HPI:

An otherwise healthy nine-year-old boy developed flu-like symptoms (nausea/vomiting, decreased oral intake, lethargy, and weakness). After three days, the boy’s father called the pediatrician’s office at 8:00PM on a Saturday night. The on-call nurse practitioner returned the call (which was recorded). The father relayed the symptoms and said that Gatorade was making the boy nauseous, but he was still drinking some ginger ale. The father expressed concern about how tired his son was—he’d slept for 24 hours straight (from 8:00 p.m. the previous night). The boy woke up only to be carried downstairs to watch some TV for a little while. He felt a little better than the day before, but he also had some rectal bleeding and some bleeding from his mouth.

The NP acknowledged the boy’s symptoms and said that most of it sounded like a viral illness, but that the rectal bleeding could be something different. She asked the father several questions in order to get a better understanding of the boy’s condition, including:  

• Was he alert? (father’s response: yes but very tired)
• Had he passed any urine? (response: yes)
• Did he have a fever or rash? (response: no)

The NP then asked the father whether he thought the child was “OK” tonight or felt he should be seen right away. The father replied that he didn’t think he needed to be seen right now. The NP agreed and made plans for him to be seen in the office the next morning (Sunday) after 8:00AM, and she told him to call back if anything developed during the night. The father asked, “I don’t need to worry about him not taking any food? He is taking some ginger ale.” The NP responded by telling him to push the ginger ale and make sure he’s urinating periodically. The NP documented the call in the medical record, including that the father was offered an ED visit (although that was not specifically said, per the audio recording).

At about 4:00AM, the father checked his son and noted that his son was sleeping but also noted that his son's respiratory rate had increased significantly. Since his son was sleeping, the father didn't touch him to check for fever because he didn't want to wake his son. But, the father couldn't rest worrying about why his son was breathing so much faster than normal, almost like he had just been exercising even though his son had been asleep. At about 8:30AM, when the father again checked on his son, his son was not breathing at all.   The father called 911 and started CPR. The ambulance and EMTs arrived within minutes and found the child apneic, pulseless, with fixed and dilated pupils, and his corneas cloudy.   At 9:30AM, the child was pronounced dead.
An autopsy found the cause of death to be diabetic ketoacidosis (the child had undiagnosed diabetes mellitus). His blood sugar was 1,165 (nl 50–80); potassium was 7.1 (nl 3.5–5.3); and his HgA1C was 15.3% (nl 4–5.9%).

The parents sued the nurse practitioner, alleging wrongful death of their son due to negligent delay in diagnosis and treatment of diabetic ketoacidosis.

QUESTION: Provide a brief list of diagnostics that would be required for each of your 5 possible diagnoses.

An otherwise healthy nine-year-old boy developed flu-like symptoms (nausea/vomiting, decreased oral intake, lethargy, and weakness). After three days, the boy’s father called the pediatrician’s office at 8:00PM on a Saturday night. The on-call nurse practitioner returned the call (which was recorded). The father relayed the symptoms and said that Gatorade was making the boy nauseous, but he was still drinking some ginger ale. The father expressed concern about how tired his son was—he’d slept for 24 hours straight (from 8:00 p.m. the previous night). The boy woke up only to be carried downstairs to watch some TV for a little while. He felt a little better than the day before, but he also had some rectal bleeding and some bleeding from his mouth.

The NP acknowledged the boy’s symptoms and said that most of it sounded like a viral illness, but that the rectal bleeding could be something different. She asked the father several questions in order to get a better understanding of the boy’s condition, including:  

• Was he alert? (father’s response: yes but very tired)
• Had he passed any urine? (response: yes)
• Did he have a fever or rash? (response: no)

The NP then asked the father whether he thought the child was “OK” tonight or felt he should be seen right away. The father replied that he didn’t think he needed to be seen right now. The NP agreed and made plans for him to be seen in the office the next morning (Sunday) after 8:00AM, and she told him to call back if anything developed during the night. The father asked, “I don’t need to worry about him not taking any food? He is taking some ginger ale.” The NP responded by telling him to push the ginger ale and make sure he’s urinating periodically. The NP documented the call in the medical record, including that the father was offered an ED visit (although that was not specifically said, per the audio recording).

