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VACC exam Dumps Source : VACC Vascular Access

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: 80 existent Questions

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Medical Medical VACC Vascular Access

Fresenius medical supervision Opens First community-based Vascular access carrier in Singapore | killexams.com existent Questions and Pass4sure dumps

SINGAPORE--(Marketwired - Jun eight, 2016) - Fresenius medical Care, the area's leading provider of dialysis items and capabilities opens its first community-primarily based Vascular entry service for patients with habitual kidney disorder in Singapore. Gan Kim Yong, Member of Parliament, Choa Chu Kang GRC participated at the fresh opening ceremony at Fresenius clinical supervision Teck Whye Dialysis health facility.

round 70 p.c of the Singaporean population is susceptible to setting up habitual kidney ailment as a result of increasing diabetes and hypertension.1 at present nearly 6,000 people merit hold of life-saving dialysis remedy.2 

To subsist positive productive medicine patients want an access to their bloodstream. This 'vascular entry' is often talked about as the patient's 'lifeline.' Dr. Grace Lee, scientific Director at Teck Whye Dialysis sanatorium explained during the outlet ceremony that the vascular access allows the patient's blood to stream into to and from the dialysis computer to subsist cleansed while dissipate products and further fluid are faraway from the physique. "the novel Vascular entry carrier from Fresenius clinical supervision offers a one-stop day surgery facility that provides surgical advent of the vascular entry for patients on hemodialysis. The pricing of the surgical procedure has been made corresponding to the restructured hospitals and sufferers can accomplish claims from the national clinical savings scheme Medisave."

"We want to proffer habitual kidney ailment patients the probability of a timely and cost effectual intervention for the introduction of their vascular entry. here's a vital step towards 'Care Coordination,' where they can deliver a holistic medicine and supervision routine past dialysis," mentioned Anthony Tann, Managing Director of Fresenius medical supervision Singapore. to this point nine sufferers bought their vascular access created in the health center.

anyway vascular access carrier and hemodialysis treatment Fresenius medical Care's Teck Whye clinic is offering extra novel capabilities akin to peritoneal dialysis pilot provider, in addition to screening for diabetic problems in high-possibility patients.

In his speech, Gan Kim Yong stressed on the weight of every and sundry's role in the 'conflict on Diabetes.' every day four novel instances of constant kidney failure are diagnosed in Singapore. Many are brought about by means of diabetes. "what is much more being concerned is that one in three diabetics is unaware that they absorb got diabetes. hence prevention and screening of diabetes, superior sickness manage and administration as well as public education and stakeholder collaboration to superior hoist supervision of diabetics is the key for Singaporeans," Mr. Gan concluded on the opening of the brand novel Vascular access service. "I ogle forward to Fresenius scientific Care's contribution to the group here and to improved serve their patients."

moving forward, Fresenius scientific supervision will proceed to search collaborations with the public and personal sector to extend its capabilities to deliver integrated lofty routine holistic supervision to native renal patients.

ImageMr. Gan Kim Yong, Member of Parliament, Choa Chu Kang GRC (left) and Mr. Anthony Tann, Managing Director, Fresenius scientific supervision Singapore (appropriate) on the opening of the Vascular access carrier at Fresenius scientific supervision Teck Whye Dialysis health facility.http://release.media-outreach.com/i/download/4871

company Logohttp://release.media-outreach.com/i/down load/1869

References:

1 Vivekanand Jha, et al. (2013). persistent kidney sickness: world dimension and views. The Lancet, Vol. 382, problem 9888, web page four

2 Singapore Renal Registry Annual Registry file 1999 - 2014 (period in-between)

ABOUT FRESENIUS scientific CARE: Fresenius clinical supervision is the world's greatest company of products and capabilities for people with renal illnesses of which more than 2.8 million patients global continuously suffer dialysis medication. through its community of 3,432 dialysis clinics, Fresenius scientific supervision provides dialysis treatments for 294,043 patients around the globe. Fresenius scientific supervision is besides the main issuer of dialysis items reminiscent of dialysis machines or dialyzers. together with the core enterprise, the company focuses on increasing the purview of connected clinical functions within the territory of supervision coordination.

For more information talk over with the business's web page at www.freseniusmedicalcare.com

graphic accessible: http://www2.marketwire.com/mw/frame_mw?attachid=3019174


benefit scientific Acquires Vascular Insights For PVD remedies | killexams.com existent Questions and Pass4sure dumps

No influence found, are trying novel keyword!benefit medical techniques has bought Vascular Insights ... comparable to their micropuncture and vascular entry products, and enhance their aptitude to customise the entire technique for their customers.

Cardinal fitness and prepare dinner medical proclaim exclusive compress for Customizable Vascular access Kitting solution | killexams.com existent Questions and Pass4sure dumps

DUBLIN, Ohio--(business WIRE)--Cardinal fitness and cook medical these days introduced a two-yr, exclusive settlement for the North American distribution of cook dinner clinical material venous catheter (CVC) sets with Cardinal fitness Presource® customizable procedural kits ─ featuring clinicians with advanced technology the flexibleness of customization for their vascular entry wants.

below the agreement, Cardinal health and cook dinner clinical customers at the moment are in a position to customise add-ons of their CVC procedural kits. The kits can embrace both uncoated or prepare dinner Spectrum® CVC sets, which characteristic the trade’s optimum circulation costs and a complete product line together with energy-injectable catheters. The partnership permits acute supervision suppliers to maximise value and minimize dissipate by using offering a cost-advantageous means to lower the number of elements they should supplement typical CVC procedural kits.

“We’re thrilled to companion with Cardinal health, an traffic leader in custom kitting, to expand entry to cook clinical’s CVC sets for vascular entry authorities,” spoke of Dan Sirota, vp and company unit leader of cook scientific’s crucial supervision and Interventional Radiology divisions. “improving affected person supervision and decreasing fitness supervision costs are of utmost magnitude to hospitals. They continue to subsist dedicated to offering options that streamline techniques for clinicians and empower them to provide most advantageous patient care.”

cook dinner scientific’s Spectrum catheters are impregnated with the antibiotics minocycline and rifampin and meet the newly launched 1A advice from the CDC for decreasing catheter-linked bloodstream infections (CRBSIs) if maximal unfruitful barrier precautions haven’t helped a facility gain its [infection prevention] intention.1 An estimated seventy eight,000 sufferers are infected with doubtlessly deadly CRBSIs in the U.S. yearly, with a benchmark pervade estimated at $16,550 per an infection.2 Spectrum catheters absorb been shown to subsist 5 times less supine to bear infection than procedure on my own.3

“Cardinal health specializes in developing partnerships that convey imaginitive solutions that assist accomplish it easier for their shoppers to deliver lofty first-class care,” referred to Lisa Ashby, president of class management at Cardinal fitness. “Our relationship with cook clinical is an excellent instance of the types of partnerships their consumers value – people that promote premiere rehearse standardization with advanced best products.”

