1. Read about the Ransomware attacks on hospitals and then watch the YouTube video at the link below from CBS news discussing details of the “Ryuk” ransomware. After watching the video, discuss the ways that hospital efforts to comply with regulations like HIPAA and HITECH have made them more susceptible to ransomware attacks. (6 pts).

2. How do you feel about the creation of the Coronavirus database as discussed in the WSJ this week.  Do you feel that the healthcare industry has an obligation to create such data resources.  How would HIPAA and HITECH impact such a database and what privacy issues from the privacy and human behavior article to do you see cropping up around this project?.  (7 pts)

Companies Seek to Pool Medical Records to Create Coronavirus Patient Registry

Database would make medical histories for U.S. Covid-19 patients available to government and academic researchers 

ByPatience HagginUpdated April 8, 2020 7:12 pm ET

Several health-care and software companies are seeking to create a registry of Covid-19 patients by pooling medical records from across the country, aiming to study how the disease is spreading, which population groups are most vulnerable and how effective proposed treatments are, people familiar with the matter said.

San Francisco-based Datavant Inc., which specializes in compiling medical data from a variety of sources, began spearheading one such effort in late March, one of the people said. Health-care technology companies Allscripts Healthcare Solutions Inc. MDRX -2.42% and Change HealthcareInc. CHNG -4.08% said they have committed to donate data for the effort. Health insurance provider Anthem Inc. ANTM 5.57% has been contacted about contributing medical claims data, an Anthem spokeswoman said.

The initiative is one of several sources of data the federal government is considering to monitor the spread of coronavirus in the U.S., another person familiar with the matter said.

Datavant’s proposed registry would be free for government and academic researchers to access, and would aim to include every patient who has been tested for Covid-19, the disease caused by the new coronavirus.

The registry wouldn’t include patient names or other identifying details, but would include detailed information about their past and current conditions and medications, drawing on data that originates from hospitals, pharmacies and health-insurance companies. The consortium is aiming to have data covering 80% of U.S. medical claims, including those submitted to private insurers as well as Medicaid and Medicare Advantage.

Researchers or government officials could use the data to investigate an array of questions about the illness, such as the effectiveness of hydroxychloroquine and antivirals as potential treatment. President Trump has suggested the use of hydroxychloroquine as a treatment or preventive measure, though some public-health experts have advised against it until studies are conducted. 

The data could also yield insights on which demographic groups tend to get the most extreme cases and require ventilator support, and which are resistant to infection, one of the people familiar with the matter said. Researchers also could use the data to understand infection rates among health-care workers and the effects of local policies such as social-distancing and stay-at-home orders.

Datavant is in touch with at least one federal agency, the Food and Drug Administration, about its initiative, the person said.

“The FDA recognizes the potential for many different real-world data sources to complement traditional clinical studies and speed the process of evaluating the impact of potential Covid-19 therapies,” an FDA spokesman said in a statement. “To that end, the agency is advancing relationships with partners in the public and private sectors to rapidly collect and analyze information in areas such as illness patterns and treatment outcomes.”

Change Healthcare’s president of network solutions, Kris Joshi, said in a statement, “We are facing an unprecedented health-care crisis, and data is a critical element in discovering how Covid-19 is progressing, what kind of interventions are effective and ultimately how we can remediate the situation.”

The Anthem spokeswoman said the company hasn’t committed to participating in the initiative. “Anthem takes the security of its data and the personal information of health plan members very seriously,” she said in a statement.

Merging several big data sources to create a single record for each patient will be a challenge. Datavant’s software could help accomplish that. To protect privacy, patients’ identifying details such as names and social security numbers will be “transformed through an irreversible process” into encrypted keys. Researchers will receive patient records tied to an anonymous patient ID.

The company hopes to attract additional data providers, including life-insurance providers and consumer DNA-testing companies, after the effort’s initial launch, one of the people familiar with the matter said.

Consumer DNA-testing company 23andMe Inc. is already providing data to scientists who are racing to determine whether gene variations make some people more susceptible to serious Covid-19 infection.

Cloud-based data-management company Snowflake Inc. said it is in discussions to host the database free of charge.

In addition to patients who were tested for Covid-19, the Datavant-led database might also include patients with common symptoms for the disease. It would indicate the institution where a patient was treated to help researchers study the effects of conditions at overcrowded hospitals

3.Discuss what HIPAA is meant to do around Health information.  Next, discuss how HITECH is meant to supplement and help accomplish the goals of HIPAA.  Finally, examine the authors conclusions in “How to Avoid a HIPAA Horror Story” and comment on whether or not you think HIPAAA and HITECH legislation places an appropriate or rather excessive regulatory burden on healthcare organizations today.

Don’t Tell Apps your Secrets

Can you stop your phone from leaking personal data about you? 

Increasingly, the answer appears to be no.  A recent wave of corporate-data leaks and scandals related to sharing of personal information has led to lawsuits, fines and regulatory probes in the U.S. and Europe. Yet many cellphones and mobile apps continue to gather user data, such as people’s locations and shopping preferences, in order to share the information with other companies, including advertisers.

We asked several privacy-conscious and technologically savvy people what they do to protect their personal information while using smartphones. And the responses weren’t encouraging: They mostly agreed that smartphone users are at the mercy of phone manufacturers and app developers’ data practices.

Georgia Weidman, founder and chief technology officer of Shevirah Inc., a cybersecurity company focused on mobile devices, says she doesn’t keep photos on her phones that she wouldn’t want to end up on the internet, in case a hacker accesses her phone or an app accesses the data. When even new devices can have hundreds of apps on them, Ms. Weidman says, it’s also possible she may “make a misstep somewhere.”

Other rules she sets for herself: She has different phones for work and personal use, which helps to keep different kinds of data separate. She limits to her personal device use of apps such as social-media platforms that she thinks may “spy” on her data, and she doesn’t keep sensitive information about corporate clients on any of her phones.

“It’s nice that Facebook and WhatsApp know what you like, but you give up a lot of privacy. It’s hardly worth it,” says Ms. Weidman, who explains that she uses these platforms in combination with an app that blocks ad tracking.

Christopher Weatherhead, technology lead at nonprofit Privacy International, recommends using encrypted-messaging apps, such as Facebook Inc. FB -1.64% ’s WhatsApp or Signal, instead of traditional text messages. While some apps “are more secure and have better privacy policies than something like WhatsApp,” he says, “WhatsApp is night and day superior for personal privacy and security” compared with plain text messaging.

Not everyone will go to the lengths that privacy experts do to protect their communications. But they agree there are some precautions anyone can take to guard their privacy. Here are some other steps they recommend to limit the amount of personal data that your phone collects and shares about you:

Don’t let apps access information they don’t need

When you download mobile apps, they may ask permission to track your location and other data. In some cases, apps need that information to do what they promise, like recommend restaurants nearby. But some may ask to access phone features even though they don’t require that information. They may share data with other companies that users may not be aware of. Many popular smartphone apps share users’ locations, health details and other data with social-media companies, a Wall Street Journal investigation revealed. Other apps share personal data with advertisers.

“If it’s an app that lets you play cards, it probably doesn’t need access to the inner workings of your phone, your contact list, the internet and your GPS,” Ms. Weidman says. She recommends watching what apps you’re granting access to your camera, microphone, contacts list, location data and other information.

Phone settings list options to shut off apps’ access to location and other information. Ms. Weidman recommends people review those permissions and refuse to download apps that request access to anything they don’t need.

Apps may even continue to collect data after a person stops using them. To cut down on the amount of data a phone shares, people can delete apps they no longer use, says Mr. Weatherhead.

Research new apps before downloading them

Consumers might want to search the name of an app online before downloading it, because the developer’s data practices may already be well known, says Maureen Ohlhausen, a partner at law firm Baker Botts LLP and a former chairman of the Federal Trade Commission.

A quick internet search may turn up consumer complaints, lawsuits and regulatory investigations into an app’s potential privacy violations. Privacy concerns surfaced quickly this summer as more users downloaded FaceApp, which lets people upload photos of faces and change them to look older or younger.

Don’t let advertisers track your browsing

Ms. Weidman says she uses mobile browser plug-ins to stop advertisers from tracking her web activity and from presenting her with targeted ads on social media. Plug-ins to block ad tracking are available in app stores. In addition, she uses private sessions on web browsers to prevent them from keeping a history of her searches. Depending on the browser, private sessions are often described as “incognito” or “private” windows in the toolbar.

Change the data your phone shares with advertisers

One way to limit the personal data that smartphones collect and send to advertising companies is for users to regularly reset or turn off their advertising IDs, which identify mobile-phone users, in their phones’ settings menu. If a phone user changes their advertising ID, ad profilers cannot connect data they collected before and after it was reset with the same person, This reduces the amount of detailed personal information that advertisers see from that device, Mr. Weatherhead says.

While it might seem harmless if advertising companies obtain personal information about mobile-phone users, many people may not realize that advertisers might share that data with insurance companies and other business partners, Mr. Weatherhead says.

Update software on your phone

Data leaks and cyberattacks are less likely if people use up-to-date software. Often, hackers will siphon data off devices by exploiting a problem in an app or a phone’s operating system even after companies release a new, fixed version that a victim hasn’t downloaded.

“Lots of criminal attacks go in through vulnerabilities that are fixed and that you haven’t bothered patching,” says cybersecurity expert Bruce Schneier, an adjunct lecturer at Harvard’s Kennedy School of Government and a fellow at the Berkman Klein Center for Internet and Society.

Watch for phone scams

Cellphones are becoming a more attractive target for hackers. Scammers send texts with links containing malware that could compromise personal data, Ms. Weidman says.

Hackers also call cellphones and use ploys to trick people. Don’t react immediately to suspicious texts and phone calls that claim to be fraud alerts, says Ms. Ohlhausen. For instance, she says she recently received a phone call saying there was an alert related to activity on one of her financial apps; she asked to call the company back after checking it out herself.

“They try to throw you off and get you to react immediately,” she says. “Just be skeptical, take a breath.”

Dangers on the road

Mr. Weatherhead switched to an iPhone from Android after Apple Inc. refused to help the Federal Bureau of Investigation access encrypted data on the phone of a terrorist after a shooting in 2015. Mr. Weatherhead frequently travels abroad for his job and says authorities in some countries may want to access information about his work with privacy advocates.

“I want to know the data is staying on the phone,” he says.

Ms. Ohlhausen often decides to access the internet using mobile data instead of connecting her phone to public Wi-Fi networks because the connection may be less vulnerable to hackers. “Someone could be snooping on your traffic when you’re on a public network,” she says. Some people may want to use virtual private networks to protect their connection from intruders when using public Wi-Fi, she says.

