Advanced Placement credit (AP credit)
Credit by examination for advanced coursework in high school that counts for college credit.
Academic Advisor
A professional staff person or faculty member who assists students in planning an academic program of study.
Academic Calendar
Official academic calendar of the University that lists registration dates, official holidays, important deadlines, final examinations, and commencement ceremony dates for a given session. Web site:
http://www.uta.edu/uta/acadcal
Academic Continuance
Academic Standing message after a student has received an Academic Warning that signals that a student has met the minimum requirement of earning a 2.5 semester GPA but is still not within the Table of Standards. Refer to the Undergraduate Catalog under Academic Regulations for more information.
Academic Dismissal: One Long Term
Also referred to as Dismissal One or DIS1. Academic Standing message that signals that a student is not within the Table of Standards and not allowed to enroll for one long academic term (Fall or Spring term). Refer to the Undergraduate Catalog under Academic Regulations for more information.
Academic Dismissal: One Full Academic Year
Also referred to as Dismissal Two or DIS2. Academic Standing message that signals that a student is not within the Table of Standards and not allowed to enroll for one full calendar year (entire Fall, Spring, and Summer term). Refer to the Undergraduate Catalog under Academic Regulations for more information.
Academic Probation
Academic standing message that signals that a student has less than a 2.0 cumulative grade point average but is within the Table of Standards for the current student classification. Academic Probation reflects a level of academic standing that should not be confused with Academic Warning or Dismissal. Refer to the Undergraduate Catalog under Academic Regulations for more information.
Academic Standing
A message that is placed on student’s transcript after grades post at the end of a term that indicates his or her overall academic performance at the University. Refer to the Undergraduate Catalog under Academic Regulations for more information.
Academic Warning
Academic Standing message that signals that a student has not earned a grade point average that is within the Table of Standards. Refer to the Undergraduate Catalog under Academic Regulations for more information.
Add
The addition of a course to a student’s schedule for a given session.
Advising hold
Standard Negative Service Indicator in MyMav that prevents enrollment in courses until students meet with an Academic Advisor from their major department to remove (or “clear”) the hold when students have met their advising expectations.
Alum, Alumnus/a (Alumni, plural)
A graduate or former student of UT Arlington.
Auditing
Upon instructor and University permission, individuals can hear and observe a class for no academic credit. Refer to the Undergraduate Catalog under Registration and Enrollment for more information.
B.A.
Abbreviation for Bachelor of Arts degree.
B.S.
Abbreviation for Bachelor of Science degree.
Bachelor’s degree
Degree earned after completion of the required credit hours and courses within a particular field of study in addition to general requirement courses (i.e., core curriculum and electives).
Blaze
The name of the UT Arlington mascot.
Blue Books
A standard examination booklet used for essay exams. Available at the UT Arlington Bookstore and the Market in the University Center.
Census
The day at which class rolls are frozen, and students can no longer drop a class without receiving a grade of “W” on their transcript. State funding to the institution is based on the enrollment of students on census. Officially indicated in the Academic Calendar for the university.
Cheating
Copying another’s test or assignment, communication with another during an exam or assignment; seeking aid from others when not permitted by the instructor; possession of unauthorized materials during a test; buying, using, stealing, transporting, soliciting a test, draft of a test or answer key.
Classification
Level of a student in their undergraduate career based on the number of semester hours earned. Freshman < 30 hours, Sophomore 30–59 hours, Junior 60–89 hours, and Senior 90 or greater.
CLEP
A standardized test which grants credit by examination to a student record.
Colloquia
Presentations and discussions about current research conducted and related findings.
Collusion
Without authorization, collaborating with another when preparing an assignment.
Commencement
Graduation ceremonies held at the end of the Fall and Spring terms. Officially indicated in the Academic Calendar for the university.
Commuters
Students who do not reside in campus residence halls, apartments, or houses.
Concurrent Enrollment
Enrolled at UT Arlington and another institution of higher education at the same time.
Cooperative Education Programs (Co-op’s)
Programs that alternate periods of formal study at the university and periods of work under the supervision of a UT Arlington faculty member and work supervisor.
Core Curriculum
University and State mandated courses to ensure that students obtain a well-rounded education from English Composition, Literature, Liberal Arts/Humanities, U.S. History, U.S. Political Science, Mathematics, Natural Sciences, Social/Cultural Studies, Fine Arts, and oral and computer proficiency. Refer to the Undergraduate Catalog under the Degree Program Requirements section for more specific information.
Course Number
Courses at UT Arlington are designated with a standard prefix and number (e.g., ENGL 1301). ENGL is a course prefix and tells a student which department offers the course or names a cluster of courses. The standard list of UT Arlington prefixes can be found in the Undergraduate Catalog under Course Abbreviations. The course number denotes the level of the course, number of credit hours, and distinguishing number in a department. Refer to the Undergraduate Catalog under the Undergraduate Admissions section for more specific information.
Credit by Exam
Academic course credit given to students based on performance on national standardized tests (e.g., AP, CLEP, IB, DANTES) or Advanced Standing Exams offered by some departments. Refer to the Undergraduate Catalog under the Undergraduate Admissions section for more specific information.
Cumulative Grade Point Average
Overall grade point average for all classes taken at UT Arlington; see semester grade point average as well.
Dental Admissions Test (DAT)
A standardized test that helps dental schools assess the qualifications of a candidate applying for dental school.
Dead Week
Actually called Final Review Week at UT Arlington. Five class days prior to final examinations during the long sessions that allow students to prepare for finals. Refer to the Undergraduate Catalog for more specific information.
Dean
Leading academic official of a school or college. Considered a member of the faculty as well.
Disciplinary Probation
A sanction given to students by the Office of Student Conduct for offenses against the Code of Student Conduct.
Doctoral degree
Highest degree obtained in academics. Abbreviated Ph.D. Person with a Ph.D. is referred to as “Dr. So-and-so.”
Drop
The deletion of a course to a student’s schedule for a given session.
Drop for Non-Pay
A deadline prior to the beginning of a session in which students are dropped from their enrolled coursework if payment or arrangements for payment have not been made.
Elective
A course that student can choose freely from all departments on campus in a degree plan that counts toward the required hours to graduate with a Bachelor’s degree. Should not be confused with a Major Elective that is a specified list of courses that a student can choose from in the major.
Expulsion
A permanent suspension from the university.
Faculty
The body of individuals that teach courses at an institution. Comprised of Professors, Associate and Assistant Professors, Lecturers, and Instructors including tenure-track and non-tenure track (sometimes also called adjunct faculty) faculty.
FAFSA
Abbreviation for Free Application for Federal Student Aid. Form that must be completed prior to receiving federal and state financial aid.
FERPA
Abbreviation for the Family Educational Rights and Privacy Act of 1974. Policy that governs what student information can be shared with the public, including parents, spouses, siblings, etc. Refer to the Undergraduate Catalog under Academic Regulations for more information.
Finals
Abbreviation for Final Examinations. Examinations given to students at the end of a session. Official final exam schedule can be found at the Office of Records Web site, www3.uta.edu/ registrar/FinalExamSched.asp. Officially indicated in the Academic Calendar for the University.
Financial Aid
Award Any loan, work-study employment, grant, or scholarships offered to help a student meet the cost of attaining an education and related expenses. Fraternities Organizations of men who seek to develop social, leadership, and service opportunities on and off campus to enhance their educational experience and contribute to their personal development. Full-time Student A student who enrolls in a long semester (Fall or Spring) for 12 or more semester credit hours. Refer to the Undergraduate Catalog under Undergraduate Admissions for information on full-time status in short sessions.
Graduate Teaching Assistants (GTAs)
Graduate students hired to teach courses or assist a professor teaching a course.
Graduate Management Admissions Test (GMAT)
A standardized test that helps business schools assess the qualifications of applicants for advanced study in business and management.
Good Standing
Academic Standing designation for students with a cumulative GPA of 2.0 or higher.
Grade Point Average (GPA)
A four-point grading system, used to measure academic performance (4.0 = A, 3.0 = B, 2.0 = C, 1.0 = D, and 0.0 = F).
Graduate Record Exam (GRE)
A standardized test used by graduate level programs across the nation used to assess the qualifications of applicants for advanced study in higher education.
Grants
A form of financial aid that does not require the student to pay the money back upon graduation or leaving school.
Greek Life
Community comprised of four governing bodies that represents 30 fraternities and sororities on campus.
Harassment
Verbal or non-verbal conduct which creates an intimidating, hostile, or offensive working or educational environment.
Hazing
Any action or situation that recklessly or intentionally endangers the mental or physical health of a student for the purpose of initiation or admission into an organization. Hazing is illegal in the State of Texas. Refer to the Undergraduate Catalog under the Student Involvement and Policies section for more specific information.
Independent Study
Course credit earned by students who work one-on-one with a faculty member completing research and projects on an area of interest to the student and faculty member.
Internship
Experiential learning opportunity in which students can receive college credit for work conducted in the workforce under the supervision of a UT Arlington faculty member and Work Supervisor.
Intramural Sports
Campus-sponsored recreational and competitive activities for men, women, and co-recreational teams.
Labs
Experiential class time often used to apply information and processes presented in lecture.
Last Drop Day
A deadline during a given session in which students can drop a course with the assistance of an academic advisor in their major department. Officially indicated in the Academic Calendar for the University. Late Registration Period at the beginning of each session for students who were unable to register during the regular registration period. Students often use this time period to add/drop/swap courses. Officially indicated in the Academic Calendar for the University.
Latin Honors
Honorable designation at graduation for students earning exemplary GPAs in a certain number of credit hours. Refer to the Under- graduate Catalog under the Graduation section for more specific information. Lecture Oral presentation of critical information, history, background, theories, or processes by a faculty member. Loans, Student Funding offered to students to pay for educational expenses based on the FASFA and available funding provided to the institution. Requires that the students repay the principal amount and interest. Major A field of study (i.e., body of coursework) determined by the faculty of a given area of study or department.
Major Course
A course that is required in order to earn a Bachelor’s degree in that major. Major Elective A course that is offered in the major that a student can freely choose.
Master’s Degree
An advanced degree obtained in academics. Abbreviated M.A.(Masters of Arts), M.S. (Masters of Science), M.B.A. (Masters of Business Administration), etc.
Math Placement Test (MPT)
Placement test given to incoming students to determine their readiness to complete certain levels of the UT Arlington math curriculum. Not to be confused with the GMAT or Miller Analogies Test.
Medical College Admissions Test (MCAT)
A standardized test that helps medical schools assess the qualifications of a candidate applying for medical professional school.
