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 Reply to this student post with less than 20 % similarity APA style

 

1. The goal of understanding the concepts of culture is to make it possible for the nurse to provide culturally congruent care, this means providing care that fits the life patterns, values and set meanings of the patient. To achieve this kind of care the nurse needs to learn the defining characteristics of the patient’ culture, their health care practices and their perceptions of health care and wellbeing. In order to apply cultural concepts, one must first identify potential conflicts between the patients’ needs, their practices and their cultural values (Andrews & Boyle, 2016).

To achieve a culturally competent practice Leininger suggested three different modes. Cultural care preservation where one retains relevant care values. Cultural care accommodation, where one negotiates with the patient and family for a beneficial health outcome, and Cultural care repatterning, where one has to change the patient lifestyle for a new and beneficial health care pattern (Andrews & Boyle, 2016).

Specialized community interventions tailored to the people that is being served are more likely to be in accordance to the community needs and have a better chance of success. Developing these interventions is a collaboration between providers, community leaders and consumers. It is important that these approaches are designed so we can address the needs of individuals, families and the aggregates in the communities. (Andrews & Boyle, 2016)

2. To understand the factors that affect the health or illness of a group one must perform a community assessment, factors like the demographics, number of people, average age, social class and morbidity. Also, the location of the community, urban, rural, weather, diseases characteristics of the area, economic, religious, political systems. All of these factors will play a role in how people do in regards to health care, the availability of services that are convenient and culturally compatible with the patient will determine the likelihood that the patient seeks treatment or care when needed (Hunt, 2013).

Additionally. the nurse should be aware of the subcultures (aggregates that establish different rules from the mainstream group), each subculture needs to be understood in order to plan and provide care in a culturally sensitive way (Andrews & Boyle, 2016).

3.  In order to take care of the refugee population we have to keep in mind that these individuals left their place of origin with a conviction that their lives were in danger, so they are escaping persecution of some kind. In these cases, a thorough assessment needs to be performed before planning to provide care. Factors that need to be known to the nurse include the amount of time the family or the patient has been in the US, if they spent time in other places, camps, or rural areas, languages spoken, religious practices, ethnic identity, family roles and social support available. Once this assessment has been completed the nurse can begin to plan interventions that are culturally sensible for the family (Andrews & Boyle, 2016).

Is important for refugee communities to get access to preventive care, planning dental care, mammography, pap smears, prostate and testicular exams may be a new concept for them and they may need education and assistance to get this kind of care. It is not uncommon that refugees come from cultures where they do not have access to these interventions and they may not be aware of their existence or need. Also is important to keep in mind that for many refugees is important the gender of the provider, women may have been abused or raped in their country, and may avoid healthcare completely if they cannot find a female provider, careful assessment needs to be performed in order to not aggravate an already existing trauma. Another type of trauma to keep in mind when dealing with refugees includes the mental distress and possible residual PTSD from tortures and stressed suffered when fleeing their countries (Andrews & Boyle, 2016).

4.  Health equality, the idea that every individual should have access to the same level of care and that all individuals must be care for without discrimination due to race, ethnicity or cultural background. (Andrews & Boyle, 2016).

Diversity should be present in the healthcare workforce, having a mixture of different ethic backgrounds, sexual orientations, socioeconomic levels allow the patient to feel accepted being different, since a mix of different workers exist in the healthcare facility (Andrews & Boyle, 2016).

Partnership the idea of creating a good and beneficial relationship between the providers and community members and community organizations, these partnerships include reciprocal relationships, focus on prevention education, and understanding community needs (Andrews & Boyle, 2016).

Empowerment moving people of different backgrounds that share a vulnerability, having them work together to achieve the care they need results in empowerment of the individual and the community to take control of their health (Andrews & Boyle, 2016).

If we can built a healthcare system that is composed of a diverse workforce that will allow our community members to not feel threatened because of being different, that also promotes equity in health services in a community that participates in a partnership with the providers and feels empowered in their health decisions we would have successfully breach the culture barriers that many minorities face in our country.

Reference

Andrews, M. M., & Boyle, J. S. (2016). Transcultural Concepts in Nursing Care. Alphen aan de Rijn, Netherlands: Wolters Kluwer.

Hunt. R. R. (2013). Introduction to Community Based Nursing (Fifth ed.). Philadelphia, PA: LWW.

Purnell, L. D. (2014). Guide to Culturally Competent Health Care. Philadelphia, PA: F.A. Davis Company.

Healthcare provider shortage is a real problem faced by the nation which was exacerbated by implementation of the Affordable Care Act. So, having more providers will definitely impact the quality of patient care highly positively. The quality of patient care will improve when more skilled primary care providers, nurse practitioners (NP’s), focused on disease prevention will have the full scope of practice. Also, since NP’s have a different angle and approach to patient care, patients will enjoy a different experience with them. The difference lies within how the patient is treated. NP’s are educated in holistic care, focusing on wellness and disease prevention but not all physicians treat patients in that manner (Tracy & O’Grady, 2019). NPs are touted by the nursing profession as less expensive, same quality providers that are able to increase access to the uninsured by charging lower fees (Tracy & O’Grady, 2019). Also, there are a few studies that have shown that patient readmission rates and hospital usage are lower with medical doctors (Nickitas, Middaugh, & Aries, 2016). On the contrary, studies demonstrate that NP’s improve patient outcomes on the units they serve (Nickitas et al., 2016).

References

Tracy, M. F., & O’Grady, E. T. (2019). Hamric and Hanson’s advanced practice nursing: An integrative approach (6th ed.). St. Louis, MO: Elsevier.

Nickitas, D., Middaugh, D., & Aries, N. (2016). Policy and Politics for Nurses and other Health Professionals: Advocacy and Action. Burlington, MA: Jones & Bartlett Learning.

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Complete the following assignment following the instructions and using the source listed below:

Source: Cihon, P. J., & Castagnera, J. O. (2017). Employment and labor law (9th ed.). Boston, MA: Cengage Learning.

On July 29, 2016, Delphi Golf, Inc. and the union entered a collective bargaining agreement. The majority of the company’s employees covered by the agreement had not designated the union as their collective-bargaining representative. The agreement contains a union-security clause requiring employees who are members in good standing of the union to maintain their membership in good standing and all other employees to become members of the union on or before the 31st day following the effective date of the agreement or the date of their hire. The union instructed Delphi Golf, Inc. not to employ three servers for restaurant positions in the company because the servers were not members of the union. The company is an employer within the meaning of Section 2(2) of the act engaged in commerce within the meaning of Section 2(6) and (7) of the act.   Explain in a two-page essay the process and steps your company will have to take to defend this action. Explain the defenses to the action and if the union employees have valid claims. What actions by the employer should have been done differently, if at all? What actions by the union should have been done differently? Who, if anyone, is liable? You are required to use at least your textbook as source material for your response. All sources used, including the textbook, must be referenced; paraphrased and quoted material must have accompanying APA style citations.