At about 4:00AM, the father checked his son and noted that his son was sleeping but also noted that his son's respiratory rate had increased significantly. Since his son was sleeping, the father didn't touch him to check for fever because he didn't want to wake his son. But, the father couldn't rest worrying about why his son was breathing so much faster than normal, almost like he had just been exercising even though his son had been asleep. At about 8:30AM, when the father again checked on his son, his son was not breathing at all.   The father called 911 and started CPR. The ambulance and EMTs arrived within minutes and found the child apneic, pulseless, with fixed and dilated pupils, and his corneas cloudy.   At 9:30AM, the child was pronounced dead.

An autopsy found the cause of death to be diabetic ketoacidosis (the child had undiagnosed diabetes mellitus). His blood sugar was 1,165 (nl 50–80); potassium was 7.1 (nl 3.5–5.3); and his HgA1C was 15.3% (nl 4–5.9%).

The parents sued the nurse practitioner, alleging wrongful death of their son due to negligent delay in diagnosis and treatment of diabetic ketoacidosis.

QUESTION: Identify at least 5 questions you would ask the patient's father to elicit more information to make your decision?

HPI: An otherwise healthy nine-year-old boy developed flu-like symptoms (nausea/vomiting, decreased oral intake, lethargy, and weakness). After three days, the boy’s father called the pediatrician’s office at 8:00PM on a Saturday night. The on-call nurse practitioner returned the call (which was recorded). The father relayed the symptoms and said that Gatorade was making the boy nauseous, but he was still drinking some ginger ale. The father expressed concern about how tired his son was—he’d slept for 24 hours straight (from 8:00 p.m. the previous night). The boy woke up only to be carried downstairs to watch some TV for a little while. He felt a little better than the day before, but he also had some rectal bleeding and some bleeding from his mouth. The NP acknowledged the boy’s symptoms and said that most of it sounded like a viral illness, but that the rectal bleeding could be something different. She asked the father several questions in order to get a better understanding of the boy’s condition, including: Was he alert? (father’s response: yes but very tired) Had he passed any urine? (response: yes) Did he have a fever or rash? (response: no) The NP then asked the father whether he thought the child was “OK” tonight or felt he should be seen right away. The father replied that he didn’t think he needed to be seen right now. The NP agreed and made plans for him to be seen in the office the next morning (Sunday) after 8:00AM, and she told him to call back if anything developed during the night. The father asked, “I don’t need to worry about him not taking any food? He is taking some ginger ale.” The NP responded by telling him to push the ginger ale and make sure he’s urinating periodically. The NP documented the call in the medical record, including that the father was offered an ED visit (although that was not specifically said, per the audio recording). At about 4:00AM, the father checked his son and noted that his son was sleeping but also noted that his son's respiratory rate had increased significantly. Since his son was sleeping, the father didn't touch him to check for fever because he didn't want to wake his son. But, the father couldn't rest worrying about why his son was breathing so much faster than normal, almost like he had just been exercising even though his son had been asleep. At about 8:30AM, when the father again checked on his son, his son was not breathing at all. The father called 911 and started CPR. The ambulance and EMTs arrived within minutes and found the child apneic, pulseless, with fixed and dilated pupils, and his corneas cloudy. At 9:30AM, the child was pronounced dead. An autopsy found the cause of death to be diabetic ketoacidosis (the child had undiagnosed diabetes mellitus). His blood sugar was 1,165 (nl 50–80); potassium was 7.1 (nl 3.5–5.3); and his HgA1C was 15.3% (nl 4–5.9%). The parents sued the nurse practitioner, alleging wrongful death of their son due to negligent delay in diagnosis and treatment of diabetic ketoacidosis.

Question: WHAT 10 QUESTION WOULD YOU ASK TO HELP YOU MAKE A DIFFERENTIAL DIAGNOSIS?

An otherwise healthy nine-year-old boy developed flu-like symptoms (nausea/vomiting, decreased oral intake, lethargy, and weakness). After three days, the boy’s father called the pediatrician’s office at 8:00PM on a Saturday night. The on-call nurse practitioner returned the call (which was recorded). The father relayed the symptoms and said that Gatorade was making the boy nauseous, but he was still drinking some ginger ale. The father expressed concern about how tired his son was—he’d slept for 24 hours straight (from 8:00 p.m. the previous night). The boy woke up only to be carried downstairs to watch some TV for a little while. He felt a little better than the day before, but he also had some rectal bleeding and some bleeding from his mouth.

