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The advanced practice registered nurse (APRN) role has emerged recently and has been developing into a prominent clinical position. However, not all states demonstrate the same degree of acceptance for the area. This disparity is reflected in the differences between the developments of different local legislation on the matter. Some...
Introduction Diabetes care plan development largely depends on the needs of people in the community (DeBoer, 2013). Therefore, the nursing profession should be skilled in collecting and analyzing patient data to identify the highly risky groups of populations and create a general prevention strategy. The following paper will provide the...
Introduction Advanced practice nursing is becoming substantially more popular nowadays as the role develops and expands its competencies. Nurses are encouraged to follow this career path more often, improving their capabilities and engaging in more productive work. The scope of the role has also diversified since its inception, creating additional...
Patient Questionnaire Summary The interviewed patient is a 71-year old Hispanic female residing alone in a suburban area in her house but maintains strong close relationships with her children’s families. In terms of health-related beliefs, longevity is perceived as a fate-given and something characteristic to the family. Concerning the health...
Introduction Obesity is a nutritional disorder characterized by excessive caloric intake more than the body’s requirement resulting in an increase in fat deposition in the body tissues. Clinically, the inadequacy or excessive nutritional information is determined by dividing a person’s mass in kilogram to their height in meters to find...
Bioethical principles in medical experiments are vitally important, but not every participant understands the related risks. Miss Eversâ Boys, a 1997 American film, demonstrates the disregard of human rights in medicine. The film is based on a true story of the long-lasting Tuskegee experiment, conducted by a group of specialists,...
Introduction This presentation will explore the PICOT question related to the potential improvements in the quality of life of a target population. The question calls for research on the best method of reducing fall-related injuries in adults 65 years old and older. The answer to this question is synthesized by...
Person 1 The report in question provides valuable insights into the way students see the problem of smoking. I am not smoking, and I am for the creation of smoke-free zones. Ridner, Hahn, Staten, and Miller (2006) note that the vast majority of students agree that smoke-free environments are critical....
Abstract In general, PICOT may be defined as a specific acronym used in nursing that is traditionally applied for the creation of a clinical question to direct the health care providerâs search for reliable evidence. An appropriately devised PICOT question is highly significant as it establishes the process of research...
Introduction The studied question refers to the use of acupuncture in comparison to opioid medicine when treating chronic pain in adults from 40 to 60 years of age. Opioid medicine is often prescribed as the primary treatment of chronic pain. Due to an ongoing opioid crisis in the United States,...
Introduction The study aim was to evaluate the perceptions, attitudes and the knowledge level of practicing nurses towards the use of evidence-based practice in primary health care. The study also goes further to assess the effect of nursing education on these parameters relating to evidence-based care. The target population comprised...
Perceptions of Hospice Care among African-Americans Hospice care is a crucial practice to facilitate a satisfying life for an individual expected to die soon. Collective acts of compassion care are critical in achieving objectives describing the social practice. This discussion summarizes end-of-care attributes in the article âPerceptions of hospice care...
Many patients that stay at the hospital have various skin conditions of different severity. It is essential to be aware of them and ensure that they are well-managed and do not create problems for the patient. Moreover, for patients with low mobility, such as those in long-term care, the risk...
Vital role of nurses Sound relationship, cooperation and coordination among the nurses (Ulutasdemir, 2018). Improved communication efficacy Quality of communication in a hospital setup and its direct impact Preparation of an effective communication improvement plan In any healthcare system, nurses play a vital role in delivering essential healthcare services to...
Introduction The care of patients with pressure ulcers in intensive care units (ICUs) is highly relevant to nursing since the responsibility for this problem often lies with junior medical employees. The need to relate knowledge and existing practices to address the issue is the goal of the Quality Improvement project,...
Problem When nurses are forced to work with larger numbers of patients than they can adequately manage, the likelihood of patients dying, getting injured, getting injections, and being sent home earlier without appropriate education increases. This results in patients returning to the hospitals, often with more health issues than previously....
The article is about the use of an intervention package and teamwork training to address the risk of self-contamination during personal protective equipment (PPE) doffing tasks. The study is a randomized control trial (RCT) conducted in the Johns Hopkins Hospital Biocontainment Unit in Baltimore, Maryland, and approved by the institutional...