About Cardinal health

Headquartered in Dublin, Ohio, Cardinal fitness, Inc. (NYSE: CAH) is a $103 billion fitness supervision services traffic that improves the cost-effectiveness of fitness care. as the enterprise behind fitness care, Cardinal fitness helps pharmacies, hospitals, ambulatory surgery facilities and medical professional workplaces focal point on patient supervision whereas cutting back prices, improving effectivity and improving pleasant. Cardinal fitness is a vital link within the health supervision provide chain, offering prescription drugs and medical products to more than 60,000 areas day after day. The traffic is additionally a number one company of clinical and surgical products, together with gloves, surgical attire and fluid administration products. moreover, the enterprise helps the turning out to subsist diagnostic traffic with the aid of offering clinical items to clinical laboratories and working the nation's greatest community of radiopharmacies that dispense items to advocate within the early analysis and medication of sickness. Ranked #19 on the Fortune 500, Cardinal health employs more than 30,000 individuals worldwide. more suggestions in regards to the company could subsist institute at cardinalhealth.com and @CardinalHealth on Twitter.

About prepare dinner medical

a worldwide pioneer in medical breakthroughs, prepare dinner clinical is dedicated to developing effectual options that improvement tens of millions of patients global. these days, they combine clinical devices, medication, biologic grafts and mobilephone healing procedures throughout greater than 16,000 products serving more than 40 medical specialties. situated in 1963 through a visionary who do affected person wants and ethical company practices first, cook is a family-owned traffic that has created greater than 10,000 jobs worldwide. For extra suggestions, visit www.cookmedical.com. comply with cook dinner clinical on Twitter and LinkedIn.

1 O’Grady NP, Alexander M, Burns LA, et al. guidelines for the prevention of intravascular catheter-connected infections. Am J Infect control. 2011;39(4 suppl 1):S1-S34.

2 facilities for sickness handle and Prevention. a must-have signals: principal line-associated blood stream infections–u.s., 2001, 2008, and 2009. MMWR Morb Mortal Wkly Rep. 2011:60(eight): 243-2488

three Hanna H, Benjamin R, Chatzinikolaou I, et al. “lengthy-time term silicone central venous catheters impregnated with minocycline and rifampin abate charges of catheter-connected bloodstream infection in melanoma sufferers: a prospective randomized scientific trial;” J Clin Oncol. 2004; 22(15):3163-3171.

Presource is a registered trademark of Allegiance organisation

photographs/Multimedia Gallery purchasable: http://www.businesswire.com/cgi-bin/mmg.cgi?eid=50148458&lang=en




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VACC exam Dumps Source : VACC Vascular Access

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Test designation : VACC Vascular Access
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: 80 existent Questions

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VACC Vascular Access

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CE: Original Research Does Certification in Vascular Access Matter? An Analysis of the PICC1 Survey | killexams.com existent questions and Pass4sure dumps

Accreditation or certification by an external agency is common in many professions. In the territory of health care, certification denotes that a person has specific qualifications for performing a positive job or set of activities. First, it signifies the completion of a prescribed course of study and the resultant acquisition of specialized erudition and skills. Second, it attests to some demonstration of such learning, usually through a qualifying examination. Lastly, it serves to assure the public and other stakeholders of competence in a domain. Although some controversy regarding the expense and value of certification has recently emerged,1, 2 there is substantial evidence linking certification to greater job satisfaction, knowledge, and sense of empowerment among both physicians and nurses.3, 4 Among nurses, certification has besides been associated with improved attitudes, better practice, and greater pecuniary compensation.5, 6

In the specialty of vascular access, the most common certifications are those administered by the Vascular Access Certification Corporation (which offers Vascular Access–Board Certified [VA-BC] certification) and by the Infusion Nurses Certification Corporation (which offers Certified Registered Nurse Infusion [CRNI] certification). Although these certifications vary in content and emphasis, they partake positive essential features. Both require a minimum number of hours of clinical sustain in planning, managing, and evaluating intravenous infusions and in inserting vascular access devices. Both besides emphasize evidence-based approaches; and both certifications are often obtained by clinicians who specialize in inserting peripherally inserted central catheters (PICCs).

Although condition boards of nursing require health supervision facilities to absorb written policies and procedures that ensure demonstration of competency by vascular access specialists, certification is not mandatory for practice. Some organizations animate certification as a condition of employment, but others accomplish not. To their knowledge, no study has examined whether certified and noncertified PICC inserters differ with respect to their practices and views about PICC use.

Study purpose. Understanding whether and how certification might impress PICC practices and outcomes is critical to informing policy and improving patient safety. Using data from a national survey of vascular access specialists, they compared the characteristics of certified PICC inserters to those of noncertified inserters. Their objective was to gather information regarding whether and how certified and noncertified PICC inserters differ with respect to their practices and views about PICC use. They hypothesized that, compared with noncertified inserters, certified inserters would report having greater sustain and would subsist more likely to drudgery in leadership positions. They besides hypothesized that certified inserters would report greater exercise of evidence-based practices.

METHODS

Study setting and participants. They partnered with the Association for Vascular Access (AVA) and the Infusion Nurses Society (INS) to ration a survey aimed at vascular access specialists who insert PICCs (the PICC1 survey). The AVA is a multidisciplinary professional organization for vascular access specialists, and the INS is a professional nursing organization for nurses who participate in various aspects of infusion therapy. Both organizations maintain membership directories accessible for practice-relevant surveys. They absorb a combined membership of over 8,300 specialists, although not every members insert PICCs. These agencies delineate the most common sources of certification in vascular access.

