NRS-493 Capstone Project Topic Selection and Approval Solved
Grand Canyon University NRS-493 Capstone Project Topic Selection and Approval Solved-Step-By-Step Guide
This guide will demonstrate how to complete the NRS-493 Capstone Project Topic Selection and Approval Solved assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.
How to Research and Prepare for NRS-493 Capstone Project Topic Selection and Approval Solved
Whether one passes or fails an academic assignment such as the Grand Canyon University NRS-493 Capstone Project Topic Selection and Approval Solved depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.
After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.
How to Write the Introduction for NRS-493 Capstone Project Topic Selection and Approval Solved
The introduction for the Grand Canyon University NRS-493 Capstone Project Topic Selection and Approval Solved is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.
How to Write the Body for NRS-493 Capstone Project Topic Selection and Approval Solved
After the introduction, move into the main part of the NRS-493 Capstone Project Topic Selection and Approval Solved assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.
Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.
How to Write the Conclusion for NRS-493 Capstone Project Topic Selection and Approval Solved
After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.
How to Format the References List for NRS-493 Capstone Project Topic Selection and Approval Solved
The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.
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Write a 500-750 word description of your proposed capstone project topic. Include the following:
- The problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project that will be the focus of the change proposal.
- The setting or context in which the problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project can be observed.
- A description (providing a high level of detail) regarding the problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project.
- Effect of the problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project.
- Significance of the topic and its implications for nursing practice.
- A proposed solution to the identified project topic with an explanation of how it will affect nursing practice.
Sample Answer for NRS-493 Capstone Project Topic Selection and Approval Solved
I have read the articles below in references to presenting a presentation but i had to establish my own personal feelings in regards to the discussion question topic 9 -1. The personal strength that I have regarding professional presentation is that I have research my topic and did the required research to present it. This is not a topic that someone else has presented to me it something that I feel is necessary and deserved by the personnel at the company that I am precepting at. When presenting an idea that you believe in some anxiety can be eliminate by knowing what you know. What I have come to know is my proposal has been worked on for the last 9 weeks and this not only beneficial to the staff it’s also rewarding to the residents at this facility. My weakness in this presentation would be not getting the audience to consider the proposal that I have work so hard on. I must present in a way as if I am marketing a product to enhance me. I must do my best in this presentation. I keep telling myself that I am not doing this just for a grade. This is to prove that not only the employees are well deserving. It is to show that I value my position as a nurse and that I took an oath to advocate not only for patients but for the wellbeing of my fellow employees. I am fearful, but I must give it all I got. So please pray with me that my proposal will be received and considered with high evaluation.
Capstone Change Project Topic: Childhood Obesity
Childhood obesity has become a grave epidemic and among the top public health and social issue in the United States and globally. According to the State of Childhood Obesity (2022), approximately 16.2% of young people in the US aged between 10 and 17 years are obese. The implications of childhood of obesity are dire including far-reaching effects such as ill-health and a decline in life expectancy rates among this population. As such, childhood obesity needs to be resolved to prevent the escalation of its effects. Children with obesity are likely to suffer from conditions including breathing related conditions such as asthma and sleep apnea, high cholesterol and high blood pressure, high risk of insulin resistance and diabetes, and increased risk of psychological and social problems such as poor self-esteem and discrimination (Sanyaolu et al., 2019). Childhood obesity is also associated with long-term effects such as high chances of becoming obese in adulthood and the associated chronic diseases. Other than the health issues, childhood obesity is also linked to serious economic impacts involving heavy expenditure on the condition.
Based on these devastating effects of childhood obesity, it is imperative to address the condition to prevent worrying conditions such as cancers, stroke, hypertension, and cardiovascular disease (Sanyaolu et al., 2019). This project can address the issue of childhood obesity by using various techniques. One of the best techniques includes the utilization of educational programs to create awareness among parents, learning institutions, and the community to ensure a healthy lifestyle for children and improve obesity outcomes (Mastrocola et al., 2020).