Mav Express Card
Photo identification issued to enrolled UT Arlington students. Used to access certain campus services as well as off-campus discount program.
Mavericks
Term used to refer to UT Arlington students.
Maverick Stampede
Events series to welcome students to campus at the beginning of the Fall term.
MavMail
UT Arlington e-mail account issued to all students, faculty, and staff and source of official communication from the university.
Minor
A field of study (i.e., body of coursework) determined by the faculty of a given area of study or department that requires less credit hours to complete in comparison to a major.
MyMav
Term used to refer to the campus student information system that students use to enroll in courses, check their grades, accept their financial aid, pay their tuition, etc.
Non-Degree-Seeking Students
A student who holds a Bachelor’s degree from another accredited institution but is admitted to continue to take leveling coursework.
Overload
A course schedule that includes more than 18 semester credit hours.
Parking Permit
Decal for the windshield that allows for legal campus parking based on designation (student, faculty-staff, residential student, etc.).
Part-time Student
A student who enrolls in less than 12 semester credit hours in a given session.
Peer Academic Leaders (PALs)
Students assigned to the Student Success Course to assist new students in their transition to college life.
Ph.D.
Abbreviation for Doctoral degree; persons having earned a Ph.D. should be referred to as “Dr. X.”
Plagiarism
Using someone else’s work in your assignment without appropriate acknowledgement or making slight variations in the language and then failing to give credit to the source. An offense that constitutes the “stealing” of someone else’s work or ideas. Prerequisites Courses that need to be taken before a student can be successful in a subsequent class or accepted into a degree program.
President
The Chief Administrator of UT Arlington.
Provost
Chief Academic Officer of the University who serves as a leader to the Deans and faculty on campus as well as academic support programs and student affairs at UT Arlington.
R
Abbreviation in the Schedule of Classes for Thursday.
Registrar
Referred to at UT Arlington as the Office of Admissions, Records, and Registration. Maintains student records related to the process of admission to the university and enrollment in courses.
Registration
Period in which students can enroll in courses via the MyMav student information system. Officially indicated in the Academic Calendar for the university.
Resident Assistant (RA)
Student leader on campus that lives in the residence halls on campus and supports students within that living arrangement.
Rush
The opportunity to check out and join a fraternity or sorority.
SAP
Abbreviation for Satisfactory Academic Progress. Students receiving financial aid awards must complete a minimum number of hours based on classification. Refer to the Undergraduate Catalog under Academic Regulations for more information.
Scantrons
A form used mainly for multiple choice exams in which students must fill in the circle of their answer. Can be purchased at the UT Arlington Bookstore or Market in the University Center.
Schedule of Classes
List of courses available for a particular session via the MyMav portal.
Scholarship
Funding offered to students to pay for educational expenses based on academic achievement or certain characteristics of the student.
Semester Credit Hours
Number of credit hours a student earns for taking a particular course. Often reflects the number of class hours a student will sit in each week for that class with the exception of classes with laboratory credit.
Semester Grade Point Average
Grade point average for only courses taken during a given session.
Seminar
Course taught by a faculty member on a special topic typically with a small class size to promote student-faculty discussion.
Service Indicator
A flag on a student record in MyMav that can provide information or block certain actions from occurring. Positive service indicators are marked by a “star” in MyMav, while negative service indicators are marked by a circle with a diagonal line through it. Negative Service indicators are often referred to as “holds.”
Service Learning
Volunteer activity in which students earn assignment or course credit for reflecting or applying their experience to academic course content under the supervision of a UT Arlington faculty member.
Session
Period of time when academic coursework is offered and completed. There are seven distinct sessions that comprise the Fall, Spring, and Summer terms. Dynamic Dated Sessions are associated with all three terms.
The Shorthorn
Student-published newspaper at UT Arlington. Available in print and online.
SNAP Jobs
Student employment listing maintained by Human Resources.
Sororities
Organizations of women who seek to develop social, leadership, and service opportunities on and off campus to enhance their educational experience and contribute to their personal development.
Staff
University professionals who typically have a 12-month appointment and serve to support students or the normal functions necessary to maintain the university.
Student Accounts
Office on campus that is the point of payment and billing for tuition, fees, and charges. Also referred to as Student Financial Services.
Student Fees
Funding that students pay to the university that pays for the additional support services and programs that aid in their social, academic, and personal success.
Student ID
A ten-digit identification number issued to students that typically begins with 1000. Also can be referred to as the EmplID in MyMav or by the layperson as the “1000 number.”
Student Money Management Center
UT Arlington Student Money Management takes pride in assisting our students with their financial needs. Our office provides a website full of resources, one-on-one counseling sessions, seminars and presentations. We educate students on budgeting, savings, and credit awareness.
Subplan
A specialization of course work in a major.
Suspension
Sanction given by the Office of Student Conduct for students performing offenses against the Student Code of Conduct. Term often used interchangeably with Academic Dismissal.
Sustainability
The ability to meet the needs of the present without compromising the ability of future generations to meet their own needs. The practice of maintaining life and society through technologies, policies, and personal choices that help us use our planet’s limited resources more effectively.
Swap
The changing of sections of a course to a student’s schedule for a given session.
Syllabus
A document provided by faculty members to students which articulates the requirements for completing the course and grading and other policies and procedures related to the course.
Table of Standards
Level of performance required of undergraduate students based on their GPA and hours attempted in order to continue enrollment at the University. Refer to the Undergraduate Catalog under the Academic Regulations section for more specific information.
Term
A combination of sessions that make up the Fall, Spring, and Summer terms (i.e., Summer Intersession, 11-week session, 5-week I, and 5-week II sessions equal the Summer term).
Texas Success Initiative (TSI)
State-mandated program to ensure that entering college students have the necessary skills to perform effectively in college coursework. Students must seek assessment before enrolling in college coursework and advisement into proper developmental coursework.
TSI Assessment
A standardized test that measures reading, writing, and math skills to determine if a student has the appropriate skill levels to complete college-level coursework.
The Trailblazer
A weekly student newsletter published and distributed via the UT Arlington student e-mail account.
Transfer students
Students who enter UT Arlington and have already attempted more than 24 hours of coursework at another higher education institution.
UC
Abbreviation for the E.H. Hereford University Center.
Undergraduate Catalog
Publication that provides all of the rules and regulations regarding earning a bachelor’s degree at UT Arlington given a particular date of entry to the University. The official Undergraduate Catalog is online at
http://www.uta.edu/catalog/
.
Division of Student Success
An administrative unit to serve new incoming freshman students in their transition to the University.
Withdrawal
Dropping one or more classes in a given session. Designated on a transcript as a grade of “W.”


22.4D: Bacterial Foodborne Diseases
- Give examples of bacterial foodborne diseases in humans
Prokaryotes are everywhere. They readily colonize the surface of any type of material. Food is not an exception. Most of the time, prokaryotes colonize food and food-processing equipment in the form of a biofilm. Outbreaks of bacterial infection related to food consumption are common. A foodborne disease (colloquially called “food poisoning”) is an illness resulting from the consumption of pathogenic bacteria, viruses, or other parasites that contaminate food. Although the United States has one of the safest food supplies in the world, the U.S. Centers for Disease Control and Prevention (CDC) has reported that “76 million people get sick, more than 300,000 are hospitalized, and 5,000 Americans die each year from foodborne illness.”
The characteristics of foodborne illnesses have changed over time. In the past, sporadic cases of botulism, the potentially fatal disease produced by a toxin from the anaerobic bacterium Clostridium botulinum , were relatively common. Some of the sources for this bacterium were non-acidic canned foods, homemade pickles, and processed meat and sausages. The can, jar, or package created a suitable anaerobic environment where Clostridium could grow. However, proper sterilization and canning procedures have reduced the incidence of this disease.
While people may tend to think of foodborne illnesses as associated with animal-based foods, most cases are now linked to produce. There have been serious, produce-related outbreaks associated with raw spinach in the United States and with vegetable sprouts in Germany. These types of outbreaks have become more common. The raw spinach outbreak in 2006 was produced by the bacterium E. coli serotype O157:H7. A serotype is a strain of bacteria that carries a set of similar antigens on its cell surface. There are often many different serotypes of a bacterial species. Most E. coli are not particularly dangerous to humans, but serotype O157:H7 can cause bloody diarrhea and is potentially fatal.
All types of food can potentially be contaminated with bacteria. Recent outbreaks of Salmonella reported by the CDC occurred in foods as diverse as peanut butter, alfalfa sprouts, and eggs. A deadly outbreak in Germany in 2010 was caused by E. coli contamination of vegetable sprouts. The strain that caused the outbreak was found to be a new serotype not previously involved in other outbreaks, which indicates that E. coli is continuously evolving.