On October 1, 2016, the Marshall Company sold a large piece of machinery to the Hammond Construction Company for $80,000. The cost of the machine was $40,000. Hammond made a down payment of $10,000 and agreed to pay the remaining balance in seven equal monthly installments of $10,000, plus interest at 12% on the unpaid balance, beginning November 1. Required: Identify three alternative methods for recognizing revenue and costs for the situation described and compute the amount of gross profit that would be recognized in 2016 using each method. Discuss the circumstances under which each of the three methods would be used. My answer to question On October 1, 2016, the Marshall Company sold a large piece of machinery to the Hammond Construction Company for $80,000. The cost of the machine was $40,000. Hammond made a down payment of $10,000 and agreed to pay the remaining balance in seven equal monthly installments of $10,000, plus interest at 12% on the unpaid balance, beginning November 1. Required: Identify three alternative methods for recognizing revenue and costs for the situation described and compute the amount of gross profit that would be recognized in 2016 using each method. The Realization principle-Gross Profit $40,000 Installment Sales Method- Gross Profit $33,600 Cost Recovery Method-$0 Discuss the circumstances under which each of the three methods would be used. The Realization principle-The earnings process is judged to be complete or virtually complete. There is reasonable certainty as to the collectability of the asset to be received (usually cash) Installment Sales Method-recognizes the gross profit by applying the gross profit percentage on the sale to the amount of cash actually received. Cost Recovery Method-Defers all gross profit recognition until cash equal to the cost of the item sold has been received. Spiceland, J.D., Sepe, J.F., Nelson, M.W., & Thomas, W.B. (2016) Intermediate Accounting. 8th ed. New York: McGraw Hill. those this make any senses 

On October 1, 2016, the Marshall Company sold a large piece of machinery to the Hammond Construction Company for $80,000. The cost of the machine was $40,000. Hammond made a down payment of $10,000 and agreed to pay the remaining balance in seven equal monthly installments of $10,000, plus interest at 12% on the unpaid balance, beginning November 1. Required: Identify three alternative methods for recognizing revenue and costs for the situation described and compute the amount of gross profit that would be recognized in 2016 using each method. Discuss the circumstances under which each of the three methods would be used. My answer to question On October 1, 2016, the Marshall Company sold a large piece of machinery to the Hammond Construction Company for $80,000. The cost of the machine was $40,000. Hammond made a down payment of $10,000 and agreed to pay the remaining balance in seven equal monthly installments of $10,000, plus interest at 12% on the unpaid balance, beginning November 1. Required: Identify three alternative methods for recognizing revenue and costs for the situation described and compute the amount of gross profit that would be recognized in 2016 using each method. The Realization principle-Gross Profit $40,000 Installment Sales Method- Gross Profit $33,600 Cost Recovery Method-$0 Discuss the circumstances under which each of the three methods would be used. The Realization principle-The earnings process is judged to be complete or virtually complete. There is reasonable certainty as to the collectability of the asset to be received (usually cash) Installment Sales Method-recognizes the gross profit by applying the gross profit percentage on the sale to the amount of cash actually received. Cost Recovery Method-Defers all gross profit recognition until cash equal to the cost of the item sold has been received. Spiceland, J.D., Sepe, J.F., Nelson, M.W., & Thomas, W.B. (2016) Intermediate Accounting. 8th ed. New York: McGraw Hill. those this make any senses

             Business ethics is defined by “the application of ethics to the special  problems and opportunities businesspeople experience” (Kubasek, Browne,  Barkacs, Herron & Dhooge, 2016, p. 16). When ethical decisions  appear in a person’s life, more likely than not, a plethora of choices  are considered when determining the best course to take for justifying  our actions. In many cases, we consider our Lord and Savior Jesus  Christ, his heavenly father God, our parents, our spouses, our children,  friends, colleagues, physical and mental emotions, plus more before  committing to one-way or the other. However, when the word “business” is  placed in front of ethics, the ramifications are often much larger,  including monetary value, and the effect decisions will have on  stakeholders and the public. First Timothy 6 verses 10 states “For the  love of money is the root of all-evil: which while some coveted after,  they have erred from the faith, and pierced themselves through with many  sorrows” (KJV). By highlighting the definition of Business Ethics as  well as 1 Timothy 6:10, we expose the very public lambasting of  Volkswagen Group, whom recently stated “11 million of its diesel cars  worldwide were equipped with software that was used to cheat on  emissions test” (Lippe, 2015). A multitude of responses, questions, and  political backlash reduced Volkswagen’s image in the public, however, we  will identify the steps that should have been enforced to prevent this  incident, starting at the managerial level and ending with the Chief  Executive Officer (CEO). 

Can someone do a reply to this thread HAS TO BE 450 WORDS EACH REPLY ANSWER

Reply to the threads of 2 classmates who offer views different than  yours. Identify the points of difference in your analyses and explain  how your application of the relevant law to the facts of this situation  led you to a different conclusion.

Each reply must be 450 words supported  by 3 scholarly sources other than the textbook/course materials. Each  source must be properly cited in current APA format.

Review the  Assignment Instructions for Discussion Board Forums, noting especially  requirements for word counts, scholarly sources, and biblical worldview  integration.

Submit your replies by 11:59 p.m. (ET) on Sunday.

FIRST THREAD NEEDED TO BE REPLIED TO

 

The Result of a Decline in Business Ethics

Business ethics is defined by “the application of ethics to the special  problems and opportunities businesspeople experience” (Kubasek, Browne,  Barkacs, Herron & Dhooge, 2016, p. 16). When ethical decisions  appear in a person’s life, more likely than not, a plethora of choices  are considered when determining the best course to take for justifying  our actions. In many cases, we consider our Lord and Savior Jesus  Christ, his heavenly father God, our parents, our spouses, our children,  friends, colleagues, physical and mental emotions, plus more before  committing to one-way or the other. However, when the word “business” is  placed in front of ethics, the ramifications are often much larger,  including monetary value, and the effect decisions will have on  stakeholders and the public. First Timothy 6 verses 10 states “For the  love of money is the root of all-evil: which while some coveted after,  they have erred from the faith, and pierced themselves through with many  sorrows” (KJV). By highlighting the definition of Business Ethics as  well as 1 Timothy 6:10, we expose the very public lambasting of  Volkswagen Group, whom recently stated “11 million of its diesel cars  worldwide were equipped with software that was used to cheat on  emissions test” (Lippe, 2015). A multitude of responses, questions, and  political backlash reduced Volkswagen’s image in the public, however, we  will identify the steps that should have been enforced to prevent this  incident, starting at the managerial level and ending with the Chief  Executive Officer (CEO).

As children of God, we are instilled with the rationale between what is  right and wrong. James 4 verse 17 (KJV) states “Therefore to him that  knoweth to do good, and doeth (it) not, to him it is sin”. We are  endowed with the conscious capability to distinguish between doing  something right and doing something wrong, however, when we choose to do  something wrong, it is considered a Sin. Other factors may weigh  heavily for or against the determination of right or wrong to include  family beliefs, childhood, and life experiences. Nevertheless, as  employees working in the Legal office or the Engineering department of  Volkswagen, the responsibility to determine the best ethical, moral, and  legal path fell squarely on each and every employee to make the correct  decision, and if something was legally, morally, or ethically wrong,  say something to someone such as the Department Director, or CEO. If  fear of retribution was prevalent amongst the employees in these  departments, they should have contacted an anonymous reporting service  to present the evidence in question.