Development and dissemination of the survey. First, a literature search was conducted to identify material evidence regarding vascular access practices. These data were used to inform the evolution of survey questions related to inserting, caring for, and troubleshooting PICCs, as well as questions regarding policies, practices, and various other material topics.

The initial survey was pretested with four nurses who had sustain in inserting PICCs and expertise in the field. Based on their feedback, the instrument was revised and edited for clarity. The final survey instrument consisted of 76 questions on PICC policies and procedures at the inserters’ facilities, the exercise of technologies for PICC insertion, device management (including management of complications), inserters’ perceptions about PICC use, and inserters’ relationships with other health supervision providers. Information about respondents, such as number of years in practice, certification or noncertification status, and the primary rehearse setting, was besides collected. The survey instrument made exercise of skip logic, allowing respondents to skip questions that were contingent on a prior response.

Following its approval by the AVA and the INS, the instrument was programmed into an online survey administration tool (SurveyMonkey) to facilitate electronic dissemination. They tested the online survey to ensure its functionality. It was then announced and disseminated by the AVA and the INS to their members via an e-mail that contained an electronic link. Advertisements publicizing the survey were besides placed on the organizations’ websites. Over the next five weeks, each organization sent timed reminder e-mails to animate participation. Data were collected over a three-month term from June through August 2015. No identifiable information was collected from respondents, but a $10 Amazon gift card was offered to those who completed the survey.

The study was reviewed and deemed exempt from regulation by the University of Michigan's institutional review board before data collection began.

Identification of certified PICC inserters. To distinguish certified from noncertified PICC inserters, they first restricted the sample to respondents who indicated that they insert PICCs. They then evaluated these respondents’ answers to the question “Do you currently hold a dedicated vascular access certification?” Respondents who answered yes were asked to identify which certification they held. Those who indicated holding VA-BC or CRNI (or both) certification were categorized as certified PICC inserters. Conversely, those who lacked such certification were categorized as noncertified inserters.

Data analysis. Descriptive statistics were used to tabulate results. Since respondents weren't required to reply every questions, the response rate for individual questions was calculated based on the total number of responses to that question. Responses for certified and noncertified PICC inserters were compared across drudgery settings, rehearse patterns, and views regarding PICCs. (Given that this was their focus, they did not analyze the data in terms of nurses and nonnurses.) Bivariable comparisons were made using χ2 or Fisher's exact tests, as appropriate, for categorical data. Two-sided significance tests with α set at 0.05 was considered statistically significant. every statistical analyses were conducted using Stata/MP version 13 (StataCorp, College Station, TX).

RESULTS

Sample. The survey link was e-mailed to a combined 8,386 members of the AVA and the INS. Of these, 2,762 accessed the survey and 1,698 (61%) indicated that they inserted PICCs and were eligible for participation in the study. Of those eligible, 1,450 (85%) provided data regarding certification and made up the final cohort used for analysis. Of these, 1,007 (69%) reported being certified and 443 (31%) indicated they were not certified. Most respondents (96%) reported practicing within the United States, and every 50 U.S. states and the District of Columbia were represented. A miniature number of respondents (4%) practiced outside the United States.

General characteristics of PICC inserters. Most certified and noncertified PICC inserters identified as vascular access nurses (89% in both groups). Nonnurse inserters included respiratory therapists, physicians, and advanced rehearse providers. Significantly higher percentages of certified than noncertified inserters reported having five or more years’ sustain with inserting PICCs (78% versus 54%) and having placed 1,000 or more PICCs (58% versus 32%). A significantly higher percentage of certified than noncertified inserters worked in a facility that was affiliated with a medical school (52% versus 46%). But there was no significant disagreement between the groups regarding their facility's affiliation with a nursing school. Significantly higher percentages of certified than noncertified inserters reported being on a vascular access team with 10 or more members (35% versus 19%) and being the vascular access lead for their team (56% versus 44%).

A significantly higher percentage of certified than noncertified inserters reported that their facility had a written medical or nursing process for reviewing the necessity of PICCs on a daily basis (71% versus 58%). With respect to relationships with other providers, there was a significant disagreement between certified and noncertified inserters in their rating of advocate received from hospital leadership but not in their relationships with physicians and bedside nurses. see Table 1 for more on the universal characteristics of certified and noncertified inserters in this study.

Variations in rehearse between certified and noncertified PICC inserters. Several significant differences in reported practices were noted. For instance, a significantly higher percentage of certified than noncertified inserters reported receiving assistance from another vascular access specialist when inserting a PICC (52% versus 41%). A significantly higher percentage of certified than noncertified inserters reported having placed a PICC in a patient receiving dialysis (63% versus 51%). In doing so, certified inserters more frequently reported consulting with a nephrologist before placement (92% versus 88%). While a significantly lower percentage of certified inserters reported that their facility tracked the total number of PICCs placed each month (93% versus 97%), a significantly higher percentage indicated that it tracked PICC dwell times (70% versus 63%).

Important differences specific to insertion practices were besides found. For instance, a lower percentage of certified than noncertified inserters reported using every five unfruitful barriers (cap, mask, gown, unfruitful gloves, and full corpse drapes) (78% versus 84%). Although 96% of inserters in both groups reported using ultrasound to find a suitable vein for PICC insertion, significantly more certified than noncertified inserters indicated using ultrasound to appraise a catheter-to-vein ratio before placement (86% versus 76%) and documenting this ratio in the PICC insertion note (43% versus 30%). Similarly, significantly more certified inserters reported the exercise of electrocardiographic guidance to Place PICCs (67% versus 55%). But the percentages of certified and noncertified inserters who reported the exercise of chlorhexidine for skin antisepsis at the insertion site (96% in both groups) and the routine trimming of PICCs to an commandeer length following insertion (94% versus 92%) were similar.