Proposed PICOT Statement
In childhood obesity, can educational programs deter obesity in children and promote a healthy lifestyle in school, at home, and in community setups compared to non-intervention over six months?
References
Mastrocola, M. R., Roque, S. S., Benning, L. V., & Stanford, F. C. (2020). Obesity education in medical schools, residencies, and fellowships throughout the world: a systematic review. International Journal of Obesity, 44(2), 269-279. https://doi.org/10.1038/s41366-019-0453-6
Sanyaolu, A., Okorie, C., Qi, X., Locke, J., & Rehman, S. (2019). Childhood and adolescent obesity in the United States: a public health concern. Global pediatric health, 6, 2333794X19891305. https://journals.sagepub.com/doi/full/10.1177/2333794X19891305
The State of Childhood Obesity. (2022). 2021 Report: From Crisis to Opportunity – The State of Childhood Obesity. The State of Childhood Obesity. Retrieved from https://stateofchildhoodobesity.org/2021report/.
Sample Answer 2 for NRS-493 Capstone Project Topic Selection and Approval Solved
Nurses are obligated to ensure that patients are given the quality and safe care. This capstone change project focuses on the management of Catheter-Associated Urinary Tract Infections (CAUTI) among medical-surgical patients. CAUTI is an issue that is associated with significant implications for the quality and safety of care. The purpose of this paper is to identify the issue, project setting, problem description, implications of the problem, significance of the problem to nursing practice, and the proposed solution.
The Problem
This capstone project focuses on the management of CAUTIs in medical-surgical units. CAUTIs are among the primary healthcare concerns that plague health facilities nationwide affecting the safety and well-being of patients in medical-surgical units. They account for the bigger percentage of UTIs in hospitals. According to Gomila et al. (2019), CAUTIs affect over one million people yearly in the United States. CAUTIs are associated with dire complications such as sepsis and endocarditis, increased healthcare costs, long hospital stay days, and even death. They are also the widespread causes of bacteremia in medical-surgical units. Moreover, CAUTIs are linked to a heavy economic burden attributed to the heavy financial load needed in the treatment of infections, which causes a fiscal burden on the healthcare industry. Based on these factors, CAUTIs are considered a significant nursing issue that needs to be addressed.
The Setting
Medical-surgical units within healthcare facilities are the preferred setting for this capstone change project. The incidence of CAUTIs is linked to risk factors such as poor maintenance of the catheter and inappropriate use of indwelling catheters. These factors are common in post-operative units where the catheter is inserted into the bladder of many patients to help in draining urine after a surgical procedure (Mong et al., 2022). Catheter increases the risk of contracting CAUTIs. Therefore, a targeted intervention focusing on this setting is critical in enhancing the healthcare outcomes of patients.
Problem Description
CAUTIs are among the primary healthcare concerns that plague health facilities nationwide affecting the safety and well-being of patients in medical-surgical units. According to CDC (2021), about 15-25% of hospitalized patients need urinary catheters. However, the extended use of urinary catheters increases the risk of contracting CAUTIs. CAUTIs are associated with dire complications such as sepsis and endocarditis, increased healthcare costs, long hospital stay days, and even death. Moreover, CAUTIs are linked to a heavy economic burden attributed to the heavy financial load needed in the treatment of infections (Shaheen et al., 2019). Therefore, this project seeks to manage CAUTIs among patients in medical-surgical units to prevent adverse events and promote positive health outcomes among these patients.
Effect of the Problem
Management of CAUTIs is an issue that should concern all healthcare providers. Some of the implications of CAUTIs in the medical-surgical unit include increased chances of contracting sepsis and endocarditis, increased healthcare costs, and long hospital stay days (Van Decker et al 2021). Moreover, CAUTIs are the leading cause of death among medical-surgical patients and are also associated with a significant socio-economic load on patients and their families (Shaheen et al., 2019). The dire implications of this nursing issue make it a cause for alarm that necessitates being addressed with utmost priority in the healthcare system.
