Other people with hemophilia can be found through community counts and support networks, which only involve members who are voluntarily willing to assist hemophilia patients. It is important to remember that the hemophilia occurrence rate is significantly higher among men than women because it is an X-chromosome-linked gene. The Hemophilia...
Many patients decide to visit a doctor when the same symptom occurs for several days, and the situation does not change or even gets worse. In this case, a new patient informs about a fever for three days and asks for help. To come to one correct diagnosis, it is...
Media are used in the community to promote health and prevent disease. The most effective approach is the use of the Internet for health-promotional purposes. Community members have access to a variety of websites, such as healthymiamidade, floridahealth, miamidade, and others. At these websites, citizens can find out the location...
Biasness in a research study is known to cause a distortion between the exposure and outcome. Bias in a study results from errors in design method employed, method of data collection, as well as data analysis. According to a critical review of the controversial paper published (and later retracted) by...
H5N1 is highly contagious between birds of different species. H5N1 easily mutates creating variants which are capable of infecting birds across different species. There are some of these variants which infect human beings. The avian virus is transmitted between birds by binding to galactose receptors located in their respiratory tract....
Substance in the organism, whereas bioavailability is a subcategory of the former concept. It is based on the portion of the drug that reaches the final circulatory system. Both of them are highly dependent on the nature of the chemical. Distribution is the process of transferring the drug through the...
Features to include Physical security Electronic medical records should occupy limited physical space available. Computers should occupy limited space within health facilities where patients can interact with physicians nicely and update the status of their health profiles. Medical practitioners are the only qualified people to interpret or manipulate the medical...
The safekeeping of medical records entails the task of compiling, storing, typing, and retrieving patients’ data in health institutions. Data is documented from different sources for the purpose of facilitating ongoing medication to various patients. Patients’ data is not only important in supporting sustainable medication; it also facilitates proper health...
Daily care can be organized in several ways: The team leader approach. Registered practitioner leads a team of professionals who provide all major types of services. Patient satisfaction increases as the contact with the staff improve. However, a leader’s characteristics can affect group performance adversely. This approach can be used...
The Hindbrain or rhombencephalon is located a little over the spinal cord and is a developmental classification of parts of the vertebrates as forming part of the central nervous system. The hindbrain functions collectively in coordinating sleep patterns, equilibrium, posture, and motor activity as also regulates some unconscious but vital...
Preventative healthcare interventions are an essential part of the process of health care improvement. Moreover, preventive measures lead to managing healthcare resources in an increasingly cost-effective way. Since the U.S.’s healthcare expenditures are among the highest in the world, with the quality of care leaving much to be desired, preventative...
Monosaccharides are the smallest molecules of carbohydrates that the body absorbs after digestion of food and utilize them in the production of energy during cellular respiration. Glucose, galactose, and fructose are the three types of monosaccharides that exist in nature for they originate from cane sugar, milk sugar, and fruit...
Cosenza et al.’s article “Calcium and vitamin D intakes in children: A randomized controlled trial” is about a study, randomized controlled trial, done to determine the role of adequate intake of calcium and vitamin D in the prevention of rickets and mineralization of bones. The study aimed to demonstrate how...
Vitamin A is a fat-soluble vitamin and its functions are to improve vision and prevent clinical eye disease called xerophthalmia, maintain healthy skin, ensure the growth of healthy teeth and bones, and enhance the immune system. Fortified milk, butter, eggs, liver, and cream are animal sources of vitamin A while...
Primarily, the body uses proteins in growth and development for they are building blocks of cells, tissues, and organs. Moreover, the body uses proteins for repairing worn-out cells, tissues, and organs and maintaining their integrity. As the body requires chemical messengers, it uses proteins in the production of hormones such...
The term case management has been constantly used over the past decades in the world of literature, referring to everything that revolves around the legislative system to the medical management of a patient’s care. The use of case management to counter the use of drugs has been a constantly debated...
The healthcare sector is integral to the development and advancement of any society in the world. The HR function is fundamental and can be considered the most valuable asset in any organization in the healthcare sector. To achieve their set objectives, healthcare institutions require a robust human resources manager or...
Ethical conduct is an essential part of high-quality nursing care. According to Haddad and Geiger, ethical principles in medicine are meant to ensure that practitioners are committed to the well-being of patients (individuals, communities, and the population as a whole). While such ethical principles as accountability and beneficence seem clear...
