the nurse implements a tertiary prevention program for type 2 diabetes in a rural health clinic. which outcome indicates that the program was effective?

Answers

Answer 1

As a nurse implementing a tertiary prevention program for type 2 diabetes in a rural health clinic, there are several outcomes that could indicate the effectiveness of the program.

Tertiary prevention aims to reduce the impact of an existing condition and prevent complications or further deterioration. Here are some possible outcomes that could indicate success:

Decreased hospitalization rates: If the program is effective, there may be a decrease in the number of patients with type 2 diabetes who require hospitalization for complications such as hyperglycemia, infections, or diabetic ketoacidosis.

Improved glycemic control: Another outcome that could indicate success is improved glycemic control among patients.

This may be measured through lab tests such as hemoglobin A1C or fasting blood glucose levels.

Increased patient education and self-management: Effective tertiary prevention programs often involve education and support for patients to manage their condition independently.

Therefore, an outcome that could indicate success is an increase in the number of patients who attend diabetes self-management education classes or who demonstrate improved knowledge of their condition and self-care practices.

Improved quality of life: If the program is effective, patients with type 2 diabetes may report an improved quality of life, with fewer symptoms, less pain, and increased mobility.

In summary, the effectiveness of a tertiary prevention program for type 2 diabetes in a rural health clinic can be measured through decreased hospitalization rates, improved glycemic control, increased patient education and self-management, and improved quality of life for patients.

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Related Questions

The growth in home health care is largely attributed to which factor?

Answers

The growth in home health care is largely attributed to the aging population.

The aging population is the primary factor driving the growth in home health care. As people age, they often require more medical attention, and many prefer to receive care in the comfort of their own homes. In addition, advances in medical technology have made it possible for healthcare providers to offer many services in the home setting, rather than in a hospital or nursing home.

This has made home health care a more viable and attractive option for many patients. As a result, the demand for home healthcare services has grown rapidly in recent years and is expected to continue to do so in the future.

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an appropriate first-line drug for the treatment of depression with fatigue and low energy would be

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An appropriate first-line drug for the treatment of depression with fatigue and low energy would be Selective Serotonin Reuptake Inhibitors (SSRIs) like fluoxetine (Prozac), sertraline (Zoloft), and escitalopram (Lexapro).

SSRIs work by increasing the levels of serotonin, a neurotransmitter that regulates mood, in the brain. This leads to a reduction in depressive symptoms, including fatigue and low energy. They are generally well-tolerated and have fewer side effects than other antidepressant medications.

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weight training improves body composition by increasing fat-free mass and raising metabolism.T/F

Answers

Answer:

True.

Explanation:

True, weight training improves body composition by increasing fat-free mass and raising metabolism.

does boeing 737-800 have power outlets

Answers

Yes, some Boeing 737-800 aircraft do have power outlets installed for passengers to use. However, it ultimately depends on the airline's specific configuration and whether or not they have chosen to include power outlets as an amenity.

The presence of power outlets on a Boeing 737-800 aircraft can vary depending on the airline and specific configuration of the aircraft. Some airlines may choose to install power outlets in certain seating areas, typically in premium cabins or specific rows, to provide passengers with the convenience of charging their electronic devices during the flight.

However, it is important to note that not all airlines or all aircraft of the same model will have power outlets. The availability of power outlets can be influenced by factors such as the airline's amenities policy, the intended use of the aircraft (e.g., short-haul or long-haul flights), and the specific interior layout chosen by the airline.

To determine if a particular Boeing 737-800 aircraft has power outlets, it is best to consult the airline's website or contact their customer service directly. They can provide the most up-to-date and accurate information regarding the amenities available on their specific aircraft.

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What creatine is safe for athletes?

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When it comes to choosing a safe creatine supplement for athletes, it's important to look for products that are third-party tested and certified by organizations such as NSF International or Informed Choice. These certifications ensure that the supplement has been tested for purity, potency, and banned substances. Additionally, athletes should opt for creatine monohydrate, which is the most widely researched and safest form of creatine. It's also important to follow recommended dosage guidelines and consult with a healthcare professional before starting any new supplement regimen.

Creatine monohydrate is the most widely studied and generally considered safe and effective for athletes when used as directed. It is a naturally occurring compound found in small amounts in foods like meat and fish and is also produced by the body. Athletes often use creatine supplements to enhance their performance, increase muscle strength, and improve exercise capacity.