Significance of the Topic and its Implication for Nursing Practice
The management of CAUTIs among medical-surgical patients is an important topic in nursing practice. Nurses have the obligation to champion the safety and quality of care for patients. As such, the management of CAUTIs among medical-surgical patients aligns with this nursing obligation (Shadle et al., 2021). Moreover, the management of CAUTIs is a way of enhancing patient health outcomes and reducing CAUTIs within medical-surgical units.
Proposed Solution
The proposed solution to CAUTIs management and prevention in medical-surgical units is the adoption of intentional leadership rounding. Hedenstrom et al., (2022) define leadership rounding as a process where leaders engage with nurses and patients, talking to them directly about CAUTI prevention. Leadership rounding is crucial in providing information to caregivers and discussing with nurses particular process issues that may be encumbering progress in addressing CAUTIs in the medical-surgical units (Auten, 2021). These discussions during leadership rounding need to ensure interprofessional collaboration between providers that are involved in CAUTI management. This is critical in ensuring the sustainability of the proposed intervention.
Conclusion
This paper has given an impression of this capstone change project and the reasons it is considered applicable in nursing practice. Dealing with the issue of CAUTIs in medical-surgical units is crucial in enhancing safety and quality of care, thus enhancing positive patient outcomes.
References
Auten, K. (2021). Intentional Leadership Rounds: A Proactive Approach to CAUTI Reduction. American Journal of Infection Control, 49(6), S9. https://doi.org/10.1016/j.ajic.2021.04.035
CDC. (2021). Catheter-associated Urinary Tract Infections (CAUTI) | HAI | CDC. Retrieved from https://www.cdc.gov/hai/ca_uti/uti.html
Gomila, A., Carratalà, J., Eliakim-Raz, N., Shaw, E., Tebé, C., Wolkewitz, M., Wiegand I., Grier S., Vank C., Cuperus N., Heuvel, L., Vuong, C., MacGowan, A., Leibovici, L., Addy, I., & Pujol, M. (2019). Clinical outcomes of hospitalized patients with catheter-associated urinary tract infection in countries with a high rate of multidrug-resistance: the COMBACTE-MAGNET RESCUING study. Antimicrobial Resistance & Infection Control, 8(1), 1-8. doi: 10.1186/s13756-019-0656-6
Hedenstrom, M., Harrilson, A., Heath, M., & Dyess, S. (2022). “What’s Old Is New Again”: Innovative Health Care Leader Rounding—A Strategy to Foster Connection. Nurse Leader, 20(4), 366-370. https://doi.org/10.1016/j.mnl.2022.05.005
Mong, I., Ramoo, V., Ponnampalavanar, S., Chong, M. C., & Wan Nawawi, W. N. F. (2022). Knowledge, attitude, and practice in relation to catheter‐associated urinary tract infection (CAUTI) prevention: A cross‐sectional study. Journal of clinical nursing, 31(1-2), 209-219. https://doi.org/10.1111/jocn.15899
Shadle, H. N., Sabol, V., Smith, A., Stafford, H., Thompson, J. A., & Bowers, M. (2021). A bundle-based approach to prevent catheter-associated urinary tract infections in the intensive care unit. Critical Care Nurse, 41(2), 62-71. https://doi.org/10.4037/ccn2021934
Shaheen, G., Akram, M., Jabeen, F., Ali Shah, S. M., Munir, N., Daniyal, M., … & Khan, M. (2019). Therapeutic potential of medicinal plants for the management of urinary tract infection: A systematic review. Clinical and Experimental Pharmacology and Physiology, 46(7), 613-624.
