Benchmark – Capstone Project Change Proposal
Details:
In this assignment, students will pull together the change proposal project components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. At the conclusion of this project, the student will be able to apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice.
Students will develop a 1,250-1,500 word Benchmark Capstone Project Change Proposal Nursing Paper that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal:
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Background
Problem statement
Purpose of the change proposal
PICOT
Literature search strategy employed
Evaluation of the literature
Applicable change or nursing theory utilized
Proposed implementation plan with outcome measures
Identification of potential barriers to plan implementation, and a discussion of how these could be overcome
Appendix section, if tables, graphs, surveys, educational materials, etc. are created
Review the feedback (1, 2 & 3) from your instructor on the Topic 3 assignment, PICOT Statement Paper, and Topic 6 assignment, Literature Review. Use the feedback to make appropriate revisions to the portfolio components before submitting. Benchmark Capstone Project Change Proposal Nursing Paper
Prepare this Benchmark Capstone Project Change Proposal Nursing Paper 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 Benchmark Capstone Project Change Proposal Nursing Paper assignment to Turnitin. Please refer to the directions in the Student Success Center.
Assignment Benchmark – Capstone Project Change Proposal
View Rubric
Details:
In this assignment, students will pull together the change proposal project components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. At the conclusion of this project, the student will be able to apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice.
Students will develop a 1,250-1,500 word paper that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal:
Background
Problem statement
Purpose of the change proposal
PICOT
Literature search strategy employed
Evaluation of the literature
Applicable change or nursing theory utilized
Proposed implementation plan with outcome measures
Identification of potential barriers to plan implementation, and a discussion of how these could be overcome
Appendix section, if tables, graphs, surveys, educational materials, etc. are created
Review the feedback from your instructor on the Topic 3 assignment, PICOT Statement Paper, and Topic 6 assignment, Literature Review. Use the feedback to make appropriate revisions to the portfolio components before submitting.
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.
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Assignment Benchmark – Capstone Project Change Proposal
View Rubric
Max Points: 300
Details:
In this Benchmark Capstone Project Change Proposal Nursing Paper assignment, students will pull together the change proposal project components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. At the conclusion of this project, the student will be able to apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice.
Students will develop a 1,250-1,500 word paper that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal:
- Background
- Problem statement
- Purpose of the change proposal
- PICOT
- Literature search strategy employed
- Evaluation of the literature
- Applicable change or nursing theory utilized
- Proposed implementation plan with outcome measures
- Identification of potential barriers to plan implementation, and a discussion of how these could be overcome
- Appendix section, if tables, graphs, surveys, educational materials, etc. are created
Review the feedback from your instructor on the Topic 3 assignment, PICOT Statement Paper, and Topic 6 assignment, Literature Review. Use the feedback to make appropriate revisions to the portfolio components before submitting.
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 Benchmark Capstone Project Change Proposal 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.
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Literature Review
Abstract
Introduction: Nicotine is presented a highly addictive psychoactive substance that requires a structured strategy to address the behavioral and biological aspects of the addiction. Nicotine Replacement Therapy (NRT) is presented as one strategy that could be effective in smoking cessation efforts. The purpose is to provide evidence that supports NRT being recommended as an efficiency cessation tool for smokers who have expressed the intention to quit smoking.
Comparison of research questions: The eight articles under review all address NRT use among young adult smokers.
Comparison of sample population: The eight studies are categorized as qualitative and quantities studies with the qualitative studies recruiting a smaller sample of participants (between 11 and 15 smokers) while the quantitative studies recruited a larger sample of participants (between 100 and 3,094 smokers) Benchmark Capstone Project Change Proposal
Comparison of limitations: The qualitative studies recruited a small population sample that reduced their generalizability. Additionally, some of the research aims are too broad. The current research intends to address the limitations by recruiting a large sample of participants that will improve results generalizability and focusing on NRT as a single smoking cessation strategy.