Some supervision and maintenance practices besides varied between the two groups. For instance, significantly fewer certified than noncertified inserters reported using a combination dressing and securement device for routine supervision following placement (18% versus 26%). Most certified and noncertified inserters reported using securement devices to forestall PICC migration (95% versus 93%). But there were differences in the kind of securement devices used, with noncertified inserters more often using wing-based products than certified inserters (89% versus 80%). With respect to flushing protocols, a significantly higher percentage of certified than noncertified inserters reported using a “targeted” strategy (flushing only those lumens that weren't being actively used or were only used for blood draws) (33% versus 24%). Differences in recommended flushing techniques were besides noted: fewer certified than noncertified inserters practiced pulsatile flushing (76% versus 81%), while more certified than noncertified inserters practiced rapid propel flushes (14% versus 9%). Although frequency of flushing was similar in the two groups, there were some differences in exercise of flushing agents, with fewer certified than noncertified inserters using routine saline (63% versus 69%) and more certified than noncertified inserters using heparin (7% versus 2%). see Table 2 for more on variations in reported practices between certified and noncertified inserters.

Variations in approach to complications and views about PICC practice. Several differences in reported management of PICC complications were noted. Similar percentages of certified and noncertified inserters reported the exercise of a tissue plasminogen activator to deal catheter-related occlusions (92% versus 91%). But their approaches to managing PICC-related phlebitis varied somewhat. For instance, fewer certified than noncertified inserters said they would discuss the situation with a physician (41% versus 46%), but more certified than noncertified inserters said they would accomplish so with a nurse (10% versus 7%). The two groups besides differed regarding the management of PICC-related deep vein thrombosis, with more certified than noncertified inserters recommending ultrasound evaluation (59% versus 45%) and notification of every caregivers (59% versus 45%).

The two groups besides expressed rather different views about PICC practice. For instance, a significantly higher percentage of certified than noncertified inserters reported being empowered to remove PICCs that were idle or not clinically indicated without physician approval (26% versus 18%). Significantly more certified inserters besides felt that a higher percentage of PICCs (10% or more) were unnecessarily removed when a patient developed a fever, without compelling evidence to hint catheter infection (75% versus 63%). Similarly, significantly more certified inserters felt that a higher percentage of PICCs (10% or more) were placed for inappropriate reasons and could absorb been avoided (44% versus 34%). see Table 3 for more on variations in the reported approaches and views of certified and noncertified inserters.

DISCUSSION

To their knowledge, this is the first study to examine associations between certification in vascular access and reported practices and views related to PICC insertion and use. In their analysis of 1,450 vascular access specialists who insert PICCs, the majority of respondents (69%) reported holding certification by an accredited external agency. They institute that more certified than noncertified inserters reported working in larger facilities and on larger vascular access teams. In accordance with their hypotheses, they institute that significantly higher percentages of certified inserters reported having more rehearse sustain and greater exercise of positive evidence-based practices (such as ultrasound to determine catheter-to-vein ratio). positive supervision and maintenance practices, including approaches to managing complications such as thrombosis and phlebitis, besides varied significantly between the two groups. Collectively, these data hint that certification in vascular access is associated with significant differences in drudgery settings, rehearse patterns, and views regarding PICCs. Whether or not these variations influence the character of patient supervision and patient outcomes is a question that deserves further scrutiny.

In nursing, a substantial corpse of evidence suggests that specialty certification is associated with several improved patient outcomes. For example, a 2014 study reported a direct association between certification status among surgical and anesthetic RNs and rates of central line–associated bloodstream infections—specifically, hospitals with higher percentages of specialty-certified RNs had lower rates of such infections.7 In acute supervision settings, another study institute a significant relationship between increased rates of unit-level nursing specialty certification and fewer patient falls.8 And in an analysis of risk-adjusted surgical discharges, specialty certification in nurses with baccalaureates or higher degrees was associated with decreased mortality and failure-to-rescue rates after multivariable adjustment.9

Despite such findings, barriers to obtaining specialty certification—including want of pecuniary or logistical advocate for review courses and examinations, time constraints, and scare of failure—persist.10 With admiration to vascular access certification specifically, the fees for certification, recertification, and maintenance of credentials aren't trivial, ranging from $300 to $700 at this writing.11-13

Although the erudition groundwork in this specialty varies in quality, specific evidence-based practices absorb been associated with improved outcomes when it comes to inserting PICCs. For example, it's been demonstrated that “real-time” guidance of the PICC tip during insertion and measurement of vein size can reduce complications such as malposition and thrombosis.14-16 Similarly, using alcohol-containing chlorhexidine for cutaneous antisepsis and having multiple team members trained in placing vascular catheters has been shown to reduce the risk of catheter-related infection.17-19

In general, it seems reasonable to posit that providers with certification will subsist more likely to exercise evidence-based practices than their noncertified counterparts. Their analysis of data from the PICC1 survey supports this in part. For example, certified inserters were more likely to exercise positive evidence-based practices that reduce complication risks, including using ultrasound to evaluate catheter-to-vein ratios, using ECGs to pilot PICC placement, and receiving assistance from another team member during insertion. But certified inserters besides reported some practices that either aren't clearly supported by evidence or contradict best practice. For example, fewer certified inserters reported using every five unfruitful barriers when placing PICCs than noncertified inserters did. And more certified inserters reported placing PICCs in patients receiving dialysis, although current guidelines argue that this is contraindicated and associated with adverse outcomes, regardless of nephrologist approval.20, 21

Such findings highlight the weight not only of transmitting up-to-date evidence through certification programs, but besides of ensuring that such erudition influences practice. For example, in accordance with current INS guidelines, certified inserters might recommend an alternative device rather than a PICC in patients receiving dialysis.22 The focus thus shifts from a device-centric view to one that prioritizes the appropriateness of use.23, 24 Their findings that higher percentages of certified inserters were likely to perceive inappropriate PICC placement and to feel empowered to remove clinically unnecessary devices hint that certification may wait on pilot decisions about the suitability of PICC use. Exploring ways to further enable PICC inserters to apply evidence to practice, communicate such erudition to physicians, and act as vanguards for patient safety is paramount.23, 25

Policy implications. Given that certified inserters more frequently reported engaging in key evidence-based practices, their findings besides absorb significant policy implications. Essential next steps might embrace working with health supervision system leaders to remove pecuniary barriers to obtaining certification, encouraging the adoption and implementation of practices taught in certification programs, and measuring key outcomes based on certification status. Given their finding that more certified inserters are leaders on their vascular access teams, encouraging certification as an adjunct to career advancement might besides better staff satisfaction and retention, significant factors in organizational planning and sustainability.

