Syllabus
Master of Science in Applied Nutrition
APN 730 Medical Nutrition Therapy – Spring 2019
Credits - 3
Description
Nutrition principles, clinical nutrition assessment, the development, use, and monitoring of therapeutic diets, and nutrition support in the treatment and prevention of disease will be examined. Topics include lifestyle strategies and nutrition and therapeutic based interventions to correct nutrition insufficiencies, promote optimal health, and prevent, manage or correct medical problems. Pre-req: 605
Materials
Learning Objectives and Outcomes
Program Objectives
- Develop and utilize nutrition concepts and best-practices for nutrition and health promotion initiatives (Reinforcing, Assessment)
- Apply core research principles to measure the nutrition status and environment of individuals and communities (Reinforcing, Assessment)
- Develop communications and collaboration strategies with representatives from government, non-profit, community, and business entities regarding nutrition initiatives (Reinforcing)
- Interpret and modify explanations of complex nutrition concepts for various audiences (Reinforcing, Assessment)
- Research, develop and disseminate evidence-based and theory-driven educational materials and work-products at an audience appropriate level for topics related to nutrition and health promotion (Reinforcing)
Course Outcomes/Objectives
- Discuss the importance and the effect of nutrition therapy in a clinical setting and the contribution of medical nutrition therapy to overall patient care.
- Describe metabolic & physiological changes during disease processes & the effects of these changes on nutrient metabolism/utilization.
- Assess the nutritional status of patients and the nutrient adequacy of diets as related to specific health conditions.
- Understand therapeutic diets for specific disease states and provide medical nutrition therapy to patients/clients.
- Recommend and implement appropriate nutrition interventions (which can include diet modification and/or alternate routes of nutrition support for individuals whose medical conditions do not allow for nutrition needs to be met via ‘conventional’ PO feeding) and justify your recommendations.
- Assimilate all aspects of the Nutrition Care Process (NCP) to be able to provide comprehensive nutritional care to a patient or client.
Assignments
Case Studies
You will complete a number of case studies.
Therapeutic Diet Project
You will follow a complex therapeutic diet for five days to truly “walk in your patients’ shoes.”
Final Case Study “Live” Assignment
You will complete a case study that mimics as close as possible an interaction between a patient and a dietitian in the in-patient setting.
Reflection/E-Portfolio
You will select an artifact from the course to place in your e-portfolio and complete a reflection.
Discussion Board
You will be required to participate in discussions. Initial posts are due on Sundays, and responses are due by Tuesday. If the initial post and response are not submitted within the discussion week you will be given a zero. Posts submitted after the discussion week will not be graded.
Your success in the course relies on robust discussion, critical thinking, and peer-response. Weekly posts responding to prompts posed are meant to facilitate a deeper understanding of the broader themes of the course as well as enrich the readings, handouts, and lectures. Your initial response should be no less than 400 words. Peer-responses should be no less than 200 words and must be thoughtful, contain compliment as well as constructive criticism, and maintain a professional tone.
Furthermore, in regard to all assignments, please observe the following:
- All assignments must be completed using AMA formatting where appropriate.
- All times refer to Eastern Time (ET).
- All questions about assignments, and all questions in general, should be sent through email.
Writing Statement
As professionals in the field, you will consistently be expected to clearly and concisely articulate advanced concepts for diverse audiences at a variety of educational levels.
Graduate students are expected to produce their best quality work, including screening their work prior to submission for clarity, grammatical, spelling, formatting and mechanical issues.
While there is often a portion of each assignment’s rubric dedicated specifically to grammar, spelling, mechanics, and formatting, it is critical to understand that failure to submit work that has been adequately proofed may result in a reduction of points in other areas of the rubric. These may include, but are not limited to metrics rating professionalism or content knowledge and synthesis; work submitted in graduate courses should provide evidence of strategic reading, writing, and academic speaking skills essential for success in the discipline.