First, employees should have known there had to be something or someone  who they could report the infractions to regarding the software which  cheated diesel testing requirements. For instance, the Sarbanes-Oxley  Act of 2002 was established by Congress to protect corporate insiders  and create an anonymous reporting system for employees to present  suspicious activity by companies (McClurg,  2017). Additionally, the Dodd-Frank Act prevents Whistleblower’s, or  those who implicate their company for illegal activity, from being  discharged, demoted, suspended, threated, harassed, or removed for any  attempt of reporting the illegal activity (McClurg, 2017). Aside from  these provisions by Congress, there are multiple employee guidelines for  reporting suspicious behavior, on top of the character and courage to  stand up for what is right, and socially responsible from a company, and  an individual. Ideally, managers should have prevented this by asking  questions, remaining aware, and conscious towards the behavior of  employees and the reporting systems in place for protection, especially  since “If God is for us, who can be against us?” (Romans 8:31 KJV).

Secondly, managers or employees in Volkswagen Legal or Engineering  department, must have known that the people affected most by this  decision to cheat the software detecting system was there stakeholders,  which includes the company. For instance, Cremer and Taylor (2016)  reported that Volkswagen would take a $18.2 billion loss due to the  diesel deception scandal the company attempted in 2015. Although a loss  of $18 billion may not deplete Volkswagen of their assets, as it may  numerous companies across the world, the image and trust from customers  have drastically been impacted, and that is something that cannot be  repaired so quickly.

As the CEO of the diesel division of Volkswagen, they should have taken  full responsibility for the mistake and attempt to cheat software  detection. Afterwards, if not arrested by the Police, could have  launched a massive legal investigation into the reason why 11 million  cars were equipped with diesel deception software, in order to identify  the areas of failure from the management and legal/engineering offices,  and hold as many people accountable as possible. This response would  have revealed to the public, business ethics is much more complicated  than people imagine. In a competitive, business-run environment, money  and production become the figures of success, and through cheating the  diesel software technology, Volkswagen was able to attract more money,  product, and customers around the world. Additionally, this type of  legal investigation would perhaps reveal as Clegg, Kornberger and Rhodes (2007) stated:

Ethics  cannot be encapsulated in lists of rules that inform action; thus,  there can be            no ‘one best way’ in which good ethics may be  guaranteed through prescription, judgment or legislation. The concept of  ethics as practice cannot offer a clear black and      white grid that  divides the world into good and bad; things are more complicated. (p.  13)

Business ethics is not as easy as deciding upon right and wrong. There  are multiple ethical dilemmas that could appear, however, the basis for  decisions should be the best legal course that would potentially  increase value for the stakeholders, no matter the situation.  Additionally, an investigation into the failures of the Volkswagen  reporting system, would identify the reinvigoration of legal outlets for  suspicious reporting such as the anonymous report hotlines, employee  confidentiality policies, and clear guidelines to preventing something  like this from happening again. Also, the CEO or investigator leading  the investigation may unveil what systemic or deliberate cover-up  occurred such as Lippe (2015) belief that Volkswagen  engineers neither discussed with nor hid what they were doing from  Volkswagen’s in-house lawyers, and the in-house lawyers didn’t realize  what was going on.

Ultimately, Volkswagen’s decline in business ethics stemmed from the  competitive misconception that cheating was an attempt at achieving  company goals. The sorrows that follow the obsession with money can lead  to illegal activity, penalties, fines, and supporting the wrong-doings  of others. Furthermore, the lack of character or failure to report the  wrongdoings by employees, must be fortified and consistently addressed  from the executive level down to the lowest employee. Although an $18  billion loss is large and galvanizing, the timeline for repairing the  damage done to the environment, customers, and other stakeholders could  take decades and cost exorbitant figures.

 

References

Clegg, S. , Kornberger, M. and Rhodes, C. (2007), Business Ethics as Practice. British Journal of

Management, 18: 107-122.

Cremer, A., & Taylor, E. (2016). Volkswagen takes $18 billion hit over Emissions Scandal.

Retrieved from https://www.reuters.com/article/us-volkswagen-emissions-germany-

probe-idUSKCN0XJ19U

Kubasek, N. K., Browne, M. N., Barkacs, L., Herron, D., & Dhooge, L. (2016). Biblical

worldview edition of dynamic business law. N. J. Kippenhan (Ed.). New York, NY:

McGraw Hill Education

Lippe, P. (2015). Volkswagen: Where were the lawyers? ABA Journal. Retrieved from

http://www.abajournal.com/legalrebels/article/volkswagen_where_were_the_lawyers/

McClurg, D. D. (2017). Whistleblower protections: Internal reporting and dodd-frank’s anti-

retaliation provision. Labor Law Journal, 68(3), 156-164. Retrieved from

http://ezproxy.liberty.edu/login?url=https://search-proquest-

com.ezproxy.liberty.edu/docview/1936467803?accountid=12085

SECOND THREAD NEEDED TO BE REPLIED TO

 

Discussion Board Forum 1: Volkswagen Scandal

Jordan Contreras

Liberty University

June 3, 2018
Prevention of the Emissions Scandal

In  September of 2015 Volkswagen recalled around 500,000 diesel cars and  the company lost around $16.9 billion dollars of the company’s market  value (Jung and Bin, 2017). According to Jung and Bin (20117) 11 million  of their diesel cars contained a device that would change emission  levels during diesel-exhaust tests. When this scandal hit the media,  Volkswagen had a huge economic damage occur and they lost many  shareholders in the stock market. Diesel vehicles are typically known  for the benefits they have with durability, repair cost, and fuel  efficiency. So, when Volkswagen designed a car that was supposed to be  the top of the line the sales sky rocketed which helped with  Volkswagen’s ratings in the market. The Volkswagen scandal really hurt  their reputation, and by the CEO of the company not being honest it made  the consumers frustrated with the company and destroyed their  credibility.

According to the bible “The Lord detests lying lips, but he delights in  people who are trustworthy” (Proverbs 12:22, New International  Version). As an employee or manager in the legal office or the  engineering department I would have done a couple of things differently  to prevent this problem. First if I was an employee and I noticed  something was off or didn’t seem quite right I would have immediately  reported the incident to the managers or executive team. This would have  escalated the issue to the senior executives that way everyone is  informed of the situation.

