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For the past four decades, healthcare spending has skyrocketed as well as their costs. With the changes in health care coverage or the lack of having coverage has prompted families to delay health care. The increase in average mortality rate has increased the number of chronic illness the practitioners are attempting to manage at clinics. The more people that need to be seen the less appointment spaces that are available, forcing patient to seek medical treatment from the Emergency Rooms. This leads to overcrowding and extended wait periods to be seen.

Rising health care costs in the private sector have translated into significant insurance premium increases, unemployment, and stagnant real wages. The hourly wage growth of health benefits has stalled since 2000; while inflation adjusted family health insurance premiums have increased 58% according to the Senator Whitehouse report.

When we take a look at the health care system today, the overpriced and unnecessary services, excessive administrative costs, inefficiently delivered care, not using preventative measures, and Medical fraud cases all
are contributing to the excessive health care costs. Taking all of these things into consideration could be used to improve health care without increasing the cost and bettering the quality of care that American receives.

Reference:

Health Care Delivery System Reform and the Patient Protection & Affordable Care Act (2012, March). Found at: http://www.amia.org/sites/amia.org.files/senator-whitehouse-report.pdf.

Power Point to be Fixed

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Power Point to be Fixed

THE HISPANIC COMMUNITY OF MIAMI DADE COUNTY Grand Canyon University: NRS-427VN Instructor: Alma

