Case Vignette for Comprehensive Examination
Please read the vignette carefully. Based on information provided in the vignette, please compose a well-written and organized response to each of the questions that follow:
Presentation of the Problem
On a Saturday morning approximately three weeks ago, a woman called the local county sheriff’s office and reported that her “lunatic neighbor, had attempted to shoot her two sons Peter and Paul (ages 15 and 13) and her nephew Mario (age 15). The caller identified herself as Peter and Paul’s mother and claimed that the three boys had not been hit, but shots had been fired at them. She said, my son Peter broke his leg as he tried to run away from a spray of bullets that were being fired in his direction, and added that her sons and her nephew identified the shooter as Mr. Adams who lived up the hill from her in the forested area next to their new subdivision. She demanded that Mr. Adams be apprehended immediately, adding that he presented a threat to their community. Mr. Adams was arrested by the police at his home that evening. Mr. Adams has been held at the county jail for two weeks after being charged with “Aggravated Assault” for allegedly attempting to shoot three minors who were trespassing on his property. He denies responsibility for the charges. Although he admits to shooting his “high-velocity rifle” in the direction of the teenagers who were trespassing on his property, he stated stubbornly that his intention “was to scare them rich delinquent city boys away for good but never to hurt them like they are saying now.” Subsequently, the parents of all three boys pressed criminal charges claiming that their sons had been emotionally scarred and physically injured. In fact, upon investigation, it was found that the youngest (Paul), received treatment for anxiety and sleep disturbance following the incident and that Peter had suffered a broken leg and had hearing loss in his left ear.
Psychosocial History
Mr. George Huey Adams is a sixty-nine year old Caucasian man born on July 4, 1949, and raised in a rural area of Kentucky close to the Appalachian Mountains. Huey, as he prefers to be called, described himself as a real American, proudly emphasizing that he is one-eighth Cherokee on his paternal side. He stated, with evident bitterness, that neither the United States government nor the Cherokee Nation has acknowledged his Native American heritage. According to his background records, his parents, grandparents and great-grandparents were all born in Kentucky. He said that his family never had much money or property except for the land his family home has sat on for several generations.
Huey reported no prenatal, perinatal, or postnatal complications. Per self-report, all developmental milestones were reached within expected range.
He reported a relatively happy childhood for himself and his older sister until age 14, when his father died suddenly. Huey recalled that he never found out what really happened to his father and that his mother avoided talking about it. He remembered that his sister (four years his senior) had said on several occasions that their father had died because he drank too much and had stopped taking his “nerve pills.” Huey became tearful when he spoke about his father, emphasizing that he never developed the same closeness with his mother that he had enjoyed for 14 years with his father.
Huey suffered another traumatic event when he was sexually abused when he was 15. It was one incident perpetrated by an older man in the community. He kept this secret until he reached adulthood because of feelings of shame and guilt. He never developed close relationships with anyone after his father’s death and identified his older sister as the only important person remaining in his life. He eventually disclosed this traumatic event to his sister, who he described as very supportive in helping him emotionally.
After joining the United States Army, Huey earned a GED. He described Vietnam as a frightening experience which he “survived” by smoking marijuana every day. He acknowledged that he was introduced to LSD in Vietnam adding that everyone was doing it. His duties in Vietnam mostly consisted of doing clerical work. Huey indicated that the work was senseless, but preferable to having to work in the kitchen with a lot of angry people that were hard to please (his first assignment that had lasted only two weeks) or having to fight the North Vietnamese in the jungle. Huey never saw battle during his relatively brief stay in Vietnam. He said that he “felt rejected by the army” when he received an honorable discharge unexpectedly after serving only nine months of his original one-year duty in Vietnam. The things that he valued the most about his experience in the military were are that it gave him the opportunity to serve his country and to become an expert in handling a rifle.
After his discharge, he returned to Kentucky and settled in Louisville briefly holding several jobs as construction worker, security guard, and cook for chain restaurants. He did not like living in the city, claiming that he always felt isolated, misunderstood, and anxious. After a few years, he had saved some money and returned home to the Appalachians to live with his ailing mother who had developed serious health issues related to diabetes. The mother-and-son relationship improved significantly, and he took care of his mother until she died. During this time, Huey supported himself and his mother by relying on his savings, his mother’s pension and her Social Security benefits, his seasonal work in construction, and steady work as a handy-man. He liked to garden and to cook all of the meals. Throughout this time, Huey did not develop any close friendships, but he did enjoy going hunting by himself or with one Vietnam Veteran that he knew from his hometown.
Huey recounted that he was distraught after his mother’s death. He said he worried about how he would get by without her and what his life would be like in the future. He took his sister’s recommendation to move back to Louisville in search of a new life and to seek a well-paying job in construction. Based on his negative prior experience of living in a congested city, he chose to rent a small house in a rural area outside the city. He immediately liked the house because it sat on an acre of land with tall trees that obscured his view of the surrounding houses in the neighborhood. During this time, he met Nick who he calls the “only real love of my life.” Huey had known for many years that he was gay, but it was not until he met Nick, a biracial man four years his senior, that he fully acknowledged his sexual orientation. Nick, an electrician, moved in with him and they remained a couple for approximately five years. The relationship deteriorated once Huey insisted on moving back to his old family home in the mountains. Nick had a good job and was unwilling to relocate. Huey indicated that he was heartbroken and depressed, but that he knew he could no longer continue dealing with the congestion and traffic. He said he “needed space.”
Huey has been living alone and leading a very isolated life since he left Nick. He said that although he had faith in God, he disliked attending the local Baptist church because the preacher and the parishioners “get into my business” and “try to run my life.” He had been making repairs to the old mountain family home and spending most of his days fishing, hunting, lifting weights, attending to his garden and doing odd jobs as a handy-man. He hardly socialized with the exception of a couple of Vietnam friends that he sees occasionally to “share a beer or smoke a reefer or two.” He still misses Nick. His hopes for a reconciliation were crushed when he learned that Nick had gotten married after same-sex marriage was legalized. Huey reported feeling rejected and hopeless. After some questioning, he admitted that he had been very nervous and had been drinking and using marijuana daily during the past month before he was arrested.
According to Huey, the boys (i.e., Peter, Paul and Mario) had been trespassing and loitering on his property during the weekends (mostly on Saturdays) for the past two months. He stated that he avoided the issue as much as possible because he did not want to get into a conflict with a neighbor. Huey described himself as a peaceful man who avoids confrontation. He indicated that he had very nicely tried to reason with the boys about three times to stay off my property and respect my privacy, but to no avail. He added that he suspected the boys had been letting his chickens loose and had been walking all over his garden. He admitted that they finally caught me on a bad day, and I lost my temper, and I warned them that I was going to grab my rifle if they insisted on disrespecting me on my own piece of land. He recalled feeling aggravated and running after them while shooting his rifle close but not precisely in their direction. Huey denied that he had any intention or plan of hurting them, I just wanted to scare them away once and for all. Huey appeared emotional, overwhelmed, and even confused as he tried to recall all the details that led to the incident. He said he was having trouble remembering all the details.
Psychological/Legal History:
Huey had never been arrested before, and he denied receiving mental health treatment or being treated for emotional problems prior to the arrest. Although he denied substance use problems, he acknowledged that he had used alcohol and marijuana to ease his pain and alleviate anxiety. It is important to note that during a phone call from his sister, the forensic case manager learned that Huey had received treatment for anxiety and marijuana use at the Veteran’s Administration Hospital years ago. When he was questioned about this, Huey minimized its importance explaining that when he was actually needing help (i.e., during the nine months he served in Vietnam), no one seemed to care or offered any assistance.

Behavioral Observations
Huey appeared very anxious (wringing his hands, perspiring, preoccupied, and pessimistic about his future). He described himself as a “good patriotic man” who likes to mind his own business and expects others to do the same. He feels that he is being falsely accused. He said that he hopes that the forensic case manager can assist him in getting some medication to calm my nerves and help me sleep. It is important to note that Huey appears to be inconsistent as an informant. He has been fairly cooperative with the ongoing investigation but had difficulty remembering some of the events that led to his arrest.
Originally, based on his clean legal record, Huey was going to be allowed to post bail and required to report to a court hearing at a later date. Judge Douglas, who has known Huey for a long time, changed her mind at the last minute after recognizing that Huey did not appear to be acting like his normal self. The judge was concerned about his current mental state and requested an evaluation as to whether Mr. Adams has mental health or emotional problems that contributed to his aggressive behavior and to determine if he needs mental health services. A probation officer in the office told you that he wanted a copy of your report and that you needed to just keep it to yourself when you give me the report because Huey is not one of his probationers, but he knew Huey’s family and wants to try to help Huey.

Task Identification

You are the forensic case manager being asked to conduct a pre-trial evaluation with recommended services and referrals as needed. You are to act as a forensic mental health evaluator and produce a written case report addressing the questions below. The report will be submitted to the appropriate supervisor and to the judge.

Based on the vignette provided, please compose a well-written and organized response to each of the following questions. When writing your responses, please:

Psychological Theory and Practice

A. What assessments would you conduct to enhance your understanding of the problems of the person in the vignette and how would your choice of assessment(s) inform your diagnostic formation and treatment planning? Assessments may include structured or unstructured interviews, valid and reliable assessment measures, and/or formalized assessment procedures that may be conducted by yourself or by someone else referred by you.

B. Provide your diagnostic impressions (based on the DSM-5) for this individual. In narrative form, please describe how the individual meets the diagnostic criteria for the disorder(s) chosen in addition to the differential diagnostic thought process that you used to reach your hypotheses. Be sure to include any additional (missing) information that is needed to either rule out or confirm your differential diagnoses impressions.

Legal Theory and Application

A. Explain the background, current presentation, and behavior of the person in the vignette utilizing biological, learning, and social theories on offenders to support your position. Do not simply restate the background information from the vignette. Instead, provide a theoretically-based discussion to understand the criminal behaviors of the person in the vignette.

B. Consider the type of crime in the vignette and discuss how that type of crime generally impacts a victim of it. Do not limit yourself to discussing just the victim in this vignette. Instead obtain scholarly sources for information on how this type of crime can affect any victim, their family members, and other members of society.

C. Describe the psycholegal standards and/or definitions for each of the following: competence to stand trial, duty to warn, and insanity. Identify and describe one or more landmark case(s) for each standard (at least three cases total). Describe the elements or issues that a mental health professional usually focuses on when assessing a person�s adjudicative competence, risk and insanity, and any additional items that might be especially important to focus on in the provided vignette.

Assessment, Research and Evaluation

A. Describe tests or assessment procedures you would employ to address the psycholegal issues of (competence to stand trial, risk of dangerousness, and insanity). You may refer to these from the Psychological Theory and Assessment Section “A” if you already covered them there. Discuss what the anticipated conclusions would be based upon information provided in the vignette.
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B. Develop a research question and a testable research hypothesis regarding offenders or the type of crime that is discussed in the vignette (such as, addiction, recidivism, criminal behavior, etc.). Explain the variables in your question and the type of research study that could answer your question as well as why that research would make a contribution to the field of forensic psychology.