Limitations. This study has several limitations. First, they used data from a survey that targeted vascular access specialists belonging to two great professional organizations; thus, selection prejudice might impress their findings. Second, they defined certified inserters as those who reported current certification by one or both of two agencies; findings may differ if reporting was inaccurate or if different standards are used to define certification status. Third, although they observed differences in rehearse patterns and views by certification status, they cannot assign these differences solely to this characteristic. Nor can certification status subsist separated from employer or site-specific requirements that might influence rehearse and views. Studies that examine these relationships in more detail are necessary.

CONCLUSION

Certification in vascular access appears to subsist associated with significant differences among PICC inserters with admiration to their practices and views. Encouraging broader adoption of this credential—which is currently often voluntary—may subsist warranted. Further research to foster a better understanding of the repercussion of certification on patient outcomes is essential. In particular, studies aimed at clarifying how certification influences thinking and rehearse in clinical settings are needed if they are to unlock the potential of this professional training.

REFERENCES 1. Hayes J, et al Association between physician time-unlimited vs time-limited internal medicine board certification and ambulatory patient supervision character JAMA 2014 312 22 2358–63 3. Beaudoin G, et al Supporting and empowering nurses undergoing critical supervision certification Clin Nurse Spec 2016 30 4 216–26 4. Peterson LE, et al Physician satisfaction with and rehearse changes resulting from American Board of Family Medicine maintenance of certification performance in rehearse modules J Contin Educ Health Prof 2016 36 1 55–60 5. Beck SL, et al Oncology nursing certification: relation to nurses’ erudition and attitudes about pain, patient-reported pain supervision quality, and pain outcomes Oncol Nurs Forum 2016 43 1 67–76 6. Burchill CN, Polomano R Certification in emergency nursing associated with vital signs attitudes and practices Int Emerg Nurs 2016 27 17–23 7. Boyle DK, et al The relationship between direct-care RN specialty certification and surgical patient outcomes AORN J 2014 100 5 511–28 8. Boyle DK, et al Longitudinal association of registered nurse national nursing specialty certification and patient falls in acute supervision hospitals Nurs Res 2015 64 4 291–9 9. Kendall-Gallagher D, et al Nurse specialty certification, inpatient mortality, and failure to rescue J Nurs Scholarsh 2011 43 2 188–94 10. Ciurzynski SM, Serwetnyk TM Increasing nurse certification rates using a multimodal approach J Nurs Adm 2015 45 4 226–33 14. Rossetti F, et al The intracavitary ECG routine for positioning the tip of central venous access devices in pediatric patients: results of an Italian multicenter study J Vasc Access 2015 16 2 137–43 15. sharp R, et al The catheter to vein ratio and rates of symptomatic venous thromboembolism in patients with a peripherally inserted central catheter (PICC): a prospective cohort study Int J Nurs Stud 2015 52 3 677–85 16. Walker G, et al Effectiveness of electrocardiographic guidance in CVAD tip placement Br J Nurs 2015 24 14 S4–S12 17. Mimoz O, et al Skin antisepsis with chlorhexidine-alcohol versus povidone iodine-alcohol, with and without skin scrubbing, for prevention of intravascular-catheter-related infection (CLEAN): an open-label, multicentre, randomised, controlled, two-by-two factorial visitation Lancet 2015 386 10008 2069–77 18. Mimoz O, et al Chlorhexidine-alcohol versus povidone iodine-alcohol antisepsis for catheter-related infection prevention: an open-label, multicentre, randomised controlled visitation [poster presentation] Intensive supervision Med Exp 2015 3 Suppl 1 A409 19. Pronovost P, et al An intervention to abate catheter-related bloodstream infections in the ICU N Engl J Med 2006 355 26 2725–32 20. McGill RL, et al Peripherally inserted central catheters and hemodialysis outcomes Clin J Am Soc Nephrol 2016 11 8 1434–40 21. McGill RL, et al Inpatient venous access practices: PICC culture and the kidney patient J Vasc Access 2015 16 3 206–10 22. Gorski L, et al Infusion therapy standards of rehearse J Infus Nurs 2016 39 1S S1–S156 23. Chopra V, et al The Michigan Appropriateness pilot for Intravenous Catheters (MAGIC): results from a multispecialty panel using the RAND/UCLA appropriateness routine Ann Intern Med 2015 163 6 Suppl S1–S40 24. Moureau N, Chopra V Indications for peripheral, midline and central catheters: summary of the MAGIC recommendations Br J Nurs 2016 25 8 S15–S24 25. Meyer BM, Chopra V affecting the needle forward: the imperative for collaboration in vascular access J Infus Nurs 2015 38 2 100–2

For more than 240 additional continuing nursing education activities on advanced rehearse nursing topics, travel to www.nursingcenter.com/ce.


School-located vaccination programs could reduce flu cases and deaths among children | killexams.com existent questions and Pass4sure dumps

Offering flu vaccines at elementary schools could expand vaccination rates and reduce costs, according to a novel study reported in the scientific journal Vaccine by researchers from UC Davis Health System; the Monroe County, N.Y., Department of Public Health; University of Rochester Medical Center; and U.S. Centers for Disease Control and Prevention (CDC).

New research shows that school-located clinics could expand access to seasonal flu vaccines for children, who are among those most at risk for the flu and its complications. novel research shows that school-located clinics could expand access to seasonal flu vaccines for children, who are among those most at risk for the flu and its complications.

The best protection against flu for children at least 6 months of age is the seasonal vaccine, yet vaccination rates among children are low, according to the CDC. Only about 40 percent of children received a 2012-2013 flu vaccine, which is typically provided in a primary-care setting.

“Primary-care practices may not absorb the capacity to vaccinate every U.S. children against seasonal influenza,” said Byung-Kwang Yoo, an associate professor of public health sciences at UC Davis and lead author of the study. “If the CDC’s recommendations were followed, primary-care offices would absorb to accommodate 42 million additional patient visits during the five-month window for each flu season.”

The vaccine can subsist lifesaving, especially for children, who are among those most at risk for the flu and its complications. The CDC reports that 90 percent of children who died from flu during 2012-2013 were not vaccinated. This is why public health experts absorb made it a priority to identify cost-effective ways to broaden access to flu vaccines for children.