The NP acknowledged the boy’s symptoms and said that most of it sounded like a viral illness, but that the rectal bleeding could be something different. She asked the father several questions in order to get a better understanding of the boy’s condition, including:  

• Was he alert? (father’s response: yes but very tired)
• Had he passed any urine? (response: yes)
• Did he have a fever or rash? (response: no)

The NP then asked the father whether he thought the child was “OK” tonight or felt he should be seen right away. The father replied that he didn’t think he needed to be seen right now. The NP agreed and made plans for him to be seen in the office the next morning (Sunday) after 8:00AM, and she told him to call back if anything developed during the night. The father asked, “I don’t need to worry about him not taking any food? He is taking some ginger ale.” The NP responded by telling him to push the ginger ale and make sure he’s urinating periodically. The NP documented the call in the medical record, including that the father was offered an ED visit (although that was not specifically said, per the audio recording).

At about 4:00AM, the father checked his son and noted that his son was sleeping but also noted that his son's respiratory rate had increased significantly. Since his son was sleeping, the father didn't touch him to check for fever because he didn't want to wake his son. But, the father couldn't rest worrying about why his son was breathing so much faster than normal, almost like he had just been exercising even though his son had been asleep. At about 8:30AM, when the father again checked on his son, his son was not breathing at all.   The father called 911 and started CPR. The ambulance and EMTs arrived within minutes and found the child apneic, pulseless, with fixed and dilated pupils, and his corneas cloudy.   At 9:30AM, the child was pronounced dead.

An autopsy found the cause of death to be diabetic ketoacidosis (the child had undiagnosed diabetes mellitus). His blood sugar was 1,165 (nl 50–80); potassium was 7.1 (nl 3.5–5.3); and his HgA1C was 15.3% (nl 4–5.9%).

The parents sued the nurse practitioner, alleging wrongful death of their son due to negligent delay in diagnosis and treatment of diabetic ketoacidosis.

1. Identify at least 5 questions you would ask the patient's father to elicit more information to make your decision.

Tony and Suzie are ready to expand Great Adventures even further in 2019. Tony believes that many groups in the community (for example, Boy Scouts, church groups, civic groups, and local businesses) would like to hold one-day outings for their members. Groups would engage in outdoor activities such as rock climbing, fishing, capture the flag, paintball, treasure hunts, scavenger hunts, nature hikes, and so on. The purpose of these one-day events would be for each member of the group to learn the importance of TEAM (Together Everyone Achieves More).

Tony knows that most people are not familiar with these types of activities, so to encourage business he allows groups to participate in the event before paying. He offers a 4% quick-payment discount to those that pay within 10 days after the event. He also guarantees that at least eight hours of outdoor activities will be provided or the customer will receive a 20% discount. For the first six months of the year, the following activities occur for TEAM operations.

Jan. 24   Great Adventures purchases outdoor gear such as ropes, helmets, harnesses, compasses, and other miscellaneous equipment for $4,700 cash.
Feb. 25   Mr. Kendall’s Boy Scout troop participates in a one-day TEAM adventure. Normally, Tony would charge a group of this size $3,200, but he wants to encourage kids to exercise more and enjoy the outdoors so he charges the group only $2,700. Great Adventures provides these services on account.
Feb. 28   The Boy Scout troop pays the full amount owed, less the 4% quick-payment discount.
Mar. 19   Reynold’s Management has its employees participate in a one-day TEAM adventure. Great Adventures provides services on account for $3,700, and Reynold’s agrees to pay within 30 days
Mar. 27   Reynold’s pays the full amount owed, less the 4% quick-payment discount.
Apr. 7   Several men from the Elks Lodge decide to participate in a TEAM adventure. They pay $7,200, and the event is scheduled for the following week.
Apr. 14   The TEAM adventure is held for members of the Elks Lodge.
May. 9   Myers Manufacturing participates in a TEAM adventure. Great Adventures provides services on account for $5,700, and Myers agrees to pay within 30 days.
Jun. 1?30   Several MBA groups participate in TEAM adventures during June. Great Adventures provides services on account for $22,500 to these groups, with payment due in July.
Jun. 30   Myers Manufacturing fails to pay the amount owed within the specified period and agrees to sign a three-month, 7% note receivable to replace the existing account receivable.

