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Discussion: Over-Treatment and Under-Treatment of Addiction The term levels of treatment refers to a continuum arranged by intensity of treatment. The levels of treatment range from the least to the most intense and aggressive approaches. The American Society of Addiction Medicine's Patient Placement Criteria (PPC), the most frequently used and studied treatment levels classification system, divides the intensity continuum into four levels (Mee-Lee & Gastfriend, 2008). The PPC starts with Level I, outpatient treatment, which includes the least aggressive approaches. The system increases incrementally in intensity ending with Level IV, intensive inpatient treatment. The appropriate level of treatment is determined by many factors, including the severity of addiction, prior treatment history, and the unique needs of the individual receiving the services. It is often desirable to try the least intrusive and restrictive level of treatment appropriate, as long as the individual's safety is not jeopardized. Other important factors must also be considered when determining the appropriate level of treatment, such as the need to continue earning a living or raising a family and the individual's stage of readiness for treatment (Prochaska, DiClemente, & Norcross, 1992). Knowledge of the levels of treatment may help an addiction professional determine the most appropriate levels of care based on the unique needs of each individual. Over-treatment and under-treatment of addiction can interfere with a client's progress on the path toward recovery and result in adverse consequences. For this Discussion, review this week's readings. Then review the media and reflect on how the counselor employed the continuum of levels of treatment in the counseling session with Marge. Consider potential consequences of over-treating or under-treating Marge. .
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Psychological Interventions in Inpatient Medical Settings: A Brief Review
Psychological Interventions in Inpatient Medical Settings: A Brief ReviewHealthcare and Medical Sciences
Background: Behavioral health conditions are prevalent among patients in inpatient medical settings and when not adequately treated contribute to diminished treatment outcomes and quality of life. Substantial evidence has demonstrated the effectiveness of psychological interventions in addressing behavioral health conditions in a range of settings but, to a lesser extent with psychologically-based interventions delivered in inpatient medical settings. Purpose: The purpose of this paper is to increase attention on psychological interventions being delivered to patients across a broad spectrum of medical specialties in inpatient medical settings to support the implementation of interventions to address increasing patient needs. Methods: This selected, brief review of the literature sought to describe published psychologically-based interventions delivered in inpatient medical settings. A search for studies catalogued on PubMed from 2007 to 2016 was examined and studies were included in the review if they were delivered within inpatient medical settings. Two reviewers independently assessed relevant studies for criteria. Results: A total of ten articles met the inclusion criteria with interventions targeting outcomes across four primary domains: 1) pain and fatigue; 2) cognition; 3) affective/emotional and; 4) self-harm. Several articles support interventions grounded in Cognitive-Behavioral Therapy and brief psychological interventions. Most studies reported favorable outcomes for the interventions relative to controls. Conclusions: Psychologically-based interventions, especially those that integrate components of cognitive-behavioral therapy and a multidisciplinary approach, can be implemented in inpatient medical settings and may promote improved patient outcomes. However, the quality of this evidence requires formal assessment, requiring more comprehensive reviews are needed to replicate findings and clarify effectiveness of interventions.Prospective Payment System
The document discusses the Medicare Inpatient Prospective Payment System (IPPS) which determines payment to hospitals based on Diagnosis Related Groups (DRGs). The IPPS was implemented in 1983 based on a Yale study from the 1970s. DRGs classify patients into groups based on diagnoses, treatment, age, resource use, and length of stay. There are now over 750 Medicare Severity DRGs (MS-DRGs) used to more precisely classify hospital stays and facilitate payment. The IPPS system puts the cost risk on hospitals by setting prospective payment rates based on average costs rather than actual costs.
Lecture 16: Patient Compliance-Dr.Naif
The document discusses factors that affect patient compliance with medical treatment. It examines compliance vs adherence and discusses factors like individual characteristics, disease factors, environmental factors, and the practitioner-patient relationship. Educational interventions have been found to have limited effectiveness on compliance, while behavioral strategies that focus on changing behaviors have been more effective. Reasons patients give for non-compliance include issues like side effects, cost, forgetting, and lack of belief in treatment effectiveness.
PatientBillofRights
The pharmaceutical industry has made it very difficult to know what the clinical trial evidence actually is regarding psychotropics. Consequently, primary care physicians and other front-line practitioners are at a disadvantage when attempting to adhere to the ethical and scientific mandates of evidence based prescriptive practice. This article calls for a higher standard of prescriptive care derived from a risk/benefit analysis of clinical trial evidence. The authors assert that current prescribing practices are empirically unsound and unduly influenced by pharmaceutical company interests, resulting in unnecessary risks to patients. In the spirit of evidenced based medicine’s inclusion of patient values as well as the movement toward health home, we present a patient bill of rights for psychotropic prescription. We then offer guidelines to raise the bar of care equal to the available science for all prescribers of psychiatric medications.
Adesão terapeutica
Therapeutic education of patients with chronic diseases like coronary heart disease is crucial to improve adherence to treatment plans. It involves using tools to motivate patients and provide information to help them actively manage their disease at the center of the treatment process. This ensures optimal adherence and reduces the risk of further health events. Therapeutic education aims to help patients understand their disease and treatment, cooperate with healthcare providers, live healthily and improve their quality of life. It has been shown to be effective by improving treatment adherence, reducing complications and increasing quality of life for various chronic conditions.
Chapter 14Mental HealthChapter ObjectivesOutline issue.docx
Chapter 14
Mental Health
Chapter Objectives
Outline issues inherent in the provision of mental health care in the correctional setting.
Understand when inmate participation in mental health care and treatment can be required.
Explore the right to privacy with regard to mental health records.
Introduction
Provision of mental health services is a necessary and complex part of any correctional operation.
Attention to planning and implementation of services to meet the mental health needs of population greatly contribute to a smooth running facility; inattention can lead to problems, negative publicity and litigation.
Correctional administrators must know the standards for care of mentally ill offenders.
Process for care of the mentally ill has changed significantly over the past fifty years. With the advent of psychopharmacology and focused therapies most people suffering from mental illness may be managed in outpatient settings.
Introduction
The management of most mentally ill patients as outpatients has resulted in the deinstitutionalization of people needing care.
However, the lack of community resources and existing support systems has led to the inadequate treatment of some mentally ill persons and has resulted in their placement in the criminal justice system.
Current data reflect more mentally ill persons in jails and prisons than in community mental institutions.
About half of the inmate population has been diagnosed with a mental health problem with approximately 16% diagnosed with serious mental illness.
The Diagnostic and Statistical Manual of Mental Disorders
Most commonly used classification system of mental illness and defects.
A mental disorder is a: “clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and that is associated with present distress or disability.”
Major mental disorders include diagnosis of: schizophrenia, major depression, or bipolar disorder.
Many inmates demonstrate personality dysfunction and meet criteria for Antisocial Personality Disorder and other personality disorders, which remain difficult to treat.
Guidelines and Standards
The responsibility for provision of care to those who are denied the ability to choose their own care because of confinement has been defined in the Courts and standards of several organizations published to review.
The current standard of care requires basic and clinically relevant care. Problems arise when care falls below accepted standards and may result in deliberate indifference.
Deliberate indifference can be evidenced by: lack of access, failure to follow through with care, insufficient provision of staff resources, and poor outcomes due to negligent care.
Guidelines and Standards
Several organizations have established minimum guidelines for the treatment of mentally ill in correctional environments:
a. American Correctional Association (ACA)
b. American Medical Association (AMA)
c. American Public He.
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This document summarizes a systematic review of studies examining mind-body practices for the treatment of psoriasis. The review identified 9 relevant randomized controlled trials involving a total of 379 participants comparing mind-body interventions like meditation, mindfulness, hypnosis and relaxation techniques to conventional medical treatments or other complementary interventions. While the studies showed some improvements in disease symptoms and psychosocial outcomes, the review found high risks of bias and noted limitations in the available evidence.
Therapeutic Interaction: A Perception of Therapist towards Patients with Anxi...
The present research was conducted (a) to describe the socio-demographic information of
psychotherapist providing therapy to patients of anxiety disorder (b) to examine the therapeutic interaction on
various variables of therapeutic participation, resistance and dysphoric concern (related to patient’s
responses), and directive support for the patients (variable related to his/herself). It was hypothesized that
therapist would rate significantly high on therapeutic interaction (therapeutic participation, directive support,
resistance and dysphoric concerns) with anxiety patient. Sample comprised of thirty five psychotherapist
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Inventory was administered to assess perception of therapeutic interaction of psychotherapist. Descriptive
statistics and one sample t test were calculated for the analysis of data. Results revealed that most of the
therapists, possessed MS degree in Clinical Psychology. Results indicate that there is a significant high rating
on therapeutic interaction, therapeutic participation, directive support, resistance and dysphoric concern of the
psychotherapist who are providing therapy to the anxiety patients. Therapeutic interaction is perceived by the
therapist as supportive, whereas participation, resistance and dysphoric concerns of the patients were also
perceived high by the therapist in initial sessions. Findings will be helpful for psychologist and other
professionals to plan the therapeutic interventions for anxiety patients
Recommended
Psychological Interventions in Inpatient Medical Settings: A Brief Review
Psychological Interventions in Inpatient Medical Settings: A Brief ReviewHealthcare and Medical Sciences
Background: Behavioral health conditions are prevalent among patients in inpatient medical settings and when not adequately treated contribute to diminished treatment outcomes and quality of life. Substantial evidence has demonstrated the effectiveness of psychological interventions in addressing behavioral health conditions in a range of settings but, to a lesser extent with psychologically-based interventions delivered in inpatient medical settings. Purpose: The purpose of this paper is to increase attention on psychological interventions being delivered to patients across a broad spectrum of medical specialties in inpatient medical settings to support the implementation of interventions to address increasing patient needs. Methods: This selected, brief review of the literature sought to describe published psychologically-based interventions delivered in inpatient medical settings. A search for studies catalogued on PubMed from 2007 to 2016 was examined and studies were included in the review if they were delivered within inpatient medical settings. Two reviewers independently assessed relevant studies for criteria. Results: A total of ten articles met the inclusion criteria with interventions targeting outcomes across four primary domains: 1) pain and fatigue; 2) cognition; 3) affective/emotional and; 4) self-harm. Several articles support interventions grounded in Cognitive-Behavioral Therapy and brief psychological interventions. Most studies reported favorable outcomes for the interventions relative to controls. Conclusions: Psychologically-based interventions, especially those that integrate components of cognitive-behavioral therapy and a multidisciplinary approach, can be implemented in inpatient medical settings and may promote improved patient outcomes. However, the quality of this evidence requires formal assessment, requiring more comprehensive reviews are needed to replicate findings and clarify effectiveness of interventions.Prospective Payment System
The document discusses the Medicare Inpatient Prospective Payment System (IPPS) which determines payment to hospitals based on Diagnosis Related Groups (DRGs). The IPPS was implemented in 1983 based on a Yale study from the 1970s. DRGs classify patients into groups based on diagnoses, treatment, age, resource use, and length of stay. There are now over 750 Medicare Severity DRGs (MS-DRGs) used to more precisely classify hospital stays and facilitate payment. The IPPS system puts the cost risk on hospitals by setting prospective payment rates based on average costs rather than actual costs.
Lecture 16: Patient Compliance-Dr.Naif
The document discusses factors that affect patient compliance with medical treatment. It examines compliance vs adherence and discusses factors like individual characteristics, disease factors, environmental factors, and the practitioner-patient relationship. Educational interventions have been found to have limited effectiveness on compliance, while behavioral strategies that focus on changing behaviors have been more effective. Reasons patients give for non-compliance include issues like side effects, cost, forgetting, and lack of belief in treatment effectiveness.
PatientBillofRights
The pharmaceutical industry has made it very difficult to know what the clinical trial evidence actually is regarding psychotropics. Consequently, primary care physicians and other front-line practitioners are at a disadvantage when attempting to adhere to the ethical and scientific mandates of evidence based prescriptive practice. This article calls for a higher standard of prescriptive care derived from a risk/benefit analysis of clinical trial evidence. The authors assert that current prescribing practices are empirically unsound and unduly influenced by pharmaceutical company interests, resulting in unnecessary risks to patients. In the spirit of evidenced based medicine’s inclusion of patient values as well as the movement toward health home, we present a patient bill of rights for psychotropic prescription. We then offer guidelines to raise the bar of care equal to the available science for all prescribers of psychiatric medications.
