Wellspring has determined that the cost driver for housekeeping is square feet and that the cost driver for administration and financial services is the number of employees

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Wellspring has determined that the cost driver for housekeeping is square feet and that the cost driver for administration and financial services is the number of employees. Using the step-down method of cost allocation, what is the allocation of financial services costs to medicine? Assume housekeeping costs are allocated first, followed by administration and then by financial services.a. $159,184b. $161,306c. $158,080d. $162,344e. $165,657

 
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The amount of unreimbursed qualified medical expenses reported

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The amount of unreimbursed qualified medical expenses reported on Form 8889, line 15 is $_______.Interview Notes• Yvette Kohen, age 45, is a single parent raising her son, Gabriel.• Yvette qualifies to file as Head of Household.• For the last four years, Yvette has had family health coverage through a High Deductible Health Plan (HDHP) from her employer.• Yvette has had an HSA for several years.• In 2015, she contributed $1,500 to her HSA.• Yvette’s uncle helped her out and contributed $3,500 to her HSA in 2015.• Yvette’s employer also contributed $800 to her HSA in 2015.• Yvette paid the following expenses in 2015 using money from her HSA:– $625 for outpatient knee surgery for Yvette– $275 for prescription medicine for Yvette– $400 for emergency room visit for Gabriel– $150 for electric toothbrushes and toothpaste for the family

 
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Wellspring Community Hospital has two patient service departments, medicine and surgery

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Wellspring Community Hospital has two patient service departments, medicine and surgery. The patient service departments are supported by the housekeeping department, the financial services department, and the administration department. The administration department of Wellspring Community Hospital has compiled the following information: Housekeeping $200,000 direct costs 3,000 square feet 250 employees Administration $400,000 direct costs 5,000 square feet 500 employees Financial services $300,000 direct costs 2,000 square feet 100 employees Medicine $1 million direct costs 53,000 square feet 2,600 employees Surgery $1.5 million direct costs 40,000 square feet 2,300 employees Wellspring has determined that the cost driver for housekeeping is square feet and that the cost driver for administration and financial services is the number of employees. Using the direct method of cost allocation, what is the approximate allocation rate for housekeeping costs? (Round to the nearest cent.)a. $2.15b. $1.94c. $2.11d. $2.00e. $5.00

 
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Use the following information to complete Luke and Lisa Lane’s 2014 federal income tax return, including the following forms and schedules