Even with the efforts of healthcare experts all over the world, obesity still remains one of the foundational sources of health issues on a global scale. Apart from being a major risk in itself due to the increased pressure that extra weight puts on patients, obesity also serves as the...
Difference between Qualitative and Quantitative Research Qualitative research is the inquiry of social phenomena as it exists in the natural setting, for example, the beliefs and practices of doctors on a certain aspect of health. As a result, âwhyâ becomes the focus as the aim is to gain insight into...
Introduction An electronic health record (EHR) is defined as the digital version of patients’ paper charts. The technology is real-time, patient-centered, and it avails records instantly and securely to approved users. Within the last decade, medical facilities have consistently used this software to manage efficiency during practice (Robson et al.,...
People develop different attitudes towards euthanasia and its legalization importance. They use many reasons to support this idea for terminally ill patients to stop their suffering and stay autonomous. About 72% of Americans believe in the necessity of lifting the ban (as cited in Lane, 2019). Despite a variety of...
The pathophysiology of osteoarthritis indicates that the condition is most common in people who are elderly and overweight. At old age, the tissue in the joints is prone to tear and wear. According to Mr. F.’s case, it was more likely that the knee cartilage had thickened to help bear...
Introduction The case describes how the management of Jonkoping county council found in Sweden manages the healthcare system under its jurisdiction. The county is served by a population of 9000 employees. It has three healthcare facilities under its jurisdiction. The case also describes the population situation on the ground and...
Introduction In the present day, cerebral palsy (CP) may be regarded as the most frequently occurring motor disability among children. At the same time, considerable misunderstanding related to this chronic condition still exist, especially within communities all over the world. CP is a permanent, chronic, and incurable disorder, however, it...
Introduction There are a number of severe medical conditions that are considered very serious and can cause concern for doctors. Some diseases are not extremely dangerous for adults, but when they occur in children and adolescents, additional measures and treatments are required since childrenâs bodies are much weaker. One such...
Summary Benefits and Implications The selected community, Jordan town, is presently experiencing numerous social and health problems that could affect the experiences of many citizens. Some of the leading ones include poverty, challenges associated with diversity, diabetes, obesity, and environmental concerns. This report proposes a new health care system change,...
At present, the health care system is becoming increasingly complex and fragmented. In order to provide a high level of health care service to patients, interprofessional collaboration is of utmost importance. Doctorally prepared nurses are important actors in medical teamwork, collaborating with other professionals, and acting on different levels. In...
Introduction Remembering events of the past in detail can present a difficulty for most, especially if they involve a complex set of actions, dialogues, or behaviors. For example, remembering whether one has locked the door after leaving for work is manageable, but recalling whether youâve also turned off the stove...
Implementation The management of pressure ulcers plays an inherent nursing role in reducing the associated comorbidities, including the risk of infections and bleeding. Some of the potential strategies that nurses can implement in managing pressure ulcers include the two-hourly turning of bedridden patients. Frequently changing the patients’ lying position in...
It goes without saying that patient-centered nursing practice is based on the ethical principles of beneficence and nonmaleficence. However, in certain circumstances, patientsâ safety may be negatively affected by predominantly unintentional medication administration errors. Cloete (2015) defines them as preventable events ârelated to medication which results in a failure in...
Introduction The quality improvement project dedicated to catheter-associated urinary tract infections (CAUTIs) prevention is almost complete. The data collection procedures have been performed, and the resulting data have been analyzed. With the data dissemination in progress, it makes sense to reflect on the project and its contribution to the development...
The mass media, in particular social networks, have an increasing influence on society. People read the information on social networks and may believe an unreliable source or interpret it mistakenly, which leads to severe consequences for the community and health workers. The post with a photo about the coronavirus vaccine’s...
Historically, the insurance carriers mostly have paid regular fees; however, Medicare reimbursement is not the same for Nursing Practitioners (NPs) and Medical Doctors (MDs). In the Medicare fees, only 85% of the standard prices are catered for regarding NPs, while on the other hand, the MDs receive 100% (Phillips, 2019)....
Introduction People aged over 65 years constitute 13.1% of the American population. Over 20% of the elderly live in the areas designated as rural (Mishkovsky, Dalbey & Bertaina, 2010). In my past work as a nurse, I discovered that many elderly people in rural areas were not receiving quality health...