1. Record TEAM adventure transactions occurring during the first six months of 2019.

2. As of June 30, 2019, Great Adventures finishes its first 12 months of operations. If Suzie wants to prepare financial statements, part of the process would involve allowing for uncollectible accounts receivable.

a. Suppose Suzie estimates uncollectible accounts to be 8% of accounts receivable (which does not include the $5,700 note receivable from Myers Manufacturing). Record the adjustment for uncollectible accounts on June 30, 2019.

b. Prepare a partial balance sheet showing the net accounts receivable section.

Tony and Suzie are ready to expand Great Adventures even further in 2022. Tony believes that many groups in the community (for example, Boy Scouts, church groups, civic groups, and local businesses) would like to hold one-day outings for their members. Groups would engage in outdoor activities such as rock climbing, fishing, capture the flag, paintball, treasure hunts, scavenger hunts, nature hikes, and so on. The purpose of these one-day events would be for each member of the group to learn the importance of TEAM (Together Everyone Achieves More).

Tony knows that most people are not familiar with these types of activities, so to encourage business he allows groups to participate in the event before paying. He offers a 5% quick-payment discount to those that pay within 10 days after the event. He also guarantees that at least eight hours of outdoor activities will be provided or the customer will receive a 20% discount. For the first six months of the year, the following activities occur for TEAM operations.

Consider the following information as of June 30, 2022.

• Suzie estimates uncollectible accounts to be 10% of accounts receivable (which does not include the $60,000 note receivable from Myers Manufacturing). Prepare the adjusting entry for uncollectible accounts.
• Accrue one month of interest on the note receivable from Myers Manufacturing

1. Record each of the transactions listed above in the 'General Journal' tab. Review the 'General Ledger' and the 'Trial Balance' tabs to see the effect of the transactions on the account balances.
2. Record the adjusting entries in the 'General Journal' tab.
3. Review the adjusted 'Trial Balance' as of June 30, 2022, in the 'Trial Balance' tab.
4. Prepare an income statement for the period ended June 30, 2022, in the 'Income Statement' tab.
5. Prepare a classified balance sheet as of June 30, 2022 in the 'Balance Sheet' tab.
6. Record the closing entries in the 'General Journal' tab.

A study was performed among 40 boys in a school in Edinburgh to look at the presence of spermatozoa in urine samples according to age [15]. The boys entered the study at 8−11 years of age and left the study at 12−18 years of age. A 24-hour urine sample was supplied every 3 months by each boy. Table 10.28 gives the presence or absence of sperm cells in the urine samples for each boy together with the ages at entrance and exit of the study and the age at the first sperm-positive urine sample. For all parts of this question, exclude boys who exited this study without 1 sperm-positive urine sample (i.e., boys 8, 9, 14, 25, 28, 29, 30). 10.47 Provide a stem-and-leaf plot of the age at first sperm-positive urine specimen. *10.48 If we assume that all boys have no sperm cells at age 11 (11.0 years) and all have sperm cells at age 18, then estimate the probability of first developing sperm cells at ages 12 (i.e., between 12.0 and 12.9 years), 13, 14, 15, 16, and 17. *10.49 Suppose mean age at spermatogenesis = 13.67 years, with standard deviation = 0.89 years and we assume that the age at spermatogenesis follows a normal distribution. The pediatrician would like to know what is the earliest age (in months) before which 95% of boys experience spermatogenesis because he or she would like to refer boys who haven’t experienced spermatogenesis by this age to a specialist for further follow-up. Can you estimate this age from the information provided in this part of the problem? *10.50 Suppose we are uncertain whether a normal distribution provides a good fit to the distribution of age at spermatogenesis. Answer this question using the results from Problems 10.47−10.49. (Assume that the large-sample method discussed in this chapter is applicable to these data.)

