Design your own study using one of the following statistical tests: one-sample t-test, paired samples t-test, independent samples t-test, or ANOVA. Give (1) your sample, (2) research question, (3) the appropriate test with the null and research hypotheses, and (4) the two variables, including (a) how you would measure both variables and (b) each variable’s level of measurement. Be creative. Do not include data in your response.

Response Posts:

Read the posts of other learners and respond to at least 2 other learners. Your responses are expected to be substantive in nature and reference the assigned readings, as well as other theoretical, empirical, or professional literature to support your views and writings.

DISUSSION 1:

For my study, I will be examining the effect that regular exercise has on self-reported indicators of major depressive disorder. The sample will be selected from University volunteers who test with an initial score greater than or equal to 10 using the widely accepted “Patient Questionnaire 9 (PHQ-9)”, suggesting at least moderate depression (Kroenke, et al. 2001). The sample will be further filtered to include only volunteers who report participating in little-to-no daily exercise, and who lack physical disabilities making daily exercise unreasonably difficult or unsafe. The final cohort will be asked to perform a daily exercise routine designed by a personal trainer who will provide initial instruction. After 2 months, each member of the study that reports that they completed the daily exercises at least half the time will again be administered the PHQ-9. Study members who reported that they did not perform the exercises at least half the time will be retroactively removed from the cohort. The final PHQ-9 scores of the final cohort will be compared to the initial PHQ-9 scores to measure any change. The research question I seek to answer is whether regular daily exercise can impact symptoms of depression. To answer this question I will use a paired samples t-test to compare the mean PHQ-9 scores before and after the study period. This test will attempt to disprove the null hypothesis that there was no significant change in PHQ-9 over the course of the study, and thus lend support to the research hypothesis that there was a change in mean PHQ-9 by the end of the study. The variables used in this study are 1) whether or not an individual participates in regular daily exercise (nominal), and 2)  PHQ-9 score, which is the sum of 9 multiple-choice questions in which each possible answer to each question is assigned a score from 0-3, the sum PHQ-9 score for each individual is a discrete interval variable consisting of whole numbers from 0 to 27, with higher numbers corresponding to a higher degree of depression.

DISCUSSION 2:

My study will be a paired samples t-test. My study will have 100 people with diabetes try a new medication meant to help lower their hemoglobin A1c. Their A1c will be measured before they start this medication and 1 year later. Hemoglobin A1c is measured via a blood test, and helps to identify how well your blood sugar is controlled over the previous 3 months.My sample is 100 people with diabetes. My research question is is there will be a difference in the means of the samples A1c results before and after taking the medication.My null hypothesis is that there will be no difference in the means of the samples A1c results before and after taking the medication.My two variables are: A1c results prior to taking the medication and A1c results after taking the medication. 

I’m working on a nursing discussion question and need an explanation to help me learn.

Respond to these 3 different discussion board with 2 or 3 paragraphs and 2 references for each of the 3 discussions. Do not combine the 3 answers, you need to post each answer with its 2 references. Use APA 7th book

Alcohol Withdrawal Syndrome

The case that I will share in this discussion is under substance use disorder. The patient I have is J.R, a 52 y/o Hispanic male admitted to the hospital for alcohol withdrawal. He was alert, oriented x3 with periods of confusion and forgetfulness. He is single with no children and lives with his father and brothers. He has a history of GERD, alcohol abuse for 35 years, claiming he drinks 5-7 (32oz) a day. He denies any health concerns or abuse; however, he has had a suicide attempt in 2001 in which he cut his wrist. He has anxiety for years and identifies himself as an alcoholic. He went to rehab 5-6 times and Alcohol Anonymous, but he gets disappointed and relapses. He is currently unemployed and has no insurance.

He was admitted to the unit with a chief complaint of chest pain and stated that he had an anxiety attack that caused him to have shortness of breath. He was referred to addiction medicine and social work. Since covid-19 is still affecting California currently, some consults call the patient in their room. During the addiction medicine consult, an RN called the patient, but the patient declined to answer any questions and stated that he was okay. The nurse placed information on alcohol and drug treatment programs in the patient discharge summary and signing off. He was given his morning medication, including chlordiazepoxide (Librium), and was given lorazepam (Ativan) an hour prior.