It is commonly known that the usage of Foley catheters provides an opportunity to help patients on their way to recovery. Still, nowadays professionals tend to mention that it can also have an adverse influence on oneâs health condition (Stickler, 2014). Love and Rodrigue (2013) noticed that urinary catheters may...
This paper seeks to identify the key aspects of the fight against HIV in Australia and also considering the other approaches undertaken by Malawi and China in the fight against the scourge. The main article is the Sixth National Strategy (2010- 2013) in Australia. The main approaches discussed include funding,...
As Khloe Kardashian has said, “There is no such thing as perfect. Nobody attains perfection. But if you keep trying, you grow and evolve, and to me, that’s the point: To be a better person today than I was yesterday; to become the best possible version of myself.” In this...
Introduction The significance of Central Venous Catheters (CVC) in providing patients with an opportunity to receive the necessary nutrition after a complicated surgery can hardly be underrated (Stanley, âVeith, â& Wakefield, 2014). However, traditionally, the PICC tools are preferred to the rest of the options. However, studies show that PICC...
Vulnerability and Its Relation With Community Health Nursing Vulnerability is a complex concept and it is defined differently in different settings. When it comes to nursing, researchers note that there is hardly a single definition. For instance, Tomm-Bonde (2012) states that there are two major types of definitions that focus...
Policy reforms are necessary for the health sector in improving health outcomes. Globally, healthcare and public health systems are managed through sound health policies. The policies guide the operations of health systems and directly affect the availability and provision of health care globally. Consequently, in enacting policy reforms, it is...
Inflammatory breast cancer is regarded as one of the most severe types of cancer and accounts for about 5% of all breast tumors. This type of breast cancer was first described by Sir Charles Bell in 1814 as âa purple color on the skin over the tumor accompanied by shooting...
Transformational leadership is one of the most potent and effective management styles, continually improving and altering the workplace. Such strategy initiates positive changes in the subordinates, focused on helping them achieve the milestones, and motivating them to develop professionally. Transformational leaders are evident to possess certain traits, such as intellectual...
Introduction Diabetes remains one of the major health concerns both at the federal and community level. Much work is done to change the state of affairs for the better with significant results. Still, because the problem lies at the cultural level and has to do with the peopleâs idea of...
Introduction Infectious disease prevention. The aim of vaccination. Immunization schedules. Objective Population Vaccinations play a significant role in both personal and public health. Vaccines help to prevent the spread of diseases that are infectious, harmful, and lethal. The aim of immunization is to gain immunity to potentially dangerous conditions while...
Introduction The project, which was dedicated to the use of chlorhexidine washcloths with the aim of preventing catheter-associated urinary tract infections (CAUTIs), has been completed. With only five patients, the conclusions that could be drawn from the data were limited. The number of staff members that were recruited was greater...
Background and explanation Oregon Community Health Information Network (OCHIN) A healthcare IT NGO headquartered in Portland, Oregon United States. It is managed by a board of directors (majorly volunteers from member clinics). A membership of approximately 70 providers (with more than 300 clinics). Initiated in 2001 to facilitate integration of...
Introduction Pressure area care is an inherent plan of care for hospitalized patients. Pressure area sore causes significant pain in adult patients admitted to healthcare settings. This complication is particularly prevalent in bedridden patients and negatively impacts diseases’ prognosis (Mitchell, 2018). The treatment modalities are made difficult due to the...
Athenahealth and NextGen Healthcare Products Description of Clinical Issue In the healthcare industry, medication errors and adverse drug events are serious problems. They cause harm to more than 1.5 million Americans each year and have severe implications for nurses (Da Silva & Krishnamurthy, 2016). By reducing human mistakes and connectivity...
Providing access to resources for maternal health is one of the foundational requirements that healthcare policies must meet. However, due to the lack of updates and resources, some of the states may have less than satisfactory policies on the subject matter. Due to high poverty rates and the resulting lack...
Introduction Most countries are now experiencing a remarkable demographic shift considering the growing aging population. The number of people aged 65 years or older was 524 million in 2010 globally (Odden et al., 2011). Odden et al. have indicated that this figure rise to 1.5 billion in 2050. Improvements in...
Angina refers to discomfort or chest pain that occurs when the heart muscle does not get blood rich in oxygen. There are two types of angina, and an individual experiences pain, pressure, or a squeezing feeling (Reeh et al., 2019). Stable angina is the most common and is controlled by...