Van Decker, S. G., Bosch, N., & Murphy, J. (2021). Catheter-associated urinary tract infection reduction in critical care units: a bundled care model. BMJ Open Quality, 10(4), e001534. http://dx.doi.org/10.1136/bmjoq-2021-001534
Sample Answer 3 for NRS-493 Capstone Project Topic Selection and Approval Solved
Capstone project selection involves a suggestion, an issue, suggestion, or the educational need that a given project is supposed to focus on. In this project, the main issue is type 2 diabetes among African Americans; type 2 diabetes is a common health problem among African Americans and other races. The disorder is mainly associated with the poor lifestyle such as adherence to poor diet and lack of regular physical activities that can increased metabolic activities within the body. Also, type 2 diabetes may be hereditary. African Americans are always at high risk of type 2 diabetes as a result of prevalence of obesity, genetic traits, as well as the insulin resistance. The purpose of this paper is to analyze the problems associated with type 2 diabetes among African Americans.
The Problem
Type 2 diabetes is a common problem among African Americans. In other words, it is a common problem that often begins after forty years. It occurs as a result of the inability of the body to make enough insulin or property utilized the available ones, a scenario that leads to the increase in blood sugar level in the blood. Past research shows that black adults are at higher risk of developing type 2 diabetes when compared to the White adults. Type 2 diabetes continues to cause increased complications among African Americans. In other words, African Americans are more vulnerable to type 2 diabetes given the genetic components and the lifestyle (Sankar et al., 2018). African Americans have higher rates of obesity, a condition which is linked to the insulin resistance. Insulin resistance precedes glucose intolerance which eventually results in diabetes. According to World Health Organization (WHO), African American adults have a 60% probability of being diagnosed with diabetes when compared to non-Hispanics or Whites. Ascertainment completeness of type 2 diabetes among African Americans is estimated to be 98% (Sankar et al., 2018).
The Setting
The setting for the study will be healthcare institutions and communities. In these settings, only the individuals who are vulnerable to type 2 diabetes will be considered. Within the communities, all the patients under the self-management and those who are under the hospital care will be considered in the process of the study.
Problem Description
There are increasing cases of type 2 diabetes in the United States, and even though the condition is associated with all races, American Americans are the most affected group at 15.1% followed by Hispanic blacks at 12.7% (Sankar et al., 2018). The prevalence of type 2 diabetes is linked to the economic status and the level of accessibility to the healthcare services. Mortality wise, African American hand a double chance of succumbing to diabetes compared to the whites. The disparity is type 2 diabetes prevalence is linked to the mixed factors. First, African American children have low birth-weight and maternal-fetal stress which increases the chances of diabetes.
The prevalence of obesity among African Americans is also associated with the higher rates of obesity, a condition which is associated with increase in insulin resistance. Also, African Americans have cultural food customs and practices that hinder the management of diabetes. Diabetes continues to cause more deaths especially among the African American population. Some other contributing factors to the disease include limited access to healthy foods and balanced diet due to low social economic status.
Effect of the Problem
Type 2 diabetes is one of the main health concern among African Americans. The disorder causes many deaths and health complications among African American community. Another main concern of type 2 diabetes among African Americans is the limited access to the medical services. Non-Hispanic Blacks have suboptimal glycemic control compared to whites which can be linked to poor self-care behaviors among the blacks. From their review, the researchers found out that a major disparity among the blacks lies in medication adherence but exercise and diet have no disparity. Generally, type 2 diabetes, coupled with the low social economic status, complicates the living standards of African American communities.
Significance of the Problem
Type 2 diabetes is one of the leading cause of death in the United States of America. In other words, it is the seventh leading cause of deaths among the American population and globally. By the year 2014, the estimated number of people suffering from diabetes globally was 422 million (Sankar et al., 2018). In the United States, the number of people with diabetes stands at 30.1 million with 21 million suffering from type 2 diabetes. Type 2 diabetes causes increased poverty among African Americans due to expensive medication and general care. African Americans are 2.3 times more likely to die from type 2 diabetes compared to Whites. Addressing the issue of type 2 diabetes in the nursing practice is significant in increasing knowledge on the appropriate care to be undertaken. The approaches learnt may be used to reduce nurse burnout, as well as the medication errors.