Leadership, Consultation, and Ethics
A. What are the ethical and legal dilemmas this vignette introduced? What would be your immediate steps and why? Please be specific and make sure that you describe your process of ethical decision making and the solutions/consequences to which this process might lead. Your discussion should be informed by the American Psychological Association�s Ethics Code as well as the Specialty Guidelines for Forensic Psychologists.
Interpersonal Effectiveness
A. What diversity factors, cultural considerations, or other demographic variables pertaining to the person in the vignette would you take into account in rendering diagnoses, choosing assessment measures, forming case conceptualizations, and designing the treatment plan? Be sure to discuss cultural/diversity factors that could apply even if they are not explicitly mentioned in the vignette.

B. Your writing, use of citations, ability to form a logical argument, and proper APA Style, including the use of paraphrasing, will be evaluated as a measure of your interpersonal effectiveness. No response is required for “B”.

Write a 400-600 word summary of your personality, as described by the Big 5 Inventory. Discuss the upsides and downsides of the pattern of the 5 dimensions or traits of your personality. We know three of the Big 5-conscientiousness, openness, and extroversion are closely associated with leadership and effectiveness. How do your scores reflect your readiness to become a leader? Include a reflection about how your personality shapers your behavior toward work, school, and teamwork.

Write a 500-600 word paper including an introduction on communication , and two main topics (Essential Principles of communication in professional nursing AND Advantages of Using a Formulated Checklist for Handoff Communication) Followed by a conclusion statement.

AFRICAN AMERICAN
Total numbers in the U.S.
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Percent of the total U. S. population
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Average household size
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% with college degrees
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Average or median income levels
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Geographic location(s) � metro, states, etc.
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Brands that have higher than average purchase for each group
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Identify specific products which have above average usage for each group
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Best media to use to target each group
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ASIAN AMERICAN
Total numbers in the U.S.
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% with college degrees
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Geographic location(s) � metro, states, etc.
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Brands that have higher than average purchase for each group
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Identify specific products which have above average usage for each group
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Best media to use to target each group
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HISPANIC AMERICAN
Total numbers in the U.S.
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Percent of the total U. S. population
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Rate of growth
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Average household size
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Average age
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% with college degrees
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Average or median income levels
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Geographic location(s) � metro, states, etc.
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Brands that have higher than average purchase for each group
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Identify specific products which have above average usage for each group
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Best media to use to target each group
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Part 2 – Analysis of Business Potential for Each Group

For each ethnic group write a minimum of 2 paragraphs analyzing the business potential using the information found in your research for Part 1 and additional research necessary to complete your analysis.
African American
Comments/rationale narrative
Asian American
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Hispanic American
Comments/rationale narrative
Bibliography/Citations

Introduction

Milgram’s Experiment reveals that the majority of people are willing to obey the authority figure by following instructions to perform acts that conflict with their coincidence. Besides, the Lord of Flies is a real example of obeying authority. This is because the Lord of Flies shows that boys are willing to follow any chain of command. The connections show that there are less evil people than good. However, society acts as the foundation of a person’s wrongdoing or evil. Milgram’s Experiment assessed people’s reaction told to give a painful electric shock, while in the Lord of Flies by William Golding readers are introduced to actors of evil and good. The study shows that despite many individuals being useful in the world, only a few are great.  The purpose of this study is to show how William Golding in the Lord of Flies connects with Milgram’s Experiment themes to demonstrate how people are willing to obey orders from an authority figure. The paper provides a clear analysis of the link between the Lord of Flies and Milgram’s Experiment and the implications it has on the modern day leadership style and how people are willing to obey a chain of command from an authority figure. Theoretical

Milgram’s Experiment was carried out to show how people obey authorities under all circumstances, especially people who instructed them to perform acts that conflict the coincidence of purposes. The purpose of Milgram’s Experiment was to give students electric shocks by separating them from the subject and establishing a tape recorder, which was integrated with electronic shocks. Therefore, if the answers were inaccurate, the teacher would administer a shock to the learner by an increasing voltage for each wrong answer, while for the correct answer, the teacher would go to the next word pair. Milgram’s Experiment was in a controlled setting such that the learner could not attempt to quit the experiment, which led to the establishment of status and authority (Batson and Daniel, 2016, 10). Milgram’s Experiment showed factors that affect obedience. For instance, the status of location showed that prestige of location increase obedience, while less personal responsibility increases obedience. Besides, individuals tend to obey others if they acknowledge their authority as legally based or/and morally right. Thus, the uniformity of the authority figure can provide people with status as well as peer support or presence of others disobeying the authority figure decreases the obedience level. Milgram’s Experiment showed that proximity to authority plays a significant role in obedience as people can easily resist orders from authority if they are not nearby (Haslam and Stephen, 2017, 63). 

In Milgram’s Experiment, the teacher does not know that the shocks are not real, and the student behind the participation is in the experiment working with Milgram. Besides, the learner is getting words pairs incorrect on purpose, making the experiment fake despite showing the importance of obeying authority. Therefore, the actual experiment is on the teacher. Despite the increased yelling by participants, they continue to finish the experiment. As much as many participants wished to stop, Milgram used four phrases to entice them to finish the exercise. The motivating phrases were, “please continue, the experiment requires you to continue, it is necessary for you to continue and you have no other choice, you must go on (Haslam, Nick, Loughnan, and Perry, 2014).”

The Lord of Flies by William Golding introduced characters of evil and good. The study shows that despite many individuals being useful in the world, only a few are great. This is because people control how their environment influences their actions and behaviors. During the feast, Jack sat like a leader and idol as he issued commands such as who was going to join his tribe. Through his command and leadership authority, most of the boys accepted because they wanted meat and protection from Jack. Besides, despite Jack punishing Wilfred for no particular or apparent reason, Roger and the rest of the boys of the tribe felt nothing wrong about it. This is because none of the boys had the courage or confidence to stand up for Wilfred. Therefore, the Lord of Flies by William Golding showed that people have a fear of authority and quickly give up justice. Moreover, Jack and Roger tortured Eric and Sam, forcing them to submit to Jack’s command and join his tribe. This shows that authority forces the weak people to follow them using violent action and false use of authority. The failure of Jack to admit that he took too much power and authority shows that influential leaders are not willing and lack the courage to admit mistakes such as enslaving others. The analysis of the Lord of Flies shows that civilized officers are part of an adult world in which violence and war are associated with social order and civilization. People are expected to obey authority as influential leaders do things to destroy the peaceful world, similar to what Jack did to the boys and vice versa.  

Connections

The comparison of Milgram’s Experiment and the novel of the Lord of Flies show that the boys feared the beast referred as the electronic shocks, while they allowed Jack to gain power and authority through obedience to his command. The review shows that it is easier to control people and persuade them to be savagery by obeying the experiments. This is because the boys followed the authority or command to get protection or avoid the electric shock. The connection between Milgram’s Experiment and the novel of the Lord of Flies is evident in that both boys follow the order to obtain protection or avoid electronic shocks. For instance, the boys are stranded and end up following the commands from Jack without comprehending the reasons for doing it. Besides, from both sets of experiments, it is evident that people follow orders without questioning the consequences or impacts on the other party. 

William Golding in the Lord of Flies presents the obedience idea in Milgram’s Experiment through the connections of actors take as a leader, Jack, and Ralph, and the other actors who ideally obey the leader’s command or orders without questioning. This connection shows how people or kids are ready and willing to obey the authority figure that has leadership skills. Besides, both Lord of Flies and Milgram’s Experiment present the obedience idea through leaders and the ones who unthinkingly follow commands and believe that they should be led. People who want to be led wait for commands and orders to follow and they believe they need to be directed by a leader as Jack demonstrated by allowing characters to follow him without question. This undeniably connects with Milgram’s Experiment on obedience. This is because according to the Milgram’s Experiment, persons are possibly to obey commands by authority figures. Therefore, the robust scenarios of obedience on the Lord of Flies are indicators of Milgram’s Experiment. 

The novel on the Lord of Flies presents the obedience theme, which is accurately connected, to Milgram’s Experiment on obedience. This is because many instances demonstrate the obedience theme. For instance, Jack is the leader of a group of hunters in a jungle who target to kill a pig, and the group follows him to the jungle without questioning and obediently. The boys have drifted away with the words of command such as “kill the pig,” “cut her throat. Spill her blood”(Laurent et al., 2015, 300). It is evident that the kids are carried away with the obedience feeling as hunters and Jack manipulate the boys’ fear of the beast, making them obey him even further for protection and safety. The boys not only see Jack as a powerful leader but also obey him without question. Besides, there are other particular moments during the hunting game where Jack uses is authority and command to instill fear in the boys as they obey him unquestioningly. These instances in the novel of the Lord of Flies present how far the obedience feeling can take people. The kids lose their morality and rational thinking by following commands. Despite the increased use of command, which instills fear and obedience to the boys, the sense of obedience goes off-limits, which signals that things can easily go out of control. Jack who is their leader for the sake of security and food because the boys do everything tells this. Thus, the novel by William Golding in the Lord of Flies presents the idea obedience in Milgram’s Experiment as it shows that without no doubt individuals will obey commands from others if they perceive them as leaders or authorities (Branson and Buckroyd, 2017, 20). 

William Golding presents the obedience idea in Milgram’s Experiment in the final chapter of the Lord of Flies. In the last chapter of the Lord of Flies, there are clear instances where the boys obey authority figure as well as carrying them to higher levels. It is evident when Jack acts as a leader and as an idol giving commands during the feast where the boys obey the orders without question. Jack commands the boys to join his tribe, and all except Ralph agree to the idea. However, the reason behind Ralph objection is because he is supposedly the chief. The sense of obedience manifested in Milgram’s Experiment is present in this scenario as all hunters obey Jack and fail to either object or to question the idea of being a tribe. Despite Wilfred getting punished for no apparent reasons, Roger and the rest of the boys of the tribe do not feel it or question for a reason for the punishment. This shows that they lacked courage and confidence to stand up for Wilfred because their submission and loyalty to their authority blocks them. Even though Ralph wants to call for an assembly to question Jack, the boys once again prove their obedience and loyalty to their authority figure. Instances of obedience in the novel of the Lord of Flies stem from the idea of obedience from Milgram’s Experiment. In both groups of boys, they accept the command or authority figure by carrying out the orders issued to them by the leader or teacher. For instance, if the boys are told to eat, they eat, and if told to fetch something for the leader, they do so. Also, they sit down when told to do so and even if the leader says they should be punished, they accept it without question. This result significantly connects with obedience from Milgram’s Experiment (Gridley and Jenkins, 2017, 25). 

Critical and Relevance

William Golding successfully puts the obedience idea in the Lord of the Flies novel by installing Jack as the leader. Jack is obeyed, and his subjects follow his commands or orders without questioning. The connections of two scenarios show that philosophic and legal aspects of obedience are of enormous importance. The excessive willingness of people to go to any level in the order of authorities constitutes the main findings of research and the idea that most directly demands full justification. The study shows that people with authority tend to control the outcome and actions of others. The experiments reveal that a more significant part of people are just willing to comply with authority figures who directs merely them to execute acts that may vary or conflict with their individual coincidence, while the Lord of Flies by William Golding is a real example of obedience to authorities because the people are willing to obey any chain of authority (Hollander, 2017, 430). We live in a world where people demand obedience from the authority for them to function well for a society. However, obedience can have significant impacts on a society because authority figures have little to justify actions.  Thus, conformity is an impact that influences people to do things they may not have otherwise done. Evidence shows that both obedience and conformity lead to atrocious actions. Therefore, horrendous crimes against humanity have happened and yet people fail to question the actions of authority figures. The experiment shows that discipline and obedience are learned through social conventions. Thus, individuals are able of substantial evil and great good according to the circumstances they are positioned in. in addition, acts of both resistance and obedience have the power to motivate and inspire people to obey commands of an authority figure.