Numerous scientific studies have demonstrated the safety and benefits of creatine monohydrate supplementation when taken within recommended doses. It is important to follow the recommended guidelines and consult with a healthcare professional or sports nutritionist for personalized advice.

While creatine monohydrate is generally safe, individuals with pre-existing medical conditions, such as kidney or liver disease, should exercise caution and consult with their healthcare provider before starting any supplementation regimen. It's also crucial to purchase creatine from reputable sources to ensure quality and avoid any potential contamination.

Athletes should remember that using any dietary supplement, including creatine, should be part of a well-rounded approach that includes proper training, nutrition, rest, and overall health management.

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Blaine spends a good part of her day sitting on the floor with all of the children at her childcare facility. She has noticed that her back and shoulders have been bothering her lately and suspects that it may be due to sitting on the floor so much. How could Blaine alter her floor-sitting to be more supportive of her back and shoulders?


Place herself against the wall for support.


Wear a back brace.


Sit with legs sprawled out and spread as far as possible.


Sit upright on her knees with them tucked underneath her.

Answers

Wearing a back brace will help Blaine sit in a proper posture without affecting her other physical activities.

Sitting against the wall for support will give Blaine temporary relief, but it will eventually hurt her, as it is not the recommended posture for longer duration.

Sitting upright on the knees starts hurting after some time. The pain not only shoots in the legs, but also in the back, disturbing the posture. It also causes tingling sensation after some time.

Thus, the correct answer is option B.

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a nurse understands that for the parathyroid hormone to exert its effect, what must be present?

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The nurse understands that for the parathyroid hormone (PTH) to exert its effect, the presence of target cells with specific receptors is crucial.

Parathyroid hormone PTH is responsible for maintaining the balance of calcium and phosphate levels in the body. It acts on three primary target sites: bones, kidneys, and the gastrointestinal tract.

In bones, PTH stimulates the release of calcium by increasing osteoclast activity. In the kidneys, it promotes calcium reabsorption and phosphate excretion. Additionally, PTH indirectly increases intestinal calcium absorption through the activation of vitamin D.

Proper function of PTH is essential for maintaining overall bone health and mineral homeostasis.

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the most prominent health risk for women engaged in intense training for their sports is:

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The most prominent health risk for women engaged in intense training for their sports is overtraining syndrome. This occurs when an individual trains excessively without allowing enough time for recovery and rest. Overtraining can lead to physical, emotional, and psychological symptoms such as fatigue, reduced performance, mood swings, increased risk of injury, and decreased immune function.

It is important for athletes to listen to their bodies and prioritize rest and recovery to prevent overtraining syndrome. Additionally, nutrition and hydration play a crucial role in supporting the body during intense training and promoting recovery. In summary, overtraining syndrome is the most prominent health risk for women engaged in intense sports training, and it is crucial to prioritize rest, recovery, and proper nutrition to prevent it.


The most prominent health risk for women engaged in intense training for their sports is the Female Athlete Triad. This condition consists of three interrelated components: low energy availability (with or without disordered eating), menstrual dysfunction, and decreased bone mineral density. It is important for female athletes to maintain a balanced diet, monitor their menstrual cycles, and ensure adequate bone health to prevent the development of this triad and its potential consequences.

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the absolute maximum amount of oxygen you can consume during peak exercise is referred to as

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The absolute maximum amount of oxygen you can consume during peak exercise is referred to as "VO2 max."


VO2 max, or maximal oxygen consumption, is the highest rate at which your body can utilize oxygen during intense exercise.

It is a measure of cardiovascular fitness and aerobic endurance, as it indicates how efficiently your body can deliver and use oxygen to produce energy during physical activity.



Summary: VO2 max represents the absolute maximum amount of oxygen your body can consume during peak exercise, and it is an important indicator of aerobic fitness and endurance.

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Which of the following is an indicator of survival over the next two years in very old person?
a. increased lung capacity
b. low T cell activity
c. high cortisol activity
d. high T cell activity

Answers

The correct answer is d. high T cell activity.High T cell activity is considered an indicator of survival over the next two years in very old individuals.