Contributions and Attributions
- OpenStax College, Biology. October 16, 2013. Provided by : OpenStax CNX. Located at : http://cnx.org/content/m44607/latest...ol11448/latest . License : CC BY: Attribution
- OpenStax College, Biology. October 23, 2013. Provided by : OpenStax CNX. Located at : http://cnx.org/content/m44607/latest...ol11448/latest . License : CC BY: Attribution
- pathogen. Provided by : Wiktionary. Located at : en.wiktionary.org/wiki/pathogen . License : CC BY-SA: Attribution-ShareAlike
- zoonosis. Provided by : Wiktionary. Located at : en.wiktionary.org/wiki/zoonosis . License : CC BY-SA: Attribution-ShareAlike
- plague. Provided by : Wiktionary. Located at : en.wiktionary.org/wiki/plague . License : CC BY-SA: Attribution-ShareAlike
- OpenStax College, Bacterial Diseases in Humans. October 16, 2013. Provided by : OpenStax CNX. Located at : http://cnx.org/content/m44607/latest...e_22_04_02.jpg . License : CC BY: Attribution
- OpenStax College, Bacterial Diseases in Humans. October 16, 2013. Provided by : OpenStax CNX. Located at : http://cnx.org/content/m44607/latest...e_22_04_01.jpg . License : CC BY: Attribution
- OpenStax College, Bacterial Diseases in Humans. October 16, 2013. Provided by : OpenStax CNX. Located at : http://cnx.org/content/m44607/latest...e_22_04_03.jpg . License : CC BY: Attribution
- OpenStax College, Biology. October 16, 2013. Provided by : OpenStax CNX. Located at : http://cnx.org/content/m44607/latest/?collection=col11448/latest . License : CC BY: Attribution
- Bacterial biofilm. Provided by : Wikiversity. Located at : en.wikiversity.org/wiki/Bacterial_biofilm . License : CC BY-SA: Attribution-ShareAlike
- OpenStax College, Signaling in Single-Celled Organisms. November 7, 2013. Provided by : OpenStax CNX. Located at : http://cnx.org/content/m44454/latest/ . License : CC BY: Attribution
- nosocomial. Provided by : Wiktionary. Located at : en.wiktionary.org/wiki/nosocomial . License : CC BY-SA: Attribution-ShareAlike
- biofilm. Provided by : Wiktionary. Located at : en.wiktionary.org/wiki/biofilm . License : CC BY-SA: Attribution-ShareAlike
- OpenStax College, Bacterial Diseases in Humans. October 16, 2013. Provided by : OpenStax CNX. Located at : http://cnx.org/content/m44607/latest...e_22_04_02.jpg . License : CC BY: Attribution
- OpenStax College, Bacterial Diseases in Humans. October 16, 2013. Provided by : OpenStax CNX. Located at : http://cnx.org/content/m44607/latest...e_22_04_01.jpg . License : CC BY: Attribution
- OpenStax College, Bacterial Diseases in Humans. October 16, 2013. Provided by : OpenStax CNX. Located at : http://cnx.org/content/m44607/latest...e_22_04_03.jpg . License : CC BY: Attribution
- Biofilm. Provided by : Wikipedia. Located at : en.Wikipedia.org/wiki/File:Biofilm.jpg . License : CC BY-SA: Attribution-ShareAlike
- OpenStax College, Biology. October 16, 2013. Provided by : OpenStax CNX. Located at : http://cnx.org/content/m44607/latest/?collection=col11448/latest . License : CC BY: Attribution
- antibiotic. Provided by : Wiktionary. Located at : en.wiktionary.org/wiki/antibiotic . License : CC BY-SA: Attribution-ShareAlike
- OpenStax College, Bacterial Diseases in Humans. October 16, 2013. Provided by : OpenStax CNX. Located at : http://cnx.org/content/m44607/latest...e_22_04_02.jpg . License : CC BY: Attribution
- OpenStax College, Bacterial Diseases in Humans. October 16, 2013. Provided by : OpenStax CNX. Located at : http://cnx.org/content/m44607/latest...e_22_04_01.jpg . License : CC BY: Attribution
- OpenStax College, Bacterial Diseases in Humans. October 16, 2013. Provided by : OpenStax CNX. Located at : http://cnx.org/content/m44607/latest...e_22_04_03.jpg . License : CC BY: Attribution
- Biofilm. Provided by : Wikipedia. Located at : en.Wikipedia.org/wiki/File:Biofilm.jpg . License : CC BY-SA: Attribution-ShareAlike
- OpenStax College, Bacterial Diseases in Humans. October 16, 2013. Provided by : OpenStax CNX. Located at : http://cnx.org/content/m44607/latest...e_22_04_05.jpg . License : CC BY: Attribution
- OpenStax College, Biology. October 16, 2013. Provided by : OpenStax CNX. Located at : http://cnx.org/content/m44607/latest/?collection=col11448/latest . License : CC BY: Attribution
- botulism. Provided by : Wiktionary. Located at : en.wiktionary.org/wiki/botulism . License : CC BY-SA: Attribution-ShareAlike
- serotype. Provided by : Wiktionary. Located at : en.wiktionary.org/wiki/serotype . License : CC BY-SA: Attribution-ShareAlike
- OpenStax College, Bacterial Diseases in Humans. October 16, 2013. Provided by : OpenStax CNX. Located at : http://cnx.org/content/m44607/latest/Figure_22_04_02.jpg . License : CC BY: Attribution
- OpenStax College, Bacterial Diseases in Humans. October 16, 2013. Provided by : OpenStax CNX. Located at : http://cnx.org/content/m44607/latest/Figure_22_04_01.jpg . License : CC BY: Attribution
- OpenStax College, Bacterial Diseases in Humans. October 16, 2013. Provided by : OpenStax CNX. Located at : http://cnx.org/content/m44607/latest/Figure_22_04_03.jpg . License : CC BY: Attribution
- Biofilm. Provided by : Wikipedia. Located at : en.Wikipedia.org/wiki/File:Biofilm.jpg . License : CC BY-SA: Attribution-ShareAlike
- OpenStax College, Bacterial Diseases in Humans. October 16, 2013. Provided by : OpenStax CNX. Located at : http://cnx.org/content/m44607/latest...e_22_04_05.jpg . License : CC BY: Attribution
- OpenStax College, Bacterial Diseases in Humans. October 16, 2013. Provided by : OpenStax CNX. Located at : http://cnx.org/content/m44607/latest..._22_04_06f.jpg . License : CC BY: Attribution
Key Points
- Food and food-processing equipment are usually colonized by biofilms.
- A foodborne disease is an illness resulting from the consumption of pathogenic bacteria, viruses, or other parasites that contaminate animal or plant-based food.
- Proper sterilization techniques and canning procedures have reduced the incidence of botulism.
- E. coli outbreaks have become more common as new strains continue to evolve.
Key Terms
- serotype : a group of microorganisms characterized by a specific set of antigens
- botulism : poisoning caused by the toxin from Clostridium botulinum, a type of anaerobic bacteria that grows in improperly-prepared food


9.2: Quality Care
Quality is defined in a variety of ways that impact nursing practice.
ANA Definition of Quality
The American Nurses Association (ANA) defines quality as, “The degree to which nursing services for health care consumers, families, groups, communities, and populations increase the likelihood of desirable outcomes and are consistent with evolving nursing knowledge.” [1] The phrases in this definition focus on three aspects of quality: services (nursing interventions), desirable outcomes, and consistency with evolving nursing knowledge (evidence-based practice). Alignment of nursing interventions with current evidence-based practice is a key component for quality care. [2] Evidence-based practice (EBP) will be further discussed later in this chapter.
Quality of Practice is one of the ANA’s Standards of Professional Performance. ANA Standards of Professional Performance are “authoritative statements of the actions and behaviors that all registered nurses, regardless of role, population, specialty, and setting are expected to perform competently.” See the competencies for the ANA’s Quality of Practice Standard of Professional Performance in the following box. [3]
Competencies of ANA’s Quality of Practice Standard of Professional Performance [4]
- Ensures that nursing practice is safe, effective, efficient, equitable, timely, and person-centered.
- Incorporates evidence into nursing practice to improve outcomes.
- Uses creativity and innovation to enhance nursing care.
- Recommends strategies to improve nursing care quality.
- Collects data to monitor the quality of nursing practice.
- Contributes to efforts to improve health care efficiency.
- Provides critical review and evaluation of policies, procedures, and guidelines to improve the quality of health care.
- Engages in formal and informal peer review processes of the interprofessional team.
- Participates in quality improvement initiatives.
- Collaborates with the interprofessional team to implement quality improvement plans and interventions.
- Documents nursing practice in a manner that supports quality and performance improvement initiatives.
- Recognizes the value of professional and specialty certification.
Reflective Questions
- What Quality of Practice competencies have you already demonstrated during your nursing education?
- What Quality of Practice competencies are you most interested in mastering?
- What questions do you have about the ANA’s Quality of Practice competencies? Where could you find answers to those questions (e.g., instructors, preceptors, health care team members, guidelines, or core measures)?
This chapter will review content related to the competencies of the ANA’s Quality of Practice Standard of Professional Performance. Additional information about peer review is discussed in the “ Leadership and Management ” chapter, and specialty certification is discussed in the “ Preparation for the RN Role ” chapter.
Quality and Safety Education for Nurses
The Quality and Safety Education for Nurses (QSEN) project advocates for safe, quality patient care by defining six competencies for prelicensure nursing students: Patient-Centered Care, Teamwork and Collaboration, Evidence-Based Practice, Quality Improvement, Safety, and Informatics. These competencies are further discussed in the “ Advocacy ” chapter.
Framework of Quality Health Care
A definition of quality that has historically guided the measurement of quality initiatives in health care systems is based on the framework for improvement originally created by the Institute of Medicine (IOM). The IOM name changed to the National Academy of Medicine in 2015. The IOM framework includes the following six criteria for defining quality health care [5] , [6] :
- Safe: Avoiding harm to patients from the care that is intended to help them.
- Effective: Providing services based on scientific knowledge to all who could benefit and refraining from providing services to those not likely to benefit (i.e., avoiding underuse and misuse).
- Patient-centered: Providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions.
- Timely: Reducing waits and sometimes harmful delays for both those who receive and those who provide care.
- Efficient: Avoiding waste, including waste of equipment, supplies, ideas, and energy.
- Equitable: Providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and socioeconomic status.
This framework continues to guide quality improvement initiatives across America’s health care system. The evidence-based practice (EBP) movement began with the public acknowledgement of unacceptable patient outcomes resulting from a gap between research findings and actual health care practices. For EBP to be successfully adopted and sustained, it must be adopted by nurses and other health care team members, system leaders, and policy makers. Regulations and recognitions are also necessary to promote the adoption of EBP. For example, the Magnet Recognition Program promotes nursing as a leader in catalyzing adoption of EBP and using it as a marker of excellence. [7]
Magnet Recognition Program
The Magnet Recognition Program is an award from the American Nurses Credentialing Center (ANCC) that recognizes organizational commitment to nursing excellence. The award recognizes organizations worldwide where nursing leaders have successfully aligned their nursing strategic goals to improve the organization’s patient outcomes. To nurses, Magnet Recognition means education and development are available through every stage of their career. To patients, it means quality care is delivered by nurses who are supported to be the best that they can be. [8] See Figure 9.2 [9] for an image related to the Magnet Recognition Program.
Reimbursement Models
Quality health care is also defined by value-based reimbursement models used by Medicare, Medicaid, and private insurance companies paying for health services. As discussed in the “ Health Care Reimbursement Models ” section of the “Health Care Economics” chapter, value-based payment reimbursement models use financial incentives to reward quality health care and positive patient outcomes. For example, Medicare no longer reimburses hospitals to treat patients who acquire certain preventable conditions during their hospital stay, such as pressure injuries or urinary tract infections associated with use of catheters. [10] These reimbursement models directly impact the evidence-based care nurses provide at the bedside and the associated documentation of assessments, interventions, and nursing care plans to ensure quality performance criteria are met.
CMS Quality Initiatives
The Centers for Medicare & Medicaid Services (CMS) establishes quality initiatives that focus on several key quality measures of health care. These quality measures provide a comprehensive understanding and evaluation of the care an organization delivers, as well as patients’ responses to the care provided. These quality measures evaluate many areas of health care, including the following: [11]
- Health outcomes
- Clinical processes
- Patient safety
- Efficient use of health care resources
- Care coordination
- Patient engagement in their own care
- Patient perceptions of their care
These measures of quality focus on providing the care the patient needs when the patient needs it, in an affordable, safe, effective manner. It also means engaging and involving the patient so they take ownership in managing their care at home.
