DRNC Leadership Practicum

DRNC Scenario for CRJ-565 Leadership in Criminal Justice

This Leadership Practicum centers around the Democratic-Republican National Convention theme. This practicum is worth 10% of the final grade, and involves a case study analysis that is to be submitted at the end of Module 6.

Background

The following story is a fictional account of planning and preparation leading up to the mythical Democratic-Republican National Convention (DRNC) event in Miami, Florida. The story is loosely based on an amalgamation of real life occurrences in the lead up to the Free Trade Area of the Americas conference in Miami, Florida in 2003. The names of all the characters in the story are fictional.

As you read the story, keep in mind what contemporary criminal justice issues are likely to arise. At the end of the story, you will be asked to respond to several questions related to this scenario.

Miami-Dade Police has been designated as the lead local agency and lead operational planner for the event security. This policy differs significantly from the 2003 FTAA in which the City of Miami was designated as the lead local agency. Director Melanie Duncan is the head of the Miami-Dade Police Department. In turn, Director Duncan has designated Major Louis Warren as the Incident Commander and lead planner for the Department’s DRNC mobilization.

Since this event meets the criteria of a National Special Security Event (NSSE), the U.S. Secret Service has been designated as the lead coordinating agency with overarching statutory authority for the planning and execution of the event. Supervisory Special Agent Samantha Salerno has been appointed as the lead agent in-charge for the event.

Case Study – Innovation and Stagnation at the Miami-Dade Police Department

The police departments of the City of Miami and of Miami-Dade County have had their share of experience with civil disturbances over the last 40 years. There were the race riots in 1968 (Liberty City Riot), 1980 (McDuffie Riot), 1982 (Luis Alvarez Riots), and 1989 (Lozano Riots) in the Liberty City and Overtown areas. Then there was the Elian Gonzalez civil disturbance in April 2000.

In each of these incidents, segments of local minority communities (either African-American or Cuban) rioted as the result of some perceived injustice against their ethnic groups. The riots resulted from either police shooting young black men, or from the federal government deporting a young Cuban boy back to his home in Cuba.

One incident of civil unrest – the 1980 “McDuffie Riots” was particularly destructive. Three days of rioting in Liberty City, Overtown, Brownsville, and Coconut Grove, resulted in 18 deaths and over 180 serious injuries. The damage caused by the rioting was estimated at $100 million and was thought to have caused the permanent loss of over 3,000 jobs in the black communities of Miami. Morale among the rank and file of both major police departments in the County were at an all-time low.

The McDuffie incident is also significant, in that it led to the innovation of the modern Mobile Field Force (MFF) model for police response to civil unrest. The “Miami-Dade” model, as it is commonly referred to, was actually a co-invention by officers from the City of Miami Police Department (MPD) and the Dade County Public Safety Department (now called the Miami-Dade Police Department – MDPD).

In effect, both police departments had sustained considerable injury and damage, both physically and to their reputations as a result of these civil disturbances. Much of the damage resulted from lack of aggressive response from the officers who had been shell-shocked from the community’s reaction to the killing of Arthur McDuffie, and the resulting not-guilty verdict of the involved officers.

Ironically, it was during the difficult times of the post-McDuffie period that many innovations, such as the Mobile Field Force concept were born. It did not take long before the MFF concept was put to a test with the 1982 “Luis Alvarez/Overtown” riots and again in 1989 with the “Lozano” riots. In both cases, the field forces worked marvelously, as both civil disturbances were quickly quelled.

By the time that the Mobile Field Forces were used to quell the Elian Gonzalez disturbances in 2000, the MDP and MDPD had become renowned for their innovative crowd control practices. The subsequent innovation of Special Event Response Teams (SERT) as an intermediary response to peaceful or marginally disobedient crowds further added to the MDPD’s expert standing among national and global police departments.

In 2001, the MDPD hosted a week-long Disorder Management Symposium that was attended by commanders and supervisors from departments throughout the United States, as well as a few from other nations. The MFF concept (and later the SERT model) has been adopted by police departments across the nation as the best way to deal with large and unruly crowds.

The Free Trade Area of the Americas Conference (FTAA)

The FTAA agreement between the United States and the majority of Latin American and Caribbean nations had come about as the result of global economic meetings between the heads of state of those countries during the Summit of the Americas Conference in Miami-Dade in 1984. Like the NAFTA agreement before it, the FTAA has drawn a considerable amount of opposition from the anti- globalization “fair trade” crowd.

The violent protests against global economic structures and free trade agreements first came about in 1999, during the World Trade Organization (WTO) conference in Seattle, Washington. These riots caught the authorities by surprise and signaled a shift in the paradigm of police civil disorder management. After Seattle, there were several other violent protests by an informal anti-globalization

alliance of unionists, communists, and anarchists. These included riots in Montreal, Canada; Genoa, Italy; Cancun, Mexico; and Washington D.C. Not only were the WTO conferences being targeted, but other worldwide economic forums such as the G-8 Conference and the World Economic Forum (WEF) were also being singled out by the radical groups.

The secretariat of the FTAA decided to bring the conference to Miami, Florida in November of 2003. High-level delegations from all the participating nations of the Western Hemisphere would be converging in Miami for the one-week conference. Being aware that the conference would attract the same type of violent protestors seen at Seattle, Montreal, Genoa, and Washington D.C., both the MPD and the MDPD commenced preparations for the likelihood of very large crowds and violent protests.