T cells are a type of immune cell that play a crucial role in the body's defense against infections and diseases.  However, studies have shown that older individuals with higher T cell activity have better immune function and a reduced risk of mortality. .Increased lung capacity (option a) can be beneficial for respiratory health but is not specifically linked to survival in very old individuals. Low T cell activity (option b) would imply weakened immune function and increased vulnerability to infections, which is generally associated with a higher risk of mortality. High cortisol activity (option c), which is associated with chronic stress, can have negative effects on overall health and may increase the risk of various health conditions.

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the literal meaning of life is whatever you're doing that prevents you from killing yourself
T/F

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The literal meaning of life refers to the existence of living organisms and their vital processes.

While individuals may find personal meaning or purpose in various activities that contribute to their mental and emotional well-being, this statement is not a universal or literal definition of life.

Life encompasses a wide range of experiences and biological processes that allow living organisms to grow, reproduce, and maintain homeostasis.


Summary: The literal meaning of life is not solely about preventing oneself from self-harm, but instead involves a broader understanding of biological processes and experiences of living organisms.

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which of the following is one of the three signs of an autism spectrum disorder?

Answers

There are three main signs of an autism spectrum disorder: social communication challenges, difficulty with social interaction, and repetitive behaviors or restricted interests. This is a long answer because it includes a description of all three signs.

Social communication challenges may include difficulty understanding and using nonverbal cues such as facial expressions or tone of voice, delayed speech development, or using language in unusual ways such as repeating phrases. Difficulty with social interaction may manifest as a lack of interest in other people, difficulty making and maintaining friendships, or a lack of understanding of social norms.

Repetitive behaviors or restricted interests may include repetitive movements such as hand flapping or rocking, obsessively focusing on specific topics or objects, or difficulty adapting to changes in routines or environments. It's important to note that these signs can vary greatly between individuals and may be more or less pronounced depending on the person.

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A manic episode must last at least _____ to meet the diagnostic criterion for bipolardisorder.
A) 2 days
B) 1 week
C) 2 weeks
D) 1 month.

Answers

"A manic episode must last at least 1 week to meet the diagnostic criterion for bipolar disorder."

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a manic episode is characterized by a distinct period of abnormally and persistently elevated, expansive, or irritable mood. To be diagnosed with bipolar disorder, the duration of a manic episode must be at least 1 week, or if hospitalization is required, the episode can be of any duration. It is important to note that the specific diagnostic criteria and duration may vary depending on the version of the DSM and professional clinical judgment.

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which of the following statements is true regarding premenstrual dysphoric disorder (pmdd)?

Answers

Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome (PMS) that affects some women before their menstrual cycle.


PMDD is a condition that causes physical and emotional symptoms that can interfere with daily life, such as anxiety, depression, irritability, and mood swings.

These symptoms typically occur during the luteal phase of the menstrual cycle, which is the 2 weeks before menstruation.



Summary: PMDD is a severe form of PMS that causes physical and emotional symptoms during the luteal phase of the menstrual cycle. It can interfere with daily life and cause anxiety, depression, irritability, and mood swings.

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What would cause a nurse to suspect that an infection has developed under a cast?
A)Complaint of paresthesia
B)Cold toes
C) Increased respirations
D)"Hot spots" felt on cast surface

Answers

Answer:

D. "Hot spots" felt on cast surface.

Explanation:

"Hot spots" felt on cast surface would cause a nurse to suspect that an infection has developed under a cast.

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which characteristic best describes enriched grain products?

Answers

Vitamins, nutrients and iron

how does the vo2max of a sedentary college student compare to an older athlete?

Answers

Answer: The collage studant has the same VO2max

Explanation:

what critical role is often played by pigs in the epidemiology of influenza virus?

Answers

Pigs are known to be one of the most important animal hosts in the epidemiology of influenza virus.

They are susceptible to both avian and human influenza viruses, making them a potential site for genetic reassortment of the virus. This means that if a pig is infected with both a human and avian influenza virus at the same time, the viruses can mix and create a new strain that could potentially be more infectious or deadly to humans. Pigs are also often involved in the transmission of the virus from birds to humans or from pigs to humans. Therefore, it is crucial to closely monitor the health of pigs in order to prevent the spread of influenza virus.