The quality of patient-nurse interaction can significantly define the overall patient outcomes. As stated by Nilsen et al., “the use of verbal and nonverbal interaction behaviors can help establish a synergistic care relationship between nurses and patients.” Therefore, it is essential to pay attention to both verbal and nonverbal communication...
Glomerular blood pressure together with renal blood flow (RBF) is considered as the determining factor that defines the proper glomerular filtration. The decreased renal blood flow and renal venous congestion mainly caused by heart failure episodes might result in impaired kidney function. Therefore, kidney disease and diminished renal function commonly...
The guest speaker in the video is a recreation therapist who works at the Jackson Recreation Center in Miami, Florida. The speaker’s name is Kelly Messett, and she graduated from college in 1997. The Jackson Recreation Center is a state-of-the-art facility where medical professionals help people with different types of...
Introduction The nurse retention crisis has become a pertinent issue that must be addressed sooner rather than later for the welfare of the American people. The role of nurses in the healthcare process cannot be overlooked and their retention is a priority to prevent a full-blown overload of the entire...
The immune system is principally organized around three-layered defenses of increasing specificity – the physical barriers, innate immune system, and the adaptive immune system. The physical barriers form the outermost protection layer and include the skin, eyelids, mucous membranes, normal flow of urine, tears, linings of the mouth, lungs, and...
The immune system is a complex process that involves the interaction of various biological components in the body that are involved in defending the body against infections. As such, because of this immune system complexity, there is no single approach that can be reliably used in the determination of this...
Both IgA and IgE are important immunoglobulin isotopes that play significant key roles in body defense mechanisms. Like most other site-specific antibodies found in the body, IgA is selective in nature and its functions are largely limited within the mucosa sites of the body which makes it one of the...
Psychosocial stressors may be of different forms, including a number of factors like working conditions, decision-making processes, or even the level of social support. This type of stress takes place as soon as a person understands what some threats to self-esteem or self-respect are possible, and these threats influence considerably...
The Safety Management System, or SMS, of an organization, is a set of rules and guidelines that define the proper procedures for an organization to follow in order to achieve optimal safety levels. In addition to general safety policies that cover the daily operation of an organization, a Safety Management...
Introduction Medication administration errors may threaten patients’ safety and lead to negative health outcomes. When nurses administer and dispense medications to their patients, they should confirm the “five rights” of drug administration: “right patient, right medication, right dose, right route and right time” (Mulac et al., 2021, p. 1021). Therefore,...
PIO Question: In patients suffering from acute bronchitis, do antibiotics reduce sputum production, cough or days off? Patient: patients with acute bronchitis Intervention: antibiotics Outcome: reduction of sputum production, cough and/or days off. I found it somewhat difficult to effectively find relevant information for my PIO question originally. Bronchitis is...
There are many requirements for the work of nurses, and the use of creativity in treatment is one of them. Creativity has a significant impact on the professional activities of nurses. They often need to make decisions quickly, develop and implement new and non-standard ideas, and be flexible when solving...
Introduction Diabetes is still common in the U.S. population aged 18 and older and remains the eighth leading cause of death. Regarding prevalence trends, the percentage of adult U.S. citizens with type I/type II diabetes diagnosis has grown from 9% to 12% between 1999 and 2016 (Centers for Disease Control...
Asthma is a chronic health condition that affects millions of Americans annually. According to the Centers for Disease Control and Prevention (CDC, 2021b), currently, nearly 25 million people are struggling with asthma nationwide, constituting almost 8% of the US population. For this reason, the topic of interest for the present...
Introduction Physician-assisted suicide (PAS) is a topic that has ignited a relentless debate because of the argument that surrounds its execution. Assisted suicide happens when a patient shows his or her intention to die and appeals to a doctor to help him or her in this process. The recent advancement...
Introduction This paper presents a critical analysis of quantitative research articles by Qasem & Hweidi (2017), as well as Mohsen et al. (2020). The purpose of the first study was to assess Jordanian caregivers’ understanding of evidence-based prevention of surgical site infections (SSIs). Additionally, the authors aimed to determine the...