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Celaya Aug 12, 2018 Lorena Hernandez, Idongesit Akazue, Jennifer Thomas, Ace Rodriguez, Maria Salas. Introduction • The Hispanic community refer to the Spanish speaking group of people in America. • The community comprise of Hispanic Americans and Latino Americans. • The community holds the second fastest growing community in the U.S. • The communities live in places like California, Arizona, and Nevada. Community And Community Boundaries • The community boundaries comprise some parts of the original Republic of Mexico in 1821. • The Hispanic community comprises 16.7% of the American population. • More than 50% of the community lives in the Southwest region of the U.S. • Community includes Mexicans, Puerto Ricans, Dominicans, Salvadorans, and Cubans. The Geographic And Geopolitical Nature Of The People • The Hispanic community is a young community in the U.S. • Huge populations in the country immigrate to the U.S. with university degrees. • The Hispanic community has contributes to demographic changes in America. • The community is increasing its political power in the U.S. The Financial & Education Level Of The Hispanic People • The U.S. born among the community recorded increased financial literacy as compared to the immigrants. • Low levels of understanding of financial concepts among the community. • The community is making large attempts to increase its college enrollment rate. • The dropout rate of the communnity is dropping significantly. The Ethnic And Phenomenological Features Of The Community • The Hispanic community comes from different backgrounds. • The major religion of the community is Christianity. • The cuisine of the community is famous across the country. • The community is growing its consciousness levels in the U.S. Types Of Social Interactions, Common Goals, And Interests Of The Community. • Most of the community members are very diverse from one another. • The community has limited common goals. • The community holds a lot of interest in the family unit. • Most of the community support their families in their countries through remittances. Barriers And Challenges Faced By The Community. • • • • Immigration. Low SES and education. Acculturation Language Conclusion • The Hispanic community’s growth keeps expanding exponentially. • The community comprises many diverse groups. • The community’s political power is increasing. • Challenges like language and education remain unsolved for the community. Interview with Angie Ngoc B. L. Interview performed on July 28th, 2018, by Lorena Hernandez • Doctor of Medicine (M. D.), Internal Medicine Larkin Community Hospital • Main role / responsibilities of interviewee : advice and diagnosis for patients, follow-up and monitoring of treatment adherence, regular check-ups, emergencies. => Mostly secondary and tertiary prevention. Population and Diseases of Interest • – Profile of patients: Children (5-17 years) Emergencies (including those in need of surgery) Elderly (check-ups and treatment adherence) • – Most frequent medical conditions : Diabetes (obesity, unhealthy lifestyles) Liver disease (excessive drinking, sometimes addiction) HIV (increasing prevalence, transmission mostly through sexual intercourse) Challenges in the local/state healthcare system • Understaffing in hospitals and clinics • Prohibitive cost of treatment (poverty, raise of healthcare costs, insurance insufficient / absent) • Also problem for hospitals’ finances (unpaid bills) => Heavily burdened medical care delivery system Health Assessment • High prevalence of obesity and diabetes, esp. among the Hispanic community (Davis, Taitel et al, 2017). • Explained by unhealthy lifestyle habits • Poor diet combined with heavy drinking (since young age) also explaining high prevalence of liver diseases. • Inaccessibility of treatment bec. of lack of insurance (Qato, Wilder, et al, 2017). In Miami-Dade County, the uninsured rate in 2017 is 67.7%(“FLHealthCHARTS Data Viewer”, 2017) Lifestyle habits – Data for Miami Dade County (Florida Department of Health, 2007) (CDC, 2007) Miami-Dade County adults are much less physically active than Americans overall. Lack of Insurance • In places like South Florida’s (Dade County) the immigrant population likely contributes to the high uninsured rate. • Some don’t make enough money to quality for tax-subsidized Affordable Care Act polices. • Many are accustomed to going to emergency rooms or public health clinics when they get sick • It’s not part of their culture to have health insurance • When they do obtain insurance, they do not understand how to use is or even how to make an appointment. Diabetes • Unhealth lifestyles (high fats and high carb (“Latino Health Disparities”, n.d.) • Hispanic youth population consumes a total 40 % of their calories from solid fats and added sugar (“Latino Health Disparities”, n.d.) • Low income neighborhoods have limited access to healthy foods and an abundance of fast food and low cost convenience store. (“Latino Health Disparities”, n.d.) • In Miami-Dade County the 2017 Death Rate for Diabetes was 19.7% for the Hispanic population. This is compared to the entire Florida population that was at 20.7%. (“FLHealthCHARTS Data Viewer”, 2017) Liver Disease • Chronic liver disease is the leading cause of death in Hispanic communities • In Miami-Dade County the 2017 Death Rate for Chronic Liver Disease and Cirrhosis was 5.8% for the Hispanic population. This is compared to the entire Florida population that was at 11.4%.(“FLHealthCHARTS Data Viewer”, 2017) HIV • HIV (increasing prevalence, transmission mostly through sexual intercourse) • In Miami-Dade County the 2017 Death Rate HIV/AIDS was 2.1% for the Hispanic population. This is compared to the entire Florida population that was at 3.2%.(“FLHealthCHARTS Data Viewer”, 2017) Recommendations on Improvement Opportunities • Lack of Insurance • Provide help in filling out forms and explaining benefits • Diabetes • Provided educational cooking classes for alternative Hispanic meals • Liver Disease • Providing AA groups tailored to the Hispanic population • Hosting “dry” social events to increase awareness and demonstrate that fun can be had with the use of ETOH • HIV • Education tailored to the Hispanic population • Distributing free condoms at social gatherings Existing Health Initiatives and Partnerships in Miami Dade County • RX4HEALTH PROGRAM (HTTP://WWW.MIAMIDADE.GOV/PARKS/RX4HEALTH.ASP) – Public: Adult, Youth, Children • Main objectives : live longer and healthier, prevent heart diseases, high blood pressure, prevent type 2 diabetes, prevent weight gain. – Activities: Walk for Life, Enhance Fitness, Yoga, Zumba, Pilates, Tai Chi, Water Aerobics – Walk with Ease : program aimed at teaching how to incorporate physical activity in everyday life. Possibility to participate in a sixweek group program led by a trained leader. – Developed by the Miami-Dade County Parks, Recreation and Open Spaces Department Initiatives funded by United Way of Miami-Dade (2018) • Family Christian Association of America [FCAA] “Healthy Kids Miami”: education and awareness activities + physical assessment to create lifelong healthy eating and wellness habits in children. Funding: $99,502 • Open Door Health Center Health Promotion, Disease Prevention Program: medical services + selfmanagement education & support groups for uninsured people with diabetes & other chronic health conditions. Funding: $29,851 Promotion of healthy eating and cooking programs for children in school settings Grants’ total value: $25,000. References (1) • Daviglus, M. L., Pirzada, A., Durazo‐Arvizu, R., Chen, J., Allison, M., Avilés‐Santa, L., … & Sorlie, P. D. (2016). Prevalence of low cardiovascular risk profile among diverse Hispanic/Latino adults in the United States by age, sex, and level of acculturation: The Hispanic Community Health Study/Study of Latinos. Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, 5(8). • CDC (2007). Nutrition, Physical Activity, and Obesity: Data, Trends and Maps- Nutrition. Retrieved from : https://nccd.cdc.gov/dnpao_dtm/rdPage.aspx?rdReport=DNPAO_DTM.Expl oreByLocation&rdRequestForwarding=Form • Davis, A. M., Taitel, M. S., Jiang, J., Qato, D. M., Peek, M. E., Chou, C. H., & Huang, E. S. (2017). A national assessment of medication adherence to statins by the racial composition of neighborhoods. Journal of racial and ethnic health disparities, 4(3), 462471. References (2) • FLHealthCHARTS Data Viewer. (2017). Retrieved from http://www.flhealthcharts.com/charts/DataViewer/DeathVie wer/DeathViewer.aspx?indNumber=0091 • Florida Department of Health (2007). . Retrieved from: http://www.floridacharts.com/charts/mapp_report.aspx • Hurtibise, R. (2016). Sun Sentinel – We are currently unavailable in your region. Retrieved from http://www.sunsentinel.com/business/consumer/fl-uninsured-rate-falls-20160913story.html • Patel, S. R., Sotres-Alvarez, D., Castañeda, S. F., Dudley, K. A., Gallo, L. C., Hernandez, R., … & Redline, S. (2015). Social and health correlates of sleep duration in a US Hispanic population: results from the Hispanic Community Health Study/Study of Latinos. Sleep, 38(10), 1515-1522. References (3) • Qato, D. M., Wilder, J., Zenk, S., Davis, A., Makelarski, J., & Lindau, S. T. (2017). Pharmacy accessibility and costrelated underuse of prescription medications in lowincome Black and Hispanic urban communities. Journal of the American Pharmacists Association, 57(2), 162-169. • United Way of Miami-Dade (2018). Health Programs. Retrieved from: https://unitedwaymiami.org/what-wedo/our-work-in-health/health-programs/
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In March of 2010 the Affordable Care Act was enacted, this was designed to ensure that everyone had access to health care and more affordable health care. It original design was to realign and encourage collaboration between health and healthcare system (Public Health, n.d.). One of the initiatives was a Public Health Workforce Loan Repayment Program. This was to attempt to make sure that there were enough nurses to care for these patients. The incentive of having loan repayment would cost the participant three year commitment to public health agency, the Health & Human Service Department offers a repayment program (American Nurses Association, 2014).