As  a manager you have a couple of options that could have taken place in  order to prevent this incident. I would have designed an ethics and  compliance training program, made my team take the course, led by  example, created a strong culture to enforce policies, and designed a  strict hiring policy. When designing the ethics and compliance training  program I would have made is mandatory for my team to take. In addition  to this I would made my team sign a paper showing that they took the  course. This would hold them accountable for their actions if any  mischief or foul play were to of taken place. Next, I would lead by  example. I would hold my team accountable for their actions and make  actions have rewards and consequences. This would go in hand with  creating a strong culture to enforce policies and procedures. Rules and  laws are created for a reason. No acceptation. So, by holding my  employees up to high standards you can set the expectation that foul  play is not permitted. Lastly, I would create a strict hiring process to  ensure you are hiring the most trust worthy candidates. In order to  achieve this goal, I would design mandatory behavioral and personality  test that will need to be taken prior to interviewing and do an  extensive background check. By making candidates take a behavioral test  you are able to gauge what type of personality they may have, that could  lead up to foul play. There were several actions that Volkswagen could  have taken to help gain credibility in the media but instead they  decided not to admit their actions were wrong and deceiving. In result  to their actions that they made they lost valuable customers and ruined  their credibility in the market. As a manager I would of done several  things differently to prevent this incident, held true to my morals and  the way God would of wanted me to take action.

Damage Control and Honesty from the CEO

The CEO of Volkswagen was given an impossible situation to handle when  the media broke free that the company and deceived so many people.  “Corporate fraud committed under climate mitigation pressure is becoming  more frequently observed in line with the ever-increasing environmental  standards and relevant regulation enforcements” (Li, McMurray, Xue,  Liu, Sy, and 2018). However, the bible say’s “whoever walks in integrity  walks securely, but he who makes his ways crooked will be found out”  (Proverbs 10:9. New International Version). Lying is never the answer,  you will get caught. To live in a Godly way, you have to admit the  mistakes made by you or your employees. Being honest helps with your  credibility, the company’s credibility and ensures that we are making  choices the way God would want us to.

When  the media broke free about the scandal, as the CEO over the diesel  division I would have first gathered all of the facts. I would have done  as much research as possible, brought on a team of investigators to  look into the incident, and immediately terminated those involved. As a  final step I would have held a press conference to speak openly about  the incident that occurred, and recalled all vehicles involved. During  this press conference I would have gone over what we as a company are  doing to handle all of the recalled vehicles, what we intend to do to  accommodate those customers affected by the incident, and gone public  about the termination of employees involved in the incident. By showing  the public that we are taking matters very seriously could help save the  company’s reputation. To prevent future incidents from occurring strong  policy and procedures needs to be written and enforced. When the legal  team is telling engineers not move forward with the incident and they do  so anyways this needs to be escalated up to the proper executive. If  the executives choose not to solve the incident than it needs to be  reported so legal action can take place. When preventing future  incidents than Volkswagen has to be up front and honest with the  situation at hand. There are no exceptions to cheating to getting a  head. You are ultimately hurting the company even more and aren’t living  in the way of god. Investigations need to be occurring but at random  time periods to ensure that the company is abiding by the rules. The  findings of the investigations need to be made public. When rebuilding  Volkswagen’s reputation, you need to be up front and honest about  everything going on internally. It is important to live by the way of  God, keep your morals, report anything unethical that is occurring, and  remember that the customers are what drives the sales of the business.  You will drastically hurt yourself in the market if they feel that they  are being lied and manipulated. Since Volkswagen has made poor choices  around their scandal they now need to do damage control and be  transparent with their customers and make everything public.

 

References

Jung, J. & Park, S. B. (2017, January 1). Case Study: Volkswagen’s Diesel Emissions Scandal.

Thunderbird International Business Review. 59 (1). 127-137. Retrieved from http://rx9vh3hy4r.search.serialssolutions.com/?ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Case+Study%3A+Volkswagen%27s+Diesel+Emissions+Scandal&rft.jtitle=Thunderbird+International+Business+Review&rft.au=Jung%2C+Jae+C&rft.au=%E2%80%9CAlison%E2%80%9D+Park%2C+Su+Bin&rft.date=2017-01-01&rft.issn=1096-4762&rft.eissn=1520-6874&rft.volume=59&rft.issue=1&rft.spage=127&rft.epage=137&rft_id=info:doi/10.1002%2Ftie.21876&rft.externalDBID=n%2Fa&rft.externalDocID=10_1002_tie_21876¶mdict=en-US

Li, L., McMurray, A., Xue, J., Liu, Z., & Sy, M. (2018, January 20). Industry-wide corporate

fraud. Journal of Cleaner Production. 172 (1). 3,167-3,175. Retrieved from https://ac-els-

cdn-com.ezproxy.liberty.edu/S0959652617327099/1-s2.0-S0959652617327099-

main.pdf?_tid=86e8669c-1366-43af-9ca5-93ef022bea2f&acdnat=1527826213_

92823702e5c9e426563d12e9b250891f

Lippe, P. (2015, October 13). Volkswagen: Where were the lawyers? ABA Journal. Retrieved

from http://www.abajournal.com/legalrebels/article/volkswagen_where_were_

the_lawyers

Reitze, A. W. (2016, July 1). The Volkswagen Air Pollution Emissions Litigation.

Environmental Law Reporter. 46 (7). 10,564-10,571. Retrieved from

http://ezproxy.liberty.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&

db=eih&AN=116583737&site=ehost-live&scope=site

             Business ethics is defined by “the application of ethics to the special  problems and opportunities businesspeople experience” (Kubasek, Browne,  Barkacs, Herron & Dhooge, 2016, p. 16). When ethical decisions  appear in a person’s life, more likely than not, a plethora of choices  are considered when determining the best course to take for justifying  our actions. In many cases, we consider our Lord and Savior Jesus  Christ, his heavenly father God, our parents, our spouses, our children,  friends, colleagues, physical and mental emotions, plus more before  committing to one-way or the other. However, when the word “business” is  placed in front of ethics, the ramifications are often much larger,  including monetary value, and the effect decisions will have on  stakeholders and the public. First Timothy 6 verses 10 states “For the  love of money is the root of all-evil: which while some coveted after,  they have erred from the faith, and pierced themselves through with many  sorrows” (KJV). By highlighting the definition of Business Ethics as  well as 1 Timothy 6:10, we expose the very public lambasting of  Volkswagen Group, whom recently stated “11 million of its diesel cars  worldwide were equipped with software that was used to cheat on  emissions test” (Lippe, 2015). A multitude of responses, questions, and  political backlash reduced Volkswagen’s image in the public, however, we  will identify the steps that should have been enforced to prevent this  incident, starting at the managerial level and ending with the Chief  Executive Officer (CEO). 

Can someone do a reply to this thread HAS TO BE 450 WORDS EACH REPLY ANSWER

Reply to the threads of 2 classmates who offer views different than  yours. Identify the points of difference in your analyses and explain  how your application of the relevant law to the facts of this situation  led you to a different conclusion.

Each reply must be 450 words supported  by 3 scholarly sources other than the textbook/course materials. Each  source must be properly cited in current APA format.

Review the  Assignment Instructions for Discussion Board Forums, noting especially  requirements for word counts, scholarly sources, and biblical worldview  integration.

Submit your replies by 11:59 p.m. (ET) on Sunday.

