Final paper As the final paper in this course, each student will write a case study research paper based on a topic finalized through discussions under Discussion Question 6 (Week 9). The primary goal of this case study is to document environmental justice histories and recent environmental planning efforts in selected cities in New Jersey. Each student will choose one city and conduct extensive research (self-initiated) on the given topic by reading newspaper and journal articles, book chapters, and other reliable/credible resources (not Wikipedia or personal blogs). Please contact your instructor if you have confusion about any particular source material or you need assistance with this research. If a student is interested in a NJ city that is not listed below, please discuss that as part of DQ 6. Initial resources: In order to understand the background, please read the following article before doing any research or selecting any city for your case study. The Burning Issue: New Jersey’s new law will shield poor communities from new sources of pollution. What about existing ones? https://grist.org/justice/new-jersey-environmental-justice-law-covanta-incinerator-newark-camden/ In addition, please check out the following two web sites: Office of Environmental Justice, NJ DEP, https://www.nj.gov/dep/ej/policy.html US EPA Environmental Justice Mapping Tool: https://www.epa.gov/ejscreen Specific instructions for the paper: Length of the paper for general undergraduate students – 6 to 8 pages Use Double space, Times font, size 12. Papers must have in-text citations and a list of references (the list will not be counted within the minimum page limits). Please do not use direct quotes unless extremely necessary.

Figures or tables are optional but can be added, if needed (will not be counted within the minimum page limits). Papers must be free of typos and grammatical errors. Please write, edit, and revise. The paper should follow a good structure and must use sub-headings for the following major sections (please be creative with the sub-heading titles): Introduction (Purpose of the paper, an introduction to the city and its brief general history, its population (socioeconomic conditions according to latest Census data), characteristics of its built and natural environments, etc.) History of environmental injustice in this city (please provide evidences with appropriate references) Discussion of projects, programs, and environmental planning efforts (e.g., policies, regulations) in this city that are directly or indirectly related to environmental injustices. Did environmental injustices increase or decrease due to these projects/programs/efforts? How did the affected population (or population in general) react to such projects, policies, or planning efforts? Concluding remarks (Based on your findings but not your speculations, what have been done so far, how effective they were, what needs to be done in the near future and how, who will do that – local, state, federal agencies? Nonprofits? Etc.) No late submission is allowed for the final paper. Final paper presentation Record a 3-minute verbal presentation (audio or video) and submit the digital file (e.g., mp4, avi) on Canvas. No late submission will be accepted. Do not create a PowerPoint. You may write/read a script, if you like, so that all important information can be presented within 3 minutes. The presentation should give a quick overview of all four major sections of the paper. Please consider general people as your audience, so do not use jargons or heavy-duty academic verbiage. Please do not forget to introduce yourself in the beginning of your presentation.

Your task for this assignment is to research a Wikipedia page for a topic of your choosing (*see below for guidelines) and to describe how the record of that page has changed over time. You should aim to find larger trends, explain big changes (or series of changes), and try to offer explanation for those changes. Your essay should not be a description of a historical event/person, etc. as told by Wikipedia, nor should it simply be a list of individual revisions. It should instead seek to explain the “big picture” of how this particular page has changed over time. Imagine yourself knowing nothing about the topic and reading the Wikipedia page for the first time. And then imagine yourself reading the same Wikipedia page prior to significant edits. How might your (the reader’s) understanding of that topic be different based on which version of the page you read? Some questions to consider include: What kind of material has been added/discarded? Are there common themes regarding these changes? Are new interpretations (rather than simply fact) being offered in material that is being added/removed? For factual edits, why might someone be including/removing that material? Could it advance (or counter) an historical interpretation that is not being explicitly advanced? Do you see trends over time, where groups of chronological-similar edits differ markedly from a set of edits at a different period? – This might particularly be the case for a topic that has great significance/relevance today. Your essay should be 800-1100 words (roughly 3 pages double-spaced). You will submit your essay via a dropbox on Canvas by the due date as outlined on the syllabus and Canvas schedule. It should be written in complete sentences, organized in paragraphs, with a clear introduction that clearly defines your thesis/argument.

