The concept of theory in any discipline implies a set of interrelated ideas and approaches which help to systematize the existing knowledge. Theories base on definitions propositions, models, etc., which are directly or implicitly connected to the discipline. For example, the conceptions of nursing theories include patients and communication...
Introduction Research performs an essential role in many life spheres, and nursing is not an exception. It helps scientists collect and analyze existing information as well as generate conclusions that would be beneficial for many people. That is why every piece of research meets particular criteria to be credible. In...
Limitations of the Study The significance of emotional intelligence as a part of the general notion of emotional competence is critical in nursing. The ability to decipher the changes in a patient’s attitudes and emotional stage, as a whole, is critical in meeting the needs of the patient in question...
This paper presents the evaluation of a nursing article “Patient Satisfaction with the Quality of Nursing Care” that was written by Anita Karaca and Zehra Durna. In that article, the authors discuss the importance of measuring patients’ satisfaction and its potential drivers. The research aimed to identify and examine key...
Introduction and Brief Definition of Literature Review Literature review constitutes an essential part of medical education research. Defined by Maggio, Sewell, and Artino as a comprehensive summary of what is known on the specific topic, it forms the basis for all the phases of further research. After clearly identifying its...
Introduction Hospital-acquired infections (HAIs) are a cause of significant morbidity and mortality among patients in primary and intensive care units. Moreover, HAIs are associated with an increased cost of care for patients, hospitals, and the healthcare system in general. According to King et al. (2016), a substantial number of HAIs...
Disparities in access to care among minority populations directly affect health care outcomes – diabetes rates are 30% higher in Native Americans and Latinos, infant mortality is 2.5 times higher for black babies than for white, while life expectancy for black men and women is 10 years fewer compared to...
Why did You Select the Article? The article named “The Challenges of Nursing Students in the Clinical Learning Environment: A Qualitative Study” was selected. Learning in the clinical environment can be difficult, unpredictable, and unstable for students (Baraz, Memarian, & Vanaki, 2015). Therefore, this article was chosen because it contains...
The aim of the study conducted by Kennedy, Trevis, and Kent correlated with the research question and was the following: are there connections between measures of patient satisfaction and favorable health outcomes? The sample of the study includes 171 hospitals that offered data through the University HealthSystem Consortium (UHC) database....
Research question The research question chosen for the current exploration is the following: “Is there a connection between patient satisfaction and patient outcomes?” The research question was chosen due to the need for hospitals to consider the metric of patient satisfaction when increasing the quality of their care and ensuring...
Two important loci of focus exist. They include internal and external foci. The internal focus targets the subject’s body movements, whereas the external focus centers on the effects that the performer’s movements have on the surroundings. There is a lot of evidence showing that external focus of attention yields better...
Abstract The article is aimed to provide a personal perspective regarding the current problems that are affecting the US healthcare system. The author highlights three main areas in the current US healthcare setup as the reasons for the decline. The first is the lack of direction in the allocation of...
Introduction MRSA or methicillin-resistant Staphylococcus aureus recently have hugged headlines as health science still had to find details of combatting the disease. It is a strain of Staphylococcus aureus resistant to methicillin and other antibiotics with about 16 epidemic strains discovered and two particular strains — clones 15 and 16...
Introduction One of the most primary preferences in life is whether a couple wants to have offspring. This choice obliges many females who are not prepared to have children to face the verdict of abortion. Abortion is an appealing subject because it entails consequences that are societal, religious, political, lawful,...
Introduction Health is the first most important form of wealth. Health –the physical, mental, and social health of an entire population- is a nations fundamental natural resource. Health is the essential foundation that supports and natures growth, learning, personal well-being, social fulfillment, enrichment of others, economic production and constructive citizenship....
Introduction It is not a secret that healthcare remains an essential element of people’s lives. Nowadays, it is difficult to imagine a person who has never applied to medical institutions either for medical help or for immunization to prevent diseases. Therefore, access to healthcare is a crucial factor that defines...
Introduction Financial planning is a necessary tool for managing health organization’s activities. But this process is individual for each particular medical institution. It is compiled on the basis of the priorities of the action, the model of the provision of services, and the approaches of management teams regarding the development...
Effectiveness, efficacy, and sustainability are critical issues in the delivery of medical services in every country. Unfortunately, different variations in the quality of healthcare outcomes continue to be recorded in the United States. A detailed analysis of such gaps can make it possible for stakeholders and policymakers to implement superior...
