Task 1.

1. 200 words – Provide a brief overview of the concept of food desert as it relates to urban community. What impact does food desert and access to healthy foods have on population health, within urban communities?  

2. 200 words – Consider the character Nurse Lisa in the book “The Hate You Give”. Consider how the concept of food desert affect her and her family? For example, as a nurse within an underserved urban community her role is to advocate for the health and wellbeing of her clients and community members. What methods/ education can she provide to her clients to increase their access to health good choice when there is limited supplies? 

3. 200 words – Consider the novel “The Hate You Give” relate the novel and it setting to the concept of food desert. 

4. 100 words – How would a community health nurse or public health official address the issue of food desert? 

5. 100 words – What key stakeholders within the community would the official speak to and coordinate with to resolve this problem?

6. 100 words – Provide at least 3 community programs (interventions) that could be established to resolve the problem of food desert? 

7. 200 words – How would you coordinate these interventions? What is the most important aspect of the program intervention? Consider (funding, needs assessment, policy developments etc.)?

Task 2. 

1. 200 words- What are the determinants of health? How does the determinants of health impact health outcome within underserved urban communities?

2. 200 words- Of the many detriments of health which do you think is the most impactful and why? how does the determinants of health relate to the book “The Hate You Give”? provide example? 

Respond to the questions above in APA 7th format.

Each question MUST have subheadings.

Provide at least 7 scholarly resources including the book “The Hate You Give” and the attached textbook. 

 PLEASE FOLLOW THE INSTRUCTIONS BELOW

ZERO PLAGIARISM

4 REFERENCES

Students will:

• Develop effective documentation skills to examine group therapy sessions with children and adolescents *
• Develop diagnoses for child and adolescent clients receiving group psychotherapy *
• Analyze legal and ethical implications of counseling child and adolescent clients with psychiatric disorders *

Select two clients you observed or counseled this week during a group therapy session for children and adolescents. Note: The two clients you select must have attended the same group session. If you select the same group you selected for the Week 8 or Week 9 Journal Entries, you must select different clients.

Then, address in your Practicum Journal the following:

• Using the Group Therapy Progress Note in this week’s Learning Resources, document the group session.
• Describe each client (without violating HIPAA regulations), and identify any pertinent history or medical information, including prescribed medications.
• Using the DSM-5, explain and justify your diagnosis for each client.
• Explain any legal and/or ethical implications related to counseling each client.
• Support your approach with evidence-based literature.

1)  Submit 1 document per part

Part 1: Complete the file “Template Soap Note”  taking into account the following information:

Diagnosis:   (R97.20) Elevated prostate specic antigen [PSA]  

Part 2: Complete the file “Template Soap Note” taking into account the following information:

     Diagnosis:   (H93.13) Tinnitus, bilateral 

Part 3: Complete the “Sample Soap ” taking into account the following information:

    Diagnosis:   (M54.2) Cervicalgia 

2)¨******APA norms, please use headers

          All paragraphs must be narrative and cited in the text- each paragraphs

          Bulleted responses are not accepted

          Dont write in the first person 

          Dont copy and pase the questions.

          Answer the question objectively, do not make introductions to your answers, answer it when you start the paragraph

         Submit 1 document per part

3) It will be verified by Turnitin and SafeAssign

4) Minimum 4 references per part not older than 5 years

Create a pamphlet using your choice of publishing software to educate the staff for which you are the nurse leader. The pamphlet must cover a current patient safety issue.

Examples include:

Teaching aging adults to care for themselves at home

Teaching patients about the possible implications of polypharmacy and providing the skills to avoid self-medication errors

Other appropriate safety issues such as workplace safety

If you have a question about a specific topic, check with your instructor.

Your pamphlet must include the following items:

At least five tips describing preventive care for the patient

Information that should be shared with family or caregivers

Local resources in the community that might be available for this type of safety concern

At least three references published in the last five years; APA format must be used

 I NEED A REPONSE TO THIS ASSIGNEMNT

2 REFERENCES

Therapy for Patients with Personality Disorder

            Personality disorder can be described as a set of behaviors where individuals can identify themselves with and relate to the environment. Most mental health disorders are difficult to diagnose since there is no lab point out for sure what it is. Bipolar personality disorder like most mental health disorder have similar symptoms that are subjective, and so the clinician depends on what the person tells them how they feel. According to the American Psychiatric Association. (, 2013).  A personality disorder is an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment. For this paper, I will be discussing borderline personality disorder, its treatment, both psychotropic and psychotherapy.