Mr. Schneier says he accepts that a certain amount of risk comes with using the apps he wants. Two-factor authentication adds an extra layer of security to apps and makes it harder for hackers to access data, he says.

“Passwords are easy to steal, passwords are easy to guess,” he says. “Use two-factor authentication. It’s kind of a no-brainer.”

“Most of your security and privacy is not in your hands,” Mr. Schneier says. “You don’t have the ability to reverse-engineer it. You just don’t know.”

4. Revisit your healthcare app from last week.  After reading the “Don’t Tell Apps your Secrets article”, discuss some of the data collected by your app.  Especially focus on data that may be protected by HIPAA or HITECH.  Next, discuss some of the ways your app uses concepts from the privacy and human behavior article to encourage users of the app to provide their data even if they may have privacy concerns.  

Health Promotion & Middle-Age Adults 

Please note, I also need 2 responses!!!  It can be any additional comment or adding additional information about the same topic

Please name each question!!!! Do not use question #, find the attachment as an example

For this Discussion, your instructor will assign you a case number     !!!!!! Case 1 ONLY!!!!

Case 1Case 2Case 3 Cases

J.G. is a nurse practitioner working in a health clinic. Her clinic provides care to a majority of Hispanic migrant farmworkers during the summer months. Farmworkers in the area are susceptible to health problems because they are in a low-income bracket and may be exposed to unsanitary working and housing conditions. The workers do not tend to seek preventive care because of finances, transportation, and fear of deportation in many instances.

She struggles with the delivery of fragmented services within the migrant community because individuals move around frequently. In her encounters with the patients she serves, she has to stress early the importance of screening and follow-up care. She must also carefully assess the level of health literacy when providing education. In addition, She remains culturally sensitive to the beliefs and practices of the population she serves.

K.Y. is an employee-health nurse practitioner for a large corporation. Her role is to advocate for her clients by helping them improve their quality of life, both for the present and the future, through the identification of risk factors, health promotion, and other nursing interventions. The majority of the employees She sees are middle-age adults.

Her clients come to see her for a variety of reasons, including stress, mental illness, and on-the-job injuries. K.Y. assists her clients by providing education about healthy lifestyle choices, referrals to community resources, and counseling.

R.K. is a home health nurse practitioner who delivers primary care to a predominantly Medicare population. The role of the home health nurse practitioner is to provide assessments to individuals inclusive of the environment, provide direct skilled care and treatment, and provide education and referrals as needed. He must work closely with the patient and his or her caregiver in trying to prevent complications of illness.

R.K. specializes in providing wound care services in the home. He visits many diabetic patients living in a senior community. These patients are considered to be homebound and use wheelchairs or walkers to reach the common dining room where meals are served every evening. He is interested in assessing the nutritional content of the meals that are served.

Questions for the case

Create a list of health hazards associated with the migrant population in general and the one referred on the case. Which would be your recommendations to the migrant population to prevent injuries related to those hazards and how to improve their health.

Make a summary of the typical biological changes in the middle-age adult.

Create a list of recommendations of major activities older adults can engage in to promote health and prevent frailty.

Once you received your case number; answer the specific question on the table above. Then, continue to discuss the 3 topics listed below for your case:

Discuss how you would advise young adults in selecting contraceptive methods. Do you have any personal, religious reservations, or discomforts that would interfere with your ability to advise clients and ask them how they would address these personal conflicts?

Have students develop a smoking cessation plan for a client.

Evaluate the impact of poverty on older adults. Make sure to include the impact on their physical and mental health and health promotion recommendations.

Perer 1:

 NUR 601: HEALTH PROMOTION & DISEASE PREVENTION Discussion 7 Case 2As people approach 35 to 65 years of age, they are classified as middle-aged adults. There are many changes that happen to our bodies as we go though these years. Patients’ hair will start to turn, white or gray and become thinner, this weight tends to be more around the hips and abdomen. Patients tend to gain weight due to the ability to lose weight decreases. Patients tend to become less active. Joints become stiffer, arthritis, and other joint and bone difficulties start. Patients start to lose height and loose of bone density. Most organ systems slow down, and decrease output, like our hearts, lungs, and bowels, kidney.  Increase risk for heart and lung disease, due to blood vessel become thicker and less flexibility. Women start going though menopause, and men may start to have decrease in sexual function (Edelman, 2018).            Teaching young adults about contraception options, could be a difficult discussion. We as health care providers need to inform them of all their options, condoms (male and female), birth control pill, intrauterine device (IUD), diaphragms, the day after pill, and cycle method. The Affordable Care Act has made some of these options more readily available for them (Daley, 2018).  My religious beliefs do not hinder me from offer all options to patients. I am a firm believer in allow people to choose the best options for them. I am in the medical field to help provide the best care I can for my patients and advocate for them.            Promoting a smoking cessation program is a very difficult discussion. Unless the patient is ready to commit to stopping, the plan will not work. It is very important to make sure the patient has a support system; it is easy to fail. The best place to start to be to find the best plan for the patient. Everyone does it different, some use a nicotine patch or gum, some can start to decrease the amount, and some stop cold turkey. There are meeting and support groups for patients who are looking to stop, so matching them with the right group will help the patient succeed (Chase, 2020).            Working in a field where I face the older population daily. Many of them do not have the money to have help in caring for themselves or for their loved ones. I see many patients who need to be in a nursing home or have in home care. Some patients come to the hospital due to increase confusion, usually due to not eating enough or not drinking enough fluids to stay hydrated. Some patients come in with bed sore due to being in bed and the family is unable to help the patient. We also see in the reports from the ambulance companies describe the way the patient was found or the status of the environment the patient was found. Hearing patients say things like they cannot afford the medications need to get better, is heart breaking. I had one patient’s family ask about how the hospital bills for phone calls, and they went on to say cause the patient is so confused and keeps making phone calls to people. I work for hospice, so some of our consults for palliative care surprise these older patients (Rowley, 2021). They may not want to admit they are ready for hospice but once we explain it covers most of their medication, they are more likely to sign up. Some of them can go back home with their loved ones, some we help find placement for them. The hospital or our staff help the family apply for Medicaid. Most of these older patient just need some guidance in finding programs that can assist them.ReferencesChase, W., Zurmehly, J., Amaya, M., & Browning, K. K. (2020). Implementation of a Smoking Cessation e?Learning Education Program for Oncology Clinic Healthcare Providers: Evaluation With    Implications for Evidence?Based Practice. Worldviews on Evidence-Based Nursing, 17(6), 476–     482. https://doi.org/10.1111/wvn.12476Daley, A. M., & Polifroni, E. C. (2018). “Contraceptive Care for Adolescents in School-Based Health Centers Is Essential!”: The Lived Experience of Nurse Practitioners. Journal of School    Nursing, 34(5), 367–379. https://doi.org/10.1177/1059840517709503Edelman, C. K. (2018). Health Promotion Throughout the Life Span 9 th edition. St. Louis, MI: Elsevier.Rowley, J., Richards, N., Carduff, E., & Gott, M. (2021). The impact of poverty and deprivation at the end                      of life: a critical review. Palliative Care & Social Practice, 1–19.                                                               https://doi.org/10.1177/26323524211033873

Peer 2:

M7 Discussion – Initial Post – Case 3A healthcare professional can promote population and community health by supporting prevention and wellness initiatives and providing information, educating the population, and promoting healthier behaviors. For example, health care professionals can engage the population in lifestyle changes that can reduce chronic diseases like diabetes and hypertension (Griffiths et al., 2020). Older adults are at increased risk for developing certain diseases such as osteoarthritis. Unfortunately, there is no cure for this disease, and the treatment focuses on maintaining joint mobility, reducing disability, and minimizing pain (Dlugasch & Story, 2020). Non-pharmacological treatments and prevention of this disease include physical therapy and weight loss to increase mobility. According to the Centers for Disease Control and Prevention (CDC), adults aged 65 or older should get at least 150 minutes a week of moderate-intense aerobic exercise, like a brisk walk and at least two times a week do a muscle-strengthening activity (Gammack, 2017). Another common problem in older adults is osteoporosis, a progression of bone mass and decreased bone quality, increasing the risk of fractures (Dlugasch & Story, 2020). The recommendations for preventing this disease would include physical therapy to strengthen the joints, increase dietary calcium and vitamin D ingestion, and safety measures to prevent falls, such as removing clutters or using an assistive device.For this reason, it is relevant to provide recommendations for major activities older adults can engage in to promote health and prevent frailty. Physical activity in older adults has been shown to improve physical, cognitive, and functional status and reduce the risk of frailty (Gammack, 2017). The nurse practitioner (NP) should encourage home-based activities to improve the long-term compliance of a physical activity program. In addition, the NP should plan group-based exercises to increase participation and compliance. Some forms of exercise include brisk walks, strengthening exercises outdoor, flexibility, and aerobic movements.Selecting Contraceptive MethodsThe choice of a contraceptive method is a complex decision, and the provider should identify patient­-centered reproductive goals, document medical history/potential complications, and give information on different contraceptive methods. Once a patient and provider find a method suitable for the patient the provider should inform how to take the medication, how often, efficacy, effect on menstrual bleeding, adverse side effects, and effect on future fertility (da Silva et al., 2022). Dual method use should be encouraged among adolescents and young adults to prevent both unintended pregnancies and sexually transmitted infections.Health care providers have an essential role in providing information and supporting patients’ decision-making about contraceptive methods through contraceptive counseling and ensuring that a woman can access high-quality and non-judgmental reproductive health care services and contraceptive methods (Todd & Black, 2020). In shared decision-making, patients are acknowledged for their preferences, and providers contribute their medical knowledge about the different options and how they relate to patients’ preferences.Smoking Cessation PlanCigarette smoking is a significant health risk for several diseases, including cardiovascular disorders, respiratory problems, and cancers (Kim et al., 2019). Smoking cessation is recommended, and it is associated with many advantages, such as reducing symptoms of depression and anxiety and improving the quality of life for former smokers (Kim et al., 2019). One smoking cessation plan would be the e-health tools, such as telephone-based smoking cessation. A study showed that the integration of e-health tools in primary healthcare settings could improve knowledge about cessation treatments among smokers and integrate smoking cessation into routine care (Cupertino et al., 2019).Impact of Poverty on Older Adults Poverty is associated with adverse health outcomes among older adults, impacting their physical and mental health (Stolz et al., 2017). Studies have shown that people continuously or partially uninsured were more likely to suffer significant functional declines compared with those who were continuously insured, and people with higher levels of income, assets, and private health insurance tend to maintain better physical functioning in middle and old age (Chung et al., 2018). In addition, poverty is a risk factor for death by suicide in older adults. Suicide prevention strategies for older adults should be tailored explicitly by income level (Choi et al., 2019).ReferencesChoi, J. W., Kim, T. H., Shin, J., & Han, E. (2019). Poverty and suicide risk in older adults: A retrospective longitudinal cohort study. Int J of Geriatr Psychiatry, 34(11), 1565-1571. https://doi.org/10.1002/gps.5166 (Links to an external site.)Chung, R. Y. N., Chung, G. K. K., Gordon, D., Wong, S. Y. S., Chan, D., Lau, M. K. W., Tang, V. M. Y., & Wong, H. (2018). Deprivation is associated with worse physical and mental health beyond income poverty: A population-based household survey among Chinese adults. Qual Life Res, 27, 2127–2135. https://doi.org/10.1007/s11136-018-1863-yCupertino, A. P., Cartujano-Barrera, F., Perales, J., Formagini, T., Rodriguez-Bolanos, R., Ellerback, E. F., Ponciano-Rodriguez, G., & Reynales-Shigematsu, L. M. (2019). “Vive sin tabaco… ¡Decídete!” Feasibility and acceptability of an e-health smoking cessation informed decision-making tool integrated in primary healthcare in Mexico. Telemedicine and e-Health, 25(5). https://doi.org/10.1089/tmj.2017.0299 (Links to an external site.)da Silva, R. R., da Silva Filho, J. A., de Lima, E. R., Belém, J. M., Pereira, R. S., & de Oliveira, C. A. N. (2022). Woman-centered shared decision-making to promote contraceptive counseling: An integrative review. Revista Brasileira de Enfermagem, 75(5), 1–8. https://doi.org/10.1590/0034-7167-2021-0104 (Links to an external site.)Dlugasch, L., & Story, L. (2020). Musculoskeletal function. In L. Dlugasch, & L. Story (Eds.), Applied pathophysiology for the advanced practice nurse (1st ed., pp. 572-625). Jones and Bartlett Learning. ISBN: 978-1-284-15045-2Gammack, J. K. (2017). Physical activity in older persons. Missouri medicine, 114(2), 105–109.Griffiths, J. C., de Vries, J., McBurney, M. I., Wopereis, S., Serttas, S., & Marsman, D. S. (2020). Measuring health promotion: Translating science into policy. European Journal of Nutrition, 59, 11–23. https://doi.org/10.1007/s00394-020-02359-1 (Links to an external site.)Kim, S. J., Chae, W., Park, W. H., Park, M. H., Park, E. C., & Jang, S. I. (2019). The impact of smoking cessation attempts on stress levels. BMC Public Health, 19, 267. https://doi.org/10.1186/s12889-019-6592-9 (Links to an external site.)Stolz, E., Mayerl, H., Waxenegger, A., & Freidl, W. (2017). Explaining the impact of poverty on old-age frailty in Europe: Material, psychosocial and behavioral factors. European Journal of Public Health, 27(6), 1003–1009. https://doi.org/10.1093/eurpub/ckx079 (Links to an external site.)Todd, N., & Black, A. (2020). Contraception for adolescents. Journal of clinical research in pediatric endocrinology, 12(1), 28–40. https://doi.org/10.4274/jcrpe.galenos.2019.2019.S0003 