FIRST THREAD NEEDED TO BE REPLIED TO

 

The Result of a Decline in Business Ethics

Business ethics is defined by “the application of ethics to the special  problems and opportunities businesspeople experience” (Kubasek, Browne,  Barkacs, Herron & Dhooge, 2016, p. 16). When ethical decisions  appear in a person’s life, more likely than not, a plethora of choices  are considered when determining the best course to take for justifying  our actions. In many cases, we consider our Lord and Savior Jesus  Christ, his heavenly father God, our parents, our spouses, our children,  friends, colleagues, physical and mental emotions, plus more before  committing to one-way or the other. However, when the word “business” is  placed in front of ethics, the ramifications are often much larger,  including monetary value, and the effect decisions will have on  stakeholders and the public. First Timothy 6 verses 10 states “For the  love of money is the root of all-evil: which while some coveted after,  they have erred from the faith, and pierced themselves through with many  sorrows” (KJV). By highlighting the definition of Business Ethics as  well as 1 Timothy 6:10, we expose the very public lambasting of  Volkswagen Group, whom recently stated “11 million of its diesel cars  worldwide were equipped with software that was used to cheat on  emissions test” (Lippe, 2015). A multitude of responses, questions, and  political backlash reduced Volkswagen’s image in the public, however, we  will identify the steps that should have been enforced to prevent this  incident, starting at the managerial level and ending with the Chief  Executive Officer (CEO).

As children of God, we are instilled with the rationale between what is  right and wrong. James 4 verse 17 (KJV) states “Therefore to him that  knoweth to do good, and doeth (it) not, to him it is sin”. We are  endowed with the conscious capability to distinguish between doing  something right and doing something wrong, however, when we choose to do  something wrong, it is considered a Sin. Other factors may weigh  heavily for or against the determination of right or wrong to include  family beliefs, childhood, and life experiences. Nevertheless, as  employees working in the Legal office or the Engineering department of  Volkswagen, the responsibility to determine the best ethical, moral, and  legal path fell squarely on each and every employee to make the correct  decision, and if something was legally, morally, or ethically wrong,  say something to someone such as the Department Director, or CEO. If  fear of retribution was prevalent amongst the employees in these  departments, they should have contacted an anonymous reporting service  to present the evidence in question.

First, employees should have known there had to be something or someone  who they could report the infractions to regarding the software which  cheated diesel testing requirements. For instance, the Sarbanes-Oxley  Act of 2002 was established by Congress to protect corporate insiders  and create an anonymous reporting system for employees to present  suspicious activity by companies (McClurg,  2017). Additionally, the Dodd-Frank Act prevents Whistleblower’s, or  those who implicate their company for illegal activity, from being  discharged, demoted, suspended, threated, harassed, or removed for any  attempt of reporting the illegal activity (McClurg, 2017). Aside from  these provisions by Congress, there are multiple employee guidelines for  reporting suspicious behavior, on top of the character and courage to  stand up for what is right, and socially responsible from a company, and  an individual. Ideally, managers should have prevented this by asking  questions, remaining aware, and conscious towards the behavior of  employees and the reporting systems in place for protection, especially  since “If God is for us, who can be against us?” (Romans 8:31 KJV).

Secondly, managers or employees in Volkswagen Legal or Engineering  department, must have known that the people affected most by this  decision to cheat the software detecting system was there stakeholders,  which includes the company. For instance, Cremer and Taylor (2016)  reported that Volkswagen would take a $18.2 billion loss due to the  diesel deception scandal the company attempted in 2015. Although a loss  of $18 billion may not deplete Volkswagen of their assets, as it may  numerous companies across the world, the image and trust from customers  have drastically been impacted, and that is something that cannot be  repaired so quickly.

As the CEO of the diesel division of Volkswagen, they should have taken  full responsibility for the mistake and attempt to cheat software  detection. Afterwards, if not arrested by the Police, could have  launched a massive legal investigation into the reason why 11 million  cars were equipped with diesel deception software, in order to identify  the areas of failure from the management and legal/engineering offices,  and hold as many people accountable as possible. This response would  have revealed to the public, business ethics is much more complicated  than people imagine. In a competitive, business-run environment, money  and production become the figures of success, and through cheating the  diesel software technology, Volkswagen was able to attract more money,  product, and customers around the world. Additionally, this type of  legal investigation would perhaps reveal as Clegg, Kornberger and Rhodes (2007) stated:

Ethics  cannot be encapsulated in lists of rules that inform action; thus,  there can be            no ‘one best way’ in which good ethics may be  guaranteed through prescription, judgment or legislation. The concept of  ethics as practice cannot offer a clear black and      white grid that  divides the world into good and bad; things are more complicated. (p.  13)

Business ethics is not as easy as deciding upon right and wrong. There  are multiple ethical dilemmas that could appear, however, the basis for  decisions should be the best legal course that would potentially  increase value for the stakeholders, no matter the situation.  Additionally, an investigation into the failures of the Volkswagen  reporting system, would identify the reinvigoration of legal outlets for  suspicious reporting such as the anonymous report hotlines, employee  confidentiality policies, and clear guidelines to preventing something  like this from happening again. Also, the CEO or investigator leading  the investigation may unveil what systemic or deliberate cover-up  occurred such as Lippe (2015) belief that Volkswagen  engineers neither discussed with nor hid what they were doing from  Volkswagen’s in-house lawyers, and the in-house lawyers didn’t realize  what was going on.

Ultimately, Volkswagen’s decline in business ethics stemmed from the  competitive misconception that cheating was an attempt at achieving  company goals. The sorrows that follow the obsession with money can lead  to illegal activity, penalties, fines, and supporting the wrong-doings  of others. Furthermore, the lack of character or failure to report the  wrongdoings by employees, must be fortified and consistently addressed  from the executive level down to the lowest employee. Although an $18  billion loss is large and galvanizing, the timeline for repairing the  damage done to the environment, customers, and other stakeholders could  take decades and cost exorbitant figures.

 

References

Clegg, S. , Kornberger, M. and Rhodes, C. (2007), Business Ethics as Practice. British Journal of

Management, 18: 107-122.

Cremer, A., & Taylor, E. (2016). Volkswagen takes $18 billion hit over Emissions Scandal.

Retrieved from https://www.reuters.com/article/us-volkswagen-emissions-germany-

probe-idUSKCN0XJ19U

Kubasek, N. K., Browne, M. N., Barkacs, L., Herron, D., & Dhooge, L. (2016). Biblical

worldview edition of dynamic business law. N. J. Kippenhan (Ed.). New York, NY:

McGraw Hill Education

Lippe, P. (2015). Volkswagen: Where were the lawyers? ABA Journal. Retrieved from

http://www.abajournal.com/legalrebels/article/volkswagen_where_were_the_lawyers/

McClurg, D. D. (2017). Whistleblower protections: Internal reporting and dodd-frank’s anti-

retaliation provision. Labor Law Journal, 68(3), 156-164. Retrieved from

http://ezproxy.liberty.edu/login?url=https://search-proquest-

com.ezproxy.liberty.edu/docview/1936467803?accountid=12085

SECOND THREAD NEEDED TO BE REPLIED TO

 

Discussion Board Forum 1: Volkswagen Scandal

Jordan Contreras

Liberty University

June 3, 2018
Prevention of the Emissions Scandal

In  September of 2015 Volkswagen recalled around 500,000 diesel cars and  the company lost around $16.9 billion dollars of the company’s market  value (Jung and Bin, 2017). According to Jung and Bin (20117) 11 million  of their diesel cars contained a device that would change emission  levels during diesel-exhaust tests. When this scandal hit the media,  Volkswagen had a huge economic damage occur and they lost many  shareholders in the stock market. Diesel vehicles are typically known  for the benefits they have with durability, repair cost, and fuel  efficiency. So, when Volkswagen designed a car that was supposed to be  the top of the line the sales sky rocketed which helped with  Volkswagen’s ratings in the market. The Volkswagen scandal really hurt  their reputation, and by the CEO of the company not being honest it made  the consumers frustrated with the company and destroyed their  credibility.

