Discuss the national and international ROUTE OF TRANSMISSION of the disease causing the outbreak.

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Discuss the national and international ROUTE OF TRANSMISSION of the disease causing the outbreak.

Paper , Order, or Assignment Requirements

In this task, you will analyze a recent global outbreak of a communicable disease. It must be an outbreak that has crossed international borders. You are asked to choose ONE of the following communicable diseases to address in your task:
� influenza
� measles
� respiratory syndrome coronavirus
� meningococcal disease
You will be asked to describe the epidemiology and transmission of the outbreak. In addition, you will be asked to analyze the effect of the outbreak on your community at the systems level. And finally, you will be expected to discuss what actions would be appropriate for a community health nurse when confronted with an outbreak of pandemic proportions.

Section A.
A1. Select ONE of the listed diseases and find a recentSPECIFIC OUTBREAK. These websites �The Centers for Disease Control and World Health Organization – are great resources to help you track down a global outbreak. Describe the specific details of the causative agent, geographical spread, hosts, mode of transmission, incubation and communicability periods, symptoms, mortality rate, morbidity characteristics of those affected, etc. Where appropriate you will provide specific data. The specific outbreak needs to be a documented outbreak with numbers of cases, dates, and other epidemiological data. It does need to be an outbreak that has crossed international borders. It does not need to be an outbreak in your specific community nor does it have to have entered the United States. See this link – https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6236a5.htmfor an example of the kind of outbreak they are looking for. The evaluators really want a description that says, for example, � there were x number of confirm/suspected cases in country one for x number of days, from x month/year to xmonth/year, somehow the disease crossed international borders (identify travel, vector, refugees, etc. as the culprit). The disease then infected y number of individuals in the next country, for ynumber of days, from y month/year to y month/year.�

2. Analyze the EPIDEMIOLOGICAL DETERMINANTS of the outbreak. Once you have found a specific outbreak, you can discuss the epidemiological determinants of thisoutbreak more fully. What are epidemiological determinants? A determinant is anything that increases disease frequency in a population. Risk Factors and Transmission are both epidemiological determinants. However, you should discuss other determinants relevant for your outbreak here such as infectivity (how easily spread is it?), virulence (how deadly is it?), mode of transmission (Vector? Contact? Aerosol?), climate considerations (i.e. does the vector survive arid or cold temperatures?), antigenic stability (i.e. Influenza) and any other appropriate variable.

 

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Communicable Disease

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Communicable Disease

Write a paper (2,000-2,500 words) in which you apply the concepts of epidemiology and nursing research to a communicable disease. Refer to “Communicable Disease Chain,” “Chain of Infection,” and the CDC website for assistance completing this assignment.

Communicable Disease Selection

Choose one communicable disease from the following list:

  1. Chickenpox
  2. Tuberculosis
  3. Influenza
  4. Mononucleosis
  5. Hepatitis B
  6. HIV
  7. Ebola
  8. Measles
  9. Polio
  10. Influenza

Epidemiology Paper Requirements

Address the following:

  1. Describe the communicable disease (causes, symptoms, mode of transmission, complications, treatment) and the demographic of interest (mortality, morbidity, incidence, and prevalence). Is this a reportable disease? If so, provide details about reporting time, whom to report to, etc.
  2. Describe the determinants of health and explain how those factors contribute to the development of this disease.
  3. Discuss the epidemiologic triangle as it relates to the communicable disease you have selected. Include the host factors, agent factors (presence or absence), and environmental factors. (The textbook describes each element of the epidemiologic triangle). Are there any special considerations or notifications for the community, schools, or general population?
  4. Explain the role of the community health nurse (case finding, reporting, data collecting, data analysis, and follow-up).
  5. Identify at least one national agency or organization that addresses the communicable disease chosen and describe how the organization(s) contributes to resolving or reducing the impact of disease.
  6. Discuss a global implication of the disease. How is this addressed in other countries or cultures? Is this disease endemic to a particular area? Provide an example.

A minimum of three peer-reviewed or professional references is required.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

NRS427V-RS-CommunicableDiseaseChain.doc

 
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Describe the role of nursing informatics

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Discussion:

Week 5 Project

Compilation

Summarize, in 3-4 pages, this assignment that provides information from Weeks 1 to 4.