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Use the following information to complete Luke and Lisa Lane’s 2014 federal income tax return, including the following forms and schedules: Form 1040, Schedules A, B, C, D, E, SE, Forms 2106, 4562 (for dental practice), 8582, 8863, 8949, 1040-V. If information is missing, use reasonable assumptions to fill in the gaps.FACTS:1. Luke O. and Lisa I. Lane are married and file a joint return. Luke is a self-employed dentist and Lisa is a college professor. Luke and Lisa have three children. The oldest is Luther who lives at home. Luther is a part-time law student at South Texas College of Law (1303 San Jacinto, Houston, TX 77002, Tax ID 74-1554976) and worked part-time during the year, earning $1,800, which he spent for his own support. Luke and Lisa provided $7,000 toward Luther’s support (including $4,500 per Form 1098-T for Luther’s fall 2014 tuition). They also provided over half the support of their daughter Laura who is a full-time student at the University of St. Thomas. Laura worked part-time as an independent contractor during the year, earning $3,400. Laura lived at home until she was married December 1, 2014. She filed a joint return with her husband Lawrence who earned $40,000 during the year. Lyndon is the youngest and lived in the Lane’s home the entire year. The Lanes provide the following additional information:Luke and Lisa would like to take advantage on their return of any educational expenses paid for their children.The Lanes do not want to contribute to the Presidential election campaign.The Lanes live at 300 Drew Street, Houston, TX 77006.Daytime phone number: Enter your cell phone number.Luke’s birthday is 3/6/1960 and his social security number is 461-45-7777.Lisa’s birthday is 4/8/1962 and her social security number is 463-85-8888.Luther’s birthday is 11/15/1991 and his social security number is 465-11-2222.Laura’s birthday is 2/28/1995 and her social security number is 466-66-5555.Lyndon’s birthday is 12/15/2002 and his social security number is 467-69-1111.The Lanes do not have any foreign bank accounts or trusts.Everyone had minimum essential health insurance coverage for all of 2014, provided by Lisa’s employer.2. Lisa is a lecturer at the University of Houston, 4800 Calhoun, Houston, TX 77204, employer ID number 74-6001399. She earned $36,000 in 2014. The university withheld federal income tax of $3,575, social security tax of $2,232, and Medicare tax of $522.3. The Lanes received $900 of interest from Wells Fargo Bank on a joint account. They received interest of $1,200 on city of Dallas bonds they bought in January with the proceeds of a loan from Green Bank. They paid interest of $900 on the loan. Luke received a dividend of $550 on IBM stock he owns. Lisa received a dividend of $380 on Microsoft Corporation stock she owns. Luke and Lisa received a dividend of $895 on jointly owned stock in Coca Cola Corporation. All of the dividends are qualified dividends.4. Luke practices under the name “Luke O. Lane, DDS.” His business is located at 2700 Bagby Street, Houston, TX 77006 and his employer ID number is 76-0244109. Luke’s gross receipts during the year were $120,000. He uses the cash method of accounting for his business. He has filed timely all required Forms 1099. His business expenses are as follows: Advertising                                                                                                     $1,300Professional dues                                                                                                 480Professional journals                                                                                            385Contributions to employee benefit plans                                                        $2,000Malpractice insurance                                                                                      3,300Fine for over-billing state of Texas for work performed on welfare patient 5,000Insurance on office contents                                                                                720Interest on money borrowed to refurbish office                                                  600Accounting services                                                                                        2,100Office expenses                                                                                                  388Office rent                                                                                                      12,000Dental supplies (used/consumed during year)                                                7,872 Utilities                                                                                                           3,376 Wages                                                                                                             30,000Payroll taxes                                                                                                    2,295In June 2014, Luke decided to refurbish his office. This project was completed and the assets placed in service on July 1. Luke’s expenditures included $8,000 for new office furniture, $6,000 for new office machinery/equipment, and $2,000 for a new computer. Luke elected to compute his cost recovery using MACRS double-declining balance depreciation. He did not elect to use Section 179 immediate expensing and he chose not to claim any bonus depreciation.5. The Lanes purchased a single-family house as rental property for $155,000 on January 1, 2010, and immediately placed it into service. The house is located at 702 Cavalcade Street, Houston, TX 77009. The Lanes allocated $140,000 to the house and $15,000 to the land. They hold the property as rental property and manage it themselves. From January 1, 2010, they have rented the house to the same tenant. They depreciate the house using MACRS depreciation rules and conventions applicable to residential realty. The Lanes collected total rent of $12,000 in 2014. They had the following expenses related to the rent house in 2014:Property insurance                              $1,100Property taxes                                     1,600 Maintenance                                           950Depreciation (to be computed)               ???6. The Lanes sold 200 shares of Tapp Corporation stock on October 3, 2014, for $42 a share, minus a $50 commission on the sale. The Lanes had purchased the stock for $10 a share on January 15, 2011. The broker reported the sale on Form 1099-B and included the correct basis and holding period to be reported to IRS.7. Lisa is required by the University of Houston to visit several high schools in the Houston area to evaluate UH students who are doing their practice teaching. However, she is not reimbursed for the expenses she incurs in doing this. During the spring semester (January through April 2014), she drove her 2012 Honda Civic 6,855 miles in fulfilling this obligation. Lisa drove an additional 6,718 personal miles during 2014. She has been using the car since June 30, 2013. Lisa uses the standard mileage rate to calculate her car expenses. She has kept a mileage log that supports the mileage in 2014. Her Honda is available for personal use and she also has access to her husband’s car for personal use.8. Luke and Lisa have given you a file containing the following receipts for expenditures during the year:Prescription medicines and drugs (net of insurance reimbursement)                          $ 398Doctor and hospital bills paid (net of insurance reimbursement)                               2,785Sales taxes paid per actual receipts                                                                             3,766Real estate taxes on personal home                                                                            4,862Interest on home mortgage per Form 1098 (paid to JPMorgan Chase Bank) 8,893Interest on personal credit cards (consumer purchases)                                                 564Cash contribution to Holy Rosary Church                                                                 3,500Payroll deductions for Lisa’s contributions to the United Way                                    200Professional dues (Lisa)                                                                                                 400Professional subscriptions (Lisa)                                                                                    450Fee for 2013 tax return preparation paid April 15, 2014 (deduct all on Schedule A)   6009. The Lanes made timely estimated federal income tax payments of $1,800 each quarter on the following dates: 4/15/2014, 6/15/2014, 9/15/2014 and 12/31/2014. They would like to receive a refund for any overpayment; they do not want direct deposit. They will mail a check if they have a balance due. They will file their return by printing and mailing it to IRS.