Group Case Study Video Presentation

For this assignment, groups of 3 students will create a narrated presentation regarding a patient case scenario, using the Group Case Study guidelines provided to you. Students will be assigned to groups and your assigned group can be found in the People navigation link on the left side of your Canvas page.

Use of the current APA format for PowerPoint (PPT) presentations is expected. One group member should submit the PPT slides AND the recorded Zoom video to Assignments in Canvas for grading. Post the PPT in the Threaded Discussion section, then view and evaluate two peers’ presentations for full credit for the assignment.

Activity Criteria:

1. Select a patient that you have encountered in the clinic setting who has signs and symptoms of at least three psychiatric disorders and one medical condition.
2. Provide a 10-12 PPT slide overview of the case using Zoom

Other:?Incorporate current clinical guidelines NIH Clinical Guidelines (Links to an external site.) or APA Clinical Guidelines (Links to an external site.), research articles, and the role of the PMHNP in your presentation.

• Graduate Mental Status Exam Guide.docx
• How to Upload a Zoom Video into Studio
• How to Embed a Studio Video in a Discussion on Canvas

Reminder: It is important that you complete this assessment using your critical thinking skills. You are expected to synthesize your clinical assessment, formulate a psychiatric diagnosis, and develop a treatment plan independently. It is not acceptable to document “my preceptor made this diagnosis.” An example of the appropriate descriptors of the clinical evaluation is listed below. It is not acceptable to document “within normal limits.”

Submission Instructions:

• The presentation is original work and logically organized,?formatted, and cited in the current APA style, including citation of references.
• The presentation should consist of 10-15 slides and be less than 10 minutes in length (excluding the introduction and reference page).?

• Incorporate a minimum of four current (published within the last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work. Journal articles and books should be referenced according to APA style, 7th Edition (the library has a copy of the APA Manual).
• Students must wear their lab coats and conduct the video in a professional setting, or the presentation will not be graded.
• Complete the Zoom video assignment and submit it by 11:59 PM ET Sunday
• Your initial post is worth 95 points.
• You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your reply posts are worth 5 points. Your total score will be reduced by 5 points if two peer reviews are not completed. How to do Peer Reviews in Canvas (Links to an external site.)

• All replies must be constructive and use literature where possible.
• Please post your initial response by 11:59 PM ET Sunday, and comment on the posts of two other groups by 11:59 PM ET Thursday in Module 7.
• Late work policies, expectations regarding proper citations, acceptable means of responding to peer feedback, and other expectations are at the discretion of the instructor.
• You can expect feedback from the instructor within 48 to 72 hours from the Sunday due date

Grading Rubric

Your assignment will be graded according to the grading rubric.