Conclusion

From the connection between Milgram’s Experiment and Lord of Flies, several factors force people to carry obedience to the extreme, even without questioning the command. People justify their behavior be assigning responsibility to authorities rather than themselves, and they define their behavior which is expected of them as a routine. Besides, evidence from the experiment shows that people do not want to offend or be rude to authority and they obey orders. Therefore, it is essential for people to question orders and reasons behind their issue. This will ensure that obedience is acknowledged and is not adhered out of fear. The results show how people follow orders and obey leaders without question. This is a disappointing aspect of leadership style as the leaders directly threatened people in order to guarantee the protection and security.

Healy, S. J., Osei, K., & Gaillard, T. (2014). Comparative study of glucose homeostasis, lipids and lipoproteins, HDL functionality, and cardiometabolic parameters in modestly severely obese African Americans and white Americans with prediabetes: implications for the metabolic paradoxes. Diabetes care, DC_141803.

A2 Quantitative Article
Background or Introduction	The author provides detailed information on the high prevalence of diabetes and cardiovascular-related diseases. The author discusses the prevalence of diabetes and cardiovascular-related diseases in African American population in respect to metabolism of, Low-Density Lipoproteins (LDL), insulin resistance, and High-Density lipoproteins (HDL). The researchers state that there are an existing literature gap and aim of the study to provide data on the gap.
Review of Literature	The literature review provided summarizes research studies that have focused on explaining the association between diabetes mellitus, cardiac-related conditions, HDL and LDL.
Methodology	The methodology gives the sample size (145 patients) and demographic data collected, that is age, race, and gender. The methodology discusses the parameters measured in the study including insulin, blood glucose, LDL, HDL, Body Mass Index (BMI) and glycosylated hemoglobin levels. The methodology also specifies the patient populations excluded from the study, based on the legibility criteria.
Data Analysis	Data analysis details include the expressions used for the parameters, for instance, Standard deviation, the formats used for calculations, for example, Friedwald equation for calculating HDL and LDL.The article describes computer application software such as Bergman MINMOD Millennium version 6.1 software programs used to analyze data.
Researcher’s Conclusion	Modestly severe diabetes mellitus plays a similar and slightly different role in the pathological development of glucose hemostasis imbalance across black and white patients who are obese.

(Healy, Osei, & Gaillard, 2014).

A2. Critique of Evidence

The authors conclude that pathological mechanisms underlying cardiac-related conditions such as atherosclerosis, coronary artery disease (CAD) are equally affected by the HDL and LDL functionality mechanisms.  However, data in the introduction states that the prevalence of cardiac-related conditions and diabetes mellitus are generally more prevalent among African Americans than any other race. 

The literature review presents evidence that only explains the lack of cardio-protective properties of HDL and is an anti-oxidative role in the prevention of cardiovascular conditions in diabetes mellitus. However, the evidence does not show the existence of defective cardioprotective properties of HDL in DM. This article discusses deficiency of cardioprotective properties of HDL. 

The results of the study indicate the presence of high levels of HDL and low LDL among diabetic African Americans despite the high prevalence of cardiovascular conditions. On the other hand, White Americans had high levels of LDL, and low HDL, accounting for cardiovascular conditions in pre-diabetic status (Healy, Osei, & Gaillard, 2014).

A3. Protection of Human Subjects and Cultural Consideration

The patient completed consent forms before enrolment into the study. Generally, informed consent in research informs participants on the purpose of research, benefits and potential risks.

The patients diagnosed with certain conditions such severe functional conditions of liver and kidneys and receiving specific treatments were excluded from the study.

The consent form was reviewed by the Ohio State University Biomedical Research Committee Institutional Review Board (Healy, Osei, & Gaillard, 2014).

A3.Strengths and limitations of the Study

Strengths. The study participants were drawn from two different races. Further, the sample size number was large enough for measurement of the study variables.

Weaknesses. The study was cross-sectional, and therefore cause-effect relations between variables could not be established. Additionally, the imbalance between the genders of participants could have impacted the results of the study (Healy, Osei, & Gaillard, 2014).

A5.Evidence and Nursing Practice

The application of weight management approaches in obese patients diagnosed with diabetes should be put into consideration variation in the role of lipoproteins in the pathology of cardiovascular-related diseases.  The role of race in cardiovascular disease occurrence in diabetes is a primary etiological consideration while managing diabetic and obese patients. Additionally, assessment of cardiovascular disease in obese diabetic patient needs to pay attention to the relationship between BMI, race, and lipid profile indicators (Healy, Osei, & Gaillard, 2014).

Tol, A., Sharifirad, G., Shojaezadeh, D., Tavasoli, E., & Azadbakht, L. (2013). Socio-economic factors and diabetes consequences among patients with type 2 diabetes. Journal of education and health promotion, 2.

B1.Qualitative Article
Background or Introduction	The article provides information on global, regional and national diabetes statistics.The introductory part gives data on the outcomes of diabetes inform of lifestyle impacts and complications on other body organs and systems.The background information describes the economic burden of diabetes.
Review of literature	The literature review provides data on discrepancies that are evident in the management and utilization of diabetes management healthcare services.Review of literature compares the health quality outcomes across populations from several ethnic groups.
Methodology	The research design described is a cross-sectional study design.The sample size as is provided (304 participants).The parameters and variables measured are listed as occupational background, health behavior pattern and occurrence of a complication
Data Analysis	The data were analyzed through SPSS and Fisher’s formula
Researcher’s Conclusion	The researcher concludes that resources allocation, empowering populations and elevation of populations’ social status improves diabetes clinical outcomes.

(Tol, Sharifirad, Shojaezadeh, Tavasoli, & Azadbakht, 2013).

B2.Critique of evidence

The evidence provided in the background information supports the author’s conclusion. In the introduction part, the evidence provided indicates that discrepancies are presented in the form of compilations, occupational and social functioning effects of diabetes across socio-economic groups. The author’s conclusion states that differences occur in the type and amount of the outcomes in the management of diabetes across socio-economic backgrounds. The literature review informs on the increased utilization of resources supports the author’s conclusion that social-economic factors impact on the outcomes of diabetes (Tol et al., 201). 

B3.Protection of Human and Cultural Consideration

The study’s proposal, ethical consideration, and methodology were presented to the Institutional Review Board for consideration. The study subjects signed informed consent forms. The signed consent form was an indication of the study participant’s agreement to participate in the study. The information in the form listed the risk and the benefits of the study. Additionally, the consent forms contained the terms of participating in the study (Tol et al., 201).

B4.Strengths and Limitations

Strengths. The research’s parameters relevant in diabetes include; weight, blood pressure, and calculated Body Mass Index. The study was conducted in a clinical setting where parameters and vital signs associated with diabetes were measured (Tol et al., 201).

Weaknesses. The study’s inclusion criteria did not put into consideration the demographic variations in the participants, including, age, race, and gender of the respondents. Additionally, the study did not involve community-based data collection to inform on the community-based outcomes in diabetes (Tol et al., 201).

B5.Evidence and Nursing practice

Nursing relies on socio-economic data in the assessment phase of the nursing process. Socioeconomic data an implies the nursing diagnosis, planning, and implementation of nursing interventions. The variation of outcomes of diabetes with changes in socio-economic class informs nursing practice on the need for detailed patient history when assessing diabetes patients. The evidence from the study described in the article is useful in predicting the outcomes of various diabetes management approaches. Additionally, diabetes management policies and approaches need to be based on the information that the outcomes of the condition vary between individuals from different socioeconomic classes and groups (Tol et al., 201).

Description, Significance, and Current Practice

Description. Falls in the hospitals setting constitute the most prevalent type of accident within a hospital setting. According to the World Health Organization, falls are the second most common cause of accident-related deaths after road traffic accidents. Falls account for 646,000, deaths every year in the world. The inpatient hospital falls most commonly occur among individuals aged above 65 years. Falls in a hospital setting within the age of above 65 years are more common among the males than females. Falls result in brain injury, most commonly traumatic brain injury fractures such as of hipbones and soft tissue injury and bleeding (Barker, 2014). The occurrence of falls leads to fear and worry of subsequent falls, leading to reduced physical activity. Reduced physical activity reduces the strength of bones and muscles, further increasing the probability of sustained falls in the future. A patient who sustains falls is treated for bone fractures, brain hematoma or general bleeding. Besides, fall cause further healthcare complications, including cognitive functioning impairment such as the loss of memory and motor functions (Centers for Disease Control and Prevention, 2015).

Significance. In the year 2015, the cost of managing falls was estimated at $50 billion of the healthcare expenditure. Out of the total number of falls in the world, approximately 37 million cases require medical attention. Additionally, 17 million of cases of falls constitute disability assisted lost years lost. In the United States of America, about 30% of the population aged 65 years and above sustain falls annually, constituting about 9,000, annually. According to CDC, 3 million people in the USA are treated in the emergency departments for injuries resulting from falls in hospitals.

Further, the CDC states that approximately 800,000 injuries resulting from falls require hospitalization. The prevalence of falls among the population aged above 65 years of age has been increasing annually. CDC predicts that by the year 2030, falls will account for seven deaths every hour in the USA (Florence, Bergen, Atherly, Burns, Stevens, & Drake, 2018).   

Current Practice. Currently, there are several practices to prevent falls inpatient setting. The practice guidelines provided by the Rees-Jones Trauma Center injury flow sheets are used for the screening patient for the risk of falls. The criteria are used as a guideline to assess the risk of a patient sustaining a fall. Assessing the nature and outcome of previous falls assists in predicting the risk and outcome of future falls. Healthcare practice concerning falls among the elderly also involves the assessment of the need for vitamin D supplementation that aids in strengthening the bones. Physical exercise is also an essential management component of falls. Physical exercises increase muscle strength and improve gait. Reviewing medication that contributes to falls is a useful practice (Ayton, O’Brien, Treml, Soh, Morello, & Barker, 2017).

The Impact of the Problem. Falls among the elderly have an impact on healthcare institutions and patients significantly. Healthcare providers have to modify building structures to prevent falls. One of the ways to prevent falls is through the construction of support bars in places such as bathrooms and rails on staircases. Additionally, healthcare providers have had to spend more resources on the management of injuries resulting from falls among the elderly. Falls among the elderly reduce the individual self-care and thus reduced capacity to maintain health behavior pattern.

Picot Table

Population (P)	The focus population in this topic consists of patients aged 65 years and above. Increase in age has been associated with increased vulnerability to falls in the hospital setting due to impaired cognitive, sensory and memory functioning and lack of physical activities and bone and muscle weakness.
Intervention (I)	Patient education and discussion of falls with the patient. The patient can accurately report medication side effects such as dizziness. Education of elderly patients on risks of falls with an increase in age informs on the need for the patient’s participation in prevention and adherence measures against falls among the group of patients.
Comparison(C)	The comparison is made between the current prevention measures and patient education, and discussion with the patient.
Outcomes (O)	Increase in the rate of patients’ participation and reporting of previous falls, medication side effects and other symptoms of fall.
Timeline (T)	The timeline will be six months

PICOT Question. Is patient education on falls more effective than the current falls prevention measures among patients aged 65 years and above in six months? 