The article under consideration is written by Angela F. Clark and entitled “Effect of a neonatal abstinence syndrome training program on nurses’ confidence and ability to use the Finnegan scoring tool.” The study is aimed to examine the effectiveness of a nursing education program on neonatal abstinence syndrome (NAS) and...
Introduction COVID-19 vaccines are essential to prevent a pandemic, combined with adequate testing and precautions that already exist. The immunization prepares people’s bodies to tussle against a specific infection, virus, or disease. Unlike most drugs that treat the disease, vaccines destroy it. In modern society, there are different views on...
The health of humanity is the most valuable and important aspect of the life of modern society. Its preservation and strengthening are considered the primary tasks of countries around the world. In this process, an important role belongs to such medical specialists as nurses. This work requires performing tasks on...
Introduction It is important to note that pressure ulcers are a widespread problem that affects patients’ wellbeing, health, and recovery. The key purpose of the given analysis is to determine whether or not the integration of evidence-based checklist tools in the nursing care process can effectively reduce the occurrence rate...
Introduction Modern medicine relies heavily on the latest innovations in programming and engineering, contributing greatly to its overall efficiency. ICD-10-CM, with its application in diagnosis and medical coding, has become an irreplaceable tool within this niche. Physicians, coders, health information managers, nurses, and other healthcare workers, utilize ICD-10-CM to help...
The Health Insurance Portability and Accountability Act of 1996 (HIPPA) is a law whose primary purpose is to protect patients’ confidential health information. The Privacy Rule’s standards govern the disclosure of personal health information (“Health Insurance Portability and Accountability Act,” 2021). Healthcare professionals should familiarize themselves with these guidelines and...
Introduction Most people are constantly striving to be healthier and fitter to attain better well-being and have a positive view of themselves. As a result, to improve their health, they turn to different methods of doing so. Some people prefer relying on well-researched and studied techniques, which can be generally...
Summary Nurses must attend to the requirements of their patients. Legal, ethical, moral, and practical criteria are met in fulfilling this obligation. As a result of the trust placed in nursing staff to deliver the utmost medical care possible, this is warranted. In particular, prescription activities with a high risk...
Introduction: Relevance of the Topic The number and variety of diseases are increasing day by day. Although current medicine regularly works to find methods of combating illnesses, people’s exposure to various ailments remains relatively high, and their prevalence is global. Disease prevention is one of the most critical tasks of...
A patient-centric health information management system ensures patient safety in several ways, including reducing medical errors, facilitating communication among healthcare providers, and providing access to health information. Throughout patient hospital stay, healthcare personnel is involved in patient care, which increases the risk of miscommunication error. Implementing this system will reduce...
Healthcare policy and procedures help standardize daily operational activities in every organization. Health policy enhances clarity in dealing with critical issues of health and safety, regulatory requirements, and legal formalities. Even though the role of health policy cannot be disputed, how it is managed justifies the quality of care. As...
Introduction Obesity is more than some excess weight that a person has due to their eating habits. In reality, this condition is more complex and presents a combination of medical, psychological, and behavioral factors. Although the DSM-5 manual does not recognize obesity as a psychological disorder, it is still a...
Journal Name and Year Published Cancer risk associated with chronic diseases and disease markers: Prospective cohort study, published in 2018. General Epidemiology of the Issue Chronic illnesses are a major contributor to the world’s annual mortality rate. For instance, they were responsible for 71% of the global deaths in 2015...
The immune system’s primary task is to protect the body from antigens like germs, poisons, and cancerous cells from invading and damaging them. External protection in the form of skin is the first line of protection; non-specific immune cells are the second line of defense; and the specific immune system,...
The John Hopkins University School of Nursing is of unquestionable moral standing, and the institute articulates its core values like excellence, respect, diversity, integrity, and accountability. It would therefore be a reasonable assumption that the university would expect the same high values to be embodied in its students. I view...
In my opinion, a life well-lived is one that is lived in such a way that it makes a difference in the lives of other people. However, I believe that it takes more than mere raw skill and good intentions to make an optimal difference. A solid educational background proves...
Any situation which can potentially turn into a conflict is dangerous for any staff unity. However, even with the best management system, such situations are inevitable due to some basic human instincts. Regarding the case with holiday coverage, trying to find a compromise between all the staff members has a...
Located at the stern of the abdominal cavity, the kidneys are positioned on each side of the spine and are capable of receiving blood from the harmonized flow of the blood commencing from the renal arteries and then deplete to the renal veins. Typically, the left kidney is on average...