Rubric

Group Video Case Presentation and Psychiatric SOAP Note Rubric

Group Video Case Presentation and Psychiatric SOAP Note Rubric

Criteria	Ratings	Pts
This criterion is linked to a Learning OutcomeChief ComplaintChief Complaint (Reason for seeking health care) – S	4 to >3.0 pts Exemplary Includes a direct quote from patient about presenting problem 3 to >2.0 pts Distinguished Includes a direct quote from patient and other unrelated information 2 to >0.0 pts Developing Includes information but information is NOT a direct quote 0 pts Novice Information is completely missing	4 pts
This criterion is linked to a Learning OutcomeDemographics – S	2 pts Exemplary Begins with patient initials, age, race, ethnicity, and gender (5 demographics) 1.5 pts Distinguished Begins with 4 of the 5 patient demographics (patient initials, age, race, ethnicity, and gender) 1 pts Developing Begins with 3 or less patient demographics (patient initials, age, race, ethnicity, and gender) 0 pts Novice Information is completely missing	2 pts
This criterion is linked to a Learning OutcomeHistory of the Present Illness (HPI) – S	5 to >3.0 pts Exemplary Includes the presenting problem and the 8 dimensions of the problem (OLD CARTS – Onset, Location, Duration, Character, Aggravating factors, Relieving factors, Timing and Severity) 3 to >2.0 pts Distinguished Includes the presenting problem and 6 of the 8 dimensions of the problem (OLD CARTS – Onset, Location, Duration, Character, Aggravating factors, Relieving factors, Timing 2 to >1.0 pts Developing Includes the presenting problem and 4 of the 8 dimensions of the problem (OLD CARTS – Onset, Location, Duration, Character, Aggravating factors, Relieving factors, Timing 1 to >0 pts Novice The presenting problem is not clearly stated and/or there are < 4 of the 8 dimensions of the problem (OLD CARTS – Onset, Location, Duration, Character, Aggravating factors, Relieving factors, Timing	5 pts
This criterion is linked to a Learning OutcomeAllergies – S	2 pts Exemplary Includes NKA (including = Drug, Environmental, Food, Herbal, and/or Latex or if allergies are present (reports for each severity of allergy AND description of allergy) 1.5 pts Distinguished If allergies are present, students list type Drug, environmental factor, herbal, food, latex name and include severity of allergy OR description of the allergy 1 pts Developing If allergies are present, students lists only the type of allergy name 0 pts Novice Information is completely missing	2 pts
This criterion is linked to a Learning OutcomeReview of Systems (ROS) – S	5 to >3.0 pts Exemplary Includes a minimum of 3 assessments for each body system, assesses at least 9 body systems directed to chief complaint, AND uses the words “admits” and “denies” 3 to >2.0 pts Distinguished Includes 3 or fewer assessments for each body system, assesses 5-8 body systems directed to chief complaint, AND uses the words “admits” and “denies” 2 to >0.0 pts Developing Includes 3 or fewer assessments for each body system, and assesses less than 5 body systems directed to chief complaint, OR student does not use the words “admits” and “denies” 0 pts Novice Information is completely missing	5 pts
This criterion is linked to a Learning OutcomeVital Signs – O	2 pts Exemplary Includes all 8 vital signs, (BP (with patient position), HR, RR, temperature (with Fahrenheit or Celsius and route of temperature collection), weight, height, BMI (or percentiles for pediatric population) and pain.) 1.5 pts Distinguished Includes at least 6 vital signs, (BP (with patient position), HR, RR, temperature (with Fahrenheit or Celsius and route of temperature collection), weight, height, BMI (or percentiles for pediatric population) and pain.) 1 pts Developing Includes at least 4 vital signs, (BP (with patient position), HR, RR, temperature (with Fahrenheit or Celsius and route of temperature collection), weight, height, BMI (or percentiles for pediatric population) and pain.) 0 pts Novice Information is completely missing	2 pts
This criterion is linked to a Learning OutcomeLabs, Diagnostic Tests and Screening Tools – O	3 pts Exemplary Includes a list of the labs, diagnostic tests or screening tools reviewed at the visit, values of lab results or screening tools, and highlights abnormal values, OR acknowledges no labs/diagnostic tests were reviewed. 2 pts Distinguished Includes a list of the labs, diagnostic tests, or screening tools reviewed at the visit, but does not include the values of lab results or screening tools, but does not highlight abnormal values. 1 pts Developing Includes a list of the labs, diagnostic tests, or screening tools reviewed at the visit but does not include the values of the results or highlight abnormal values. 0 pts Novice Information is completely missing.	3 pts
This criterion is linked to a Learning OutcomeMedications-S	4 to >3.0 pts Exemplary Includes a list of all of the patient reported psychiatric and medical medications and the diagnosis for the medication (including name, dose, route, frequency) 3 to >2.0 pts Distinguished Includes a list of all of the patient reported psychiatric and but omits the medical medications and the diagnosis for the medication (including name, dose, route, frequency) 2 to >0.0 pts Developing Includes a list of some of the patient reported psychiatric and/or medical medications and the diagnosis for the medication (omits the dose, route, frequency of the medications) 0 pts Novice Information is completely missing	4 pts
This criterion is linked to a Learning OutcomePast Medical History-S	3 pts Exemplary Includes (Major/Chronic, Trauma, Hospitalizations), for each medical diagnosis, year of diagnosis and whether the diagnosis is active or current 2 pts Distinguished Includes (Major/Chronic, Trauma, Hospitalizations), for each medical diagnosis, either year of diagnosis OR whether the diagnosis is active or current 1 pts Developing Includes each medical diagnosis but does not include year of diagnosis or whether the diagnosis is active or current 0 pts Novice Information is completely missing	3 pts
This criterion is linked to a Learning OutcomePast Psychiatric History-S	5 to >3.0 pts Exemplary Includes (Outpatient and Hospitalizations), for each psychiatric diagnosis (including addiction treatment), year of diagnosis and 3 to >2.0 pts Distinguished Includes (Outpatient and Hospitalizations), for each psychiatric diagnosis (omits addiction treatment), year of diagnosis 2 to >0.0 pts Developing Includes (Outpatient and Hospitalizations), for each psychiatric diagnosis (including addiction treatment), does not include the year of diagnosis 0 pts Novice The information is completely missing	5 pts
This criterion is linked to a Learning OutcomeFamily Psychiatric History-S	3 pts Exemplary Includes an assessment of at least 6 family members regarding, at a minimum, genetic disorders, mood disorder, bipolar disorder and history of suicidal attempts 2 pts Distinguished Includes an assessment of at least 4 family members regarding, at a minimum, genetic disorders, mood disorder, bipolar disorder and history of suicidal attempts 1 pts Developing Includes an assessment of at least 2 family members regarding, at a minimum, genetic disorders, mood disorder, bipolar disorder and history of suicidal attempts 0 pts Novice Information is completely missing	3 pts
This criterion is linked to a Learning OutcomeSocial History-S	3 pts Exemplary Distinguished Includes all 11 of the following: tobacco use, drug use, alcohol use, marital status, employment status, current and previous occupation, sexual orientation, sexually active, contraceptive use/pregnancy status, and living situation. 2 pts Distinguished Includes at least 8 of the following: tobacco use, drug use, alcohol use, marital status, employment status, current and previous occupation, sexual orientation, sexually active, contraceptive use/pregnancy status, and living situation. 1 pts Developing Includes all 6 of the following: tobacco use, drug use, alcohol use, marital status, employment status, current and previous occupation, sexual orientation, sexually active, contraceptive use/pregnancy status, and living situation. 0 pts Novice Information is completely missing.	3 pts
This criterion is linked to a Learning OutcomeMental Status Exam-O	10 to >8.0 pts Exemplary Includes all 10 components of the mental status exam (appearance, attitude/behavior, mood, affect, speech, thought process, thought content/ perception, cognition, insight and judgement) with detailed descriptions for each area 8 to >5.0 pts Distinguished Includes all 8 components of the mental status exam (appearance, attitude/behavior, mood, affect, speech, thought process, thought content/ perception, cognition, insight and judgement) with detailed descriptions for each area 5 to >3.0 pts Developing Includes >6 components of the mental status exam (appearance, attitude/behavior, mood, affect, speech, thought process, thought content/ perception, cognition, insight and judgement) with some descriptions for each area 3 to >0 pts Novice Includes <3 components of the mental status exam (appearance, attitude/behavior, mood, affect, speech, thought process, thought content/ perception, cognition, insight and judgement) OR detailed descriptions is not included for each area	10 pts
This criterion is linked to a Learning OutcomePrimary Diagnoses-A	5 to >3.0 pts Exemplary Includes a clear outline of the accurate principal diagnosis AND lists the remaining diagnoses addressed at the visit (in descending priority) 3 to >2.0 pts Distinguished Includes a clear outline of the accurate diagnoses addressed at the visit but does not list the diagnoses in descending order of priority 2 to >0.0 pts Developing Includes an inaccurate diagnosis as the principal diagnosis 0 pts Novice Information is completely missing	5 pts
This criterion is linked to a Learning OutcomeDifferential Diagnoses-A	3 pts Exemplary Includes at least 2 differential diagnoses for the principal diagnosis 2 pts Distinguished Includes 2 differential diagnoses for the principal diagnosis 1 pts Developing Includes 1 differential diagnosis for the principal diagnosis 0 pts Novice Information is completely missing	3 pts
This criterion is linked to a Learning OutcomeOutcome Labs/Screening Tools – O	3 pts Exemplary Includes appropriate diagnostic/lab testing or screening tool 100% of the time OR acknowledges “no diagnostic testing or screening tool clinically required at this time” 2 pts Distinguished Includes appropriate diagnostic/lab testing 50% of the time OR acknowledges “no diagnostic testing or screening tool clinically required at this time” 1 pts Developing Includes appropriate diagnostic testing less than 50% of the time. 0 pts Novice Information is completely missing.	3 pts
This criterion is linked to a Learning OutcomeTreatment	8 to >6.0 pts Exemplary Includes a detailed pharmacologic and non pharmacological treatment plan for each of the diagnoses listed under “assessment”. The plan includes ALL of the following: drug/vitamin/herbal name, dose, route, frequency, duration and cost as well as education related to pharmacologic agent. For non-pharmacological treatment, includes: treatment name, frequency, duration. If the diagnosis is a chronic problem, student includes instructions on currently prescribed medications as above. 6 to >4.0 pts Distinguished Includes a detailed pharmacologic and non pharmacological treatment plan for each of the diagnoses listed under “assessment”. The plan includes 4-7 of the following: drug/vitamin/herbal name, dose, route, frequency, duration and cost as well as education related to pharmacologic agent. For non-pharmacological treatment, includes: treatment name, frequency, duration. If the diagnosis is a chronic problem, student includes instructions on currently prescribed medications as above. 4 to >2.0 pts Developing Includes a detailed pharmacologic and non pharmacological treatment plan for each of the diagnoses listed under “assessment”. The plan includes 4 of the following: drug/vitamin/herbal name, dose, route, frequency, duration and cost as well as education related to pharmacologic agent. Non-pharmacological treatment NOT included. If the diagnosis is a chronic problem, student includes instructions on currently prescribed medications as above. 