Conclusion: Overall, the present research intends to present evidence that supports NRT use among smokers who have presented quitting intention to improve cessation efficiency.
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Introduction
Nicotine is identified as a highly addictive psychoactive substance. In fact, it is behaviorally and biologically addictive making it difficult for cigarette smokers to quit as any quitting action would be accompanied by withdrawal symptoms (Barbeau, Burda & Siegel, 2013). To address the concern that links quitting with harm, nicotine replacement therapy (NRT) has been proposed. The therapy acts by replacing nicotine with a less harmful material so that the behavioral and biological aspects of smoking are not disrupted (Silla, Beard & Shahab, 2014). As such, nursing practitioners should recommend NRT for smokers who have expressed the intention to quit in order to improve the cessation efficiency. Benchmark Capstone Project Change Proposal.
A comparison of research questions
The present research intends to compare the cessation efficiency of NRT against other smoking cessation therapies with the intention of identifying the most efficient approach for use by cigarette smokers intending to quit. As such, it intends to answer the question of: Is NRT is more efficient than other smoking cessation therapies to justify special attention from nursing personnel? To answer this question, it is prudent to collect secondary information from sources talking about NRT. Buller et al. (2014) asked the question: How useful and effective is nicotine patch (NRT) in smoking cessation interventions? Silla, Beard and Shahab (2014) ask the question of: what attitudes and beliefs do smokers and ex-smokers exhibit towards NRT? Barbeau, Burda and Siegel (2013) ask the question: do e-cigarettes present better efficacy results when compared to other NRT strategies? Thurgood et al. (2015) ask two questions. The first question is: what is the effectiveness of different smoking cessation interventions for patients with substance use disorders? The second question is: what is the impact of smoking cessation treatment on substance use outcomes? Garcia-Rodriguez et al. (2014) ask the question: What are the estimated relapse rates and predictors to smoking when using NRT among young adults? Benchmark Capstone Project Change Proposal.Chen et al. (2016) ask the question: What are the high-risk smoking behaviors and barriers to smoking cessation among homeless individuals? Hakim, Chowdhury and Uddin (2017) ask the question: What are the correlates of unsuccessful smoking cessation among adults in Bangladesh? Diemert et al. (2013) asked the question: What are the predictors of young adults smoking cessation behavior? The research questions from the eight selected journal articles are all concerned with smoking cessation, six of them focusing on NRT. Their relevance to the current research is highlighted by the fact that they all address the same topic (smoking cessation) for the same population (young adults). As such, they will be useful in answering the present question of whether NRT is more efficient than other smoking cessation therapies to justify special attention from nursing personnel.
A comparison of sample populations
Buller et al. (2014) applied a quantitative research approach whereby a sample of 3,094 smokers was recruited aged between 18 and 30 years. Silla, Beard and Shahab (2014) applied a qualitative approach that recruited 15 participants who included current and ex-smokers. Barbeau, Burda and Siegel (2013) applied a qualitative approach that recruited 11 participants who included 9 men and 2 women. Thurgood et al. (2015) applied a qualitative approach that evaluated randomized control trials published between 1990 and 2014. Garcia-Rodriguez et al. (2014) applied a quantitative research approach that relied on secondary data from Waves 1 and 2 of the National Epidemiologic Survey of Alcohol and Related Conditions. Chen et al. (2016) applied a quantitative research approach that recruited 100 smokers from a homeless shelter. Hakim, Chowdhury and Uddin (2017) applied a quantitative research approach that used secondary data from 2009 Global Adult Tobacco Survey (GATS) for Bangladesh in which 1,552 smokers older than 14 years were recruited. Diemert et al. (2013) applied a quantitative design that relied on secondary data from the Ontario Tobacco Survey in which 592 young adult smokers were recruited as participants. The eight studies are focused on smokers as the population of interest, with the qualitative studies recruiting a smaller sample of participants (between 11 and 15 smokers) while the quantitative studies recruited a larger sample of participants (between 100 and 3,094 smokers). The present study will make use of these aspects by focusing on recruiting the participants from the population of interest (smokers older than 17 years) Benchmark Capstone Project Change Proposal.