“The flu is a disease with lofty probability of reaching epidemic levels even though they absorb an effectual vaccine,” said Yoo, who was with the University of Rochester when the study was conducted. “Our goal is to find ways to ensure that the best prevention is as accessible as possible.”

The Monroe County study team conducted a prospective, randomized visitation during late 2009 that involved 18 urban and 14 suburban elementary schools with more than 13,000 students in the Rochester, N.Y., area. Two onsite flu vaccination clinics were held four weeks apart at 21 of these schools, with a total student population of 9,027. The remaining 11 schools, with a total of 4,534 students, served as the control-group site where vaccination clinics were not held.

The researchers then compared the overall flu vaccination rates of children enrolled in every schools included in the study. The results showed a 13.2 percentage point extend in vaccination rates among children with access to school-located vaccination clinics.

Because the health department–academic seat collaborators had hypothesized that direct-vaccination costs would subsist lower in onsite school clinics than in traditional pediatric practices, they were at first surprised when their cost analysis revealed the opposite. The per-dose direct cost, $54.26, of onsite school vaccination clinics was — in the first year of the program — higher than the mean, $38.23, or median, $21.44, of the direct cost of flu vaccinations in pediatricians’ offices.

“This is likely because the start-up onsite program required substantial administration time and costs related to obtaining informed consent from parents,” said Yoo.

However, when the analysis considered costs related to taking children to pediatricians’ offices for flu vaccines, the per-dose cost decreased to $19.26, falling below both the denote and median costs of obtaining flu vaccinations in medical practices.

The pattern dropped even more substantially — to just $3.90 per dose — when data from the second day of the school-located clinics was excluded from the analysis.

“Participation in the second clinics was much lower, while administration costs remained the same,” said Yoo. “But some children were noiseless vaccinated on the second day, so the team’s next goal is to refine operations.”

The Monroe County team is currently evaluating data from the subsequent 2010-2011 flu season. During that year, vaccination clinics were held only once per school, which may reduce project costs. Currently led by Peter Szilagyi of the University of Rochester, the team is besides developing an online consent process to further better efficiency. If those efforts show savings over traditional flu-vaccine delivery sites, the researchers will pose the school-located vaccination program as a national model for broadening flu prevention.

Byung-Kwang Yoo © UC RegentsByung-Kwang Yoo

Additional authors on the economic evaluation were senior author Maureen Kolasa of the CDC and coauthors Sharon Humiston of Children’s charity Hospitals and Clinics in Kansas City, Mo.; Peter Szilagyi and Stanley Schaffer of the University of Rochester School of Medicine and Dentistry; and Christine Long of the University of Rochester seat for Community Health.

The paper, titled “Cost effectiveness analysis of elementary school-located vaccination against influenza — Results from a randomized controlled trial,” is published in the April 17 issue of Vaccine. Copies of the study are available to credentialed journalists by contacting Elsevier’s newsroom at newsroom@elsevier.com or +31 20 4853564.

The research was supported by the CDC (grant U01IP000195) and National Institute of Allergy and Infectious Disease (grant 1K25AI073915).

For more information about flu, visit the CDC’s website at http://www.cdc.gov/flu/keyfacts.htm or the UC Davis Health System website at https://www.ucdmc.ucdavis.edu/medicalcenter/healthtips/2010-2011/02/20110217_spring-flu.html

Vaccine is the pre-eminent journal for those interested in vaccines and vaccination. It is the official journal of The Edward Jenner Society, The International Society for Vaccines and The Japanese Society for Vaccinology. For information, visit www.elsevier.com/locate/vaccine

UC Davis Health System is improving lives and transforming health supervision by providing excellent patient care, conducting groundbreaking research, fostering innovative, interprofessional education and creating dynamic, productive partnerships with the community. The academic health system includes one of the country's best medical schools, a 619-bed acute-care teaching hospital, a 1,000-member physician's rehearse group and the novel Betty Irene Moore School of Nursing. It is home to a National Cancer Institute-designated comprehensive cancer center, an international neurodevelopmental institute, a emanate cell institute and a comprehensive children's hospital. Other nationally prominent centers focus on advancing telemedicine, improving vascular care, eliminating health disparities and translating research findings into novel treatments for patients. Together, they accomplish UC Davis a hub of innovation that is transforming health for all. For information, visit healthsystem.ucdavis.edu.


The Anti-Vaccination Movement: Spreading Misconceptions,Fueling Epidemics,Circulating Misinformation | killexams.com existent questions and Pass4sure dumps

“Outdated” diseases, such as measles, absorb affected over 900 people in the past three years in the United States. “Informed” celebrities, such as Dr. Oz, absorb spread misconceptions about autism in relation to vaccination. One thing’s for certain: “dangerous,” “unchecked,” and “useless” vaccinations are the reasons for the cessation of polio, measles, smallpox, and pertussis epidemics. At the proximate of the 18th century, Edward Jenner invented the first vaccine by injecting cowpox-infected bodily fluid into a boy that was infected with the disease. Ever since then, deadly diseases had preventions as soon as ethical, acceptable, and safe vaccines hit the market. For decades and even centuries, people felt privileged to absorb access to this medical innovation that saved millions of lives internationally. Lately, however, preventable diseases unheard of in decades absorb resurfaced as a result of the anti-vaccination movement. This movement resulted from citizens of first world countries taking this privilege for granted by believing that diseases such as measles were completely eradicated. Misconceptions about inoculation blew completely out of proportion, ranging from unscientific links with autism to fraudulent anecdotes and studies. Consequently, medical doctors such as Paul Offit absorb dedicated their lives to eliminating the negative stigma that frequently surrounds immunization. The anti-vaccination movement, fueling misconceptions and catastrophically harming children, threatens the well-being of society. Vaccinations must subsist reinstated as one of the most valuable and vital modern-day developments of mankind to forestall further denouncement and devaluation incited by skeptics.

On February 28, 1998, an article was published in The Lancet titled, “Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children”Wakefield). The doctor behind the article, Andrew Wakefield, was undoubtedly the man that sparked the autistic side of the anti-vaccine movement. Wakefield was the first to ever publish a study that showed a correlation between autism and vaccination. This experiment was completely disproved and even retracted by the Lancet, but its repercussion in terms of the anti-vaccine movement was incredibly devastating. The doctor’s data was institute fraudulent and falsified, and he was ultimately stripped of his medical license. Scientists, doctors, and medical professionals rejoiced; they thought an era of misconception regarding vaccination was ending rather than beginning.