2 to >0 pts Novice Information is comp https://readyassignments.com/wp-content/uploads/2024/02/New-Project15.png 0 0 bonniejecinta https://readyassignments.com/wp-content/uploads/2024/02/New-Project15.png bonniejecinta2024-04-05 16:48:422024-04-05 16:48:42St Thomas University Group Case Study Patient Condition Presentation Conception in The 21st Century Discussion April 5, 2024/0 Comments/in Health Medical /by bonniejecinta Description Choice two of the following ” What do you think ” statements and write one page of each of them. What Do You Think?Conception in the 21st century More than 30 years ago, Louise Brown captured the world’s attention as the first testtube baby—conceived in a petri dish instead of in her mother’s body. Today, assisted reproductive technology is no longer experimental; it is used more than 160,000 times annually with American women, producing more than 60,000 babies (Centers for Disease Control and Prevention, 2013). Many new techniques are available to couples who cannot conceive a child through sexual intercourse. The best-known technique, in vitro fertilization, involves mixing sperm and egg in a petri dish and then placing several fertilized eggs in the mother’s uterus, with the hope that they become implanted in the uterine wall. Other methods include injecting many sperm directly into the fallopian tubes or a single sperm directly into an egg. means that a baby could have as many as five “parents”: the man and woman who provided the sperm and egg; the surrogate mother who carried the baby; and the mother and father who rear the baby. New reproductive techniques offer hope for couples who have long wanted a child but have been unable to conceive, and studies of the first generation of children conceived via these techniques indicates that their social and emotional development is normal (Golombok, 2013). But there are difficulties as well. Only about one third of attempts at in vitro fertilization succeed. What’s The sperm and egg usually come from the prospective parents, but sometimes they are provided by donors. Typically, the fertilized eggs are placed in the uterus of the prospective mother, but sometimes they are placed in the uterus of a surrogate mother who carries the baby to term. This more, when a woman becomes pregnant, she is more likely to have twins or triplets because multiple eggs are transferred to increase the odds that at least one fertilized egg will implant in the mother’s uterus. (An extreme example of this is “Octomom,” a woman who had octuplets following in vitro fertilization.) She is also at greater risk for giving birth to a baby with low birth weight or birth defects. Finally, the procedure is expensive—the average cost in the United States of a single cycle of treatment is between $10,000 and $15,000—and often is not covered by health insurance. These problems emphasize that although technology has increased the alternatives for infertile couples, pregnancy on demand is still in the realm of science fiction. At the same time, the new technologies have led to much controversy because of complex ethical issues associated with their use. One concerns the prospective parents’ right to select particular egg and sperm cells; another involves who should be able to use this technology. Pick your egg and sperm cells from a catalog? Until recently, prospective parents have known nothing about egg and sperm donors. Today, however, they are sometimes able to select egg and sperm based on physical and psychological characteristics of the donors, including appearance and race. Some claim that such prospective parents have a right to be fully informed about the person who provides the genetic material for their baby. Others argue that this amounts to eugenics, which is the effort to improve the human species by allowing only certain people to mate and pass along their genes. Available to all? Most couples who use in vitro fertilization are in their thirties and forties, but many older women have begun to use the technology. Some of these women cannot conceive naturally because they have gone through menopause and no longer ovulate. Some argue that it is unfair for a child to have parents who may not live until the child reaches adulthood. Others point out that people are living longer and that middle-aged (or older) adults make better parents. (We discuss this issue in more depth in Chapter 13.) What do you think? Should prospective parents be allowed to browse a catalog with photos and biographies of prospective donors? Should new reproductive technologies be available to all, regardless of age? What Do You Think?When juveniles commit serious crimes should they be tried as adults? Traditionally, when adolescents under 18 commit crimes, the case is handled in the juvenile justice system. Although procedures vary from state to state, most adolescents who are arrested do not go to court; instead, law enforcement and legal authorities have considerable discretionary power. They may, for example, release arrested adolescents into the custody of their parents. However, when adolescents commit serious or violent crimes, there will be a hearing with a judge. This hearing is closed to the press and public; no jury is involved. Instead, the judge receives reports from police, probation officers, school officials, medical authorities, and other interested parties. Adolescents judged guilty can be placed on probation at home, in foster care outside the home, or in a facility for youth offenders. Because juveniles are committing more serious crimes, many law enforcement and legal authorities believe that juveniles should be tried as adults. Advocates of this position argue for lowering the minimum age for mandatory transfer of a case to adult courts, increasing the range of offenses that must be tried in adult court, and giving prosecutors more authority to file cases with juveniles in adult criminal court. Critics argue that treating juvenile offenders as adults ignores the fact that juveniles are less able than adults to understand the nature and consequences of committing a crime. Also, they argue, punishments appropriate for adults are inappropriate for juveniles (Steinberg et al., 2009). What do you think? Should we lower the age at which juveniles are tried as adults? Based on the theories of development we discussed, what guidelines would you propose in deciding when a juvenile should be tried as an adult? What Do You Think? Does marriage education work? The Healthy Marriage Initiative really focused a great deal of attention on ways to lower the divorce rate (Fincham & Beach, 2010). One approach endorsed by many groups, called marriage education, is based on the idea that the more couples are prepared for marriage, the better the relationship will survive over the long run. More than 40 states have initiated some type of education program. Do they work? Most education programs focus on communication between the couple; the programs provide general advice, not specific ways to deal with a couple’s issues. Because only a minority of couples currently attend a marriage education program, there is plenty of room for improvement. Several religious denominations have their own version of marriage education programs; the Catholic’s Pre-Cana program is one example. There are numerous challenges to more extensive community-based marriage education programs. For example, in some cases, the education programs were originally developed to address poverty (Administration for Children and Families, 2010). Many couples cohabit and are less likely to attend marriage education programs even though there is little evidence that cohabitation improves communication skills between the couple (Fincham & Beach, 2010). As a result, versions of marriage education programs are being adapted for younger adults (who, if they marry while young, have a much higher risk for divorce) and for single adults (to teach them about communication skills). In addition, programs timed at key transition points (e.g., engagement) have also been developed (Halford, Markman, & Stanley, 2008). Rather than intervene with couples before they marry, some programs target already-married couples (O’Halloran et al., 2013). One of the best known of these programs is Worldwide Marriage Encounter. Research to date shows that these skills-based education programs have modest but consistently positive effects on marital quality and communication (Cowan, Cowan, & Knox, 2010; O’Halloran et al., 2013). Perhaps not surprisingly, couples who report more problems at the beginning of the program appear to benefit most. These positive outcomes are resulting in a broadening of the approaches used by marriage educators to topics beyond communication. How these programs develop and whether more couples will participate remain to be seen. What does appear to be the case is that if couples agree to participate in a marriage education program, they may lower their risk for problems later on. What do you think? Would you be willing to participate in a marriage education program? What Do You Think? Do women lean out when they should lean in? Sheryl Sandberg is unquestionably successful. She has held some of the most important, powerful positions in some of the most recognizable technology companies in the world. When she published her book Lean In: Women, Work, and the Will to Lead in 2013, she set off a fierce debate. Sandberg claimed that there is discrimination against women in the corporate word. But she also argued that an important reason women do not rise to the top more often is due to their unintentional behavior that holds them back. She claimed that women do not speak up enough, need to abandon the myth of “having it all,” must set boundaries, need to get a mentor, and must not “check out of work” when thinking about starting a family. The national debate around these topics raised many issues: Sandberg’s ability to afford to pay for support may make her points irrelevant for women who do not have those resources; her husband’s ability and willingness to share in child rearing and household chores may make her arguments irrelevant for single parents; she was “blaming the victim”; no one ever puts men in these situations of having to choose; and so on. Does Ms. Sandberg have a valid point to make? Do men and women differ in how they approach careers? Are the differences she notes inherent in men and women, or are they learned? What support systems that are currently missing need to be put in place? What do you think? What Do You Think? How long would you want to live? We have considered evidence that average longevity has increased significantly over the past century. This means that there have never been as many older adults alive at one time than there are right now, and this will only increase during the next several decades at least. Getting older brings with it many positives (in terms of experience, well-being, and other things people enjoy in life) and negatives (especially biological and physical changes, as we will see). This raises an important question for current generations: How long do you want to live? What, for you, would be the optimal length of life? For some people, the optimal length of life is the number of years they can continue to live independently and well. For others, it’s as long as their life has meaning. What is it for you? What are the things that help you define your answer? What do you think? What Do You Think? Reforming Social Security and Medicare Few political issues have been around as long and are as politically sensitive as those that concern making Social Security and Medicare fiscally sound for the long term. The basic issues have been well known for decades: The present method for raising and distributing revenues in Social Security and Medicare are not sustainable (Social Security and Medicare Boards of Trustees, 2013). Because Social Security and Medicare are based on current workers paying a tax to support current retirees, the looming funding problems depend critically on the worker-to- retiree ratio. This declining ratio places an increasing financial burden on workers to provide the level of benefits to retirees that people have come to expect. Because of this declining ratio, unless major structural changes are made, the Social Security and Medicare systems are headed toward bankruptcy in the foreseeable future, requiring significant reductions in benefits to match expenditures with revenues (Social Security and Medicare Board of Trustees, 2013). So it’s no wonder that young and middle-aged adults have little faith that Social Security or Medicare will be there for them. Potential solutions to these problems differ. Because Social Security is essentially an income assurance program, there appear to be more options with it. Among the possibilities proposed over the years are: Privatization: Various proposals have been made for allowing or requiring workers to invest at least part of their money in personal retirement accounts managed by either the federal government or private investment companies. Another option would be to allow individuals to create personal accounts with a portion of the funds paid in payroll taxes. Means-test benefits: This proposal would reduce or eliminate benefits to people with high incomes. • Increase the number of years used to compute the benefit: Currently, benefits are based on one’s history of contributions over a 35-year period. This proposal would increase that period to perhaps 40 years. Increase the retirement age: The age of eligibility for full Social Security benefits is increasing slowly to age 67 in 2027. Various proposals have been made to speed up the increase, to increase the age to 70, or to connect the age at which a person becomes fully eligible to average longevity statistics. Adjust cost-of-living increases downward: Some proposals have been made to lower those increases given to beneficiaries that result from increases in the cost of living. Increase the payroll tax rate: One direct way to address the coming funding shortfall is to increase revenues through a higher tax rate. Increase the earnings cap for payroll tax purposes: This proposal would either raise or remove the cap on income subject to the Social Security payroll tax (the maximum taxable earnings for Social Security was $117,000 in 2014). Make across-the-board reductions in Social Security pension benefits: A reduction in benefits of 3% to 5% would resolve most of the funding problem. None of these proposals for Social Security has universal support. Many proposed solutions would significantly disadvantage certain people—especially minorities and older widows—who depend almost entirely on Social Security for their retirement income (Polivka, 2010). Nevertheless, a range of options continues to be discussed. In contrast, fixing Medicare is more difficult (Davis, 2013). As a health care entitlement program, Medicare must pay for all medically necessary covered benefits for enrollees; except for constraints placed on the program by the health insurance financing mechanism, there are no limits on overall Medicare spending. That leaves the only viable approaches based on (1) further restructuring of the health care system to manage costs better, (2) restructuring of the funding mechanisms including both the Medicare taxes on wages and the premiums and co-pays, or (3) some combination of both. Solving the funding problems facing Social Security and Medicare will become increasingly important in the next few years. What do you think should be done to stabilize them? What Do You Think? The Marlise Munoz case On November 26, 2013, Erick Muñoz, a firefighter in a town near Dallas, came home to find his wife, 33-year-old Marlise, lying on the kitchen floor after experiencing a blood clot in her lungs. She was rushed to John Peter Hospital in Fort Worth, where she arrived alive but not breathing. Within two days, she was declared brain dead. She had made it clear that she did not wish to be left on life support; so her husband and parents informed the physicians in the