Executive Summary This project aims to collect relevant data related to chronic condition management. The topic of this project is chronic disease management and the problem is that Anthem has 85% of diabetes readmission rates while the national standard is set at 56.8%. Data review will be done by examining...
Introduction As healthcare in the United States evolves, advanced practice registered nurses (APRNs) are beginning to play a critical role in improving patient outcomes. Despite the apparent benefits of advanced care nursing practice, there are significant barriers for APRNs to practice at the fullest extent of their training, experience, and...
Lobbying Government for Funds to Support Nursing Issue The direct activities for health care improvement compose one of the key nursing profession essentials. Lobbying implies that a nurse is to speak out against or in support of a specific proposed or introduced legislation (Franck, 1997). To make a health care...
Introduction Nursing remains one of the key fields that support the delivery of exemplary and timely medical services to patients with diverse needs. Those in this profession should develop powerful personal philosophies that will make it easier for them to act ethically, guide others, and create reliable environments for transforming...
When providing care, nurses are guided by certain recommendations and regulations, as well as their personal philosophy. I use the essentials of doctoral education for advanced nursing practice and AONE competencies to guide my professional life. These standards are specifically helpful inpatient training, which is one of the most important...
Introduction The pharmaceutical industry should be discussed in the context of its global expansion. The problem is that the global business world has altered significantly in recent decades, leading to positive and negatives outcomes for globally oriented industries (Gaudillière 2015). Buyer behaviour has changed significantly, resulting in the generation of...
Introduction An article Use of Repeated Intravenous Ketamine Therapy in Treatment-resistant Bipolar Depression with Suicidal Behavior: a Case Report from Spain describes the efficacy of ketamine as a treatment for bipolar depression with signs of suicide (López-Díaz, et al., 2017). Main effects of ketamine The authors point out that “ketamine...
Executive Summary Informatics in healthcare is becoming increasingly important, which is emphasized by the regulations and a shift towards using Electronic Health Record (EHR) systems. The Independence Medical Center, although it possesses an EHR system, does not benefit from its capabilities due to improper use that leads to financial and...
Introduction The proposed project deals with the issue of chronic disease management and strategies for approaching the problem that Anthem as an insurer can implement. The argument is that nearly a half of the United State’s population has at least one chronic condition and this element of care provision is...
Mental Health System A comprehensive mental health system should include facilities that receive patients with acute and chronic conditions as well as people of all ages, genders, and socioeconomic backgrounds. In the center of the framework, one may place the Maryland state hospital, which provides long-term services to all admitted...
Relevant Stakeholders Related to Impact Analysis Hospital leaders play an essential role in the management of electronic health record (EHR) systems at Vila Health. Their responsibilities include operations management, the oversee of direct business services, the maintenance of medical records, as well as general leadership efforts associated with CEO and...
Introduction In modern healthcare environment, technology provides easy access to digital communication, and nurses apply social media for a wide range of purposes. With such advantages as information sharing and learning, there comes great responsibility for protecting patients’ sensitive data. The Health Insurance Portability and Accountability Act of 1996 (HIPAA)...
Introduction Nowadays science and medicine are developing quickly, and new methods, ideas, and trends appear quite often. They are intended to meet the requirements and needs of the modern world. Remote medical care and solutions for the opioid epidemic in the USA belong to the most important issues. The purpose...
Health care problem In the US, racial and ethnic minorities experience considerable disparities in health care services. According to Fiscella and Sanders (2016), ethnic minorities have limited access to preventative care, chronic disease control, hospitalization, obstetrician care, and behavioral healthcare. In particular, American Indian (AI) and Alaska Native (AN) people...
Introduction Obesity is an acute issue many individuals living in the United States have encountered. Currently, there are many policies aimed at minimizing the effects of this healthcare problem. The purpose of this paper is to analyze some of the obesity-related policies. The report addresses the prevalence of obesity within...
Introduction Affordability of quality care is fundamental for the functioning of any society. Concerns around access to healthcare in the United States are growing as the shortcomings of the system become more and more apparent to the public, care providers, and the authorities. There are a number of issues in...
Introduction There are various methods of research in any field of expertise, and nursing is not an exception. In this essay, three summaries of literature from journals and three abstracts of studies about the methods of research in nursing will be included. Also, the differences between conceptual and theoretical frameworks...
Introduction The United States healthcare system has been a subject of public debate for a long time. US hospitals possess some of the most technologically advanced instruments in the world, but due to the extremely expensive cost, only a limited number of patients can afford to use them. The experience...