Early, preliminary planning at the MDPD started as soon as the department became aware of the conference. Many of the strategic and tactical concepts that were developed for the FTAA had already been conceptualized by a select number of mid-level managers (lieutenants) who had been aware of the problems in Seattle, Genoa, and Montreal for several years. It had become obvious, that the Mobile Field Force concept that had been born in Miami-Dade would no longer work against this new type of radicalized adversaries. So when the chiefs and directors of the two police departments ordered their planners to get ready for the FTAA conference, the lieutenants who were assigned the task already had a concept in mind.

It was clear to these lieutenants that there had been a major paradigm shift in civil unrest since the time of the race riots of the 1980s. The mobile field force concept that the Miami-Dade Police had innovated in the 80s and perfected in the 90s would no longer work against this new type of opponent. The new paradigm demanded that changes be made to the tactics and weapons used by the field forces. Unfortunately, as with all change, there would be many institutional barriers to the changes that the lieutenants were contemplating.

Simply stated, the new MDPD strategic direction conceived by the small cadre of lieutenants in response to the Anarchist/anti-globalization protestors expected for the FTAA was this:

? Emphasis on the offensive rather than reliance on defense alone (i.e., do not be passive)

? Inside and outside deployment (i.e., do not put all your forces behind a fence)

? Emphasis on unit mobility, rather than the static, linear tactics of the past

? Intelligence driven (know your opponent’s every move ahead of time)

? Proactive enforcement (i.e., strike early and strike hard – don’t wait until things get out of hand)

? Matching up with the adversary: “The right tool for the right job” (There were many different

types of protestors, and protest behaviors, therefore different types of units were created to

match up against each type)

? Emphasis on strict unit discipline (to prevent being goaded into a disadvantageous skirmish)

It would take a considerable amount of persuasion by the cadre of mid-level lieutenants before the upper command staff would “buy into” these new concepts. Ironically, the first (and unanticipated)

barrier that the lieutenants encountered was resistance from the members of the Mobile Field Force Training Committee. This committee had been established in the mid-80s and was comprised mostly of sergeants, and a few lieutenants… many of whom had played roles in the early innovation of the original concept field force concept. These sergeants and lieutenants were once on the cutting edge of innovation, but for the past 20 years, very few new ideas had come to fruition. There had been a few suggestions to incorporate the use of Pepperball and other less lethal munitions into the field force tactics, but more often than not, the committee’s recommendations fell on deaf ears as the ideas were floated up the chain of command.

By 2003, the Mobile Field Force Training Committee had become a shell of its former self. It stopped innovating and had become a barrier to other peoples’ innovative ideas. That year, a sergeant from the Training Bureau made a presentation to the full committee on the incorporation of bicycle patrol officers into the field forces. Some of the lieutenants at that meeting loved the idea, but the old sergeants who had been in the committee for many years thought the idea of using bicycles was foolish. They didn’t see how bicycle patrol officers could function in the old “stomp and grind” tactics that field force was noted for.

The Mobile Field Force Training Committee had once been the cutting edge of innovation for the Miami- Dade Police Department. Now its members had become cynical and desensitized, in part because of the many rejections of its ideas over the years. The committee had become an old man’s debate society where nothing of much value ever came out. Worse yet, as the Training Bureau sergeant that proposed the bicycle idea came to find out, the committee had become a place where new ideas would come to die.

Planning for the DRNC

By 2013, most of the sergeants and lieutenants of the original Mobile Field Force Training Committee had long retired. A new cadre of veteran officers had taken their place. Many of these officers had participated on the front lines of the FTAA disturbances in 2003. The bicycle component and the Pepperball munitions that were initially rejected by the old committee had now been accepted as the norm. The FTAA mobilization had been a great success and many police departments around the country had emulated Miami-Dade’s new offensive and nimble tactics. Miami-Dade Police had regained its reputation for being considered to be at the cutting edge of mobile field force tactics.

Since the FTAA, there have been several similar large scale special events that have led to some degree of civil disturbances. The 2004 political conventions in Boston and New York City, as well as the 2008 Republican National Convention in Minneapolis and the 2012 RNC in Tampa, Florida. To prepare for the DRNC in Miami-Dade, Major Louis Warren had scoured the after action reports of all these major events. He wanted to make sure that he learned from the mistakes of his predecessors, as well as learn from their successes. Warren was a hard working manager and he would not allow himself to be unprepared for the DRNC. He promised himself that he would not leave any stone unturned as he prepared for the biggest event of his life.

Assignment Instructions

For the purpose of this assignment, you are to play the role of Major Louis Warren, the Incident Commander and principal planner of security for the DRNC. You are to consider the factors that led to successful innovations at MDPD in the past, as well as factors that blocked other innovations. As the principal planner for the DRNC, what actions would you take to encourage new ideas from the front line officers in the Department that could further improve crowd control tactics? What steps would you take to overcome barriers to new ideas?

I need a response for a discussion post, please find post below

Review of Case Study 3

Patient Information:

Initials: M.R Age: 15 Sex: Male Race: Asian

CC: pain in both knees

HPI: M.R. is a 15-year-old Asian male who presents to the clinic today with a chief complaint of pain in bilateral knees. The patient reported the pain had been on and off for the past two weeks on a scale of 5/10. The pain got worse, which led him to stop playing basketball, and he was worried he would not be able to play in the finals. The patient reports that he feels a catching sensation under the patella. The pain is worst when he uses the stairs and stands up from a sitting position. He takes OTC Advil 200mg 2-3 times a day which helps, but the pain is not totally gone.