 
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Other Question: A case Study of Maria Grace Type of document: Research Paper

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Other Sources: 4, APA Instructions: A Case study of Maria Grace, Age 49 Experienced a stroke; has uncontrolled high blood pressure. • Examine the continuum of care a patient may need and research the services available in Houston area to support the patient. • You will convey your findings in a compelling writing. • Investigate the healthcare organizations in Houston area. Based on the services this hypothetical patient needs, select four actual settings in which he/she would receive care. • Research to analyze specific services the hypothetical patient might need, beginning with the onset or diagnosis of an illness or injury and concluding with an end-point of your choosing (i.e., recovery, symptom management, end of life). Also, research the types of organizations that provide those services. • Gather information related to the types of insurance each organization accepts. Typically, this would include Medicare, Medicaid, and various types of insurance programs. • What challenges related to payment for services do you anticipate your patient may experience? • Review the Institute for Healthcare Improvement (2014) resource and consider what it means for healthcare to be safe, effective, patient-centered, timely, efficient, and equitable. • Based on your hypothetical patient’s needs, analyze why professionals in healthcare organizations settings you selected need to be aware of the “Six Institute of Medicine Aims.” • APA Format • 4 References

 
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Telemedicine involves providing care to consumers at remote locations using technology

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Telemedicine involves providing care to consumers at remote locations using technology.TrueFalse4 pointsQuestion 2A prospective payment system pays providers based on their actual expenses.TrueFalse4 pointsQuestion 3Most residents in long-term care facilities prefer rooms that are:privatethree-bedsemi-private4 pointsQuestion 4Comparing an organization’s strengths and weaknesses with its competitors is part of:self-assessmentexternal assessmentstrategy developmentimplementation4 pointsQuestion 5″Health information systems are built on the foundation of three processing phases data input, data output, and: “data managementdata retrievaldata collectiondata verification4 pointsQuestion 6Which of the following types of disclosure of health information is not permitted by HIPAA without the consumer s permission?disclosures made in emergency circumstancesinformation used for marketing purposesdisclosures made in response to public health needsidentification of a body or the cause of death4 pointsQuestion 7″When compared to public relations, marketing is”narrower in scopeessentially the samebroader in scopeunrelated4 pointsQuestion 8″Medicaid serves the “”medically indigent,”” those have no other coverage, and cannot afford to pay for their own care. “TrueFalse4 pointsQuestion 9Managed care applies only to private insurance systems.TrueFalse4 pointsQuestion 10Comparing an organization’s strengths and weaknesses with its competitors is part of:self-assessmentexternal assessmentstrategy developmentimplementation4 pointsQuestion 11Ultimate accountability for an organization rests with:the administratorthe governmentthe board4 pointsQuestion 12The long-term care system has historically been proactive in facing problems.TrueFalse4 pointsQuestion 13Providers will have to share some of the financial risk of caring for disadvantaged populations.TrueFalse4 pointsQuestion 14The first step in measuring quality is determining what is meant by quality.TrueFalse4 pointsQuestion 15″The Nursing Home Compare initiative by CMS is designed to raise consumer awareness of the quality of care in nursing facilities, promote consumer use of Medicare s information, and: “Pressure facilities to improve quality”Identify high-performing facilities, making them eligible for added reimbursement”Generate additional business for MedicareExpose poorly-performing facilities to ridicule4 pointsQuestion 16″Autonomy, as used in the context of long-term care, means: “Accessibilitybeneficenceself-determination4 pointsQuestion 17″The four types of Position Power are Reward Power, Coercive Power, Connection Power, and:”day-to-day powernegotiated powerillegitimate powerlegitimate power4 pointsQuestion 18″The most commonly-used types of quality measures are process, outcomes, and: “documentationstructureobservationactivity4 pointsQuestion 19″Long-term care administrators are subject to two types of liability, professional liability and: “personal liabilityregulatory liabilitythe boardgeneral liablity4 pointsQuestion 20Planning scenarios are designed to:Predict the futurePrepare for possible future eventsMaintain the status quoMaintain the status quo4 pointsQuestion 21Most private long-term care insurance is sold to:individualsstate govt.employersmanged care organizations4 pointsQuestion 22Medicaid is managed by:the federal governmentstate governments under federal guidelinesNeither the federal or state governmentsState governments without federal involvement4 pointsQuestion 23Negative feedback is also calledpersonal feedbackpunitive feedbackunwanted feedbackconstructive4 pointsQuestion 24The impact of the large number of “baby boomers” on long-term care:has peakedwill grow over the next two decadeswill not be significantwill not be felt for a couple of decades4 pointsQuestion 25Dividing the market into distinct groups of consumers is:market divisionmarket segmentationmarket isolationmarketing mix