            Borderline personality disorder (BPD) is a pattern of instability in interpersonal relationships, self-image, and affects, and marked impulsivity as defined in Diagnostic and statistical Manual-5 (DSM-5) American Psychiatric Association. (, 2013).   BPD symptoms are characterized by the inability of the patient to maintain stable relationships, excessive worrying, feeling lonely, or thinking no one loves them, having problems of being able to regulate their emotions leading to frequent irritability, and feeling depressed and injurious behaviors. Borderline personality disorder (BPD) is a severe mental disorder with symptoms such as affective instability, impulsivity, and self-harm according to Beck, E., et al. (2016). Proper treatment depends on properly identifying the correct personality disorder since many behaviors exist with similar symptoms and comorbid disorders. This comorbidity makes it difficult for a PMHNP who is just beginning difficulty and challenging to treat. In this case, monotherapy is usually not very effective, and hence use of psych pharmacology and psychotherapies should be encouraged, targeting each symptom described or observed by the clinician. BPD may co-occur with substance use disorder (SUD). Research has indicated that chronic, excessive use of substances and problems due to excessive use are potential indicators of the BPD diagnosis that is the BPD impulsivity criterion, according to Trull, T. J., et al. (2018).

            Evidence-based practice research has shown that Mentalization-based behavior group (MBT) therapy and dialectical behavioral therapy (DBT) effectively treat BPD. As for the MBT, the primary goal is to strike a balance between the authority and structure of each session with an open mind to explore the curious stance of the patient. The patients’ profound difficulties with interpersonal functioning and affect regulation require therapeutic techniques potent enough to counteract the difficulties that can arise during sessions. According to Beck, E., et al. (2016). MBT is based on attachment theory and psychodynamic principles and has a high degree of structure and a clear treatment goal of improving patients’ mentalizing skills and may last up to a year. DBT, on its part, focuses on the patient’s inability to control their emotions. It is based on the fact people with BPD are especially sensitive in their reactions and the difficulties to control their tempers either due to their environment they grew up in or due to trauma during childhood or adolescence. The goal here is to train the mind to manage their emotions when exposed to uncomfortable situations. DBT is a good research psychosocial treatment that has been found effective for treating BPD. DBT helps them avoid being so judgmental and critical about themselves as good for nothing person leading to suicidal thoughts.

            Treating BPD with psychopharmacology drugs focuses on the priority symptoms that the person is most concerned about or display as destroying his/her life. Psychotic symptoms such as irritability, suicide ideation, or attempt or self-injurious behaviors might begin with psychotic medications such as Depakote, topiramate, Lamictal, which are anticonvulsants drugs, use off label to treat this disorder. Also, lithium and atypical antipsychotics such as Olanzapine and Abilify that have proven effective in decreasing this disorder. Patients might benefit from antidepressants if they exhibit depression symptoms too. Care must be taken in selecting this medication as their side effects might lead to medication non-compliant. Depakote and lithium levels need to be monitored to avoid toxicity. One will have to assess for insomnia as people with this condition might express irritability and emotional instability.

            Diagnosing BPD, like most mental health illnesses, must be done with care, empathy but at At the same time setting professional boundaries. These patients often take offense when told about their diagnosis as they are often in denial, attentional seeking behaviors, for instance, stating that they were going to hurt themselves. The diagnosis, therefore, must be presented in a manner that validates them with offers to assist them in overcoming their difficulties in controlling like their depression, irritability, suicide ideations, not feeling loved or abandoned by their loved ones.

References.

American Psychiatric Association. (, 2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Beck, E., Bo, S., Gondan, M., Poulsen, S., Pedersen, L., Pedersen, J., & Simonsen, E. (2016). Mentalization-based treatment in groups for adolescents with borderline personality disorder (BPD) or subthreshold BPD versus treatment as usual (M-GAB): study protocol for a randomized controlled trial. Trials, 17(1), 1-13.