The article by Ferguson et al. (2018) “Factors associated with elevated blood pressure or hypertension in Afro-Caribbean youth: A cross-sectional study” provides information on risk factors for high blood pressure (BP) among Afro-Caribbean young adults. It is a cross-sectional study involving data analysis of relevant variables, including anthropometric and BP...
Introduction The research topic of the current study is sociodemographic and cultural factors of attention hyperactivity disorder (ADHD). The planned research will investigate socioeconomic and cultural factors the possible causes of ADHD and will design the research following the recommendations of Jacobsen (2016). The study is concentrated on this topic...
Wood Johnson’s Foundation Work The Institute of Medicine (IOM report, titled “Future of Nursing: Leading Change, Advancing Health” and made public in 2010 was the result of 2 years of hard work and collaboration between the IOM and Robert Wood Johnson Foundation (RWJF) (IOM, 2010a). The initiative sought to assess...
The quality of healthcare services is the crucial concept of the S-P-O model. Structure, process, and outcome, the principal components of the model base on the quality in all aspects. The structure is the competence of caregivers and medical equipment, the process includes all the elements such as treatment and...
Need for a Health Information Professional The introduction of an Electronic Health Record (EHR) system into the environment of a healthcare organization is a crucial step needed to ensure that patient data is promptly and effectively managed without being lost in the process. Studies show that the use of the...
Introduction The possibility of influencing consumer demand is a valuable entrepreneurial driver that is usually utilized to increase sales of specific goods or services. However, in some cases, marketing practices are aimed in the opposite direction and involve active advertising in relation to reducing the share of product sales. This...
Differences Between Surface EMG and Fine Wire (or Needle) EMG Electromyography (EMG) is a technique used to measure the action of muscles, thereby producing data that enable the comprehension of muscle coordination during movement. Two modes of EMG exist, namely invasive and noninvasive. Surface EMG is an adaptable and non-invasive...
Introduction A health information system (HIS) supports integrated functions such as patient data collection, compilation, management, and transmission. Hospitals use HIS to ensure patient-centered care and improve quality and safety (Sittig & Singh, 2017). This paper discusses a HIS project implemented in a satellite facility in compliance with current HITECH...
ACNPs and PCNPCs differences Acute care nurse practitioners (ACNPs) and primary care nurse practitioners (PCNPs) differ in their scope of practice, training, and practice settings. PCNPs aims at providing continuous care with particular emphasis put on health promotion, treating chronic conditions, and creating long-term relationships with patients and their families...
The case under review involves treating depression with person-centered therapy (PCT). The patient is Joanna, a 50-year-old woman complaining of feeling lonely and unworthy of love. She has been divorced for 8 years and has two children of 21 and 24 years old who do not live with her. Joanna...
Introduction With increased competition in the field of health care, medical organizations have begun to apply marketing tools to dissociate from their rivals and attract more clients. To remain competitive, a healthcare organization sometimes needs to rethink its marketing strategy and make some necessary changes. One of the recent improvements...
Interview Summary For this interview, my nurse colleague working for the Geriatric Care clinic was selected to clarify the challenges faced by this organization. The role of the chosen interview lies in managing routine care for older adult patients, including their nutrition, hygiene, medication intake, and other services. As stated...
Introduction It is hard to disagree that if the healthcare organization wants to be successful, it needs to have a good strategy and plan. However, it is not very easy to make a plan that will lead a company to its bright future. There are several types of planning and...
The observed site was the Woodbridge High School in Woodbridge, NJ where the school nurse was interviewed. The school nurse has a wide variety of responsibilities which cover primary, secondary, and tertiary care. Most often it is tertiary care by responding and administering care to students and staff as needed....
Introduction In medical sciences, nursing research is of particular importance. The history of nursing begins with the distant past, and during its existence, it has undergone many changes and revisions, especially in recent decades. One of the most prominent figures in this field is Patricia Benner, who has developed a...
Introduction The topic of the given capstone project is the increased rate of hospital-acquired pressure ulcers (HAPUs) in the US. I am studying the practice problem of HAPUs so that I can help my organization make a difference for patients and their families attempting to address this issue. This topic...
Introduction Innovative solutions to the management of patients’ personal data have had a tremendous impact on the healthcare industry, causing a massive shift in the process of data collection, analysis, and storage. The Electronic Health Record (EHR) framework has become one of the most common tools for handling patient data,...
The article “Improving resiliency in healthcare employees” by Werneburg et al. (2018) examines the influence of a specific training program on increasing resiliency and improving health behaviors in healthcare employees. This article was published in the American Journal of Health Behavior in 2018. The research conducted by these authors involved...