Adesão terapeutica
Therapeutic education of patients with chronic diseases like coronary heart disease is crucial to improve adherence to treatment plans. It involves using tools to motivate patients and provide information to help them actively manage their disease at the center of the treatment process. This ensures optimal adherence and reduces the risk of further health events. Therapeutic education aims to help patients understand their disease and treatment, cooperate with healthcare providers, live healthily and improve their quality of life. It has been shown to be effective by improving treatment adherence, reducing complications and increasing quality of life for various chronic conditions.
Chapter 14Mental HealthChapter ObjectivesOutline issue.docx
Chapter 14
Mental Health
Chapter Objectives
Outline issues inherent in the provision of mental health care in the correctional setting.
Understand when inmate participation in mental health care and treatment can be required.
Explore the right to privacy with regard to mental health records.
Introduction
Provision of mental health services is a necessary and complex part of any correctional operation.
Attention to planning and implementation of services to meet the mental health needs of population greatly contribute to a smooth running facility; inattention can lead to problems, negative publicity and litigation.
Correctional administrators must know the standards for care of mentally ill offenders.
Process for care of the mentally ill has changed significantly over the past fifty years. With the advent of psychopharmacology and focused therapies most people suffering from mental illness may be managed in outpatient settings.
Introduction
The management of most mentally ill patients as outpatients has resulted in the deinstitutionalization of people needing care.
However, the lack of community resources and existing support systems has led to the inadequate treatment of some mentally ill persons and has resulted in their placement in the criminal justice system.
Current data reflect more mentally ill persons in jails and prisons than in community mental institutions.
About half of the inmate population has been diagnosed with a mental health problem with approximately 16% diagnosed with serious mental illness.
The Diagnostic and Statistical Manual of Mental Disorders
Most commonly used classification system of mental illness and defects.
A mental disorder is a: “clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and that is associated with present distress or disability.”
Major mental disorders include diagnosis of: schizophrenia, major depression, or bipolar disorder.
Many inmates demonstrate personality dysfunction and meet criteria for Antisocial Personality Disorder and other personality disorders, which remain difficult to treat.
Guidelines and Standards
The responsibility for provision of care to those who are denied the ability to choose their own care because of confinement has been defined in the Courts and standards of several organizations published to review.
The current standard of care requires basic and clinically relevant care. Problems arise when care falls below accepted standards and may result in deliberate indifference.
Deliberate indifference can be evidenced by: lack of access, failure to follow through with care, insufficient provision of staff resources, and poor outcomes due to negligent care.
Guidelines and Standards
Several organizations have established minimum guidelines for the treatment of mentally ill in correctional environments:
a. American Correctional Association (ACA)
b. American Medical Association (AMA)
c. American Public He.
Mind Body Practices for Psoriasis-Crimson Publishers
This document summarizes a systematic review of studies examining mind-body practices for the treatment of psoriasis. The review identified 9 relevant randomized controlled trials involving a total of 379 participants comparing mind-body interventions like meditation, mindfulness, hypnosis and relaxation techniques to conventional medical treatments or other complementary interventions. While the studies showed some improvements in disease symptoms and psychosocial outcomes, the review found high risks of bias and noted limitations in the available evidence.
Therapeutic Interaction: A Perception of Therapist towards Patients with Anxi...
The present research was conducted (a) to describe the socio-demographic information of
psychotherapist providing therapy to patients of anxiety disorder (b) to examine the therapeutic interaction on
various variables of therapeutic participation, resistance and dysphoric concern (related to patient’s
responses), and directive support for the patients (variable related to his/herself). It was hypothesized that
therapist would rate significantly high on therapeutic interaction (therapeutic participation, directive support,
resistance and dysphoric concerns) with anxiety patient. Sample comprised of thirty five psychotherapist
providing therapy to diagnosed anxiety patients in OPD (Outdoor patient department). Psychotherapy Process
Inventory was administered to assess perception of therapeutic interaction of psychotherapist. Descriptive
statistics and one sample t test were calculated for the analysis of data. Results revealed that most of the
therapists, possessed MS degree in Clinical Psychology. Results indicate that there is a significant high rating
on therapeutic interaction, therapeutic participation, directive support, resistance and dysphoric concern of the
psychotherapist who are providing therapy to the anxiety patients. Therapeutic interaction is perceived by the
therapist as supportive, whereas participation, resistance and dysphoric concerns of the patients were also
perceived high by the therapist in initial sessions. Findings will be helpful for psychologist and other
professionals to plan the therapeutic interventions for anxiety patients
Treatment evaluation
1. Researchers evaluate the effectiveness of therapies through methods like meta-analyses of existing studies to identify the most effective treatments for issues like depression. Common factors like the therapeutic relationship contribute to positive outcomes.
2. While therapies like CBT are supported as effective, researchers still do not fully understand why they work. Prevention strategies aim to reduce mental illness at the primary, secondary, and tertiary levels through skills training, early identification and treatment, and relapse prevention.
3. Evaluating therapeutic effectiveness and identifying common success factors helps improve treatments, while prevention research works to reduce mental illness occurrence and severity.
Running head STRATEGIC PLAN FOR CHANGE1STRATEGIC PLAN FOR.docx
Running head: STRATEGIC PLAN FOR CHANGE
1
STRATEGIC PLAN FOR CHANGE
2
Strategic Plan for Change
Jennifer Zimmerman
Walden University- NURS 6201
December 29, 2017
Improving Patient Experience who are Undergoing Chemotherapy from an Outpatient setting to an Inpatient Setting
1.
Introduction and Statement of the Problem
1.1.
What is the problem?
Outpatient chemotherapy sessions are sufficient in most organizations, especially for those receiving curative intent chemotherapy (Davidoff et al. 2013). The patients who meet the set criteria end up receiving supportive care post induction chemotherapy, as well as different cycles as other outpatients. Outpatient management can be made safe and the transition to inpatient more efficient, which is considered a challenge for most healthcare organizations. The problem at hand in this section has been adequately analyzed, which involves the transition of patients receiving chemotherapy from outpatient to inpatient in healthcare facilities.
1.2.
Why is it important enough to warrant a change?
Outpatient care especially for most patient has become a familiar concept that is driven by increased healthcare costs and more so, the increased demand for existing inpatient resources in different organizations (Joana et al. 1987). Improved supportive care in inpatient is also another reason for the need to embrace the transition, and patient wishes to spend the least amount of time, especially in waiting for service delivery in the outpatient setting. With these concepts in mind, it is important enough to warrant a change. Patient satisfaction ought not to be ignored in different healthcare organizations. There is a need to, therefore, be on the forefront in enhancing adequate care, and embracing inpatient plans for the chronically ill patients.
1.2.1.
Scholarly Reference #1
Joana, L., Mary, H., Alan, M., Andrew, B., & Steven, C., (1987). Case Mix and Changes in inpatient and outpatient chemotherapy. PubMed 8(4): 65-71.
In most healthcare settings, the therapy provided in outpatient has been associated with substantial tumors, chemotherapy involving high doses, and then followed by autologous stem cell transplantation. Outpatient administration of consolidation cycles has been reported, which emphasizes the major problem in this scholarly soured. According to the authors, the transition to inpatient to outpatient care should be considered and priority to solve the efficiency problems at hand.
1.2.2.
Scholarly Reference #2
Hayes, J. (2014). The theory and practice of change management. Palgrave Macmillan.
This source deals with theory and practice of change management. Change management is an adequate practice in the healthcare setting. There is a need for all healthcare organizations to be at the forefront to ensure that healthcare, both inpatient and outpatient are realized. The source provides and explains outpatient inefficiency for chronic patients as the worst problem in the medical profession. Th ...
Rebecca Ruggear Senior Thesis 2013
The document discusses patient non-adherence to medical treatment plans. It summarizes research showing that healthcare providers and patients have differing views on adherence levels. The main reasons for non-adherence are identified as lack of education, forgetfulness, and cost/complexity of treatment plans. The document reports on surveys of healthcare providers and patients, finding that both groups agree responsibility for adherence is primarily on patients, but that doctors and other providers should better educate patients. Improving communication between providers and patients is seen as key to increasing treatment adherence.
Research MethodsLaShanda McMahonUniversity o.docx
Research Methods
LaShanda McMahon
University of Phoenix
Formulating the Problem Statement and the Purpose Statement
Over the past decade, there have been several changes in drug addiction treatment that has shown results that show reduced associated health and social costs by more than the cost of the treatments. It has been found that treatments cost much less that the alternatives, such as incarcerating people with addictions. There are many savings related to healthcare, which includes, total savings that can exceed costs with a ratio of 12 to 1. Major savings to the individual and to society also stems from fewer interpersonal conflicts; greater workplace productivity; and fewer drug-related accidents, including overdoses and deaths (Woody, M.D., 2018).
Problem Statement
A common misperception is detoxification cures the addiction, yet addiction is a chronic disorder requiring long term multimodal treatment (Korsmeyer et al., 2009. Long-term treatment for substance abuse and co-occurring disorders might reduce recidivism rates and lessen costs for rehabilitation. Goldstein, A. (1997). examined the benefits of long-term substance abuse and posited the benefits. Goldstein further suggested not treating addiction appropriately or at all contributes to the high costs associated with substance use in the United States.
Insurance companies are reluctant to support long term substance abuse treatment; however, Weisner, Ray, Mertens, Satre and Moore (2003) noted patients receiving a minimum of six months substance treatment abstained from drug and alcohol use at least five years after treatment yet abusers of alcohol were less likely to remain sober for lengthy periods of time after treatment (Weisner et al., 2003).
According to the National Drug Institute (2012), every dollar invested in substance abuse treatment yields a return of $5.50 in reduced drug-related crime, costs associated with criminal justice, and theft. Healthcare savings can exceed costs by a 12 to 1 ratio. Therefore, drug addiction treatment reduces costs associated with primary care and is less costly than incarceration. Addressing addiction also contributes to the more positive aspects of life, such as increase in work productivity, and fewer incidents related to drug use, fewer overdoses and deaths.
Purpose Statement
The purpose of this correlational study is to see if a relationship exists among periods of sobriety and four levels of substance abuse treatment. The research will examine substance abuse treatment throughout various levels of care: higher levels (detox, Inpatient (IP), and Residential (RTC) and lower levels (partial hospitalization (PHP), Intensive Outpatient (IOP), and routine Outpatient (OP). Current trends in substance abuse treatment provides evidence that length of treatment is inadequate contributing to more frequent relapses among substance abusers. Longer treatment options for addiction may reduce the number of relapses, reduce costs asso.
NR451_Milestone2_Design_Proposal allen
This document discusses using daily telephone counseling to maintain medication compliance for patients with schizophrenia. It finds that medication noncompliance is a significant issue, with rates around 20-45% within the first 6 months after being prescribed medication. However, studies have shown that daily telephone compliance calls can significantly decrease noncompliance. The document proposes a pilot program using a multidisciplinary team to provide daily telephone counseling to patients using a standardized assessment tool. The goal is to increase compliance and decrease hospitalization rates and costs compared to patients not receiving calls.
Psychotherapy Efficacy Research: Critical Review
This document provides a critical review of psychotherapy efficacy research. It discusses various types of psychotherapy and important terms in research methodology. While efficacy research aims to establish causal relationships through controlled trials, its results often lack external validity and generalizability. Comparative studies generally find no significant differences between major psychotherapy approaches. The document concludes that common factors like the therapeutic alliance, rather than specific techniques, are crucial for effective therapy. More research is still needed to determine the most effective treatments for specific disorders.
Three Mountains Regional Hospital· Medical and surgical facility.docx
Three Mountains Regional Hospital
· Medical and surgical facility.
· Offer outpatient and inpatient surgeries.
· Committed to providing high-quality health services.
Electronic Medical Record
Defined as medical records kept on a computer.
Records are kept by doctors, health care providers, hospital or medical office staff.
Contents of EMR
The records contain general patient information, such as:
· Health condition
· Diagnostic tests
· Prescriptions and
· Treatment
· Personal details like name, contacts, and date of birth
EMRs are safe and confidential.
Records can be shared securely through a network.
HIPPA/
Confidentiality
It is a U.S legislation that safeguards medical information.
The law provides privacy and security to health data.
It requires health care information to be handled with confidentiality.
Level of Confidentiality
High-levels of confidentiality assured when transferring, receiving, sharing, or handling protected health information.
Release of Information
To maintain patient confidentiality and comply with set laws, health information will only be released upon written authorization by the patient.
The process of requesting your health records at Three Mountains Regional hospital is as follows:
· Obtain, fill and submit Authorization for Release of Health Information Form
·
· Form must be completed and signed.