Name: Mr. W.S. Age: 65-year-old Sex: Male Source: Patient Allergies: None Current Medications: Atorvastatin tab 20 mg, 1-tab PO at bedtime PMH: Hypercholesterolemia Immunizations: Influenza last 2018-year, tetanus, and hepatitis A and B 4 years ago. Surgical History: Appendectomy 47 years ago. Family History: Father- died 81 does not report information Mother-alive, 88 years old, Diabetes Mellitus, HTN Daughter-alive, 34 years old, healthy Social Hx: No smoking history or illicit drug use, occasional alcoholic beverage consumption on social celebrations. Retired, widow, he lives alone. SUBJECTIVE: Chief complain: “headaches” that started two weeks ago Symptom analysis/HPI: The patient is 65 years old male who complaining of episodes of headaches and on 3 different occasions blood pressure was measured, which was high (159/100, 158/98 and 160/100 respectively). Patient noticed the problem started two weeks ago and sometimes it is accompanied by dizziness. He states that he has been under stress in his workplace for the last month. Patient denies chest pain, palpitation, shortness of breath, nausea or vomiting. ROS: CONSTITUTIONAL: Denies fever or chills. Denies weakness or weight loss. NEUROLOGIC: Headache and dizzeness as describe above. Denies changes in LOC. Denies history of tremors or seizures. HEENT: HEAD: Denies any head injury, or change in LOC. Eyes: Denies any changes in vision, diplopia or blurred vision. Ear: Denies pain in the ears. Denies loss of hearing or drainage. Nose: Denies nasal drainage, congestion. THROAT: Denies throat or neck pain, hoarseness, difficulty swallowing. Respiratory: Patient denies shortness of breath, cough or hemoptysis. Cardiovascular: No chest pain, tachycardia. No orthopnea or paroxysmal nocturnal dyspnea. Gastrointestinal: Denies abdominal pain or discomfort. Denies flatulence, nausea, vomiting or diarrhea. Genitourinary: Denies hematuria, dysuria or change in urinary frequency. Denies difficulty starting/stopping stream of urine or incontinence. MUSCULOSKELETAL: Denies falls or pain. Denies hearing a clicking or snapping sound. Skin: No change of coloration such as cyanosis or jaundice, no rashes or pruritus. Objective Data CONSTITUTIONAL: Vital signs: Temperature: 98.5 °F, Pulse: 87, BP: 159/92 mmhg, RR 20, PO2-98% on room air, Ht- 6’4”, Wt 200 lb, BMI 25. Report pain 0/10. General appearance: The patient is alert and oriented x 3. No acute distress noted. NEUROLOGIC: Alert, CNII-XII grossly intact, oriented to person, place, and time. Sensation intact to bilateral upper and lower extremities. Bilateral UE/LE strength 5/5. HEENT: Head: Normocephalic, atraumatic, symmetric, non-tender. Maxillary sinuses no tenderness. Eyes: No conjunctival injection, no icterus, visual acuity and extraocular eye movements intact. No nystagmus noted. Ears: Bilateral canals patent without erythema, edema, or exudate. Bilateral tympanic membranes intact, pearly gray with sharp cone of light. Maxillary sinuses no tenderness. Nasal mucosa moist without bleeding. Oral mucosa moist without lesions,.Lids non-remarkable and appropriate for race. Neck: supple without cervical lymphadenopathy, no jugular vein distention, no thyroid swelling or masses. Cardiovascular: S1S2, regular rate and rhythm, no murmur or gallop noted. Capillary refill < 2 sec. Respiratory: No dyspnea or use of accessory muscles observed. No egophony, whispered pectoriloquy or tactile fremitus on palpation. Breath sounds presents and clear bilaterally on auscultation. Gastrointestinal: No mass or hernia observed. Upon auscultation, bowel sounds present in all four quadrants, no bruits over renal and aorta arteries. Abdomen soft non-tender, no guarding, no rebound no distention or organomegaly noted on palpation Musculoskeletal: No pain to palpation. Active and passive ROM within normal limits, no stiffness. Integumentary: intact, no lesions or rashes, no cyanosis or jaundice. Assessment Essential (Primary) Hypertension (ICD10 I10): Given the symptoms and high blood pressure (156/92 mmhg), classified as stage 2. Once the organic cause of hypertension has been ruled out, such as renal, adrenal or thyroid, this diagnosis is confirmed. Differential diagnosis: 1. Renal artery stenosis (ICD10 I70.1) 1. Chronic kidney disease (ICD10 I12.9) 1. Hyperthyroidism (ICD10 E05.90) Plan Diagnosis is based on the clinical evaluation through history, physical examination, and routine laboratory tests to assess risk factors, reveal identifiable causes and detect target-organ damage, including evidence of cardiovascular disease. These basic laboratory tests are: 1. CMP 1. Complete blood count 1. Lipid profile 1. Thyroid-stimulating hormone 1. Urinalysis 1. Electrocardiogram 1. Pharmacological treatment: The treatment of choice in this case would be: Thiazide-like diuretic and/or a CCB 1. Hydrochlorothiazide tab 25 mg, Initial dose: 25 mg orally once daily. 1. Non-Pharmacologic treatment: 1. Weight loss 1. Healthy diet (DASH dietary pattern): Diet rich in fruits, vegetables, whole grains, and low-fat dairy products with reduced content of saturated and trans l fat 1. Reduced intake of dietary sodium: <1,500 mg/d is optimal goal but at least 1,000 mg/d reduction in most adults 1. Enhanced intake of dietary potassium 1. Regular physical activity (Aerobic): 90–150 min/wk 1. Tobacco cessation 1. Measures to release stress and effective coping mechanisms. Education 1. Provide with nutrition/dietary information. 1. Daily blood pressure monitoring at home twice a day for 7 days, keep a record, bring the record on the next visit with her PCP 1. Instruction about medication intake compliance. 1. Education of possible complications such as stroke, heart attack, and other problems. 1. Patient was educated on course of hypertension, as well as warning signs and symptoms, which could indicate the need to attend the E.R/U.C. Answered all pt. questions/concerns. Pt verbalizes understanding to all Follow-ups/Referrals 1. Evaluation with PCP in 1 weeks for managing blood pressure and to evaluate current hypotensive therapy. Urgent Care visit prn. 1. No referrals needed at this time.