In addition to the work you completed in the last four weeks, your assignment should also:

  • Include an introduction and a conclusion.
  • Implement the recommendations from the instructor.
  • Describe the role of nursing informatics.
  • Explain how nursing informatics or technology in health care will help or hinder your leadership.

On a separate references page, cite all sources using APA format.

  •  APA-format

Submission Details

  • Support your responses with examples.
  • Name your document SU_NSG4029_W5_Project_LastName_FirstInitial.doc.
 
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Data Collection and Measurement Assignment

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Data Collection and Measurement Assignment

Access the following information. You may read the PDF online or download it.

American Nurses Association. (2014). Fast facts: The nursing workforce 2014: Growth, salaries, education, demographics & trends. ANA. http://nursingworld.org/MainMenuCategories/ThePracticeofProfessionalNursing/workforce/Fast-Facts-2014-Nursing-Workforce.pdf (Links to an external site.)Links to an external site.

  1. Review these facts, and describe what the results say about this sample of the nursing workforce.
  2. What do you believe was the intent of the researcher who designed the survey?
  3. The next process for our study is to collect data. The research design will indicate the best data to be collected. The tools that we use to collect data need to be reliable and valid. Define these terms with respect to research, and explain why they are important.
  4. Consider data collection and measurement methods for your nursing clinical issue. Explain how you would collect data and what measurement methods you would use. Data Collection and Measurement Assignment
 
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Discuss three programs that qualify as socialism and explain whether you support or oppose them. Are there any that you think should be eliminated? Why or why not?

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Discuss three programs that qualify as socialism and explain whether you support or oppose them. Are there any that you think should be eliminated? Why or why not?

question 1 Compare and contrast structural functionalist and conflict theories’ approaches to American medicine. Discuss the three approaches to medical treatment and describe which you think would work best for the following situation: Fulanita′s 89 year old grandmother is in a coma and has been diagnosed with kidney failure. The doctors say that her life can be prolonged for a few years if she goes on dialysis. However, the family members disagree on the best way to care for her. Some members of the family want to bring the grandmother home to allow her to die naturally arguing that grandma would not want extreme measures to be taken. Others want grandma to be given dialysis three times a week for an hour (as the doctors suggest). Finally, discuss the intersections of class, race and gender as well as the problem of food deserts. question 2 Describe three ways the rise of the industrialist economy increased levels of stratification in regard to class, race and gender. Explain the three ways that the industrial revolution changed working conditions as well as many other conditions of life. Even in the U.S., there are programs that would qualify as socialism; discuss three programs that qualify as socialism and explain whether you support or oppose them. Are there any that you think should be eliminated? Why or why not?

 

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Center for Disease Control (CDC)

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If it were within your power to have the National Institute of Health (NIH) or the Center for Disease Control (CDC) focus on one disease to eliminate from the planet, which disease would this be?

In your post you should address the following aspects:

Put the name of your choice in the subject title of your post so other students can easily see which diseases have already been nominated.

Points will be deducted for duplicate entries (unless the time stamps on both posts are very close together, suggesting they were being written at the same time).

Name and describe the disease and/or microbe (including its scientific name).

Explain the progression, symptoms, current treatment and/or prevention strategies used to combat the disease.

Identify if it is viral, prion, protist, or bacteria.

This means it has to be a communicable disease that you choose! No cancers, genetic disorders or diseases caused by abiotic factors allowed!)

Explain how it is transmitted.

Be sure to include important aspects of the microbe’s biology or transmission method that is unique and incorporate appropriate vocabulary introduced in the learning materials.

How many people globally or nationally are affected by this disease?

Are there certain parts of the world or individuals/races/population subsets where this disease is more prevalent?

Relate why you think this particular disease should receive disproportionate attention/focus/funding above all others.

Do you have personal experience with this disease, do you simply find it too terrible to allow its continued persistence, or…?