· Specify information to be released.
· Health practitioner to review request and clinical appropriateness for release.
· After approval, information is released.
NB:
The following Protected health information cannot be shared without patient permission:
· Test and laboratory results
· Demographic information
· Mental health condition
· Medical histories and
· Insurance information
Privacy Pledge
At Three Mountains Regional Hospital, we pledge to keep all your information private and confidentiality in compliance with the law and through our
You did a nice job with the brochure layout, as it looks very good and you made a nice use of graphics and language. Nice work on the EMR. You need to discuss the joint committee requirement and add a citation to show that you used the material. In the HIPPA section, good job defining how HIPPA provides privacy and security protection. You need to expand and tell the patient how HIPPA is used by the facility to ensure their privacy. Your release of information good and explains the process as nice use of steps a patient needs to do besides just contacting the facility to get a form . You need to draft a more developed privacy pledge that adds a goal to comply with all federal and state laws regarding privacy to your pledge.
specific privacy policies.
Title
ABC/123 Version X
1
Grading Guide for Issues of Substance Abuse and Addiction
CPSS 420
1
University of Phoenix Material
Week 5: Substance Abuse Treatment
Content (80%)
Points Earned:
· All key elements of the assignment are covered in a substantive way. Major points are stated clearly; are supporte ...
Effect of Behavioral Intervention on Reducing Symptom Severity during First C...
IOSR Journal of Nursing and health Science is ambitious to disseminate information and experience in education, practice and investigation between medicine, nursing and all the sciences involved in health care. Nursing & Health Sciences focuses on the international exchange of knowledge in nursing and health sciences. The journal publishes peer-reviewed papers on original research, education and clinical practice.
By encouraging scholars from around the world to share their knowledge and expertise, the journal aims to provide the reader with a deeper understanding of the lived experience of nursing and health sciences and the opportunity to enrich their own area of practice. The journal publishes original papers, reviews, special and general articles, case management etc.
Xx..health related quality of lif e
This document discusses health-related quality of life (HRQOL) and how it is measured. Some key points:
1. HRQOL assessments evaluate how medical treatments impact patients' overall well-being and ability to function, not just clinical outcomes like survival. It is a multidimensional concept.
2. Valid and reliable HRQOL instruments use standardized questions across domains to accurately capture patients' perceptions over time. Instruments must demonstrate properties like reliability, validity, and responsiveness to change.
3. Comparing HRQOL scores to appropriate comparison groups and clinically meaningful thresholds is important for interpreting results in research and clinical practice. Both general and disease-specific HRQOL instruments are used.
Running head SEARCHING AND CRITIQUING THE EVIDENCE1SEARCHING .docx
Running head: SEARCHING AND CRITIQUING THE EVIDENCE 1
SEARCHING AND CRITIQUING THE EVIDENCE 4
Searching and Critiquing the Evidence
Student’s Name
Institution
Date
Searching and Critiquing the Evidence
There are various research studies that have been done on the outcome of self-care on Type 2 Diabetes Mellitus patients. In most of the studies, the most prevalent results are that self-care is an effective method of improving the health and lifestyle outcomes of Type 2 Diabetes patients. Krishna and Boren (2008) conducted a systematic review of evidence-based studies done between 1996 and 2007. The study analyzed 18 researches done within the selected time period and found that using phone calls and text messages to assist diabetes patients could improve the self-management outcomes. Shrivastava et al. (2013) analyzed the effectiveness of self-management for the diabetes mellitus patients. The study found that self-care helps to reduce the rate of morbidity and mortality among diabetes patients.
In addition, Steinsbekk et al. (2013) conducted a meta-analysis comparing the differences between the outcomes of group based self-management education and routine treatment for Type 2 diabetes patients. The study analyzed 21 studies that included studied on 2833 participants. The results of the meta-analysis showed that group-based self-management education helped to improve the psychosocial, clinical, and lifestyle outcomes among the diabetes patients. Lastly, Tang et al. (2008) examined the impact of social support and quality of life on the self-care behaviors of African American Type 2 diabetes patients. The study followed an observational design with 89 African-American adults, who were aged 40 and above. The study found that social support is vital for self-management to be effective in diabetes treatment.
The selected studies have helped to strengthen the merit of my selected theoretical framework. The theory selected for the study was Dorothea Orem’s Self Care Theory. These studies have helped to demonstrate some important evidence-based facts about the effectiveness of self-care for diabetes patients hence helping to prove the credibility of the theory. The scrutiny of these studies has helped to discover the degree of effectiveness of this theory and the best application methods that can make it an effective approach to improving the outcomes of patients with Type 2 Diabetes Mellitus.
Levels of Evidence in the Articles
The classification of the level of evidence of a given research is important in evidence-based studies because they help to show how accurate, credible, or reliable a research is (Gray, Grove & Sutherland, 2017). The most prevalent evidence in the research articles analyzed is Level II evidence. Level II evidence is one that is obtained from at least one randomized control trial (Moran, Burson & Conrad, 2017). The articles by Krishna and Boren (2008) and Steinsbekk et al. (2013) conducted meta-analyses of various rese ...
RESEARCH ARTICLE Open AccessEthical deliberations about in.docx
RESEARCH ARTICLE Open Access
Ethical deliberations about involuntary treatment:
interviews with Swedish psychiatrists
Manne Sjöstrand1*, Lars Sandman2,3, Petter Karlsson5, Gert Helgesson5, Stefan Eriksson4 and Niklas Juth5
Abstract
Background: Involuntary treatment is a key issue in healthcare ethics. In this study, ethical issues relating to
involuntary psychiatric treatment are investigated through interviews with Swedish psychiatrists.
Methods: In-depth interviews were conducted with eight Swedish psychiatrists, focusing on their experiences of
and views on compulsory treatment. In relation to this, issues about patient autonomy were also discussed. The
interviews were analysed using a descriptive qualitative approach.
Results: The answers focus on two main aspects of compulsory treatment. Firstly, deliberations about when and
why it was justifiable to make a decision on involuntary treatment in a specific case. Here the cons and pros of
ordering compulsory treatment were discussed, with particular emphasis on the consequences of providing
treatment vs. refraining from ordering treatment. Secondly, a number of issues relating to background factors
affecting decisions for or against involuntary treatment were also discussed. These included issues about the
Swedish Mental Care Act, healthcare organisation and the care environment.
Conclusions: Involuntary treatment was generally seen as an unwanted exception to standard care. The respondents’
judgments about involuntary treatment were typically in line with Swedish law on the subject. However, it was also
argued that the law leaves room for individual judgments when making decisions about involuntary treatment. Much
of the reasoning focused on the consequences of ordering involuntary treatment, where risk of harm to the
therapeutic alliance was weighed against the assumed good consequences of ensuring that patients received needed
treatment. Cases concerning suicidal patients and psychotic patients who did not realise their need for care were
typically held as paradigmatic examples of justified involuntary care. However, there was an ambivalence regarding the
issue of suicide as it was also argued that risk of suicide in itself might not be sufficient for justified involuntary care. It
was moreover argued that organisational factors sometimes led to decisions about compulsory treatment that could
have been avoided, given a more patient-oriented healthcare
organisation.
Keywords: Psychiatry, Bioethics, Personal autonomy, Paternalism, Coercion, Involuntary commitment
Background
Whether it is justifiable to treat patients against their
will and, if so, when, is a central question in medical eth-
ics and law. Respect for autonomy is a central principle
in contemporary healthcare ethics [1]. A common asser-
tion is that respect for autonomy in healthcare implies,
at a minimum, that patients should not be coerced or
manipulated into treatment if they are capable of making
autonomous decis.
Can CER and Personalized Medicine Work Together
CER aims to evaluate treatment effectiveness in real-world populations, while RCTs only consider homogeneous groups. CER and personalized medicine (PM) seem to conflict, but several analytical approaches allow CER to incorporate individual differences. Subgroup analysis identifies treatment effects in clinical subgroups. Predictive learning uses multivariate models to predict individual responses early. These approaches help CER address PM by showing what treatments work best for which specific patient groups or individuals. The speaker provides examples of using these methods and argues they can help optimize drug development and healthcare decisions by guiding treatment selection based on individual patient characteristics.
The Four Topics Approach to Ethical Decision MakingJonsen and c.docx
The Four Topics Approach to Ethical Decision Making
Jonsen and colleagues’ (2010) Four Topics Method for ethical analysis is a practical approach for nurses and other healthcare professionals. The nurse or team begins with relevant facts about a particular case and moves toward a resolution through a structured analysis. In healthcare settings, ethics committees often resolve ethical problems and answer ethical questions by using a case-based, or bottom-up, inductive, casuistry approach. The Four Topics Method, sometimes called the Four Box Approach (Table 2-1) is found in the book Clinical Ethics: A Practical Approach to Ethical Decisions in Clinical Medicine (Jonsen et al., 2010).
This case-based approach allows healthcare professionals to construct the facts of a case in a structured format that facilitates critical thinking about ethical problems. Cases are analyzed according to four topics: “medical indications, patient preferences, quality of life, and contextual features” (Jonsen et al., 2010, p. 8). Nurses and other healthcare professionals on the team gather information in an attempt to answer the questions in each of the four boxes. The Four Topics Method facilitates dialogue between the patient–family/surrogate dyad and members of the healthcare ethics team or committee. By following the outline of the questions, healthcare providers are able to inspect and evaluate the full scope of the patient’s situation and the central ethical conflict. After the ethics team has gathered the facts of a case, an analysis is conducted. Each case is unique and should be considered as such, but the subject matter of particular situations often involves common threads with other ethically and legally accepted precedents, such as landmark cases that involved withdrawing or withholding treatment. Though each case analysis begins with facts, the four fundamental principles—autonomy, beneficence, nonmaleficence, and justice—along with the Four Topics Method are considered together as the process, and resolution take place (Jonsen et al., 2010).
TABLE 2-1 Four Topics Method for Analysis of Clinical Ethics Cases
Medical Indications: The Principles of Beneficence and Nonmaleficence
1. What is the patient’s medical problem? Is the problem acute? Chronic? Critical? Reversible? Emergent? Terminal?
2. What are the goals of treatment?
3. In what circumstances are medical treatments not indicated?
4. What are the probabilities of success of various treatment options?
5. In sum, how can this patient be benefited by medical and nursing care, and how can harm be avoided?
Patient Preferences: The Principle of Respect for Autonomy
1. Has the patient been informed of benefits and risks, understood this information, and given consent?
2. Is the patient mentally capable and legally competent, and is there evidence of incapacity?
3. If mentally capable, what preferences about treatment is the patient stating?
4. If incapacitated, has the patient expressed prior ...
Treatment
This document discusses various approaches to treating drug addiction. It covers assessing addiction severity and readiness to change using tools like the Addiction Severity Index. It outlines principles of treatment including using a variety of behavioral and pharmacological therapies tailored to the individual. Comorbidity between substance abuse and mental illness is common requiring accurate diagnosis and integrated treatment. Factors like age, gender, criminal justice involvement and availability of treatment influence outcomes.
Homeopathic treatment of elderly patients - a prospective observational study...
The severity of disease showed marked and sustained improvements under homeopathic treatment,
but this did not lead to an improvement of quality of life. Our findings might indicate that homeopathic medical
therapy may play a beneficial role in the long-term care of older adults with chronic diseases and studies on
comparative effectiveness are needed to evaluate this hypothesis.
Program Overview
The Life Science Addiction Treatment Center is a private residential facility that offers short, moderate, and long-term inpatient treatment for adults struggling with alcohol and/or drug addiction. Its mission is to provide evidence-based treatment in a professional and affordable manner using a personalized approach. The treatment program utilizes principles from cognitive behavioral therapy and other therapeutic models. It offers a variety of group and individual therapy sessions, educational workshops, recreational activities, and medical and psychiatric support to help clients develop coping skills and achieve rehabilitation and wellness goals. The facility is located in a serene natural setting near Montreal, Quebec and employs a multidisciplinary clinical team.
Explore the Relationship between Post Traumatic Growth, Ways of Coping and An...