Current Medications: Advil 200mg PO 2-3x/day as needed for pain

Allergies: NKDA

PMH: Childhood vaccines up to date, Influenza vaccine- 11/2021. Denies any major or serious injury. Denies any surgical procedure. Denies hospitalization.

Soc Hx: Patient lives with mom and dad with two younger sisters. He is currently in 9th grade and a member of the basketball team. He loves to surf and play with his siblings.

Fam Hx:

• Mother- HTN, hyperlipidemia
• Father- HTN, hyperlipidemia, hyperthyroidism
• Sister/s- no health issues
• Maternal grandmother- diabetes, hyperlipidemia
• Maternal grandfather- COPD
• Paternal grandmother- Alzheimer’s Disease
• Paternal grandfather- HTN, hyperlipidemia, diabetes

ROS:

GENERAL: Denies weight loss. Denies fatigue. Denies fever or chills.

HEENT: Denies headache. Denies changes in vision or blurred vision. Wears contact lenses. Denies hearing loss and earache. Denies congestion, runny nose, or nose bleeds. Denies sore throat. Denies difficulty in swallowing.

SKIN: Denies rashes and itching. Denies lesions.

CARDIOVASCULAR: Denies any chest pain or discomfort. Denies palpitations. Denies swelling or edema.

RESPIRATORY: Denies shortness of breath or any difficulty of breathing. Denies cough.

GASTROINTESTINAL: Denies any abdominal pain. Denies any vomiting. Denies constipation or diarrhea.

GENITOURINARY: Denies any pain or discomfort when urinating.

NEUROLOGICAL: Denies headache, dizziness, syncope, paralysis, and ataxia.

MUSCULOSKELETAL: Complains of bilateral knee pain. Complains of pain in the bilateral knee when using the stairs and when standing from a sitting position. Complains of tenderness in joint line to bilateral knees. Denies any weakness.

HEMATOLOGIC: Denies any bleeding or bruising.

LYMPHATICS: Denies enlarged nodes. No history of splenectomy.

PSYCHIATRIC: Denies depression or anxiety.

ENDOCRINOLOGIC: Denies heat or cold intolerance. Denies polyuria or polydipsia.

Physical exam:

VS: Ht. 5’7”, Wt. 152 lbs., BMI. 23.8, Temp. 98.8, R.19, P. 88, BP. 100/60 right arm, O2 Sats 99%

General: The patient is well-developed, well-nourished, wearing appropriate clothing, and very pleasant. Alert and oriented, answers questions appropriately and cooperative. The patient follows the command. Noticed the patient rubbing both knees multiple times.

HEENT: Head normocephalic, atraumatic. PERRLA. External auditory canals were patent, and no swelling or drainage was noted. Bilateral tympanic membrane intact without erythema or effusion noted. Nares patent bilaterally. No polyps noted, nasal mucosa pink without rhinorrhea. No sinus tenderness. The oral mucosa is pink and moist.

Neck: Supple, full range of motion. No thyromegaly. No carotid bruits. No masses palpated. No tracheal deviation was noted. No neck pain or stiffness.

Skin: No rashes or lesions noted.

Respiratory: Bilateral lungs clear to auscultation. No SOB was noted or respiratory distress. Breathing unlabored.

Cardiovascular: Normal S1 and S2. Mo murmurs. Rhythm regular. No peripheral edema, cyanosis, nor pallor was noted. Extremities are warm and well perfused without clubbing, cyanosis, or edema. Capillary refill is less than 2 seconds.

Abdomen: Bowel sounds are present in all quadrants. Soft, non-tender, no distention noted. No masses or organomegaly were noted. No guarding or rebound tenderness was noted.

Musculoskeletal: Full ROM in upper extremities. Limited ROM noted in bilateral lower extremities. Popping and clicking sounds were noted with bilateral flexion of the knees. Tenderness was noted during examination when pressure was applied. Pain was noted during squatting and standing. No swelling was noted to bilateral knees.

Neurological: Alert and oriented x 3. Follows command, cooperative. Speech is normal. Normal strength and tone in all muscles. No gross focal, motor, or sensory deficits.

Diagnostic results: Xray of bilateral knees, MRI of bilateral knees

Differential Diagnoses:

1. Meniscal Tear

1. Patellar Tendonitis

1. Bursitis

1. ACL Tear

1. Patellar Fracture

Assessing Musculoskeletal Pain

Knee pain in teens results from various reasons, including overuse, specific knee injury, or other medical conditions. According to Ball et al. (2019) an acute incident or overuse and repetitive trauma can result in injuries in the muscles, bones, and supportive joint structures. In the scenario provided, in order to diagnose knee pain and knee injury, a thorough history and physical is imperative. The patient should provide when the onset of pain started, what the patient was doing when the pain started and additional information, including frequency, severity, aggravating and relieving factors.