Rizvi, S. L., Hughes, C. D., & Thomas, M. C. (2016). The DBT Coach mobile application as an adjunct to treatment for suicidal and self-injuring individuals with borderline personality disorder: A preliminary evaluation and challenges to client utilization. Psychological services, 13(4), 380.

Trull, T. J., Freeman, L. K., Vebares, T. J., Choate, A. M., Helle, A. C., & Wycoff, A. M. (2018). Borderline personality disorder and substance use disorders: an updated review. Borderline personality disorder and emotion dysregulation, 5(1), 15.

INTRODUCTION

Healthcare organizations accredited by the Joint Commission are required to conduct a root cause analysis (RCA) in response to any sentinel event, such as the one described in the scenario attached below. Once the cause is identified and a plan of action established, it is useful to conduct a failure mode and effects analysis (FMEA) to reduce the likelihood that a process would fail. As a member of the healthcare team in the hospital described in this scenario, you have been selected as a member of the team investigating the incident. 

SCENARIO

It is 3:30 p.m. on a Thursday and Mr. B, a 67-year-old patient, arrives at the six-room emergency department (ED) of a sixty-bed rural hospital. He has been brought to the hospital by his son and neighbor. At this time, Mr. B is moaning and complaining of severe pain to his (L) leg and hip area. He states he lost his balance and fell after tripping over his dog.

Mr. B was admitted to the triage room where his vital signs were B/P 120/80, HR-88 (regular), T-98.6, and R-32, and his weight was recorded at 175 pounds. Mr. B. states that he has no known allergies and no previous falls. He states, “My hip area and leg hurt really bad. I have never had anything like this before.” Patient rates pain at 10 out of 10 on the numerical verbal pain scale. He appears to be in moderate distress. His (L) leg appears shortened with swelling (edema in the calf), ecchymosis, and limited range of motion (ROM). Mr. B’s leg is stabilized and then is further evaluated and discharged from triage to the emergency department (ED) patient room. He is admitted by Nurse J. Nurse J finds that Mr. B has a history of impaired glucose tolerance and prostate cancer. At Mr. B’s last visit with his primary care physician, laboratory data revealed elevated cholesterol and lipids. Mr. B’s current medications are atorvastatin and oxycodone for chronic back pain. After Mr. B’s assessment is completed, Nurse J informs Dr. T, the ED physician, of admission findings, and Dr. T proceeds to examine Mr. B.

Staffing on this day consists of two nurses (one RN and one LPN), one secretary, and one emergency department physician. Respiratory therapy is in-house and available as needed. At the time of Mr. B’s arrival, the ED staff is caring for two other patients. One patient is a 43-year-old female complaining of a throbbing headache. The patient rates current pain at 4 out of 10 on numerical verbal pain scale. The patient states that she has a history of migraines. She received treatment, remains stable, and discharge is pending. The second patient is an eight-year-old boy being evaluated for possible appendicitis. Laboratory results are pending for this patient. Both of these patients were examined, evaluated, and cared for by Dr. T and are awaiting further treatment or orders.

After evaluation of Mr. B, Dr. T writes the order for Nurse J to administer diazepam 5 mg IVP to Mr. B. The medication diazepam is administered IVP at 4:05 p.m. After five minutes, the diazepam appears to have had no effect on Mr. B, and Dr. T instructs Nurse J to administer hydromorphone 2 mg IVP. The medication hydromorphone is administered IVP at 4:15 p.m. After five minutes, Dr. T is still not satisfied with the level of sedation Mr. B has achieved and instructs Nurse J to administer another 2 mg of hydromorphone IVP and an additional 5 mg of diazepam IVP. The physician’s goal is for the patient to achieve skeletal muscle relaxation from the diazepam, which will aid in the manual manipulation, relocation, and alignment of Mr. B’s hip. The hydromorphone IVP was administered to achieve pain control and sedation. After reviewing the patient’s medical history, Dr. T notes that the patient’s weight and current regular use of oxycodone appear to be making it more difficult to sedate Mr. B.