The social worker spoke to me before seeing the patient and gave her information on how the patient is regarding cognition. The social worker gave him counseling, possible coping techniques, and a rehab referral list. The dilemma that I felt is how can the RN who worked for addiction medicine dismissed the consult that easily. The patient might be impaired due to withdrawal and medication. The patient was very groggy while speaking to the nurse over the phone; what if the social worker didn’t come? Is it because the patient does not have insurance? I was very thankful that the social worker arrived. If not, then I would feel that there is no justice in my patient’s case.

The Alcohol Withdrawal Syndrome (AWS) is the typical Alcohol Dependence Syndrome presentation (Sachdeva et al., 2015). The symptoms happen when an alcohol-dependent individual tries to stop or reduce heavy or prolonged alcohol use. The most common manifestations are tremor, restlessness, insomnia, nightmares, paroxysmal sweats, tachycardia, fever, nausea, vomiting, seizures, hallucinations (auditory, visual, and tactile), increased agitation, and tremulousness (Sachdeva et al., 2015). These signs and symptoms are caused by the interruption of the constant exposure of the Central Nervous System (CNS) to alcohol itself (Sachdeva et al., 2015). Hoffman and Weinhouse (2021) stated that alcohol simultaneously enhances inhibitory tone (via modulation of gamma-aminobutyric acid [GABA] activity) and inhibits excitatory tone (via modulation of excitatory amino acid activity). In a patient with alcohol dependence, homeostasis is only preserved with ethanol—abrupt cessation results in the central nervous system overactivity (Hoffman & Weinhouse, 2021).

The neurotransmitters involved in alcohol withdrawal are GABA, Glutamate, and Dopamine. The GABA receptor complex has particular binding sites for ethanol. Chronic ethanol use induces insensitivity to GABA. Cessation of alcohol or a reduction from chronically elevated concentrations results in decreased inhibitory tone (Hoffman & Weinhouse, 2021). When glutamate binds to the N-methyl-D-aspartate (NMDA) receptor, calcium influx leads to neuronal excitation by binding to the NMDA complex’s glycine receptor. Ethanol inhibits glutamate-induced excitation. Cessation of alcohol or a reduction from chronically elevated concentrations results in unregulated excess excitation (Hoffman & Weinhouse, 2021). Increases in dopamine during withdrawal likely contribute to hyperarousal (Hoffman & Weinhouse, 2021). The CYP-450 enzyme affected is CYP-450 2E1 which oxidizes ethanol to acetaldehyde, and then to acetic acid, roles also played by alcohol and aldehyde dehydrogenases ( Peter Guengerich & Avadhani, 2018).

Benzodiazepines (BZD) are the mainstay treatment in alcohol withdrawal (Sachdeva et al., 2015). The most used benzodiazepines for alcohol detoxification are chlordiazepoxide, diazepam (long-acting) and lorazepam, oxazepam (short/intermediate-acting). Benzodiazepines are cross-tolerant with alcohol and modulate anxiolysis by stimulating GABA-A receptors. It may serve as a substitute for the agent that is being withdrawn (Sachdeva et al., 2015). BZDs have been found effective in 1) preventing agitation and alcohol withdrawal seizures, 2) preventing delirium tremens, and 3) as cross-tolerant agents with ethanol (Sachdeva et al., 2015).

The management of alcohol withdrawal is directed at alleviating symptoms and identifying and correcting metabolic derangements. Benzodiazepines are used to control psychomotor agitation and prevent progression to more severe withdrawal. Supportive care, including intravenous (IV) fluids, nutritional supplementation, and frequent clinical reassessment, including vital signs, is essential (Hoffman & Weinhouse, 2021).