 
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Other Question: REPLY TO DISCUSSION BOARD Type of document: Other

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OtherSources: 0, APAInstructions: This will be a reply to two discussion board articles by myfellow students. Differentiate between discussion board # 1 and#2. Each reply should be around 10-15 lines with 1-2 referenceseach. thanks Discussion board 1. The greatest risk with burns involves the decrease in the volumeof blood plasma, hypovolemia. This substantial fluid lossusually occurs within the first 24 hours after injury. In thefirst 8-12 hours, the fluid shifts from the intravascular spacesto the interstitial fluid compartments. These shifts and fluidlosses are caused by an increase in capillary permeabilityresulting in shifts of not only fluid, but protein andelectrolytes are also shifted out of the intravascularcompartment into the external environment or tissues. Signs andsymptoms of hypovolemic shock secondary to burns can includeanxiety, cold, confusion, low blood pressure, rapid pulse anddecrease urine output (McCance, H. & Huether, S. 2014). References Kaplan, L. & Pinsky, M. Medscape: system inflammatory responsesyndrome. August 2016. Retrieved from: emedicine.Medscape.com/article/168943-overview McCance, H. & Huether, S. (2014). Pathophysiology: the biologicbasis for disease in adults and children. 7th ed. St. Louis, MI. Elsevier: Mosby. Discussion board #2 3. Consider the massive fluid shifts that occur in early acuteburn injury. Explain how and where the fluid shifts, and whatsigns and symptoms result from this shift. Luo et al. (2015) describes burn injuries as disruptinghomeostasis and resulting in increased capillary permeability.The increased capillary permeability causes hypovolemia becausethere is a significant amount of fluid loss from the circulatingblood volume (McCance & Huether, 2014). Fluid begins to leakfrom the circulation and into the interstitial space as well asevaporate (Luo et al., 2015). Intravenous fluid is administeredsuch as lactated ringers to attempt to restore volume during thistime (McCance & Huether, 2014). Due to the decreased circulatingblood volume there is decreased cardiac output, vascularischemia, acute renal failure, cardiovascular collapse and thiscan sometimes lead to death (Luo et al., 2015). There isevaporative water loss due to loss of skin; the natural barrierto evaporation (McCance , 2014). Alterations in cellularmetabolism are also seen during a burn injury and that furtherresults in increased cell membrane permeability and this can beseen by the many electrolyte imbalances that occur (McCance , 2014). Burn shock describes the fluid shifts seen inacute burn injury as well as the cellular component (McCance , 2014). Urine output will begin to taper off or stopcompletely due to the hypovolemic state to conserve thecirculating volume (McCance & Huether, 2014). When the burnpatient is resuscitated by fluids it causes edema, which canultimately lead to airway obstruction and worsening pulmonaryedema, however, if the patient is not properly fluid resuscitatedit can result in death (McCance & Huether, 2014). Adequate fluidadministration will assist with urine output. Capillary integritytypically restores after 24 hours if adequate fluid resuscitationoccurred (McCance & Huether, 2014). Luo, Q., Li, W., Zou, X., Dang, Y., Wang, K., Wu, J., & Li, Y.(2015). Modeling Fluid Resuscitation by Formulating Infusion Rateand Urine Output in Severe Thermal Burn Adult Patients: ARetrospective Cohort Study. Biomed Research International,2015(508043), 1-8.doi:10.1155/2015/508043 McCance, K. L., & Huether, S. E. (2014). Pathophysiology: thebiologic basis for disease in adults and children (7th ed.). St.Louis, MO:Elsevier Mosby.