Grading Policy
Your grade in this course will be determined by the following criteria:
Grade Breakdown
| Assignment | Points |
|---|---|
| Case Studies | 20 |
| Student Syllabus Contract | 1 |
| Draft of Final Assignment, Part One | 5 |
| Case Study Creation | 15 |
| Therapeutic Diet Project | 15 |
| Final Case Study "Live" Assignment | 15 |
| Reflection/ePortfolio | 5 |
| Discussion Board | 24 |
| Total | 100 |
Grade Scale
| Grade | Points Grade | Point Average (GPA) |
| A | 94 – 100% | 4.00 |
| A- | 90 – 93% | 3.75 |
| B+ | 87 – 89% | 3.50 |
| B | 84 – 86% | 3.00 |
| B- | 80 – 83% | 2.75 |
| C+ | 77 – 79% | 2.50 |
| C | 74 – 76% | 2.00 |
| C- | 70 – 73% | 1.75 |
| D | 64 – 69% | 1.00 |
| F | 00 – 63% | 0.00 |
Schedule
Weekly Schedule
Week One: Jan 2 – Jan 8
Week Two: Jan 9 – Jan 15
Week Three: Jan 16 – Jan 22
Week Four: Jan 23 – Jan 29
Week Five: Jan 30 – Feb 5
Week Six: Feb 6 – Feb 12
Week Seven: Feb 13 – Feb 19
Week Eight: Feb 20 – Feb 24
Major Due Dates
- Nutrition-Focused Physical Assessment Mini-Case Study – Week 1 – Tuesday 1/8
- Optional Assignment – Week 1 – Tuesday 1/8
- ADIME Note #1 – COPD and EN Mini Case Study – Week 2 – Tuesday 1/15
- Decide on Secondary Conditions/Considerations for Case Study – Week 2 – Tuesday 1/15
- Submit Draft of Part One of Final Project – Week 3 – Tuesday 1/22
- ADIME Note #2 – NICU Case Study – Week 4 – Tuesday 1/29
- Case Study Creation – Week 5 – Tuesday 2/5
- ADIME Note #3 and Bariatric Case Study – Week 6 – Tuesday 2/12
- Submission of Therapeutic Diet Project – Week 7 – Tuesday 2/19
- Final Case Study “Live” Assignment – Week 7 – Tuesday 2/19
- Reflection/E-Portfolio – Week 8 – Sunday 2/24
- Discussion Board Posts and Responses Every Sunday and Tuesday of Week 1 through Week 7.
Week 8 posts are due on the last Friday (2/22) and Sunday (2/24) of the term.
Week One:
Weekly Learning Outcomes
- Explain the role of the nutrition/dietetics professional as a member of interdisciplinary healthcare teams.
- Describe each component of the Nutrition Care Process (NCP)
- Evaluate patient information to complete a nutrition assessment
Lectures
- Introduction to Course
- Nutrition Care Process Overview
- Nutrition Assessment
Required Readings
- Chapters 1 – 4 of Nelms’ Textbook – The Role of Nutrition Therapy in Health Care; The Nutrition Care Process; Nutrition Assessment; and Nutrition Intervention and Nutrition Monitoring and Evaluation
- The Joint Commission’s Official ‘Do Not Use’ List of Abbreviations https://www.jointcommission.org/facts_about_do_not_use_list/
- Worthington et al. When is parenteral nutrition appropriate?: Consensus Recommendation from ASPEN. JPEN, 2017;41(3):324-377.
- Balla Kohn J. Adjusted or ideal body weight for nutrition assessment? J Acad Nutr Diet, 2015;115(4):680.
See course for additional readings.
Assignments
- The Nutrition-Focused Assessment Mini-Case Study
- Decide the Setting and Primary Nutrition-Related Disease Situation for Final Project
- Optional Assignment – Nutrient Requirements, General EN, and General PN
Discussions
DB1: Introductions
DB2: P.E.S. Statements for Nutrition-Focused Physical Assessment Cast Study
Week Two: Inpatient 1 – Adult Nutrition Consult
Weekly Learning Outcomes
- Develop an ADIME note in response to a patient case scenario.
- Determine the appropriate level of nutrition education and counseling that can and should occur in the inpatient setting.
- Apply clinical critical thinking skills towards the creation of a case study.
Lectures
- Nutrition Counseling and Education in the Inpatient Setting
Required Readings
- Box 13.2 in textbook – Brief Nutrition Counseling for Hypertension: Steps in Behavioral Counseling (“5 A’s) – p.303
- Pages 277-278 of textbook: Nutrition Counseling Strategies for Behavior Change
- Motivational Interviewing – Learn About MI’s Place in Nutrition Counseling and Essential Tools for Enhancing Client Motivation. Dawn Clifford, PhD, RD. In Today’s Dietitian – July 2016 issue https://www.todaysdietitian.com/newarchives/0716p48.shtml
- Boyce B. Patient activation: What it is and how registered dietitian nutritionists can make it happen. J Acad Nutr Diet, 2015;116(1):15-18.