Meniscal Tear

Physical assessment of meniscal tear includes joint line tenderness, swelling, effusions, and a positive meniscus-specific test (Vinagre et al., 2022). In addition, depending on the type of tear and injury characteristics, intermittent catching, snapping, locking, or instability may be present. The authors noted that sports-related injuries such as soccer, football, basketball, skiing, and wrestling are associated with risk factors for meniscal tear. Other risk factors include higher body mass index, delayed reconstruction of Acute cruciate ligament (ACL), and Asian children having a higher prevalence of discoid meniscus. For the young population, MRI has a lower sensitivity and specificity for detecting meniscal injuries. MRI can diagnose discoid meniscus when three or more consecutive sagittal sections demonstrate a continuity of the meniscus between the anterior and posterior horns (Vinagre et al., 2022).

Patellar Tendonitis

Cincinnati Children’s (n.d.) defines patellar tendonitis, also called “jumper’s knee”, as an inflammation of the patellar tendon related to jumping motion, usually in athletes. The signs and symptoms include pain in the front surface of the knee, the area over the tendon is tender, and it may be swollen. With no specific injury, patellar tendonitis can happen over time. The pain usually happens at the start of exercise and can happen during actions like standing, sitting for a long time, or using the stairs. An X-ray is ordered by the healthcare provider to rule out any other bone fracture.

Bursitis

Prepatellar bursitis is caused by pressure from constant kneeling, a direct blow to the front knee, and to athletes who participate in sports such as football, basketball, and wrestling. It can also be caused by a bacterial infection (AAOS, 2022). Healthcare providers will ask the patient the severity, the onset, and how long the patient had symptoms of pain and discuss the risk factors of pain. Usually, x-rays are ordered to rule out any fracture and have a clear picture of the bone. Bursitis is usually diagnosed in physical examination, but MRI may be ordered to check for other soft tissue injuries. According to AAOS (2022) Symptoms of bursitis includes pain with activity, but not usually at night. Rapid swelling on the kneecap, tenderness, and warmth to touch of the affected site. The presence of fever and chills and redness may be caused by infection.

ACL Tear

According to John Hopkins Medicine (n.d.) a sudden pivoting or cutting maneuver during football, basketball, and soccer can injure or tear the ACL. A popping or a snapping sound can be felt or heard at the time of injury, and immediate swelling of the knee develops within the first several hours, and the swelling can be limited if ice is applied to the knee. An X-ray is ordered to rule out any fracture to the bone. An MRI is also beneficial to clarify ACL tear if the information provided by the patient is inconclusive.

Patellar Fracture

A fractured kneecap “patella” is caused by a direct blow to the front of the knee from a car accident or a sporting injury and a fall onto the concrete (Cedars Sinai, n.d.). An X-ray is ordered to take pictures of the knee from several angles to determine the extent of the injury. In a patellar fracture, swelling and a deformed appearance of the knee are visible. The patient usually has difficulty extending the leg, and severe pain is experienced when moving the knee in different directions. When applying pressure to the kneecap, tenderness is noted by the healthcare provider.

Conclusion

In conclusion, an accurate diagnosis of knee pain requires specific physical examination skills. A thorough history must include characteristics of the patient’s pain, mechanical symptoms such as locking, popping, or the feeling of giving away. The timing and the mechanisms of the injury are also important in assessing the knee. Careful inspection of the knee must be included in the physical inspection. The palpation for tenderness, assessment of joint effusion, and the testing of range-of-motion are all beneficial for the appropriate diagnosis of knee pain. If an injury is suspected, radiographs should be obtained to rule out any other fracture and to clarify the disease.

For me and my friend are both nurses . Would it be nice if the topic is related to this field. Thank you

Informative Speech Outline Assignment

For this assignment you will upload the full-sentence outline of your informative speech. Use the “Sample Informative Outline” example provided in Week 4 as a template for this assignment. There’s also an example in our text.

Outlines help in several ways:

1. They help organize your thoughts so your speech is easy to follow.
2. They keep you on track so you don’t research beyond the scope of your speech.
3. They give you a clear idea of how much time it will take to present.
4. They provide notes for you to use when you deliver the speech.

Step One: Choose a topic.

You will attempt to inform your audience by providing novel information on a topic that is relevant to your audience. Choosing a good topic for this speech is key.

Step Two: Do your research.

You will need at least two sources and should provide a list of references at the end of the outline.

Step Three: Organize your ideas.

Follow the speech examples provided.

Be sure to clearly state your thesis and preview your main points in the Introduction, provide section transitions throughout the speech, and cite sources as you present new ideas. Remember to conclude your speech with a re-statement of your thesis.

Step Four: Tailor your speech.

Using your initial outline, begin writing a detailed outline of your speech (e.g. full outline). When you have a complete version of your speech, begin practicing to see if it fits within the window of time given. You only have 7-9 minutes to deliver this speech, so use this practice as a chance to edit yourself. If your speech runs far less than 7 minutes, you need to add more material. If the speech runs way over 9 minutes, you need to cut some material.

As you practice, you can create a speaking outline by shortening statements to phrases or key words. You can also include cues to prompt you throughout the delivery. The speaking outline is a tool to guide you while speaking.

Upload your outline using the submit button below. Use this naming protocol for your document file:

melisadavid603@yahoo.com	Mon, Apr 18, 1:10 PM (3 days ago)
to me

SAMPLE INFORMATIVE OUTLINE

All main points should be in full sentence form. All transitions should be completely written out in full sentence form. All cites should be written out completely, boldfaced, and clearly demarcated with quotation marks and a parenthetical reference; paraphrases also require a parenthetical reference.