Visit the CMS What is a Quality Measure web page.
Accreditation
Accreditation is a review process that determines if an agency is meeting the defined standards of quality determined by the accrediting body. The main accrediting organizations for health care are as follows:
- The Joint Commission
- National Committee for Quality Assurance
- American Medical Accreditation Program
- American Accreditation Healthcare Commission
The standards of quality vary depending on the accrediting organization, but they all share common goals to improve efficiency, equity, and delivery of high-quality care. Two terms commonly associated with accreditation that are directly related to quality nursing care are core measures and patient safety goals.
Core Measures
Core measures are national standards of care and treatment processes for common conditions. These processes are proven to reduce complications and lead to better patient outcomes. Core measure compliance reports show how often a hospital successfully provides recommended treatment for certain medical conditions. In the United States, hospitals must report their compliance with core measures to The Joint Commission, CMS, and other agencies. [12]
In November 2003, The Joint Commission and CMS began work to align common core measures so they are identical. This work resulted in the creation of one common set of measures known as the Specifications Manual for National Hospital Inpatient Quality Measures. These core measures are used by both organizations to improve the health care delivery process. Examples of core measures include guidelines regarding immunizations, tobacco treatment, substance use, hip and knee replacements, cardiac care, strokes, treatment of high blood pressure, and the use of high-risk medications in the elderly. Nurses must be aware of core measures and ensure the care they provide aligns with these recommendations. [13]
Read more about the National Hospital Inpatient Quality Measures .
Patient Safety Goals
Patient safety goals are guidelines specific to organizations accredited by The Joint Commission that focus on health care safety problems and ways to solve them. The National Patient Safety Goals (NPSG) were first established in 2003 and are updated annually to address areas of national concern related to patient safety, as well as to promote high-quality care. The NPSG provide guidance for specific health care settings, including hospitals, ambulatory clinics, behavioral health, critical access hospitals, home care, laboratory, skilled nursing care, and surgery.
The following goals are some examples of NPSG for hospitals [14] :
- Identify patients correctly
- Improve staff communication
- Use medicines safely
- Use alarms safely
- Prevent infection
- Identify patient safety risks
- Prevent mistakes in surgery
Nurses must be aware of the current NPSG for their health care setting, implement appropriate interventions, and document their assessments and interventions. Documentation in the electronic medical record is primarily used as evidence that an organization is meeting these goals.
Read the current agency-specific National Patient Safety Goals.
- American Nurses Association. (2021). Nursing: Scope and standards of practice (4th ed.). American Nurses Association. ↵
- Stevens, K. R. (2013). The impact of evidence-based practice in nursing and the next big ideas. OJIN: The Online Journal of Issues in Nursing, 18 (2), manuscript 4. https://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-18-2013/No2-May-2013/Impact-of-Evidence-Based-Practice.html ↵
- American Nurses Association. (2021). Nursing: Scope and standards of practice (4th ed.). American Nurses Association. ↵
- American Nurses Association. (2021). Nursing: Scope and standards of practice (4th ed.). American Nurses Association. ↵
- Agency for Healthcare Research & Quality. (2018, November). Six domains of health care quality. https://www.ahrq.gov/talkingquality/measures/six-domains.html ↵
- Institute of Medicine (US) Committee on Quality of Health Care in America. (2001). Crossing the quality chasm: A new health system for the 21st century. National Academies Press. https://pubmed.ncbi.nlm.nih.gov/25057539/ ↵
- Stevens, K. R. (2013). The impact of evidence-based practice in nursing and the next big ideas. OJIN: The Online Journal of Issues in Nursing, 18 (2), manuscript 4. https://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-18-2013/No2-May-2013/Impact-of-Evidence-Based-Practice.html ↵
- American Nurses Credentialing Center. (n.d.). ANCC magnet recognition program. https://www.nursingworld.org/organizational-programs/magnet/ ↵
- “ Magnet_Recognition_Logo_CMYK_-png-.png ” by Mattmitchell37 is licensed under CC BY-SA 4.0 ↵
- James, J. (2012, October 11). Pay-for-performance . Health Affairs. https://www.healthaffairs.org/do/10.1377/hpb20121011.90233/full/ ↵
- CMS.gov. (2020, February 11). Quality measures . https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/QualityMeasures ↵
- John Hopkins Medicine. (n.d.). Core measures. https://www.hopkinsmedicine.org/patient_safety/core_measures.html ↵
- The Joint Commission. (n.d.). Measures. https://www.jointcommission.org/en/measurement/measures/ ↵
- The Joint Commission. (2022). 2022 national patient safety goals. https://www.jointcommission.org/standards/national-patient-safety-goals/ ↵


15.3: Problems on Random Selection
Exercise \(\PageIndex{1}\)
(See Exercise 3 from " Problems on Random Variables and Joint Distributions ") A die is rolled. Let \(X\) be the number of spots that turn up. A coin is flipped \(X\) times. Let \(Y\) be the number of heads that turn up. Determine the distribution for \(Y\).
- Answer
-
PX = [0 (1/6)*ones(1,6)]; PY = [0.5 0.5]; gend Do not forget zero coefficients for missing powers Enter gen fn COEFFICIENTS for gN PX Enter gen fn COEFFICIENTS for gY PY Results are in N, PN, Y, PY, D, PD, P May use jcalc or jcalcf on N, D, P To view the distribution, call for gD. disp(gD) % Compare with P8-3 0 0.1641 1.0000 0.3125 2.0000 0.2578 3.0000 0.1667 4.0000 0.0755 5.0000 0.0208 6.0000 0.0026
Exercise \(\PageIndex{2}\)
(See Exercise 4 from " Problems on Random Variables and Joint Distributions ") As a variation of Exercise 15.3.1 , suppose a pair of dice is rolled instead of a single die. Determine the distribution for \(Y\).
- Answer
-
PN = (1/36)*[0 0 1 2 3 4 5 6 5 4 3 2 1]; PY = [0.5 0.5]; gend Do not forget zero coefficients for missing powers Enter gen fn COEFFICIENTS for gN PN Enter gen fn COEFFICIENTS for gY PY Results are in N, PN, Y, PY, D, PD, P May use jcalc or jcalcf on N, D, P To view the distribution, call for gD. disp(gD) 0 0.0269 1.0000 0.1025 2.0000 0.1823 3.0000 0.2158 4.0000 0.1954 5.0000 0.1400 6.0000 0.0806 7.0000 0.0375 8.0000 0.0140 % (Continued next page) 9.0000 0.0040 10.0000 0.0008 11.0000 0.0001 12.0000 0.0000
Exercise \(\PageIndex{3}\)
(See Exercise 5 from " Problems on Random Variables and Joint Distributions ") Suppose a pair of dice is rolled. Let \(X\) be the total number of spots which turn up. Roll the pair an additional \(X\) times. Let \(Y\) be the number of sevens that are thrown on the \(X\) rolls. Determine the distribution for \(Y\). What is the probability of three or more sevens?
- Answer
-
PX = (1/36)*[0 0 1 2 3 4 5 6 5 4 3 2 1]; PY = [5/6 1/6]; gend Do not forget zero coefficients for missing powers Enter gen fn COEFFICIENTS for gN PX Enter gen fn COEFFICIENTS for gY PY Results are in N, PN, Y, PY, D, PD, P May use jcalc or jcalcf on N, D, P To view the distribution, call for gD. disp(gD) 0 0.3072 1.0000 0.3660 2.0000 0.2152 3.0000 0.0828 4.0000 0.0230 5.0000 0.0048 6.0000 0.0008 7.0000 0.0001 8.0000 0.0000 9.0000 0.0000 10.0000 0.0000 11.0000 0.0000 12.0000 0.0000 P = (D>=3)*PD' P = 0.1116
Exercise \(\PageIndex{4}\)
(See Example 7 from " Conditional Expectation, Regression ") A number \(X\) is chosen by a random selection from the integers 1 through 20 (say by drawing a card from a box). A pair of dice is thrown \(X\) times. Let \(Y\) be the number of “matches” (i.e., both ones, both twos, etc.). Determine the distribution for \(Y\).
- Answer
-
gN = (1/20)*[0 ones(1,20)]; gY = [5/6 1/6]; gend Do not forget zero coefficients for missing powers Enter gen fn COEFFICIENTS for gN gN Enter gen fn COEFFICIENTS for gY gY Results are in N, PN, Y, PY, D, PD, P May use jcalc or jcalcf on N, D, P To view the distribution, call for gD. disp(gD) 0 0.2435 1.0000 0.2661 2.0000 0.2113 3.0000 0.1419 4.0000 0.0795 5.0000 0.0370 6.0000 0.0144 7.0000 0.0047 8.0000 0.0013 9.0000 0.0003 10.0000 0.0001 11.0000 0.0000 12.0000 0.0000 13.0000 0.0000 14.0000 0.0000 15.0000 0.0000 16.0000 0.0000 17.0000 0.0000 18.0000 0.0000 19.0000 0.0000 20.0000 0.0000
Exercise \(\PageIndex{5}\)
(See Exercise 20 from " Problems on Conditional Expectation, Regression ") A number \(X\) is selected randomly from the integers 1 through 100. A pair of dice is thrown \(X\) times. Let \(Y\) be the number of sevens thrown on the \(X\) tosses. Determine the distribution for \(Y\). Determine \(E[Y]\) and \(P(Y \le 20)\).
- Answer
-
gN = 0.01*[0 ones(1,100)]; gY = [5/6 1/6]; gend Do not forget zero coefficients for missing powers Enter gen fn COEFFICIENTS for gN gN Enter gen fn COEFFICIENTS for gY gY Results are in N, PN, Y, PY, D, PD, P May use jcalc or jcalcf on N, D, P To view the distribution, call for gD. EY = dot(D,PD) EY = 8.4167 P20 = (D<=20)*PD' P20 = 0.9837
Exercise \(\PageIndex{6}\)
(See Exercise 21 from " Problems on Conditional Expectation, Regression ") A number \(X\) is selected randomly from the integers 1 through 100. Each of two people draw \(X\) times independently and randomly a number from 1 to 10. Let \(Y\) be the number of matches (i.e., both draw ones, both draw twos, etc.). Determine the distribution for \(Y\). Determine \(E[Y]\) and \(P(Y \le 10)\).