See course for additional readings.
Assignments
- ADIME Note #1 – COPD & EN Mini Case Study
- Decide on the Secondary Conditions/Considerations for Case Study
Discussions
DB1: Share with the class which of the four therapeutic diets you have selected and explain your reasons for choosing this particular diet.
DB2: Mini Case Study
Week Three: Inpatient 2 – Adult Length of Stay
Weekly Learning Outcomes
- Develop supporting materials for your mock patient case study scenario.
- Evaluate changes in the nutritional status of patients with an increased length of stay (LOS).
- Identify strategies for addressing nutrition-related concerns in LOS patients that still respects the medical conditions, procedures, tests, etc. they are facing.
Lectures
- Paul W. Resources
Required Readings
- Butterworth CE. The Skeleton in the Hospital Closet. Nutrition Today. 1974.
- Tobert CM, Mott SL, and Nepple KG. Malnutrition Diagnosis during Adult Inpatient Hospitalizations: Analysis of a Multi-Institutional Collaborative Database of Academic Medical Centers. JAND, 2017. (Currently in press…but will be published, I assume, by start of class).
- ASPEN Malnutrition Definitions Webpage and included links: https://www.nutritioncare.org/Guidelines_and_Clinical_Resources/Toolkits/Malnutrition_Toolkit/Definitions/
- Nelms Textbook: p. 52 (Table 3.14 in Textbook – Clinical Characteristics the Clinician Can Obtain and Document to Support a Diagnosis of Malnutrition) and p. 103 – Refeeding Syndrome.
- Malnutrition Quality Improvement Initiative webpage and included links: http://malnutritionquality.org/
Please see course for additional readings.
Assignments
Discussions
Week Four:
Weekly Learning Outcomes
- Complete the Nutrition Care Process for a pediatric case study
- Describe how nutrition support differs for pediatric patients as compared to adults
- Describe how nutrient needs change throughout infancy and childhood
Lectures
- Introduction to Topic
- Guest Lecture
Required Readings
- Nelms Textbook. There is not a specific chapter or chapters devoted to pediatrics. This information is included throughout the book. Therefore, please be sure to study the following pages/sections:
- p.7 (Box 1.3 – Role of RD in Pediatric Care)
- p.49-52 (figure 3.8; Nutrition Care Criteria: Evaluation and interpretation of height and weight in infants and children; Box 3.3 – Pediatric Nutrition Assessment; Table 3.6)
- p. 83-84 (Box 4.5 – Pediatric Nutrition Education/Counseling)
- p. 101 (Box 5.5 Nutrition Support of Pediatric Patient)
- p.141 (Box 7.6 Fluid and Electrolyte Imbalance)
- p. 188-189 (Box 9.9 – Pediatric Food Allergy)
- p.257 (Box 12.4 – Pediatric BMI)
- p. 278-279 (Underweight in Infants/Children
- p.257 (Box 12.4 – Pediatric BMI)
- p. 331 (Box 13.14 Congenital Heart Defects)
- p. 358 (Box 14.4 GER in Infants)
- p. 422 (Box 15.5 – Pediatric Crohn’s)
- p. 426 (Table 15.16 – Etiology of SBS in Children)
- p. 483 (Box 17.3 – T2DM in Children)
- p. 601-606 (Nutrition Therapy for Epilepsy and Seizure Disorders and Box 20.2 – Nutrition Therapy for Developmental Delays)
- p. 639-645
- p. 717 (Box 24.2 – Classifications of Pediatric HIV Infection)
- p. 728 (Box 24.3 – Pregnancy Outcomes and Infant Feeding [In HIV])
- p. 737 (Box 25.1 – Pediatric Muscular Dystrophy)
- p. 747 – 748 (Rickets)
- Chapter 26 – Metabolic Disorders
- Harding J et al. Advances in nutrition of the newborn infant. Lancet, 2017.
- Jimenez L et al. Timing of the initiation of parenteral nutrition critically ill children. Curr Opin Clin Nutr Metab Care, 2017.