Proposed Solution
Nurse led diabetes education is one of the main approach of providing solution to the type 2 diabetes among African American communities. The educational programs will enhance adherence to the appropriate diet. Additionally, the approach will also enhance the incorporation of self-management approaches when it comes to the management of type 2 diabetes. Nurse led diabetes education will also enhance the understanding of the preventive measures and the appropriate steps that can be undertaken to prevent the spread of type 2 diabetes among African American communities.
The application of nurse led diabetes education will impact the nursing practice in various ways. It will enhance the provision of knowledge on various diabetic management processes and the procedures that can be undertaken to manage the increasing cases of type 2 diabetes. Nurse led diabetes education involve learning control measures and the best preventive processes. It also, facilitate understanding of the best life-styles to be adopted by those who are prevalent to the disease.
Conclusion
Capstone project selection involves a suggestion, an issue, suggestion, or the educational need that a given project is supposed to focus on. In this project, the main issue is type 2 diabetes among African Americans; type 2 diabetes is a common health problem among African Americans and other races. Type 2 diabetes is a common problem among African Americans. In other words, it is a common problem that often begin after forty years.
References
Sankar, V., Justin, A., Payman, H. M., Swathy, P., Kumar, N. S. C., & Kumar, R. S. (2018). Medication adherence and clinical outcomes in type 2 diabetes mellitus patients with depression: A prospective interventional study. Age, 30(35), 1.
Sample Answer 4 for NRS-493 Capstone Project Topic Selection and Approval Solved
The Issue
Statistics provided by the US Department of Health and Human Services focused on Minority Health indicate that African American adults are eight times more likely to be diagnosed with diabetes compared to their non-Hispanic White counterparts, and are 4.2 times more likely to present with end-stage renal diseases compared to the same cohort population. A study by Bancks et al. (2017) linked the high disparity in prevalence of the disease among African Americans and non-Hispanic Whites to certain biological risk factors, among them, BMI, blood pressure, fasting glucose level, lung function, waist measurement, etc., which are all linked to obesity. With obesity being the key driver of the incident, a rigorous campaign to encourage lifestyle change through comprehensive educational programs harbors the potential to reverse the trend, as this project proposes.
The Setting
Obesity in African-Americans can be observed in community churches. According to research, members of several African-American community churches demonstrate signs of obesity hence it would be appropriate to target them for this research project.
Description
Population trends, health outcomes and associated healthcare costs associated with diabetes has increasingly gained traction in as far as the need to improve U.S. population health is concerned. Overall, estimates show that about 9.1% of the U.S. population has been diagnosed with diabetes, 5.2% remain undiagnosed but suffering from the disease, and a further 38.0% showing the signs of prediabetes (Golden et al., 2017; Arambepola et al., 2016). A study by Creamer et al. (2016) shows that diabetes is the sixth leading cause of disability in the country, and responsible for a mortality rate of 20.9 percent per 100000 persons, making it officially the country’s seventh leading cause of death. Given its comparatively high prevalence among African American sub-population as indicated by Bancks et al. (2017), its toll on this sub-population can only get grimmer.
Impact of Diabetes on the Work Environment
Given its high prevalence among African-Americans, diabetes has impacted the nursing field because of its associated burdens. The existing prevalence of the condition has influenced health care setting to have multifaceted-ted interventions at both the outpatient and inpatient sections (Golden et al., 2017). However, studies reveal that this has caused financial strain on health care settings, which impacts the quality of care that they offer.