intensive care unit of their desire to act on those views and asked the physicians to disconnect her from the machine. The physicians refused. Why? Marlise was 14 weeks pregnant, and the physicians believed that a Texas law prohibiting the removal of life support from a pregnant patient trumped the patient’s and family’s clear wishes. What followed was a legal battle pitting an individual’s and her family’s wishes not to have life prolonged by machine in the case of brain death and the belief that Texas law makes those desires irrelevant in certain cases, essentially requiring that such patients be kept alive on machines. At the core of the debate was the law, initially passed in 1989 and amended in 1999, that states that a person may not withdraw or withhold “life-sustaining treatment” from a pregnant patient. People agreed that the law was aimed at situations in which the pregnant woman was in a coma or persistent vegetative state and “alive” under the laws pertaining to the definition of death. At issue was whether the law also applied to women who were declared brain dead. The hospital decided that it did; Marlise’s family argued that it did not. Laws such as the one in Texas are common; at least 31 states have laws restricting the ability of physicians to terminate life support for terminally ill pregnant women, irrespective of what those women or their families want. The Texas law requires that life support be maintained no matter how far into the pregnancy the woman is. Marlise’s case raised several issues for medical ethicists. Many pointed out that if she is brain dead, then she cannot be a patient, and physicians cannot be compelled to treat a deceased person. Others pointed out that because Marlise was dead and the fetus had not reached the point of being viable outside the womb, then there was no hope for the fetus. Still others argued that even if the chances for the fetus to survive to viability were remote, the fetus’s rights to that chance supersede the dead mother’s and her family’s. On January 24, 2014, Texas state judge R. H. Wallace, Jr., ruled that Marlise, by then 22 weeks pregnant, could be disconnected from life support. The judge agreed with the family’s argument that the hospital had erred in its application of the Texas law. Medical records also indicated that the fetus was “distinctly abnormal” and suffered from hydrocephalus (an accumulation of fluid in the brain) as well as a likely cardiac problem. Because the hospital decided not to appeal the ruling, Marlise was taken off the machine on January 26. Marlise’s case raises numerous issues about the rights of individual patients, their families, and the unborn. Whose rights are more important? What happens if there is a conflict? Can a state overrule end-of-life decisions that reflect deep personal and religious convictions? How do medical personnel respond if they are required to keep all pregnant women on life support? Are there public obligations to cover the medical expenses in such cases? What do you think? Should Marlise Muñoz have been removed from life support? https://readyassignments.com/wp-content/uploads/2024/02/New-Project15.png 0 0 bonniejecinta https://readyassignments.com/wp-content/uploads/2024/02/New-Project15.png bonniejecinta2024-04-05 16:48:422024-04-05 16:48:42Conception in The 21st Century Discussion Bowie State University Nursing Treating Patients with Sleep Question April 5, 2024/0 Comments/in Health Medical /by bonniejecinta Description Assignment 2: Assessing and Treating Patients With Sleep/Wake Disorders Sleep disorders are conditions that result in changes in an individual’s pattern of sleep (Mayo Clinic, 2020). Not surprisingly, a sleep disorder can affect an individual’s overall health, safety, and quality of life. Psychiatric nurse practitioners can treat sleep disorders with psychopharmacologic treatments, however, many of these drugs can have negative effects on other aspects of a patient’s health and well-being. Additionally, while psychopharmacologic treatments may be able to address issues with sleep, they can also exert potential challenges with waking patterns. Thus, it is important for the psychiatric nurse practitioner to carefully evaluate the best psychopharmacologic treatments for patients that present with sleep/wake disorders. Reference: Mayo Clinic. (2020). Sleep disorders. https://www.mayoclinic.org/diseases-conditions/sle… To prepare for this Assignment: Review this week’s Learning Resources, including the Medication Resources indicated for this week. Reflect on the psychopharmacologic treatments you might recommend for the assessment and treatment of patients with sleep/wake disorders. The Assignment: 5 pages Examine Case Study: Pharmacologic Approaches to the Treatment of Insomnia in a Younger Adult. https://cdn-media.waldenu.edu/2dett4d/Walden/NURS/… will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes. At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature. Introduction to the case (1 page) Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient. Decision #1 (1 page) Which decision did you select? Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature). Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples. Decision #2 (1 page) Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature). Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples. Decision #3 (1 page) Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature). Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples. Conclusion (1 page) Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature. The Decision Tree Assignments are based on interactive case studies that allow you to explore pharmaceutical options and make decisions centered on the client’s needs.   You will be asked to make three decisions concerning the medication to prescribe to a client in the assigned scenarios.  At each decision point, you must evaluate all options before selecting your decision and moving through the rest of the exercise. The rationale for your decisions must be supported with a minimum of five academic resources from the primary and secondary literature. While you may use the course text to support your rationale, it will not count toward the resource requirement. Your 5-paper will be written on the interactive case study entitled, Pharmacologic Approaches to the Treatment of Insomnia in a Younger Adult.  This case can be found in the week 8 folder under the Resources tab. https://cdn-media.waldenu.edu/2dett4d/Walden/NURS/…Click on Required Media to expand the case. If your first draft is more than 5 pages, you should consolidate your writing.  In my experience, papers greater than 5 pages in length are repetitive and/or contain extraneous information that is not part of the required content.  Part of this exercise is to learn how to sift through the literature and extract the pertinent information.  Failure to do so may result in point deductions for issues with clarity.  The final draft that you submit must follow the format endorsed by the nursing program, and this paper must address the required content outlined in the grading rubric and instructions.  The required format is illustrated in the writing template.  The writing template and grading rubric can all be found under the Assignment tab in the week 8 folder.  The formal instructions, my notes on grading, and the late policy are shown below: Assignment #2:  Decision Tree Introduction to the case (1 page) You must briefly summarize the case. You must also highlight the specific patient factors that will impact your decision making when prescribing medication for this patient.  Please note that background information on the diagnosis, diagnostic criteria, or diagnostic testing is NOT required.  It is assumed that you know this; therefore, you should devote yourself to summarizing the case and highlighting specific patient factors that will impact your decisions rather than discussing the aforementioned items.  After all, you only have one page (or less) to cover the required information.   Be aware that the writing template and grading rubric require your introduction to end with ONE sentence that is your thesis statement.  See the writing template for format and the grading rubric for details on how you are graded on this statement. Body of your document The body of your document should contain three sections that are labeled as follows:  decision #1, decision #2, and decision #3.  Each section should address the topics below.  In your writing, you should be concise, clear, and thorough.  Pharmacokinetics, pharmacodynamics, and specific patient factors must be considered in your writing in order to get full credit.  Decision #1 (1 page) Which decision did you select? Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature). Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples. *In order to receive full credit here, your ethical considerations must be clearly identified as such.  You can identify them in one of two ways:  (1)  You can identify them within each section.  For example, “My ethical considerations are .”  (2)  Or you can identify them separately in a new section labeled “Ethical Considerations.”  This new section should be inserted after the section entitled Decision #3 and before the Conclusion section.  Either one of these options is acceptable. Decision #2 (1 page) Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature). Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.  *See Decision #1 for more information. Decision #3 (1 page) Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature). Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.  *See Decision #1 for more information. Conclusion (1 page) Summarize your recommendations on the treatment options you selected for this patient. As stated in the writing template, “The conclusion section should recap the major points of your paper. Do not introduce new information in this paragraph.” Required Readings (click to expand/reduce)American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596 Fernandez-Mendoza, J., & Vgontzas, A. N. (2013). Insomnia and its impact on physical and mental health. Current Psychiatry Reports, 15(12), 418. https://doi.org/10.1007/s11920-012-0418-8 Levenson, J. C., Kay, D. B., & Buysse, D. J. (2015). The pathophysiology of insomnia. Chest, 147(4), 1179–1192. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC43881… Morgenthaler, T. I., Kapur, V. K., Brown, T. M., Swick, T. J., Alessi, C., Aurora, R. N., Boehlecke, B., Chesson, A. L., Friedman, L., Maganti, R., Owens, J., Pancer, J., & Zak, R. (2007). Practice parameters for the treatment of narcolepsy and other hypersomnias of central origin. SLEEP, 30(12), 1705–1711. https://j2vjt3dnbra3ps7ll1clb4q2-wpengine.netdna-s… Morgenthaler, T. I., Owens, J., Alessi, C., Boehlecke, B, Brown, T. M., Coleman, J., Friedman, L., Kapur, V. K., Lee-Chiong, T., Pancer, J., & Swick, T. J. (2006). Practice parameters for behavioral treatment of bedtime problems and night wakings in infants and young children. SLEEP, 29(1), 1277–1281. https://j2vjt3dnbra3ps7ll1clb4q2-wpengine.netdna-s… Sateia, M. J., Buysse, D. J., Krystal, A. D., Neubauer, D. N., & Heald, J. L. (2017). Clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults: An American Academy of Sleep Medicine clinical practice guideline. Journal of Clinical Sleep Medicine, 13(2), 307–349. https://jcsm.aasm.org/doi/pdf/10.5664/jcsm.6470 Winkleman, J. W. (2015). Insomnia disorder. The New England Journal of Medicine, 373(15), 1437–1444. https://doi.org/10.1056/NEJMcp1412740Medication Resources (click to expand/reduce)U.S. Food & Drug Administration. (n.d.). Drugs@FDA: FDA-approved drugs. https://www.accessdata.fda.gov/scripts/cder/daf/in… Note: To access the following medications, use the Drugs@FDA resource. Type the name of each medication in the keyword search bar. Select the hyperlink related to the medication name you searched. Review the supplements provided and select the package label resource file associated with the medication you searched. If a label is not available, you may need to conduct a general search outside of this resource provided. Be sure to review the label information for each medication as this information will be helpful for your review in preparation for your Assignments. alprazolam amitriptyline amoxapine amphetamine desipramine diazepam doxepin eszopiclone flunitrazepam flurazepam hydroxyzine imipramine lemborexant lorazepam melatonin methylphenedate modafinil armodafinil carnitine clomipramine clonazepam nortriptyline pitolisant ramelteon sodium oxybate solriamfetol SSRI’s temazepam trazodone triazolam trimipramine wellbutrin zaleplon zolpidem https://readyassignments.com/wp-content/uploads/2024/02/New-Project15.png 0 0 bonniejecinta https://readyassignments.com/wp-content/uploads/2024/02/New-Project15.png bonniejecinta2024-04-05 16:47:572024-04-05 16:47:57Bowie State University Nursing Treating Patients with Sleep Question ENS 331 San Diego State University Fuelling Optimally Essay April 5, 2024/0 Comments/in Health Medical /by bonniejecinta Description In 400 words or more: Based on the lecture and reading, which pyramid is more reflective of your current intake? Which pyramid would fit your lifestyle and nutritional needs better? Of all the nutrients, vitamins and minerals listed in the chapter, where is there a deficit in your intake? What specific foods could provide what you need? Chapter Six — Fuelling Optimally Objectives 1) Identify Macro vs micro nutrients Macro: Protein, Carbohydrate, Fats Micro: Vitamins, Minerals, Fluids 2) Analyze 2 different food pyramids Do you eat to live or live to eat? Our ancestors, to survive had to not only find a food supply, which required physical exertion, but learn how to store that energy in the form of fat. For the majority of Americans, food supply is not an issue, but excess storage of energy is! Our food supply is increasingly tantalizing us with fast food, ordering in, eating out, with most portions suited for 2-3 persons, not one. Couple this sea change in eating habits with sedentariness, and we don’t have to wonder why obesity is an epidemic, contributing to numerous diseases. How many