Detection of covid-19 using an infrared fever screening system (IFSS) based on deep learning

Review Comments-1:

1. Detection of covid-19 using an infrared fever screening system (IFSS) based on deep learning

technology is the proposed title of this paper.

2. Keyword should be start with capital letter.

3. How to detect the visual images?

4. Selection of ML should be justified by the author.

5. How to provide screening data for each individual as output?

6. Explain the role of pooling layers?

7. Literary style of the paper should be improved.

8. Paper should be prepared as per template prescribed.

9. Figures are of poor resolution and clarity.

10. Minimum of 15 reference papers should be used in the reference section.

11. Dataset details are inadequate.

Review Comments-2:

There are adjustments for the authors have to be considered:

1. Detection of Covid-19 using an Infrared Fever Screening System (IFSS) based on Deep

Learning Technology is the proposed title of the paper.

Proceedings by Previous Publications

2022, 2021, 2020, 2019, 2018, 2017

2. There is evidence of research, but you need to relate it to your own study and more literature-

based evaluation in the discussion

3. The strengths and weaknesses of the method described in the paper can be clearly defined.

4. Comparative analysis with existing models related to efficiency computation may be provided

in a tabular format

5. The figures are of poor clarity and resolution. Figures taken from the literature should be cited

for their source.

6. Try to cite all the references used in the work and some of the references are not cited in the

work

7. Conclusion and Future Scope should be improved related to the proposed work.

Research solutions and detail the appropriate Microsoft Windows access controls

PointsComments
1. Research solutions and detail the appropriate Microsoft Windows access controls including policies, standards and procedures that define who users are, what they can do, which resources they can access, and what operations they can perform on a system.1010
2. Research and detail the cryptography methods to protect organizational information using techniques that ensure its integrity, confidentiality, authenticity and non-repudiation, and the recovery of encrypted information in its original form.1010
3. Research and devise a plan to thwart malicious code and activity by implementing countermeasures and prevention techniques for dealing with viruses, worms, logic bombs, Trojan horses and other related forms of intentionally created deviant code.1010
4. Research and formulate a plan to implement monitoring and analysis by determining system implementation and access as well as an incident response plan for security breaches or events.1010
5. Research and detail security guidelines for contains the two proxy servers and Internet access control for the organization1010
6. Research and define best practices for the security of NextGard’s organization.

What is the objective of footprinting?

Critical Thinking

There are numerous tools/techniques that allow hackers to gather a considerable amount of information about a target.

Write a short paper on footprinting by answering all the following:

· What is the objective of footprinting?

· What are some various footprinting tools/techniques?

· What type of information can these footprinting tools/techniques provide?

· How can organizations defend against footprinting and reconnaissance activities?

Your paper is required to be 3-4 pages in length, Not including the title and reference pages. It should follow 7th APA style guidelines, as appropriate.

It is strongly encouraged that you submit all assignments to the Turnitin Originality Check prior to submitting it to your instructor for grading. If you are unsure how to submit an assignment to the Originality Check tool, please review the Turnitin Originality Check Student Guide in your Student User Manual for step-by-step instructions.

Using SQL Server Management Studio Designer tools, create the database.

PART 1

Assignment Instructions

You will need to install and use Microsoft SQL Server Express and Microsoft SQL Server Management Studio (SSMS) for this course. You can download the latest versions of these free software products here:

Microsoft SQL Server Express

Microsoft SSMS

· Identify the elements to be included in the physical data model.

· Using SQL Server Management Studio Designer tools, create the database.

· Using SQL Server Management Studio Designer tools, create the tables (convert entity names to table names).

· Using SQL Server Management Studio Designer tools, associate column names (convert attribute names to column or field names), datatype, and number of characters for each attribute (field).

· Using SQL Server Management Studio Designer tools, establish the primary keys for each of the tables.