It is necessary to mention that one of the core steps of the clinical needs assessment process is the development of tools and procedures that would be reasonable in a particular situation. Moreover, it is imperative to focus on such aspects as cost-efficiency and reliability. Instruments should be validated to...
Subjective Portion The subjective portion of the note lacks some crucial information. Generalized abdominal pain should be addressed in a detailed manner to determine the possible diagnoses from the vast of those characterized by this symptom. In the HPI section, there is data of the patient’s age – 47 years...
Introduction Here, an analysis of the data collected for a Capstone project, which is dedicated to reducing catheter-associated urinary tract infections (CAUTIs), will be presented. The project involves investigating the effectiveness of 2% chlorhexidine washcloths in preventing CAUTIs, and it uses a pre-test post-test design. The siteâs nursing team was...
The odds ratio is a certain measure of the strength of association between an outcome and exposure of an event. It means that this concept represents the likelihood of an occurrence of a particular result of interest given a specific risk factor compared to the odds of the given outcome...
Diagnosis Condition is typically characterized by presence of blood clots They are situated in the lower part of the body, often the legs The clots lead the limb to swell noticeably The clot is in a deep vein, complicating detection Many of the symptoms are shared with other conditions Differential...
Introduction Social media undoubtedly plays an irreplaceable part in peopleâs lives. It gives them the ability to get new information, discuss, and share posts and state their opinions on various topics. Such a vast usage of the internet leads to a substantial change in the professional field as well. Proper...
Introduction The study was intended to figure out issues that enable or bar the adoption guidelines when taking care of patients with cardiovascular risks in the primary care setting. Clinical guidelines are critical in the efforts to improve healthcare outcomes as well as ensuring the provision of quality healthcare with...
The rapidly changing composition of the population considerably affects the health care system. The universal approach, addressing in similar way patients of different ages, races, and cultures, has demonstrated its inadequacy. Thus, healthcare professionals need to consider these variables while making a treatment plan for different population groupsâ representatives. In...
The present study was aimed to investigate the influence of dentifrice abrasivity and toothbrush stiffness on the development of NCCLs. Three questions were raised: Does the abrasive level have an influence on the initiation and progression of NCCLs? Does the stiffness of the toothbrush have an impact on the initiation...
Clinical Problem Nurse practitioners (NPs) should possess adequate skills to support the health needs of their clients. Evidence of teaching their patients is something critical for these practitioners. An NP supporting individuals with diabetes should use powerful education plans to produce the best goals. The educational process should focus on...
The issue of teenage pregnancy continues to attract attention from parties in various sectors. Although the society continues to shun teenage pregnancy, there haven increasing consent that its effects spread beyond the teenage mother, her child, and family. In this regard, efforts directed towards mitigating the teenage pregnancy menace continue...
Introduction The change project was initiated to decrease the time intervals of the Door to Balloon (D2B) in ST-Elevation Myocardial Infarction (STEMI) patients. In order to suggest an appropriate plan, the literature review, clinical data analysis, process for analysis as well as SMART goals were conducted in previous works. Besides,...
Introduction Leaders in healthcare organizations should be ready to provide timely feedback to their followers if they are to deliver desirable medical outcomes. This paper gives a summary of the article âThe Art of Giving Feedbackâ and sheds more light about the best practice for providing timely feedback. The contents...
Cultural competence is an essential part of the professionalism of healthcare workers. The world constantly faces new challenges as the society in the majority of countries becomes more multinational because of globalization. In this case, nurses and doctors have to pay special attention to the origins of the patient in...
Evidence-Based Health Evaluation and Application One way to enhance public health and the quality of life among patients is to conduct research and use the findings for evidence-based practices. Study results provide proof for public health improvement initiatives (PHII). The director of Safe Headspace, Alicia Balewa, has successfully applied the...
Code of ethics implies given principles formulated by an organization to guide professionals to conduct their business by established fundamental values and expected standards. In nursing, the code helps in shaping professional behavior by assisting nurses to distinguish between right and wrong when making their decisions (Park, 2012). This paper...
Introduction Depression is a prevalent mental health concern in adolescents, with a significant proportion developing it in medium to severe variations. It can have significant effects on their lives, particularly considering that adolescence is a critical period in the formation of oneâs life afterward. As such, treating it effectively is...