- Answer
-
gN = 0.01*[0 ones(1,100)]; gY = [0.9 0.1]; gend Do not forget zero coefficients for missing powers Enter gen fn COEFFICIENTS for gN gN Enter gen fn COEFFICIENTS for gY gY Results are in N, PN, Y, PY, D, PD, P May use jcalc or jcalcf on N, D, P To view the distribution, call for gD. EY = dot(D,PD) EY = 5.0500 P10 = (D<=10)*PD' P10 = 0.9188
Exercise \(\PageIndex{7}\)
Suppose the number of entries in a contest is \(N\) ~ binomial (20, 0.4). There are four questions. Let \(Y_i\) be the number of questions answered correctly by the \(i\)th contestant. Suppose the \(Y_i\) are iid, with common distribution
\(Y =\) [1 2 3 4] \(PY =\) [0.2 0.4 0.3 0.1]
Let \(D\) be the total number of correct answers. Determine \(E[D]\), \(\text{Var} [D]\), \(P(15 \le D \le 25)\), and \(P(10 \le D \le 30)\).
- Answer
-
gN = ibinom(20,0.4,0:20); gY = 0.1*[0 2 4 3 1]; gend Do not forget zero coefficients for missing powers Enter gen fn COEFFICIENTS for gN gN Enter gen fn COEFFICIENTS for gY gY Results are in N, PN, Y, PY, D, PD, P May use jcalc or jcalcf on N, D, P To view the distribution, call for gD. ED = dot(D,PD) ED = 18.4000 VD = (D.^2)*PD' - ED^2 VD = 31.8720 P1 = ((15<=D)&(D<=25))*PD' P1 = 0.6386 P2 = ((10<=D)&(D<=30))*PD' P2 = 0.9290
Exercise \(\PageIndex{8}\)
Game wardens are making an aerial survey of the number of deer in a park. The number of herds to be sighted is assumed to be a random variable \(N\) ~ binomial (20, 0.5). Each herd is assumed to be from 1 to 10 in size, with probabilities
| Value | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
| Probability | 0.05 | 0.10 | 0.15 | 0.20 | 0.15 | 0.10 | 0.10 | 0.05 | 0.05 | 0.05 |
Let \(D\) be the number of deer sighted under this model. Determine \(P(D \le t)\) for \(t = 25, 50, 75, 100\) and \(P(D \ge 90)\).
- Answer
-
gN = ibinom(20,0.5,0:20); gY = 0.01*[0 5 10 15 20 15 10 10 5 5 5]; gend Do not forget zero coefficients for missing powers Enter gen fn COEFFICIENTS for gN gN Enter gen fn COEFFICIENTS for gY gY Results are in N, PN, Y, PY, D, PD, P May use jcalc or jcalcf on N, D, P To view the distribution, call for gD. k = [25 50 75 100]; P = zeros(1,4); for i = 1:4 P(i) = (D<=k(i))*PD'; end disp(P) 0.0310 0.5578 0.9725 0.9998
Exercise \(\PageIndex{9}\)
A supply house stocks seven popular items. The table below shows the values of the items and the probability of each being selected by a customer.
| Value | 12.50 | 25.00 | 30.50 | 40.00 | 42.50 | 50.00 | 60.00 |
| Probability | 0.10 | 0.15 | 0.20 | 0.20 | 0.15 | 0.10 | 0.10 |
Suppose the purchases of customers are iid, and the number of customers in a day is binomial (10,0.5). Determine the distribution for the total demand \(D\).
- How many different possible values are there? What is the maximum possible total sales?
-
Determine \(E[D]\) and \(P(D \le t)\) for \(t = 100, 150, 200, 250, 300\).
Determine \(P(100 < D \le 200)\).
- Answer
-
gN = ibinom(10,0.5,0:10); Y = [12.5 25 30.5 40 42.5 50 60]; PY = 0.01*[10 15 20 20 15 10 10]; mgd Enter gen fn COEFFICIENTS for gN gN Enter VALUES for Y Y Enter PROBABILITIES for Y PY Values are in row matrix D; probabilities are in PD. To view the distribution, call for mD. s = size(D) s = 1 839 M = max(D) M = 590 t = [100 150 200 250 300]; P = zeros(1,5); for i = 1:5 P(i) = (D<=t(i))*PD'; end disp(P) 0.1012 0.3184 0.6156 0.8497 0.9614 P1 = ((100<D)&(D<=200))*PD' P1 = 0.5144
Exercise \(\PageIndex{10}\)
A game is played as follows:
- A wheel is spun, giving one of the integers 0 through 9 on an equally likely basis.
- A single die is thrown the number of times indicated by the result of the spin of the wheel. The number of points made is the total of the numbers turned up on the sequence of throws of the die.
- A player pays sixteen dollars to play; a dollar is returned for each point made.
Let \(Y\) represent the number of points made and \(X = Y - 16\) be the net gain (possibly negative) of the player. Determine the maximum value of
\(X, E[X], \text{Var} [X], P(X > 0), P(X \ge 10), P(X \ge 16)\)
- Answer
-
gn = 0.1*ones(1,10); gy = (1/6)*[0 ones(1,6)]; [Y,PY] = gendf(gn,gy); [X,PX] = csort(Y-16,PY); M = max(X) M = 38 EX = dot(X,PX) % Check EX = En*Ey - 16 = 4.5*3.5 EX = -0.2500 % 4.5*3.5 - 16 = -0.25 VX = dot(X.^2,PX) - EX^2 VX = 114.1875 Ppos = (X>0)*PX' Ppos = 0.4667 P10 = (X>=10)*PX' P10 = 0.2147 P16 = (X>=16)*PX' P16 = 0.0803
Exercise \(\PageIndex{11}\)
Marvin calls on four customers. With probability \(p_1 = 0.6\) he makes a sale in each case. Geraldine calls on five customers, with probability \(p_2 = 0.5\) of a sale in each case. Customers who buy do so on an iid basis, and order an amount \(Y_i\) (in dollars) with common distribution:
\(Y =\) [200 220 240 260 280 300] \(PY =\) [0.10 0.15 0.25 0.25 0.15 0.10]
Let \(D_1\) be the total sales for Marvin and \(D_2\) the total sales for Geraldine. Let \(D = D_1 + D_2\). Determine the distribution and mean and variance for \(D_1\), \(D_2\), and \(D\). Determine \(P(D_1 \ge D_2)\) and \(P(D \ge 1500)\), \(P(D \ge 1000)\), and \(P(D \ge 750)\).
- Answer
-
gnM = ibinom(4,0.6,0:4); gnG = ibinom(5,0.5,0:5); Y = 200:20:300; PY = 0.01*[10 15 25 25 15 10]; [D1,PD1] = mgdf(gnM,Y,PY); [D2,PD2] = mgdf(gnG,Y,PY); ED1 = dot(D1,PD1) ED1 = 600.0000 % Check: ED1 = EnM*EY = 2.4*250 VD1 = dot(D1.^2,PD1) - ED1^2 VD1 = 6.1968e+04 ED2 = dot(D2,PD2) ED2 = 625.0000 % Check: ED2 = EnG*EY = 2.5*250 VD2 = dot(D2.^2,PD2) - ED2^2 VD2 = 8.0175e+04 [D1,D2,t,u,PD1,PD2,P] = icalcf(D1,D2,PD1,PD2); Use array opertions on matrices X, Y, PX, PY, t, u, and P [D,PD] = csort(t+u,P); ED = dot(D,PD) ED = 1.2250e+03 eD = ED1 + ED2 % Check: ED = ED1 + ED2 eD = 1.2250e+03 % (Continued next page) VD = dot(D.^2,PD) - ED^2 VD = 1.4214e+05 vD = VD1 + VD2 % Check: VD = VD1 + VD2 vD = 1.4214e+05 P1g2 = total((t>u).*P) P1g2 = 0.4612 k = [1500 1000 750]; PDk = zeros(1,3); for i = 1:3 PDk(i) = (D>=k(i))*PD'; end disp(PDk) 0.2556 0.7326 0.8872
Exercise \(\PageIndex{12}\)
A questionnaire is sent to twenty persons. The number who reply is a random number \(N\) ~ binomial (20, 0.7). If each respondent has probability \(p = 0.8\) of favoring a certain proposition, what is the probability of ten or more favorable replies? Of fifteen or more?
- Answer
-
gN = ibinom(20,0.7,0:20); gY = [0.2 0.8]; gend Do not forget zero coefficients for missing powers Enter gen fn COEFFICIENTS for gN gN Enter gen fn COEFFICIENTS for gY gY Results are in N, PN, Y, PY, D, PD, P May use jcalc or jcalcf on N, D, P To view the distribution, call for gD. P10 = (D>=10)*PD' P10 = 0.7788 P15 = (D>=15)*PD' P15 = 0.0660 pD = ibinom(20,0.7*0.8,0:20); % Alternate: use D binomial (pp0) D = 0:20; p10 = (D>=10)*pD' p10 = 0.7788 p15 = (D>=15)*pD' p15 = 0.0660
Exercise \(\PageIndex{13}\)
A random number \(N\) of students take a qualifying exam. A grade of 70 or more earns a pass. Suppose \(N\) ~ binomial (20, 0.3). If each student has probability \(p = 0.7\) of making 70 or more, what is the probability all will pass? Ten or more will pass?
- Answer
-
gN = ibinom(20,0.3,0:20); gY = [0.3 0.7]; gend Do not forget zero coefficients for missing powers Enter gen fn COEFFICIENTS for gN gN Enter gen fn COEFFICIENTS for gY gY Results are in N, PN, Y, PY, D, PD, P May use jcalc or jcalcf on N, D, P To view the distribution, call for gD. Pall = (D==20)*PD' Pall = 2.7822e-14 pall = (0.3*0.7)^20 % Alternate: use D binomial (pp0) pall = 2.7822e-14 P10 = (D >= 10)*PD' P10 = 0.0038
Exercise \(\PageIndex{14}\)
Five hundred questionnaires are sent out. The probability of a reply is 0.6. The probability that a reply will be favorable is 0.75. What is the probability of at least 200, 225, 250 favorable replies?
- Answer
-
n = 500; p = 0.6; p0 = 0.75; D = 0:500; PD = ibinom(500,p*p0,D); k = [200 225 250]; P = zeros(1,3); for i = 1:3 P(i) = (D>=k(i))*PD'; end disp(P) 0.9893 0.5173 0.0140
Exercise \(\PageIndex{15}\)
Suppose the number of Japanese visitors to Florida in a week is \(N1\) ~ Poisson (500) and the number of German visitors is \(N2\) ~ Poisson (300). If 25 percent of the Japanese and 20 percent of the Germans visit Disney World, what is the distribution for the total number \(D\) of German and Japanese visitors to the park? Determine \(P(D \ge k)\) for \(k = 150, 155, \cdot\cdot\cdot, 245, 250\).