Matrix Articles 

Authors	Journal Name	Year of Publication	Research Design	Sample Size	Outcome Variables Measured	Level	Results/ Author’s suggested Conclusions
AytonBrien, Treml, Soh, Morello,Barker	Australian Journal of Aging	2018	Secondary analysis	96	The environment in the prevention of falls challenges elderly patients.	I	Elderly patients require direct supervision and assistance to prevent falls
Avanecean D1, Calliste, Contreras1, Lim 1, Fitzpatrick A,2.	JBI Database System Rev Implement Reports	2017	Review of secondary data	100	Patient-focused interventions resulted in reduced rates of falls	III	Patient-tailored intervention in preventing falls should be implemented.
McEwan, Baker, Armstrong, Banerjee 3.	International Journal Of emergency medicine	2018	Cross-sectional study design	27	Increase in the rate of patients’ participation and reporting of previous falls, medication side effects and other symptoms of fall	II	The patient can accurately report medication side effects such as dizziness.
Stenhagen, Ekström, Nordell, Elmståhl	Clinical Interventions in aging	2014	Longitudinal study design	1,540	Falls were associated with a reduction in ADLs.	I	Management of falls among elderly patients should include a focus on ADLs.
Sato S, Kakamu T,Hidaka T,	Geriatric and Gerontology	2018	Longitudinal study design	242	Psychological and behavioral impairments are associated with risk of falls among the elderly increases.	I	Behavioral and psychological impairments should be used as an indicator in predicting the risk of falls.

Research Strategy

Key Words. The keywords used in search of the articles are; falls, Inpatient, Elderly patients, preventive measures, education, and awareness.

The Number and Types of Articles

In order to choose four articles, I reviewed a total of ten articles. Out of the four articles, two were non-research evidence articles while the other two were research evidence articles.  Two of the articles were qualitative while the other two were quantitative research articles. Two articles were random controlled trials, and the other two were recommendations of expert committees.

The article by Bergen, Stevens, Burns (2018) is one of the non-research articles describing the current statistics on falls among the elderly. The article describes the current practices on preventing falls. The article utilizes recommendation from The National Council on Aging and the CDC. The article is level VII of evidence.

The article by Wendy Barker (2018) is the other non-research article. The article describes additional preventative measures against falls among the elderly in the hospital setting. The article describes physical exercises, cognitive and behavioral training as preventive measures against falls among the elderly. The article is level VII evidence that contains recommendations by various researchers on ways to prevent falls among the elderly.

The article written by Lipardo and Tsang (2018) is one of the research evidence articles. The article is level II evidence which reports on the results of randomized control trial on the rehabilitative approaches applied as preventative measures against falls.

Lastly, the article by Bjerk, Brovold, Skelton, and Bergland (2017), is also level II evidence. The article compares the effectiveness of aerobic exercises and home-based exercises in preventing falls among the elderly.

The Number and Types of Articles. Non-Evidence Articles. The article by Bergen, Stevens, Burns (2018), identifies the current statistics in the USA on falls among the elderly. The article identifies the current practice on prevention of falls including physical activities, vitamin D supplementation, and medication adjustments. The article provides international and national guidelines on the prevention of falls applied in the USA and elsewhere in the world, for example, guidelines American and British Geriatrics Societies (AGS/BGS) Clinical Practice Guidelines.

Additionally, the article provides the economic burden of falls among elderly patients within hospital settings.  The article discusses the prevention of falls among the elderly through quality improvement assessments. The article notes the lack of discussion between healthcare professionals and the patient on the prevention of falls among the elderly. What the article reports on the economic costs of managing falls among elderly patients.

The article by Wendy Barker (2018) identifies the real update on the guidelines including physical exercise for the elderly patients, nutritional supplementation and assessment of risks for future falls and the patients’ education concerning the risk of falls. The article describes multifactorial interventions, including cognitive training, and nutritional measures appropriate for the prevention of falls among the elderly. Further, the author list participation in prevention of falls programs as another means towards addressing the problem of falls among the elderly. Gait and balance strengthening are additional interventional approaches that the author of the article identifies as appropriate means towards prevention of falls affecting the elderly. 

 Research Evidence Articles. The article by Lipardo and Tsang (2018) investigates the effectiveness of a combination of physical activities and cognitive training as ways of preventing falls among elderly patients. The background of the study identifies that there is a significant amount of data on the impact of physical activities training on the level of prevention against falls among the elderly. Further, the background information presents evidence from previous studies about the availability of evidence on the effectiveness of cognitive training. However, there is lack of evidence on the impact of combined cognitive training and physical exercises as a means of preventing falls among the elderly. 

The study methodology describes the process of data collection that involves the formation of three groups; one for physical activities and another for cognitive training and the third research group comprising of patients where both physical activities and cognitive training were both applied. The outcomes of the interventions were measured regarding cognitive functioning, physiological and psychological outcomes. The study concludes that the impact of combined interventions through physical activities and leads to reduced rates of falls among the elderly. 

The article by Bjerk, Brovold, Skelton, and Bergland (2017) is a research-based article describing the research on the impacts of the falls prevention program. The background describes that assessing the effectiveness of a falls prevention programs consisting of a single individual’s approaches. However, the introduction part of the article appreciates the lack of sufficient evidence on the effectiveness of the multifactorial approach to preventing of falls among the elderly. The study presented in this article has a sample size of 150 patient, aged 67 years and above and who have the history of falls in the last 12 months. The study consists of a control group that receives conventional interventions. The intervention is performed for three months and a follow-up exercise for six months. Baseline data were collected on gait, the speed of walking, walking habits and activities of daily living. The same parameters were measured at three months and six months of interventions. 

In all of the practices, both the research evidence articles and non-research evidence articles, patient education is not researched as much as other interventional approaches. Additionally, patient education, as compared to the other conventional prevention programs of falls among elderly patients. Therefore, based on the data provided in the above-described articles, there is a need to compare the effectiveness of patient education on prevention of falls in comparison to the other traditional method of preventing and managing falls. 

Recommended Practice Change

The evidence provided indicates that patient education is one of the effective ways to prevent falls among the elderly. According to McEwan, Baker, Armstrong, Banerjee (2018), patient education facilitates patient centered preventative measures against falls. Ayton Brien, Treml, Soh, Morello, Barker (2018), explain that patient education increases patients independence among the elderly. Stenhagen, Ekström, Nordell, Elmståhl (2014), patient education on the importance of physical exercises increase participation of the patient in activities of daily living. 

Therefore, assessing the difference between the home environment and the hospital environment helps determine the risk of falls. Additionally, the ability of patients to adjust to the new hospital environment should form the basis for assessing the risk of falls during admissions. 

Implementing recommendations

Stakeholders. One of the key stakeholders is the patient who has sustained falls or at risk of sustaining falls in a hospital setting. Patients provide data on the history of falls, physical, behavioral or cognitive impairments. The history of falls, impairments in behavioral, physical and cognitive functioning increase the risk of falls within the hospital. The assessment of these risks requires data provided by the patient during the initial contact. Nurses and other healthcare workers are key stakeholders in implementing the recommendations put forward. The healthcare personnel carries out recommendations on assessment to determine the risks of falls and carry out preventive measures such as physical exercises, vitamin D supplementation, and medication modification. One of the highly recommended measures is patient education. Nurses and healthcare professionals are vital to carrying out patient education on the risks of falls and preventive measures against falls within the hospital setting.  Healthcare policy makers and leaders are vital stakeholders about the policies required to develop policies that align with the needs of elderly patients. Implementation of preventive measures against falls requires additional resources. Therefore, government, the policymakers, and healthcare revenue sources need to be involved in determining and assessing the cost-effectiveness of the new preventive measures against falls among the elderly.

Possible Barriers. Resistance to the introduction of newly effective preventive measures against falls among the elderly. Some of the healthcare professionals may be resistant to the change in management approach. Elderly patients who experience falls also diagnosed with cognitive disorders such as dementia. Obtaining data and information from such groups of patient with memory loss may be problematic. 

Strategies to Overcome Barriers. Education of healthcare workers on the importance of new approaches to prevent falls among the patients reduces resistance to chance (Avanecean, Calliste, Contreras, Lim, & Fitzpatrick, 2017). Secondly, cognitive impairments should be managed through psychological and psychiatric interventions. Cognitive deficits contribute to falls among the elderly, and therefore psychological interventions are necessary (Sato, Kakamu, Hidaka, 2018).

Indicator to Measure Outcome. The reduction in the number of elderly patients’ falls is an appropriate indicator to assess the effectiveness of recommended preventive measures. Measuring the number of falls within a given period informs the impact and comparison with data before the implementation of preventive measures. 

1. Nursing theory used in the implementation of excellent Nursing Practices

Among the various nursing theories available in practice, I find the Nightingale’s ‘Environment Theory’ most intriguing as it has shaped my goals and values both as a student and a registered practitioner. Most fundamentally, the environment theory, propagated by Florence Nightingale (1820-1910), is based on the notion that the environment has a strong influence on patient outcomes. As such, most of the elements embedded in this theory are still practiced to date as healthcare organizations strive to provide clean air and a temperature-controlled environment for the patients hospitalized within a facility (TK & Chandran, 2017). Moreover, the environment theory comprises of seven elements that facilitate the delivery of the most optimal healthcare services to the patients. These elements focus on factors such as adequate ventilation, efficient drainage, pure water, and noise reduction. Additionally, the items in this theory put emphasis on an adequate supply of food, ample time for sleep, basking in the sun, relieving anxieties, and ensuring that the patients get a clean environment.   

More precisely, the concepts contained in the environment theory include laws of nature, human achievement of perfection, and the nursing discipline as a calling. These are coupled with the description of nursing practices as a form of art and science which is achieved through changes in the environment. Moreover, the environmental adaptation theory stipulates that nursing practices necessitate proper training and experience that differentiate it from the medicine profession (TK & Chandran, 2017).

A2. How Nurses apply the theory identified in the Implementation of their Practices

In the nursing profession, the application of these elements identified above occurs through the utilization of evidence-based practices that are supported by scientific facts and proven healthcare operations. Moreover, it involves the creation of a unique relationship between nursing practitioners and their patients. On the one hand, the environment in which a patient is placed can be manipulated to ensure delivery of the most optimal healthcare services and the achievement of positive patient outcomes. As such, nurses can adopt this model and customize a unique care plan for the patient based on his/her healthcare, spiritual, and social beliefs as well as values. On the other hand, the optimization of healthcare practices necessitates a clean setting, and nurses focus on maintaining such standards in the delivery of effective and standard healthcare practices (TK & Chandran, 2017). Nonetheless, in nursing training, the most fundamental aspect taught from the first day entails the maintenance of proper hand hygiene. It is one of the simplest and effective ways of killing germs as it prevents their spread and eradicates the development of hospital-acquired infections.