 
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Biology Question: trends and issues in nursing Type of document: Assignment

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BiologySources: 3, APAInstructions: I come from New Jersey In a formal paper of 1,000-1,250 words you will discuss the workof the Robert Wood Johnson Foundation Committee Initiative on theFuture of Nursing and the Institute of Medicine research that ledto the IOM report, “Future of Nursing: Leading Change, AdvancingHealth.” Identify the importance of the IOM “Future of Nursing”report related to nursing practice, nursing education and nursingworkforce development. What is the role of state-based actioncoalitions and how do they advance goals of the Future ofNursing: Campaign for Action? Explore the Campaign for Action webpage (you may need to researchyour state’s website independently if it is not active on thissite): http://campaignforaction.org/states Review your state’s progress report by locating your state andclicking on one of the six progress icons for: education,leadership, practice, interpersonal collaboration, diversity, anddata. You can also download a full progress report for your stateby clicking on the box located at the bottom of the webpage. In a paper of 1,000-1,250 words: Discuss the work of the Robert Wood Johnson Foundation CommitteeInitiative on the Future of Nursing and the Institute of Medicineresearch that led to the IOM report, “Future of Nursing: LeadingChange, Advancing Health.” Identify the importance of the IOM “Future of Nursing” reportrelated to nursing practice, nursing education and nursingworkforce development. What is the role of state-based action coalitions and how do theyadvance goals of the Future of Nursing: Campaign for Action? Summarize two initiatives spearheaded by your state’s actioncoalition. In what ways do these initiatives advance the nursingprofession? What barriers to advancement currently exist in yourstate? How can nursing advocates in your state overcome thesebarriers? A minimum of three scholarly references are required for thisassignment.

 
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Other Question: WEEK: Discussion response Type of document: Assignment