· Using SQL Server Management Studio Designer tools, establish any foreign keys for each of the tables (here you are converting your relationships to foreign keys).

· Create a screenshot of your SQL Management Studio showing the database and tables you have created; embed this screenshot into your Word document.

Please use the following guidance document to help you complete this assignment:  Instructions for Using the Microsoft SSMS Designer Tools to Generate the Movies Database

You will need to use the established  database design diagram  and  Movies Dataset  for this assignment. Download and use the diagram and data for your analysis.

Assignment Requirements

Microsoft SQL Server Express and SQL Server Management Studio (SSMS) MUST be installed to complete this Assignment.

Compose your Assignment in a Word document and be sure to identify yourself, your class, and unit Assignment at the top of your paper. Embed the screenshots from SQL Server Management Studio showing the work performed for the creation of the database and tables.

PART 2

In Assignment part 1, you created a physical model for a database using SQL Server Management Studio Designer tools. You can also create a database using SQL Data Definition Language (DDL) statements. In this unit, you will create the same database using the SQL CREATE statement to create the database and the tables. In business, you will have choices of different methods for creating a database, so you want to be familiar with the various options.

Assignment Instructions

You will need to install and use Microsoft SQL Server Express and Microsoft SQL Server Management Studio (SSMS) for this course. You can download the latest versions of these free software products here:

Microsoft SQL Server Express

Microsoft SSMS

Use the SQL Management Studio Query Window to implement a new version of the Movies database. You will name this database  Movies_2.

· Create the database using the SQL CREATE statement.

· Create the tables using the SQL CREATE statement.

· Associate column names and datatype using the SQL create statement.

· Establish the primary and foreign keys for each table.

· Create a screenshot of your SQL Queries that you used to create the database and tables.

You will need to use the established database design diagram and Movies Dataset you used in Assignment 1 of this unit for the Movies 2 implementation. Download and use the diagram and data for your analysis.

Assignment Requirements

Microsoft SQL Server Express and SQL Server Management Studio (SSMS) MUST be installed to complete this Assignment.

Compose your Assignment in a Word document and be sure to identify yourself, your class, and unit Assignment at the top of your paper. Embed the screenshots of your SQL statements and confirmatory output (e.g., table structure definitions) into the Word document.

 Exp22_Word_Ch02_Cumulative_Pool

Project Description:

You and a friend from college are starting a new business, Pool Pros, a pool maintenance and supplies operation. You plan to have on hand various documents and brochures related to pool ownership, one of which you are working with now. You will use skills presented in this chapter to format text, adjust alignment and indents, bullet and number lists, and incorporate various types of graphic objects that help describe the process of caring for a pool.

Start Word. Download and open   the file named Exp22_Word_Ch02_Cumulative_Pool.docx.   Grader has automatically added your last name to the beginning of the   filename. Ensure that nonprinting characters are displayed.

Select crystal-clear perfection at the end of the first body paragraph   and bold it. Select all text and change the font to Arial. Change the   alignment of selected text to Justify.

Select the first two body   paragraphs on page 1 and adjust the line spacing to 1.5. Ensure that   paragraph spacing before and after is 0 pt for the selected paragraphs. Apply   a First line indent for the two paragraphs of 0.5″. 

Select all subheadings that are   formatted in bold and change the font size to 14

Select the four paragraphs that   precede the Get Rid of Debris   heading, beginning with Check the   pool’s water balance and ending with Add   an algaecide. Add a Box, double-line border with ¾ line weight and a color of   Blue-Gray, Text 2 (fourth column, first row). Shade the bordered area with Blue-Gray, Text 2 Lighter 60%   (fourth column, third row under Theme Colors).

Display the ruler. Click or   position the insertion point at the top of the document and press ENTER.   Click or select the newly inserted blank paragraph. Drag or move the First   line indent marker back to the left margin to remove the First line indent   from the blank paragraph.