Tort reform in the health arena came into effect at the time of Bush’s reign, and the word tort means that a person, who is a victim of a civil wrong, can legally go for the redress from whom he has caused damage to. A specific type of tort action...
As a starting point, it can be argued that the most significant global health policy issue is the high instance of nutritional diseases, which have endlessly affected many people globally, especially with the take-up of a modern sedentary lifestyle. In this case, undernourishment is a disproportion or insufficiency of nutrients,...
Geneticists and pharmacologists understand that drug response is a process that depends on various factors, including age, co-morbidities, diet, and genetics. These attributes will have significant influences on the nature or quality of medical care available to the targeted patients. The genomics of a given person will dictate the genes...
Vaccination is considered to be one of the most effective means of protection against infectious diseases used in modern medicine. For over two centuries, it has been known to the general population that vaccines have demonstrated exceptional epidemiological and social success, averting an estimated 2 to 3 million deaths every...
Pareto Chart A Pareto chart is a form of a pie chart used to identify areas that require attention and priority in process improvement. In healthcare, Pareto Charts help identify the most frequent outcome of a categorical variable that establishes the root of a healthcare problem. The chart displays ordered...
Multiple frameworks that constitute the cornerstone of the healthcare system in the US differ substantially from those in high-income European countries. The US healthcare system provides clients with high-quality services and can boast of unique, highly efficient equipment. Nevertheless, the high costs of medical care, the complicated insurance system, and...
Introduction This care study is based on a 75-year-old male patient diagnosed with hypertension whom I met at the placement ward. For the purposes of confidentiality, the patient will be referred to as the patient, and the ward will be referred to as the ward. In such a manner, no...
Sally was completing an exercise to make her back and shoulders stronger. However, due to the poor technique, she felt a strong pain between the shoulder blades. According to Scutt (2020), the rhomboid muscles were affected as they are located exactly in the place of the pain. Nevertheless, it is...
This article provides a brief introduction on how specialists can provide care to patients with right-sided heart failure (HF). The uniqueness of this article is that it discusses a phenomenon that has not received enough attention in contrast to left-sided HF. Albert (2021) gives the precise definition of right-sided HF,...
Abstract RN recruitment and retention, in a sense, is a vicious circle in the healthcare system, provoking several negative consequences for both the state and the individual. Sometimes, entering the profession can be a severe mistake for several specialists. Desperate, they quit medical practice and dissuade colleagues, acquaintances, and friends...
Introduction Searching for evidence-based information is a critical activity in the research process. Identifying the best sources to use as credible references and supporting materials increases the validity of the work performed. In addition, according to Ramsey et al. (2017), locating and appraising mechanisms make it possible to highlight high-quality...
Introduction Benign prostate hypertrophy (BPH) is also known as prostate gland enlargement. This pathologic (non-cancerous) condition mostly affects men with age and provokes lower urinary tract symptoms. People with BPH usually experience pain related to blocked flows of urine out of the bladder. With time, kidney problems may emerge if...
The list of functions and responsibilities of nurses working in adult or pediatric severe somatic (oncology/hematology, immunology, resuscitation, organ transplantation, etc.) and palliative medicine is extremely wide. Due to the proximity, intensity, and duration of their contact with the wards and their families, as well as due to the very...
Introduction Ethical dilemmas often arise in the medical field, and they necessitate the application of bioethical principles. The bioethical dilemma in this case is whether Jason, who has intellectual and developmental disabilities, should be allowed to donate a kidney to his elder brother, Terrence. There are potential risks and benefits...
Introduction Despite any circumstances, individuals are inseparable from their family bonds. This fact remains true when a person takes a visit to a doctor, as their well-being is directly linked to their blood ties, both physically and mentally. Family nursing is not a new concept, but it is barely acknowledged...
The guest speaker’s name is Gracie Gonzalez, and she currently works at LAC + USC Medical Center as a recreational therapist. Gonzalez describes the facility’s population as adults and pediatric patients. The needs addressed in this facility include the mental well-being of the patients. The speaker currently works in a...
Title I touches upon the topic of insurance related to unemployed people, especially ones who lost their jobs. Title III addresses the issue of the taxes involving insurance. It also considers the question regarding the pre-tax medical savings accounts and the employees’ related taxes. Title IV is correlated with the...