Finally, at 4:25 p.m., the patient appears to be sedated, and the successful reduction of his (L) hip takes place. The patient appears to have tolerated the procedure and remains sedated. He is not currently on any supplemental oxygen. The procedure concludes at 4:30 p.m.,and Mr. B is resting without indications of discomfort and distress. At this time, the ED receives an emergency dispatch call alerting the emergency department that the emergency rescue unit paramedics are enroute with a 75-year-old patient in acute respiratory distress. Nurse J places Mr. B on an automatic blood pressure machine programmed to monitor his B/P every five minutes and a pulse oximeter. At this time, Nurse J leaves Mr. B’s room. The nurse allows Mr. B’s son to sit with him as he is being monitored via the blood pressure monitor. At 4:35 p.m., Mr. B’s B/P is 110/62 and his O2 saturation is 92%. He remains without supplemental oxygen and his ECG and respirations are not monitored.

Nurse J and the LPN on duty have received the emergency transport patient. They are also in the process of discharging the other two patients. Meanwhile, the ED lobby has become congested with new incoming patients. At this time, Mr. B’s O2 saturation alarm is heard and shows “low O2 saturation” (currently showing a saturation of 85%). The LPN enters Mr. B’s room briefly, resets the alarm, and repeats the B/P reading.

Nurse J is now fully engaged with the emergency care of the respiratory distress patient, which includes assessments, evaluation, and the ordering of respiratory treatments, CXR, labs, etc.

At 4:43 p.m., Mr. B’s son comes out of the room and informs the nurse that the “monitor is alarming.” When Nurse J enters the room, the blood pressure machine shows Mr. B’s B/P reading is 58/30 and the O2 saturation is 79%. The patient is not breathing and no palpable pulse can be detected.

A STAT CODE is called and the son is escorted to the waiting room. The code team arrives and begins resuscitative efforts. When connected to the cardiac monitor, Mr. B is found to be in ventricular fibrillation. CPR begins immediately by the RN, and Mr. B is intubated. He is defibrillated and reversal agents, IV fluids, and vasopressors are administered. After 30 minutes of interventions, the ECG returns to a normal sinus rhythm with a pulse and a B/P of 110/70. The patient is not breathing on his own and is fully dependent on the ventilator. The patient’s pupils are fixed and dilated. He has no spontaneous movements and does not respond to noxious stimuli. Air transport is called, and upon the family’s wishes, the patient is transferred to a tertiary facility for advanced care.

Seven days later, the receiving hospital informed the rural hospital that EEG’s had determined brain death in Mr. B. The family had requested life-support be removed, and Mr. B subsequently died.

Additional information: The hospital where Mr. B. was originally seen and treated had a moderate sedation/analgesia (“conscious sedation”) policy that requires that the patient remains on continuous B/P, ECG, and pulse oximeter throughout the procedure and until the patient meets specific discharge criteria (i.e., fully awake, VSS, no N/V, and able to void). All practitioners who perform moderate sedation must first successfully complete the hospital’s moderate sedation training module. The training module includes drug selection as well as acceptable dose ranges. Additional (backup) staff was available on the day of the incident. Nurse J had completed the moderate sedation module. Nurse J had current ACLS certification and was an experienced critical care nurse. Nurse J’s prior annual clinical evaluations by the manager demonstrated that the nurse was “meeting requirements.” Nurse J did not have a history of negligent patient care. Sufficient equipment was available and in working order in the ED on this day.

REQUIREMENTS

Your submission must be your original work. No more than a combined total of 30% of the submission and no more than a 10% match to any one individual source can be directly quoted or closely paraphrased from sources, even if cited correctly. An originality report is provided when you submit your task that can be used as a guide.

You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course.

A. Explain the general purpose of conducting a root cause analysis (RCA).

1. Explain each of the six steps used to conduct an RCA, as defined by IHI.

2. Apply the RCA process to the scenario to describe the causative and contributing factors that led to the sentinel event outcome.

B. Propose a process improvement plan that would decrease the likelihood of a reoccurrence of the scenario outcome.

1. Discuss how each phase of Lewin’s change theory on the human side of change could be applied to the proposed improvement plan.