References

Hoffman, R. S., & Weinhouse, G. L (2021). Management of moderate and severe alcohol withdrawal syndromes. UpToDate. https://www.uptodate.com/contents/management-of- moderate-and-severe-alcohol-withdrawal-syndromes

Peter Guengerich, F., & Avadhani, N. G. (2018). Roles of Cytochrome P450 in metabolism of ethanol and carcinogens. Advances in experimental medicine and biology, 1032, 15–35.https://doi.org/10.1007/978-3-319-98788-0_2

Sachdeva, A., Choudhary, M., & Chandra, M. (2015). Alcohol withdrawal syndrome: Benzodiazepines and beyond. Journal of clinical and diagnostic research: JCDR, 9(9), VE01–VE07. https://doi.org/10.7860/JCDR/2015/13407.6538

2.

Alcohol Withdrawal Syndrome

Alcohol consumption is widespread throughout developed countries, with over 8 million people in the U.S. dependent on alcohol (Drew et al. 2017). According to Drew et al. (2017) postulate that approximately 20% of men and 10% women will suffer an alcohol-use disorder, also half will experience withdrawal symptoms such as seizures and delirium tremens (DTs) will occur in 3-5%. According to Wong et al. (2015), stipulates that alcoholism can affect the brain and behavior in a variety of ways, and multiple factors can impact these effects. Ethanol is the primary alcohol ingested by chronic user.

DT occurs in 3-5% of patients who are hospitalized for alcohol withdrawal (Yanta et al. 2015). DT usually begins 3 days after the appearance of withdrawal symptoms and lasts for 1 to 8 days, though symptoms may appear as quickly as 8 hours from the last drink. The mortality of hospitalized patients with DT is currently estimated to be 1- 4%; however, prior to the era of benzodiazepine use and intensive care, mortality reached 35% (Schmidt et al. 2016). DT can be predicted by several factors. If seizures remain untreated, up to one third of patients progress to DT. Other common factors include history of prior DT and Clinical Institute Withdrawal Assessment of Alcohol Scale, revised (CIWA-Ar) score > 15 (Drew et al. 2017).

My case discussion for this assignment is under substance use disorder. Mr. PB is a 55

year old African American male who was brought to my hospital emergency department (ED) by EMS after he was found down in alley. This admission is one of his numerous admissions for alcohol withdrawal. In the ED he was so confused, intermittently seizing, requiring IV Ativan administration. His initial labs showed elevated cardiac enzymes, LFT, ETOH level 300mg/dl and abnormal electrolytes. Based on the above work up, intensive care consult was required, and MR. PB subsequently admitted to the intensive care unit (ICU) for further treatment. On arrival to the unit PB was still in his drenched street clothes he had on when EMS picked him up in a street alley. PB was so dirty shivering and full of urine. In a little discussion with the transporting ED nurse on patient’s hygiene. His response was “nursing is 24 hours ok” and walked away.

Assessment: After stabilizing PB I called and spoke to ED Manager about patient’s condition on admission to ICU. She gave numerous flimsy excuses for the nurse’s action. This is one of so many instances of poor care by some of the ED nurses that was never addressed. This is a management issue that hinders appropriate care. If this issue had been addressed previously PB

would not have arrived at the unit wet and shivering. This is very frustrating because it can slow down care flow of the patient. PB was talking excessively, tossing all over his bed, exhibiting tactile hallucination which is expected from alcohol syndrome (AWS). He was also very anxious, diaphoretic, palpitation with hyperreflexia. CIWA-Ar) score > 18

Management: Patients was kept calm in a controlled environment to try to reduce the risks of progression from mild symptoms to hallucinations. PB was started on intravenous rehydration, abnormal electrolytes corrected and ruled out for another comorbidity. With mild to moderate symptoms, patients should receive supportive therapy. Due to the risk of a comorbid condition called Wernicke-Korsakoff syndrome, patients can also receive a “banana bag” or cocktail of folate, thiamine, dextrose containing fluids, and a multivitamin (Newman et al. 2020). PB was also started on Serax (Oxazepam) 15mg orally every six hours with instruction to hold for sedation. Serax is part of benzodiazepine class of drugs mostly used for DT management. It works by slowing down the CNS to elicit feelings of calm and relaxation. Received Zofran 4mg IV as needed for nausea and vomiting. After two days in ICU, PB’s symptoms improved and was transfer to telemetry unit with case management consult for rehabilitation.