SPEECH TITLE: Chopsticks – History, Use, and Etiquette

SPECIFIC PURPOSE: My purpose is to inform my audience about chopsticks and the correct way to handle them.

THESIS STATEMENT/CENTRAL IDEA: While most of you may be unfamiliar with the Japanese language, visiting Japan does not have to be a culturally awkward experience if you are familiar with one important tradition – the use of chopsticks.

INTRODUCTION:

1. (Attention getter) Minasan, Ohaiyogozaimasu! Genki desuka? Watashi wa hashi ga daisuki desuyo!

2. (Clearly reveal topic/thesis) While most of you may be unfamiliar with the Japanese language,

visiting Japan, or just eating Japanese food, does not have to be a culturally awkward experience if you are familiar with one important tradition – the use of chopsticks.

3. (Reason to listen) It serves us all well to expand our horizons, and to learn about other cultures, and knowing about and learning to use chopsticks properly is one simple way we can all do that.

4. (Establishes credibility) My family moved to Japan when I was seven, and using chopsticks very quickly became a standard activity in everyday living.

5. (Previews main points) Today I’d like to share with you the history behind chopsticks, how to use chopsticks, and Japanese etiquette when eating with chopsticks.

(Transition) To begin with, I would like to give you a brief history of chopsticks. BODY:

a. Chopstick History – Chopsticks originated in China about 5,000 years ago.

i. Those too impatient to wait for their food to cool would use sticks to eat with so they wouldn’t burn their hands.

ii. Around 400 BCE, fuel became scarce, so people began cutting their food into smaller pieces to make it cook faster.

1. This eliminated the need for knives at the table, and chopsticks became a regular eating utensil.

According to the Asian Arts Mall website, the philosopher Confucius also helped spread the popularity of chopsticks…

(< http://www.asianartmall.com/chopstickshistory.htm>)

According to Confucius, “The honorable and upright man keeps well away from both the slaughterhouse and the kitchen. And he allows no knives on his table.”

2. The absence of knives on a table required that the food already be bite-

sized, and under these circumstances chopsticks were ideal to eat with. iii. Chopstick Materials

1. Most chopsticks are made with bamboo since it is inexpensive, can withstand heat and has no taste.

2. But bamboo is not the only material used. Other popular substances include jade, wood, and sometimes bone.

a. According to the California Academy of Sciences’ website on chopstick history, during dynastic times the wealthy would eat with silver chopsticks since it was believed that the tips would turn black if exposed to poisoned food, a myth that has since been proven false. (<http://research.calacademy.org/research/anthropology/ute nsil/chpstck.htm>)

b. However, the hydrogen sulfide in rotten eggs, onions, or garlic

might cause the silver to change color. iv. Difference Between Chinese and Japanese Chopsticks

1. Chopsticks made their way to Japan by 500 CE, although the Japanese altered the original form slightly.

a. Japanese chopsticks have a more rounded shape and come to a point instead of being strictly rectangular all around.

b. They are also shorter at seven inches, than the traditional ten inch Chinese chopstick.

v. Today, chopsticks can be found in a variety of colors and designs. And there are even chopsticks designed for beginners that are connected with a spring to facilitate learning.

Now that you are familiar with the history of the Japanese chopstick, we can move on to how to actually use a pair of chopsticks.

b. Allow me to demonstrate how to use chopsticks

i. To begin, the ends of the chopsticks must be even, and they need to be held in the upper third of their length.

1. Then place the lower chopstick at the base of your thumb, and let the end of it rest on your ring finger.

2. This chopstick will remain stationary.

3. The top chopstick is held between the tips of your index and middle finger, and is held steady with the base of your index finger.

4. To pick up food, you move the top chopstick with your index and middle finger, and you move the top chopstick with your index and middle finger.

ii. As I previously mentioned, knives are not usually present at the Japanese table.

1. To cut foods, press down on them with your chopsticks and spread the

chopsticks apart from each other.

iii. It may sound difficult, but with minimal practice it becomes second nature.

1. If you are looking to become more proficient in your use of chopsticks, you can easily practice with everyday objects; all you need is two bowls and dried beans or other small objects.

2. You can place the dried beans in one bowl and practice transferring them to the other.

Although learning the basics on how to use chopsticks is important, the information is almost useless if it is not paired with the cultural etiquette that comes with using chopsticks.

c. Etiquette – According to the Japan Guide Online, the following are the major etiquette mistakes that many foreigners make, but that should be avoided. (<http://www.japanguide.com/e/e2039.html>)

i. First of all, do not stick your chopsticks into your food, especially rice, since this is only done during funeral services.

ii. Do not pass food from one set of chopsticks to another, since this is also a funeral custom dealing with cremated bones.

iii. It is rude to point with your chopsticks or spear food with them. It is also rude to wave your chopsticks in the air or play with them.

iv. As in American culture, it is impolite to play with your eating utensils in a formal setting.

v. If you wish to take food from a communal bowl and have already used your chopsticks, turn them around and use the other end to bring food to your plate. vi. Lastly, when you have finished eating, lay the chopsticks in front of you, with the tips pointing left.

vii. Without this knowledge it is highly likely that you will unintentionally offend with your eating customs.

To conclude, visiting Japan does not have to be culturally stressful when armed with the knowledge of this important cultural tradition.