To receive full credit, you must:
  • Write in complete sentences that are thoughtful, well written, and free of typos.
  • Address all parts of the forum topic.
  • Use vocabulary presented in the learning materials appropriately.
  • Create a discussion and reply to another discussion by 8:00 pm on Saturday of week 6 (7 days after week 6 module becomes available).

reply to student #1

Alzheimer’s disease is a progressive disease that destroys memory and interrupts normal mental functions. These include thinking, reasoning, and typical behavior. Alzheimer’s disease is the most common type of dementia 60 to 80 percent of dementia cases are in fact Alzheimer’s. The disease starts off by causing mild memory problems, difficulty recalling information, and slips in recollection. Over time, however, the disease progresses and you may not have memory of large periods of time. Risk factors for Alzheimer’s disease include being older than 65, a family history of the disease, inheriting genes for the disease from your parents, existing mild cognitive impairment, down syndrome, unhealthy lifestyle, being female, previous head trauma, and being shut off from a community or having poor engagement with other people for extended periods of time. There’s not currently a way to prevent Alzheimer’s disease. Researches aren’t clear why some people develop it and others don’t. Alzheimer’s often starts to show up in people around mid-60s. Alzheimer’s disease is currently ranked as the sixth leading cause of death in the United States, but recent estimates indicate that the disorder may rank third, just behind heart disease and cancer, as a cause of death for older people. Alzheimer’s may be able to spread through blood transfusion but most of the time it is passed down through genes. World wide over 50 million people are living with Alzheimer’s. I believe that alzheimer’s should be focused on because so many people suffer from it and not only does the person with alzheimer’s suffer but so does the family because the person loses their memory.

reply to student #2

I think one disease the CDC should focus on eliminating from the planet is STD’s. One that I think would be very beneficial to get rid of would be HIV/AIDS.  HIV is considered a prion. It is believed that HIV started and came from a chimpanzee species that was located in Central Africa. It is believed HIV was spread when it was in these chimpanzee’s, and then once they were hunted for their meat and people were eating them, so it was mixing into their blood stream once digested. It is currently estimated that 1.1 million people in the United states are living with HIV, and 15% do not even know they have it. Worldwide, about 36.7 million people have HIV.  HIV/AIDS is spread through the contact of certain bodily fluids (such as semen, blood, etc). This means having unprotected sex with someone is the main way that this is spread. If one partner has it then the other is susceptible to get it. You cannot get it when both partners do not have it.

HIV has three different stages. The first one is called the “acute HIV infection”. This time frame starts to occur 2-4 weeks after someone becomes infected. During this time, people experience what they think is the flu, but it is really just flu like symptoms. This can last up to a few weeks. The reason people initially have this reaction is because your body realizes it is a disease and is something they need to fight off. Most people who are in this stage are completely unaware of what is going on. The second stage is called Clinical Latency, which is when the HIV is either inactive or dormant. People typically do not have symptoms in this stage, but the HIV is still there and active. This stage can progress fast if left untreated, but if someone is aware and is on medication HIV can stay in this stage for over a decade. Even though HIV is dormant during this stage, it can still be transmitted since it is in the blood stream. The third stage is when HIV turns into AIDS, which is Acquired Immunodeficiency Syndrome. This is considered the stage where it becomes the most severe. It can damage immune systems which makes people more susceptible to illnesses since their immune system is down and unable to fight them off. People in this stage are considered very infectious to others.

As of right now, there is no cure for HIV/AIDS. There are medications to help manage and control, but nothing to completely eliminate.  I believe this one should be eliminated above others because it is a disease that is located worldwide. Since it also makes the immune system more susceptible, it allows people to catch other diseases or develop cancer that potentially could have been avoided if they had not had HIV/AIDS in the first place. HIV is not as common in the US, but in 3rd world countries and other countries with a lower poverty level it is more common. I think HIV being eliminated would positively benefit the world as a whole and help these countries.

“HIV/AIDS.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 25 Apr. 2018, www.cdc.gov/hiv/.