A comparison of the limitations of the study
Although the eight studies do not clearly outline their limitations, one limitation can be gleaned in the qualitative studies. The qualitative studies recruited a very small sample of participants (between 11 and 15) when compared to the whole population of smokers thereby making the results non-generalizable. A larger sample would be required to improve the results generalizability since such a sample would be more representative of the demographic peculiarities of the population. Still, it is understood that recruiting a larger sample would have exponentially increase the research cost for the qualitative studies. The present research will address this limitation by recruiting a large number of participants while considering the cost, convenience and time aspects. Another limitation is noted in Thurgood et al. (2015) where the formulated research aim is too broad. The present study addresses this concern by focusing on NRT as a single smoking cessation strategy Benchmark Capstone Project Change Proposal .
Conclusion (with recommendations)
One must accept that nicotine is a highly addictive psychoactive substance that presents both behavioral and biological aspects. As such, there is a need to develop effective strategies to break the addiction. In addition, one must acknowledge that there are a range of strategies available for facilitating smoking cessation, although they each differ in terms of approach, effectiveness and efficacy. NRT is one such strategy that has been explored, particularly its use among young adult smokers and performance in comparison to other strategies. Eight research studies have been presented that research this aspect, but their results are limited by the use of small samples and formulation of very broad objectives. The present research will address the limitations by recruiting a large sample of participants to improve results generalizability, and narrowing the objective to focus on NRT use among smokers older than 17 years as a representative of all smokers. The intention is to present evidence that supports NRT use among smokers who have presented quitting intention to improve cessation efficiency.
References
Barbeau, A., Burda, J. & Siegel, M. (2013). Perceived efficacy of e-cigarettes versus nicotine replacement therapy among successful e-cigarette users: a qualitative approach. Addict Sci Clin Pract., 8, 5. doi: 10.1186/1940-0640-8-5 Benchmark Capstone Project Change Proposal Nursing Paper
Buller, D., Halperin, A., Severson, H., Borland, R., Slater, M., Bettinghaus, E., Tinkelman, D., Cutter, G. & Woodall, G. (2014). Effect of Nicotine Replacement Therapy on Quitting by Young Adults in a Trial Comparing Cessation Services. J Public Health Manag Pract., 20(2), E7-E15. doi: 10.1097/PHH.0b013e3182a0b8c7
Chen, J., Nguyen, A., Malesker, M. & Morrow, L. (2016). High-Risk Smoking Behaviors and Barriers to Smoking Cessation among Homeless Individuals. Respiratory Care, 61(5), 640-645. doi: 10.4187/respcare.04439
Diemert, L., Bondy, S., Brown, S. & Manske, S. (2013). Young Adult Smoking Cessation: Predictors of Quit Attempts and Abstinence. American Journal of Public Health, 103(3), 449-453. doi: 10.2105/AJPH.2012.300878
Garcia-Rodriguez, O., Secades-Villa, R., Florez-Salamanca, L., Okuda, M., Liu, S. & Blanco, C. (2014). Effect of Nicotine Replacement Therapy on Quitting by Young Adults in a Trial Comparing Cessation Services. Drug Alcohol Depend., 132(3), 479-485. doi: 10.1016/j.drugalcdep.2013.03.008
Hakim, S., Chowdhury, M. & Uddin, J. (2017). Correlates of unsuccessful smoking cessation among adults in Bangladesh. Preventive Medicine Reports, 8, 122-128. doi: 10.1016/j.pmedr.2017.08.007
Silla, K., Beard, E. & Shahab, L. (2014). Nicotine replacement therapy use among smokers and ex-smokers: associated attitudes and beliefs: a qualitative study. BMC Public Health, 14, 1311. doi: 10.1186/1471-2458-14-1311
Thurgood, S., McNeill, A., Clark-Carter, D. & Brose, L. (2015). A Systematic Review of Smoking Cessation Interventions for Adults in Substance Abuse Treatment or Recovery. Nicotine & Tobacco Research, 18(5), 993-1001. doi: 10.1093/ntr/ntv127
Project Change Proposal
Background