- Answer
-
\(JD\) ~ Poisson (500*0.25 = 125); \(GD\) ~ Poisson (300*0.20 = 60); \(D\) ~ Poisson (185).
k = 150:5:250; PD = cpoisson(185,k); disp([k;PD]') 150.0000 0.9964 155.0000 0.9892 160.0000 0.9718 165.0000 0.9362 170.0000 0.8736 175.0000 0.7785 180.0000 0.6532 185.0000 0.5098 190.0000 0.3663 195.0000 0.2405 200.0000 0.1435 205.0000 0.0776 210.0000 0.0379 215.0000 0.0167 220.0000 0.0067 225.0000 0.0024 230.0000 0.0008 235.0000 0.0002 240.0000 0.0001 245.0000 0.0000 250.0000 0.0000
Exercise \(\PageIndex{16}\)
A junction point in a network has two incoming lines and two outgoing lines. The number of incoming messages \(N_1\) on line one in one hour is Poisson (50); on line 2 the number is \(N_2\) ~ Poisson (45). On incoming line 1 the messages have probability \(P_{1a} = 0.33\) of leaving on outgoing line a and \(1 - p_{1a}\) of leaving on line b. The messages coming in on line 2 have probability \(p_{2a} = 0.47\) of leaving on line a. Under the usual independence assumptions, what is the distribution of outgoing messages on line a? What are the probabilities of at least 30, 35, 40 outgoing messages on line a?
- Answer
-
m1a = 50*0.33; m2a = 45*0.47; ma = m1a + m2a; PNa = cpoisson(ma,[30 35 40]) PNa = 0.9119 0.6890 0.3722
Exercise \(\PageIndex{17}\)
A computer store sells Macintosh, HP, and various other IBM compatible personal computers. It has two major sources of customers:
- Students and faculty from a nearby university
- General customers for home and business computing. Suppose the following assumptions are reasonable for monthly purchases.
- The number of university buyers \(N1\) ~ Poisson (30). The probabilities for Mac, HP, others are 0.4, 0.2, 0.4, respectively.
- The number of non-university buyers \(N2\) ~ Poisson (65). The respective probabilities for Mac, HP, others are 0.2, 0.3, 0.5.
- For each group, the composite demand assumptions are reasonable, and the two groups buy independently.
What is the distribution for the number of Mac sales? What is the distribution for the total number of Mac and Dell sales?
- Answer
-
Mac sales Poisson (30*0.4 + 65*0.2 = 25); HP sales Poisson (30*0.2 + 65*0.3 = 25.5); total Mac plus HP sales Poisson(50.5).
Exercise \(\PageIndex{18}\)
The number \(N\) of “hits” in a day on a Web site on the internet is Poisson (80). Suppose the probability is 0.10 that any hit results in a sale, is 0.30 that the result is a request for information, and is 0.60 that the inquirer just browses but does not identify an interest. What is the probability of 10 or more sales? What is the probability that the number of sales is at least half the number of information requests (use suitable simple approximations)?
 Orders require one of seven kinds of boxes, which with packing costs have distribution
| Cost (dollars) | 0.75 | 1.25 | 2.00 | 2.50 | 3.00 | 3.50 | 4.00 |
| Probability | 0.10 | 0.15 | 0.15 | 0.25 | 0.20 | 0.10 | 0.05 |
What is the probability the total cost of the $2.50 boxes is no greater than $475? What is the probability the cost of the $2.50 boxes is greater than the cost of the $3.00 boxes? What is the probability the cost of the $2.50 boxes is not more than $50.00 greater than the cost of the $3.00 boxes? Suggestion . Truncate the Poisson distributions at about twice the mean value.
- Answer
-
X = 0:400; Y = 0:300; PX = ipoisson(700*0.25,X); PY = ipoisson(700*0.20,Y); icalc Enter row matrix of X-values X Enter row matrix of Y-values Y Enter X probabilities PX Enter Y probabilities PY Use array operations on matrices X, Y, PX, PY, t, u, and P P1 = (2.5*X<=475)*PX' P1 = 0.8785 M = 2.5*t<=(3*u + 50); PM = total(M.*P) PM = 0.7500
Exercise \(\PageIndex{20}\)
One car in 5 in a certain community is a Volvo. If the number of cars passing a traffic check point in an hour is Poisson (130), what is the expected number of Volvos? What is the probability of at least 30 Volvos? What is the probability the number of Volvos is between 16 and 40 (inclusive)?
- Answer
-
P1 = cpoisson(130*0.2,30) = 0.2407 P2 = cpoisson(26,16) - cpoisson(26,41) = 0.9819
Exercise \(\PageIndex{21}\)
A service center on an interstate highway experiences customers in a one-hour period as follows:
- Northbound: Total vehicles: Poisson (200). Twenty percent are trucks.
- Southbound: Total vehicles: Poisson (180). Twenty five percent are trucks.
- Each truck has one or two persons, with respective probabilities 0.7 and 0.3.
- Each car has 1, 2, 3, 4, or 5 persons, with probabilities 0.3, 0.3, 0.2, 0.1, 0.1, respectively
Under the usual independence assumptions, let \(D\) be the number of persons to be served. Determine \(E[D]\), \(\text{Var} [D]\), and the generating function \(g_D (s)\).
- Answer
-
\(T\) ~ Poisson (200*0.2 = 180*0.25 = 85), \(P\) ~ Poisson (200*0.8 + 180*0.75 = 295).
a = 85 b = 200*0.8 + 180*0.75 b = 295 YT = [1 2]; PYT = [0.7 0.3]; EYT = dot(YT,PYT) EYT = 1.3000 VYT = dot(YT.^2,PYT) - EYT^2 VYT = 0.2100 YP = 1:5; PYP = 0.1*[3 3 2 1 1]; EYP = dot(YP,PYP) EYP = 2.4000 VYP = dot(YP.^2,PYP) - EYP^2 VYP = 1.6400 EDT = 85*EYT EDT = 110.5000 EDP = 295*EYP EDP = 708.0000 ED = EDT + EDP ED = 818.5000 VT = 85*(VYT + EYT^2) VT = 161.5000 VP = 295*(VYP + EYP^2) VP = 2183 VD = VT + VP VD = 2.2705e+03 NT = 0:180; % Possible alternative gNT = ipoisson(85,NT); gYT = 0.1*[0 7 3]; [DT,PDT] = gendf(gNT,gYT); EDT = dot(DT,PDT) EDT = 110.5000 VDT = dot(DT.^2,PDT) - EDT^2 VDT = 161.5000 NP = 0:500; gNP = ipoisson(295,NP); gYP = 0.1*[0 3 2 2 1 1]; [DP,PDP] = gendf(gNP,gYP); % Requires too much memory
\(g_{DT} (s) = \text{exp} (85(0.7s + 0.3s^2 - 1))\) \(g_{DP} (s) = \text{exp} (295(0.1(3s + 3s^2 2s^3 + s^4 + s^5) - 1))\)
\(g_D (s) = g_{DT} (s) g_{DP} (s)\)
Exercise \(\PageIndex{22}\)
The number \(N\) of customers in a shop in a given day is Poisson (120). Customers pay with cash or by MasterCard or Visa charge cards, with respective probabilties 0.25, 0.40, 0.35. Make the usual independence assumptions. Let \(N_1, N_2, N_3\) be the numbers of cash sales, MasterCard charges, Visa card charges, respectively. Determine \(P(N_1 \ge 30)\), \(P(N_2 \ge 60)\), \(P(N_3 \ge 50\), and \(P(N_2 > N_3)\).
- Answer
-
X = 0:120; PX = ipoisson(120*0.4,X); Y = 0:120; PY = ipoisson(120*0.35,Y); icalc Enter row matrix of X values X Enter row matrix of Y values Y Enter X probabilities PX Enter Y probabilities PY Use array opertions on matrices X, Y, PX, PY, t, u, and P M = t > u; PM = total(M.*P) PM = 0.7190
Exercise \(\PageIndex{23}\)
A discount retail store has two outlets in Houston, with a common warehouse. Customer requests are phoned to the warehouse for pickup. Two items, a and b, are featured in a special sale. The number of orders in a day from store A is \(N_A\) ~ Poisson (30); from store B, the nember of orders is \(N_B\) ~ Poisson (40).
For store A, the probability an order for a is 0.3, and for b is 0.7.
For store B, the probability an order for a is 0.4, and for b is 0.6. What is the probability the total order for item b in a day is 50 or more?
- Answer
-
P = cpoisson(30*0.7+40*0.6,50) = 0.2468
Exercise \(\PageIndex{24}\)
The number of bids on a job is a random variable \(N\) ~ binomial (7, 0.6). Bids (in thousands of dollars) are iid with \(Y\) uniform on [3, 5]. What is the probability of at least one bid of $3,500 or less? Note that “no bid” is not a bid of 0.
- Answer
-
% First solution --- FY(t) = 1 - gN[P(Y>t)] P = 1-(0.4 + 0.6*0.75)^7 P = 0.6794 % Second solution --- Positive number of satisfactory bids, % i.e. the outcome is indicator for event E, with P(E) = 0.25 pN = ibinom(7,0.6,0:7); gY = [3/4 1/4]; % Generator function for indicator [D,PD] = gendf(pN,gY); % D is number of successes Pa = (D>0)*PD' % D>0 means at least one successful bid Pa = 0.6794
Exercise \(\PageIndex{25}\)
The number of customers during the noon hour at a bank teller's station is a random number \(N\) with distribution
\(N =\) 1 : 10, \(PN =\) 0.01 * [5 7 10 11 12 13 12 11 10 9]
The amounts they want to withdraw can be represented by an iid class having the common distribution \(Y\) ~ exponential (0.01). Determine the probabilities that the maximum withdrawal is less than or equal to \(t\) for \(t = 100, 200, 300, 400, 500\).
- Answer
-
Use \(F_W (t) = g_N[P(Y \le T)]\)
gN = 0.01*[0 5 7 10 11 12 13 12 11 10 9]; t = 100:100:500; PY = 1 - exp(-0.01*t); FW = polyval(fliplr(gN),PY) % fliplr puts coeficients in % descending order of powers FW = 0.1330 0.4598 0.7490 0.8989 0.9615
Exercise \(\PageIndex{26}\)
A job is put out for bids. Experience indicates the number \(N\) of bids is a random variable having values 0 through 8, with respective probabilities
| Value | 0 | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| Probability | 0.05 | 0.10 | 0.15 | 0.20 | 0.20 | 0.10 | 0.10 | 0.07 | 0.03 |
The market is such that bids (in thousands of dollars) are iid, uniform [100, 200]. Determine the probability of at least one bid of $125,000 or less.