Community Needs Assessment Baltimore is a large metropolitan community located in the state of Maryland. Its racial composition is comprised of African Americans (62.5%), Whites (30.4%), Hispanics (5%), Asians (2.6%), and American Indians and Alaska Native (AIANs) (âQuickFacts,â 2019). The median household income between 2014 and 2018 was $48,840, with...
Most people have difficulties recalling the fine details of past complex, realistic activities or events. For instance, one can remember getting from the house to the office, locks the house but cannot recall if they closed all the windows. Similarly, there are patients with advanced memory disorders whose treatment has...
Introduction As a profession, nursing focuses on details that include harm prevention, caregiving, and protecting the clientsâ dignity. In addition, it defends and promotes the caregiversâ objective of upholding the clientsâ rights. Within the nursing profession, nurses have to apply eight main principles, which they should adhere to as they...
Introduction On the basis of the PICOT question that establishes the process of research and facilitates the development of its results the study dedicated to the impact and safety of low-dose aspirin for the prevention of cardiovascular events in patients with diabetes was conducted. This work identifies the practice issue...
The research investigates whether the implementation of a fall prevention program within the orthopedic unit will have the capacity to reduce hospital admissions and healthcare costs. This topic was selected based on the fact that injurious falls have been cited in the literature as the most widespread in-hospital adverse event...
The article, âBehavioral interventions to promote condom use among women living with HIV,â by Carvalho et al. (2011) aimed to establish effective behavioral interventions that guide healthy behavior among individuals with HIV. The study advocated for combined regimes where counseling was part. There are various perspectives from which the quality...
Summary This paper presents a profile of my neighbor whom I find rather interesting in terms of diverse background and unique worldviews and health approaches. Initials: L. Kulesh Sex: Female Age: 67 Place of birth: Kyiv, Ukraine (former USSR) The individual under analysis is an immigrant who has arrived in...
Introduction Preferred payment schemes in the healthcare industry are a matter of long and ongoing debate. Each of the three traditional reimbursement methods of health care providers is based on certain principles, having different benefits and drawbacks. However, these schemes also have similarity in some point that indicates their common...
It goes without saying that nursing plays an immeasurably significant role in modern medicine. At the same time, in the United States, advanced nurses permanently face considerable practice barriers. As a matter of fact, there are professional challenges that exist on a national level, such as barriers related to education,...
Introduction Organizations need to adapt to the forces of change. The adaptation to change enables them to serve modern society. Change is the only way that teams can remain up to date with growth and development. Kwanza Regional Medical Center Kwanza Regional Medical Center is the organization that has been...
Due to multiple changes experienced during adolescence as the transitioning period from childhood to adulthood, teenagers are quite vulnerable to stress and the related mental health concerns that it may entail when unattended. Depression is one of those issues, having recently become a major concern in adolescent health management. According...
In these uncertain times of COVID-19, most global corporations have decided to telework. This has been found as one of the best practices in line with the ânew norm,â which has been suggested by the World Health Organization (WHO) among other significant bodies. Organizations with large employee populations have conformed...
I would like to dwell on the controversial issue of telling or withholding information from patients. Honest and frank communication between the nurse and the patient is crucial to the efficient delivery of treatment. Also, nurses demonstrate their respect and trust to patients by telling the truth about symptoms, diagnosis,...
Dr. Jason Lee said it is essential to monitor allergy symptoms to know the difference between whether a person is infected with the COVID-19 or has an allergy (as cited in Somos, 2021). Allergy symptoms are nasal congestion, sneezing, while chills and muscle pain indicate COVID-19. The best solution is...
In general, the scope of nursing practice may differ across the country according to a state, however, its requirements and essential components are reflected in regulating local and federal nurse practice acts. According to Chapter 464 of the Nurse Practice Act included in Florida Statutes (2019), only certified nurse practitioners,...
Introduction It is imperative to note that the importance of resource allocation is a fascinating topic that is frequently discussed by scholars. The problem is that some of the approaches that are used may be criticized, and it can lead to numerous disagreements. Another aspect that needs to be mentioned...
Summary In order to create the visibility of the project, it is useful to apply a tree diagram. The tree diagram is a structured hierarchical list of objectives, in which lower-level targets are the basis to achieve higher-level goals. Accordingly, the paramount goal stays on the top. As the achievement...