Thurgood et al. (2016) contends that despite the desire and intention for smokers to quit, the reality will differ. This is particularly true when it is considered that there are many smoking intervention strategies with differing effectiveness. The article goes on to mention that nicotine patches, cognitive behavioral therapy, bupropion (medication), contingency management, and nicotine replacement therapy were effective in avoiding relapse for the first six months of use. Nicotine gum and counseling were identified as being effective for the first twelve months of use Benchmark Capstone Project Change Proposal. The implication is that each cessation strategy would produce unique efficacy and effectiveness results (Thurgood et al., 2016). Hakim et al. (2017) adds that cessation strategies are not guaranteed to work and only report 68% effectiveness. This suggests that 32% of smokers actively seeking to quit will fail in their attempt. Garcia-Rodriguez et al. (2014) presents a contrary opinion by noting that cessation strategies cannot be blamed for any failure. Rather, there are probabilistic and predictive factors that determine cessation failure to include time spent smoking. Diemert et al. (2013) and Chen et al. (2016) however mention that cessation failure determinants are not well understood since measures change over time and may not be relevant to predict behavior even as an individual grows older Benchmark Capstone Project Change Proposal.
Silla, beard and Shahab (2014) is more succinct in noting that nicotine replacement therapy is effective, although its use has been limited by misperceptions concerning efficacy, health consequences, and safety. Buller et al. (2014) similarly notes that nicotine replacement therapy has an efficacy of 69% within the first three months that increased to 74.8% over the next three and a half months. Still, the article notes that including a nicotine patch increases the figure from 41.9% to 84.3% at 26 weeks. The implication is that nicotine replacement therapy substituting for cigarettes would benefit smokers seeking to quit while reducing harm. Barbeau, Burda and Siegel (2013) are more cautious in noting that all available smoking cessation strategies are not 100% effective with regards to quitting. To achieve better quitting rates, there is a need to address both the behavioral and social components of smoking. Based on this awareness, there is a need to further explore the position that nicotine replacement therapy can play in smoking cessation, particularly its effectiveness when compared to other cessation strategies, and whether it can address the concerns presented by Barbeau, Burda and Siegel (2013).
Problem statement
The problem addressed by this research is an evaluation of the position the nicotine replacement therapy can play in improving smoking cessation outcomes Benchmark Capstone Project Change Proposal. In fact, it seek to compare the effectiveness of the therapy against other available cessation therapies. Although there are a range of cessation therapies available in the market, they differ in terms of efficacy and effectiveness, as well as how personal, environmental and social factors influence them. Although there are a range of smoking cessation therapies available, their use is fraught with efficacy problems that is characterized by quitting failures. The result is that smokers seeking to quit become disillusioned. As the medical fraternity strives to address the failures exhibited by the strategies, their efforts are not divorced from challenges. In fact, behavioral and social concerns are a common setback. Still, nicotine replacement therapy is explored as the more efficient cessation therapy with greater efficacy and fewer setbacks. The mentioned aspects taken into account, the notion of applying nicotine replacement therapy is not difficult to diffuse, thereby making the concept adoption a possibility though approached with caution since no clear comparison has been made to identify it as the best therapy. As such, the current study seeks to determine if nicotine replacement therapy is the best available cessation therapy when compared against other therapies within the same use setting.
Purpose of the change proposal
The purpose of the change proposal is to provide tangible and verifiable evidence to support the prioritization of nicotine replacement therapy to facilitate smoking cessation efforts. In fact, it seeks to show that nicotine replacement therapy is more efficient than other cessation strategies thus supporting policy changes that would prioritize the use of nicotine replacement therapy over other cessation therapies. Benchmark Capstone Project Change Proposal
PICOT
PICOT Question: In cigarette smokers older than 17 years (P), does nicotine replacement therapy (I), versus using other smoking cessation therapies (C), affect smoking cessation outcomes (O) over a period of three months (T)?