Despite these findings and former Dr. Wakefield’s complete want of credibility, common anti-vaccine figures such as Jenny McCarthy institute inspiration in these findings. McCarthy, mother of an autistic son, has been using her child’s diagnosis as a means to win public attention in the anti-vaccination movement. She claims that inoculating her child led to his autism. McCarthy soon became one of the biggest anti-vaccination advocates in the United States, without any feasible evidence behind her autism-vaccine link. This link is a logical fallacy, where a correlation between vaccination and autism is assumed only because both are present in a child. In fact, McCarthy’s son may absorb autism for another reason--McCarthy’s behaviors and addictions before pregnancy. Maternal drug abuse is directly correlated with autism in babies, which Jenny McCarthy was every too arrogant to advertise before and during her misconception-propelled anti-vaccination propel started. For instance, McCarthy referred to herself as a “recovering Catholic,” after trying everything from exaltation to prescription pills and ultimately getting hooked on Vicodin. These drugs definitely had a negative influence on McCarthy’s son as a growing fetus (Marcus). Although it cannot subsist stated for positive that her addictions led to his autism, that dispute is much more credible than the one accusing vaccinations. The AAP, or American Academy of Pediatrics, published in a comprehensive vaccine-autism research paper, “Studies accomplish not show any link between autism and MMR vaccine, thimerosal, multiple vaccines given at once, fevers or seizures” (“Vaccines”). Autism Speaks, a charity revolving around improving the character of life for children and adults diagnosed with autism, claimed, “Each family has a unique sustain with an autism diagnosis, and for some it corresponds with the timing of their child’s vaccinations. The results of...research is clear: Vaccines accomplish not antecedent autism” (“What Causes Autism?”). Evidently, credible sources absorb denounced the autism-vaccine link as non-existent; even though children are diagnosed with autism around the very time as they are initially inoculated, the two aren’t correlated.

There are undoubtedly side effects to immunization, but they don’t compare to the catastrophic consequences of contracting a deadly virus. Approximately 1 in 3 people report headaches following vaccination, and 1 in 100 even complain of a lofty fever as a side effect. On the other hand, diseases that vaccines prevent, such as measles, absorb incredibly worse and usually deadly consequences. A measles contraction starts with a rash that slowly spreads through the entire body. As the rash progresses, the infected absorb extremely lofty fevers. Their immune system weakens and they become more susceptible to other deadly infections. In the early 2000s, only about 37 people in the United States died from measles annually. Recently, due to the anti-vaccine there absorb been almost 650 cases in a year (“Measles”). Minimal side effects of vaccination cannot launch to compare to the devastating consequences of contracting deadly diseases.

Paul Offit, in his book Deadly Choices: How the Anti-Vaccine Movement Threatens Us All, asserts that movements against vaccination are misinformed and consequently unsafe to the well-being of society. Offit, a medical doctor, intelligently refutes every practicable dispute made against vaccination, provides a variety of anecdotes, and supports every title he makes with plenty of scientific evidence. He eliminates every arguments against vaccination in order to t stop parents from being misinformed when choosing whether or not to vaccinate, as well as to dispirit the further spread of anti-vaccine propaganda on media platforms. Offit attempts to induce the public to accomplish informed decisions with their children by warning them about the tragic consequences if they don’t. Throughout his book, Offit presents scientists that absorb made strides towards accurately informing the public about inoculation. Samuel Berkovic, a neurologist, realized the being of a link between Dravet’s Syndrome and epilepsy following vaccinations. This discovery undermined every media figure, such as Lea Thompson, who claimed that vaccinations caused seizures. Berkovic, however, didn’t merit the recognition he deserved for this brilliant medical link in 2006. The neurologists and other informed doctors that worked with him recognized his drudgery as something remarkable, but the people circulating anti-vaccination propaganda continued their fight despite it all. Rorke-Adams, another scientist mentioned by Offit in his research, examined over thirty children whose parents claimed had seizures after vaccinations; every single child she examined ended up having a different reason behind the epilepsy, ranging from vascular disorders to degenerative diseases. As Offit stated, “...despite her expertise, and despite the fact that she has supported her evaluations with cogent, well-researched opinions, Rorke-Adams often finds that petitioners prevail” (Offit 90).

Different types of vaccines are administered depending on the age and maturity level of the child. As a result, herd immunity plays an incredibly significant role before the child can receive the shot. Herd immunity, besides known as community immunity, occurs when enough people in a group are vaccinated so that the few that aren’t will besides subsist protected. However, as the amount of people not vaccinating grows tremendously, herd immunity decreases at the very rate. Physicians Phoebe Day Danzinger and Rebekah Diamond pose an extreme solution: don’t give the anti-vaxxers a choice. The two doctors wrote, “Neither of us imagined they would dedicate so much of their time to working with parents who contest what is arguably the very greatest invention of modern medicine” (Danzinger and Diamond). Furthermore, they aver why there should subsist no inoculation exemptions, regardless of personal preference or values. The truth is that these diseases do everyone at risk, since immunity is only a cogent concept when enough people are immunized. This proposition is one practicable solution to the threat of losing community immunity every over the United States.

Some pose a different solution: inform parents before their children are born to give them a better haphazard of making informed decisions in terms of immunization. Matthew Daley and Jason Glanz, in their Scientific American article “Straight Talk about Vaccination,” admiration a variety of ways to inform parents about the weight of vaccination. This includes encouraging a prenatal class or providing a forum for parents to discuss the issue amongst themselves. The most feasible proposal, however, is figuring out a better artery for doctors to schedule visits to fully provide parents with information about vaccination. Daley and Glanz besides hint scheduling divorce visits for benchmark prenatal checkups and vaccine information sessions. This would allow doctors to hoist more time carefully explaining why inoculation shouldn’t subsist taken lightly. They besides concede that often times, misinformation isn’t the parents’ fault, but the media and influences they’ve been surrounded with. Therefore, it is the responsibility of medical professionals to wait on stop the spread of misconceptions.