Pigs play a critical role in the epidemiology of influenza viruses due to their ability to act as "mixing vessels." This occurs when pigs are simultaneously infected with both human and avian influenza viruses. The genetic material of these viruses can reassort, creating new strains that may have the potential to infect humans. This reassortment can lead to the emergence of novel pandemic strains. Pigs also serve as amplifying hosts, increasing the likelihood of interspecies transmission. Therefore, monitoring and controlling influenza in pigs is essential for public health and pandemic preparedness.

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the bod pod® device is used in the ________ method of assessing body composition.

Answers

The **Bod Pod® device** is used in the **Air Displacement Plethysmography (ADP)** method of assessing body composition.

The Bod Pod® is a specialized device that measures body composition by calculating the body's volume through air displacement. The individual sits inside the Bod Pod® while measurements are taken. The device measures the amount of air displaced by the person's body, which allows for the calculation of body volume. From there, body density and body composition can be determined using specific formulas.

ADP is a non-invasive and relatively quick method for assessing body composition. It is based on the principle that lean tissue (muscle, bones, organs) and fat tissue have different densities. By accurately measuring body volume, ADP can provide information about an individual's percentage of body fat and lean mass.

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during its first few months after birth, an average newborn gains about an ounce per

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During the first few months after birth, an average newborn gains about an ounce per day. This rapid growth is essential for the baby's development and overall health. The weight gain is an indication that the baby is receiving enough nourishment and is growing properly.


In the first few days after birth, babies may lose some weight due to fluid loss. However, they typically regain this weight within a week or so. Breastfeeding or formula feeding provides the baby with the necessary nutrients to support their growth and development.

It's important to monitor a baby's weight gain to ensure they are thriving. If a baby is not gaining weight as expected, there may be an issue with their feeding or health. Regular check-ups with a pediatrician can help identify any concerns and ensure the baby is on track.

Overall, a newborn's weight gain is an essential aspect of their development and should be closely monitored in the first few months after birth.

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this branched carbohydrate is a storage form that is found in liver and muscle tissue.

Answers

Glycogen is the branched carbohydrate which is a storage form of glucose that is found in liver and muscle tissue.

In the human body, glycogen is a branched polymer of glucose stored mainly in the liver and the skeletal muscle that supplies glucose to the blood stream during fasting periods and to the muscle cells during muscle contraction.

Glycogen, the principal storage form of glucose and primary source of non-oxidative glucose for skeletal muscle and liver, confers significant contributions via its degradation by maintaining normal blood glucose levels and providing fuel for muscle contraction.

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which of the following clients are at risk for developing hypothyroidism? select all that apply.
• Onset of symptoms is gradual
• Weight gain
• Anorexia

Answers

Among the given options, the clients who are at risk for developing hypothyroidism are:

• **Onset of symptoms is gradual**

Hypothyroidism often presents with a gradual onset of symptoms, which may include fatigue, cold intolerance, dry skin, and constipation.

• **Weight gain**

Weight gain is a common symptom of hypothyroidism. The slowing down of the thyroid hormone production can lead to a decrease in metabolism and subsequent weight gain.

Clients who experience anorexia, or loss of appetite, are not typically at risk for developing hypothyroidism. Hypothyroidism is more commonly associated with weight gain rather than loss of appetite.

It's important to note that these signs and symptoms are general indicators, and a definitive diagnosis of hypothyroidism would require appropriate medical evaluation and diagnostic testing by a healthcare professional.

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an indicator commonly used to assess the health impact of a complex humanitarian emergency is:

Answers

An index generally used to assess the health impact of a complex philanthropic exigency is Crude Mortality Rate( CMR).

During the acute phase of an exigency, the crude mortality rate( CMR) is constantly expressed as the number of deaths per 10,000 people per day in complex extremities.

Disease transmission experts traditionally use the unrefined death rate( CMR) — the volume of expirations per 10,000 people each day — as an unwelcome sign of a crowd's general medical issue in a extremity circumstance. When the crowd has been chosen( alongside a optional age range), the unrefined rate is determined by partitioning the count of injury expirations by the complete number of people in the chose crowd.

situations of Mortality. During the acute phase of an exigency, the crude mortality rate( CMR) is constantly expressed as the number of deaths per 10,000 people per day in complex extremities.

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What is inflammation of glomerular membrane called?

Answers

The inflammation of the glomerular membrane is called glomerulonephritis.