Set a left tab at 1″ and a   right tab at 5″. Ensure that the right tab includes a dash leader. Press   TAB and type Your Pool. (Do not type the period.) Press TAB and type Your Way. (Do not type the period.) Change the font for Your Pool and Your Way to Lucida Calligraphy. Bold both text items on the first   line and change the font size to 10.

Click or position the insertion   point before the second sentence in the first body paragraph at the top of   page 3. The sentence begins with Add   more in hot weather. Delete the preceding space and period that ends the   first sentence. Insert an Em dash symbol and change the case of Add   to add.

Select the four paragraphs in   the shaded area near the top of page 1. Apply numbering, choosing Number   alignment: Left (1., 2., 3.).

Click or position the insertion   point at the top of the document and insert WordArt, selecting Fill: Blue,   Accent color 1; Shadow (row 1, column 2). Type Pool Maintenance. (Do not type the period.)   Change the font size of Pool   Maintenance to 24 and change the Text Fill to Black, Text 1. Ensure that WordArt   font is Arial. Wrap text at Top and Bottom and visually center the WordArt   horizontally on the first line 

Click or position the insertion   point at the end of the document and press ENTER. Insert SmartArt, selecting   Basic Cycle. Display the Text pane. Type Get rid of debris beside the first bullet. Type Vacuum pool beside the second bullet. Type Adjust   chemicals beside   the next bullet. Type Backwash filter and Add chlorine beside the next two bullets. Close the Text pane.

Adjust the SmartArt height to   3″ and the width to 5″. Choose Polished SmartArt style and change colors to Gradient Range   – Accent 3 (row 5, column 3). Choose text wrapping of Square. Align the   SmartArt object in the center relative to margins.

Click or position the insertion   point at the top of the document. Insert a Sun shape from the Basic Shapes category. Draw the   shape approximately 1″ wide and 1″ high, near the left margin on the top line   of the document. Using the Shape Format tab, adjust the height and width to   exactly 1″.

Change the shape fill of the sun   to Yellow. Insert a Cloud shape from the Basic Shapes category, sizing it to   be approximately ¾” high and ¾” wide. Position the shape so that it   overlaps the top right corner of the Sun shape. Change the shape fill of the   cloud to Light   Gray, Background 2. Send the cloud to the back so that it appears to be   peeking out from behind the sun.

Group the cloud and sun shapes   into one object. Duplicate the shape and drag the copy to the right, aligning   it at the right margin on the same line as the WordArt heading. Align the   first shape at the left margin, approximating a mirrored placement of the   copied shape.

Draw a text box of any size near   the middle of page 2. Copy the first sentence in the document, On a searing summer day, a swimming pool   is a welcome respite from the heat. (Include the period.) Paste the   copied sentence in the text box. Adjust text box height to 1″ and width   to 3″. Choose Tight text wrapping.

Change the font size of text in   the text box to 14 and change the font to Tahoma. Center the text. Click or press   Align in the Arrange group on the Shape Format tab and align the text box in   the middle and also in the center of the page. If the text box awkwardly   divides a heading, drag or move it down slightly to better position it   visually. Remove the outline from the text box and apply a shape fill of   Blue-Gray, Text 2, Lighter 80%.

View the document in Multiple   Pages and check for any poorly placed headings. Insert a page break before Vacuum the Pool at the bottom of page   1. Insert a page break before Add   Chlorine to the System at the bottom of page 2.

Save and close Exp22_Word_Ch02_Cumulative_Pool.docx.   Exit Word. Submit the file as directed.

Exp22_Word_Ch02_CumulativeAssessment – Space

Project Description:

In this project, you will use Word to prepare a document publicizing a series of space camp programs, designed for families and individuals. You will format the document as appropriate and include graphics to enhance document content.

Start Word. Download and open   the file named Exp22_Word_Ch02_CumulativeAssessment_Space.docx.   Grader has automatically added your last name to the beginning of the   filename. Ensure that nonprinting characters are displayed.