Several neurotransmitter receptors such as gama-aminobutyric acid (GABA), glutamate, dopamine, acetylcholine, and serotonin are vulnerable to the effects of alcoholism. Chronic ethanol ingestion leads to down regulation changes of the GABA receptors. Additionally, in chronic alcoholics, N-methyl-D-aspartate (NMDA) receptors undergo conformational changes and up-regulation. Therefore, when there is discontinuation of alcohol intake, patients lose the GABA inhibitory effect, leading to central nervous system (CNS) hyper stimulation.

Conclusion: Due to the widespread prevalence of alcohol use, disorders involving alcohol withdrawal are common. Alcohol withdrawal syndrome may result in morbidity and mortality, thus requiring early recognition and management. Stages of withdrawal include withdrawal symptoms, hallucinations, seizures, and delirium tremens. Treatment of AWS focuses on providing medications with GABA receptor activity (Newman et al. 2020). Benzodiazepines with symptom triggered therapy have been the predominant medication class utilized for AWS.

References

Drew, L., Brit, L. & Alex, K. (2017). The emergency management of severe alcohol withdrawal. The American Journal of Emergency Medicine, 35(7):1005-1011.

Newman, R. K. Stobart -Gallagher, M. A. & Gomez, A. E. (2020). Alcohol withdrawal.

Stat pearls Internet

Schmidt, K. J,, Doshi, M. R., Holzhausen, J.M., Natavio, A., Cadiz, M., Winegardner, J. E. (2016).

Treatment of severe alcohol withdrawal. Annals of Pharmacotherapy, 50(5):389-401.

Wong A, Benedict, N. J., Lohr. B. R., Pizon, A. F., & Kane-Gill, S. L. (2015). Management of

benzodiazepine-resistant alcohol withdrawal across a healthcare system: Benzo-

diazepine dose-escalation with or without propofol. Drug Alcohol Depend, 154:296-9.

Yanta, J. H., Swartzentruber, G. S., Pizon, A. F. (2015). Alcohol withdrawal syndrome: Improving

outcomes through early identification and aggressive treatment strategies. Emergency

Medicine, 17(6):1-20.

Basic_and_Clinical_Pharmacology_Fourteen.pdf (15.785 MB)

3.

Alcohol Use Disorder

The case I will share concerns patient CC. The patient was black, and she is 46 years old. She was brought into the hospital with a severe case of alcohol disorder. She had been abusing alcohol for a long time, and she had refused to go to rehab. Her brother and mother brought her in. In addition to having an alcohol use problem, she was also HIV positive and hypertension. This is the second time she was seeking treatment for alcohol abuse. Her family knew the importance of seeking treatment for alcohol abuse, but the patient had refused to go back despite having the problem for close to eight years now. She smokes and drinks uncontrollably. This time she passed out on the streets, and a neighbor who was walking by happened to see her. She was then rushed to the hospital. Her loved ones thought this was a good chance to seek treatment again because she does not go to Alcoholic Anonymous anymore(AA). She has a history of hypertension and takes Metropol 500mg twice a day. The patient has no known allergy.

The ethical dilemma issue in the case happened after she was hospitalized. She started having a relationship with a fellow patient admitted for the same point. It was not clear whether they were having sex, but given that I had the files for both patients, I knew that the other patient was not HIV positive. I was caught between a rock and a hard place on whether to disclose the information of one of the patients to the other as a way of protecting him. It was also not clear if what they had was a romantic relationship. Therefore, it was not easy to know whether it was appropriate to discuss the situation with both of them. I considered counseling them about safe sex; however, it would seem inappropriate if what they were having was just a platonic relationship. I was also restricted by the requirement to keep the patient information private (HHS.gov, 2015). The other patient, who was male, improved and was released earlier before it was apparent whether they had a relationship. He would come to the hospital to see her, which meant that it was impossible to tell him anything since he was no longer a patient.