C. Explain the general purpose of the failure mode and effects analysis (FMEA) process.

1. Describe the steps of the FMEA process as defined by IHI.

2. Complete the attached FMEA table by appropriately applying the scales of severity, occurrence, and detection to the process improvement plan proposed in part B. 

Note: You are not expected to carry out the full FMEA.

D. Explain how you would test the interventions from the process improvement plan from part B to improve care.

E. Explain how a professional nurse can competently demonstrate leadership in each of the following areas:

• promoting quality care

• improving patient outcomes

• influencing quality improvement activities

1. Discuss how the involvement of the professional nurse in the RCA and FMEA processes demonstrates leadership qualities.

F. Acknowledge sources, using in-text citations and references, for content that is quoted, paraphrased, or summarized.

G. Demonstrate professional communication in the content and presentation of your submission.

File RestrictionsFile name may contain only letters, numbers, spaces, and these symbols: ! – _ . * ‘ ( )
File size limit: 200 MB
File types allowed: doc, docx, rtf, xls, xlsx, ppt, pptx, odt, pdf, txt, qt, mov, mpg, avi, mp3, wav, mp4, wma, flv, asf, mpeg, wmv, m4v, svg, tif, tiff, jpeg, jpg, gif, png, zip, rar, tar, 7z
RUBRIC

Instructions

Aggregate Community Windshield Survey

There are two parts to the windshield survey assignment. In Week 1 you are required to submit a draft of your survey. In Week 2 you will submit your final windshield survey based on feedback from your instructor and your continued work.

In a Microsoft Word document of 3-4 pages formatted in APA style, you will describe the aggregate and community in which the aggregate is located. Please note that the title and reference pages should not be included in the total page count of your paper.

Describe the Aggregate

Begin the assignment by describing your aggregate. Include the following information:

• Name of the aggregate
• Geographical location and size
• Population
• A brief history
• Basic vital statistics
• Crude birth rate, infant mortality rate, life expectancy, leading causes of death, and any other relevant statistical information related to the health of the aggregate from the windshield survey.
• Explain, giving at least two reasons, why you selected this particular aggregate for your Capstone project

Windshield Survey

With the use of public transportation or by driving a vehicle around the community, you can assess the common characteristics of the community of your selected aggregate.

Key observations to make during a windshield survey include the following:

• Age and condition of the homes in the community
• Location and condition of parks and other recreational areas
• Amount of space between homes and businesses
• Neighborhood hangouts
• Transportation in the community
• Quality of streets and sidewalks
• Types/numbers of stores and other businesses
• People out in the community
• Race/ethnicity
• Cleanliness of the community
• Billboards or other media displays
• Places of worship
• Availability of services—doctor, dentist, social centers, recreation centers, hospitals

On a separate references page, cite all sources using APA format. Helpful APA guides and resources are available in the South University Online Library. Below are guides that are located in the library and can be accessed and downloaded via the South University Online Citation Resources: APA Style page. The American Psychological Association website also provides detailed guidance on formatting, citations, and references at APA Style.

• APA Citation Helper
• APA Citations Quick Sheet
• APA-Style Formatting Guidelines for a Written Essay
• Basic Essay Template

Quantitative and qualitative techniques are the main approaches used to evaluate evidence in nursing research (Liddle, Williamson & Irwig, 2016). Quantitative technique entails assessment of data and comparison of various measures used in the research study. Metrics applied in quantitative method of evidence evaluation include standard deviation, mean or average, as well as other statistical parameters. In addition, quantitative criteria is a measurable formal tool used for predicting, and ensures objectivity of both the results and applied variables.

Conceptual framework in respect to qualitative methods of evaluating evidence involve assessment of the process, meanings, experiences, and perceptions that study subjects including patients with reference to a particular variable under evaluation (Jake-Schoffman, Silfee, Waring, Boudreaux, Sadasivam, Mullen & Pagoto, 2017). However, qualitative approach is not used in measurable parameters. Nevertheless, in order to analyze the relevance of evidence, interpretation we use of emphatic comprehensions. The above implies that the findings and variables relies on the context of research study.

References

Liddle J, Williamson, M, & Irwig, L. (2016). Method for evaluating research and guideline evidence. Sydney: NSW Health Department.