A cancer diagnosis is hard to take and having cancer is not easy. Like all chronic illnesses, cancer
involves a series of negative threat to life of individual that may be due to the diagnosis and treatment of cancer
as it has the ability to shake one’s worldview and significantly impact one’s assumption about life. In addition to
commonly recognized negative effects such as posttraumatic stress symptoms (PTSS), there may also be positive
personal developmental change, including posttraumatic growth (PTG)which is affected by the anxiety level of
the patient. The purpose of the study was to determine the relationship between post traumatic growth, ways of
coping and anxiety among cancer patients. The study involved 100 cancer patients. There was a highly positive
correlation between PTG and WAYS. State-trait anxiety was found to be highly negatively co-related to post
traumatic growth and ways of coping.Thus it can be concluded that post traumatic growth and ways of coping
goes in same manner which suggest that the better the coping behavior used by cancer patients more will be the
post traumatic growth and there was negative relationship between post traumatic growth, ways of coping and
state-trait anxiety
Generalist Practice A Presentation on Steps of The Problem-Solv
Generalist Practice: A Presentation on Steps of The Problem-Solving Process
Name:
Date: May 5th, 2021
Pamela Easter !!!
1
Problem Identification or Engagement
Identify the type of problem – drug addiction and its effects on Family members.(Janice Walker is at the center of problem)
Identify how the problem has affected the rest of the community- substance abuse effects cost in the community in measurable ways including loss of productivity and unemployability; impairment in physical and mental health; reduced quality of life; increase violence; and Crime; abuse and neglect of children.
The community's general perception of the problem- the economic consequences of drug abuse severely burden federal , State, and local government resources, and the taxpayer.
The root cause of the problem- most often the cause of addiction is chronic stress, a history of trauma (PTSD), mental illness, lastly family history with addiction
Problem Identification/Engagement. The first step is to identify the type of problem the researcher is dealing with. Identify how the problem has affected the rest of the community and the community's general perception of the problem. The next step is to evaluate how the problem has affected the community or a client. Lastly, identify the root cause of the problem; where did the problem come from, or how did the victim get the problem they are facing.
2
Data Collection
Three major ways of collecting data from Clients are Interviews, Observation, and surveys
Interviews:
Engaging with the client one-on-one. Listening to client’s perspective of the problem
This method has ability to untangle the individual's problem, emotions, background, and the general social context, The Advocate can get the client's perception of the treatment
Observation:
It obtains data from clients by assessing the reaction to their respective environments
The researcher can identify factors contributing to the Client's condition
Data collection. There are many ways to collect data from a client. Three major ways of collecting data from a client are Interviews, Observation, and First Extraction.
Interviews: The researcher can speak with the patient on a one-on-one basis. A researcher or a nurse can use this method because of its ability to untangle the individual's problem, emotions, background, and the general social context, which in this paper largely revolves around the family relationship (Cohen et al., 2017). This data collection method paves the way for a nurse to get the patient's perception of the treatment and some of the elements that motivated them to embrace treatment.
Observation: it is used to obtain data from clients by assessing the reaction to their respective environments. Observation methods allow the researcher to identify social dimensions and family background factors contributing to the patient's condition.
3
Data Collection cont’d
Surveys : Can discover the problem
Clients Family History background details o ...
Discussion questions – Twain, The Man That Corrupted Hadleyburg.docx
Discussion questions – Twain, “The Man That Corrupted Hadleyburg”
Mark Twain wrote this story in 1898, toward the end of his career, and long after publishing his masterpieces
Tom Sawyer
and
Huckleberry Finn
. However, “Hadleyburg” reflects one concern that interested Twain throughout his entire career: the sarcastic skewering of middle-class morality and mannerisms. We will examine Twain’s critique of the false righteousness and hidden hypocrisies of common, civilized life as an example of Realism.
1. Hadleyburg prides itself on the honesty of its citizens. However, this focus on honesty has allowed other, less moral attitudes to take root and grow among the people. Find 2 passages that reveal at least two different sinful attitudes shared by the citizens of Hadleyburg.
2. The stranger’s plot is perfectly designed to attack the one source of pride of the townspeople. Focus on the scene describing the night the owner of the sack of gold is to be revealed. Explain what Twain to saying about human nature through the behavior of Wilson the lawyer. Find 1 passage that supports your interpretation. (Hint: Does Wilson tell the truth?)
2a. Also, Dr. Harkness ends up buying the sack of (fake) gold. Why does he do this, and what is Twain trying to say about politics and morality through that subplot? Find 1 passage that supports your interpretation. (Hint: Harkness creates a fake story about the gold. Also, why is he desperate to win the election?)
3. The Richardses were spared the humiliation the other nineteen families experienced. They even receive a reward for $38,500! However, their lives end miserably. Their miserable end is related to the one moral weakness that Richards consistently exhibits throughout the story. What is this weakness (it’s not greed) and explain how it causes a terrible ending to the Richardses’ lives. Find 1 passage that reveals this weakness.
.
Discussion Questions The difficulty in predicting the future is .docx
Discussion Questions
: “The difficulty in predicting the future is that the outcomes are unreliable, due to the occurrence of wild-card events that distort the relatively well-understand trends for the near to mid-future.” Offer an example of such a “wild-card” event and some ways in which the security professional might address it in an effective manner. Regarding the need for the security industry as a whole to maintain the professionalism and competencies needed to address emerging threats and hazards, what do you feel are its primary areas of weakness and what proposals could you offer to address them?
The Future of the Security
When considering what awaits the security profession in the years to come and those that will operate within it, developments and forecasts related to security science will in large part be impacted by what has occurred in the past and in present day. What
might
occur, what is most
plausible
and
feasible
given current and expected occurrences, and what has proven to be effective (or not) will all need to be considered in determining those issues that will remain relevant or change. So predicting the future (not in the form of Nostradamus or similar prophets) as it relates to security is a technique that considers probable or desirable outcomes in the face of known or anticipated risks. So given this backdrop, where is security heading?
Physical Security
As long as there are structures that people operate within and house various assets, there will continue to be a need to offer needed protection related to them. All of the topics discussed in this course related to walls, fencing, sensors, alarm systems, guards, locks, and other such issues will be needed in some form or fashion. Whether through manual or technological means, these will remain a constant for the security administrator in providing appropriate defensive measures for the material, tangible assets they oversee. Concerning technology, the same trend will continue in serving as a needed aid in providing security moving forward. Mobile devices of various types, functions, capabilities, and their ability to access data, the ever-increasing use of robotics and the functions they can carry out, sensors that will be able to gain more intelligence regarding detection, and high frequency security cameras that will have the capability to verify the chemical compound of an object at a distance are just some of the many technical innovations on the horizon. Yet, just as technology has taken on a greater role in providing these efforts, so too does technology represent ever-increasing concerns to the security manager.
Cyber Security
As society becomes connected on an ever-increasing basis, attention must be directed towards what implications this environment has related to not only security, but related privacy concerns as well. In
Future Scenarios and Challenges for Security and Privacy
(2016, Williams, Axon, Nurse, & Creese), the researchers took a ver.
Discussion questions – Dunbar Paul Lawrence Dunbar was a pio.docx
Discussion questions – Dunbar
Paul Lawrence Dunbar was a pioneering African-American literary artist. He was among the first black writers who achieved fame among predominantly white audiences with the accurate use of black vernacular and realistic depictions of the attitudes of African Americans while using the literary styles and conventions familiar to white writers. Only within the past twenty years have literary critics begun to appreciate the subtle and perceptive criticism of racial relations he provides beneath the smooth artistry of his works.
1. Dunbar’s “Mr. Cornelius” is extremely naturalistic, with Cornelius struggling against, and eventually losing to, large forces. What are the forces that are arrayed against him (2)? Find a passage that describes each force.
(Hint: Economics, discrimination, as well as emotional weakness are some examples of large forces.)
2. Dunbar was well aware of the story of the slave’s flight north to freedom, a traditional African-American narrative made famous by such works as Frederick Douglass’s
Narrative
and Harriet Beecher Stowe’s
Uncle Tom’s Cabin
. How is Dunbar’s story an ironic, inverted version of the flight-to-freedom story? What is Dunbar trying to say about the status of African Americans in a society newly changed by slavery’s end?
(Hint: Cornelius is from the south. Washington D.C. is north. Does going north mean freedom for him? He must return south at the end—what does going south mean for him?)
.
Discussion Questions Identify the top three threats to the home.docx
Discussion Questions:
Identify the top three threats to the homeland and describe why you chose those as the primary threats. Considering specific terrorist tactics that have been or could be used in the homeland, which do you consider to be the most intimidating and which do you see as the most likely to be used?
.
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Treatment evaluation
1. Researchers evaluate the effectiveness of therapies through methods like meta-analyses of existing studies to identify the most effective treatments for issues like depression. Common factors like the therapeutic relationship contribute to positive outcomes.
2. While therapies like CBT are supported as effective, researchers still do not fully understand why they work. Prevention strategies aim to reduce mental illness at the primary, secondary, and tertiary levels through skills training, early identification and treatment, and relapse prevention.
3. Evaluating therapeutic effectiveness and identifying common success factors helps improve treatments, while prevention research works to reduce mental illness occurrence and severity.
Running head STRATEGIC PLAN FOR CHANGE1STRATEGIC PLAN FOR.docx
Running head: STRATEGIC PLAN FOR CHANGE
1
STRATEGIC PLAN FOR CHANGE
2
Strategic Plan for Change
Jennifer Zimmerman
Walden University- NURS 6201
December 29, 2017
Improving Patient Experience who are Undergoing Chemotherapy from an Outpatient setting to an Inpatient Setting
1.
Introduction and Statement of the Problem
1.1.
What is the problem?
Outpatient chemotherapy sessions are sufficient in most organizations, especially for those receiving curative intent chemotherapy (Davidoff et al. 2013). The patients who meet the set criteria end up receiving supportive care post induction chemotherapy, as well as different cycles as other outpatients. Outpatient management can be made safe and the transition to inpatient more efficient, which is considered a challenge for most healthcare organizations. The problem at hand in this section has been adequately analyzed, which involves the transition of patients receiving chemotherapy from outpatient to inpatient in healthcare facilities.
1.2.
Why is it important enough to warrant a change?
Outpatient care especially for most patient has become a familiar concept that is driven by increased healthcare costs and more so, the increased demand for existing inpatient resources in different organizations (Joana et al. 1987). Improved supportive care in inpatient is also another reason for the need to embrace the transition, and patient wishes to spend the least amount of time, especially in waiting for service delivery in the outpatient setting. With these concepts in mind, it is important enough to warrant a change. Patient satisfaction ought not to be ignored in different healthcare organizations. There is a need to, therefore, be on the forefront in enhancing adequate care, and embracing inpatient plans for the chronically ill patients.
1.2.1.
Scholarly Reference #1
Joana, L., Mary, H., Alan, M., Andrew, B., & Steven, C., (1987). Case Mix and Changes in inpatient and outpatient chemotherapy. PubMed 8(4): 65-71.
In most healthcare settings, the therapy provided in outpatient has been associated with substantial tumors, chemotherapy involving high doses, and then followed by autologous stem cell transplantation. Outpatient administration of consolidation cycles has been reported, which emphasizes the major problem in this scholarly soured. According to the authors, the transition to inpatient to outpatient care should be considered and priority to solve the efficiency problems at hand.
1.2.2.
Scholarly Reference #2
Hayes, J. (2014). The theory and practice of change management. Palgrave Macmillan.
This source deals with theory and practice of change management. Change management is an adequate practice in the healthcare setting. There is a need for all healthcare organizations to be at the forefront to ensure that healthcare, both inpatient and outpatient are realized. The source provides and explains outpatient inefficiency for chronic patients as the worst problem in the medical profession. Th ...
Rebecca Ruggear Senior Thesis 2013
The document discusses patient non-adherence to medical treatment plans. It summarizes research showing that healthcare providers and patients have differing views on adherence levels. The main reasons for non-adherence are identified as lack of education, forgetfulness, and cost/complexity of treatment plans. The document reports on surveys of healthcare providers and patients, finding that both groups agree responsibility for adherence is primarily on patients, but that doctors and other providers should better educate patients. Improving communication between providers and patients is seen as key to increasing treatment adherence.
Research MethodsLaShanda McMahonUniversity o.docx
Research Methods
LaShanda McMahon
University of Phoenix
Formulating the Problem Statement and the Purpose Statement
Over the past decade, there have been several changes in drug addiction treatment that has shown results that show reduced associated health and social costs by more than the cost of the treatments. It has been found that treatments cost much less that the alternatives, such as incarcerating people with addictions. There are many savings related to healthcare, which includes, total savings that can exceed costs with a ratio of 12 to 1. Major savings to the individual and to society also stems from fewer interpersonal conflicts; greater workplace productivity; and fewer drug-related accidents, including overdoses and deaths (Woody, M.D., 2018).