With the scholarships and loan repayment programs, this encourages primary care providers, dentists, mental health care providers and nurses to commit to communities that are in need of their services. We are familiar with this with Native Health and is now bridging over to other public health offices.

As a nurse with a role in providing health care to the population they are able to support the long term care for these patients. Many of the patients that benefit from public health assistance are the mentally ill, the low income, mothers and babies, and the elderly. I have personally noticed an increase in the number of public health nurses and they are getting out into the community teaching and caring for the community.

Reference:

American Nurses Association. (2014). Health care transformation: The Affordable Care Act and more. Found at: www.nursingworld.org/MainMenuCatagories.Policy-Advocacy/HealthSystemReform/AffordableCareAct.pdf.

Topic 1 QD 1 and QD 2

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Topic 1 QD 1 and QD 2

250-300 words AND 1-2 references

no double space, no APA format, no name, just the answers.

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QD 1.

What is your idea of a healthy community? Provide specific examples. What do healthy communities have in common? How would you provide care for a community if your idea of a healthy community does not match your community’s definition of a healthy community?

QD 2.

Consider the different communities to which you belong:

What is the geopolitical community in you live? Why is it geopolitical?
What is a phenomenological community to which you belong? Why is it a phenomenological community?
What would some challenges and benefits be for community health nurses in providing care for different communities? For similar communities? For the same community? What are some possible solutions to the challenges?
What, if any, global health issues are present in your community? Are there any ethnic sub-communities within your community? What considerations need to be addressed?
Tags: writing skills nursing references details BSN 250-300 words

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Please write a Paragraph answering to this discussion below with your opinion. Please include citations and references in alphabetical order in case of another source.