Nursing informatics and healthcare technology are essential disciplines for any advance practice nurse. These are the disciplines that are crucial for building an effective nurse leader. The following paper aims to summarize the material studied during the course of nursing informatics and provide conclusions as for the significance of this...
Group Preference The topic of the proposed study is the areas of improvement in the current post-traumatic stress disorder therapy to enhance suicide prevention in the veteran population. Since the study aims at broadening the scope of evidence-based methods of counseling for veterans by means of changing behavioral patterns and...
Introduction This paper evaluates the portrayal of nursing as exhibited in the Scrubs series, season nine, episode 3 (Our Role Models). It delineates the nursesâ personality traits, demographics, education, and competence among others. Body Plot Prominence The show renders nurses as anonymous maidservants that hang onto the physiciansâ directives, as...
Preceptors are needed to make a difference in the transition of new nurses from classroom to the clinical setting. Barker and Pittman (2010) noted that the role of mentoring new nurses is challenging and requires the preceptor to have qualities that enhance the process of turning the nursing theory into...
Brief Description Human papillomavirus (HPV) infection signifies the commonest sexually transmitted infection across the globe. Its transmission could arise even when the infected person does not have any indications or symptoms. It exists in numerous varieties, and some have the capacity to result in medical concerns that include genital warts...
Introduction The current paper shall attempt explore the issue of high adult and child mortality rate in Haiti. The reason why Haiti has been chosen as the country of choice is because it has been categorized by the World Health Organization (WHO) as among the countries in American with high...
Staffing is the process of determining and providing a certain number and mix of healthcare personnel to produce a certain level of patient care. While the crucial point of this process is the quality of the provided services that result in patient outcomes and satisfaction, costs remain the second determinant...
Miami-Dade County has a high rate of cultural diversity. As pointed out by Healthy People (2016), the African-American community represents 19% of the areaâs population, and as to the Hispanic and Latino residents, in Miami-Dade County, they comprise about 65.5% of the whole population and are the largest community. One...
The governmentâs spending on various healthcare programs has increased sharply over the past few years. The current federal healthcare law indicates clearly that the country will spend more on various programs. This policy issue has become controversial as more individuals focus on the best strategies that can reduce the countryâs...
The article A Middle-Range Theory of Self-Care of Chronic Illness by Riegel, Jaarsma and StrĂśmberg (2012) is one of the most interesting articles exploring the application of Middle Range Theory to find solutions to chronic illness. It provides a framework for understanding the uncertainty of chronic illness experience, how to...
Background Information and Explanation The case study is focused on OCHIN, an organization that recognized some of its approaches must be revised because the number of clients has increased significantly. A particular initiative was developed to support such changes (Maccoby, Norman, Norman, & Margolies, 2013). It is imperative to mention...
Translating and disseminating research in nursing make valuable contributions to the development of science and improving the health care system. The DNP project is a culmination of nursing studies and the opportunity for such contributions. It requires choosing the appropriate strategy for the implementation of the research and skills of...
Introduction It is argued that the future of nursing is bright. This field of medicine is ready for an overhaul due to advancements in technology and the support of stakeholders. One foundation that has pushed for the overhaul of nursing is the Robert Wood Johnson Foundation (RWJF). The Foundation has...
Introduction Quality and safety belong to the most crucial aspects of healthcare delivery. It is especially significant to provide these aspects in healthcare organizations as they directly impact the patients’ health and life quality and their satisfaction with the services provided. Medical errors are much more dangerous than any other...
Competent nursing practice requires continuous improvement of skills and knowledge about the technologies, procedures, and approaches to health care based on research-informed data. The medical findings obtained using research efforts form a substantial evidential basis for nursing practice that ensures the highest quality of health care services. Thus, evidence-based practice...
Pathophysiology Pyelonephritis is infectious and inflammatory kidney disease with an extensive lesion of the pyelocaliceal system and tubules, which gradually passes into the pathological process of the glomerular apparatus. Pyelonephritis is one of the most common pathologies among microbial kidney damage in the world. It can occur both on its...
Introduction It is necessary to note that the process of the implementation of changes can be complicated by numerous internal and external forces that may be hard to handle in some situations. Numerous books and peer-reviewed articles on this subject matter are available, and some of the techniques suggested are...
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