Similarly, Nightingale’s theory describes noise reduction as a variable aspect that is easily manipulated to ensure that the patients within a healthcare facility get a favorable environment during their recovery or stay. A quiet environment promotes and supports relaxation and adequate sleep while patients are recovering from different illnesses. It further eliminates or reduces the likelihood of patients developing anxiety or nervousness as they undergo different medical procedures, aspects which would prevent them from getting proper rest and sleep. The occurrence of such interruptions would further diminish the care team’s efforts to achieve positive patient outcomes (TK & Chandran, 2017). Nonetheless, nurses apply this and other elements of the environment theory in theory professional practice by adopting the notion that people are part of nature and should thus value it accordingly. They, therefore, focus on patient-centered healthcare practices to provide holistic and evidence-based services to diverse patients. Most fundamentally, the environment theory enables the utilization of nurses’ collective experiences through the placement of patients in the best physical environmental conditions (TK & Chandran, 2017). These are coupled with the manipulation of the physical conditions in whatever important ways that facilitate the prevention of diseases and the reduction of the likelihood of their health condition from escalating to worse states.

B.   Historical Nursing figures and their contributions to the practice

Florence Nightingale (1820-1910) is well-renowned as the mother of modern nursing due to her significant contributions to the practice through a patient-centered healthcare delivery system embedded in her environment theory. Moreover, Nightingale introduced the concepts of nurses acting as patient advocates, nursing education and research, and the establishment of nursing practice standards. These are coupled with the idea of improving healthcare facilities through the establishment of standards for safe and clean hospitals. For instance, in the Crimean War, Nightingale, in the company of other practitioners worked in appalling and unimaginable environmental conditions (Ellis, 2009). Most of the patients under her care died from infectious diseases that include cholera and typhoid as compared to the wounds sustained in battle. Nevertheless, amidst the dire adversities, Nightingale persevered and overcame the horrid conditions. Her compassion, yet stringent work ethics played an integral role in the improvement of the patients’ survival rate by two-thirds. Besides, her sheer determination and commitment in helping humanity inspired myriads of nurses in the contemporary world, including myself (Ellis, 2009). As such, she is credited for pioneering modern nursing practices as most practitioners have adopted her principles in spheres such as patient advocacy, leadership, and the delivery of compassionate healthcare to the widely diverse patients. These factors serve as catalysts to the delivery of profound healthcare services and the achievement of optimal patient outcomes.

The second historical figure that played a fundamental role in shaping and influencing the healthcare services practiced today entails Mary Seacole. Seacole acquired different skills related to patient care from her mother who used her herbal medicine to treat wounds and other conditions. In spite of her tremendous achievements, Seacole was never recognized for her contributions in the nursing discipline due to the color of her skin, an African American female who was prejudiced based on racial discrimination (Ellis, 2009). Nevertheless, Seacole overcame such obstacles by paving the way for other people from minority groups to venture in healthcare practices. For instance, despite numerous applications for nursing positions during the Crimean War, Seacole was rejected each time because of her skin color. Despite having string references and qualifications for the position, Seacole was further rejected in an application to work with Nightingale due to her skin color. 

Subsequently, following the numerous rejections, Seacole traveled to Crimea and financed the establishment of a healthcare unit and a restaurant. It was in this facility that most soldiers were treated for injuries sustained in battle as it was much closer to the battlefield than that of Nightingale. She thus provided vital patient care on the actual battlefield and safeguarded the welfare of numerous soldiers (Ellis, 2009). Despite the rejection and discrimination against racial backgrounds, Seacole helped patients from all walks of life.

B2. How these contributions influence Professional Nursing Practices

The contributions of these remarkable individuals have primarily influenced my professional nursing practice through the provision of standards and guidelines that should be applied in the provision of necessary care services to the patients. On the one hand, Nightingale’s story exemplifies the concept of nursing as a calling as she left the privileges in her life in England to initiate a selfless line of work in a new environment. Crimea at the time was facing scarce resources, as well as rampant infectious diseases (TK & Chandran, 2017). Nevertheless, Nightingale worked relentlessly to improve the conditions and further implement the various concepts outlined in the environmental adaptive theory. Additionally, she served as a patient advocate for better environmental conditions. These aspects entail standard practices I apply in my day-to-day activities based on a personal oath to deliver patient-centered care to my patients. As a nurse manager, I further ensure that my colleagues and the practitioners in my team get a voice through the representation of their views to the management team.

Moreover, Nightingale applied scientific approaches to the identification of a cause and effect relationship between unsanitary environment and the increase in mortality rates associated with infectious conditions such as cholera. Her efforts significantly contributed to the reduction of the death rates through the discovery and evidence-based research and practices. These were followed closely by her involvement in nursing education through the provision of scholarship programs (TK & Chandran, 2017). Similarly, Seacole’s contributions to the field of nursing mainly influence my professional nursing practice through the determination to pursue her passion. Despite racial discrimination and the rejection from numerous applications, Seacole used her resources to start her healthcare facility at Crimea. As a self-taught caregiver, she portrayed her ability to the world by providing necessary medical services to the injured soldiers (Ellis, 2009). As such, I am inspired to seek other alternatives and utilize all opportunities to achieve personal goals as well as patient outcomes. I have thus adopted a positive and ‘can-do’ attitude in all my operations and handling different tasks.

• The differences between the roles of the State Board of Nursing and the American Nurses Association (ANA)

A state board of nursing refers to a licensing and regulatory body within a specific state whose role entails setting the standard for safe nursing services and making decisions regarding the Scope of practices within its jurisdiction. It further awards licenses to qualified candidates as they graduate to professional practitioners (Porter, 2013). More precisely, Boards of Nursing (BON) are state government agencies in each state in America which are responsible for the enforcement of the Nursing Practice Act that guides and governs nursing operations in according to the laws of a particular state. While the scope of practice for the BON varies from one state to the next, its roles include the enforcement of the Nurse Practice Act and licensure requirements (Cherry & Jacob, 2013). These are coupled with the accreditation of the training programs in various institutions, and the formulation of standards of practice. Similarly, a BON focuses on the development of policies, administrative rules, and regulations within a state.

Conversely, the American Nurses Association (ANA), formed in 1896, as the Nurses Associated Alumnae and renamed in 1911, entails a non-profit organization that focuses on the establishment and improvement of standards of nursing practices (Porter, 2013). Additionally, it advocates for the rights of registered nurses and promotes initiatives that safeguard the overall well-being of all practitioners.

C2. The influence of these organizations on personal nursing practices

These two organizations influence my nursing practice through by informing me on the dos and don’ts in the nursing profession. For instance, the Board of Nursing in Kentucky outlines the Scope of nursing practices, thereby shaping the activities carried out as stipulated by the law. It thus ensures that nurses, including myself, are responsible and accountable for actions. On the other hand, ANA works hand-in-hand with the State Board of Nursing in the establishment of a framework of standardized nursing practices within the state (Cherry & Jacob, 2013). 

In Kentucky, nursing operations are governed by the State Nurse Practice Act. As a registered nurse working in Kentucky, I am required to adhere to the various standards outlined by the law and regulation. Besides, their guiding principles facilitate the establishment of a safe and healthy working environment based on the application of ethical principles (Momennasab, Koshkaki, Torabizadeh & Tabei, 2016). Similarly, ANA facilitates the establishment of nursing practices that influence the healthcare industry through new reforms and regulations based on the issues affecting nursing operations.

C3. The requirements for Professional License Renewal in Kentucky 

Most fundamentally, the requirements for professional license renewal in Kentucky, under article 201 KAR 20: 215 of the Board of Nursing provisions, include:

• Proof of earning fourteen approved hours of contact with patients
• The acquisition of national certificate for carrying out the role of a nurse during the period
• Completing a research project on a nursing topic as a principal researcher, assistant in the investigation, or project director. 
• The publication of an article (s) on nursing
• Nursing continuing education presentation developed by the presenter and submitted to other practitioners
• Precept for nursing students or new recruits under orientation for at least five business days
• Proof indicating the attainment of seven hours of contact with the patient and evaluation of employment that meets the requirements of continued hiring (Kentucky Board of Nursing, 2019)

Failure to maintain these requirements may lead to the license being revoked, termination of employment, and denial of areas of practice within the state.

C4. The difference between Registered Nurses licensing requirements in a compact versus   non-compact state

Similarly, there are different licensing requirements for registered nurses in a compact and non-compact state. On the one hand, licensure requirements for registered nurses in a compact state include a declaration that a specific state will be an individual’s primary residence and place of work. This declaration boosts the nurse’s license eligibility in various states and the adherence to the governing laws (Kentucky Board of Nursing, 2019). On the other hand, licensure requirements in a non-compact state include sending a formal letter of application to the BON in the specific state the nurse decides to practice. 

• The differences between the functions of the FDA and those of the Center for Medicare and Medicaid Services

The Food and Drug Administration (FDA) refers to a federal government agency whose primary role entails approval or disapproval of new drugs invented by pharmaceutical companies. It further monitors the food consumed, drugs, and cosmetic products used across the nation for safety and efficacy. Contrastingly, the Center for Medicare & Medicaid Services (CMS) refers to a federal agency that operates under the Department of Health and Human Services (HHS) in the United States. Formerly Health Care Financing Administration (HCFA), the functions of the CMS include the administration of the Medicare program by working collaboratively with other governmental entities.  

According to the FDA Guidance Policy of 2007, the agency is responsible for the provision of direction in the manufacture of products and practices carried out in alternative therapeutic fields (Halpern, 2016). Nevertheless, the FDA is not mandated to evaluate other medical interventions classified under its guidance policy. For instance, it cannot evaluate practices such as the use of off-label drugs and other dietary supplements. Due to the entry of alternative therapeutic practices homeopathic products without approval of the FDA, my role as a patient advocate entails adherence to the federal and state laws when a patient requests for alternative therapy as an option (Halpern, 2016). The achievement of this goal thus necessitates the dissemination of relevant information to the healthcare practitioners working in my team and compliance with healthcare policies in the best interest of the patients, thereby safeguarding the welfare by advocating for safe perspectives.

Similarly, there are various disparities related to the alternative therapies especially when they are requested by patients or under the recommendations healthcare practitioners. For instance, in the advocacy for alternative therapeutic interventions that include acupuncture, chiropractic, the CMS provides does not cover the costs. These limitations are applied regardless of whether one or a combination of such therapies proves to be essential for the patient. As such, the CMS outlines the various guidelines for coverage in alternative therapeutic procedures. More precisely, therapeutic interventions such as acupuncture and chiropractic are not covered in the Medicare program (Momennasab, Koshkaki, Torabizadeh & Tabei, 2016). On the other hand, under the Medicare program, there are two exceptional provisions that include osteopathic medicine and chiropractic in cases where the spine needs manipulation. Consequently, patients with Medicare coverage and no health insurance forego vital interventions that involve out-of-pocket payments.  

• The Purpose and Scope of the Nurse Practice Act in Kentucky and its influence on professional operations

In Kentucky State, Nursing Practice Act is responsible for protecting the welfare of the people through the developing and enforcing state laws that govern nursing operations. As such, the Kentucky Board of Nursing monitors nursing practices, education and training, and further promulgation of their administrative roles. These are coupled with the provision of suitable guidelines that ensure safety and effectiveness in care services rendered to their patients. Moreover, the role of a registered nurse involves carrying out activities that require special skills and knowledge biological principles, physical exercises, psychological measures, and other social sciences (Kentucky Board of Nursing, 2019). These are coupled with patient education, the creation of awareness, and sensitization of the patients. Nursing practitioners are further required to maintain health through preventing different illness and administrating medical interventions per the prescriptions of physicians. Nonetheless, these services should be consistent with the Standards of Practice postulated by the American Nurses’ Association, as well as those established by nationally accepted organizations.