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Other Sources: 2, APA Instructions: Explore the human genome project website:http://www.genome.gov/12011238 Discuss the implications of the human genome project for disease identification and management. Research and discuss individualized medicine using genetic analysis (you can pick one (1) disease to discuss). Develop a plan for prevention including patient education and community intervention. i. Identify characteristics of Down syndrome and factors that increase the risk for Down Syndrome. ii. Identify characteristics of Sickle Cell Anemia and estimate the probability of occurrence when the carrier status is known. Unknown? iii. Identify characteristics of Cystic Fibrosis and describe how it is inherited. iv. Describe the importance of mutations in the development of breast cancer. Your post is due by Wednesday. You must respond to at least 2 of your classmates’ posts by Friday. Your discussion should be thoughtful and answer the questions that are put forth. You should use peer-reviewed journal articles or textbooks and include proper APA references and citations. Discussion Response. Dear writer, Review post from the fellow learners below, and write a response for each discussion post, with on reference citation to each post. Thank you Post from D* W*: mplications of the Human Genome Project The Human Genome Project (HGP) is a “worldwide project conducted by geneticists that aims to identify and map all the genes on every chromosome (VanMeter, Hubert, & Gould, 2014, p. 570). This project is a collective, international research program who desires to map and understand all of the genes that make up the human genome, and according to the National Human Genome Research Institution, the project has been quite successful (“An Overview of the Human Genome Project”, 2016). With the new-found knowledge of how many genes the human genome possesses and a complete sequence of it’s billions of base pairs, this research provides a future of increased understanding of congenital and genetic disorders. Medically, the implications for such monumental research will be life changing. Medical research facilities and physicians will now have a deeper understanding that will allow them to better diagnose, treat, prevent, and even cure these disorders. This, in turn, will provide patients who are victims of such disorders a better prognosis and quality of life. Down syndrome Down syndrome, also known as trisomy 21, is a common chromosomal disorder, resulting in numerous defects in physical and mental development (VanMeter, Hubert, & Gould, 2014, p. 580). It is a trisomy disorder. This means that there are three chromosomes rather than the normal two in the 21st chromosomal position which results in a total of 47 chromosomes (VanMeter, Hubert, & Gould, 2014, p. 576). This chromosomal anomaly develops when an error occurs during meiosis of the chromosomes in which DNA fragments are displaced, thus altering genetic information (VanMeter, Hubert, & Gould, 2014, p. 573.) Characteristics of Down syndrome Down syndrome is displayed through many identifying characteristics. For example, a person with this disorder usually has a small head, slanted eyes, protruding tongue with a high-arched palate, small hands with a single palmar crease, is short in stature, has hypotonia, and is developmentally delayed. These accompanied by visual and hearing problems, lowered immune defense, and congenital heart diseases are usually all that is needed to diagnose a patient with Down Syndrome. Factors That Increase the Risk for Down syndrome Birthing a child with Down syndrome could be highly influenced by certain factors. There are the obvious factors such as exposure to harmful materials like radiation, drugs, or alcohol that could aid in the addition of the extra chromosome. However, the increasing age of the maternal parent seems to elevate the risk that the child will be born with Down syndrome. Research shows that a mother at age 30 is at risk of approximately 1 in 1000 of bearing a child with Down syndrome, whereas at age 35 the risk increases to 1 in 500 and at age 40 to 1 in 100 (VanMeter, Hubert, & Gould, 2014, p. 580). According to the National Down Syndrome Project (2007), “of all informative cases, 93.2% were the result of chromosome nondisjunction during meiosis in the maternal germ cells and, of these, 72.6% occurred during meiosis I.” This information was in light of a study to help determine if it was, in fact, due to the increasing age of the maternal parent or the paternal parent. Their research proved to be one-sided as only “4.1%” occurred during the meiosis in the sperm. A Plan for Prevention In light of all of the research that has been performed on this specific topic, I feel that it is important that it be made more readily available to the public. People should be more aware of the risks that lead to trisomy 21. Healthcare workers, facilities, or even informed groups could host gatherings for more information on the subject, pass out flyers, increase the amount of public literature, and extend a more detailed plan for prevention to secondary and post-secondary educational facilities. The earlier that the risk factors are made known the greater the spread of information will be. Although the public has heard of these same precautions at some point before, it would benefit the prevention of the disorder if they were re-educated. Also, women that are considering having children that are 35 years old or more should be advised on the increased risk of their child having trisomy 21, and she should be made aware that prenatal testing and diagnosing is available to help her make educated decisions and preparations. A test like the triple screen test on maternal blood followed by an amniocentesis can detect Down syndrome which will provide