According to the bible “The Lord detests lying lips, but he delights in  people who are trustworthy” (Proverbs 12:22, New International  Version). As an employee or manager in the legal office or the  engineering department I would have done a couple of things differently  to prevent this problem. First if I was an employee and I noticed  something was off or didn’t seem quite right I would have immediately  reported the incident to the managers or executive team. This would have  escalated the issue to the senior executives that way everyone is  informed of the situation.

As  a manager you have a couple of options that could have taken place in  order to prevent this incident. I would have designed an ethics and  compliance training program, made my team take the course, led by  example, created a strong culture to enforce policies, and designed a  strict hiring policy. When designing the ethics and compliance training  program I would have made is mandatory for my team to take. In addition  to this I would made my team sign a paper showing that they took the  course. This would hold them accountable for their actions if any  mischief or foul play were to of taken place. Next, I would lead by  example. I would hold my team accountable for their actions and make  actions have rewards and consequences. This would go in hand with  creating a strong culture to enforce policies and procedures. Rules and  laws are created for a reason. No acceptation. So, by holding my  employees up to high standards you can set the expectation that foul  play is not permitted. Lastly, I would create a strict hiring process to  ensure you are hiring the most trust worthy candidates. In order to  achieve this goal, I would design mandatory behavioral and personality  test that will need to be taken prior to interviewing and do an  extensive background check. By making candidates take a behavioral test  you are able to gauge what type of personality they may have, that could  lead up to foul play. There were several actions that Volkswagen could  have taken to help gain credibility in the media but instead they  decided not to admit their actions were wrong and deceiving. In result  to their actions that they made they lost valuable customers and ruined  their credibility in the market. As a manager I would of done several  things differently to prevent this incident, held true to my morals and  the way God would of wanted me to take action.

Damage Control and Honesty from the CEO

The CEO of Volkswagen was given an impossible situation to handle when  the media broke free that the company and deceived so many people.  “Corporate fraud committed under climate mitigation pressure is becoming  more frequently observed in line with the ever-increasing environmental  standards and relevant regulation enforcements” (Li, McMurray, Xue,  Liu, Sy, and 2018). However, the bible say’s “whoever walks in integrity  walks securely, but he who makes his ways crooked will be found out”  (Proverbs 10:9. New International Version). Lying is never the answer,  you will get caught. To live in a Godly way, you have to admit the  mistakes made by you or your employees. Being honest helps with your  credibility, the company’s credibility and ensures that we are making  choices the way God would want us to.

When  the media broke free about the scandal, as the CEO over the diesel  division I would have first gathered all of the facts. I would have done  as much research as possible, brought on a team of investigators to  look into the incident, and immediately terminated those involved. As a  final step I would have held a press conference to speak openly about  the incident that occurred, and recalled all vehicles involved. During  this press conference I would have gone over what we as a company are  doing to handle all of the recalled vehicles, what we intend to do to  accommodate those customers affected by the incident, and gone public  about the termination of employees involved in the incident. By showing  the public that we are taking matters very seriously could help save the  company’s reputation. To prevent future incidents from occurring strong  policy and procedures needs to be written and enforced. When the legal  team is telling engineers not move forward with the incident and they do  so anyways this needs to be escalated up to the proper executive. If  the executives choose not to solve the incident than it needs to be  reported so legal action can take place. When preventing future  incidents than Volkswagen has to be up front and honest with the  situation at hand. There are no exceptions to cheating to getting a  head. You are ultimately hurting the company even more and aren’t living  in the way of god. Investigations need to be occurring but at random  time periods to ensure that the company is abiding by the rules. The  findings of the investigations need to be made public. When rebuilding  Volkswagen’s reputation, you need to be up front and honest about  everything going on internally. It is important to live by the way of  God, keep your morals, report anything unethical that is occurring, and  remember that the customers are what drives the sales of the business.  You will drastically hurt yourself in the market if they feel that they  are being lied and manipulated. Since Volkswagen has made poor choices  around their scandal they now need to do damage control and be  transparent with their customers and make everything public.

 

References

Jung, J. & Park, S. B. (2017, January 1). Case Study: Volkswagen’s Diesel Emissions Scandal.

Thunderbird International Business Review. 59 (1). 127-137. Retrieved from http://rx9vh3hy4r.search.serialssolutions.com/?ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Case+Study%3A+Volkswagen%27s+Diesel+Emissions+Scandal&rft.jtitle=Thunderbird+International+Business+Review&rft.au=Jung%2C+Jae+C&rft.au=%E2%80%9CAlison%E2%80%9D+Park%2C+Su+Bin&rft.date=2017-01-01&rft.issn=1096-4762&rft.eissn=1520-6874&rft.volume=59&rft.issue=1&rft.spage=127&rft.epage=137&rft_id=info:doi/10.1002%2Ftie.21876&rft.externalDBID=n%2Fa&rft.externalDocID=10_1002_tie_21876¶mdict=en-US

Li, L., McMurray, A., Xue, J., Liu, Z., & Sy, M. (2018, January 20). Industry-wide corporate

fraud. Journal of Cleaner Production. 172 (1). 3,167-3,175. Retrieved from https://ac-els-

cdn-com.ezproxy.liberty.edu/S0959652617327099/1-s2.0-S0959652617327099-

main.pdf?_tid=86e8669c-1366-43af-9ca5-93ef022bea2f&acdnat=1527826213_

92823702e5c9e426563d12e9b250891f

Lippe, P. (2015, October 13). Volkswagen: Where were the lawyers? ABA Journal. Retrieved

from http://www.abajournal.com/legalrebels/article/volkswagen_where_were_

the_lawyers

Reitze, A. W. (2016, July 1). The Volkswagen Air Pollution Emissions Litigation.

Environmental Law Reporter. 46 (7). 10,564-10,571. Retrieved from

http://ezproxy.liberty.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&

db=eih&AN=116583737&site=ehost-live&scope=site

  3 paragraphs with 3 at least 3 sentences each.