E2. The definition of Delegation for the Registered Nurse in Kentucky

Most fundamentally, the delegation for the registered nurse in Kentucky necessitates the assessment of the practitioner’s judgment and appropriateness to the particular tasks. These tasks include the collection, documentation, and reporting of patient information. These are accompanied by the performance of self-care tasks that include the administration of medication. Besides, the delegation of such tasks entails performance of routine checkups that do not involve ongoing assessment and nursing input (Kentucky Board of Nursing, 2019). For instance, some of these tasks include external care to the administration of urinary catheters, ambulance operations, positioning and turning patients, and other day-to-day chores. 

•  Application of different roles in my professional practice

Registered nurses (RNs) act as scientists through the application of evidence-based practices in the provision of safe and effective care services based on different techniques and skills. On the one hand, evidence-based practices govern the activities and interventions applied by nurses and their ability to work collaboratively with other practitioners in the delivery of desired patient outcomes. Similar to scientists, registered nurses apply different strategies and approaches to the determination of a suitable course of action that would lead to facilitate the achievement of desired patient outcomes. Most fundamentally, the nursing practices applied by registered nurses (RN) play an integral role in the identification of the unique traits exhibited by different practitioners (Momennasab, Koshkaki, Torabizadeh & Tabei, 2016). For instance, in the utilization of their skills, nurses assume the role of a scientist by exemplifying informed decision-making processes and intuitive development of courses of action decisions. These aspects are guided by knowledge and skills acquired from prerequisite training, research and experience in their professional practice (Marquis & Huston, 2017). 

As a detective, nurses use their skills to identify vital clues, especially in the diagnosis and physical examination of their patients, as well as the prediction of desired outcomes. These skills significantly contribute to informed decision-making and the determination of the causative factors associated with the occurrence and prevalence of a health condition. Conversely, as a nurse manager of the healing environment, nurse practitioners play an integral role in ensuring that patient and organizational goals are met accordingly (Marquis & Huston, 2017). The achievement of these objectives involves provision of direction and guidance on patient-driven goals, suitable interventions, and action steps. 

• The influence of the ANA Code of Ethics provisions in Nursing Practices

G1. Analysis

The fist provision stipulated by the ANA Code of Ethics entails practicing compassionately and respecting the decisions and welfare of the patients (Halpern, 2016). According to this provision, nurses are required to recognize the unique attributes and different backgrounds of their patients in terms of cultural, economic, religious, and social preferences. As such, it influences my nursing practice through the requirement of incorporating these factors in the development of a care plan that is customized to suit the needs of the patient. Moreover, adherence to this provision implies that I have to forego or set aside personal beliefs and values when caring for patients from diverse backgrounds. Besides, the provision of patient-centered nursing care necessitates discounting a nurse’s belief system and abiding by the oath to respect the needs of the patients irrespective of their cultural, economic, social, and religious background (Halpern, 2016). Nonetheless, these requirements have primarily shaped my approach towards nursing practices as they facilitate the elimination of biased operations and the assurance of credibility.   

Additionally, the second provision that influences the nursing practices in my operations entails commitment of nurses to their patients (Momennasab, Koshkaki, Torabizadeh & Tabei, 2016). The assurance of patient-centered care begins the moment a nurse meets a patient, his or her family members, or loved ones. The patient’s decisions in terms of the type of medical treatment he/she desires should be respected by keeping him/her abreast of any operations carried out or medical interventions administered.  As a nurse, I have an obligation to uphold and serve the interests and desires of the patient. Regardless of the disagreements posed by family members, nurses must honor the desires of their patients. Similarly, concerning effective collaboration and communication between caregivers, nurses are required to establish and maintain professional boundaries. This way, aspects such as trust, respect, and communication, are enhanced, thereby ensuring flawless operations.

G2. Description of a Nursing Error in a Clinical Practice

Nonetheless, the application of the provisions mentioned herein would occur through compliance with the codes of ethics in providing necessary care services to the patients irrespective of their background. For instance, I once made a mistake by disregarding a patient’s complaint of abdominal pain. The patient had been admitted several days ago and had constantly complained of abdominal pain, but upon examination, no underlying conditions were identified. The primary care physician working with the patient thus recommended several tests and diagnostic procedure to be carried out. He further prescribed pain relief medications for the patient to take before sleeping. During my evening rounds, I realized that the patient had not taken any of his medication, despite the worsening of his condition. Upon inquiry, the patient stated that he could not take the medication as it was against his religious belief.  I could not have such an incident happen under my watch as it would interfere with the achievement of effective care and the execution of a strategic care plan. I thus insisted and persisted that the patient should take the medication, and in return, he yelled at me to leave his room. 

Shocked, I left the room and quickly realized that I had violated the codes of ethics in honoring the patient’s desire. After a short while, I returned and apologized to the patient who, surprisingly, apologized back, stating that he should have informed me of his reservations against medical procedures. Based on this incident, it is evident that nurses are required to adhere to the provision of the regulatory bodies as they guide their operations and ensure the achievement of patient outcomes.  

• Leadership qualities and Traits that represent Excellence in Nursing 

In the nursing discipline, leadership occurs through the exemplification of qualities and traits that provide direction in challenging situations. It further involves the ability to make decisions related to the suitable course of action that should be taken based on intuitions, experiences, and evidence-based practices. As such, four leadership traits and values that I believe represent excellence in nursing include:

1.     The ability to think critically in exercising clinical and professional judgment as well as making decisions

2.     The knowledge of the requirements in the establishment of effective communication and nurse-client relationships.

3.     The enactment and understanding of the full scope of nursing practices in all operations.

4.     The application of ethical principles when dealing with complex issues involving the welfare of the patient.

As a leader at the patient’s bedside, these traits come into play when making relevant decisions regarding the suitable course of action based on his/her condition. Because the patient’s condition can change at any time, the ability to think on my feet may save his/her life by identifying the appropriate intervention. Similarly, the ability to establish an effective patient-centered care plan and relationship that is both respectful and trustworthy indicates leadership traits based on conviction (Cherry & Jacob, 2013). Similarly, the leadership traits highlighted above play a significant role within a nursing or intermediary team through the ability to critically exercise professional and clinical judgment. For instance, they foster the development of a collaborative structure in nursing care through the interaction with professionals skilled in different spheres.

Moreover, in my area of practice, the work environment influences areas such as nursing leadership, decision-making, and professional development through the requirement of feedback from the staff working in the various departments. The nursing leadership strategy applied entails the provision of recommendations and solutions to various challenges, which in turn safeguards the welfare of the patients. Similarly, all employees within the organization are encouraged to share their opinions based on independent and collaborative decision-making processes (Momennasab, Koshkaki, Torabizadeh & Tabei, 2016). However, the decisions made need to adhere to the standards, laws, and policies set by regulatory agencies and further adhere to organizational and patient outcomes. With regards to professional development, the work environment highly values personal growth and achievements. For instance, there are tuition reimbursement programs as well as academic scholarships for practitioners willing to expand their knowledge and education base (Claudette, 2014). Similar efforts and reflected in the organization hiring and recruitment processes that focus on competent and qualified personnel.              

Fundamentals of Marketing

Executive Summary

The purpose of this report was to explore potential strategies that will create a successful marketing campaign for Skullcandy Corporation to establish high-quality headphones with noise-canceling wireless headphones. The report explores the potential market segment that will give the highest headphone sales in the audio industry. The company will target the youth market segment through product differentiation and establish a more disciplined headphone marketing strategy to mitigate product imitation. The report used micro and macro environment analysis in the headphone market in Australia in order to establish the most profitable and sustainable marketing or branding strategy to adopt in Australia. The findings showed that there is increasing demand for headphones in Australia, especially the youth market segment. Therefore, the company will specifically align its headphones to position in this market segment strategically. Recommendations to Skullcandy Corporation align headphones according to market segment and sales team in order to improve customer experience. The company should also segment its retailers by consumers and align its headphones with their preferences and values for improved distribution. The future research should focus on consumer values, competitive mapping and establishing the market size for each segment for more informed decision-making strategy. 

Introduction

This report will explore potential strategies to create a successful marketing campaign for Skullcandy Venue noise-canceling wireless headphones. The goal is to improve the sales of the product and create a structured breakdown of the current consumer market, followed by recommendations to achieve this. To do this, the micro and macro environments including the marketplace and other influential factors, consumer segments and attractiveness will be dissected to demonstrate a complete understanding of expanding sales (Ratten 2015, p. 442). 

Unfortunately, Skullcandy headphones are a new release, thus a limited amount of information available online from non-advertising sources such as for their website. Information will be pulled from the official Skullcandy website, in addition to data gathered from the national statistics about the audio industry and specifically the headphone market. This report presents a market analysis of headphones in Australia by doing a market analysis of both audio industry and competitive environment (Ratten 2015, p. 445). Besides, the report identifies headphone market segmentation and provides strategies that will create competitive advantage for Skullcandy. This key limitation encountered in the collection of data and accessing information that was up to date from the company and competitors. The scope of this report covers Skullcandy’s business segmentation, and how it can improve headphone business. It also provides a comprehensive analysis of findings, strategies, and recommendations that the marketing manager of Skullcandy should adopt in order to establish and maintain a competitive advantage (Andrews and Shimp 2017, p.5). 

     1.         The Marketplace and Influencing Factors

                  1.1.         Micro

                                1.1.1.         What industry are we in? (400 words)

The chosen Skullcandy Headphones are in the audio industry branded as over ear headphones, sub branded as Bluetooth and noise canceling. Figure 1 displays how this chosen product fits into the overall audio industry. 

Figure 1 – Industry Definition

As the audio industry is so broad, it is important to identify the products brand + sub-brand to develop an appropriate marketing strategy. Although Skullcandy sells a few small speakers, they are in the audio industry for their wide variety of headphones/earphones. As Skullcandy does not have a wide variety of the types of products they market, concentrating on headphones allows them to more specifically market their product and engineer the best quality product possible (Pride 2013, p.10).

According to Andrews and Shimp (2017, p.5), the Australia market has an increasing market size for headphones. The present hype persisting in the headphones’ market is not a fad; it is the future of the audio industry. The increasing demand and adoption of headphones are attributed to the fact that various people are tethered to their electronic devices such as mobiles, tablets and music players for a substantial portion of daily activities. The primary goal is to listen to music, play games and watch videos. 

Within the industry, the team has selected three competitors to analyze with similar products and strategies, but not the same. For example, Beats by Dre is similar to Skullcandy as they are primarily a headphones/earphone company (Beats 2018). Bose, on the other hand, is strong through the entire audio industry as they not only sell headphones but produce a high-quality variety of stereo products too. Furthermore, Sony expands further than this with a “passion for technology, content, and services” (Sony, 2018), thus producing the broadest variety of products out of 3 competitors.