Select Underwater Astronaut Trainer in the first body paragraph and bold   it. Select Thermal Design Challenge   in the first body paragraph and bold it. Select all text from Space Academy on page 1 through Pack your bags on page 2 and change   the font to Cambria with a font size of 14. Change the alignment of selected   text to Justify.

Select the bulleted activities   in the Space Academy section on   page 1 and adjust the line spacing to 1.15. Ensure that paragraph spacing   before and after is 0 pt for the selected paragraphs.

Use Format Painter to copy the   format of the bulleted items in the Space   Academy section to bulleted items in the Space Camp section and also in the Adult Space Academy   section. 

Select the final three   paragraphs that are shown above the boxed area at the end of the document,   beginning with Sign up online and   ending with Pack your bags. Apply   numbering, selecting numbers that are followed by a period. Decrease the   indent so that the items begin at the left margin.

Display the ruler. Click or   select the blank paragraph above the bordered text at the end of the   document. Press ENTER. Set a left tab at 1″ and a right tab at 6″. Ensure that the right   tab includes a dash leader. Ensure that the font is 14 pt Cambria.

Press TAB and type SPACE ADVENTURE. (Do not type the period.) Press TAB and type DAVIDSON SPACE CENTER. (Do not type the period.) Drag   or move the 6” tab back to 5.5” on the ruler. Bold the tabbed line of text.

Select the tabbed line of text   and apply a Box border, choosing the first double-line style and ¾ pt width. 

Select the Space Camp Programs heading   at the top of the document. Insert WordArt, choosing Fill: Gray, Accent Color   3; Sharp Bevel (row 2, column 5). Ensure that the font size of the WordArt   heading is 36.

Click or place the insertion at   the end of the third bulleted item at the top of page 2, Compete in camp-wide Challenge nights! Press ENTER. Remove the   bullet from the new line. Insert SmartArt, selecting Circle Arrow Process from the Process group. Type Space Academy   in the top text   placeholder. Type Space Camp in the middle text placeholder. Type Adult Space   Academy in the   lower text placeholder.

Adjust the SmartArt height to   2″ and width to   2”. Change colors to Colorful Range – Accent Colors 2 to 3. Position the   SmartArt object, choosing Position in Middle Right with Square Text Wrapping.

Click or position the insertion   point at the top of the document, beside the Space Academy heading. Insert a Star: 4 Points shape from the Stars and Banners   category. Draw the shape approximately 1″ wide and 1″ high, near   the left margin on the top line of the document. Using the Shape Format tab,   adjust the height and width to exactly 1.

Click or press Align in the   Arrange group on the Shape Format tab. Ensure that Align to Page is selected.   Click or select Align and align the shape in the center. Send the star to the   back so that it is located behind the WordArt heading object.

Change the shape fill of the   star to Gray, Accent 3, Lighter 80%. Change the Shape Outline to Black, Text   1. Apply a glow effect of Glow: 5 point, Orange, Accent color 2.

Group the star and WordArt items   into one object. Change text wrapping of the grouped object to Top and   Bottom.

Select the text Space Academy is the place for trainees to   experience first-hand the future of space travel, and train to solve   technically challenging problems the first sentence in the document. Copy   the selection. Deselect the text. Draw a text box of any size near the middle   of page 1 and paste the copied sentence in the text box. End the sentence   with a period. Adjust text box height to 2″ and width to 4″.

Change the font size of text in   the text box to 20 and change the font to Baskerville Old Face. Center the text.   Adjust text wrapping of the text box to Square. Drag or move the text box to   position it at the left margin above the Space   Camp heading near the bottom of page 1. Two bulleted items should wrap on   the right side of the text box. Apply a shape fill of Gray, Accent 3, Lighter   80%.

View the document in Multiple   Pages and check for any poorly placed headings or shapes. Insert a page break   before Activities at the bottom of   page 1. Insert a page break before It’s   as easy as 1-2-3 at the bottom of page 2.