Nursing Role and Scope

Daylin Lopez

February 19, 2020

Discussion Question Week 7

Nursing by profession is very wide. Nursing career paths which are supported by graduate-level academic programs are expert clinician, clinical nurse leader, nurse educator, nurse executive, and nurse researcher. As a nurse, one can view it as a career or as a job. Nursing as a job entails obtaining the least amount of education required to obtain a license for a nurse. This is done through obtaining the minimum continuing education units which are required for licensure (Shea, 2016). Through this, one goes on with the job as long as they are located some amount of work which results in good pay. One just studies for the license to obtain the job, and get paid.

Nursing as a career entails furthering nursing studies to obtain a bachelor of science in nursing and an advanced nursing degree. To view nursing as a career entails one doing further researches which help in nursing (McGee et al., 2019). Also, one can enroll in leadership positions to guide others in the field of nursing. In my view, I consider nursing as a career. When doing a task, it is always good and necessary to do it out of passion and more efforts. I view nursing as a jovial career which entails many aspects. Interacting with patients and helping them the best from passion, knowledge and experience. It does not entail just performing tasks because one is employed to do so. It is not more of pay, but more of further studies and passion.

Professional goals related to nursing are; healthcare should be delivered appropriately, practitioners should be given enough training to help in the career, there should be enough nursing educational preparation before one qualifies to be a nurse, nurses should utilize their education and training in the right manner, nurses should undergo through an improved education system which promotes academic progression, there should be effective workforce planning and policymaking which require improved information structure and better data collection (Masters, 2017).

Many students who enroll in the field of nursing do it out of passion and desire. Patient care being the primary core objective in nursing, many strive to ensure that they offer the best they acquire from the training. An interview is one of the ways of showcasing one’s professional self. In an interview for my ideal future nursing role, I would take the following steps; know myself- the first is the thing is to acknowledge that am a nurse by profession and this is an interview of a duty of call (Shea, 2016).

Therefore, I have to follow the right procedures in the interview. Know the healthcare organization I will be interviewed from-I have to acknowledge the healthcare center where I will be interviewed from and what is required. I should also make up a follow up of the characteristics of the organization. Prepare my documents ahead of time before the interview- I should ensure that I have all the necessary documents required for the interview to avoid collisions during the interview.

Look professional- I should ensure I look presentable as a nurse during the interview. One’s appearance matters the most, and it is good to have a good appearance. Plan for the day- I should make a good plan which will suit my interview appropriately (Shea, 2016). Get some sleep- I should have enough sleep and rest before the interview to avoid confusions and forgotten during the interview.

References

Masters, K. (2018). Role development in professional nursing practice. Jones & Bartlett Learning.

McGee, J., Stephenson, E., Teel, C., Moore, W. T., & Peltzer, J. (2019). African American and

Latinx Adolescents’ Perspectives on Nursing as a Career Choice. Journal of Nursing Education58(9), 519-524.

Shea, S. C. (2016). Psychiatric interviewing E-Book: The art of understanding: A practical guide

for psychiatrists, psychologists, counsellors, social workers, nurses, and other mental health professionals. Elsevier Health Sciences.

 REPLY to La Donna

Culture is the way a certain group of people from a particular area of the world does all things including religion, dress, diet, and medical. “Ethnicity is biological and racial, and although tied to culture, may also be separate. It refers to a common social and cultural heritage passed on to each successive generation” (Giger & Davidhizar, 2002). “Acculturation, defined as the degree of an individual’s or ethnic group’s learning and adoption of another group’s values, may involve radical changes in ethnic intensity, eventually resulting in ethnic identity changes” (Borego, et. al., 2019). Acculturation refers to the acquisition and adaptation to the cultural values, attitudes, and practices of the majority culture (Borego, et. al., 2019). According to Balidemaj, “acculturation and ethnic identity are ongoing processes that affect individuals as well as communities” (Balidemaj, 2016).

Balidemaj, Albina (2016) Acculturation, Ethnic Identity, and Psychological Well-Being of Albanian-American Immigrants in the United States. All Dissertations. 1635. https://tigerprints.clemson.edu/all_dissertations/1635

Borrego, J., Ortiz-González, E., & Gissandaner, T. (2019). Ethnic and Cultural Considerations.Science Direct, 21, 461-497. doi:https://doi.org/10.1016/B978-0-12-813004-9.00021-9.

Reply to Lauren

 

There are many different cultures and ethnicities across the world, so when caring for patients understanding culture, ethnicity, and acculturation is important for a health professional to ensure cultural needs are met. Culture consists of many elements, including language, customs, beliefs, traditions, modes of communication, attitudes, beliefs, and behaviors that are shared by members of a group or society, examples of cultural groups are religions, tribes, or social organizations (Falvo, 2011). Acculturation is the adaptation of a person to a new cultural environment, including the customs values, and behaviors (Falvo, 2011). Ethnicity is biological and racial, and is a common social and cultural heritage that is passed on from generation to generation (Giger & Davidhizar, 2004) (Falvo, 2011).

The differences in these terms are culture is learned in a society, ethnicity is an individual’s nationality, and acculturation is adaptation to a new cultural environment. When caring for a patient a nurse should have an understanding of culture, ethnicity and acculturation in order to effectively communicate and care for the patient. Therefore, the health professional should be aware of cultural differences, but also assess the patients on an individual basis, as not to make cultural assumptions about a patient’s beliefs or health practices (Falvo, 2011).

Reference

Falvo, D. (2011). Effective Patient Education: A Guide To Increased Adherence. Retrieved from https://viewer.gcu.edu/RQBKXW

At its core, pathology is the study of disease. Diseases occur for many reasons. But some, such as cystic fibrosis and Parkinson’s Disease, occur because of alterations that prevent cells from functioning normally.

Understanding of signals and symptoms of alterations in cellular processes is a critical step in diagnosis and treatment of many diseases. For the Advanced Practice Registered Nurse (APRN), this understanding can also help educate patients and guide them through their treatment plans.

For this Discussion, you examine a case study and explain the disease that is suggested. You examine the symptoms reported and explain the cells that are involved and potential alterations and impacts.

To prepare:

  • By Day 1 of this week, you will be assigned to a specific scenario for this Discussion. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.
By Day 3 of Week 1

Post an explanation of the disease highlighted in the scenario you were provided. Include the following in your explanation:

  • The role genetics plays in the disease.
  • Why the patient is presenting with the specific symptoms described.
  • The physiologic response to the stimulus presented in the scenario and why you think this response occurred.
  • The cells that are involved in this process.
  • How another characteristic (e.g., gender, genetics) would change your response.

I will be adding a discussion that will need a reply after. I will add 2 of them but at a different time depending on when they are availabe.

Julia’s discussion

In this scenario, it appears that a 16-year-old boy had an allergic reaction to amoxicillin. While this is unfortunate and was probably unavoidable, the provider could have reduced the risk of a medical emergency by asking a few questions. Genetics is important as familial tendency to develop allergic conditions is thought to have a genetic link. In an article published in PubMed, the authors wrote “The allergic diseases are complex phenotypes for which a strong genetic basis has been firmly established.” (Ortiz & Barnes, 2014). It does not say in the scenario, but family medical history could have identified an increased risk for this child, but the order was most appropriate given the diagnosis of Strep throat and the available history.