Jake-Schoffman, D. E., Silfee, V. J., Waring, M. E., Boudreaux, E. D., Sadasivam, R. S., Mullen, S. P. … & Pagoto, S. L. (2017). Methods for evaluating the content, usability, and efficacy of commercial mobile health apps. JMIR mHealth and uHealth, 5(12), e190.

REPLY2

In conducting a research, the researcher often needs evidence from a variety of articles, journals, and/or other studies to direct, guide, and support his or her research. However, it is not every evidence that the researcher finds online, in journals, or in the library that can provide valuable evidence in research. In other words, evidence must be reliable and valid before it can be used in research, and must take the study’s methodology, as well as other important factors into consideration (East Carolina University Libraries, 2020).

Two different methods for evaluating evidence would include criteria pertaining to publication characteristics and criteria pertaining to study design and relevance to the study and variables of interest (Treadwell et al, 2011). Evaluating evidence through its publication characteristics involves determining the source or evidence is peer-reviewed or whether it is a practice-based publication that publishes expert opinions about a specific issue. Another publication characteristic that must be considered when evaluating research evidence is the year of publication. Evidence published not more than five years ago are considered more appropriate than older evidence. Lastly, language of publication should also be considered when evaluating research evidence because of translation problems. On the other hand, evaluating evidence through the study design and study relevance criteria involves determining the kinds of research methodology used in the evidence and the relevance of such evidence to your own study or in explaining your variables of interest, and the applicability of such evidence to nursing practice. The hierarchy of research designs and levels of scientific evidence suggests that Meta- Analysis Systematic Reviews and Randomized Controlled Trials provide a more reliable and valid evidence in nursing research (Bowen and Forrest, 2017).

                                                                                    References

Bowen, D. M., & Forrest, J. L. (2017). Translating Research for Evidence-Based Practice. Access, 10–14.

East Carolina University Libraries. (2020). Evidence-Based Practice for Nursing: Evaluating the Evidence. Available from: https://libguides.ecu.edu/c.php?g=17486&p=97640

Treadwell, J. R., Singh, S., Talati, R., McPheeters, M. L., Reston, J. T. (2011). A Framework for “Best Evidence” Approaches in Systematic Reviews [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2011 Jun. Available from: https://www.ncbi.nlm.nih.gov/books/NBK56653/

Doctorate degree Nursing program

 In your review of evidence, you locate a quasi-experimental research study as possible evidence to support a practice change. You notice that the study aims to make a prediction that relates to correlation between study variables. The study sample size is large and normally distributed. Reflect upon this scenario to address the following.

· In your appraisal of the evidence, you note that an independent variable is not present and that a Spearman’s ranked correlation is used to analyze data. Is this the correct level of correlational analysis? Explain your rationale.

· Are association and correlational analysis equivalent in determining relationships between variables?

· Do these findings impact your decision about whether to use this evidence to inform practice change? Why or why not?

Reading: 

Polit, D. F., & Beck, C. T. (Eds.). (2017). Nursing research: Generating and assessing evidence or nursing practice (10th ed.). Wolters Kluwer.

· Chapter 16: Descriptive Statistics

· Chapter 17: Inferential Statistics

· Chapter 18: Multivariate Statistics

· Chapter 19: Processes of Quantitative Data Analysis

· Chapter 20: Clinical Significance and Interpretation of Quantitative Result

1 page, single spacing.

at least 2 references (must be within 5 years so between 2015 and 2020) 

Absolutely plagirism free. Please run on turnitin.com

APA (7th ed) format. 

Examine the importance of professional associations in nursing. Choose a professional nursing organization that relates to your specialty area, or a specialty area in which you are interested. In a 750‐1,000 word paper, provide a detailed overview the organization and its advantages for members. Include the following:

1. Describe the organization and its significance to nurses in the specialty area. Include its purpose, mission, and vision. Describe the overall benefits, or “perks,” of being a member.
2. Explain why it is important for a nurse in this specialty field to network. Discuss how this organization creates networking opportunities for nurses.
3. Discuss how the organization keeps its members informed of health care changes and changes to practice that affect the specialty area.
4.  Discuss opportunities for continuing education and professional development.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. 

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.