CONCLUSION:

1. [Restate main points] We have discussed Chopsticks, we’ve learned the history of chopsticks and their origination in China, how to use chopsticks, and the etiquette necessary to use chopsticks properly.

2. Now that you are more familiar with this important Japanese tradition, you will be able to impress family and friends! But more importantly, you will be able to show respect for Japanese customs and may help alleviate the stereotype of the ignorant American in Japan.

3. Clincher: Ganbatte kudasai! Arigatougozaimashita!

BIBLIOGRAPHY

“Chopsticks History and Legend.” Asian Art Mall.

< http://www.asianartmall.com/chopstickshistory.htm>

“Chopsticks.” History of Eating Utensils. California Academy of Sciences.

< http://research.calacademy.org/research/anthropology/utensil/chpstck.htm> “Chopsticks.” Eitquette. Japan-Guide.

< http://www.japan-guide.com/e/e2039.html>

King, Alyn. “How to Use Chopsticks in Seven Easy Steps.” Gomestic. 12 Aug. 2007 <http://www.gomestic.com/Cooking/How-to-Use-Chopsticks-in-Seven-Easy-Steps.39217>

mee and my friend are both nurses . Would it be nice if the topic is related to this field. Thank you

Show Response Paper and Virtual Show Attendance Requirements:

For this semester, because many theaters across the country are still facing problems with staying open, you will not be required to go out in public to watch the shows that you’ve selected. Obviously – and hopefully – circumstances may change through the course of the semester. If you want to watch your shows in person, by all means, please go out and support live theater in a safe and healthy way. However, since we can’t predict the future, we’ll proceed through the semester with the option to watch everything online.

I’m still glad that you went through the process of researching theater in your area and deciding which of those shows was most appealing for you. I hope that when the world gets back to normal, the skills you used to complete the Show Selection Assignment will help you to find live theater to get out an watch. Remember, live theater will need your support more than ever once the theaters reopen to their full capacity. Many of you noticed this as you completed the Current Events Assignment. So as much as it pains me to substitute the experience of watching live theater with watching live recordings online, we just have to provide the option.

First of all, in order to watch a Professional Musical, Professional Straight Play, and a Theatrical Event, you’ll need to create an account with Broadway HD. You can create an account and take advantage of a 7-day free trial. NOTE: In order to not be charged for this account, you must cancel your account before the end of the free trial. That means, you should not sign up for the account until you’re ready to start watching the shows because you’ll only have 7 days to do it. Of course, you’re welcome to pay the $8.99 per month and keep the account for as long as you want. Some of you may be interested in doing that so that you can take a little more time to see the shows and complete your Show Response Paper. Some of you may be interested in doing that because you’ll find some cool stuff that you want to take more time to watch. But some of you will want to cancel on day 6 to make darn sure you don’t get charged. That’s totally fine as well.

To set up your account with Broadway HD:

• Go to broadwayhd.com
• Under Monthly, click “Choose this Plan”
• Follow the instructions to set up your account which includes the 7 day free trial. You’ll need a credit card to be able to do this.
• Note: you may want to set yourself a notification or reminder in your phone to make sure you cancel the free trial before you’re charged.

Once you’ve set up your account, you’re ready to follow the instructions below to watch a Professional Musical, Professional Straight Play, and a Theatrical Event. There are several options below for you to watch Community Theater which will be viewed on You Tube and require no subscription.

Once you’ve watched a show from each of the 4 categories (Professional Musical, Professional Straight Play, Theatrical Event, and Community Theater), you’re ready to complete the Show Response Paper. Details about the expectations for that paper will be given here below the instructions on how to watch the shows.

Remember, you’re not just writing a summary or review about each of the 4 shows that you watch. You are to compare the experience of watching shows from the different categories.

Here are the individual instructions for each category…

PROFESSIONAL MUSICAL
To watch a Professional Musical, first follow the instructions above to create an account with BroadwayHD.com, then follow the instructions below:

• In the navigation bar at the top of the screen, click on “Categories”
• Using the dropdown menu, click on “Musicals”
• You may select any one of the musicals listed on this page to count as your Professional Musical
• Note: at the bottom of the page, you can click “Load More” to expand the list of musicals

PROFESSIONAL STRAIGHT PLAY
To watch a Professional Straight Play, first follow the instructions above to create an account with BroadwayHD.com, then follow the instructions below:

• In the navigation bar at the top of the screen, click on “Categories”
• Using the dropdown menu, click on “Plays”
• You may select any one of the plays listed on this page to count as your Professional Straight Play
• Note: at the bottom of the page, you can click “Load More” to expand the list of plays

THEATRICAL EVENT
To watch a Theatrical Event, first follow the instructions above to create an account with BroadwayHD.com, then follow the instructions below:

• In the navigation bar at the top of the screen, click on “Categories”
• Using the dropdown menu, click on “Performing Arts”
• You may select “Vox Lemiere The Hunchback of Notre Dame” to count as your Theatrical Event

Or

• In the navigation bar at the top of the screen, click on “Categories”
• Using the dropdown menu, click on “Cirque du Soleil”
• You may select any one of the productions listed on this page to count as your Theatrical Event

COMMUNITY THEATER
You may select any of the following Community Theater selections to watch on You Tube:

• Newsies
• Wizard of Oz
• As an alternative to watching the two Community Theater options above, some of you may have access to a video recording of a play or musical that you or a loved one participated in at a local community theater. You’re welcome to submit a production like this as an option, but you’ll need to email me before you complete this assignment to get approval. If you choose this option, please don’t wait until the last minute because you will need time to receive the approval. You’ll also need to provide me with a link to see the show for myself so that I’ll know whether or not to grant approval.