To support the knowledge related to neonatal abstinence syndrome and care of the family experiencing addiction, it is obligatory to analyze three articles to summarize the key findings. The selected studies, which are “Criminalization of pregnant women with substance use disorders,” “Breastfeeding recommendations for women who receive medication-assisted treatment for...
Choosing between major medical and major non-medical health insurance relies on what an individual can afford as well as what are their needs. Major medical health insurance can protect against severe injury or illness through referrals to various inpatient and outpatient services. Besides, such plans meet the minimum essential benefit...
When it comes to health, sugar has a mixed reputation, with more and more diabetologists raising alarm over its negative effects on the human body in recent years. Sugar is found in all carbohydrate-containing foods, such as fruits and vegetables, grains, and dairy. As such, it is extremely difficult to...
The city of Hartford is a relatively small city with a medium population. However, the city is divided into districts by city planners as well as by the level of life. East Hartford and Manchester are divided from the city center by the river, which can be seen as ‘Ninth...
The profession of nursing plays an essential role in clinical practice by conducting medical procedures, supporting patients, and assisting doctors. Indeed, the nursing process can be defined as “a systematic method which utilizes scientific reasoning, problem-solving, and critical thinking to direct nurses in caring for patients effectively” (Semachew, 2018, p....
The problem that needs to be overcome in the daily practice of nurses is psychological burnout that occurs due to acute stress and loss of motivation. Burnout is a common phenomenon, especially in the daily activities of nurses; this ailment expresses itself in emotional exhaustion, overstrain, and frustration. All these...
Introduction In this assessment, Mr. Jose Machans, whose initials are JM, is a white 76-year-old male Hispanic American. JM reveals that he has spent most of his life as a truck driver; he divorced at 58 years old and has two children. JM confesses that he lives alone, far away...
Introduction Demographic factors intensify pressure on the healthcare system and demand new directions in healthcare provision. These factors include the variations in age, gender, income, race, and many more. Since healthcare providers such nurses are likely to treat patients of different ages, gender, income and race, it is required that...
Introduction Obesity is one of the most acute health problems of today’s American adolescents. This population group was chosen for an educational program in this area due to the increase in the number of obese people in recent years. Additionally, adolescents often have a low level of health literacy, which...
Nurses have high work and skill demands, and they must master a wide range of skills to stay professional. The evolving professional environment for community/public health nursing has necessitated the creation of competencies that will shape practice, education, research, and policy recommendations. Nursing competence is typically viewed as a complex...
Physical activity is typically expected to result in many advantages for people, but numerous professional athletes suffer from specific injuries that emerge because of involvement in sports. Also known as Jumper’s Knee, Patellar Tendinitis is among such health issues. This condition can affect people from different kinds of sport, including...
Introduction The advent of COVID-19 has posed challenges for healthcare professionals to diagnose and provide medical care to patients quickly. The most common clinical manifestation of the new coronavirus infection is bilateral pneumonia, acute respiratory distress syndrome (ARDS) was recorded in 3-4% of patients (COVID-19 – China, 2020). The recommendations...
Introduction This paper will discuss antimicrobial resistance, the global impact of it, and how nurses can impact this phenomenon. Antibiotic resistance is a term that means the loss of the ability of an antibiotic to destroy bacteria. It develops under the influence of constant changes and mutations that microorganisms are...
In the state of Georgia, not every death requires an autopsy to be performed by the coroner or medical examiner. An autopsy is mandatory when a person dies due to violence, suicide, drug overdose, or in a suspicious manner and without regaining consciousness when admitted to a hospital (Warshauer Law...
Introduction The pandemic of the infamous disease of 2019, particularly COVID-19, has caused considerable challenges in formulating preventive interventions. Notably, scientists are still in the process of researching and doing illustrative experiments on the topic of infection-related social contacts. Hence, this paper aims to collect the existing knowledge on the...
Introduction Employee retention and morale are some of the most significant metrics that affect the overall efficiency and productivity of organizations. An employee turnover rate of more than 15% indicates evident problems in either compensation policies or company culture (Stowers, 2020). In the current case, Middlefield Hospital has more than...