In the case of CC, there was a need to put her under both pharmacological and non-pharmacological care. Naltrexone was prescribed which brand name is Vivitrol 50mg by mouth twice a day. Titration of 50mg during and 100mg weekend together with cognitive-behavioral therapy. It was clear from her history that the death of her father led her to alcoholism. They were very close, and she unable to get over his death. Depression leads to alcohol abuse. Alcohol abuse had interfered with her studies, and she did not finish college. Alcoholism disrupts one’s life greatly (Mayo Clinic, 2018). She ran away from home when her loved ones said that they would take her to rehab. They were worried, and that is why they agreed not to take her for treatment again, provided she did not run away from home again. Her condition had gotten worse, and she would go for days without her family knowing where she was. Her relationship with patient DD kept her in hospital, and she showed commitment to the treatment.

The teaching considerations for patient CC must include informing her of the side effects of the medicine. The side effects include headaches, diarrhea, constipation, dizziness, among others. However, the side effects would disappear in a few days or two weeks at most (Familydoctor.org editorial staff, 2020). There was also a need to inform her caregivers what to expect once the patient was discharged. They were also told that her urge to drink would not go away because of chronic alcohol. However, the medication could help her overcome the desires. She will need a social worker and help with nutrition. There is also a need to help her turn her life around and engage in other productive activities. It was important for the patient to understand that a large intake of naltrexone could cause liver damage (Earley et al., 2017).

References

Earley, P. H., Zummo, J., Memisoglu, A., Silverman, B. L., & Gastfriend, D. R. (2017). Open-label study of injectable extended-release Naltrexone (XR-NTX) in healthcare professionals with opioid dependence. Journal of Addiction Medicine, 11(3), 224-230. https://doi.org/10.1097/adm.0000000000000302

Familydoctor.org editorial staff. (2020, September 1). Naltrexone for alcoholism. familydoctor.org. https://familydoctor.org/naltrexone-for-alcoholism/

HHS.gov. (2015, April 16). Privacy. https://www.hhs.gov/hipaa/for-professionals/privacy/index.html

Mayo Clinic. (2018, July 11). Alcohol use disorder – Diagnosis and treatment – Mayo Clinic. Mayo Clinic – Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/alcohol-use-disorder/diagnosis-treatment/drc-20369250

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Assignment 1: Case Study Assignment: Assessing Neurological Symptoms

Photo Credit: Getty Images/iStockphoto

Imagine not being able to form new memories. This is the reality patients with anterograde amnesia face. Although this form of amnesia is rare, it can result from severe brain trauma. Anterograde amnesia demonstrates just how impactful brain disorders can be to a patient’s quality of living. Accurately assessing neurological symptoms is a complex process that involves the analysis of many factors.

In this Case Study Assignment, you will consider case studies that describe abnormal findings in patients seen in a clinical setting.

To Prepare

• By Day 1 of this week, you will be assigned to a specific case study for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.
• Also, your Case Study Assignment should be in the Episodic/Focused SOAP Note format rather than the traditional narrative style format. Refer to Chapter 2 of the Sullivan text and the Episodic/Focused SOAP Template in the Week 5 Learning Resources for guidance. Remember that all Episodic/Focused SOAP notes have specific data included in every patient case.

With regard to the case study you were assigned:

• Review this week’s Learning Resources, and consider the insights they provide about the case study.
• Consider what history would be necessary to collect from the patient in the case study you were assigned.
• Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?
• Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.

The Case Study Assignment

Use the Episodic/Focused SOAP Template and create an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template provided in the Week 5 resources. Provide evidence from the literature to support diagnostic tests that would be appropriate for each case. List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each.

The sample/template is attached. Please check that. Rubric and problem statement in detail is also attached. Please let me know if you need me to send any resources which are listed in the materials

My case study is:

CASE STUDY 1: Headaches: Adaso, Adekakun, Cole-Godfrey, Coleman, Dyson and Ekenta

A 20-year-old male complains of experiencing intermittent headaches. The headaches diffuse all over the head, but the greatest intensity and pressure occurs above the eyes and spreads through the nose, cheekbones, and jaw.

Vital Organs / Unconscious State

1. Name some very important organs that are not vital organs.
2. List the functional description of all the normal vital organs, including today’s exceptions.
3. Is it possible to live without a vital organ? Why? Example?
4. Distinction between assisting or substituting vital organs. Bioethical analysis.
5. Do the following practices assist or substitute the vital organ? Why?
   • Dialysis
   • Respirator
   • Ventilator
   • Tracheotomy
   • CPR
6. Read and summarize ERD PART FIVE Introduction.
7. Unconscious state: Definition.
8. Clinical definitions of different states of unconsciousness: Compare and contrast
9. Benefit vs Burden: bioethical analysis.