 

 
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NR 511 Weekly Discussions

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NR 511 Weekly Discussions

A 56-year-old Caucasian female presents to the office today with complaints of fatigue. Upon further questioning you discover the following subjective information regarding the chief complaint.
History of Present Illness
Onset ”about 2-3 months”
Location Generalized
Duration Constant
Characteristics Progressively worsening since onset, feels tired all of the time, sleeps 8hrs per night but does not feel well rested. ”No energy to do anything I normally can do”
Aggravating factors Exertion
Relieving factors None identified
Treatments None

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Severity Denies pain; missed 1 day of work 2 weeks ago because ”couldn’t get out of bed”
Review of Systems (ROS)
Constitutional Denies fever, chills, or recent illnesses. +5lb. weight gain since last visit 6 months ago.
Eyes No visual changes or diploplia
ENT Denies ear pain, coryza, rhinorrhea, or ST. Had tonsillectomy as child Denies snoring or history of sleep apnea.
Neck Denies lymph node tenderness or swelling
Chest Denies cough, SOB, DOE or wheezing
Heart Denies chest pain
Abdomen Denies N/V/D. + Constipation
Endocrine Denies polyuria, polydipsia. + cold intolerance. Menopause status x 5 yrs.
Skin No changes in skin, hair or nails
Psych Reports worsening of depressive symptoms but thinks it is because she is so ”unproductive” lately and tired all of the time. -Suicidal or homicidal thoughts. Sleeping 8-9hrs per night (no changes), but not feeling rested.
Musculoskeletal Generalized weakness and intermittent muscles cramping in calves
History – NR 511 Weekly Discussions
Medications Multivitamin, B-Complex, Prozac 20mg, Bisoprolol-HCTZ 2.5mg/6.25mg, Calcium 500mg + Vit D3 400IU.
PMH HTN, Depression, Postmenopausal status
PSH Tonsillectomy
Allergies Iodine dyes
Social Married; Works full time as office manager of an internal medicine office; 2 kids (grown)
Habits Denies cigarettes or drug use. +Occasional glass of wine (1-2 per month).
FH Maternal GM & GF deceased with CHF, T2DM and HTN;
Mother alive (age 82) +HTN, +Hyperlipidemia, +T2DM;
Father alive (age 84) +HTN, +Hyperlipidemia, +T2DM, +ASHD (s/p CABG 2 years ago). Also had +CVA at time of CABG (work-up revealed +DVT and +PFO; remains anticoagulated);
Oldest child (26) with seasonal allergies
Youngest child (24) with Bipolar depression and ADHD, and anxiety
Physical exam reveals the following:
Physical Exam – NR 511 Weekly Discussions
Constitutional Middle aged Caucasian female alert, oriented and cooperative
VS Temp-98.2, P-74, R-16, BP 146/95, Height: 5’7”, Weight: 180 pounds
Head Normocephalic, atraumatic
Eyes PERRLA
Ears Tympanic membranes gray and intact with light reflex noted.
Nose Nares patent. Nasal turbinates without swelling. Nasal drainage is clear.
Throat Oropharynx moist, no lesions or exudate. Surgically removed tonsils bilaterally. Teeth in good repair, no cavities.
Neck Neck supple. No lymphadenopathy. Thyroid midline, small and firm without palpable masses.
Cardiopulmonary Heart S1 and s2 noted, no murmurs, noted. Lungs clear to auscultation bilaterally. Respirations unlabored. No pedal edema
Abdomen Soft, non-tender. BS active
Skin Skin overall dry, hair coarse and thick, nails without ridging, pitting or discoloration
Psych Mood pleasant and appropriate.
Musculoskeletal Strength full throughout
Neuro DTRs 2+ at biceps, 1+ at knees and ankles

1. Briefly and concisely summarize the H&P findings as if you were presenting it to your preceptor using the pertinent facts from the case. Use shorthand where possible and approved medical abbreviations. Avoid redundancy and irrelevant information. NR 511 Weekly Discussions.
2. Provide a differential diagnosis (minimum of 3) which might explain the patient’s chief complaint along with a brief statement of pathophysiology for each.
3. Analyze the differential by using the pertinent findings from the history and physical to argue for or against a diagnosis.
4. Rank the differential in order of most likely to least likely. NR 511 Weekly Discussions
5. Identify any additional tests and/or procedures that you feel is necessary or needed to help you narrow your differential. All testing decisions must be supported with an evidence-based medicine (EBM) argument as to why it is necessary or pertinent in this case. If no testing is indicated or needed, you must also support this decision with EBM.