- Answer
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Probability of a successful bid \(PY = (125 - 100)/100 = 0.25\)
PY =0.25; gN = 0.01*[5 10 15 20 20 10 10 7 3]; P = 1 - polyval(fliplr(gN),PY) P = 0.9116
Exercise \(\PageIndex{27}\)
A property is offered for sale. Experience indicates the number \(N\) of bids is a random variable having values 0 through 10, with respective probabilities
| Value | 0 | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
| Probability | 0.05 | 0.15 | 0.15 | 0.20 | 0.10 | 0.10 | 0.05 | 0.05 | 0.05 | 0.05 | 0.05 |
The market is such that bids (in thousands of dollars) are iid, uniform [150, 200] Determine the probability of at least one bid of $180,000 or more.
- Answer
-
Consider a sequence of \(N\) trials with probabilty \(p = (180 - 150)/50 = 0.6\).
gN = 0.01*[5 15 15 20 10 10 5 5 5 5 5]; gY = [0.4 0.6]; [D,PD] = gendf(gN,gY); P = (D>0)*PD' P = 0.8493
Exercise \(\PageIndex{28}\)
A property is offered for sale. Experience indicates the number \(N\) of bids is a random variable having values 0 through 8, with respective probabilities
| Number | 0 | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| Probability | 0.05 | 0.15 | 0.15 | 0.20 | 0.15 | 0.10 | 0.10 | 0.05 | 0.05 |
The market is such that bids (in thousands of dollars) are iid symmetric triangular on [150 250]. Determine the probability of at least one bid of $210,000 or more.
- Answer
-
gN = 0.01*[5 15 15 20 15 10 10 5 5]; PY = 0.5 + 0.5*(1 - (4/5)^2) PY = 0.6800 >> PW = 1 - polyval(fliplr(gN),PY) PW = 0.6536 %alternate gY = [0.68 0.32]; [D,PD] = gendf(gN,gY); P = (D>0)*PD' P = 0.6536
Exercise \(\PageIndex{29}\)
Suppose \(N\) ~ binomial (10, 0.3) and the \(Y_i\) are iid, uniform on [10, 20]. Let \(V\) be the minimum of the \(N\) values of the \(Y_i\). Determine \(P(V > t)\) for integer values from 10 to 20.
- Answer
-
gN = ibinom(10,0.3,0:10); t = 10:20; p = 0.1*(20 - t); P = polyval(fliplr(gN),p) - 0.7^10 P = Columns 1 through 7 0.9718 0.7092 0.5104 0.3612 0.2503 0.1686 0.1092 Columns 8 through 11 0.0664 0.0360 0.0147 0 Pa = (0.7 + 0.3*p).^10 - 0.7^10 % Alternate form of gN Pa = Columns 1 through 7 0.9718 0.7092 0.5104 0.3612 0.2503 0.1686 0.1092 Columns 8 through 11 0.0664 0.0360 0.0147 0
Exercise \(\PageIndex{30}\)
Suppose a teacher is equally likely to have 0, 1, 2, 3 or 4 students come in during office hours on a given day. If the lengths of the individual visits, in minutes, are iid exponential (0.1), what is the probability that no visit will last more than 20 minutes.
- Answer
-
gN = 0.2*ones(1,5); p = 1 - exp(-2); FW = polyval(fliplr(gN),p) FW = 0.7635 gY = [p 1-p]; % Alternate [D,PD] = gendf(gN,gY); PW = (D==0)*PD' PW = 0.7635
Exercise \(\PageIndex{31}\)
Twelve solid-state modules are installed in a control system. If the modules are not defective, they have practically unlimited life. However, with probability \(p = 0.05\) any unit could have a defect which results in a lifetime (in hours) exponential (0.0025). Under the usual independence assumptions, what is the probability the unit does not fail because of a defective module in the first 500 hours after installation?
- Answer
-
p = 1 - exp(-0.0025*500); FW = (0.95 + 0.05*p)^12 FW = 0.8410 gN = ibinom(12,0.05,0:12); gY = [p 1-p]; [D,PD] = gendf(gN,gY); PW = (D==0)*PD' PW = 0.8410
Exercise \(\PageIndex{32}\)
The number \(N\) of bids on a painting is binomial (10, 0.3). The bid amounts (in thousands of dollars) \(Y_i\) form an iid class, with common density function \(f_Y (t) =0.005 (37 - 2t), 2 \le t \le 10\). What is the probability that the maximum amount bid is greater than $5,000?
- Answer
-
\(P(Y \le 5) = 0.005 \int_{2}^{5} (37 - 2t)\ dt = 0.45\)
p = 0.45; P = 1 - (0.7 + 0.3*p)^10 P = 0.8352 gN = ibinom(10,0.3,0:10); gY = [p 1-p]; [D,PD] = gendf(gN,gY); % D is number of "successes" Pa = (D>0)*PD' Pa = 0.8352
Exercise \(\PageIndex{33}\)
A computer store offers each customer who makes a purchase of $500 or more a free chance at a drawing for a prize. The probability of winning on a draw is 0.05. Suppose the times, in hours, between sales qualifying for a drawing is exponential (4). Under the usual independence assumptions, what is the expected time between a winning draw? What is the probability of three or more winners in a ten hour day? Of five or more?
- Answer
-
\(N_t\) ~ Poisson (\(\lambda t\)), \(N_{Dt}\) ~ Poisson (\(\lambda pt\)), \(W_{Dt}\) exponential (\(\lambda p\)).
p = 0.05; t = 10; lambda = 4; EW = 1/(lambda*p) EW = 5 PND10 = cpoisson(lambda*p*t,[3 5]) PND10 = 0.3233 0.0527
Exercise \(\PageIndex{34}\)
Noise pulses arrrive on a data phone line according to an arrival process such that for each \(t > 0\) the number \(N_t\) of arrivals in time interval \((0, t]\), in hours, is Poisson \((7t)\). The \(i\)th pulse has an “intensity” \(Y_i\) such that the class \(\{Y_i: 1 \le i\}\) is iid, with the common distribution function \(F_Y (u) = 1 - e^{-2u^2}\) for \(u \ge 0\). Determine the probability that in an eight-hour day the intensity will not exceed two.
- Answer
-
\(N_8\) is Poisson (7*8 = 56) \(g_N (s) = e^{56(s - 1)}\).
t = 2; FW2 = exp(56*(1 - exp(-t^2) - 1)) FW2 = 0.3586
Exercise \(\PageIndex{35}\)
The number \(N\) of noise bursts on a data transmission line in a period \((0, t]\) is Poisson (\(\mu\)). The number of digit errors caused by the \(i\)th burst is \(Y_i\), with the class \(\{Y_i: 1 \le i\}\) iid, \(Y_i - 1\) ~ geometric \((p)\). An error correcting system is capable or correcting five or fewer errors in any burst. Suppose \(\mu = 12\) and \(p = 0.35\). What is the probability of no uncorrected error in two hours of operation?
- Answer
-
\(F_W (k) = g_N [P(Y \le k)]P(Y \le k) - 1 - q^{k - 1}\ \ N_t\) ~ Poisson (12\(t\))
q = 1 - 0.35; k = 5; t = 2; mu = 12; FW = exp(mu*t*(1 - q^(k-1) - 1)) FW = 0.0138


1.17: Where do you go from here?
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This chapter touched on many elements of civility and diversity, and mentioned a wide array of groups, identities, and populations. But the chapter certainly did not explore every concept or reflect every group you may encounter. In a similar way, you can’t know everything about everyone, but you can build cultural competency and understanding to make people feel included and deepen your abilities and relationships.
Sometimes learning about one group or making one person feel comfortable can be as important as addressing a larger population. To that end, consider researching or discussing one of the following topics to increase your level of civility and understanding:


9.1: Chronology
200,000 – 100,000 BP (Before Present) First behaviorally modern human emerged in Africa
c. 7000 BCE Beginnings of the Agricultural Revolution in Africa
c. 3000 BCE – 1500 CE The Bantu expansions
900s BCE Rule of Queen Makeda (Ethiopia)
c. 800 BCE – 300 CE Kingdom of Da’amat (Ethiopia)
c. 250 BCE Founding of Djenne-Jeno, one of Africa’s first cities (Western Sudan)
c. 100 – 950 CE The Empire of Aksum
c. 300 CE Ghana emerged as a state (Western Sudan)
c. 325 – 350 CE The rule of King Ezana (Aksum/Ethiopia)
c. 800 CE Ghana became an empire (Western Sudan)
1000 – 1500 CE Height of Swahili society (East Africa)
1200 – 1450 CE Height of Great Zimbabwe (southern Africa/ Zimbabwe Plateau)
1235 CE Sundiata Keita founded the Mali Empire (Western Sudan)
1324 – 1325 CE Mansa Musa performed the hajj (Western Sudan)
Early 1400s CE Portuguese began to explore the Atlantic coast of West Africa; beginnings of the Age of Exploration
1460s CE Sunni Ali built the Songhai Empire (Western Sudan)
1493 – 1528 CE Askia the Great ruled during the Golden Age of the Songhai Empire (Western Sudan)
Early 1500s CE The Portuguese built a Trading Post Empire in the Indian Ocean (East Africa)
1591 CE Moroccans invaded the Songhai Empire (Western Sudan)
1699 CE The Omanis (allied with some Swahili rulers) seized Swahili city-states from the Portuguese (East Africa)


5.10: Commas as Separators
- Demonstrate the standard uses of commas as separators
Transition Words
Transition words add new viewpoints to your material; commas before and after transition words help to separate them from the sentence ideas they are describing. Transition words tend to appear at the beginning or in the middle of a sentence, as in the following:
- Therefore , the natural gas industry can only be understood fully through an analysis of these recent political changes.
- The lead prosecutor was prepared, however , for a situation like this.
When transition words appear between two complete ideas, however, a period or semicolon is required beforehand:
- Clint had been planning the trip with his kids for three months; however, when his boss called and asked him to work, he couldn’t say no.
- Sam was retired. Nevertheless, he wanted to help out.
As you can see from these examples, a comma is always required after a transition word.
Descriptive Phrases
Descriptive phrases often need to be separated from the things that they describe. Descriptive phrases tend to come at the very beginning of a sentence, right after the subject of a sentence, or at the very end of a sentence:
- Near the end of the eighteenth century, James Hutton introduced a point of view that radically changed scientists’ thinking about geologic processes.