Glomerulonephritis is a condition characterized by inflammation of the glomerular membrane, which is part of the kidney's filtration system. The glomerular membrane consists of tiny blood vessels called glomeruli, responsible for filtering waste products and excess fluids from the blood. In glomerulonephritis, the immune system mistakenly attacks the glomeruli, leading to inflammation.

This can result in impaired kidney function, leading to symptoms such as blood or protein in the urine, swelling, high blood pressure, and decreased urine output. Glomerulonephritis can be caused by various factors, including infections, autoimmune disorders, and certain medications. Treatment options focus on managing the underlying cause, reducing inflammation, and preserving kidney function.

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almost all the girls in a class are taller than the boys. most likely the girls and boys are:

Answers

It is important to note that height is not a defining characteristic of gender, and there may be some girls who are shorter than some boys in the class. Therefore, we cannot make a definitive statement about the height of the boys and girls in the class.


Additionally, it is important to avoid making assumptions about individuals based on their gender. Just because someone identifies as a girl or a boy does not necessarily mean they will fit into societal expectations of what that gender should look like. We should respect each person's unique characteristics and not make assumptions based on their gender.



In conclusion, while it is likely that most of the girls in the class are taller than most of the boys, we cannot make a definitive statement about the height of individuals based solely on their gender. We should always strive to avoid making assumptions about people based on their gender or any other characteristic.

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when should sutures, wound clips, or staples be removed from a skin incision?

Answers

The length of time that sutures, wound clips, or staples should be left in place following a skin incision depends on the type of wound, the location of the wound, and the healing process of the patient.

Generally, sutures are left in place for 7-10 days, while wound clips and staples are typically removed within 5-14 days. However, this timeline may be extended or shortened based on the individual's healing progress and the physician's judgment. It is important to keep the wound clean and dry and to follow any instructions provided by the healthcare provider regarding wound care and suture removal. If you have any concerns or questions regarding the healing of your wound, please contact your healthcare provider for further guidance.

Sutures, wound clips, or staples should be removed from a skin incision based on the location of the wound, the healing progress, and the patient's overall health. Generally, removal occurs between 5 to 14 days after placement. Factors influencing the timing include the wound's stability, reduced risk of infection, and minimized scarring. A healthcare professional will determine the appropriate time for removal to ensure optimal healing.

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T/F. Athletes need to consume over 500 grams of protein supplements a day to build muscle.

Answers

False.

Athletes do not need to consume over 500 grams of protein supplements a day to build muscle. While protein is essential for muscle growth and repair, the recommended daily protein intake for athletes depends on various factors such as body weight, activity level, and specific goals.

The general guideline for protein intake in athletes is around 1.2 to 2.0 grams of protein per kilogram of body weight. This means that a 150-pound (68 kg) athlete would typically need between 82 and 136 grams of protein per day. Consuming excessive amounts of protein beyond the body's needs does not necessarily lead to additional muscle growth and can be unnecessary.

Meeting the recommended protein intake through a balanced diet, rather than solely relying on protein supplements, is generally sufficient for muscle development and overall athletic performance.

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to avoid injuring your hand, what is the best way to hold a crossbow?

Answers

To avoid injuring your hand while using a crossbow, it is important to hold it properly. Firstly, ensure that you have a proper grip on the crossbow's stock or handle. Place your non-dominant hand on the front of the crossbow's foregrip and hold it securely.

Your dominant hand should be on the trigger and firmly grip the crossbow's pistol grip. It is crucial to keep your fingers away from the flight rail or string as these parts can cause serious injury if not handled correctly. Additionally, make sure that your fingers are not in the path of the string when firing the crossbow. Always maintain a safe distance between your fingers and the trigger to avoid accidental discharges. Always follow the manufacturer's instructions and practice safe crossbow handling to ensure that you and others around you stay safe.

Hold the crossbow close to your body, with the stock resting against your shoulder, and use your dominant hand to grip the handle securely. Always point the crossbow in a safe direction and engage the safety mechanism until you are ready to shoot. Following these guidelines will minimize the risk of hand injuries and ensure a safe and enjoyable crossbow shooting experience.

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7. name one advantage to using agar instead of gelatin as a solidifying agent.

Answers

Agar and gelatin are both solidifying agents that are commonly used in various scientific applications such as microbiological culture media, molecular biology techniques, and food science.