Skullcandy was founded by extreme sports product designer Rick Alden (SkullCandy, 2018). Necessity for a new headphone brand came to Alden during a day of snowboarding, which during the struggle of removing earphones just to receive a phone call gave him the idea to design headphones that could not only simply switch between phone calls and music; but also look as good as they sounded and be “used and abused” (SkullCandy, 2018). Because of this, within the audio industry, Skullcandy has built a product for sport, youth, and those who share the values of the company of going for life at 100% with music by their side (Bose 2018). 

                                1.1.2.         Competitor Analysis (200 words)

Moving from their founding days of the initial struggle, Skullcandy has achieved their desired quality and trendy headphones. With their promotions, style, level of success and product specifications, three appropriate significant competitors and their relative products have been selected to analyze and compare: Bose, Sony, and Beats by Dr. Dre (beats).

Table 1 – Competitor Analysis

P	Skullcandy Venue Noise Canceling Headphones	Bose Quiet Comfort 35 wireless headphones II	Sony WH-CH700N Wireless Noise Canceling Headphones	Beats Studio 3 Wireless
Brand + Sub-Brand	Over-ear headphone, wireless and noise-canceling	Over-ear headphone, wireless	Over-ear headphone, wireless and noise-canceling	Over-ear headphone, wireless
Brand Positioning	“For people like you—like all of us”	“new technologies that would truly benefit people”	“Everything we do is to move you emotionally”	“premium consumer headphones”
Product Specifications	Noise-canceling, wireless, a fast charge, Tile (find my headphones)	Noise canceling, wireless, fast charge	Noise canceling, wireless, fast charge	Noise canceling, wireless, fast charge
Place	Skullcandy online, Tech Stores (JB HI FI, Harvey Norman, ect.)	Bose online, Tech Stores (JB HI FI, Harvey Norman, ect.)	Sony online, Tech Stores (JB HI FI, Harvey Norman, ect.)	Beats onlineTech Stores (JB HI FI, Harvey Norman, ect.)Apple Store
Price	$179.99	$499.95	$299.95	$449.95
Promotion	Targeted Niché market of action sports people.			Product placement such as athletes and musicians
Advantages & Disadv c/w our Brand and Sub-Brand	The company has the advantage of a leading market and product targeting
Other factors important to prospective buyers	Differentiation off product and imitation and quality headphones
Data was current as of 28/09/2018.Sources; https://www.sony.com.au/electronics/about-sony https://www.bose.com.au/en_au/about_bose.html https://www.beatsbydre.com/au/company/aboutus https://www.skullcandy.com/our-story https://www.skullcandy.com/shop/headphones/bluetooth-headphones/venue https://www.beatsbydre.com/au/headphones/studio3-wireless https://www.sony.com.au/electronics/headband-headphones/wh-ch700n https://www.bose.com.au/en_au/products/headphones/over_ear_headphones/quietcomfort-35-wireless-ii.html#v=qc35_ii_triple_midnight   https://www.cbsnews.com/news/skullcandy-how-a-small-company-reaches-a-big-market/

The competitor analysis shows that the companies have almost similar marketing mix strategies, similar to Skullcandy’s brand strategies. This shows that the three competitors are indeed in the strategic group. This is because they have similar strategies for Skullcandy’s strategies. This indicates that it will be essential to establish differentiation strategies for the headphone marketing in order to position Skullcandy’s as the leading provider of headphones in Australia (Sony 2018). The company will target new branding strategies that will differentiate its products from competitors. The company will critically look into technology and promotional strategies that will capture the market niche for headphones in Australia (Rynderman 2016, p.12). This should include noise cancellation and increased partnerships in order to improve the selling point of the company. 

                                1.1.3.         Company Profile and Organizational Structure

Skullcandy produces and distributes headphone products to retailers throughout Australia and other different countries globally. Skullcandy is the “leading worldwide lifestyle and performance audio brand driven by increasing creativity and irreverence of youth culture.”  The company has good market segmentation has they distribute headphone products in specialty retailers focused on and youth lifestyle and action sports. Skullcandy has a diverse range of headphones, which come with a diverse range of graphics, colours, and designs. The company offers a diverse range of headphones of high innovative performance that reflect human lifestyles. This has established customer-oriented and uniquely targeted headphones. For instance, Skullcandy offers special “Action Sports” headphones targeting enthusiasts and sportsmen of sports. Skullcandy is one of the main selling headphone companies in Australia and creates audio products as well as technology to catalyze collision of music, sports, and fashion. The company is grounded in youth culture and the spirit of ‘rock n roll’ in order to celebrate independence, individuality, ambition, and creativity. Therefore, the company embodies an exclusive design of headphones using modern celebrities in the state-of-art technology in both form and function (Breebaart 2017, p.526).  The company workers are top of consumers of the headphones that make the spirit of each employee to be found in the brand. Employees play hard and work hard. This makes the company staff love the casual work climate. The company has structured its office as a skate park and offers flexible scheduling, medical cover, and cheap-as-dirt ski passes. Besides, the company provides a powder-day policy, gym membership, room for advancement and growth. This creates the feeling of one family that creates a competitive advantage for the company and allows employees to be more creative and innovative. 

                  1.2.         Macro

The macro environment is purely external force that influences how a company will operate in a given market. These are factors, which are outside control of the company and comprise of legal, political, technological, economic, environmental and social factors. Skullcandy will be affected mostly be economic, political and technological factors in the audio industry (Benzo, Mohsen and Foural 2017, p.25).

Political Analysis

Considering that Skullcandy will be operating in the retail environment in the audio industry in Australia, political factors will be determining the force on pricing and significant company operations. For instance, an increase in the community tax would effectively increase the price of the headphones. Besides, policies of importing raw materials for making the headphones could impact the retail chain’s sourcing policies. Government policies on environmental aspects such as noise pollution could affect the packaging and marketing of the product. The stable political environment supports a transparent and robust legal system. The rule of law protects property rights and prevents corruption (Benzo, Mohsen and Foural 2017, p.25).

Economic Analysis

The economic freedom of Australia has a score of 80.9. The government spending indicators and integrity offset by decreases in property rights and labor freedom. The country has robust-free market democratic system benefits due to the effective government systems that facilitate vivacious entrepreneurial development. The audio industry is open to global competition and readily available skilled workforce, which provides opportunities to Skullcandy to enhance its creativity and innovativeness (Benzo, Mohsen and Foural 2017, p.25).

Technological Analysis

Social media is changing the way firms interact with their consumers. Online shopping for headphones generates more profits for the audio industry in Australia. The emerging trend such as the new futuristic technology like Hologram is changing the approach retailers store work. The development of RFID technology could impact the audio industry deliverables and tracking. These trends will be essential in determining the marketing mix of headphone products (Breebaart 2017, p.528).

SWOT Analysis

The SWOT analysis provides weaknesses, opportunities, strengths, and threats of Skullcandy Corporation. 

Strengths A small team with more interaction with customersFavorite among music industries and DJsInnovative and creative brandHighly profitable and returnHigh growth rate Competitive company cultureLeading market position in the audio industry	WeaknessesLimited music industry focusEasily imitatedInability to maintain growth Mainly focused on a single market nicheHighly competitive audio industry
OpportunitiesImprovement of brand loyaltyReward-based on individual metrics.New headphones’ marketsIncrease in house capacityGrowing headphone demandGlobal market expansion opportunitiesDrop in price of materials Market growth beyond expectations	ThreatsEasily  imitated with no patentsIncreased production costsPrice changesSmall product development bandwidth

The SWOT analysis shows that the company has opportunities for growth and sustaining competitive advantage in the audio industry. According to micro and macroclimate analysis, Skullcandy Inc. must change its branding strategies to avoid the increasing product imitation across the audio industry. Growth in headphones will be dependent on new; compelling features feature sets and diverse application, which will allow the company to focus majorly on the youth market segment. The company will also focus on online sales, which are a primary location for consumer headphones. It is vital to apply the brick and mortar business model in order to evolve strategically with changing market trends and sustain the increasing market share.

     2.         Consumer Segmentation

To explore the potential market, consumers need to be broken into segments based on measurable, identifiable and sizeable traits. Examining demographic segmentation proved to be the most successful way to segment our consumers, specifically through their age and attitudes towards the critical features of our product. The following table explores this in depth.

Age	Necessity for headphones	Quality importance	Relevance of cost	Brand awareness
<13	Low	Low	Very High	high
13-18	High	Low-moderate	high	Very high
18-30	High	Very high	moderate-high	moderate
30>	Moderate	High	low	low

The demand for headphones is directly related to the music industry and the demand for electronic devices. The Australia market has an increasing market size for headphones. The primary goal is to listen to music, play games and watch videos. The company should focus on the youth market due to its demand for high-quality headphones. The market segmentation shows that Skullcandy should adequately differentiate its headphones to position them as the best in the industry through noise-canceling venue wireless and innovative headphones such as Crusher 360 in order to ensuring its consumers feel the music in a fascinating manner. The youth market segment shows increasing headphones demand as well as in the sports market. The company should effectively focus on new headphone launches and partnerships in with vital other players in the global and domestic headphone market in order to consolidate its position in the headphone market and expands its customer base (Ryan 2016, p.25). 

     3.         Assess the Attractiveness of each Customer Segment

The attractiveness of each market segment is dependent on the headphones’ market size and the future trends in the audio industry. According to the above consumer segmentation, it is important to focus on the youth market segment, which provides increasing demand, and demographics that will enable Skullcandy to differentiate its products to fit the market preferences and tastes. The reasons for selecting the youth market is because it presents the increasing demand and adoption of headphones due to the increasing youths who are tethered to their electronic devices like mobiles, tablets and music players for a substantial part of their day. Therefore, focusing on the youth market will also provide Skullcandy with the opportunity and market niche to focus on skateboarders, snowboarders, and action-sports enthusiasts. The following chart shows the current and expected demand for the headphone in globally.

Australia headphones and earphones’ market, by product, 2014 – 2025 (USD Million)

Source: Grand view research  

The growing demand for headphones and quality products provides the company with a market niche to focus on quality and trendy headphones. The future of headphone products is expected to rely on appearance, design, and technology that will fit customers’ preferences, values and promote company individuality. This trendy shows that Skullcandy can penetrate its headphones in all the existing market segments with differentiated products that meet the consumer preferences. The increasing consumer demand for quality headphones may have positive impacts the market growth. Therefore, the increasing attractiveness and adoption of portable music players, tablets and smartphones are anticipated to amplify the headphones’ demand over the future (Dowd 2015, p.9). The advances in technology insights are the crucial factors attributing to increased headphone sales. The most important prolific advancements by Skullcandy in audio industry, specifically consumer segments, are the wireless connectivity and noise-cancellation. Skullcandy should focus on the emerging trends that emphasize developing headphones that ensure quality audio and saves users from hassles of wired devices. 

     4.         Recommendations for Additional Research

The micro and macro analysis provide important insight on the importance of evaluating the market trends in the audio industry that will enable the company to strategically differentiate its products to fit the current and future customer values, and preferences. Having identified the market size, internal and external factors that determine the operations of Skullcandy Corporations, it is important to establish other influential factors that will determine the future profitability of the company. Besides, the company operates in an industry where quality and prices are critical components of marketing mix strategies. Therefore, it is essential to establishing consumer preferences, values, and how culture affects the demand for headphones in the youth market segment. Also, as the marketing manager, it is essential to construct an online survey that will gather information from esteemed customers about the critical features of headphones that effectively meet their preferences. The company focuses on strategies that will meet segment demands; it is vital to establish the size of each market segment and the critical market drivers, restraints, and future opportunities in each segment (Keenan 2014, p.13). This is because these factors will impact the market dynamics and subsequent analysis of related trends. 