Submission Instructions:

• The paper is to be clear and concise and students will lose points for improper grammar, punctuation, and misspelling.
• If references are used, please cite properly according to the current APA style. Refer to your syllabus for further detail or contact your instructor.
• Complete and submit the assignment by 11:59 PM ET Wednesday
• 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 and grading from the instructor before the next assignment is due.
• Read
  • Ethical and Religious Directives (ERD) for Catholic Health Care Services (6th ed.). (2018).
    PART FIVE: Introduction
  • Watch
  • Cioffi, A. (2019, March 9). BIO 603 VITAL ORGANS ASSIST SUBST 3 9 19 [Video file]. Retrieved from BIO 603 VITAL ORGANS ASSIST SUBST 3 9 19 (Links to an external site.)
  • Cioffi, A. (2019, March 24). BIO 603 UNCONSCIOUS 3 23 19 [Video file]. Retrieved from BIO 603 UNCONSCIOUS 3 23 19 (Links to an external site.)
  • Essay/Paper RubricCriteriaRatingsPtsIdentification of Main Issues/Problems
    view longer description
    30 pts
    Distinguished
    Identify and demonstrate a sophisticated understanding of the issues/problems.
    27 pts
    Excellent
    Identifies and demonstrate an accomplished understanding of most of issues/problems.
    26 pts
    Fair
    Identifies and demonstrates a fair understanding of most of the issues/problems.
    24 pts
    Acceptable
    Identifies and demonstrates an acceptable understanding of most of the issues/problems.
    21 pts
    Unacceptable
    Identifies and demonstrate an unacceptable understanding of most of issues/problems.
    / 30 pts
    Analysis and Evaluation of Issues/Probelms
    view longer description
    25 pts
    Distinguished
    Presents an insightful, thorough analysis and evaluation of issues/problems.
    23 pts
    Excellent
    Presents a thorough analysis and evaluation of most of the issues/problems.
    21 pts
    Fair
    Presents a superficial analysis and evaluation of issues/problems.
    19 pts
    Acceptable
    Presents an acceptable analysis and evaluation of issues/problems.
    17 pts
    Unacceptable
    Presents unacceptable analysis and evaluation of issues/problems.
    / 25 pts
    Demonstrates a Conceptual Understanding
    view longer description
    25 pts
    Distinguished
    Provides a thorough, competent and interpretive responses to all issues/problems, and shows a high level of conceptual understanding.
    23 pts
    Excellent
    Provides a competent and interpretive responses to all issues/problems, and shows a moderate level of conceptual understanding.
    20 pts
    Fair
    Provides competent responses to all issues/problems, but lacks interpretation and a moderate level of conceptual understanding.
    18 pts
    Acceptable
    Provides acceptable responses to all issues/problems, lacks interpretation and a moderate level of conceptual understanding.
    17 pts
    Unacceptable
    Provides an unacceptable response to all issues/problems, and lacks interpretation and a moderate level of conceptual understanding.
    / 25 pts
    Use of Citations to Course Readings and Additional Research/Literature
    view longer description
    10 pts
    Distinguished
    Effectively uses the literature and other resources to inform their work. Exceptional use of citations and extended referencing.
    8 pts
    Excellent
    Effectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing.
    6 pts
    Fair
    Superficially uses the literature and other resources to inform their work. Moderate use of citations and extended referencing.
    4 pts
    Acceptable
    Acceptable uses of the literature and other resources to inform their work. Lack of use of citations and extended referencing.
    2 pts
    Unacceptable
    Unacceptable uses of the literature and other resources to inform their work. Unacceptable use of citations and extended referencing.
    / 10 pts
    Writing Mechanics and APA Formatting Guidelines
    view longer description
    10 pts
    Full Marks
    Demonstrate a high level of clarity, precision, and attention to detail. APA style is correct and writing is free of grammar and spelling errors.
    8 pts
    Excellent
    Demonstrate a high level of clarity. APA style and writing mechanics need more precision and attention to detail.
    6 pts
    Fair
    Demonstrate a moderate level of clarity. APA style and writing mechanics need more precision and attention to detail.
    4 pts
    Acceptable
    Demonstrate an acceptable level of clarity. APA style and writing mechanics need more precision and attention to detail.
    2 pts
    Unacceptable
    Demonstrates an unacceptable level of writing and communicating clearly. APA style and writing mechanics need serious attention.
    / 10 pts