Problem Statement
A common misperception is detoxification cures the addiction, yet addiction is a chronic disorder requiring long term multimodal treatment (Korsmeyer et al., 2009. Long-term treatment for substance abuse and co-occurring disorders might reduce recidivism rates and lessen costs for rehabilitation. Goldstein, A. (1997). examined the benefits of long-term substance abuse and posited the benefits. Goldstein further suggested not treating addiction appropriately or at all contributes to the high costs associated with substance use in the United States.
Insurance companies are reluctant to support long term substance abuse treatment; however, Weisner, Ray, Mertens, Satre and Moore (2003) noted patients receiving a minimum of six months substance treatment abstained from drug and alcohol use at least five years after treatment yet abusers of alcohol were less likely to remain sober for lengthy periods of time after treatment (Weisner et al., 2003).
According to the National Drug Institute (2012), every dollar invested in substance abuse treatment yields a return of $5.50 in reduced drug-related crime, costs associated with criminal justice, and theft. Healthcare savings can exceed costs by a 12 to 1 ratio. Therefore, drug addiction treatment reduces costs associated with primary care and is less costly than incarceration. Addressing addiction also contributes to the more positive aspects of life, such as increase in work productivity, and fewer incidents related to drug use, fewer overdoses and deaths.
Purpose Statement
The purpose of this correlational study is to see if a relationship exists among periods of sobriety and four levels of substance abuse treatment. The research will examine substance abuse treatment throughout various levels of care: higher levels (detox, Inpatient (IP), and Residential (RTC) and lower levels (partial hospitalization (PHP), Intensive Outpatient (IOP), and routine Outpatient (OP). Current trends in substance abuse treatment provides evidence that length of treatment is inadequate contributing to more frequent relapses among substance abusers. Longer treatment options for addiction may reduce the number of relapses, reduce costs asso.
NR451_Milestone2_Design_Proposal allen
This document discusses using daily telephone counseling to maintain medication compliance for patients with schizophrenia. It finds that medication noncompliance is a significant issue, with rates around 20-45% within the first 6 months after being prescribed medication. However, studies have shown that daily telephone compliance calls can significantly decrease noncompliance. The document proposes a pilot program using a multidisciplinary team to provide daily telephone counseling to patients using a standardized assessment tool. The goal is to increase compliance and decrease hospitalization rates and costs compared to patients not receiving calls.
Psychotherapy Efficacy Research: Critical Review
This document provides a critical review of psychotherapy efficacy research. It discusses various types of psychotherapy and important terms in research methodology. While efficacy research aims to establish causal relationships through controlled trials, its results often lack external validity and generalizability. Comparative studies generally find no significant differences between major psychotherapy approaches. The document concludes that common factors like the therapeutic alliance, rather than specific techniques, are crucial for effective therapy. More research is still needed to determine the most effective treatments for specific disorders.
Three Mountains Regional Hospital· Medical and surgical facility.docx
Three Mountains Regional Hospital
· Medical and surgical facility.
· Offer outpatient and inpatient surgeries.
· Committed to providing high-quality health services.
Electronic Medical Record
Defined as medical records kept on a computer.
Records are kept by doctors, health care providers, hospital or medical office staff.
Contents of EMR
The records contain general patient information, such as:
· Health condition
· Diagnostic tests
· Prescriptions and
· Treatment
· Personal details like name, contacts, and date of birth
EMRs are safe and confidential.
Records can be shared securely through a network.
HIPPA/
Confidentiality
It is a U.S legislation that safeguards medical information.
The law provides privacy and security to health data.
It requires health care information to be handled with confidentiality.
Level of Confidentiality
High-levels of confidentiality assured when transferring, receiving, sharing, or handling protected health information.
Release of Information
To maintain patient confidentiality and comply with set laws, health information will only be released upon written authorization by the patient.
The process of requesting your health records at Three Mountains Regional hospital is as follows:
· Obtain, fill and submit Authorization for Release of Health Information Form
·
· Form must be completed and signed.
· Specify information to be released.
· Health practitioner to review request and clinical appropriateness for release.
· After approval, information is released.
NB:
The following Protected health information cannot be shared without patient permission:
· Test and laboratory results
· Demographic information
· Mental health condition
· Medical histories and
· Insurance information
Privacy Pledge
At Three Mountains Regional Hospital, we pledge to keep all your information private and confidentiality in compliance with the law and through our
You did a nice job with the brochure layout, as it looks very good and you made a nice use of graphics and language. Nice work on the EMR. You need to discuss the joint committee requirement and add a citation to show that you used the material. In the HIPPA section, good job defining how HIPPA provides privacy and security protection. You need to expand and tell the patient how HIPPA is used by the facility to ensure their privacy. Your release of information good and explains the process as nice use of steps a patient needs to do besides just contacting the facility to get a form . You need to draft a more developed privacy pledge that adds a goal to comply with all federal and state laws regarding privacy to your pledge.
specific privacy policies.
Title
ABC/123 Version X
1
Grading Guide for Issues of Substance Abuse and Addiction
CPSS 420
1
University of Phoenix Material
Week 5: Substance Abuse Treatment
Content (80%)
Points Earned:
· All key elements of the assignment are covered in a substantive way. Major points are stated clearly; are supporte ...
Effect of Behavioral Intervention on Reducing Symptom Severity during First C...
IOSR Journal of Nursing and health Science is ambitious to disseminate information and experience in education, practice and investigation between medicine, nursing and all the sciences involved in health care. Nursing & Health Sciences focuses on the international exchange of knowledge in nursing and health sciences. The journal publishes peer-reviewed papers on original research, education and clinical practice.
By encouraging scholars from around the world to share their knowledge and expertise, the journal aims to provide the reader with a deeper understanding of the lived experience of nursing and health sciences and the opportunity to enrich their own area of practice. The journal publishes original papers, reviews, special and general articles, case management etc.
Xx..health related quality of lif e
This document discusses health-related quality of life (HRQOL) and how it is measured. Some key points:
1. HRQOL assessments evaluate how medical treatments impact patients' overall well-being and ability to function, not just clinical outcomes like survival. It is a multidimensional concept.
2. Valid and reliable HRQOL instruments use standardized questions across domains to accurately capture patients' perceptions over time. Instruments must demonstrate properties like reliability, validity, and responsiveness to change.
3. Comparing HRQOL scores to appropriate comparison groups and clinically meaningful thresholds is important for interpreting results in research and clinical practice. Both general and disease-specific HRQOL instruments are used.
Running head SEARCHING AND CRITIQUING THE EVIDENCE1SEARCHING .docx
Running head: SEARCHING AND CRITIQUING THE EVIDENCE 1
SEARCHING AND CRITIQUING THE EVIDENCE 4
Searching and Critiquing the Evidence
Student’s Name
Institution
Date
Searching and Critiquing the Evidence
There are various research studies that have been done on the outcome of self-care on Type 2 Diabetes Mellitus patients. In most of the studies, the most prevalent results are that self-care is an effective method of improving the health and lifestyle outcomes of Type 2 Diabetes patients. Krishna and Boren (2008) conducted a systematic review of evidence-based studies done between 1996 and 2007. The study analyzed 18 researches done within the selected time period and found that using phone calls and text messages to assist diabetes patients could improve the self-management outcomes. Shrivastava et al. (2013) analyzed the effectiveness of self-management for the diabetes mellitus patients. The study found that self-care helps to reduce the rate of morbidity and mortality among diabetes patients.
In addition, Steinsbekk et al. (2013) conducted a meta-analysis comparing the differences between the outcomes of group based self-management education and routine treatment for Type 2 diabetes patients. The study analyzed 21 studies that included studied on 2833 participants. The results of the meta-analysis showed that group-based self-management education helped to improve the psychosocial, clinical, and lifestyle outcomes among the diabetes patients. Lastly, Tang et al. (2008) examined the impact of social support and quality of life on the self-care behaviors of African American Type 2 diabetes patients. The study followed an observational design with 89 African-American adults, who were aged 40 and above. The study found that social support is vital for self-management to be effective in diabetes treatment.
The selected studies have helped to strengthen the merit of my selected theoretical framework. The theory selected for the study was Dorothea Orem’s Self Care Theory. These studies have helped to demonstrate some important evidence-based facts about the effectiveness of self-care for diabetes patients hence helping to prove the credibility of the theory. The scrutiny of these studies has helped to discover the degree of effectiveness of this theory and the best application methods that can make it an effective approach to improving the outcomes of patients with Type 2 Diabetes Mellitus.
Levels of Evidence in the Articles
The classification of the level of evidence of a given research is important in evidence-based studies because they help to show how accurate, credible, or reliable a research is (Gray, Grove & Sutherland, 2017). The most prevalent evidence in the research articles analyzed is Level II evidence. Level II evidence is one that is obtained from at least one randomized control trial (Moran, Burson & Conrad, 2017). The articles by Krishna and Boren (2008) and Steinsbekk et al. (2013) conducted meta-analyses of various rese ...
RESEARCH ARTICLE Open AccessEthical deliberations about in.docx
RESEARCH ARTICLE Open Access
Ethical deliberations about involuntary treatment:
interviews with Swedish psychiatrists
Manne Sjöstrand1*, Lars Sandman2,3, Petter Karlsson5, Gert Helgesson5, Stefan Eriksson4 and Niklas Juth5
Abstract
Background: Involuntary treatment is a key issue in healthcare ethics. In this study, ethical issues relating to
involuntary psychiatric treatment are investigated through interviews with Swedish psychiatrists.
Methods: In-depth interviews were conducted with eight Swedish psychiatrists, focusing on their experiences of
and views on compulsory treatment. In relation to this, issues about patient autonomy were also discussed. The
interviews were analysed using a descriptive qualitative approach.
Results: The answers focus on two main aspects of compulsory treatment. Firstly, deliberations about when and
why it was justifiable to make a decision on involuntary treatment in a specific case. Here the cons and pros of
ordering compulsory treatment were discussed, with particular emphasis on the consequences of providing
treatment vs. refraining from ordering treatment. Secondly, a number of issues relating to background factors
affecting decisions for or against involuntary treatment were also discussed. These included issues about the
Swedish Mental Care Act, healthcare organisation and the care environment.
Conclusions: Involuntary treatment was generally seen as an unwanted exception to standard care. The respondents’
judgments about involuntary treatment were typically in line with Swedish law on the subject. However, it was also
argued that the law leaves room for individual judgments when making decisions about involuntary treatment. Much
of the reasoning focused on the consequences of ordering involuntary treatment, where risk of harm to the
therapeutic alliance was weighed against the assumed good consequences of ensuring that patients received needed
treatment. Cases concerning suicidal patients and psychotic patients who did not realise their need for care were
typically held as paradigmatic examples of justified involuntary care. However, there was an ambivalence regarding the
issue of suicide as it was also argued that risk of suicide in itself might not be sufficient for justified involuntary care. It
was moreover argued that organisational factors sometimes led to decisions about compulsory treatment that could
have been avoided, given a more patient-oriented healthcare
organisation.
Keywords: Psychiatry, Bioethics, Personal autonomy, Paternalism, Coercion, Involuntary commitment
Background
Whether it is justifiable to treat patients against their
will and, if so, when, is a central question in medical eth-
ics and law. Respect for autonomy is a central principle
in contemporary healthcare ethics [1]. A common asser-
tion is that respect for autonomy in healthcare implies,
at a minimum, that patients should not be coerced or
manipulated into treatment if they are capable of making
autonomous decis.
Can CER and Personalized Medicine Work Together
CER aims to evaluate treatment effectiveness in real-world populations, while RCTs only consider homogeneous groups. CER and personalized medicine (PM) seem to conflict, but several analytical approaches allow CER to incorporate individual differences. Subgroup analysis identifies treatment effects in clinical subgroups. Predictive learning uses multivariate models to predict individual responses early. These approaches help CER address PM by showing what treatments work best for which specific patient groups or individuals. The speaker provides examples of using these methods and argues they can help optimize drug development and healthcare decisions by guiding treatment selection based on individual patient characteristics.
The Four Topics Approach to Ethical Decision MakingJonsen and c.docx
The Four Topics Approach to Ethical Decision Making
Jonsen and colleagues’ (2010) Four Topics Method for ethical analysis is a practical approach for nurses and other healthcare professionals. The nurse or team begins with relevant facts about a particular case and moves toward a resolution through a structured analysis. In healthcare settings, ethics committees often resolve ethical problems and answer ethical questions by using a case-based, or bottom-up, inductive, casuistry approach. The Four Topics Method, sometimes called the Four Box Approach (Table 2-1) is found in the book Clinical Ethics: A Practical Approach to Ethical Decisions in Clinical Medicine (Jonsen et al., 2010).