- Position of the Academy of Nutrition and Dietetics: Nutrition Guidance for Healthy Children Ages 2 to 11 Years, JAND, 2014.
- Fenton TR and Kim JH. A systematic review and meta-analysis to revise the Fenton growth chart for preterm infants. BMC Pediatrics, 2013. (Note – you can download just the growth chart for ease of plotting at this link: https://prism.ucalgary.ca/handle/1880/49514)
- Becker P, et al. Consensus statement of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition: Indicators Recommended for the Identification and Documentation of Pediatric Malnutrition (Undernutrition). Nutrition in Clinical Practice, 2015. 30(1): 147-161.
Please see course for additional readings.
Assignments
- ADIME Note #2 – NICU Case Study
Discussions
DB1: Mid-Course Check-In
DB2: Outpatient Adolescent Mini Case Study
Week Five: Outpatient 1 – Older Adult Long-Term Care
Weekly Learning Outcomes
- Evaluate how the role of a nutrition professional in the long-term care setting differs from a typical inpatient RD.
- Explain to caregivers the pros and cons of nutrition support in an elderly patient.
- Describe how nutrition support differs for geriatric patients as compared to adults.
- Describe how nutrient needs change with advancing age.
Lectures
- Week Five Lecture
Required Readings
- Nelms Textbook. There is not a specific chapter or chapters devoted to geriatrics or long-term care facilities. This information is included throughout the book. Therefore, please be sure to study the following pages/sections:
- p. 3 (Table 1.1)
- p. 6-7 (Box 1.2 – The Role of the RD in Long-Term Care)
- p. 63 (Box 3.4 – Nutrition Assessment of Older Adult Populations)
- p. 84 (Box 4.6 – Unique Features of Geriatric Nutrition Education/Nutrition Counseling)
- p. 90 (Box 5.2 – Nutrition Support of Older Patients)
- p. 141 (Box 7.6 – Susceptibility of Pediatric and Geriatric Populations to Fluid and Electrolyte Imbalances
- p. 157-177 (Immune System, Cellular Injury, & Wound Healing)
- p. 217-238 (Pharmacology, specifically information related to geriatric population and polypharmacy)
- p. 258 (Box 12.5 – Interpretation of BMI in Older Adults)
- p. 278 (Underweight in Older Adults section)
- p. 329 (Box 13.13 – Aging in Heart Disease)
- p. 348-349 (Dental caries and Box 14/1 – Geriatric GI Tract Physiology)
- p. 450 (Box 16.4 – Alcoholism in Older Adults)
- p.497 (Box 17.8 – Type 2 DM in Older Adults)
- p. 753 (Box 25.8 – Osteoarthritis in Older Adults and the Use of Alternative Treatments)
- 2010 Academy Position Paper – Individualized Nutrition Approaches for Adults in Health Care Communities
- 2010 Academy Position Paper – Food and Nutrition Programs for Community-Residing Older Adults.
- 2012 Academy Position Paper – Food and Nutrition for Older Adults: Promoting Health and Wellness
- Interview Blog Post on Dietitians of Canada Website. “Expectations Meeting Reality: A dietitian Learning Long-Term Care” https://www.dietitians.ca/Advocacy/Priority-Issues-(1)/Health-Systems/Long-Term-Care
Please see course for additional readings.
Assignments
- Case Study Creation
Discussions
DB1: Create a short scenario (no more than 1 paragraph) of a situation where a resident is unable to make a decision for themselves regarding the use of nutrition support (enteral feeding) and the family/friends are looking for information and are perhaps in disagreement about a course of action to take.
Week Six: Outpatient 2 – Adult Weight Management Setting
Weekly Learning Outcomes
- Assist patients in determining the weight loss modality(ies) that will best reduce their obesity-related comorbidities and maximize potentially weight loss benefits while also taking into account their goals and wishes.
- Compare different weight loss modalities (lifestyle modification, very low-calorie diet/intensive lifestyle interventions, pharmacotherapy, surgical procedures) on benefits, risks, efficacy, weight maintenance, and cost.
- Describe the manifestation of obesity bias in general society and the medical community specifically.
Lectures
Required Readings
- Apovian CM et al. Pharmacological Management of Obesity: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab, 2015.
- Jensen et al. 2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults. Circulation, 2013.