1796 was one of the most significant years in medical history when the first vaccine came into existence. Its being for the past couple of centuries has shifted public conviction of it for the worse. A negative stigma now surrounds the word vaccination, as if it’s something unsafe and fatal, rather than the diseases it prevents. Plenty of doctors, including Paul Offit, Rorke-Adams, Day Danzinger, and Rebekah Diamond absorb heavily advocated for inoculation as a means to hold epidemics from happening. Professionals outweigh the credibility of the likes of Jenny McCarthy and Dr. Oz, who absorb been sedate promoters of the anti-vaccine movement. Vaccination is and continues to subsist essential in everyday life, from protecting herd immunity to ensuring the safety of children from resurfacing deadly diseases and infections. Overall, the anti-vaccination movement is one sparked by misconceptions and misinformation that must subsist stopped to hold children robust and the world epidemic-free.

Works CitedDaley, Matthew F., and Jason M. Glanz. "Straight Talk about Vaccination." Scientific American. 11 Aug. 2011. Web. 30 Mar. 2017.Danziger, Phoebe Day, and Rebekah Diamond. "We Can’t Convince Anti-Vaxxers of Science. They need to Mandate Vaccination."Slate Magazine. 25 July 2016. Web. 29 Mar. 2017.Marcus, Stephanie. "Jenny McCarthy Ecstasy: Actress Tried To absorb Sex With A Tree While On Ecstasy." The Huffington Post. TheHuffingtonPost, 09 Nov. 2012. Web. 28 Mar. 2017."Measles." KidsHealth. Ed. Scott A. Barron. The Nemours Foundation, Feb. 2015. Web. 29 Mar. 2017."Measles Cases and Outbreaks." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 06 Mar. 2017. Web. 27 Mar. 2017.Offit, Paul A. Deadly Choices: How the Anti-vaccine Movement Threatens Us All. novel York: Basic , a Member of the Persecus book Group, 2015. Print."Possible Side-effects from Vaccines." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 02 Dec. 2016. Web. 29 Mar. 2017.U.S. Department of Health and Human Services. "Vaccines" Vaccines. U.S. Department of Health and Human Services, 11 Oct. 2006. Web. 29 Mar. 2017."Vaccines antecedent Seizures?: Samuel Berkovic, An Unsung Hero." Parenting Patch. 02 Dec. 2013. Web. 29 Mar. 2017.Wakefield, Andrew. "Ileal-lymphoid-nodular Hyperplasia, Non-specific Colitis, and Pervasive Developmental Disorder in Children." The Lancet. Elsevier Limited, 28 Feb. 1998. Web. 27 Mar. 2017."What Causes Autism?" Autism Speaks. 24 July 2012. Web. 29 Mar. 2017.



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International Edition Textbooks

Save huge amounts of cash when you buy international edition textbooks from TEXTBOOKw.com. An international edition is a textbook that has been published outside of the US and can be drastically cheaper than the US edition.

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Highlights > Recent Additions
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Operations & Process Management: Principles & Practice for Strategic ImpactOperations & Process Management: Principles & Practice for Strategic Impact
By Nigel Slack, Alistair Jones
Publisher : Pearson (Feb 2018)
ISBN10 : 129217613X
ISBN13 : 9781292176130
Our ISBN10 : 129217613X
Our ISBN13 : 9781292176130
Subject : Business & Economics
Price : $75.00
Computer Security: Principles and PracticeComputer Security: Principles and Practice
By William Stallings, Lawrie Brown
Publisher : Pearson (Aug 2017)
ISBN10 : 0134794109
ISBN13 : 9780134794105
Our ISBN10 : 1292220619
Our ISBN13 : 9781292220611
Subject : Computer Science & Technology
Price : $65.00
Urban EconomicsUrban Economics
By Arthur O’Sullivan
Publisher : McGraw-Hill (Jan 2018)
ISBN10 : 126046542X
ISBN13 : 9781260465426
Our ISBN10 : 1260084493
Our ISBN13 : 9781260084498
Subject : Business & Economics
Price : $39.00
Urban EconomicsUrban Economics
By Arthur O’Sullivan
Publisher : McGraw-Hill (Jan 2018)
ISBN10 : 0078021782
ISBN13 : 9780078021787
Our ISBN10 : 1260084493
Our ISBN13 : 9781260084498
Subject : Business & Economics
Price : $65.00
Understanding BusinessUnderstanding Business
By William G Nickels, James McHugh, Susan McHugh
Publisher : McGraw-Hill (Feb 2018)
ISBN10 : 126021110X
ISBN13 : 9781260211108
Our ISBN10 : 126009233X
Our ISBN13 : 9781260092332
Subject : Business & Economics
Price : $75.00
Understanding BusinessUnderstanding Business
By William Nickels, James McHugh, Susan McHugh
Publisher : McGraw-Hill (May 2018)
ISBN10 : 1260682137
ISBN13 : 9781260682137
Our ISBN10 : 126009233X
Our ISBN13 : 9781260092332
Subject : Business & Economics
Price : $80.00
Understanding BusinessUnderstanding Business
By William Nickels, James McHugh, Susan McHugh
Publisher : McGraw-Hill (Jan 2018)
ISBN10 : 1260277143
ISBN13 : 9781260277142
Our ISBN10 : 126009233X
Our ISBN13 : 9781260092332
Subject : Business & Economics
Price : $77.00
Understanding BusinessUnderstanding Business
By William Nickels, James McHugh, Susan McHugh
Publisher : McGraw-Hill (Jan 2018)
ISBN10 : 1259929434
ISBN13 : 9781259929434
Our ISBN10 : 126009233X
Our ISBN13 : 9781260092332
Subject : Business & Economics
Price : $76.00
VACCVACC
By Peter W. Cardon
Publisher : McGraw-Hill (Jan 2017)
ISBN10 : 1260128474
ISBN13 : 9781260128475
Our ISBN10 : 1259921883
Our ISBN13 : 9781259921889
Subject : Business & Economics, Communication & Media
Price : $39.00
VACCVACC
By Peter Cardon
Publisher : McGraw-Hill (Feb 2017)
ISBN10 : 1260147150
ISBN13 : 9781260147155
Our ISBN10 : 1259921883
Our ISBN13 : 9781259921889
Subject : Business & Economics, Communication & Media
Price : $64.00
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