NR 511 Weekly Discussions

Week 6: Discussion Part Two
.
CBC with differential
WBC 8.6 x10E3/uL
RBC 4.44 x 10E6/uL
Hemoglobin 14.0 g/dL
Hematocrit 41.2%
MCV 93fL
MCH 31.5 pg
MCHC 34.0 g/dL
RDW 13%
Platelet 241 x 10E3/uL
Neutrophils % 67%
Lymphocytes % 22%
Monocytes % 8%
Eosinophils % 3%
Basophils % 0%
Absolute Neutrophils 5.7 x 10E3/uL
Absolute Lymphocytes 1.9 x 10E3/uL
Absolute Monocytes 0.7 x 10E3/uL
Eosinophils Absolute 0.3 x 10E3/uL
Basophile Absolute 0.0 x 10E3/uL
Immature Grans % 0%
Absolute Immature Grans 0.0 x 10E3/uL
TSH with Reflex to FT4
TSH 6.770 uIU/mL
FT4 0.62 ng/dL
PHQ-9 Depression Score=10 (previous was 5 at last visit 6 months ago)
1. What is your primary diagnosis for this patient as the cause for the CC of fatigue? (support your decision for your diagnosis with pertinent positives and negatives from the case)
2. Identify the corresponding ICD-10 code. NR 511 Weekly Discussions.
3. Provide a treatment plan for this patient’s primary diagnosis which includes:
o Medication*
o Any additional testing necessary for this particular diagnosis*
o Patient education*
o Referral
4. Provide an active problem list for this patient based on the information given in the case.
5. Are there any changes that you would make to the patient’s overall plan at this time? Must provide an evidence-based medicine (EBM) argument to support any treatments or testing decisions. NR 511 Weekly Discussions.
6. Provide an appropriate follow-up plan (include any additional testing that you feel is necessary and include an EBM argument). NR 511 Weekly Discussions.

*If part of the plan does not warrant an action, you must explain why. ALL medication and testing decisions (or decisions not to treat with medication or additional testing) MUST be supported with an EBM argument. Over-the-counter (OTC) and RXs must be written in full as if handing a script to the patient in the office.
Search entries or author . NR 511 Weekly Discussions

 
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As a nurse leader–manager, it is helpful to look at all of these aspects, especially as they relate to strategic planning and the sustainability of the organization

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Large…small…
Urban…rural…
For profit…non–profit…
Acute care…primary care
Teaching organization…research facility
Myriad characteristics influence the experiences of patients, nurses, and others in any health care setting. In addition to the factors noted above, the mission, vision, and values that guide an organization, as well as an institution’s commitments to patient care, teaching, and/or research, warrant significant consideration.
As a nurse leader–manager, it is helpful to look at all of these aspects, especially as they relate to strategic planning and the sustainability of the organization. To that end, for this Discussion you compare multiple aspects of two organizations and consider the implications for nursing. In addition, you will apply a Strategic Planning tool, such as SWOT or Balanced Scorecard, or Six Sigma principles to establish one realistic goal or objective consistent with the mission of the organization.
To Prepare

  • Review the information in the Learning Resources regarding strategic planning; types of organizations; organizational commitments to patient care, teaching, and/or research; and the mission, vision, and values of organizations.
  • Using the Internet, research various health care organizations (including those with which you are already familiar) that differ in focus, commitment, and mission, vision, and values. For the purposes of this Discussion, select two organizations with significant differences.
  • Compare information about the two organizations. Based on the information presented in the Learning Resources, how do they differ?
  • What are some possible implications of these differences for various stakeholders (e.g., nursing administration, patients, and community)? What does this mean for nursing’s role within each organization?
  • Identify a goal or objective based on a strategic planning tool, such as SWOT or Balanced Scorecard, or Six Sigma consistent with the mission of the organization.

BY DAY 3

Post and Contrast two differing health care organization’s mission, vision, and values, and describe at least two potential implications of these distinctions for stakeholders of each organization. Explain how this informs the focus for nursing, noting the role that nursing administration plays in supporting and fulfilling the mission, vision, and values, and organizational strategies. Write a goal or objective, based on a strategic planning tool, such as SWOT, Balanced Scorecard, or Six Sigma consistent with the mission of one of the organizations.
Read a selection of your colleagues’ responses.

BY DAY 6

Respond to at least two of your colleagues on two different days using one or more of the following approaches:

  • Ask a probing question, substantiated with additional background information and evidence.
  • Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
  • Validate an idea with your own experience and additional sources.
  • Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings
 
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Determine three (3) areas of competency that you think are most important to effectively manage a medical group practice.