Introduction Phoenix is the most well-known private healthcare provider in the United Kingdom. Its vision and mission are all focused on providing clients with the best services possible. Phoenix’s advantages include a favorable geographic position and reliable information systems. However, extensive hours for nurses and inflation are two of the...
Introduction As a part of society, any person has a chance of getting infections. Those infections can vary in terms of transmission, symptoms, ways of treatment, and other characteristics. There can also be differences in how the public treats a person with a virus concerning protecting one’s health or from...
In this scenario, the patient is an 80-year called Richard who is scheduled for a total hip arthroplasty surgery. As part of the hospital’s practices, Richard was informed of the expected length of stay in the hospital following the procedure. The length that the patient was informed of surprised him,...
Introduction The proposed change initiative discussed in parts I and II aims to mitigate staff shortages in health care settings. According to World Health Organization (WHO), nursing and other medical staff deficits are projected to reach over 13 million by 2035 (Marć et al., 2018). Staff shortages in medical facilities...
Airaksinen, Jaakko, Christian Hakulinen, Laura Pulkki-Råback, Terho Lehtimäki, Olli T. Raitakari, Liisa Keltikangas-Järvinen, and Markus Jokela. 2016. “Neighborhood Effects in Health Behaviors: A Test of Social Causation with Repeat-Measurement Longitudinal Data.” The European Journal of Public Health 26 (3): 417-421. Web. This article examines how the characteristics of the neighborhood...
Direct-to-Customer testing is a type of genomic testing sold online. Thus, customers can freely buy a special kit and collect and post their saliva analysis to a DTC company following the instructions. The received result contains data reflecting variants in a person’s genetic code. This information is intended to reveal...
Introduction The human body is perfectly designed for long-term viability and life expectancy determined by how a person takes care of their health. It is known that life expectancy is predominantly dependent on the lifestyle that people create for themselves. With age, the human body and life change, and an...
Annotated Bibliography Kayaalp, M. (2018). Patient privacy in the era of big data. Balkan Medical Journal, 35(1), 8-17. Web. The author has a Ph.D. degree in computer science and vast research interests, ranging from the implications of machine learning for medical informatics to cybersecurity issues within the healthcare field. His...
Introduction Nowadays, many situations occur when healthcare professionals have to make difficult decisions according to various ethical principles, which is not always straightforward due to the specificity of the medical care field. The corresponding difficulties can be exceptionally sharp within the critical care setting because treating patients with life-threatening illnesses...
Closser, S., et al. (2016). The global context of vaccine refusal: Insights from a systematic comparative ethnography of the global polio eradication initiative. Medical Anthropology Quarterly, 30(3), 321-341. Web. The case study under review explores the public response to polio vaccination in seven African as well as Asian countries with...
Introduction A pressure ulcer, also known as a pressure sore, is currently a common medical condition among the patient population in nursing facilities. According to Borojeny et al. (2020), a pressure ulcer is “a localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result...
Purpose The objective of this task is to debunk one of the popular myths that “people should avoid all fats if they are trying to be healthy or lose weight.” In particular, that message will provide three appeals, namely, logical, ethical, and emotional, to show the inferiority and harm of...
What is Lordosis Lordosis is a clinical syndrome characterized by a bulge at the front of the spine, which can be normal or pathological (Yamak et al., 2018). Each person’s physiological status is monitored. The lumbar and cervical spines are bent in this position, the pathological condition of the spine...
Introduction Research on humans is integral for progress in different disciplines, including medicine, psychology, and sociology. However, such studies should take into account the ethical dimensions for conducting an experiment. In addition, proper procedures should be followed to ensure that the outcome is justifiable and upholds the dignity of participants...
The availability of the dissatisfied patients is an indication that Metropolitan Health is failing to uphold its vision and mission statements. 60% of the respondents are not likely to recommend the health facility to their close associates, including their families and friends (Gopi et al., 2019). The patient survey data...
Fraud and Abuse Fraud and abuse in the healthcare sector include the acts of healthcare providers that are deemed to have defrauded the healthcare facilities, and government or abused the right to bill for services rendered. However, the distinction between fraud and abuse is never clear. The degree of intent...
Nursing practice is one of the fundamental components of the healthcare system in any country, including the USA. The American Nurse Association (2010) outlined six basic areas in which American nurses can guide the public and political leaders to improve people’s health and wellness. Each of these key areas is...