I’m working on a social work discussion question and need an explanation to help me understand better.

In a thoughtful and respectful manner, respond to the following questions:

1. Christians are called to show compassion and understanding; if it will bring happiness to homosexuals, why should we oppose same-sex marriage?
2. If you believe same-sex marriage should not be opposed, then explain why not? Use biblical and empirical support for your answer.
3. How may one stand for something like same-sex marriage without being judgmental? Support your view on the difference between confronting sin and being judgmental using scripture.    

 

I’m working on a social work discussion question and need an explanation to help me learn.

Rounds and dyads are excellent techniques for support and counseling groups, and they may also be effectively used in other types of groups. Describe one specific example of a round and one specific example of a dyad exercise that you could implement in a meeting with a task group, project group, or team to enhance the motivation, decision making process, performance, and/or productivity of the group. Offer helpful recommendations on how to refine or adapt these exercises and feel free to share relevant experiences from group/team meetings in your personal or professional context.

I’m working on a nursing discussion question and need an explanation to help me study.

A phenomenon is the term used to describe a perception or responses to an event. Examples of phenomena in nursing include caring and responses to stress. Assumptions are the ideas that we take for granted. They explain the nature of the concepts in the theory, giving it structure.

Choose a middle-range theory or grand theory that, in your opinion, can be applied to research.

What is the phenomenon of concern in this theory?

What are the assumptions underpinning this theory?

You are an assistant practice manager of a medical practice where the physicians specialize in diagnosis and treatment of cancer patients. The mission of the practice encompasses the area of the patient’s mental health associated with a cancer diagnosis. To address the psychological and sociological issues that patients endure, the physicians have decided to institute a program to address these factors. Your practice manager has put you in charge of the project.

Using the Total Quality Management/ COI protocols, address the following:

1. Developing a plan:  

• Describe the premise of the program and/or what goals would you need to consider.
• Describe two specific outcomes that you would want to achieve through the program.
• Describe three specific activities that you believe would be possible techniques for achieving those outcomes.
• For each the three specific activities that you considered, discuss the strengths, weaknesses, opportunities, and threats (SWOT) for each.
• Identify the one specific activity, from the possible techniques above, that you believe is the best option to reach the best outcomes.
• Provide details to support your rationale for choosing this one specific activity
• Describe the technique (s) by which you will measure the effectiveness of your activity.

1. Present your plan in clear, scholarly, and grammatically correct language. You can choose to present the plan in any format that you think will be most effective in conveying your decision process.

The Program “Harm Reduction” provided by Sacramento County, target people who are living with a substance use disorder. I propose to adapt this program, to target youth choosing to join a gang, instead of getting involved in curriculum activities, such as music program, sports, and theater. I would recommend using incentives, to get them to want to focus on their future, such as access to programs, and extra curriculum activities, that prepare at risk youth for future careers, and shift their outlook on life. Provide interactive educational engagement programs, such as classroom theory and on the job training in chosen career field, or what they are passionate about. It is important to think outside of the box for at risk youth, their needs are specific and programs should be tailored to provide the supplies, skills, and education, that they lack access to. It is also imperative to involve the youth in planning programs, because they need to become aware of their self-worth, and recognize the importance of valuing the gifts, talents and abilities, they have to offer. They have to be assisted to get to a position, where they are able to see a bright future, a place of hope.

 The powerful increase in intercultural cooperation and the attendant compound problems of fairness, racism, intolerance, fear, and marginalization have compelling negative impacts on disparate social organizations, and point to the need for artistry and groundworks that can oversee these problems (Gopalakrishnan.)