Significance of Diabetes among African-Americans
The issue of diabetes among African-Americans is significant given the health care and financial burdens that it causes to them. According to research, diabetes ranks the highest in health care spending in the United States at $101.4 billion. Further, it is sixth in the list of disability causing diseases in the US while its mortality rate stands at 20.9 per 100,000 population (Tan et al., 2015). Narrowed down to the African-American population, the statistics are even grimmer as it occupies the top three slots in terms of mortality and morbidity. Thus, handling it while it is still at the nascent stage becomes paramount. Moreover, given that nurses handle the greater burden of the condition during care, it becomes fundamental that solutions are discovered for the disease. Indeed, nurses play a leading role in implementing intervention measures both at the community and care setting levels to improve the quality of life of the affected individuals.
Proposed Solution
The effectiveness of educational programs in the management, control and treatment of diabetes has been tested by different scholars, among them Nazar, Bojerenu, Safdar and Marwat (2016), which established that education can minimize the chances of complications among the affected, thus reducing the associated morbidity and mortality rates. In particular, the study showed that a pragmatic educational program with key functional targets, such as glucose awareness training complimented by cognitive behavioral therapy form an effective approach to balancing blood glucose level, especially in those suffering from Type I Diabetes. Further, educational and psychosocial interventions also tend to have positive impacts on the management of different diabetes consequences (Chrvala, Sherr, & Lipman, 2016; Capozza et al., 2015). Also, encouraging self-management education, with professional interventions at intervals, would go a long way in enhancing glycaemic control as it ensures patients suffering from type 2 diabetes develop the capacity to track their glycosylated hemoglobin.
References
Arambepola, C., Ricci-Cabello, I., Manikavasagam, P., Roberts, N., French, D. P., & Farmer, A. (2016). The impact of automated brief messages promoting lifestyle changes delivered via mobile devices to people with type 2 diabetes: a systematic literature review and meta-analysis of controlled trials. Journal of medical Internet research, 18(4), e86.
Bancks, M. P., Kershaw, K., Carson, A. P., Gordon-Larsen, P., Schreiner, P. J. & Carnethon, M. R. (2017). Association of modifiable risk factors in young adulthood with racial disparity in incident Type 2 Diabetes during middle adulthood. Journal of the American Medical Association, 318(24), pp. 2457-2465. doi: 10.1001/jama.2017.19546. PMID: 29279935.
Capozza, K., Woolsey, S., Georgsson, M., Black, J., Bello, N., Lence, C., … & North, C. (2015). Going mobile with diabetes support: a randomized study of a text message–based personalized behavioral intervention for type 2 diabetes self-care. Diabetes Spectrum, 28(2), 83-91.
Chrvala, C. A., Sherr, D., & Lipman, R. D. (2016). Diabetes self-management education for adults with type 2 diabetes mellitus: a systematic review of the effect on glycemic control. Patient education and counseling, 99(6), 926-943.
Creamer, J., Attridge, M., Ramsden, M., Cannings‐John, R., & Hawthorne, K. (2016). Culturally appropriate health education for Type 2 diabetes in ethnic minority groups: an updated Cochrane Review of randomized controlled trials. Diabetic Medicine, 33(2), 169-183.
Golden, S. H., Maruthur, N., Mathioudakis, N., Spanakis, E., Rubin, D., Zilbermint, M., & Hill-Briggs, F. (2017). The case for diabetes population health improvement: Evidence-based programming for population outcomes in diabetes. Current Diabetes Reports, 17(7). doi: 10.1007/s11892-017-0875-2
Nazar, C. M. J., Bojerenu, M. M., Safdar, M., & Marwat, J. (2016). Effectiveness of diabetes education and awareness of diabetes mellitus in combating diabetes in the United Kingdom; a literature review. Journal of Nephropharmacology, 5(2), pp. 110-115.
Tang, T. S., Funnell, M. M., Sinco, B., Spencer, M. S., & Heisler, M. (2015). Peer-led, empowerment-based approach to self-management efforts in diabetes (PLEASED): a randomized controlled trial in an African American community. The Annals of Family Medicine, 13(Suppl 1), S27-S35.