And those are your alternatives to watching theater live. It breaks my heart to encourage watching recorded theater. It’s just simply not the same thing. But I definitely think it’s the right thing to do under these circumstances.

And finally, here are the specifics of what you should submit for the paper…

Show Response Paper
Tell me what you thought about the shows in comparison to each other. Don’t simply write about what happened in the shows. I don’t want to read a synopsis of the four shows you watched. I want to know how you felt about the experiences that you had watching four different types of productions.

Here are some questions you can use to prompt you through the writing of your paper:

Did you like them? Why? Did you hate them? Why? What aspects of the productions did you find successful? What aspects do you feel could be improved upon? Which one was your favorite? Why? Which one was your least favorite? Why? How did they compare to each other? After seeing these four types of productions, which type of theater are you most likely to attend again? How did watching these productions change your appreciation of Theater?

You do not have to wait until the deadline to submit this paper. I would recommend writing this paper as soon as you have completed viewing your fourth show. That way the shows will be fresh in your memory. I would also recommend that after you watch your first, second, and third shows that you take notes, or perhaps begin the first drafts of this paper. This way you will have notes to refer to for the first, second, and third shows.

These papers are to be no more than THREE pages long, double spaced, and written in twelve-point font. There’s no minimum, but you should probably get pretty close to the three page maximum.

Some things to keep in mind when writing your paper

I want to give you instructions on what is expected in terms of structure, so that you can receive the highest marks possible. Students who follow these instructions often see an improvement in their writing assignment grades, not only in this class but others. Good academic writing is important in any course. Believe me, professors are happy when they see such effort put forth.

Papers for this course have an inherently subjective grading component; meaning that a portion of the final grade cannot help but be based on my opinion of your work. Therefore, I try to make structure and grammar weigh significantly, so that the grade has a strong objective base. Strong structure and grammar will earn between a B and a B+ (80-89) depending upon how well the sentences build in each paragraph, etc. Any writing that earns an A (90 or higher) is of strong academic quality and additional points are based on how well the writing flows, builds, and drives.

It is not my philosophy when grading papers that you start with a 100 for the assignment and lose points from there. Rather, you start with a blank expectation and earn the grade by accomplishing the above and below mentioned standards in your writing. Therefore, my best advice is to write academically-

• Use strong structure (the body of the paper should have a clear beginning, middle, and end. So should each paragraph).
• Be succinct. The assignment is three pages for a reason; to limit the space in which you have to express yourself. Therefore, if you are attempting strong analysis it becomes very important to pick your words well and build to a point. Each sentence should build and drive the thought of the overall analysis, because there is no space to waste.
• Spell check and be strict about grammar.
• Make sure you do something to identify the title of a play (underline, italicize, or place in quotation marks).

I need comments about this Q&A.

What treatment should this patient receive to relieve symptoms during an asthma attack?

In this scenario, the given patient has mild asthma and notes that the patient has Exercise-Induced Bronchospasm (EIB) or other known as Exercise-Induced Asthma. It happens mostly to people with asthma. Thus, exercise causes bronchospasm, wherein the airways in the lungs narrow when a person exercises, making it harder to breathe (Rosenthal & Burchum, 2021). For adults and adolescents like this patient, it is recommended to use low-dose Inhaled Corticosteroid (ICS)- formoterol, commonly used budesonide-formoterol in a single inhalation of 200/6 mcg (delivered dose 160/4.5). Thus, it relieves the bronchospasm by using a bronchodilator with corticosteroids to prevent any reoccurring and severe exacerbation attacks(Rosenthal & Burchum, 2021). However, suppose this medication is not available. In that case, a patient could still use Short-acting Beta-agonists, but a patient needs to inhale a low dose of ICS (Global Initiative for Asthma, 2021). Furthermore, one must be cautious, as past recommendations of inhaling only Short-acting Beta-agonists (SABA) that had been found to increase asthma attack death due to exacerbation of asthma. That is why corticosteroids were added in low doses for the attack to lessen the inflammation and decrease the aggravation.

Q2. If the patient’s asthma attacks occur more frequently, what changes in therapy might be appropriate?

In starting asthma medication therapy, a patient needs to be reexamined 2-3 months after or whenever there is a frequent attack. Suppose these attacks occur more frequently than exercise; to provide the best quality care, Healthcare professionals need to assess the patient’s medication adherence, inhalation techniques, or any environmental stimuli that can cause aggravation or asthma attacks. If identified any problems, the patient needs a proper education or reinforcement before stepping up with the medications (Global Initiative for Asthma, 2021).

If identified, with assessment and evaluation, depending on how frequent asthmatic episodes are without any problem with techniques or adherence, the patient might consider taking low doses of budesonide-formoterol or daily low dose of ICS with SABA pre-exercise. Thus, this will consider a maintenance and reliever treatment (MART). If the patient is taking SABA, consider adding ICS-Long-acting Beta Agonist (LABA) with as-needed SABA. Moreover, consider checking within 2-3months. If this does not reduce asthma attacks and episodes more frequently, consider increasing medication, adding moderate ICS, adding long-acting muscarinic antagonists, adding sublingual allergen immunotherapy, and refer for phenotyping (Global Initiative for Asthma, 2021).