This case-based approach allows healthcare professionals to construct the facts of a case in a structured format that facilitates critical thinking about ethical problems. Cases are analyzed according to four topics: “medical indications, patient preferences, quality of life, and contextual features” (Jonsen et al., 2010, p. 8). Nurses and other healthcare professionals on the team gather information in an attempt to answer the questions in each of the four boxes. The Four Topics Method facilitates dialogue between the patient–family/surrogate dyad and members of the healthcare ethics team or committee. By following the outline of the questions, healthcare providers are able to inspect and evaluate the full scope of the patient’s situation and the central ethical conflict. After the ethics team has gathered the facts of a case, an analysis is conducted. Each case is unique and should be considered as such, but the subject matter of particular situations often involves common threads with other ethically and legally accepted precedents, such as landmark cases that involved withdrawing or withholding treatment. Though each case analysis begins with facts, the four fundamental principles—autonomy, beneficence, nonmaleficence, and justice—along with the Four Topics Method are considered together as the process, and resolution take place (Jonsen et al., 2010).
TABLE 2-1 Four Topics Method for Analysis of Clinical Ethics Cases
Medical Indications: The Principles of Beneficence and Nonmaleficence
1. What is the patient’s medical problem? Is the problem acute? Chronic? Critical? Reversible? Emergent? Terminal?
2. What are the goals of treatment?
3. In what circumstances are medical treatments not indicated?
4. What are the probabilities of success of various treatment options?
5. In sum, how can this patient be benefited by medical and nursing care, and how can harm be avoided?
Patient Preferences: The Principle of Respect for Autonomy
1. Has the patient been informed of benefits and risks, understood this information, and given consent?
2. Is the patient mentally capable and legally competent, and is there evidence of incapacity?
3. If mentally capable, what preferences about treatment is the patient stating?
4. If incapacitated, has the patient expressed prior ...
Treatment
This document discusses various approaches to treating drug addiction. It covers assessing addiction severity and readiness to change using tools like the Addiction Severity Index. It outlines principles of treatment including using a variety of behavioral and pharmacological therapies tailored to the individual. Comorbidity between substance abuse and mental illness is common requiring accurate diagnosis and integrated treatment. Factors like age, gender, criminal justice involvement and availability of treatment influence outcomes.
Homeopathic treatment of elderly patients - a prospective observational study...
The severity of disease showed marked and sustained improvements under homeopathic treatment,
but this did not lead to an improvement of quality of life. Our findings might indicate that homeopathic medical
therapy may play a beneficial role in the long-term care of older adults with chronic diseases and studies on
comparative effectiveness are needed to evaluate this hypothesis.
Program Overview
The Life Science Addiction Treatment Center is a private residential facility that offers short, moderate, and long-term inpatient treatment for adults struggling with alcohol and/or drug addiction. Its mission is to provide evidence-based treatment in a professional and affordable manner using a personalized approach. The treatment program utilizes principles from cognitive behavioral therapy and other therapeutic models. It offers a variety of group and individual therapy sessions, educational workshops, recreational activities, and medical and psychiatric support to help clients develop coping skills and achieve rehabilitation and wellness goals. The facility is located in a serene natural setting near Montreal, Quebec and employs a multidisciplinary clinical team.
Explore the Relationship between Post Traumatic Growth, Ways of Coping and An...
A cancer diagnosis is hard to take and having cancer is not easy. Like all chronic illnesses, cancer
involves a series of negative threat to life of individual that may be due to the diagnosis and treatment of cancer
as it has the ability to shake one’s worldview and significantly impact one’s assumption about life. In addition to
commonly recognized negative effects such as posttraumatic stress symptoms (PTSS), there may also be positive
personal developmental change, including posttraumatic growth (PTG)which is affected by the anxiety level of
the patient. The purpose of the study was to determine the relationship between post traumatic growth, ways of
coping and anxiety among cancer patients. The study involved 100 cancer patients. There was a highly positive
correlation between PTG and WAYS. State-trait anxiety was found to be highly negatively co-related to post
traumatic growth and ways of coping.Thus it can be concluded that post traumatic growth and ways of coping
goes in same manner which suggest that the better the coping behavior used by cancer patients more will be the
post traumatic growth and there was negative relationship between post traumatic growth, ways of coping and
state-trait anxiety
Generalist Practice A Presentation on Steps of The Problem-Solv
Generalist Practice: A Presentation on Steps of The Problem-Solving Process
Name:
Date: May 5th, 2021
Pamela Easter !!!
1
Problem Identification or Engagement
Identify the type of problem – drug addiction and its effects on Family members.(Janice Walker is at the center of problem)
Identify how the problem has affected the rest of the community- substance abuse effects cost in the community in measurable ways including loss of productivity and unemployability; impairment in physical and mental health; reduced quality of life; increase violence; and Crime; abuse and neglect of children.
The community's general perception of the problem- the economic consequences of drug abuse severely burden federal , State, and local government resources, and the taxpayer.
The root cause of the problem- most often the cause of addiction is chronic stress, a history of trauma (PTSD), mental illness, lastly family history with addiction
Problem Identification/Engagement. The first step is to identify the type of problem the researcher is dealing with. Identify how the problem has affected the rest of the community and the community's general perception of the problem. The next step is to evaluate how the problem has affected the community or a client. Lastly, identify the root cause of the problem; where did the problem come from, or how did the victim get the problem they are facing.
2
Data Collection
Three major ways of collecting data from Clients are Interviews, Observation, and surveys
Interviews:
Engaging with the client one-on-one. Listening to client’s perspective of the problem
This method has ability to untangle the individual's problem, emotions, background, and the general social context, The Advocate can get the client's perception of the treatment
Observation:
It obtains data from clients by assessing the reaction to their respective environments
The researcher can identify factors contributing to the Client's condition
Data collection. There are many ways to collect data from a client. Three major ways of collecting data from a client are Interviews, Observation, and First Extraction.
Interviews: The researcher can speak with the patient on a one-on-one basis. A researcher or a nurse can use this method because of its ability to untangle the individual's problem, emotions, background, and the general social context, which in this paper largely revolves around the family relationship (Cohen et al., 2017). This data collection method paves the way for a nurse to get the patient's perception of the treatment and some of the elements that motivated them to embrace treatment.
Observation: it is used to obtain data from clients by assessing the reaction to their respective environments. Observation methods allow the researcher to identify social dimensions and family background factors contributing to the patient's condition.
3
Data Collection cont’d
Surveys : Can discover the problem
Clients Family History background details o ...
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Discussion questions – Twain, The Man That Corrupted Hadleyburg.docx
Discussion questions – Twain, “The Man That Corrupted Hadleyburg”
Mark Twain wrote this story in 1898, toward the end of his career, and long after publishing his masterpieces
Tom Sawyer
and
Huckleberry Finn
. However, “Hadleyburg” reflects one concern that interested Twain throughout his entire career: the sarcastic skewering of middle-class morality and mannerisms. We will examine Twain’s critique of the false righteousness and hidden hypocrisies of common, civilized life as an example of Realism.
1. Hadleyburg prides itself on the honesty of its citizens. However, this focus on honesty has allowed other, less moral attitudes to take root and grow among the people. Find 2 passages that reveal at least two different sinful attitudes shared by the citizens of Hadleyburg.
2. The stranger’s plot is perfectly designed to attack the one source of pride of the townspeople. Focus on the scene describing the night the owner of the sack of gold is to be revealed. Explain what Twain to saying about human nature through the behavior of Wilson the lawyer. Find 1 passage that supports your interpretation. (Hint: Does Wilson tell the truth?)
2a. Also, Dr. Harkness ends up buying the sack of (fake) gold. Why does he do this, and what is Twain trying to say about politics and morality through that subplot? Find 1 passage that supports your interpretation. (Hint: Harkness creates a fake story about the gold. Also, why is he desperate to win the election?)
3. The Richardses were spared the humiliation the other nineteen families experienced. They even receive a reward for $38,500! However, their lives end miserably. Their miserable end is related to the one moral weakness that Richards consistently exhibits throughout the story. What is this weakness (it’s not greed) and explain how it causes a terrible ending to the Richardses’ lives. Find 1 passage that reveals this weakness.
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Discussion Questions The difficulty in predicting the future is .docx
Discussion Questions
: “The difficulty in predicting the future is that the outcomes are unreliable, due to the occurrence of wild-card events that distort the relatively well-understand trends for the near to mid-future.” Offer an example of such a “wild-card” event and some ways in which the security professional might address it in an effective manner. Regarding the need for the security industry as a whole to maintain the professionalism and competencies needed to address emerging threats and hazards, what do you feel are its primary areas of weakness and what proposals could you offer to address them?
The Future of the Security
When considering what awaits the security profession in the years to come and those that will operate within it, developments and forecasts related to security science will in large part be impacted by what has occurred in the past and in present day. What
might
occur, what is most
plausible
and
feasible
given current and expected occurrences, and what has proven to be effective (or not) will all need to be considered in determining those issues that will remain relevant or change. So predicting the future (not in the form of Nostradamus or similar prophets) as it relates to security is a technique that considers probable or desirable outcomes in the face of known or anticipated risks. So given this backdrop, where is security heading?
Physical Security
As long as there are structures that people operate within and house various assets, there will continue to be a need to offer needed protection related to them. All of the topics discussed in this course related to walls, fencing, sensors, alarm systems, guards, locks, and other such issues will be needed in some form or fashion. Whether through manual or technological means, these will remain a constant for the security administrator in providing appropriate defensive measures for the material, tangible assets they oversee. Concerning technology, the same trend will continue in serving as a needed aid in providing security moving forward. Mobile devices of various types, functions, capabilities, and their ability to access data, the ever-increasing use of robotics and the functions they can carry out, sensors that will be able to gain more intelligence regarding detection, and high frequency security cameras that will have the capability to verify the chemical compound of an object at a distance are just some of the many technical innovations on the horizon. Yet, just as technology has taken on a greater role in providing these efforts, so too does technology represent ever-increasing concerns to the security manager.
Cyber Security
As society becomes connected on an ever-increasing basis, attention must be directed towards what implications this environment has related to not only security, but related privacy concerns as well. In
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Discussion questions – Dunbar Paul Lawrence Dunbar was a pio.docx
Discussion questions – Dunbar
Paul Lawrence Dunbar was a pioneering African-American literary artist. He was among the first black writers who achieved fame among predominantly white audiences with the accurate use of black vernacular and realistic depictions of the attitudes of African Americans while using the literary styles and conventions familiar to white writers. Only within the past twenty years have literary critics begun to appreciate the subtle and perceptive criticism of racial relations he provides beneath the smooth artistry of his works.
1. Dunbar’s “Mr. Cornelius” is extremely naturalistic, with Cornelius struggling against, and eventually losing to, large forces. What are the forces that are arrayed against him (2)? Find a passage that describes each force.
(Hint: Economics, discrimination, as well as emotional weakness are some examples of large forces.)
2. Dunbar was well aware of the story of the slave’s flight north to freedom, a traditional African-American narrative made famous by such works as Frederick Douglass’s
Narrative
and Harriet Beecher Stowe’s
Uncle Tom’s Cabin
. How is Dunbar’s story an ironic, inverted version of the flight-to-freedom story? What is Dunbar trying to say about the status of African Americans in a society newly changed by slavery’s end?
(Hint: Cornelius is from the south. Washington D.C. is north. Does going north mean freedom for him? He must return south at the end—what does going south mean for him?)
.
Discussion Questions Identify the top three threats to the home.docx
Discussion Questions:
Identify the top three threats to the homeland and describe why you chose those as the primary threats. Considering specific terrorist tactics that have been or could be used in the homeland, which do you consider to be the most intimidating and which do you see as the most likely to be used?
.
Discussion questions – Hurston Zora Neal Hurston attended Ho.docx
Discussion questions – Hurston
Zora Neal Hurston attended Howard University, then Barnard College, and studied anthropology while becoming a popular figure of the Harlem Renaissance. Her studies earned her a post-graduate fellowship to study Southern black folktales. These folktales become the basis for her fiction. During her life, Hurston’s writing, while popular with general audiences, was not well-received by critics, particular black literary reviewers who wanted her to focus more on racial inequality. After being wrongly accused of a crime, Hurston finished her career in poverty and obscurity. She has recently become an extremely important writer for her depictions of black women, particularly in the now-acclaimed
Their Eyes Were Watching God
(1937).