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The important elements of the Affordable Care Act (ACA) is the availability of health insurance to millions of Americans who did not previously qualify for insurance. Prior to healthcare reform individuals could not get health care coverage with pre-existing conditions and insurance companies could drop you from your plan without warning if a person falls sick. Insurance companies also showed bias based on a person’s gender or socioeconomic status. However, with the ACA, individuals are able to buy insurance irrespective of their pre-existing conditions, and their premiums cannot be higher because of their age, gender, or medical history. Also, patients will be able to receive routine/preventative health care at no cost. “The Affordable care act bans lifetime and most annual dollar coverage limitations, the use of preexisting condition exclusions, and excessive waiting periods (i.e., longer than 90 days), and requires the use of “modified community rating” so that prices can vary only to a limited degree based on age, as well as by family size and tobacco use. The law also guarantees the right to internal and external impartial appeal procedures when coverage is denied, and requires insurers to cover routine medical care as part of clinical trials involving cancer and life-threatening illnesses (Rosenbaum, 2011).”

Starting in 2014, most adults under age 65 with incomes up to about $15,000 per year for single individual (higher income for couples/families with children) will qualify for Medicaid in every state. Families of four or more who do not make over 80,000 a year and their job doesn’t offer affordable insurance may be eligible for tax credit to help pay for insurance (MACMH, 2018).

The nurses’ role in the new healthcare reform is educating patients and becoming a resource on how health insurance can be accessed through the ACA. Individuals can be referred by the nurse to the website healthcare.gov, where they can shop at the marketplace for the best insurance plans. Nurses can support families and communities to get healthy. They can also advocate for free preventative healthcare services. The ACA allows individuals joining a new healthcare plan to receive recommended preventative care services with no out of pocket costs. Nurses should obtain the information needed to effectively communicate how to access healthcare insurance and reach as many uninsured people as possible (Wakefield, 2013).

References:

Wakefield, M. (2013, December 21). https://www.reflectionsonnursingleadership.org/fea…

Topic 4 DQ 1

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Topic 4 DQ 1

Please write a paragraph with your opinion based on the text bellow. Please include citations and references in case you need to used for the question:

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When interviewing a patient, the nurse must always take into consideration the patients culture. Violating cultural norms may jeopardize a professional relationship. Because cultural beliefs vary from country to country and sometimes region to region, ask the person about culturally relevant aspects of male-female relationships at the beginning of the interview (Jarvis, 2016). In many cultures, it is not unusual for a female to refuse to be examined by a male and vice versa. When interviewing Mrs. Li, the nurse most consider the Asian culture. For example, in the Asian culture it is very common to share information among family members, good health is achieved through proper balance of yin and yang, diseases are classified as hot or cold, they may complain about drawing blood, and may not complain about what is bothering them. All these factors affect the interview by the nurse and the nurse must respect their beliefs (Fundamentals of Nursing, 2011). It is imperative that all nurses become culturally sensitive to all patients.

The abuse assessment screen is the oldest short domestic violence screening tool. It is still used today. The Abuse Assessment Screen was developed for the detection of abuse during pregnancy. It consists of five questions. The tool has been translated into six languages, and it also includes body maps for documentation of injuries. Here are the 5 questions asked during this screening:

1. Have you ever been emotionally or physically abused by your partner or someone important to you?

2. Within the last year, have you been hit, slapped, kicked, or otherwise physically hurt by someone?

3. Since you have been pregnant, were you hit, slapped, kicked, or otherwise physically hurt by someone?

4. Within the last year, has anyone forced you to have sexual activities?

5. Are you afraid of your partner or anyone you listed above?

Domestic violence is widely recognized to be a public health issue of epidemic proportions. One in four U.S. women will be abused by an intimate partner during her life-time (WHEC). If the nurse suspects that Mrs. Li has been abused, they have the right to provide Mrs. Li with information on how to get help. The nurse can give information on local resources or hotlines to call for help and assistance. Unlike child and elder abuse, it is not mandatory to report suspected domestic abuse in adult males and females. Many times, when there is abuse, the patients will deny it, make up stories, or fail to report it.

References

Taylor, Carol., Lillis, Carol., LeMone, Priscilla., Lynn, Pamela., (2011). Fundamentals of

Nursing. The Art and Science of Nursing Care. Seventh Edition. Wolters Kluwer

Health/Lippincott Williams & Wilkins.