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Determine three (3) areas of competency that you think are most important to effectively manage a medical group practice.

Challenges for Group Practice Administrators and Recruitment Strategy for Practice Managers”

Predict two (2) external and / or internal challenges facing today’s medical group practice administrators. Compose a strategy to manage the challenges in question. Justify your response. Imagine that you work for a medium-sized healthcare organization and the organization is hiring a medical practice manager. Determine three (3) areas of competency that you think are most important to effectively manage a medical group practice. Next, suggest a recruitment strategy that includes the method you would use to advertise the position and the information you would include in the job posting to attract qualified candidates. Justify your response.

 

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Evaluate test procedures and materials to ensure that potentially offensive content or language is avoided (see Unit 7 assignment).

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Element 9 states that a test user, “evaluate(s) the available evidence on the performance of test takers of diverse subgroups . . . determine(s) to the extent feasible which performance differences may have been caused by factors unrelated to the skills being assessed.” Together, the previous course assignments and this current one involving Element 9 will provide you with the data, research, and literature reviews across all nine elements of the Code to assist your decision-making process about the appropriate selection of a test.
For this final assignment:
Locate reviews or research related to how Element 9 applies to your selected test. If the research or reviews do not address this element in any way, then you will need to cite the references your reviewed and note that they were lacking in in addressing this element, drawing appropriate conclusions for when a test is lacking such evidence.
Synthesize all of the data and information you gathered on your selected test throughout the course and identify highlights, both positive and negative, both advantages and disadvantages, according to all nine elements of the Code.
Evaluate your selected test based on these data and draw a conclusion about whether or not it is a test that you would select, recommend, or even defend, if necessary in practice. Note: You should not merely copy and paste your earlier assignments for the final paper. Instead you will be synthesizing the research you completed for each element into a summary of that element that you will offer in support of your final evaluation. (For example, note that the technical quality element (that is, Element 5) will be only a synthesis and evaluation and not a repeat of the annotated bibliography you completed in Unit 5.)
Identify the strengths or weaknesses for each element, and determine if the information about that element supports (or opposes) the use of your selected test in the field and population to be served.
Incorporate recommendations about ways to improve the selected test.
Review all of your evaluations for each element and recommended improvements to the test, and write an overall evaluation and determination about the use of your selected test. Would you recommend this test to a school district or business that you are employed as a consultant? Would you be able to defend the use of this test in a court proceeding?
Organize your paper using the following headings:
Title page (required) (one page).
Abstract (required) (one page).
The Code of Fair Testing Practices in Education (a minimum of four pages). (For each element, identify strengths and weaknesses, evaluate the selected test for the element, and make recommendations, if any for improvement, citing appropriate standards of practice.)
Element 1. Purpose: Define the purpose for testing, the content, and skills tested (see Unit 2 assignment).
Element 2. Appropriateness: Evaluate appropriateness of test content, skills tested, and content covered (see Unit 2 assignment).
Element 3. Materials: Evaluate materials for which clear, accurate, and complete information is provided (see Unit 2 assignment).
Element 4. Training: Test users have appropriate knowledge, skills, and training (see Unit 2 assignment).
Element 5. Technical Quality:
Synthesis of evidence of reliability (see Unit 5 assignment).
Synthesis of evidence of validity (see Unit 5 assignment).
Element 6. Test Items and Format: Evaluate test items, test format, directions, manuals and scores (see Unit 7 assignment).
Element 7. Test Procedures and Materials: Evaluate test procedures and materials to ensure that potentially offensive content or language is avoided (see Unit 7 assignment).
Element 8. Modifications and Accommodations: Evaluate if tests provide appropriately modified forms or procedures for test takers with disabilities (see Unit 7 assignment).
Element 9. Group Differences: Evaluate evidence on performance of test takers of diverse subgroups.
Summary (two pages).
Overall recommendation to use the selected test in the field and with populations to be served.
If recommending the use of the selected test, identify the greatest strengths you discovered and determined in its use. Additionally, identify any limitations or concerns that may still exist with its use regardless of the recommendation. Are there still concerns for the test in certain situations?

 
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