- Position of the Academy of Nutrition and Dietetics: Interventions for the Treatment of Overweight and Obesity in Adults. JAND, 2016.
- Puzziferri N, Long-term follow-up after bariatric surgery: a systematic review. JAMA, 2014.
- Puhl R and Suh Y. Health consequences of weight stigma: Implications for Obesity Prevention and Treatment. Curr Obes Resp, 2015.
- Nelms Textbook: Chapter 12 (Diseases and Disorders of Energy Imbalance; and Chapter 14 (Diseases of the Upper Gastrointestinal Tract) pages 342-348 and 367-369, Tables 14.20 and 14.21 (p. 369-370), and Practitioner Interview (p 374-375).
Please see course for additional readings.
Assignments
- Correspond with your instructor about setting up a time for your “live” case study project.
- ADIME Note #3 and additional questions — Bariatric Surgery Case Study
Discussions
DB1: Obesity Bias
DB2: Mini Case Study – Medical Weight Loss Management
Week Seven: Outpatient 3 – Dialysis Clinic
Weekly Learning Outcomes
- Describe the pathophysiology of renal diseases and failure.
- Discuss how medical nutrition therapy is utilized in the treatment of kidney disease patients, particularly those requiring dialysis.
- Utilize the nutrition care process in the treatment of kidney disease patients
Lectures
- Renal Guest Lecture
Required Readings
- Nelms Textbook Chapter 18 – Diseases of the Renal System
- AND and NKF 2010 Joint Position Stand on Renal RD SOPs
- Morris A et al. Integrating renal nutrition guidelines into daily family life: a qualitative exploration. J Hum Nutr Diet, 2017.
- Explore the DOPPS website (https://www.dopps.org/AboutUs.aspx), specifically looking at current published research from this trial (https://www.dopps.org/PublishedResearch/OurPublications.aspx)
- General Guidelines for Nutrition Care of the Renal Patient – Abbreviated KDOQI Guidelines
Please see course for additional readings.
Assignments
- Submission of Therapeutic Diet Project
- Final Case Study “Live” Assignment
Discussions
DB1: Renal Case Study
Week Eight: Wrap Up and Final Reflection
Weekly Learning Outcomes
- Complete a mock nutrition evaluation in “real time” by applying course content and clinical expertise.
- Reflect on your professional and academic growth over the past 8 weeks of the course.
Lectures
- Course Wrap Up
Required Readings
- None
Assignments
- Final Case Study “Live” Assignment
- ePortfolio Reflection
Discussions
DB1: Therapeutic Diet Assignment Reflection
Student Resources
Online Student Support
Your Student Support Specialist is a resource for you. Please don't hesitate to contact them for assistance, including, but not limited to course planning, current problems or issues in a course, technology concerns, or personal emergencies.
Questions? Visit the Student Support Applied Nutrition page
UNE Libraries:
- Library Access for all students: Your library login ID and password are the same as the ones you use to log into Brightspace.
- Applied Nutrition Database
- Library Questions: Ask a librarian or phone library staff at (207) 602-2361 or (207) 221-4330.
UNE Student Academic Success Center
The Student Academic Success Center (SASC) offers a range of services to support your academic achievement, including tutoring, writing support, test prep and studying strategies, learning style consultations, and many online resources. To make an appointment for tutoring, writing support, or a learning specialist consultation, go to une.tutortrac.com. To access our online resources, including links, guides, and video tutorials, please visit:
Information Technology Services (ITS)
- ITS Contact: Toll Free Help Desk 24 hours/7 days per week at 1-877-518-4673
Accommodations
Any student who would like to request, or ask any questions regarding, academic adjustments or accommodations must contact the Student Access Center at (207) 221-4438 or pcstudentaccess@une.edu. Student Access Center staff will evaluate the student's documentation and determine eligibility of accommodation(s) through the Student Access Center registration procedure.
Online Peer Support
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Information Technology Services (ITS)
Students should notify their Student Support Specialist and instructor in the event of a problem relating to a course. This notification should occur promptly and proactively to support timely resolution.
ITS Contact: Toll-Free Help Desk 24 hours/7 days per week at 1-877-518-4673.
Career Ready Program
The College of Professional Studies supports its online students and alumni in their career journey!
