Identify and attend a community, hospital or other organizational board. Select one member of the board to interview and shadow. Observe how this leader provides a unique voice related to quality, safety, and fiduciary aspects of patient care delivery and/or community health as it relates to policy discussions and decisions. Submit the agenda for the board meeting attended along with a 3 – 5 page (double spaced) written reflection of your observational experience. Clearly identify the name, title and role of the board leader your shadowed, his/her level of engagement/participation in board discussions related to safety, transparency, costs, patient-centeredness, quality of care or community health. If you attend a board which does not include a nurse board member, reflect on how a nurse could have brought different perspectives to the table. Use proper APA citation. See grading rubric for more specific expectations. https://www.ectorcountyisd.org/domain/4432 Website that includes live meeting for 9?18/18. I include what I began to write and the board meeting agenda.
Endoscopic sinus medical procedure, a broadly utilized strategy in the treatment of ceaseless sinus infection can prompt real (0-1,5 %) and minor (1,1-20,8% ) intricacies. These inconveniences are as yet essential these days. Focal sensory system (CNS) fistula, drain, meningitis, orbital damage and even demise are significant pathologies. These are typically the consequence of damage of fovea ethmoidalis or orbital structures [1-4]. On the off chance that the skull base life systems and its conceivable varieties are outstanding these dangers will be limited. ‘Fovea ethmoidalis’ which seperates ethmoid cells from foremost cranial fossa shapes the top of ethmoidal labrynth [5, 6]. Fovea ethmoidalis clings to horizontal lamella of cribriform plate which is a medially found thin bone . Keros  ordered the profundity of olfactory fossa as the tallness of horizontal lamella in 1962. As indicated by his order if the stature of sidelong lamella <3mm this kind of olfactory fossa is called keros type i> 1 mm (27.5%), in 38 patients had > 2 mm (19%) contrast was found. Forty-eight of them female and 45 were male. In seven of similar patients demonstrated foveal shape asymmetry moreover. Normal right ethmoid rooftop stature 7.59 ± 2.25 mm ,normal left ethmoid rooftop tallness was estimated 7.75 ± 2.38 mm. In men with sort 2 foveal shape the gathering’s normal stature of the ethmoid rooftop (9.59 ± 2.77 mm) was higher than the foveal state of sort 1 gathering (7.66 ± 2.36 mm) (p = 0.042). In ladies, the normal stature of the ethmoid top of sort 2 gathering (8.75 ± 1.76 mm) was higher than sort 1 gathering (7.34 ± 2.11 mm) (p = 0.03). There was no measurably huge contrast was seen between the midpoints of statures of ethmoid rooftops in Keros type I, II and III patients. Right and left ethmoid rooftop statures were thought about altogether of 200 patients. There was an asymetry among left and right sides in 93 patients (46.5%) . In 55 patients > 1 mm contrast (27.5%), in 38 patients had > 2 mm distinction (19%) was found. Forty-nine of them were female, 44 of them were male. Five of similar patients indicated asymmetry in the state of the fovea moreover. In 54 patients (27%), asymmetry was seen in both ethmoid rooftop stature and olfactory fossa profundity . Twenty-nine of them were female, twenty-five of them were male. In a similar gathering; the foveal shape in four patients demonstrated asymmetry moreover. For the Keros type I patients the two sides of the olfactory fossa profundity asymmetry proportion was observed to be increasingly (53,3%) than alternate sorts. For a similar estimation, the proportions were discovered 40,8% and 29,4 % with Keros type II and type III separately. Kerosian ethmoid rooftop stature of the two sides in patients with sort I, asymmetry proportion was observed to be more noteworthy (40.0%). For a similar estimation, the outcomes were 33.3% and 29.4% in Keros type III and type II individually. In the Keros type I patients foveal shape asymmetry was observed to be more noteworthy (20.0%) than alternate sorts . The foveal shape asymetry for Keros type II was 4.2% and 4.08% for Keros type III separately. Talk: The ethmoid sinuses have uncommon significance particularly in patients experiencing sinus medical procedure . Since these sinuses are near fundamental organs, for example, the front cranial fossa, dura, orbita, optic nerve and foremost ethmoid vein [12, 13]. Amid endoscopic sinus medical procedure, the greatest probability of damage of the skull base is in Keros type III cases in which olfactory fossa are profound . In 1962, in Keros’ investigation with 450 patients, type II patients at a rate of 70.16% (which was the most well-known sort in that review), type III 18.25% and type I 11.59% of the patients . In our investigation 3.75% of the patients were Keros type I (Figure 1), 59.5% of the patients were Keros type II (Figure 2), 36.75% of the patients were Keros type III (Figure 3) . After the purpose of the intersection of fovea ethmoidalis with cribriform plate and the profundity; the shape and symmetry of these structures are additionally essential . In our investigation, in 93 patients (46.5%), olfactory fossa tallness asymmetry was distinguished and in another 93 patients (46.5%) foveal shape asymmetry was found. In 54 cases with stature asymmetry there was likewise shape asymmetry (27%). In an investigation made by Basak et al.  in Turkey on 64 youngsters with Keros type I, type II and type III frequencies were clarified in the accompanying way; 9%, 53% and 38% . Anderhub et al.  investigated 272 instances of German kids for the examination of instances of ethmoid rooftop . The consequences of their investigation were as per the following: 14.2% of the patients Keros type 1, 70.6% of the patients Keros type II, 15.2% of the patients Keros type III . In Jang and his collegues think about , on 205 grown-up patients, type II was the most well-known (69,5%). In Alazzaw and his collegues consider  on 150 patients with 3 separate ethnic gathering type I 80%, type II 20% and type III 0% of the patients were recognized. In an investigation made by Elwany and et al.  on 300 Egyptian 42,5% of sort I, 56,8% sort II and 1,4% sort III were found individually. In this investigation, the sort II olfactory fossa was the commonest type in men (66.7%), while the sort I fossa was commonest in ladies (53%). In an examination made by Souza et al.  on 200 Brazilian with sort I 26,3%, type II 73,3% and type III, 0,5% of detailed cases. Solares et al.  in United States inspected 50 cases, 83% of the cases type I, 15% sort II and %2 type III individually. In an examination in Turkey Erdem et al.  indicated 8,1% in 136 patients with sort 1, 59,6% sort II, 32,3% sort III; Sahin et al.  in 100 cases distinguished 10% of the patients type I, 61% sort II, 29% sort III. Dr. Satish Nair , discovered that 77,2% of sort II in the examination, 17,2% of sort I and 5,6%. of sort III 5,6% individually. As found in the examinations, contrasts are seen between various nations. In an investigation by Lebowitz et al.  200 paranasal tomographies were deciphered. In 86 of the cases, olfactory fossa shapes were symmetric and their statures were>3mm>