Save and close Exp22_Word_Ch02_ML2_CumulativeAssessment_Space.docx.   Exit Word. Submit the file as directed.

PU Strategy Formulation Presentation

In 2004, High Deductible Health Plans (HDHP) came into being as an employer sponsored alternative to more traditional health plans. Since the passage of the Patient Protection and Accountable Care Act in 2010, there has been in increase in the volume of HDHP enrollments. At present, roughly 29% of the U.S. population is enrolled in a HDHP. These plans require employees to setup health savings accounts (HSA), which are pre-taxed dollars set aside to cover allowable healthcare-related expenses. In order for a HDHP to be considered a qualifying plan, there must be a minimum annual deductible and an out-of-pocket maximum. These amounts are typically adjusted upward by the Internal Revenue Service (IRS) to account for inflation.

Since the enrollees are taking on more of the financial risk through the higher deductibles, the monthly premiums tend to be lower than are typically associated with more traditional health plans. Since consumers are having to pay more out of their pockets to cover healthcare costs, they are becoming more price sensitive and inclined to shop around for best pricing from providers and provider organizations.

On January 1, 2019, the Inpatient Prospective Payment System rule went into effect, which requires hospitals receiving reimbursement from the Centers for Medicare and Medicaid Services (CMS) to post their standard procedure prices online. President Trump implemented this rule in an attempt to create a society of informed health care consumers. Now that consumers are becoming more cost conscious and expecting the best possible value for their dollar spent, providers and provider organizations need to reexamine their marketing strategies.

Memorial Hermann, the largest healthcare system in Southeast Texas, believes it’s time to audit their marketing strategy and propose specific marketing strategies that the System can employ to expand their overall work share. This graded activity is designed to familiarize you with concepts typically associated with strategic marketing to include, but necessarily limited to: target marketing, brand management, advertising and promotion management, social media, website and search engine marketing/search engine optimization, Internet marketing, and marketing research to include analytics and qualitative analysis.

According to their website, Memorial Hermann states that:

“At Memorial Hermann, we’re all about advancing health. Yours. It begins by redefining healthcare. That means bringing together all aspects of the health system – care delivery, physicians and health solutions to create a truly integrated health system. Our 5,500 affiliated physicians and 24,000 employees practice evidence-based medicine with a relentless focus on quality and patient safety. Our efforts continue to result in national awards and recognition, including being ranked one of the nation’s Top 5 large health systems by Truven Health for patient safety and quality. The largest not-for-profit health system in Southeast Texas, Memorial Hermann has 14 hospitals and numerous specialty programs and services conveniently located throughout the Greater Houston area. Memorial Hermann-Texas Medical Center is one of the Nation’s busiest Level I trauma centers and the primary teaching hospital for McGovern Medical School at UTHealth. We offer leading-edge diagnostic technologies and treatment techniques as well as Houston’s first health information exchange that shares vital patient data among care providers, helping to ensure patients receive the right care at the right time. Our Memorial Hermann Physician Network, MHMD, comprises physicians from Memorial Hermann Medical Group, UTHealth and private physicians and specialists. Memorial Hermann Health Solutions’ subsidiaries offer comprehensive, integrated health solutions that deliver quality benefits while helping to contain costs. We’ve proudly served this community for more than 108 years, and contribute some $438 million annually through school-based health centers and other programs.”

Unit Learning Outcomes

ULO 3: Recommend marketing strategies based on the application of marketing analytics and qualitative research.

ULO 4: Critique organizational social media and Internet marketing strategies to ascertain alignment with a firm’s directional strategy.

ULO 5: Evaluate the benefits and consequences of content and search engine marketing as tools to engaging customers and creating value.

Directions

Initial Posting

To aid you in successfully completing this assignment, you might consider using scholarly and credible sources to lookup topics related to brand management, advertising and promotion management, digital marketing platforms, and Internet marketing.