According to the required reading this week, the clinical manifestations of an allergic reaction are related to histamine being released into the body McCance, K. & Huether, S., 2019) . Acute allergic reactions are mediated by IgE antibodies and arises rapidly after exposure. Symptoms include hypotension, bronchospasm, angioedema (swelling), and urticaria (itching), all reported reactions in this scenario. Acute allergic reactions result from the immune system identifying a substance, in this case, amoxicillin as dangerous as a result of previous exposure (Bhattacharya, 2010). After exposure, there are antibody receptors for that substance in the body, another exposure results in the rapid release of histamine and other mediators from basophils and mast cells. Basophils and mast cells both look granulated. The granules are tiny packets of chemicals: histamine, leukotrienes, and cytokines, and other mediators. When the IgE antibodies on the surface of the basophils and the mast cells encounter an identified allergen, it triggers the cells to degranulate, releasing the contents of the granules out of the cell, where they can act in the body. The release of these vasoactive mediators results in a sudden drop in blood pressure and blood volume, flushing, itching, and bronchospasm, and potential death due to shock.

In the case that his boy had other factors such as he was female, had a family history of sensitivities or autoimmune disorders would have increased his risk of having an allergic reaction. The article “Genetics of allergic disease” went on to say, “Several reports have found that allergic diseases such as asthma, rhinitis, conjunctivitis, and dermatitis as well as allergic reactions to drugs and foods, are more common in patients with the autoimmune disease systemic lupus erythematosus.” (Ortiz & Barnes, 2014). It is important to get a full medical history and family history to avoid potential drug reactions like what was described in this scenario. While genetics alone does not guarantee a reaction, it does increase the risks and should be considered when implementing medications in a patient’s care.

References

Bhattacharya, S. (2010, January). The facts about penicillin allergy: A review. PubMed Central (PMC). Retrieved March 1, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3255391/

McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier

Ortiz, R., & Barnes, K. (2014, November 21). Genetics of allergic diseases. PubMed Central (PMC). Retrieved February 28, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4415518/

Jens Discussion

Discussion Response

The scenario displays a patient that has strep throat. Strep throat is caused by group A streptococci or streptococcus pyogenes (Krishnan et al., 2016). There are many factors that can play a role in regard to how severe the disease can be for the compromised individual. Genetic context is one of those factors. Many people wonder why some children are more prone to getting strep throat over others. Research has shown that a combination of genetic and immunological factors makes some individuals more suspectable (Dan et al., 2019). Kids with recurrent episodes of strep throat have a decrease of both B and follicular helper T cells, and have smaller geminal center areas (Dan et al., 2019). Thus, a poor immune response is associated with these kids. Genetic testing suggests that group A streptococci tonsillitis is more prevalent in people who have two specific gene variants in the HLA region (Dan et al., 2019).

The patient presented with enlarged tonsils, sore throat and cervical adenopathy. These symptoms occurred from the invasion of streptococcus pyogens. The body tries to fight the illness by sending white blood cells to kill the bacteria, which causes an inflammatory response. When foreign bodies are presented to the lymphoid cells, cellular proliferation and enlargement occurs (Maini & Nagalli, 2021). Hyperemia and oedema cause the tonsils to enlarge and convert the lymphoid follicles into abscesses that then become crypts (McCance & Huether, 2019). These crypts produce exudate. A temperature of 99.6 may or may not be an immune response. If the low-grade temp is in correlation with the infection, it is the bodies way to kill the bacteria and make it harder for the pathogen to survive.

Anaphylaxis is a severe reaction with rapid onset and is characterized by breathing or circulatory problems and is usually connected with skin and mucosal changes (Reber et al., 2017). This allergic reaction occurred when the boy took amoxicillin. This response occurred because the body failed to protect itself from the foreign body or antigen (Reber et al., 2017). The exposure to the allergen caused large quantities of Immunoglobin E (IgE) to be released. The antigen binds to IgE which causes chemicals to be released. One of these chemicals that is released from the basophils and mast cells is histamine (Reber et al., 2017). Histamine causes bronchoconstriction, increased gastric motility, vasodilation, and increased vascular permeability (Reber et al., 2017). Histamine is a defense mechanism used to try to destroy the antigen (Reber et al., 2017). Histamine is what caused the boy to have swelling of the tongue and lips, difficulty breathing and audible wheezing.

The effector cells involved in the allergic reaction are mast cells, basophils, macrocytes/macrophages and neutrophils (Reber et al., 2017). Mast cells are key players in anaphylaxis and IgE dependent allergies (Reber et al., 2017). Mast cells emit large numbers of FcεRI, the IgE receptor, during an immune response to an allergen (Reber et al., 2017). These receptors activate the secretion of chemicals such as histamine and cysteinyl leukotrienes (Reber et al., 2017).

Basophils can also express high levels of FcεRI (Reber et al., 2017). There is not enough evidence to show how important basophils are in the pathology of anaphylaxis, however, basophils can help diagnose or determine allergens during an allergen sensitivity test (Reber et al., 2017). IgE dependent activation of human basophils is correlated with higher basophil cell surface makers and forms the basis of “basophil activation tests” or allergen tests (Reber et al., 2017).

Monocytes/macrophages respond to anaphylatoxins and express high levels of FcγRs (Reber et al., 2017). However, there is not enough research to show how much monocytes/macrophages are involved in the anaphylaxis process (Reber et al., 2017). Along with monocytes/macrophages, neutrophils are also an area of continuing studies. Research has recently shown that neutrophils have a T cell priming ability which enhances eosinophil migration (Reber et al., 2017).

Perhaps if the individual in the scenario was a female, the symptoms wouldn’t have been as severe. A study was conducted on mice that showed female mice were more resistant to the group A Steptococcus bacteria (Krishnan et al., 2016). The male mice had greater concentrations of inflammatory cytokines and chemokines, and greater bacterial dissemination (Krishnan et al., 2016).

References

Dan, J. M., Havenar-Daughton, C., Kendric, K., Al-kolla, R., Kaushik, K., Rosales, S. L., Anderson, E. L., LaRock, C. N., Vijayanand, P., Seumois, G., Layfield, D., Cutress, R. I., Ottensmeier, C. H., Linestam Arlehamn, C. S., Sette, A., Nizet, V., Bothwell, M., Brigger, M., & Crotty, S. (2019). Recurrent Group A streptococcus tonsillitis is an immune susceptibility disease involving antibody deficiency and aberrant T follicular helper cells. Science Translational Medicinehttps://doi.org/10.1126/scitranslmed.eaau3776

Krishnan, K. C., Mukundan, S., Alagarsamy, J., Laturnus, D., & Kotb, M. (2016). Host genetic variation and sex differences potentiate predisposition, severity, and outcomes of Group A Streptococcus mediated necrotizing soft tissue infections. Infection and Immunity84(2), 416–424. https://doi.org/10.1128/IAI.01191-15

Maini, R., & Nagalli, S. (2021). Lymphadenopathy. Treasure Island, FL: StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK558918/

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