- James Lovelock, who first measured CFCs globally , said in 1973 that CFCs constituted no conceivable hazard.
- All of the major industrialized nations approved, making the possibility a reality .
In each example, the phrase separated by the comma could be deleted from the sentence without destroying the sentence’s basic meaning. If the information is necessary to the primary sentence meaning, it should not be set off by commas. Let’s look at a quick example of this:
- Incorrect example: Juliet named her hamster after Zeus the god of thunder.
- Correct example: Juliet named her hamster after Zeus, the god of thunder.
The description of Zeus as the god of thunder is not necessary information for your audience to understand the meaning of the sentence, because Zeus’s identity is common knowledge. Therefore, the words the god of thunder should be set off with a comma.
However, sometimes this gets more tricky and there is more than one right answer, like in the sentences below:
- Jefferson’s son, Miles, just started college.
- Jefferson’s son Miles just started college.
Depending on the situation, either of these sentences could be correct. You would write the first sentence if Jefferson only has one son and his name is Miles. If Jefferson only has one son, then the name Miles is not needed information and should be set off with commas.
You would write the second sentence if Jefferson has multiple sons, and it is only his son Miles who just got into college. In the second sentence, Miles is necessary information, because until his name is stated, you can’t be sure which of Jefferson’s sons the sentence is talking about.
This test can be very helpful when you’re deciding whether or not to include commas in your writing.
Adjacent Items
Adjacent items are separated so that the reader can consider each item individually. Consider the following sentence:
- The river caught fire on July 4, 1968, in Cleveland, Ohio.
The dates (July 4, 1968) and places (Cleveland, Ohio,) are juxtaposed, and commas are needed because the juxtaposed items are clearly different from each other. This applies to countries as well as states: “Paris, France, is beautiful this time of year.”
Contributors and Attributions
- Revision and Adaptation.. Provided by : Lumen Learning. License : CC BY-NC-SA: Attribution-NonCommercial-ShareAlike
- Style For Students Online.. Authored by : Joe Schall. Provided by : The Pennsylvania State University. Located at : https://www.e-education.psu.edu/styleforstudents/ . Project : Penn State's College of Earth and Mineral Sciences' OER Initiative. License : CC BY-NC-SA: Attribution-NonCommercial-ShareAlike
- Image of lioness. Authored by : PDPhotos. Provided by : Pixabay. Located at : pixabay.com/photos/lioness-lion-caught-fence-cage-3208/. License : Other . License Terms : pixabay.com/service/terms/#license


1.8: Learning Activities
Exercises
(Answers to the exercises are located in the Answer Key at the back of the book).
Case Study #1
Eli, age 4, arrives at Urgent Care with his grandmother; he is staying with his grandparents while his parents are on vacation. Eli was playing in the woods behind his grandparents’ home today while his grandpa was clearing brush and returned to the house with a raised, red rash on the left side of his face and arms and hands bilaterally. “I am really itchy,” Eli says, “And my face and arms really hurt.” His grandmother states that they have seen poison ivy in the woods in the past, and Eli’s grandpa didn’t warn him before they went out today. You notice as you observe Eli that he is itching his arms, and his left eye appears swollen.
The MD gives you the following orders:
-
- Start a peripheral IV STAT
- Administer diphenhydramine 25 mg IV now and q8h prn for rash
1. What should you consider when initiating an IV for Eli?
An interactive H5P element has been excluded from this version of the text. You can view it online here:
https://wtcs.pressbooks.pub/nursingadvancedskills/?p=69#h5p-1
An interactive H5P element has been excluded from this version of the text. You can view it online here:
https://wtcs.pressbooks.pub/nursingadvancedskills/?p=69#h5p-2
An interactive H5P element has been excluded from this version of the text. You can view it online here:
https://wtcs.pressbooks.pub/nursingadvancedskills/?p=69#h5p-3
Test your knowledge using a NCLEX Next Generation-style question . You may reset and resubmit your answers to this question an unlimited number of times.


9.10: Stages of Parenting
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Ellen Galinsky traced six distinct stages in the life of a parent in relation to their growing child. Much like how a child moves through stages. By looking at these different stages of parenting, those who work with children and youth can gain some insight into parental needs and concerns. [114]
| Age of Child | Main Tasks and Goals | |
|---|---|---|
| Stage 1: The Image-Making Stage | Planning for a child; pregnancy | Consider what it means to be a parent and plan for changes to accommodate a child. |
| Stage 2: The Nurturing Stage | Infancy | Develop an attachment to child and adapt to the new baby. |
| Stage 3: The Authority Stage | Toddler and preschool | Parents create rules and figure out how to effectively guide their child’s behavior. |
| Stage 4: The Interpretive Stage | Middle childhood | Parents help their children interpret their experiences with the social world beyond the family. |
| Stage 5: The Interdependence Stage | Adolescence | Parents renegotiate their relationship with adolescent children to allow for shared power in decision-making. |
| Stage 6: The Departure Stage | Early adulthood | Parents evaluate their successes and failures as parents. |
How does understanding these stages assist in your work with parents?


6.S: Introduction to Chemical Reactions (Summary)
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To ensure that you understand the material in this chapter, you should review the meanings of the following bold terms in the following summary and ask yourself how they relate to the topics in the chapter.
Scientific laws are general statements that apply to a wide variety of circumstances. One important law in chemistry is the law of conservation of matter , which states that in any closed system, the amount of matter stays constant.
Chemical equations are used to represent chemical reactions . Reactants change chemically into products . The law of conservation of matter requires that a proper chemical equation be balanced . Coefficients are used to show the relative numbers of reactant and product molecules.
In stoichiometry , quantities of reactants and/or products can be related to each other using the balanced chemical equation. The coefficients in a balanced chemical reaction are used to devise the proper ratios that relate the number of molecules of one substance to the number of molecules of another substance.
Chemical reactions can be classified by type. Combination reactions (also called composition reactions ) make a substance from other substances. Decomposition reactions break one substance down into multiple substances. Combustion reactions combine molecular oxygen with the atoms of another reactant.
Oxidation reactions are reactions in which an atom loses an electron. Reduction reactions are reactions in which an atom gains an electron. These two processes always occur together, so they are collectively referred to as oxidation-reduction (or redox ) reactions . The species being oxidized it called the reducing agent , while the species being reduced is the oxidizing agent . Alternate definitions of oxidation and reduction focus on the gain or loss of oxygen atoms, or the loss or gain of hydrogen atoms. Redox reactions are easily balanced if the overall reaction is first separated into half reactions , which are individually balanced.
Oxidation-reduction reactions are common in organic and biological chemistry. Respiration , the process by which we inhale and metabolize oxygen, is a series of redox reactions. In the absence of oxygen, redox reactions still occur in a process called anaerobic metabolism . Antioxidants such as ascorbic acid also play a part in the human diet, acting as reducing agents in various biochemical reactions. Photosynthesis , the process by which plants convert water and carbon dioxide to glucose, is also based on redox reactions.


17.5: Checklist for NG Tube Enteral Feeding By Gravity with Irrigation
Use the checklist below to review the steps for completion of the “NG Tube Enteral Feeding by Gravity with Irrigation.”
Steps
Disclaimer: Always review and follow agency policy regarding this specific skill.
- Verify the provider’s order.
- Gather supplies: stethoscope, gloves, towel, irrigating solution (usually water), and irrigation set with irrigating syringe, pH tape, and prescribed tube feeding.
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Perform safety steps:
- Perform hand hygiene.
- Check the room for transmission-based precautions.
- Introduce yourself, your role, the purpose of your visit, and an estimate of the time it will take.
- Confirm patient ID using two patient identifiers (e.g., name and date of birth).
- Explain the process to the patient and ask if they have any questions.
- Be organized and systematic.
- Use appropriate listening and questioning skills.
- Listen and attend to patient cues.
- Ensure the patient’s privacy and dignity.
- Assess ABCs.
- Don the appropriate PPE as indicated.
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Perform abdominal and nasogastric tube assessment:
- Assess skin integrity on the nose and ensure the tube is securely attached.
- Use a flashlight to look in the nares to assess swelling, redness, or bleeding.
- Ask the patient to open their mouth and look for curling of the tube in the patient’s mouth. The tube should go straight down into the esophagus.
- Lower the blankets and move the gown up to expose the abdomen. Inspect from two locations.
- Auscultate bowel sounds and then palpate the abdomen. If the patient is receiving NG suctioning, turn off the suction prior to auscultation.
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Check for tube placement:
- Verify tube measurement at insertion site based on documentation.
- If agency policy dictates, test the pH of the aspirate. The pH should be equal or less than 5.5.
- If agency policy dictates, measure and document residual amount. Instill residual back into gastric tube if placement was confirmed.
- Draw up 30 mL of water in a 60-mL syringe. (If applicable, use sterile water according to agency policy.)
- Connect the syringe to the tubing port (not the blue pigtail).
- Instill 30 mL water.
- Reconnect the plug tube or clamp tube.
- Remove the plunger from the syringe and attach the syringe to the NG tube.
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Complete tube feeding administration:
- Verify the order for the type of formula, amount, method of administration, and rate.
- Check the expiration date on the formula.
- Verify if the tops of the containers need cleaning or if feeding needs mixing/shaking.
- Add the formula to the syringe until the ordered amount is administered. Hold the syringe above the insertion site and allow it to enter via gravity.
- Assess the patient for tolerance of the feeding. Slow infusion as necessary. Do not allow air to enter the tube when refilling the syringe.
- After formula is administered, flush the NG tube with 30 mL of water.
- If a patient is unable to tolerate the feeding, slow or stop the infusion. Document and report the intolerance.
- Disconnect the syringe and plug the NG tube.
- Maintain the patient at or above a 30-degree angle for a minimum of one hour to prevent aspiration. Ask the patient if they have any questions and thank them for their time.
- Perform hand hygiene.
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Ensure safety measures when leaving the room:
- CALL LIGHT: Within reach
- BED: Low and locked (in lowest position and brakes on)
- SIDE RAILS: Secured
- TABLE: Within reach
- ROOM: Risk-free for falls (scan room and clear any obstacles)
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Document assessment findings and report any concerns according to agency policy. When documenting the procedure, include the following:
- Time performed
- Irrigation solution used
- Quantity instilled
- Residual amount, color, odor, and consistency
- Method for checking the placement (including pH of gastric contents, if performed)
- Related assessments
- Amount of tube feeding
- Patient tolerance for the procedure