Methods: This is a quality improvement project using the 2As and R method of smoking cessation to improve referral rates to a pharmacy smoking cessation program. Providers in a pulmonary clinic were educated on the 2As and R method, the in-house pharmacy smoking cessation program, and how to place referrals to the program. Data was obtained from the pharmacy program coordinator and reviewed by the principal investigator.

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Does your car pull when you are on the road? This could be a sign of a bad wheel bearing. If your car starts to pull in the wrong direction or not to go where you are wanting it to, it could be due to a bad wheel bearing or something related to your tires. Or you might notice your car starts to drift as you drive. The best thing to do is to take it in right away as your wheels are a huge factor to your safety on the road!

If you live in the Columbus, Ohio, area, come and check us out at Harris Automotive! We are here to help you with all your car problems and repairs.

Lastly, check your ABS light! If your vehicle has an anti-brake system, your ABS light could be on due to bad wheel bearings. Check the dashboard of your car to see if it’s on. Bring your car into your local automotive shop to have the professionals correctly diagnose the problem.

A good sign that your wheel bearings need to be replaced is when your steering wheel is shaking continually. First, check the pressure of your tires, and then check to see if it still shakes after that. This shaking happens when your wheel bearings loosen or deteriorate over time. Get your wheels repaired right away to avoid any further damage and high-cost repairs.

Conclusion: The 2As and R method of smoking cessation is effective in increasing the number of referrals to a smoking cessation program. The change was not statistically significant, however, the improvement in referral rates was encouraging.

Results: The pre-intervention rate of referrals to the pharmacy was 6.47% (18 patients out of 278) and the post-intervention rate was 10.91% (30 patients out of 275). Although there was an increase in referral rates post-intervention, this increase was not statistically significant. The increase does demonstrate clinical significance.

The best thing to do to find out if you have a wheel bearing problem is to LISTEN! This is the most common way to know for sure if the sound is coming from your wheels. While driving, make sure to pay attention to where the sound is coming from and which wheel you think it’s coming from as well. This will be important to be able to tell your mechanic when getting your wheels repaired. Bad wheel bearings can make multiple sounds, like a grinding or loud grating sound.

The condition of your car wheels is key to your vehicle safety! The design and function of your wheels and the wheel bearings are quite complex. Your car’s wheel bearings are the metal balls that are held together by a ring that allows the wheels to spin with little friction. The wheel bearings of your wheels help to bring smooth rotation to your tires and friction free movement on the road. Here are five signs that your wheel bearings could be bad or to keep in mind for the future.

Another sign is your car feels loose when driving. What we mean by loose is it can feel like you have less control when driving and less ability to maneuver. Many times, the wheel bearings of cars can become worn and need to be replaced in some way. Your local mechanic will be able to tell you exactly what is happening so you can pinpoint the problem to prevent any future ones.

Background: Smoking is a habit of millions of Americans despite the associated preventable health issues and death that it produces. Smoking cessation programs, particularly those using pharmacotherapy, are effective in increasing smoking cessation rates. However, smoking cessation programs remain underutilized.

Purpose: The purpose of the DNP project is to educate providers on using the 2As and R (ask, advise, and refer) of smoking cessation to assess a patient’s readiness to quit and refer to smoking cessation counseling. For providers working in an urban pulmonary clinic, does education regarding the use of the 2As and R method as a standardized intervention to assess readiness for referral to smoking cessation counseling compared to no education regarding a standardized intervention increase the number of patients referred for smoking cessation counseling over eight weeks?

Holloway, Jennifer, "Using the 2As and R Method to Encourage Referral to Smoking Cessation Counseling in an Urban Pulmonary Clinic" (2023). Doctor of Nursing Practice Projects. 105. https://digitalcommons.jsu.edu/etds_nursing/105

Make sure to keep these five signs in the back of your mind if you ever suspect bad wheel bearings on your vehicle! The more you know how to prevent further damage to your wheels, the better for you and your wallet. It will also keep you and your family safe on the road. Wheel bearing problems can cost from around $307 to $422 for replacement, but the cost is lower for simple repairs. It all depends on your vehicle and the specific repairs it needs.

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