of us burn calories at work? How about after work? Is our leisure time in front of a screen or phone? Most of us did not grow up walking to school. Most people don’t walk or engage in vigorous activity. This combination of more energy in and less energy out has created a desperate need for educating ourselves. Nutrients: The saying goes “If you eat like a slug, you act like one”. Conversely,If you fuel like an athlete at least you have the potential to act like one. If we were eating nutrient dense food, would we overeat as much? Are people getting fat eating beans and rice, or too much fruit? The answer is no., because nutritious food satiates our gut and our brain.l Nutrients can be broken down into six categories: Protein, carbohydrate, fats, vitamins, minerals and water. Protein carbohydrate and fats are macro nutrients because they make up the bulk of our diet. Vitamins and minerals are micronutrients, we need them in small amounts on a daily basis. As for water, the body needs a generous supply of it to thrive. Protein: Protein is made up of amino acids which are the building blocks for our cell walls, muscle tissue, hormones and enzymes. These nine amino acids make up a complete protein, such as meat, eggs, dairy, chicken, seafood (anything with a head on it). Fruits, grains and vegetables (with the exception of soy) are incomplete proteins. Animal protein is a better source of essential amino acids (as well as iron and vitamin B12, however those on a vegetarian diet can combine grains, beans and leafy vegetables to get the complete protein they need. Training builds proteins, another benefit of training! Aerobic training builds aerobic enzyme proteins that produce energy, and strength training builds contractile proteins for strength. To accomplish this at least 15 percent of your daily caloric intake should be protein. There’s always debate among coaches as to how much protein their athletes need, especially those in endurance sports or strength and conditioning. Existing studies support a dietary intake of 1.2 to 1.6 grams of protein per kilogram of body weight for endurance athletes, and for strength athletes, 1.6 to 1.8 grams per kilogram of body weight (American College of Sports Medicine, 2000, Lemon, 1995). Carbohydrate: Referred to as “carbs” they often are associated with the high caloric snack foods we shovel down. These are generally simple carbohydrate, but there is complex carbohydrate and fiber, which are essential for providing fuel for the body and brain food. Carbohydrate provides energy and is first to be burned off when you expend energy. Throughout the world, the major source of energy for most cultures is beans, rice and grains. We need these complex carbohydrates in their most whole form. When we strip grain of its bran and germ and then “enrich” it with vitamins, we’re getting a facsimile of a whole grain, void of the nutrients and fiber. The more “enriched”, the less fiber, the less happy your digestive system will be. Read your labels! A guideline for cereal is at least 5 grams of fiber and less than 5 grams of sugar. Very few cereals are low sugar, which is why steel cut oats is a great breakfast. Sweeten with fruit whenever possible. Simple sugars, like sucrose and fructose contain energy but no nutrients (i.e. vitamins and minerals). Fresh fruit contains simple sugars, but it also provides important nutrients. Studies show America is not getting fat on complex carbs like whole grains, beans and brown rice, but on bottled fruit juices and refined carbohydrate. Recalibrate your palate by letting the unadulterated sweetness of fruit sweeten your smoothies, your yogurt, your mineral water, and be your dessert! Fat: This macronutrient is so often misunderstood, however it is an absolutely essential nutrient in a healthy diet and too little is a bad thing. Fat is the most efficient way to store energy with 9.4 calories per gram, versus 4.1 and 4.3 calories for carbohydrate and protein. Besides storing energy, it transports and helps us absorb vitamins A, D, E and K, conducts nerve impulses, and cushions vital organs. It makes up a large portion of bone marrow and brain tissue It makes food taste better, and when food is more satiating, we crave less sugar and simply eat less. Our small intestine breaks down fat and distributes it to cells for energy or to adipose tissue (the layer of fat beneath your skin) for storage. As we know there was a time in human history where we needed this fat storage for survival–however unless you’re dealing with semi starvation as one of the last Alaska Survivors in the series Alone, most of us aren’t tapping into our fat stores for survival. It isn’t just fat that converts to fat, excess carbs and protein gets converted to fat and stored in adipose tissue. Fat is essential yet is it all created equal? The three primary fatty acids are saturated, monounsaturated and polyunsaturated. These fatty acid chains reflect how many hydrogen molecules they have and how they break down in your body. Saturated fats are found in meat and dairy. Olive oil is considered mono unsaturated and margarine, polyunsaturated. Better to have olive oil or butter than margarine which is processed with hydrogenation. Read your labels! Hydrogenation creates trans fatty acids and are found in many snack foods, extending their shelf life. Avoid these! The healthiest fats you can consume come from salmon (omega 3s and 6s), sardines, nuts, seeds, avocado. This is their whole food form and includes all the nutrients, phytochemicals and fiber as well as the fat. Roughly 25 percent of your daily calories should come from fat. But again, quality is critical! We need to eat more nutrient rich foods, fewer calorie rich foods. The body has an amazing healing and protective ability when we consume the most nutrient dense foods. When we consume foods completely devoid of nutrients like sugar, fake sweeteners, processed foods, hydrogenated oils and most fast foods, we set up our immune system for illness. Our ability to fight off a virus once we’ve been exposed is directly affected by the quality of our diet prior to being exposed. Again, poor nutrition not only makes us more susceptible to illness, but impacts the length and severity of the illness. Micro nutrients: Vitamins and minerals are essential for life however they are needed in very small doses. The small amount of vitamins and minerals needed is readily available in a well balanced, nutrient dense diet. As mentioned earlier, fat soluble vitamins like A, D E and K are absorbed with fats in the diet. An excess of water soluble vitamins like B complex and C are flushed away in the urine. As you look at the table below, notice the food sources giving you the vitamins your body needs. Minerals have an important supporting role in our health and maintain the body’s enzyme and cellular activity, some hormones, bones, muscle and nerve activity, and acid base balance. Minerals are available in many food sources but concentrations are higher in animal tissues and products. Do you need to take a vitamin or mineral supplement? Ideally, if you are eating nutrient dense macro nutrients, you will be getting the micro nutrients you need. If one is training hard, while losing weight, it’s possible supplementation might be important. Look at the chart below and the foods giving you the minerals you need. The goal is not to erase all “fun” food from your diet, but to include more nutritional bang for your calorie buck by filling up on this first! Hydration: Interestingly water contains no energy or vitamins, just trace amounts of minerals, yet water is the most important nutrient in the body. Making up more than half the body’s weight, water is essential for the absorption of vitamins and minerals in food. Water transports energy, gases, waste products, hormones, antibodies, and heat. It maintains the acid-base balance in the blood. Water regulates your temperature through perspiration, and lubricates surfaces and membranes. Water awareness has risen considerably over the past decades. Most likely you were sent off to school as a child with a water bottle in your backpack. As for bottled water? A study by a consumer advocacy group found that of the 1,000 bottles and 103 brands tested in the U.S., about one-third were contaminated with bacteria, arsenic or synthetic organic chemicals and at least one-fourth were drawn directly from the tap (Natural Resources Defense Council, 1999). The Food and Drug Administration (FDA) concluded that bottled water, on average was not safer or more pure than regular tap water. In spite of this 1 in 15 American households spends between 250 and 10,000 times more for water by choosing to purchase bottled water (U.S. FDA, 1999). If you want to test your tap water, get a filtration kit and have it tested. If you want better tasting water, a reverse osmosis system is recommended, or for a lot less money a Brita filtration system that you refill daily. Satisfy your thirst with water How much is enough? A general rule of thumb is dividing your body weight in pounds by two, and drinking that number in ounces of water per day. So a 150 pound person would drink 75 ounces of water a day. Know how many water bottle refills that is for you. An excellent habit is to rehydrate yourself first thing every morning with a glass of water, before consuming anything else. If working out in hot weather or simply sweating a lot, you’ll need considerably more water. Another simple indication you are hydrating enough is urinating frequently with pale yellow urine. Nutrient Density: High sugar, low nutrient foods give us empty calories. High nutrients relative to the calories or energy that is provided are said to have packed calories. Take note of this when it comes to drinking your calories. Sodas–empty calories! Diet sodas– empty nutrition, and worse, the fake sugars distort the flavor of sweetness on your palate, so that a naturally sweet food like a piece of fruit is not as appreciated. Elevate your palate by eliminating fake sugar. This includes stevia, monk fruit, xylitol, all of it! Better to sweeten some ice tea or mineral water with a little fruit juice; or a protein smoothie with fruit: you can gradually ratchet down your palates propensity for sweetness. Summing up with food pyramids: Take a look at the following two food pyramids and how they compare or contrast. MyPlate is the recommendation from the U.S Department of Agriculture and US Dept of Health and Human Services. Notice the size of the quadrants on this plate. The idea is to add more vegetables, fruits, whole grains and pure dairy, while giving lean protein a supporting role. No one food pyramid will represent all Nutrition Counselors recommendations. https://readyassignments.com/wp-content/uploads/2024/02/New-Project15.png 0 0 bonniejecinta https://readyassignments.com/wp-content/uploads/2024/02/New-Project15.png bonniejecinta2024-04-05 16:47:572024-04-05 16:47:57ENS 331 San Diego State University Fuelling Optimally Essay Ohio State University Medical Center Nursing Essay April 5, 2024/0 Comments/in Health Medical /by bonniejecinta Description Write a book review for “Cutting for Stone by Abraham Varghese” using the book review resources and outline in the “PowerPoints, Readings and Videos” folder for this week’s module. At a minimum you will want to provide a summary and a critical evaluation of the book. Use the resources provided in this module to select the areas/or questions you want to address and then develop your outline prior to writing the review. The summary should not be the major part of the review but does need to establish the background for the book and identify the author’s thesis (purpose) for writing the book. The critical evaluation should include your thoughts, reactions and responses to the book. This should include your evaluation of how well the author met or did not meet the thesis of the book and your evaluation of selected elements of the book. You do not have to write about every event or character in the book. However, you will want to make a connection in your book review to the Global Health themes that we’ve discussed throughout the course Minimum number of words for this assignment is 1,500 single spaced. Less than 1500 will have point deductions, more is acceptable Use APA style for both in text citation and in the reference section Cite all sources of information or data used in your review that are not your own If you quote from the book under review, simply follow the quotation with the page number(s) in parentheses. For example: The author argues that “American women seem to have preferred careers over parenting” (p. 345). Quotes that go over three lines in length should be single-spaced in a “block quote” format with the page citation at the end of the block quote. If you have to cite other sources for quotations or facts, use APA citation style. Reviews should be written in a formal manner. As with other written assignments, be sure to avoid using colloquialisms (“a lot” or “etc.”), contractions (“cannot” instead of “can’t”) and avoid using the first person (I, you, we, us). Include references at the end of your report – especially the main book being reviewed. https://www.newyorker.com/magazine/2010/08/02/lett… https://www.nytimes.com/2016/02/07/magazine/should-a-man-have-told-his-mother-in-law-that-she-was-dying.html?