Additionally, you may want to consider topics associated with the strategic importance of brand and its’ management; representation import of branding to consumers; consumer behaviors; and activities involved in managing an advertising campaign. This is neither intended nor to be construed as an “all inclusive” listing of topics related to this assignment, but may serve as a good starting point for your review of the existing literature.

You are a member of the Memorial Hermann Health System’s Marketing Department, located in Houston, Texas. The Department Director has asked you to propose specific marketing strategies that the System can employ to expand their overall market share. You will be asked to prepare a brief presentation, not to exceed 15 minutes, to members of your marketing team. In preparation for your presentation, you are expected to prepare a PowerPoint slide deck with voice over.

Based on his life story and the variables listed in “Factors that Impact Past, Current & Future Housing” (e.g., income, educational level, health, race, culture, public policy), identify which factors identified in Samuel’s story likely influenced how he arrived at his current housing situation.

Post your Samuel findings:

Step 1: Looking Back: How did he get there?

  1. Based on his life story and the information in the “Housing Policies & Race Relations” historical chart, identify which policies/historical events likely influenced how Samuel arrived at his current housing situation. Be sure to also explain how and why these policies affected his trajectory to his current housing.
  2. Based on his life story and the variables listed in “Factors that Impact Past, Current & Future Housing” (e.g., income, educational level, health, race, culture, public policy), identify which factors identified in Samuel’s story likely influenced how he arrived at his current housing situation. Be sure to also explain how and why these factors affected his trajectory to his current housing.
  3. Using the paper/markers provided, draw a visual representation of how you see the above factors influenced Samuel’s trajectory/pathway into his current housing situation.

Step 2: Looking Forward: Where is he headed?

  1. Using the information identified above, consider what Samuel’s housing situation will be in the future (e.g., as he ages). What type of housing will it be? Why?
  2. Using the paper/markers provided, draw a visual representation of what you anticipate Samuel’s future housing situation will look like. Be sure to include the trajectory/pathway you anticipate he will follow, as well as the factors (and their specific influences) that you expect will lead to his future housing situation.

Step 3: Class Discussion:

  1. Be prepared to describe/explain your group’s findings for Step 1 and 2 (above), using the visual representations you have prepared:
    1. What do you see as the factors that led Samuel to his current housing situation? Why?
    2. What do you see as the factors that will lead to Samuel’s future housing situation? Why?
    3. What roles do public policies play in determining Samuel’s past, current, and future housing situations?
    4. What challenges did your group experience in interpreting Samuel’s life course?
    5. How did you resolve these challenges?
    6. What role did your own social location have on how you interpreted Samuel’s past and future?                                                              part 2
    7. 1. What similarities/differences did you notice between the content of each presentations? Please be specific!2. What do you think accounts for these similarities/differences? Why?3. What can we learn about senior housing from this activity? Why?4. What questions/concerns do you have regarding this topic/activity?                                                                                          part
    8. .  
    9.      1.  Select, consider and explain how one of the “Required” readings for this week (your choice) relates to Week 8’s Samuel activity and this week’s presentations/discussions (please be specific).2. Select, consider and explain how one of the “Module” readings for this week (your choice) relates to last week’s Samuel activity and this week’s presentations/discussions (please be specific).

Samuel is a 56-year-old science teacher who both lives and works in Robbinsdale, MN. He and Lisa have been married for 7 years—not long after they met at a support group for widowed spouses. After Lisa’s son, now 23, moved away for college, Samuel and Lisa moved into a split-level condo so that there would be room for Samuel’s father to come live with them some day. Samuel’s father, once a Tuskegee Airman, is a quiet but fiercely independent man who has other ideas. His father’s current memory lapses, however, have Samuel concerned that his father probably shouldn’t live on his own much longer.