Age at
Boy Entrance First positive Exit Observations
1 10.3 13.4 16.7 − − − − − − − − − − + + − − − − + + + − − 2 10.0 12.1 17.0 − − − − − − − − + − − + + − + − − + − + − − − − − + + 3 9.8 12.1 16.4 − − − − − − − − + − + + − + + + + + + − − + + − + 4 10.6 13.5 17.7 − − − − − − − − − − − + + − − − + − − − − 5 9.3 12.5 16.3 − − − − − − − − − − − − + + − − − − + − − − − − − − − 6 9.2 13.9 16.2 − − − − − − − − − − − − − − − − − + − − − − − − − 7 9.6 15.1 16.7 − − − − − − − − − − − − − − − − − − − + − − − + 8 9.2 — 12.2 − − − − − − − − − − − − 9 9.7 — 12.1 − − − − − − − − − 10 9.6 12.7 16.4 − − − − − − − − − − − − + − + + + + + − − + + − + 11 9.6 12.5 16.7 − − − − − − − − − − + − − + − + − − + + + 12 9.3 15.7 16.0 − − − − − −− − − − − − − − − − − − − − − − − + + 14 9.6 — 12.0 − − − − − − − − − 16 9.4 12.6 13.1 − − − − − − − − − − + + + + 17 10.5 12.6 17.5 − − − − − − − + − + + + + + + + + − − + − − + + 18 10.5 13.5 14.1 − − − − − − − − − − + − − 19 9.9 14.3 16.8 − − − − − − − − − − − − − − − + − − − − − + − + 20 9.3 15.3 16.2 − − − − − − − − − − − − − − − − − − − − − + + + 21 10.4 13.5 17.3 − − − − − − − − + + − + − + + − + − + + + 22 9.8 12.9 16.7 − − − − − − − − − − − + + + + − + + + + − + + − + − − 23 10.8 14.2 17.3 − − − − − − − − − − − − + − − + + + − + 24 10.9 13.3 17.8 − − − − − − − − + + + + − + + + + + − + + − − 25 10.6 — 13.8 − − − − − − − − − − − 26 10.6 14.3 16.3 − − − − − − − − − − − − − + − − − + − − − 27 10.5 12.9 17.4 − − − − − − − − + − + + + + − − − + + − − + + + + 28 11.0 — 12.4 − − − − − − 29 8.7 — 12.3 − − − − − − − − − − − − − − 30 10.9 — 14.5 − − − − − − − − − − − − − 31 11.0 14.6 17.5 − − − − − − − − − − − − + + + + + + + + + + − + 32 10.8 14.1 17.6 − − − − − − − − − − − + + − − + − − − − − − 33 11.3 14.4 18.2 − − − − − − − − − − − + + − + + − − + − − − − − 34 11.4 13.8 18.3 − − − − − − − + − − − + − − − + + + − − + − + 35 11.3 13.7 17.8 − − − − − − − + + + − + − − − + + + − + + 36 11.2 13.5 15.7 − − − − − − − − − + − − − − − − − − 37 11.3 14.5 16.3 − − − − − − − − − − − + − + + − − − 38 11.2 14.3 17.2 − − − − − − − − − − − + − − + − + + + + + + − 39 11.6 13.9 14.7 − − − − − + − − − 40 11.8 14.1 17.9 − − − − + − + − + − + + + + − − − − 41 11.4 13.3 18.2 − − − − + + + − + − − − − − + + + + + − − 42 11.5 14.0 17.9 − − − − − − − + + − − − − − − − + + − + −

A 35-year-old African American woman36 weeks gestation, gravida 2, para 1100, delivered a 7-pound baby boy 4 hours ago with Apgar scores 7 and 9 at 1 minute and 5 minutes, respectively. The nurse entered the postpartum room and noted that the baby was near the cold window, which was directly under the air-conditioning vent. The nurse suggests to the mother to place the baby in a different part of the room. The mother tells the nurse that she is concerned about her baby. The mother requests that her baby not go back to the nursery because she noticed a bruise on her infant’s bottom and some bloody discharge in her baby’s diaper when she changed the diaper 30 minutes ago. (Learning Objectives 2, 8)

Based on the information above, answer the following questions:

1. Can you explain the newborn’s assessment to the mother regarding any potential abnormalities? What advice would you provide to this new mother?
2. Why did the nurse suggest placing the baby in a different part of the room?

Please provide the Stata commands and outputs where necessary, thank you.

4. The following are data on

y = quit rate per 100 employees in manufacturing

x = unemployment rate

The data are for United States and cover the period 1990-2002.

(a) Estimate the regression and report the results

(b) Construct a 95% confidence interval for β.

(c) Test the hypothesis H₀ : β = 0 against the alternative β=0 at the 5% significance level.

(d) Test Normality of the residuals using Jarque-Bera test.

(e) What is likely to be wrong with the assumptions of the classical normal linear model in this case? Discuss.

In an effort to replace the destruction of trees, five regions of the US have been tracking the annual rate of trees being planted (per thousand) in each region and the annual rate of trees being destroyed (per thousand). Additionally, the tree population (in thousands) by region has been recorded for five different years. The data is given in the tables below. Determine the number of trees planted and the number destroyed in each of the years listed.