2. Hurston’s “How It Feels to Be Colored Me” is a modernist-style literary montage—a series of (loosely organized) images, impressions, memories, observations on experiencing life as a black woman. The montage is quite humorous since she often states that she doesn’t know what “colored” is. The montage can be broken down into a diverse set of themes. Find 1 passage for each theme:
a. earliest memories of life before she knew what “race” was
b. the idea of “race” is imposed on her by others
c. moments where she recognizes her racial identity emerging suddenly
d. she lives a life that is bigger than what “race” tells her she must be
Please use the Answer Sandwich method to answer each question. The passages you add to your answer should be around 2-4 sentences long. Please include a page reference.
Keep in mind that I may select any of these questions to be the upcoming quiz question. Also, I use these discussion questions to create the exams and the major paper assignment. So do your best on each question.
https://bucket-hozzify.storage.googleapis.com/wp-content/uploads/2021/02/08211149/Robert-S.-Levine_-Michael-A.-Elliott_-Sandra-M.-Gustafson_-Amy-Hungerford_-Mary-Loeffelholz-The-Norton-Anthology-of-American-Literature-Volumes-C-D-E-W.-W.-Norton-Company-2016.pdf
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Discussion Questions Compare and contrast through a critical an.docx
Discussion Questions
: Compare and contrast through a critical analysis of the following laws and strategies with an emphasis on how they enhance port maritime operations: Maritime Transportation Security Act of 2002, The SAFE Port Act, and The Small Vessel Security Strategy.
Response must be 400 words or more in APA style format.
.
Discussion questions (self evaluation)Examine nursing roles th.docx
Discussion questions (self evaluation)
Examine nursing roles that meet the emerging health needs of individuals, families, communities and populations.
Explore historical, legal, social, cultural, political, and economic forces that influence the client, nursing practice, and the health care system.
Evaluate strategies that can be used by public and community health nurses to improve the health status and eliminate health disparities of vulnerable populations.
Predict trends in lifestyles that will affect the health of communities and the future challenges for nursing.
Plan, analyze, implement and evaluate public health surveillance and outbreak investigation
Develop strategies to deliver nursing care in the preparedness, response, and recovery phases of disaster management.
Initial should have 400 words. Reference in APA format 7th edition.
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Discussion QuestionReflecting on what you have learned abou.docx
Discussion Question:
Reflecting on what you have learned about the social determinants of health, SDOH, how can nurses work collaboratively with physicians and other health care professionals to improve primary care, reduce overutilization and improve underutilization of healthcare services? Include in your response how fostering an environment of diversity and cultural awareness among healthcare providers builds a stronger healthcare team and improves care delivery to healthcare consumers.
Initial 400 words. Reference APA format 7th edition.
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Discussion questionMotivation is the all-ensuing mechanism t.docx
Discussion question
Motivation is the all-ensuing mechanism that determines how much and how well a student will learn. Treating it as strictly an internal mechanism, explain how learners; needs, goals, beliefs, interests, and emotions can influence their motivation to learn.
RESPOND TO THESE STUDENTS POSTS
Tashi post
Motivation is something that looks different in everyone. When we look at what motivates one person and assume we can teach based on that, we will not be successful in reaching all students. Looking at motivation strictly from an intrinsic lens, meaning a student’s needs, goals, beliefs, interests and emotions, teachers need many resources. I think that one of the biggest tools that teachers need is relationships. Understanding where a student’s motivation is coming from, or not coming from, can lead to engagement. For example, if a student’s basic needs are not being met, they will not be motivated to learn their math facts because they have greater needs. This is where the relationship and understanding of where students are at is so important for a teacher. They have the ability to create goals with these students. However, on the flip side, a student that knows they want to go to college may be motivated based on their goals for themselves and will engage because they want to do well and achieve a goal in the future.
Motivation can create opportunity as well as hinder progress. It is so important in education. A student’s belief in themselves can create these opportunities or hinder their progress as well. Understanding how a teacher can use motivation through an intrinsic lens can help all students in their class.
Jasmine post
Motivation is defined as the processes that initiate, direct, and sustain behavior. Motivated students put out more effort, persist longer, learn more, and score higher on tests (Lazowski & Hulleman, 2016). Intrinsic motivation is the natural human tendency to seek out and conquer challenges as we pursue personal interests and exercise our capabilities. When we are intrinsically motivated, we do not need incentives or punishments, because the activity itself is satisfying and rewarding (Anderman & Anderman, 2014; Deci & Ryan, 2002; Reiss, 2004). When I think of intrinsic motivation I don't associate it with younger children as much as I would with older children. I can relate to intrinsic motivation myself because just learning something new motivates me to learn more. Also, seeing those A's and B's keeps me wanting to learn more. I feel the more I learn the more I'll be able to teach someone in the future. That is motivation enough for me to keep going. The students I currently work with get excited when they are able to identify numbers and letters and this motivates them to keep learning. You can see the excitement on their faces when they answer something correctly.
.
Discussion QuestionHow much, if any, action on ergonomics in th.docx
Discussion Question:
How much, if any, action on ergonomics in the work-place should rely on the voluntary actions of employers (as favored by George W. Bush) and how much should be mandatory on the part of managements. Explain.
Read the following:
Chapter 9 – Institutional Issues under Collective Bargaining
Chapter 10 – Administrative Issues under Collective Bargaining
Chapter Summaries
Chapter 9 – Institutional Issues under Collective Bargaining
The rights and duties of the employers, employees, and unions are the institutional issues of collective bargaining. On occasion, they can be more troublesome than the economic questions involved with wages and benefits. Some of the longest and most bitter strikes have resulted from conflict over the institutional questions of labor relations.
One of the most controversial issues is union membership as a condition of employment. Labor organizations seeking greater security have negotiated a number of compulsory union membership devices, the most common being the union shop. The closed shop, maintenance-of-membership arrangement, agency shop, and the preferential shop are other security measures that appear less frequently. The growth of the union shop is best explained by the Taft-Hartley prohibition of the closed shop in firms engaged in interstate commerce. The goal of each of these measures is to establish and maintain the institutional security of the union. Such devices are present in about 82 percent of today’s collective bargaining contracts.
There are elements of morality, labor relations stability, and power in this area. Union security may provide stability in industrial relations, but is it moral to compel a worker to join a union? Are these ideological and philosophical issues a mere disguise for the real goal, increased power and influence? Some twenty-two states now have legislation that bans any form of compulsory union membership. These “right-to-work” laws are formidable obstacles in the path of union institutional security. Although Congress has preemptive power in the field of interstate commerce, this state legislation is likely to be allowed to stand.
More than 95 percent of current contracts contain a checkoff procedure by which the employer collects union dues, and often other fees, by deduction from the worker’s paycheck. The advantage to the union is a savings of time and money. The checkoff also can benefit the employer, which explains why it is not a crucial issue of negotiation. Taft-Hartley requires the written authorization of the employee for such an arrangement, which is irrevocable for one year, or the duration of the contract, whichever is shorter. Usually the individual has an annual opportunity to rescind his authorization. If he or she does not, the checkoff remains in force for another year.
The obligations of the union are typically set down in one or more provisions of the contract. The most important is a pledge by the union not to strik.
Discussion QuestionConsider a popular supplement you andor y.docx
Discussion Question:
Consider a popular supplement you and/or your family and friends take.
Can you think of a supplement that is commonly taken that could easily be replaced by eating more of a certain food or type of foods?
Is there a population group that would find it more difficult to get the recommended amount of vitamins and minerals through diet changes?
.
Discussion QuestionDiscuss opportunities for innovation and en.docx
Discussion Question
Discuss opportunities for innovation and entrepreneurship in emerging global markets, particularly those with a growing middle class, or those where harsh economic conditions dictate the need for innovation if basic human needs are to be met.
What steps must be taken to encourage innovation in these markets?
Will the same incentives and techniques be effective in all emerging markets?
What can be done in instances where government does not encourage or is even hostile to entrepreneurship?
Design and present a list of talking points you might use when you meet with industry and government leaders in one of these markets as you attempt to build a creative mind-set among local civic leaders, businesses, and citizens.
The final paragraph (three or four sentences) of your initial post should summarize the one or two key points that you are making in your initial response.
Your posting should be about 1 page (400 to 500 words) in length.
.
Discussion Question(s)Im interested in the role of women-- in t.docx
Discussion Question(s)
I'm interested in the role of women-- in the colonial family, in colonial society, etc. Based on what you've read in the book (and in lecture), how much power do you think women had in colonial Latin America? what kind of control were they able to exert? (keep in mind two things: the patriarchal system, and the fact that patriarchy does not equal one-sided dominance.)
Lecture 9
Your author for this course, Burkholder (et. al.)*, states from the outset of the chapter we are reading this week that the Family is the foundation of colonial society (p. 216). That is a bold statement, especially since so much of colonial Latin America is built on violence, religion, labor, and the construction of Spanish political structures once Spaniards started settling in the Americas. However, he states it more clearly than I can when he says, "while race, wealth, occupation, and gender all helped to identify an individual's position in the social structure,
these elements were usually evaluated in the framework of a broadly defined family
" (p. 216).
Think about some of the issues that we talked about last week concerning race (which I know is still fresh in your mind!). Among the issues that the lecture, the reading, and all the rest of us in this class discussed was how race was a bit more slippery than we usually think about it in the United States (this of course does not make it any less harmful, just different). Nonetheless, if we think about all the moves that some people were able to make racially-- up or down the ladder/hierarchy, depending on the situation-- a lot of those moves were not only based on the ideology of the family, but they were also decided on those terms as well. In other words, the ideology of the family helped organize colonial Latin American societies-- not just husband, wife, kids, grandparents, etc. Families were more than blood relations, but rather a collective of biological and fictive relationships that offer a means for people navigate colonial society both economically and politically.
Family meant a lot of different things, but most of all, it is important to remember that being a member of a family was certainly about marriage and blood relations, but it was also kind of like being a member of a "crew" (is that a word that people use these days? Yes? No? I'm a little old, so maybe there is a new word). Anyway, marriages, parentage, god-parentage, and even simply being close enough to a family to be considered part of it almost always had political implications. Like I said, it was how people made their moves.
Let's take marriage as an example. Because the population of colonial Latin America was diverse from the beginning (marriages or coupling between native folks and Spaniards in the early years of conquest and settlement started the ball rolling on a rather mixed population), people in different
castas,
(or "racial castes"-- people who were of mixed descent/race) would use marria.
Discussion Question(s)Why do you think that Native Allies and Af.docx
Discussion Question(s)
Why do you think that Native Allies and African Conquistadors were not mentioned in European accounts of the conquest? Do you think it was intentional or unintentional? Why?
Portrayals of Malintzin have been unfair to her, historically. My question is this: why do you think the stories have been so unfair to her, while Cortes and other conquistadors are either rewarded or ignored for actually carrying out the conquest?
How do your readings connect to either of these questions?
Lecture 3- Steamrolling?
"Malintzin was the indigenous woman who translated for Hernando Cortés in his dealings with the Aztec emperor Moctezuma in the days of 1519 to 1521. "Malintzin," at least, was what the Indians called her. The Spanish called her doña Marina, and she has become known to posterity as La Malinche. As Malinche, she has long been regarded as a traitor to her people, a dangerously sexy, scheming woman who gave Cortés whatever he wanted out of her own self-interest.
The life of the real woman, however, was much more complicated. She was sold into slavery as a child, and eventually given away to the Spanish as a concubine and cook. If she managed to make something more out of her life--and she did--it is difficult to say at what point she did wrong."
Actually, that is a good question: what did she do wrong? Not much, it turns out-- having been sold by her family, and again by the subsequent owners, exactly what kind of loyalty was she supposed to have? Who was it that she was supposed to not "sell out?" No one, it turns out. Historians today know that she was doing her best to stay alive, and make a life for herself, and given her situation and life experiences, it is hard to expect anything more.
For me, at least, this raises a simple question: why are people in such a hurry to blame Malintzin for the conquest, when, in fact, they should be blaming the Spanish? Why did the blame shift to her, instead of where it should have been-- on Cortes and his men? Just curious.
The Indigenous Allies:
Check out this Prezi presentation! Short and sweet! Think about it alongside your readings! (Links to an external site.)
ñ
Spanish, Slavery, and Encomiendas (Early Colonial Period)
In U.S. History, people debate quite a lot about the plight of Native Americans. Some people believe that Native Americans were given a chance to be a part of the developing American culture, others say they were not. Still others, citing the diminishing numbers of Native Americans and the active role that the U.S. government and its white citizens took in killing and displacing Native Americans, call it genocide. In Latin America, it is a little more complicated.