It is important to establish both online and hard copy surveys and questionnaires that will specifically provide key information about consumer segmentation, market size, and future trends or drivers, which will affect each market, segment. Using survey and questionnaire as the methodology for data collection, the main questions will be centred in establishing what segment will drive or lead market growth as well as why and how will market constraints, drivers, and future opportunities impact the market dynamics, how is the competitive landscape and the market behaviour of participants as well as what are the critical sustainability strategies adopted by main market players? This information will provide essential data for analysis in order to establish the market size, market growth and an in-depth analysis of sustainability strategies and their impacts on growth and competition. These findings will provide the basis for establishing branding strategies and differentiation opportunities that will guide the way for establishing market positioning (Dowd 2015, p.143). The advantage of an online survey and questionnaire is that they will provide real-time data and accurate information that will enhance the efficiency of selecting right marketing strategies. The other advantage of this data collection methodology will be able to reach a large target audience and can be tailored to specific people easily in consumer segmentation. The data is efficiently transferred to a computer for the easy analysis. The disadvantage is that the survey can get time wasters and ruin the data. The gathered information will be crucial in directing the company marketing strategy. This will inform Skullcandy to strategically differentiate its products to fit in the market segment and position itself as the leading producer and distributor of headphones in Australia (Keenan 2014, p.15). This will also be essential in identifying and tracking key market drivers in the audio industry that can significantly affect the selected business strategy. 

     5.         Conclusion

In summary, the findings of this report have adequately been analyzed to inform the strategy to adopt in the audio industry in Australia. The analysis of micro and the macro environment has ensured that the marketing strategy covers the essential market values and consumer preferences. This report explored potential strategies to create a successful marketing campaign for Skullcandy in the field of noise-canceling wireless headphones. The goal is to improve the sales of the product and create a structured breakdown of the current consumer market, followed by recommendations to achieve strategic positioning. The report has tackled vital areas to inform strategic recommendations and provide insight for future research. The most significant prolific advancement by Skullcandy in audio technology, specifically consumer segment, is the wireless connectivity and noise cancellation. Skullcandy should focus on the emerging trends that emphasize developing headphones that offer quality audio and saves users from challenges of wired products. This will be an essential branding strategy that will allow Skullcandy to differentiate its product perfectly according to consumer preferences and values.

6.0 Recommendations

According to the findings of this report, it is crucial for Skullcandy Corporation to strategically differentiate its products to fit wireless connectivity and noise cancellation. The market manager should ensure a leading position in the production and distribution of high-quality headphones in the audio industry. The need for a more clear definition of the brand and market segment means that Skullcandy should ensure clear messages to excite its customers. The company should amplify differentiation and develop a more disciplined headphone marketing strategy to mitigate product imitation. The company should better align headphones according to market segment and sales team in order to improve customer experience. The company should also segment its retailers by consumers and align its headphones with their preferences and values for improved distribution. 

7.0 References

Andrews, J.C. and Shimp, T.A., 2017. Advertising, promotion, and other aspects of integrated marketing communications. Nelson Education, pp.3-25.

Beats by Dr Dre 2018, About Us, Beats by Dr Dre,  viewed 1st October 2018, <https://www.beatsbydre.com/au/company/aboutus>

Beats by Dr Dre 2018, Beats Studio 3 Wireless, Beats by Dr Dre,  viewed 1st October 2018, <https://www.beatsbydre.com/au/headphones/studio3-wireless>

Benzo, R., Mohsen, M.G. and Fourali, C., 2017. Marketing Research: Planning, Process, Practice. SAGE,m pp. 25.

Bose 2018, About Bose, Bose,  viewed 1st October 2018, <https://www.bose.com.au/en_au/about_bose.html>

Bose 2018, Bose QuietComfort 35 wireless headphones II, Bose,  viewed 1st October 2018, <https://www.bose.com.au/en_au/products/headphones/over_ear_headphones/quietcomfort-35-wireless-ii.html#v=qc35_ii_triple_midnight>

Breebaart, J., 2017. No correlation between headphone frequency response and retail price. The Journal of the Acoustical Society of America, 141(6), pp.EL526-EL530.

Dowd, R.M., 2015. Multi-listener headphone system with luminescent light emissions dependent upon selected channels. U.S. Patent 9,143,595.

https://www.cbsnews.com/news/skullcandy-how-a-small-company-reaches-a-big-market/

Keenan, T.P., 2014. Technocreep: the surrender of privacy and the capitalization of intimacy. Greystone Books Ltd, pp.6-17.

Pride, W.M., 2013. Marketing 2014. Cengage Learning, pp. 2-25. 

Ratten, V., 2015. Athletes as entrepreneurs: the role of social capital and leadership ability. International Journal of Entrepreneurship and Small Business, 25(4), pp.442-455.

Ryan, D., 2016. Understanding digital marketing: marketing strategies for engaging the digital generation. Kogan Page Publishers, pp.25.

Rynderman, B., 2016. The licensing of new recorded music business models in Australia: Current practice, the barriers to entry and an investigation in to the need for legislative reform(Doctoral dissertation, Queensland University of Technology), pp.10-20.

SkullCandy 2018, Our Story, SkullCandy,  viewed 1st October 2018, <https://www.skullcandy.com/our-story>

SkullCandy 2018, Venue Active Noise Canceling Wireless Headphone, SkullCandy,  viewed 1st October 2018, <https://www.skullcandy.com/shop/headphones/bluetooth-headphones/venue>

Sony 2018, About Sony, Sony,  viewed 1st October 2018, <https://www.sony.com.au/electronics/about-sony>

Sony 2018, WH-CH700N Wireless Noise Cancelling Headphones, Sony,  viewed 1st October 2018, <https://www.sony.com.au/electronics/headband-headphones/wh-ch700n>

Forbidden Archeology
According to Michael Cremo, human existed over 150000 years ago or probably millions of years ago. According to his research, he used megalithic structures to show that human existed 150000 years ago. For instance, he used Hampi, India and Osaka walls in Japan. Michael also used Paleoliths, old stones to show human existence millions of years ago. He also uses the writings on walls to show that human life existed many years ago and a speech by Michael Faraday 150000 supports his analogy. Archeological evidence in Hueyatlaco, Mexico was discovered with human artifacts, of 250000 years ago. He believes that the footprints are for human showing that human existed 1.3 million years ago. Besides, he used Buenos Aires Skull to show that human pre-ensanadan formation existed 1.5 million years ago (Cremo 30).
Cremo’s Methodology
Cremo used secondary data in order to obtain his evidence that human existed millions of years ago. Therefore, the methodology is an analysis of secondary data or findings from other archeologists. Cremo uses examples of archeological evidence such as the findings in Hueyatlaco, Mexico of human footprints and Buenos Aires Skull showing pre-ensanadan formation (Cremo 30).
Primary and Secondary Literature
Primary literature is the physical object which was created or written during study time, which is a result of initial scientific research or observation such as footprints. Secondary literature is the analysis and interpretation of primary sources. The primary literature discusses the direct and firsthand evidence on history and existence of human life and includes artifact and pictures (Cremo 30).
Secondary Texts
Cremo’s opinion about secondary texts do not contain evidence of extreme human antiquity because secondary texts lack the primary record immediacy and they include information is already analyzed, processed, interpreted and commented in such a manner to alter the originality of information (Cremo 30).
Primary Texts
It is valid that primary texts both present and past provide evidence of extreme human antiquity. This is because they provide firsthand and direct evidence about work of art and events of human history.
Historian of Science
I agree with Oldroyd claims. This is because there is a significant problem regarding the lack of assurance in scientific truth. It is evident that most of the claims are unfounded and present real assumption of human existence over the years, considering that Cremo uses other people’s archeological findings, which are scientifically not proven (Cremo, 2012, p.13).
Virginia SteenMclntyre
The self-publishing by Virginia SteenMclntyre and his team findings of an archeological site near Pueblo, Mexico was rejected and job losses for going against the university rules. They independently published the findings and received a backlash from colleagues and lost a job and her career was finished. According to Cremo, the work was rejected because it contradicts the theory of the archaeologist that human never existed 250000 years ago (Cremo 30).
Modern human Anatomic
According to Cremo’s research, the anatomically modern human beings’ presence can be traced in Europe. This is according to the traces of man in the Crag or shell of human face discovered by Henry Stopes in 1881. The basis is that the red crag existed in Europe 2-3 million years ago. Jacques discovered a human skull in Abbeville, France. Critics argued that the information was not accurate and no traces of human existence at that time (Cremo 30).
Pre-ensanadan formation
The pre-ensanadan formation is the formation that is beneath the volcanic rock that led to the discovery of human skull. At that time, the human skull was discovered.
Han Reck’s finding at the Olduvai Gorge
Reck skeleton was discovered in Olduvai with a variety of ape-men including the Homo habilis. He discovered a human skeleton between 1.15 and 1.77 million years old of human remains in the early 1930s. Reiner Protsch was a German scientist who used carbon 14 dating to determine the age of the skeleton. He believes the bone fragments’ samples were not authenticated and were on a third of the standard sample. The sample was probably contaminated by carbon 14. Protsch findings should be discredited due to his questionable character and competence (Cremo 30).
Human Jaw
The fossil human jaw born was discovered at Suffolk by Robert. The findings were human jaw born found to exist 2-3 years old in Suffolk, Ipswich. This was significant evidence showing the existence of human live 2-3 million years ago (Cremo 30).
Mary Leaky
In 1979, Mary Leaky announced footprints at Laetoli, Tanzania. She believes that the Laetoli footprints are indistinguishable from human footprints. Other scientists supported her discovery because the footprints resemble modern human footprints. Critics argue that the footprints were found by a volcanic hill 3.7 million years old and scientist and Leaky believe that no human existed approximately million years ago (Cremo 30).
Italy and Human Skull
An anatomically modern human skull was discovered in Castenedolo, Italy in the late 19th century, by Ragazzoni. It was a reasonably complete anatomically modern human skull, and the original place was relocated. Some scientists have found a rock over 4 million years old, and 400 years ago intrusive burial was made. He claims the layers above the skeleton were intact and was 4 million years old (Cremo 30).
California Gold Mine
The California Gold Mines discovered human bones and human artifacts in the 19th century. The findings were found to belong to the early years of EAC, 15 million years old. William Holmes was the anthropologist who discovered and analyzed these findings by a gold mine. The scientist believes that the findings should not have published if the facts do not fit the theory. This meant that the artifacts were wrong. Cremo aligns these findings by doing secondary analysis by getting pictures to support the evidence. The FCC was involved in publications and making the discovery more authentic (Cremo 30).
Ape Man
There is archeological evidence consistent with many findings that humanity has existed in other many shapes. He believes that evidence does not show that anatomically modern humans of so-called ape-man. This view contradicts the academic mainstream of human evolution from ape to modern human.
Vedic Perspective and Modern Scientific Perspective
In the Vedic perspective, an answer is given by a Vedic concept through creativity. Moreover, it uses an all-pervading field of intelligence, life force, and consciousness. Modern Scientific Perspective is a generative process that occurred to influence neurological or biological systems.