Step 1: Looking Back: How did he get there? 1. Based on his life story and the information in the “Housing Policies and Race Relations” historical chart, identify which policies/historical events likely influenced how Samuel arrived at his current housing situation. Be sure to also explain how and why these policies affected his trajectory to his current housing.

2. Based on his life story and the variables listed in “Factors That Impact Past, Current, and Future Housing” (e.g., income, educational level, health, race, culture, public policy), identify which factors identified in Samuel’s story likely influenced how he arrived at his current housing situation. Be sure to also explain how and why these factors affected his trajectory to his current housing.

3. Using the paper/markers provided, draw a visual representation of how you see the previously noted factors influencing Samuel’s trajectory/pathway into his current housing situation. Step 2: Looking Forward: Where is he headed?

4. Using the information identified earlier, consider what Samuel’s housing situation will be in the future (e.g., as he ages). What type of housing will it be? Why?

5. Using the paper/markers provided, draw a visual representation of what you anticipate Samuel’s future housing situation will look like. Be sure to include the trajectory/pathway you anticipate he will follow, as well as the factors (and their specific influences) that you expect will lead to his future housing situation. Step 3: Class Discussion:

6. Be prepared to describe/explain your group’s findings for Step 1 and Step 2, using the visual representations you have prepared: a. What do you see as the factors that led Samuel to his current housing situation? Why? b. What do you see as the factors that will lead to Samuel’s future housing situation? Why? c. What roles do public policies play in determining Samuel’s past, current, and future housing situations?

What are Red’s strengths? 

  Red Yoder is an 80-year-old farmer who lives alone in the farmhouse where he grew up. It is located 20 miles outside of town. Red has been a widower for 10 years. His son Jon manages the farm now, but Red is still involved in the decision making. Red’s current medical problems include insulin dependent diabetes complicated by an open foot wound. He also has some incontinence and difficulty sleeping. 

Red is awaiting a visit from the home health nurses. He relates that he has an open wound on his big toe that developed after walking in a new pair of shoes. When his daughter-in-law Judy saw the wound, she called the family doctor, who suggested a visit by the wound care nurse who works with the home health agency. Red agreed as long as his VA benefits cover the costs. Red is aware that his son and daughter-in-law have concerns about him living alone, but Red insists that while he needs a little help from Jon and Judy at times, he is still capable of caring for himself. 