them with the opportunity to make vital decisions about their and their child’s future (VanMeter, Hubert, & Gould, 2014, p.580). References An Overview of the Human Genome Project. (2016, May 11). Retrieved September 03, 2017, from https://www.genome.gov/12011238/ Freeman, S. B., Allen, E. G., Oxford-Wright, C. L., Tinker, S. W., Druschel, C., Hobbs, C. A., & … Sherman, S. L. (2007). The National Down Syndrome Project: Design and Implementation. Public Health Reports, 122(1), 62-72. VanMeter, K., Hubert, R. J., & Gould, B. E. (2014). Chapter 21: Congenital and Genetic Disorders. In Gould’s pathophysiology for the health professions (5th ed., pp. 569-582). St. Louis, MO: Elsevier/Saunders. Post from S* s* Sharon Simmons – Importance of Mutations in the Development of Breast Cancer Sharon Simmons posted Sep 3, 2017 3:11 PM Subscribe This page automatically marks posts as read as you scroll. Adjust automatic marking as read setting Importance of Mutations in the Development of Breast Cancer Skin cancer is the most commonly diagnosed cancer in women, with breast cancer being second. Each year approximately 200,000 women in the United States develop breast cancer, and one in nine American women will develop breast cancer in their lifetime. The incidence of hereditary breast cancer range between 5 to 10 percent to as many as 27 percent of all breast cancer (NIH. Human Genome Research Institute. 2014). Most breast cancer is through acquired DNA changes, rather than hereditary. DNA is the chemical in each of our cells that makes up our genes. Mutated DNA causes normal breast cells to become cancerous. Some of these mutations are acquired and some are hereditary. Genetic testing can identify some women who are at risk for hereditary breast cancer. Hereditary breast cancer is not just caused by the BRCA1 and BRCA2 genes that were originally identified, but scientist believe many genes are accountable for these breast cancers. It is thought that children of parents with a BRCA1 or BRCA2 mutation have a 50 percent chance of inheriting the gene mutation (NIH. Human Genome Research Institute. 2014). Lawrence Brody, PH.D., chief of the Genome Technology Branch and senior investigator of Molecular Pathogenesis Section at the Nation Human Genome Research Institute, reports that one of the main reasons cancer death rates have stayed the same is because scientist still don’t understand the molecular changes that turn a normal cell into a cancerous one. Dr. Brody’s laboratory was among the first to report that women that are positive for carrying mutations of the BRCA1 or BRCA2 gene have a much higher risk of developing breast and ovarian cancer, with a 50 to 80 percent increased risk of breast cancer over a lifetime (Mjoseth. March 15, 2012). This information has allowed Dr. Brody and other researchers to understand the risks that occur due to these genetic mutations. In addition, to an increased risk for breast and ovarian cancer the BRCA1 or BRCA2 gene mutation is found to cause an increased risk in colon, prostate, gastric, melanoma, and pancreatic cancers (Mehrgou and Akouchekian. May 15, 2016). Women and men alike, are benefiting from the understanding of genes and breast cancer and their correlation. It is allowing women and men to be tested early for the BRCA1 and BRCA2 genes, and other genes less commonly known such as PTEN or TP53 (American Cancer Society. August 18, 2016). This early knowledge allows patients to speak with a geneticist so they can make rational educated decisions, concerning prevention, early detection, and treatments that are specific to the individual type of cancer or gene mutation. The identification of the genetic changes and type of cancer allows for a proper prognosis to be given to patients (Mjoseth. March 15, 2012). Early and frequent breast cancer screenings should be performed in those that are positive for gene mutations. Often, prophylactic treatment such as mastectomies are performed, or the patient is started on tamoxifen. Tamoxifen has been found to reduce the risk of developing breast cancer by 50 percent. Other drugs are currently being studied to see if it is effective in preventing breast cancer (NIH. National Human Genome Research Institute. November 7, 2014). It is the duty of nurses to be educated as much as possible about different screening tests that are available and to be able to provide education to the patient and their families concerning early detection, prevention, and treatment. There is a wealth of information out there that is available in books, online sources, through brochures, and through various organizations such as the American Cancer Society, and specific breast cancer organizations. These resources should be readily available for any patients that seek questions or have concerns regarding breast cancer. This should be provided at community mobile mammography screenings and local events where booths could be set up to allows individuals to come by for information. References: AAON. (November 7, 2014). Specific Genetic Disorders. Learning About Breast Cancer. NIH. National Human Genome Research Institute. Online 9/2/2017. https://genome.gov/100/00507/learning-about-breast-cancer/ Mjoseth. (March 15, 2012). Researchers Examine Genomics for Breast Cancer Treatment. National Human Genome Research Institute. Online 9/2/2017. https://www.genome.gov/27546796/ AAON. (August 18, 2016). How Does Breast Cancer Form? Inherited Gene Changes. American Cancer Society. Online 9/2/2017. www://cancer.org/cancer/breast-cancer/about/how-does-breast-cancer-form.html Mehrgou and Akouchekian. (May 15, 2016). The Importance of BRCA1 and BRCA2 Gene Mutations in Breast Cancer Development. Medical Journal of the Islamic Republic of Iran https://ncbi.nlm.nih.gov/pmc/articls/PMC4972064/

 
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