The removal, displacement, and murder of Native Americans is undeniable in U.S. history, but such actions did not take place in Mexico, or other parts of Latin America, at least not on the same scale. The reason for this is that the goals of the British and the Spanish were different wh.
Discussion Question(This post must be at least 200 words.)What d.docx
Discussion Question(This post must be at least 200 words.)
What do you think of the tone of "Orders Given to the Twelve"? What
was
the tone? Do you think it is appropriate for the kind of document it is, given when it was written, and why it was written? Why or why not? How does that contrast to the tone in the second document (The Holy Men Respond...)?
Lecture, Week 4
Lecture------
Here is an excerpt from a historian (Camille Townsend) who talks about some of the myths surrounding Cortes's arrival in Mexico (keep an eye out for what I put in bold):
"In 1552, Francisco López De Gómara, who had been
chaplain
and secretary to Hernando Cortes while he lived out his old age in Spain, published an account of the conquest of Mexico. López de Gómara himself had never been to the New World, but he could envision it nonetheless. "Many [Indians] came to gape at the strange men, now so famous, and at their attire, arms and horses, and they said,
'These men are gods!' "
The
chaplain
was one of the first to claim in print that the Mexicans had believed the conquistadors to be divine. Among the welter of statements made in the Old World about inhabitants of the New, this one found particular resonance. It was repeated with enthusiasm, and soon a specific version gained credence: the Mexicans had apparently believed in a god named Quetzalcoatl, who long ago had disappeared in the east, promising to return from that direction on a certain date. In an extraordinary coincidence, Cortes appeared off the coast in that very year and was mistaken for Quetzalcoatl by the devout Indians."
Of course, Townsend continues by saying that no educated person really believes this story. In fact, it was largely fabricated by a chaplain who had never been to the Americas, but rather was taking care of Cortes in Spain during his last years.
Much has been made about the role of the church during the early years of the conquest, and I think that much of what has been written in recent years has been fair, even if they have been criticizing the church for many years. The truth is, the Catholic church (or its representatives back in the colonial period in Latin America) were quite rough on the indigenous people throughout Latin America, calling it a "spiritual conquest."
You will also remember from last week's lecture, when we talked about the ways in which encomiendas were being used, and how Antonio de Montesinos basically called out all of the
encomenderos
and called them bad Christians for not preaching to them while they were essentially enslaving indigenous folks on the land that the Spanish crown granted them.
I bring up this point because it is often forgotten that the military conquest and the "spiritual conquest" of Latin America go hand in hand.
A few years ago, Pope Francis admitted as much (not quite), when he apologized for all of the things that the Catholic Church and its representatives did to the indigenous people in Latin America durin.
Discussion Question(s)What were the colonial misgivings about m.docx
Discussion Question(s)
What were the colonial misgivings about "monarchy-wide
cortes
in February of 1810 (p. 350). What do you think of the relationship between the monarchy (or the Central Junta) and the colonials in Spanish America? Do you think that the
criollos
were waiting for independence the whole time? Why or why not?
Lecture 13
Over the last two weeks, we talked about the Caroline and Bourbon Reforms in Spanish America, and I am sure that after reading Chapters 9 and 10, you feel like movements for Independence in colonial Latin America were only days away from happening (maybe only a week, since I post these on Sunday). But no!
As upset as the
criollos
might have been by the dramatic economic and political changes that occurred (not the least of which the fact that the power that they had worked for generations to gain was being taken away by
peninsulares
), the
criollos
still remained loyal to the Spanish Crown. Independence was certainly something that was whispered about in dark corners, but only by the bold, and perhaps the stupid. If we start during this era of Independence in the Americas, we
have
to start with the American Revolution--
Hey-- I'm not happy about it either (this is
Latin American History
darn it!)!
But the American Revolution was the first war for independence in the Americas, so it certainly played an important role.
Kind of.
I mean, your book is kind of right-- the French Revolution definitely played a much bigger role, but keep in mind:
1) The American Revolution was fought from around 1775 to about 1783
2) The French Revolution was fought from 1789 through the 1790s.
Just because the American Revolution was first does not mean that it had a bigger influence than the French (it did NOT). However, keep in mind that the movements for independence throughout Latin America were just as much about ideas as they were about economics-- ok, they were
almost
as much about ideas as economics-- and thus, knowing that there was a neighbor to the north that was able to shrug off colonial power certainly had a psychological effect, if not quite a political one.
The truth is, the eventual movements of independence throughout Latin America was really a combination of things, but one of the largest factors was
time--
time was needed for these ideas to sink in, and time was needed for things to totally unravel in Europe.
And it really did start with the French Revolution, and Napoleon's rise to power:
No, not that Napoleon, THIS Napoleon:
Also happening in the late 18th century (the late 1700s) was the Haitian Revolution, which, if the world wasn't turned upside down already, it definitely was by then. Check out the generally informative Powerpoint I put together about the Haitian Revolution (via your email), and connect it to your text.
Freedom was happening everywhere, and it was happening in many different ways (and in Spain, it was happening largely in the context of Napoleon's at.
Discussion Question(s)The reading for this week was a grab bag o.docx
Discussion Question(s)
The reading for this week was a grab bag of different perspectives on life under colonial rule, or "living in an empire." They talked about the city and the countryside, religious life and secular life, popular culture, education, and intellectual development, and so on. Which of these sections struck you as being most interesting? Which struck you as being most important for the study of colonial (and perhaps modern!) Latin America? Why?
Lecture 10
What does it mean to live in an empire?
No, that's probably not what you were thinking. Instead, were you thinking something like this?
Maybe. Star Wars, for people who might not know (I don't know what college students are into these days), looks like a simple tale of good against evil. The evil empire fighting against a scrappy band of rebels intent on overthrowing their evil masters. In a sense, this might be the way that you see colonial Latin America, too-- the evil Spanish against the good indigenous people of the Americas. I wouldn't blame you, either-- after weeks of learning about the conquest, encomiendas, the mita system (under the Spanish) and the doings of the Catholic church (especially during the conquest), it would be easy to think of the Spanish empire (or the Spanish) as evil. In fact, I don't think I am going to try and convince you otherwise.
However, it might be worth remembering that we are looking at this history right now, in 2015-- not in the period itself. Therefore, whereas today you might think of the Spanish as evil, as time passed during the colonial era in Latin America, for the poor, the castas, and yes the indigenous folks, the Spanish and the Spanish colonial system was simply a way of life. It was something that they lived with, adjusted to, and yes, even sometimes rebelled against (locally, of course, not on a large scale. That happens later).
Therefore, to stretch the Star Wars metaphor even further (yikes), I would say that even though most of you might think of Spanish colonialism like this--
-- it is more likely that it was much more like this:
In other words, we can all agree that in hindsight that colonial Latin America was oppressive, but for most people, instead of plotting rebellion in their basements or back rooms, most people just tried to find a way to survive in the middle of it all, and make the best life they could for themselves despite the horrible conditions. So we can think about how nice and pure life would have been without the invasion of the Spanish, but since that was a luxury that the poor, the castas, and the indigenous people living in colonial Latin America did not have, we might instead think about the ways in which colonial society forced adjustments upon how various groups of people lived, as the colonial empire itself expanded and became more and more complex.
Spain asserted its control through urban planning. Cities were laid out in grids, centered on the most important government buil.
Discussion Question(s)Could Latin American reactions to the Bour.docx
Discussion Question(s)
Could Latin American reactions to the Bourbon (Caroline era) Reforms be attributed to intellectual change (Enlightenment), religious changes (expulsion of the Jesuits, for instance), economic change (taxes), or political change (taking criollos off their prestigious jobs and replacing them with Peninsulars)? Was it any one of these specifically? All of them? (and if you are going to say "all of them," do you think one might have had more influence than the others?) Why?
Lecture 12
This is where things start to get serious, because Spain isn't playing around anymore. Yes, we are still talking about the Bourbon Reforms- but more specifically, the Caroline Reforms (which happened during the reign of King Charles III, from 1759-1788). The reason that this is so important is because there was a lot of stuff happening during this period: rebellions, revolts, the expulsion of the Jesuits (a specific Catholic order of priests) from Spanish America and Spain, and perhaps most of all, more political reorganization.
But the question is the same as it was last week: why? Well, as we noted last week, there were a lot of conflicts in which Spain had found itself on the wrong side. Take, for example, The Seven Years' War: this particular war is known these days as the first true World War, but for a long time it was called the French and Indian War.
Oooh!!!!--- why was it called the "French and Indian War"? Because the people who named it that (British and British colonists in North America) believed that the world revolved around them. "we are fighting the French and the Indians-- let's call it the French and Indian War!" Of course, when you call it that you are ignoring the fact that it wasn't just the French, Indians, and British fighting one another. In fact, here is who was fighting:
1) France
2) Native Americans (on both sides in North America)
3) Britain
4) Saxony
5) Sweden
6) Russia
7) Prussia (basically Germany)
8) Hanover (basically more Germany)
9) Spain (later)
10) Portugal (later)
And this war (the fighting), with all these people involved, took place in:
1) Europe
2) Africa
3) North America
4) Philippines
5) India
6) Central America
The war was happening everywhere, it seems. And yet, people in the United States called it The French and Indian War. Dorks. I kind of want to tell the British and their colonists in North America this:
But that's why they called it the French and Indian War for so long.
In any case, Spain-- as noted above-- came late to the party, and joined the war on the French side in 1762.
As you might have predicted, this did not go well. France lost, but more importantly for our purposes, Spain lost by extension. And they lost big! First and foremost, they lost Cuba (albeit temporarily), they lost Florida-- gone forever in the Spanish empire (however, considering what it turned into in the 21st century,
maybe they dodged a bullet (this link is not for the faint of heart.
Discussion Question(s)Clearly there is potential for major probl.docx
Discussion Question(s)
Clearly there is potential for major problems as the Bourbon Reforms are enacted over much of the 18th century. What were those problems? In what way do you think the Spanish crown could have lessened the pain of these reforms while still maintaining control over the Spanish colonies? Or was there no hope? (and if there was no hope, why do you say that?)
Lecture 11
Wen I was a young undergraduate (at a community college in southern California that will remain nameless-- I will give you all one guess in our discussion forum), I remember the week that my class was to discuss The Bourbon Reforms.
Sadly, it was not about what I was hoping.
Sigh.
Nonetheless, I remember being really interested in what was happening, because it was at this point in the class that I started to see the long chain of events that led to independence throughout most Latin American countries.
See, before I learned about the Bourbon Reforms, I was under the impression that the Independence movements (and wars) in Latin America happened from the bottom-up, which is to say that I thought they were led by Mestizos, Castas, and indigenous folks. For example, think of Mexico: Father Hidalgo, a priest and a champion of the peasant classes in New Spain (Mexico), he brings all these different people together-- people who have been stepped on for too long by colonial powers, and he issues "El Grito,", which was a unified cry of the underrepresented people for independence! Together, they would finally throw off the yoke of Spanish oppression and lead their own country to INDEPENDENCE! Yaaaaaayyyyy!
Sadly, it didn't happen like that.
Yes, Father Hidalgo did issue "El Grito de Dolores," but the conditions that led to the independence movement in New Spain (and the changing of its name to Mexico) didn't hit the peasants the hardest (the peasants were already being hit pretty hard), and the Independence movement was not led by peasants, the working classes, nor the indigenous people-- even if they did spark it. In fact, some say that Father Hidalgo and the people following him didn't want independence...they just wanted a better king.
But let's save that disappointment for later.
See, when I took that class and learned what the Bourbon Reforms were, I started to understand why independence happened throughout much of Latin America in the early 19th century (1800s).
The Bourbon Reforms (and the Caroline Reforms within them) were a set of political, economic, and administrative changes that came from Spain.
Now, speaking quite generally, one of the biggest changes was one that happened gradually, then suddenly: the termination of the sale of
audiencia
positions. See, up until this point, much of Spanish Latin America operated on that old saying that I have brought up a few times, "
obedezco pero no cumplo
", which roughly translated means, "I obey but I do not comply." (you may have a better translation-- give it a shot in the forum!)
.
Discussion Question Week #1· Discover which agencies, in.docx
Discussion Question Week #1
· Discover which agencies, in your state, are responsible for public health of citizens.
· Research if there are centralized or decentralized management of state responsibilities?
· Determine minimum 3 key indicators of health.
· Review the agency sites and upload the links to the Moodleroom, week #1
· Be prepared to discuss in class, week #2
STATE IS FLORIDA!!
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