However, agar has several advantages over gelatin that make it a more preferred choice in many applications.

One major advantage of agar over gelatin is its origin. Agar is derived from algae and is thus suitable for use in vegetarian and vegan diets, whereas gelatin is derived from animal collagen and is not suitable for those diets.

Moreover, agar is more heat-stable than gelatin and can withstand higher temperatures, making it more suitable for use in microbiological culture media that require sterilization at high temperatures.

Another advantage of agar is that it forms a firmer gel than gelatin and can hold its shape better. This property makes it more suitable for techniques such as gel electrophoresis or bacterial colony counting, where the solid medium needs to maintain its shape.

Additionally, agar is less prone to liquification at higher temperatures, allowing for longer storage times and greater stability of solid media.

In summary, agar is a more versatile and reliable solidifying agent compared to gelatin, owing to its origin, heat stability, firmness, and resistance to liquification.

These advantages have made agar a preferred choice for a wide range of scientific applications.

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unlike most other concepts of health, holistic health considers _____ to be part of overall health.

Answers

Unlike most other concepts of health, holistic health considers **mental, emotional, and spiritual well-being** to be part of overall health.

Holistic health takes a comprehensive approach to well-being, recognizing that physical health is interconnected with mental, emotional, and spiritual aspects. It emphasizes the integration of these dimensions to achieve optimal health and wellness. Holistic health views individuals as whole beings rather than focusing solely on physical symptoms or ailments.

By considering mental, emotional, and spiritual aspects, holistic health recognizes the influence of thoughts, emotions, beliefs, and lifestyle factors on overall well-being. It promotes practices such as mindfulness, stress management, self-care, and the pursuit of purpose and meaning.

In summary, holistic health acknowledges that true wellness encompasses more than just physical health, emphasizing the importance of nurturing and balancing mental, emotional, and spiritual aspects for overall well-being.

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A different airplane travels at a constant speed of 500 miles per hour. Write an equation that models the number of miles flown, y, by this airplane given x hours. Identify the dependent variable and describe why it is the dependent variable. How many miles will this airplane travel in 3.5 hours?Enter your equation, description, and answer in the box provided. the philip morris company changed its name to altria in an attempt to create a new? A. Social identity, B. Interpretive sociology, C. feminism a butcher has a beam balance and masses 0.5kg and 2kg.How would he measure 1.5kg of meat on the beam balance at once? Write the equation in standard form for the circle that has a diameter with endpoints(4,7) and (12,7). when disabling sid filtering on a forest trust, what netdom switch should be used? an ip network address has been subnetted so that every subnetwork has 14 usable host ip addresses. what is the appropriate subnet mask for the newly created subnetworks? chronic diseases are the only type of diseases that afflict people in developed countries.T/F competitiveness doesn't include: effectiveness.operations management.profitability.operations strategy.productivity. one is not tru regarding to electrons and its energy absorbers or emits ? A.the radius of an atoms are directly proporshin with electrons energy.B.as waveleng of emited increase energy also increase.C.as enery decrease wave lengths are decrease. D. as frequency increase the energy also increase. in the term hemoglobin, what does the root/combining form refer to? Which methods are used by Microsoft to prevent software piracy? (Choose two answers)a. The product key must be successfully activated b. The computer must have a registered BIOS keyc. The computer must have a static IP addressd. The computer must have a product key in the mona lisa, the figure in the painting is painted in a lifelike way, which is an example of . schubert and his friends organized evening gatherings of artists, writers, and musicians, called: During world war 1 which countries were part of the allied powers and which were apart of the central powers? Write a letter to the editor of the daily news complaining to him about child - kidnapping in your community and suggest three ways it can be curbed. all the members of the same species that inhabit a particular area form a. an ecosystem b. a community c. an ecological niche d. a population 1. What is the area of the trapezoid? The diagram is not drawn to scaleO 36 cm^2O 64 cm^2O 128 cm^2O 110 cm^211 cm4cmh5 cm the state and federal governments collect vital statistics in the u.s. including births, deaths, marriages, divorces, and changes in civil status. what is the main purpose for collecting this information? what persuades the lynching party to give up Which of the following do functionalists not view as a social function of religion?a. Social cohesionb. "Blessing" social values and normsc. Distracting individuals from their own status in lifed. Maintaining or changing the status quo