Womens Health and Education Center. Violence Against Women. Retrieved from:

http://www.womenshealthsection.com/content/vaw/vaw011.php3

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Topic 4 DQ 1

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During initial assessment of Ms. Li, it is important for the health care provider to perform a cultural assessment to determine current cultural practices and language barriers. It is important to check for understanding. The health care provider may determine that Ms. Li is more reserved and avoids eye contact as this can be a sign of disrespect in Asian culture. It is important for the health care provider to establish a professional role an assume authority. Ms. Li may need reassurance that all information provided on assessment will be kept private. The health care provider should be patient and consider silence as moments for reflection on information that has been discussed. They should provide clear and full information and be attentive of non-verbal cues. Lastly, the health care provider should address immediate needs and give corrective advise.

The abuse assessment screen is a tool utilized by health care providers to quickly assess for signs of abuse during assessment. This tool is designed to assess for domestic violence, abuse during pregnancy, and abuse to women with disabilities. It is comprised of three to five questions and each question assesses current emotional, sexual, and physical abuse and the frequency and severity of the abuse. This assessment should be completed by the health care provider when they are alone with the patient.

If abuse is discovered during assessment the nurse should take a non-judgmental and open approach by listening, communicating belief, validating the decision to disclose, and emphasizing the unacceptability of violence. The nurse must assess the immediate safety of the patient, contact authorities, and work with the interdisciplinary team to ensure the patient has a safety place to discharge to. The nurse should also provide community resources such as shelters and refer counseling services.

References

American Psychiatric Association. (2018). Working with Asian American Patients. Retrieved from https://www.psychiatry.org/psychiatrists/cultural-…

Crisis Prevention Institute. (2018). Domestic Violence: What can Nurses do? Retrieved from https://www.crisisprevention.com/Blog/September-20…

The American College of Obstetricians and Gynecologists. (2017). Abuse Assessment Screen. Retrieved from https://www.acog.org/About-ACOG/ACOG-Departments/W…

Epidemiology Paper

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Epidemiology Paper

Write a paper (2,000-2,500 words) in which you apply the concepts of epidemiology and nursing research to a

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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:

Chickenpox
Tuberculosis
Influenza
Mononucleosis
Hepatitis B
HIV
Ebola
Measles
Polio
Influenza
Epidemiology Paper Requirements

Address the following:

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.
Describe the determinants of health and explain how those factors contribute to the development of this disease.
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?
Explain the role of the community health nurse (case finding, reporting, data collecting, data analysis, and follow-up).
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.
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.

Epidemiology Question

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Epidemiology Question

Attached pls find the Communicable Disease Chain

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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:

Chickenpox
Tuberculosis
Influenza
Mononucleosis
Hepatitis B
HIV
Ebola
Measles
Polio
Influenza
Epidemiology Paper Requirements

Address the following:

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.
Describe the determinants of health and explain how those factors contribute to the development of this disease.
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?
Explain the role of the community health nurse (case finding, reporting, data collecting, data analysis, and follow-up).
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.
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

​Chronic Disease Health Promotion and Maintenance/for adults age 35–65

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​Chronic Disease Health Promotion and Maintenance/for adults age 35–65

Chronic Disease Health Promotion and Maintenance/for adults age 35–65

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Chronic Disease

Pick One chronic disease from the list below. Write a 2–3-page paper discussing the concepts of health promotion, health maintenance, health restoration and health teaching to an adult patient with this chronic disease. Be sure to integrate Evidence Based Practice into your discussion.

  • Chronic Obstructive Pulmonary Disease
  • Hypertension
  • Coronary Artery Disease
  • Diabetes Mellitus
  • Rheumatoid Arthritis
  • Heart Failure
  • Depression
  • Thyroid Disease

To view the Grading Rubric for this Assignment, please visit the Grading Rubrics section under Course Resources.

Assignment Requirements

Before finalizing your work, you should:

  • be sure to read the Assignment description carefully (as displayed above)
  • consult the Grading Rubric (under Course Resources) to make sure you have included everything necessary
  • utilize spelling and grammar check to minimize errors

Your writing Assignment should:

  • follow the conventions of Standard English (correct grammar, punctuation, etc.)
  • be well ordered, logical, and unified, as well as original and insightful
  • display superior content, organization, style, and mechanics
  • use APA 6th Edition format for organization, style, and crediting sources.

How to Submit

Submit your Assignment to the unit Dropbox before midnight on the last day of the unit.

When you are ready to submit your Assignment, click the Dropbox tab and select this unit’s basket from the dropdown menu, then attach your file. Make sure to save a copy of your work and be sure to confirm that your file uploaded correctly.