I understand you want to hear my story; well I’m not much for talking, but I can give you the highlights. There’s a lot that’s happened over my 80 years. From the top. My name is Sherman Yoder, but I answer to “Red.” No one around here even remembers my real name. I was born in this house in the downstairs bedroom. Mom had already delivered six kids and there was no way I was waiting for Dad to finish feeding the hogs and get Mom to town before I come out. Mom used to love to tell that story. Dad bought this farmhouse and the first hundred acres right before he went off to WWI. The folks saw good times and bad in this ol’ place and so have I. All my brothers and sisters left the land as soon as they could. I was the only one of the lot to care about this place and want to carry on what Dad started. I really haven’t gone far from this spot in my entire life. The one time I got it in my head to try something different; I wound up in Korea with an Army uniform on. I was glad to get back to this place after that stint and here I’ve been ever since. Married the neighbor girl Bessie when I got back. Her dad wasn’t so sure that it would work out since she was 8 years younger than me and she intended to go off to the state college. We sure did prove him wrong; we celebrated our 50th anniversary the week before Bessie died. The ladies at the church had the hall all decorated up and we brought Bessie home from the hospital for the afternoon. She was bound and determined to live for that day; no way did she want her friends to go to that much work for her to not show up. I couldn’t believe it when the ladies had to prepare for the reception after we buried Bessie in that same hall one week later. We had such a good life together. That was 10 years ago. I don’t do much of the farm work anymore. Our son Jon takes care of the crops and the few animals we have. I still go out to the hen house every morning to collect the eggs. I’m a little stiff in the morning, but I get loosened up enough to walk out to gather some fresh eggs to go with my bacon for breakfast. I get in to town at least once a week; on Monday morning me and my buddies meet at the VFW for our coffee and donut break. I get caught up on all the town gossip and we laugh and bellyache about what’s going on in the world. Three weeks ago I celebrated my 80th birthday. My daughter in law, Judy, organized a big “to do” at the church after the Sunday service with cake and ice cream and all the fixins’ for my party. I had a big piece of cake but skipped the ice cream. Doc Baker was there and I knew he would scold me about too much sugar. Six months ago he told me I had diabetes and I started taking a pill for it, but a few weeks ago he put me on insulin. I figure I should be able to eat what I want; come on, I’m not going to live forever, and it was my favorite cake, German chocolate. I ate it in the kitchen so the Doc wouldn’t see me; wouldn’t you know, his office nurse Helen came in the kitchen with a load of dishes just as I was putting the last bite in my mouth. She just winked at me and smiled. After the party I went out to the mall with Jon and the grandkids. I’m not one for shopping much, but I needed a new ink cartridge for my printer and the computer store is the one place I like to look around in. Too bad we parked clear on the other end of the mall so the kids could go by their favorite stores for Grandpa to buy them a little something. Jon got real mad at me when I asked if I could sit and rest for a while, so I just kept walking. I guess my new shoes were a little tight; I didn’t feel anything but when I got home there was some blood on my sock, and then I saw a sore on my big toe. It must not be too bad since it’s not hurting except when I try to put my shoes on. I showed the sore to Jon and Judy the other day and Judy said she would call the doctor to see what she should put on it. Jon gets so irritated when I need extra help; I hope I can just continue to soak my foot in hot water to clean it out. Judy was a nursing assistant out at the old folk’s home for many years; I’m hoping she will be able to help me with this. I like the idea of the home nurses coming out here as long as my VA benefits pay for it. That way they can see that I’m doing just fine living here on my own. I was searching on the Internet for the best way to treat this sore; there are so many sites that talk about foot sores if you’re a diabetic. Some of those pictures are pretty scary; I can’t sleep at night thinking about what could happen if this doesn’t heal. Of course I haven’t slept through the night for years. Even the couple of beers I have at night when I’m on the computer don’t seem to be helping anymore. Judy sometimes gives the kids Benadryl to help them sleep so I’ve been taking a couple when I go to bed; they seem to help me sleep a little better. As a matter of fact, I need to wrap this up now. I promised Jack, my grandson in college, that I’d Skype him in a few minutes. He just started the agronomy program at the university. I love to hear about what he’s learning and give him encouragement to come back to the farm.

1. What are Red’s strengths? 

2. What are your concerns for this patient? 

3. What is the cause of your concern? 

4. What information do you need? 

5. What are you going to do about it?

6. What is Red experiencing? 

Second monologue: Occurs two weeks later. “As much as I hate to miss it, I don’t think I’ll go into town today. I never miss Monday morning coffee at the VFW with my buddies. Sometimes my friends worry about me; they will probably wonder where I am. I know it’s only 20 miles, but I just haven’t felt like eating the last couple of days; maybe I’ve got the flu that’s going around. I’m not sure if I should take my insulin because I’m not eating, but my blood sugar was 203 when I poked my finger this morning. How can that be when I’m not eating? Wow! I just took of my sock to check on my sore and my whole foot is red and big. I haven’t looked at it for a few days; it was just a little pink the last time I checked it. I should have paid closer attention to those pills I was supposed to take, that antibiotic. The nurse wanted to make sure I didn’t get an infection in that toe. She comes tomorrow to change the bandage; I’d better make sure to take the antibiotic today.”

1. What are Red’s strengths? 

2. What are your concerns for this patient? 

3. What is the cause of your concern? 

4. What information do you need? 

5. What are you going to do about it? 

6. What is “Red” experiencing?