Literature search strategy employed
This study makes use of both primary and secondary information. Collecting the secondary information involves inspecting relevant publications that have been peer-reviewed to ascertain their opinions and perceptions concerning the research topic. To aid the research validity and reliability, only respectable, peer-reviewed and English language publications will be accepted in the study. The search will be conducted using Boolean/phrase that identify equivalent texts and subjects as well as related phrases. The search will be restricted to publications from 2013 to 2018 (materials published in the last five years), that are presented in English. Other search limiters comprise textual materials on humans as subjects. The search expanders comprise applying related words, probing inside the articles’ full text, and evaluating subjects that are equivalent to the current topic. The search strategy is based on the awareness that perusing pertinent peer-reviewed literature and presenting related information helps to address the PICOT question.
Evaluation of the literature
As part of the initial portion of the critical appraisal process, discussed by Melnyk & Fineout-Overholt (2011), three vital areas will be assessed for each of the literature sources. Each source will be questioned on the validity, reliability, and applicability of its results. Following these key questions, the studies will be critically evaluation using Melnyk and Fineout-Overholt (2011) rapid critical appraisal tools. Benchmark Capstone Project Change Proposal . The rapid critical appraisal tools will help ascertain the evidence level for each source, how well each study was carried out, and how useful each source is to practice. In fact, the source for evaluating the literation and the level of evidence of each study is the Rating System for the Hierarchy of Evidence (Melnyk & Fineout-Overholt, 2011). Each study will be examined to determine its study design. Once the type of evidence is determined, the Hierarchy of Evidence chart, in the Melnyk & Fineout-Overholt textbook, will be consulted to define which of the seven levels of evidence each study falls under.
Applicable change or nursing theory utilized
The study applies Orem’s Self-Care Deficit Theory. The theory seeks to improve nursing quality. In fact, it holds that an individual must be at the fore-front of self-care by actively carrying out activities to maintain good health while acknowledging that the capacity is influenced by basic conditioning factors that include family system, health care system, gender, and age (Shah, 2015) Benchmark Capstone Project Change Proposal. In essence, it places a demand on the health, developmental and universal deviation as self-care requisites such that any inadequacy in the self-care requisites would be interpreted as a self-care deficit or the patient’s need for self-care. It correlates nursing objectives and concepts in a unique way to create a new perspective for looking at an existing problem. At the theory’s core is the concession that every individual holds the ultimate responsible for personal health with nursing acting as a form of interaction to improve personal health (Didisen, Binay & Yardimci, 2017). Considering the current objective of identifying the best smoking cessation strategy, the present study intends to present evidence to show that nicotine replacement therapy is the more efficient and effective therapy. It is important to note that although including elements of the theory would allow for nursing practice to improve, this improvement must be consistent with validated principles, laws and theories (Shah, 2015).