The Career Ready Program provides tools and resources to help students explore and hone in on their career goals, search for jobs, create and improve professional documents, build professional network, learn interview skills, grow as a professional, and more. Come back often, at any time, as you move through your journey from career readiness as a student to career growth, satisfaction, and success as alumni.
Policies
AMA Writing Style Statement
In keeping with the requirements of the Journal of the Academy of Nutrition and Dietetics and the Journal of Nutrition Education and Behavior, the American Medical Association (AMA) Manual of Style, 11th edition is the required writing format for this course and is available at both UNE libraries under the title "AMA Manual." Additional support for academic writing and AMA format is provided throughout the coursework as well as at the UNE Portal for Online Students.
Online resources: AMA Style Guide
Turnitin Originality Check and Plagiarism Detection Tool
The College of Professional Studies uses Turnitin to help deter plagiarism and to foster the proper attribution of sources. Turnitin provides comparative reports for submitted assignments that reflect similarities in other written works. This can include, but is not limited to, previously submitted assignments, internet articles, research journals, and academic databases.
Make sure to cite your sources appropriately as well as use your own words in synthesizing information from published literature. Webinars and workshops, included early in your coursework, will help guide best practices in AMA citation and academic writing.
You can learn more about Turnitin in the guide on how to navigate your Similarity Report.
Late Policy
Assignments: Assignments submitted after the due date and time will receive a deduction of 10% of the total possible grade for each day it is late. After three days, the assignment will not be accepted. No assignments will be accepted after the course ends.
Discussion posts: If the initial post is submitted late, acceptance of the discussion board is at the discretion of the faculty. Any posts submitted after the end of the Discussion Board week will not be graded (does not apply to practicum).
Students are encouraged to make every effort ahead of time to contact their instructor and their student support specialist if they are not able to meet an assignment deadline. Arrangements for extenuating circumstances may be considered by faculty.
Technology Requirements
Please review the technical requirements for UNE Online Graduate Programs: Technical Requirements
Course Evaluation Policy
Course surveys are one of the most important tools that University of New England uses for evaluating the quality of your education, and for providing meaningful feedback to instructors on their teaching. In order to assure that the feedback is both comprehensive and precise, we need to receive it from each student for each course. Evaluation access is distributed via UNE email at the beginning of the last week of the course.
Attendance Policy
8 week: Students taking online graduate courses through the College of Professional Studies will be administratively dropped for non-participation if a graded assignment/discussion post is not submitted before Sunday at 11:59 pm ET of the first week of the term. Reinstatement is at the purview of the Dean's Office.
16 week: Students taking online graduate courses through the College of Professional Studies will be administratively dropped for non-participation if a graded assignment/discussion post is not submitted before Friday at 11:59 pm ET of the second week of the term. Reinstatement is at the purview of the Dean's Office.
Student Handbook Online - Policies and Procedures
The policies contained within this document apply to all students in the College of Professional Studies. It is each student's responsibility to know the contents of this handbook.
UNE Course Withdrawal
Please contact your student support specialist if you are considering dropping or withdrawing from a course. The last day to drop for 100% tuition refund is the 2nd day of the course. Financial Aid charges may still apply. Students using Financial Aid should contact the Financial Aid Office prior to withdrawing from a course.
Academic Integrity
The University of New England values academic integrity in all aspects of the educational experience. Academic dishonesty in any form undermines this standard and devalues the original contributions of others. It is the responsibility of all members of the University community to actively uphold the integrity of the academy; failure to act, for any reason, is not acceptable. For information about plagiarism and academic misconduct, please visit UNE Plagiarism Policies.
Academic dishonesty includes, but is not limited to the following:
- Cheating, copying, or the offering or receiving of unauthorized assistance or information.
- Fabrication or falsification of data, results, or sources for papers or reports.
- Action which destroys or alters the work of another student.
- Multiple submissions of the same paper or report for assignments in more than one course without permission of each instructor.
- Plagiarism, the appropriation of records, research, materials, ideas, or the language of other persons or writers and the submission of them as one's own.
Charges of academic dishonesty will be reviewed by the Program Director. Penalties for students found responsible for violations may depend upon the seriousness and circumstances of the violation, the degree of premeditation involved, and/or the student’s previous record of violations. Appeal of a decision may be made to the Dean whose decision will be final. Student appeals will take place through the grievance process outlined in the student handbook.