Q3. What will you assess to determine if this patient is a good candidate for contraceptives, and what will you prescribe? (Include brand and generic name, route, frequency, and dose). What is the mechanism of action of the contraceptive you prescribed and the adverse effects?

Healthcare providers need to assess the patient physically, mentally, emotionally, socially, and financially. Healthcare professionals need to identify physical needs, determining patients’ age, body, weight, vital signs, and any past and present medical conditions that are contraindicated for specific contraceptives to evaluate patients for any pregnancy or any Sexually transmitted disease that might be advantageous or disadvantageous on choosing a contraceptive method. Additionally, healthcare professionals need to explain the side effects of diverse kinds of contraception. Another area is the patient’s emotional needs, readiness, and goals, whether the patient’s plan for future pregnancy or not, whether the patient is willing to do it daily, or wants it for a more extended period if she has any problems with needles or any okay with inserting IUD. Socially, whether the patient is considering any protection for STD or whether being sensitive to others seeing it. And financially, the cost and availability of various kinds of contraceptives.

Given the patient’s age and being a college student, I would consider her to use Intrauterine Device (IUD), the most reliable birth control. I would prescribe a hormone-free copper (Paragard). With this age and busy with college, a hormonal IUD might benefit her since it does not carry any risk of side effects of hormonal birth control medications. The primary mechanism of action of this IUD is that it causes a foreign body reaction and chemical changes that are toxic to sperm. The good thing about this IUD is that it can last for 10years (Rosenthal & Burchum, 2021). A non-surgical procedure is done during a routine visit to be inserted from the cervical canal to the uterine cavity.

Moreover, if a patient decides to get pregnant, the patient can be pregnant right away once the IUD is taken away. Additionally, the ParaGard can be used as emergency contraception if inserted five days after unprotected sex. However, there are some side effects of this method. It includes Bleeding between periods, Cramps, Severe menstrual pain, and heavy bleeding (Mayo Clinic, 2022). Another essential thing to understand is that IUDs cannot protect patients from STDs—Healthcare professional needs to discuss this and provide another secondary contraceptive against STDs like a condom to protect against STDs.

Q4. The patient states she heard a pill can help her acne. What would you prescribe and your rationale? (Include brand and generic name, dose, route, and frequency).

To guide the patient more clearly, I would like to assess further and evaluate the patient’s condition and concerns. I am torn between two medications for acne. I am caught between Isotretinoin and hormonal agent. However, as a young woman like her, I prefer to give her a hormonal agent. That means it could function as an oral contraceptive and help with her acne. I would recommend combinations of Oral contraceptives (OCs)- drospirenone/Ethinyl estradiol (generic), YAZ (brand name), 28-day pack 3mg/20mcg tab x24, then inert tab x4. Patient to start on day one of the menstrual cycle or 1st Sunday after the onset of menses. The patient using the copper IUD does not have any hormones, so it would be fine if she chose to take OCs for acne and still wanted to get a copper IUD (Planned Parenthood, 2014).

Q5. The patient is concerned because her mother and sister developed fractures in their legs and vertebra after menopause. She wants to know what medication and other advice will prevent osteoporosis. You discuss bisphosphonates. How are they used in the prevention and treatment of osteoporosis?

Bisphosphonates work in target areas of higher bone turnover by slowing down the cells which break down bone (osteoclasts). Therefore, they slow down bone loss, allowing the bone-building cells (osteoblasts) to work more effectively. Thus, it can help strengthen the bone and help to prevent it from getting any weaker. Be mindful of taking this medication with a full glass of water and remain upright for 30 minutes (Cancer Research UK, 2019). To prevent osteoporosis after menopause, the patient needs to be mindful of recommended Vitamin D and Calcium. Vitamin D is for absorption. The patient needs to adjust needs for calcium increases to 1200 mg/day. At the same time, a patient needs to increase his lifestyle on promoting bone health, including walking, weight-bearing exercise, avoiding excessive alcohol, and smoking (Rosenthal & Burchum, 2021).

Q6. How would you treat this patient’s acute gouty attack? Please list the trade and generic name and the dose of therapy. What is the mechanism of action of your choice of prescription?

In acute gout attacks, the main priority is to reduce inflammation and pain. Thus, the patient needs Nonsteroidal Anti-inflammatory Drugs (NSAIDs). It is considered the first choice and much tolerable. I will use Indomethacin (generic name) and Indocin (brand name). The mechanism of action of this medication inhibits cyclooxygenase, reducing prostaglandin and thromboxane synthesis. For acute gout, the patient could start with 50 mg three times a day until the pain is tolerable, then reduce dosage and continue dosing for 3-5 days (Rosenthal & Burchum, 2021).

References:

Cancer Research UK. (2019, November 27). How bisphosphonates work. How bisphosphonates work | Cancer Research UK. Retrieved April 13, 2022, from https://www.cancerresearchuk.org/about-cancer/cancer-in-general/treatment/bisphosphonates/how-bisphosphonates-work

Global Initiative for Asthma. (2021, June 17). 2021 Gina Main Report – Global Initiative for Asthma. GINA. Retrieved April 13, 2022, from https://ginasthma.org/gina-reports/