_r=1 http://www.pbs.org/wgbh/frontline/film/being-mortal/ QUESTION 2 Response Post Read one of your peer’s arguments for or against the “Claim” and provide a brief critique of their argument. Is their argument for against the claim clear and understandable? Why or why not? Do they show a clear understanding of the metaphors they selected and do the metaphors they selected provide appropriate support to their argument? Why or why not? The minimum number of words for the response is 200. Amber Bates Metaphors and other figures of speech are critical and important in explaining or describing an illness or disease. COLLAPSE Top of Form Are metaphors and other figures of speech critical and important in explaining or describing an illness or disease? I think in most situations they are. Metaphors are used to help describe a situation in a more people friendly way (Napolitano,2019). A metaphor can also help a patient relate to the disease or condition in a way that is relatable to most people. Medical conditions and disease process can be quite extensive. The information is not easy for anyone to just pick up and understand. In the book, Illness as a Metaphor getting cancer is described as a scandal to one’s life, and that the patient is “invaded” by alien cells (Sontag, 1978). Cancer is at the very core an abnormal growth of cells that invade healthy cells. Describing cancer as an invasion of the body from alien cells can help a patient relate to what is occurring. Some examples of how metaphors can help people understand a complex medical subject are found in the book Cutting For Stone. In the Chapter “The Missing Finger” the author uses this metaphor, “The orange dye transformed the digits into an oversized lollipop” ( Verghese, 2016 pg 26). The metaphor creates a picture even for the non-medical professional of what it looks like when antiseptic is used. Normally you would only picture this if you had worked in an operating room prior to reading this story. The author gives a metaphor that everyone, including non-medical people, can visualize creating a better understanding of the situation. Another metaphor Found in Chapter nine, “More Blood! For God’s sake pour it in” ( Verghese,2016 pg116) . This metaphor immediately provides an image of blood needing to be poured in, like a pitcher pouring water into a cup. This allows the reader to understand the severity and importance the blood plays in the situation. Importance and understanding are the exact reasons we use metaphors to help educate our patients in healthcare. In my own career I use metaphors to help a patient visualize what is occurring in their body. I feel the better a patient understands, relates, and connects to the illness the more compliant they are. For example, when I am dealing with a patient who has or is newly diagnosed with diabetes, I often describe what is happening in their blood stream using a visual of a straw and thick sugar water. Many patients with diabetes do not fully understand that elevated blood sugars can affect any organ in the body that blood touches. I once had a diabetic who had visual troubles related to prolonged uncontrolled diabetes. They did not understand how their vision was harmed because they had high blood sugar. I explained, like thick sugar water can become slow and sluggish in a narrow straw clogging at the smallest meeting point, the same is for your blood vessels and elevated sugar. I would ask them to picture adding more and more sugar to a small amount of water. What happens over time the water is sludge and easily can clog an opening like a straw. It is harder to suck the water because it has become so thick. The same thing occurs in the tiniest blood vessels in diabetes. They eye, kidney, heart, and feet are damaged because they have smaller blood vessels it becomes harder for them to suck the oxygen and nutrients needed from the blood for function. Explaining the disease process in a way that anyone can see and relate to makes it easier to understand. Diabetics are also more at risk for infections, my metaphor for this is because bugs like sugar. When a patient can visualize that their elevated sugar is actual creating the food for the virus or bacteria, they are more likely to be complaint and better at managing their disease because who wants to have bug food? Educating our patients in a way they understand is providing great care. I think all healthcare providers know the more educated our patients are the better the outcomes. Now there are always outliers to any plan. Although I feel that metaphors are critical and important for education and better outcomes, some diseases do not allow for this process. An example of this is autism. Many autistic patients take everything very literally, so a practitioner must be acutely aware of how they explain and discuss things to them. Like the metaphor in Illness as a metaphor, “In cancer the patient is “invaded” by alien cells” (Sontag, 1978). The autistic patient might think an alien is coming to invade their body. In this situation it would not be helpful to our patients. As health care professionals we need to be aware of the type of patient we are educating and talking to when we decide to use metaphors. Health care is never a one sided plan works for everyone. It is knowing your patient and being able to adaptively use different communication skills to serve the one you are caring for. While I do think in most situations’ metaphors are a great tool to help increase a patient understanding of the disease process, I recognize that not always is it the tool required, such as in autism. References Napolitano, S. (2019, February 28). Metaphors in healthcare: To better comprehend and to improve awareness. MedicinaNarrativa.eu. Retrieved April 14, 2022, from https://www.medicinanarrativa.eu/metaphors-in-heal… Sontag, S. (n.d.). illness as metaphor. Sontag, S. (1978) illness as metaphor. McGraw-Hill Ryerson Ltd., Toronto. – references – scientific research publishing. Retrieved April 14, 2022, from https://www.scirp.org/(S(351jmbntvnsjt1aadkozje))/… Verghese, A. (2016). Cutting for stone: A novel. Alfred A. Knopf Bottom of Form https://readyassignments.com/wp-content/uploads/2024/02/New-Project15.png 0 0 bonniejecinta https://readyassignments.com/wp-content/uploads/2024/02/New-Project15.png bonniejecinta2024-04-05 16:47:132024-04-05 16:47:13Ohio State University Medical Center Nursing Essay OSU Medical Center Presentation April 5, 2024/0 Comments/in Health Medical /by bonniejecinta Description Overview You will create a short Power Point presentation teaching your audience how to put into practice the fundamental principles that influence transcultural interaction and communication. You will develop a 4-slide presentation, a title slide, presentation slides with narrative notes and a reference slide. Review the information below prior to starting your PowerPoint presentation. Scenario: Everyone entering a healthcare system should obtain evidence-based care that is culturally and linguistically appropriate. The U.S. Department of Health and Human Services’ Office of Minority Health developed the Culturally and Linguistically Appropriate Services Standards (CLAS Standards) to improve quality, advance health equity and help eliminate health care disparities (Andrews et al., 2020). Utilizing 4 (2 from Communication and Language Assistance and 2 from other area of standards) of the National CLAS Standards, in your own words, build a 4 slide presentation teaching your peers how to address the standards at your work place. The PowerPoint?presentation should be in APA format and include: Title slide (include your name and section number) and brief introduction of project (1 slide – No narrative notes) 4 total CLAS Standards (2 slides – Narrative notes in APA format with APA formatted citations) Select 2 of the 4 Communication and Language Assistance Standards Select 2 of any other standards from: Governance, Leadership, and Workforce, or Engagement, Continuous Improvement, and Accountability References slide (2 references required: 1 course material and 1 peer-reviewed reference) (1 slide – No narrative notes) You might consider using one of these templates for your presentation (you can use any PowerPoint template that you choose).? Visit: https://thepoint.lww.com Password- Fall2021@19 Think- Speak – Act Cultural Health Think- Speak – Act Cultural Health: Part 2 https://journals.lww.com/naqjournal/Abstract/2019/… QUESTION 2 PLEASE RESPOND TO 2 OF YOUR PEERS’ POSTINGS. Peer Responses: Minimum of one (1) peer-reviewed reference. WEBSITES are NOT considered peer-reviewed. Response posts: Minimum 150 words excluding references. Sherry Anne Bengson Transcultural Communication COLLAPSE Top of Form Our obligation as nurses is to care for our patients, regardless of where they come from or what culture they inhabit. For this discussion we will address various cultures encountered within my workplace, education I have within communication whiled defining what communication is, how I meet the patients’ person a desires in combination with traditional/cultural needs within work, and what I feel is most challenging in regard to transcultural communication. Working in a Los Angeles County hospital, I’m met with many different cultures in my workplace varying from Argentinian, Chinese, Hispanic to name a few. Unfortunately, I do not have an education in communication, although had I known how much nursing dealt with communication I wish I had obtained somewhat of an education in it. I think communication can best be defined by the ability to reciprocate needs and wants between two people by any means necessary. According to CLAS standards, not only does communication include verbal and physical, but print material and signage as well (Andrews et al., 2020).When my patients speak a different language from me, regardless of whether there is a family person who can help translate, I always try to utilize hospital resources in obtaining a professional translator. Within my work, I’m effort to meet the patients’ personal desires in combination with their cultural and traditional needs, I always try to include them in their care and ask them what works for them. For instance, because people’s tolerance to pain varies, I often get patients who tell me Motrin will work whereas Tylenol will not. I think the greatest challenge of transcultural communication is simply being able to communicate with others in a language that they would understand. It’s important to note that communication is key to truly providing proper and quality care (Larsen et al., 2020). We have to be able to see the person as a whole and not just treat them for their ailments and health disparities. In conclusion, communication is just as important as nursing itself, if not more important. Without proper communication it is extremely difficult to provide care alone. From explaining what procedures are to be done to obtaining consent, it all requires communicating with the patient. Without communication our care becomes little to nothing. References Andrews, M. M., Boyle, J. S., & Collins, J. W. (2020). Transcultural Concepts in Nursing Care (8th ed.). Wolters Kluwer. Larsen, R., Mangrio, E., & Persson, K. (2020). Interpersonal communication in transcultural nursing care in India: A descriptive qualitative study. Journal of Transcultural Nursing, 32(4), 310–317. https://doi.org/10.1177/1043659620920693 Bottom of Form Jon Bezilla Transcultural Communication Top of Form In this post, I will discuss the different cultures I encounter in the workplace, communication, how I communicate with patients who speak a different language from me, how I am able to meet my patients’ desires combined with their cultural or traditional needs, and what the greatest challenges are with transcultural communication. In my hospital and on my unit, I have encountered multiple different cultures throughout my nursing career. Cultures ranging from Hispanic to African and Muslim to Jewish. Each of these patients required a unique form of care that was consistent with their culture. For example, any Jewish patients that I would encounter would require a kosher meal and I would always ensure that that was the case. Being able to communicate with every culture is key to providing proper care for each individual patient. Communication is the ability to exchange information both verbally and nonverbally between individuals or groups (Brooks et al., 2019). When communication becomes a barrier, it is imperative to find a solution. For example, when a patient speaks a different language from me, I have utilized colleagues, family members, and translators to ensure that information was not getting misconstrued. By being able to effectively communicate with my patients, I am also able to meet their personal desires in conjunction with their cultural and traditional needs. Asking questions and listening to the patient responses allows me the opportunity to work within my hospital setting to try and find a solution. For example, accommodating a patient’s gender preference with regards to a nurse or nursing assistant seems like a small ask, but when it comes to certain cultures it can be a big deal. Although it may seem like I have all the answers, transcultural communication is not always so simple. There are many challenges to communicating and providing proper care to patients of different cultures. Some of these challenges include not only a language barrier, but the inability to educate patients to a desired level on their diagnosis and plan of care, not being able to communicate with a patient based on limited interpreter options, and the length of time needed to provide care for these patients (Betancur et al., 2020). In conclusion, the ability to effectively communicate with patients of different cultures is key to providing the best possible care for every patient. There may be challenges to providing care in some instances but having a little patience and utilizing the resources within your hospital can illicit positive results for all. References: Betancur, S., Walton, A. L., Smith-Miller, C., Wiesen, C., & Bryant, A. L. (2020). Cultural Awareness: Ensuring high-quality care for limited English proficient patients. Clinical Journal of Oncology Nursing, 24(5), 530–537. https://doi-org.proxy.library.ohio.edu/10.1188/20…. Brooks, L. A., Manias, E., & Bloomer, M. J. (2019). Culturally sensitive communication in healthcare: A concept analysis. Collegian, 26(3), 383–391. https://doi-org.proxy.library.ohio.edu/10.1016/j.c… https://readyassignments.com/wp-content/uploads/2024/02/New-Project15.png 0 0 bonniejecinta https://readyassignments.com/wp-content/uploads/2024/02/New-Project15.png bonniejecinta2024-04-05 16:46:262024-04-05 16:46:26OSU Medical Center Presentation About Us We are a professional assignment help website for all students in all academic levels and disciplines. We strive to help students achieve their desired grades. 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