Proposed implementation plan with outcome measures
Addressing any variations that come up will only be successful if the research has an awareness of the change-associated pressures. That is for the reason that the research must convince medical stakeholders that change is necessary to achieve favorable care outcomes. The convinced stakeholders would then give their support for the change to be implemented. Since implementing the change needs a good plan that is prepared in consultation with the stakeholders, it is only right that the research understand all aspects of the change. Additionally, it is not hard to accept the researcher’s failure to understand the pressures associated with the change would impede capacity to solve new problems as they occur. This is considering the fact that any change must be realistic, achievable and measurable. Understanding the need for change and explaining it to the other stakeholders ensures that they provide meaningful support for the project. In this respect, the research who oversees the change must have a good awareness of the change-associated pressures as part of the implementation plan even as support for the change is sought from stakeholders. Benchmark Capstone Project Change Proposal
Identification of potential barriers to plan implementation, and a discussion of how these could be overcome
Four principal barriers were identified and noted as possible hindrances to the project. Firstly, there is inadequate knowledge and data about the proposed change. In fact, it is noted that medical personnel do not know the best smoking cessation therapy since evidence from a comprehensive study has not been conducted. The knowledge barrier will be addressed by preparing information on the change and presenting it to the personnel to improve their understanding while justifying the change. Secondly, access to supportive technology necessary for the change is limited. Convincing medical partners to support the change through funding that offers capital for the acquisition and purchase of the supportive technologies will be the solution. Thirdly, there is lack of support from principal stakeholders, particularly poor morale, negativity and variable attitudes from medical personnel. This barrier will be addressed through discussion forums in which the medical personnel’s apprehensions are addressed by convincing them that the change is necessary. Finally, there is potential for structural, organization, cultural and social barriers to the change presenting. This will be addressed by reviewing the existing structures and designing the change to circumvent any clashes with the structures. Benchmark Capstone Project Change Proposal
References
Barbeau, A., Burda, J. & Siegel, M. (2013). Perceived efficacy of e-cigarettes versus nicotine replacement therapy among successful e-cigarette users: a qualitative approach. Addict Sci Clin Pract., 8, 5. doi: 10.1186/1940-0640-8-5
Buller, D., Halperin, A., Severson, H., Borland, R., Slater, M., Bettinghaus, E., Tinkelman, D., Cutter, G. & Woodall, G. (2014). Effect of nicotine replacement therapy on quitting by young adults in a trial comparing cessation services. J Public Health Manag Pract., 20(2), E7-E15. doi: 10.1097/PHH.0b013e3182a0b8c7
Chen, J., Nguyen, A., Malesker, M. & Morrow, L. (2016). High-risk smoking behaviors and barriers to smoking cessation among homeless individuals. Respiratory Care, 61(5), 640-645. doi: 10.4187/respcare.04439
Didisen, N., Binay, S. & Yardimci, F. (2017). Orem’s Self-care Deficit Theory and Nursing Care in Relation to Pneumonia: A Case Report. Studies on Ethno-Medicine, 11(4), 311-317. doi: 10.1080/09735070.2017.1357223
Diemert, L., Bondy, S., Brown, S. & Manske, S. (2013). Young adult smoking cessation: predictors of quit attempts and abstinence. American Journal of Public Health, 103(3), 449-453. doi: 10.2105/AJPH.2012.300878
Garcia-Rodriguez, O., Secades-Villa, R., Florez-Salamanca, L., Okuda, M., Liu, S. & Blanco, C. (2013). Probability and predictors of relapse to smoking: results of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Drug Alcohol Depend., 132(3), 479-485. doi: 10.1016/j.drugalcdep.2013.03.008
Hakim, S., Chowdhury, M. & Uddin, J. (2017). Correlates of unsuccessful smoking cessation among adults in Bangladesh. Preventive Medicine Reports, 8, 122-128. doi: 10.1016/j.pmedr.2017.08.007 Benchmark Capstone Project Change Proposal
Melnyk B.M & Fineout-Overholt E. (2011). Evidence-Based Practice in Nursing & Healthcare: A Guide to Best Practice. Philadelphia, PA: Lippincott, Williams & Wilkins.
Shah, M. (2015). Compare and Contrast of Grand Theories: Orem’s Self-Care Deficit Theory and Roy’s Adaptation Model. International Journal of Nursing Didactics, 5(1), 39-42. doi: 10.15520/ijnd.2015.vol5.iss01.28.39-42
Silla, K., Beard, E. & Shahab, L. (2014). Nicotine replacement therapy use among smokers and ex-smokers: associated attitudes and beliefs: a qualitative study. BMC Public Health, 14, 1311. doi: 10.1186/1471-2458-14-1311
Thurgood, S., McNeill, A., Clark-Carter, D. & Brose, L. (2015). A systematic review of smoking cessation interventions for adults in substance abuse treatment or recovery. Nicotine & Tobacco Research, 18(5), 993-1001. doi: 10.1093/ntr/ntv127 Benchmark Capstone Project Change Proposal