THE UNIVERSITY OF MEMPHIS
POST TRAUMATIC STRESS
DISORDER
EARLY INTERVENTION FOR OUR SOLDIERS
LESLIE JAYROE
4/25/2011
HPRO 7720
Post Traumatic Stress Disorder and Our Soldiers- Providing Earlier Intervention
History
There is a significant amount of information out there on post traumatic stress disorder and the
military, and this is mostly due to the fact that our combat soldiers were the ones observed over
time to determine the effects war has had on them. Post traumatic stress disorder (PTSD) can
be thought of as a "young" diagnosis. PTSD has been around for centuries, but it was n~t until
1980 that it was made an official disorder. However, throughout history, people have
recognized that exposure to combat situations can have an intensely negative impact on the
people who are involved in these situations. (Mathew Tull, 2009) PTSD has previously been
described ia-410J e ~s "combat fatigue," "shell shock," or "war neurosis," and is defined by the
American Psychiatric Association as an anxiety (emotional) disorder which stems from a
particular incident evoking significant stress. (Bentley, 2005) PTSD is not limited to combat
soldiers but can also be found among survivors of the Holocaust, of car accidents, of sexual
assaults, and of other traumatic experiences. War has always had a severe psychological effect
on people, and with the war our country is currently in, more and more of our soldiers are
suffering from PTSD. After a traumatic experience, the mind and the body are in shock, but as
the victim makes sense of what happened and processes his/her emotions, healing takes place
leading toward normal function once again. With PTSD, one remains in psychological shock.
The memory of what happened and their feelings about it are disconnected. In order to move
on, it's important to face and feel those memories and emotions. One effective approach is
through counseling. (Mathew Tull, 2009)
The symptoms of PTSD can occur all of a sudden, progressively, come and go over time, or
appear out of nowhere. Sometimes, symptoms are triggered by something that reminds a
31 Page
person of the original traumatic event, such as a noise, an image, certain words, or a smell.
While everyone experiences PTSD differently, there are three main types of symptoms:
(Bentley, 2005)
1. Re-experiencing the traumatic event
2. Avoiding reminders of the trauma
3. Increased anxiety and emotional arousal
According to the Graffiti of War Project, in 2007, the number of diagnosed cases in the military
jumped 50%. One in every five military personnel returning from Iraq and Afghanistan has
PTSD, and 20% of the soldiers who've been deployed since 2001 have PTSD which is over
300,000. More troops are serving their second, third or fourth tours of duty, which dramatically
increases stress according to medical heath experts. Also, extended tour lengths from 12
months to 15 months were done to prov ...
question 1The goal of the Six Sigma program is to achieve a leve.docxIRESH3
question 1
The goal of the Six Sigma program is to achieve a level of quality that is as close to perfection as possible. Sigma is actually a statistical term used to gauge how far a process deviates from perfection. Explain how the disciplines within Six Sigma can improve hospital efficiency and hospital profitability?
question 2
What is your personal definition of continuous quality improvement? How would you relate this definition to operations in a health care organization? How do we try to build new methods of practicing based on profound knowledge, most of which already is tacit in the organization, as well as the new knowledge that the CQI process generates?
question 3
What is the value of supply chain management? How does supply chain management impact the financial position of an organization?
question 4
Why would an organization need to measure the capacity (throughput) of the various resources (x-ray equipment, exam rooms, length of stay, etc.)? How does capacity management support decision-making?
Assignment 1
For this assignment, you are required to write a research paper (4-6 pages) on methods of quality measurement. Your paper must include the following:
1) Detailed summary of at least two different methods of quality measurement.
2) Examples of how the methods may be used to improve organizational effectiveness.
3) Evaluation of the methods.
4) At least four references.
Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
Assignment 2
For this assignment, you are required to write a reflection and self-evaluation of your understanding of health care business analyses. Your assignment should include a discussion of the following:
1) A summary of your understanding of health care business analyses: In your own words, why is it important? What does it entail?
2) What was the most significant concept you learned during the course? How did the course assignments assist in your understanding of this concept?
3) What questions do you still have about health care business analyses? Was there anything else you were expecting to learn that the course did not cover?
4) How would you rate your overall understanding of health care business analyses? What steps do you plan on taking to increase your knowledge and understanding?
PTSD
Post-traumatic stress disorder (PTSD) is a biopsychological condition associated with very stressful or life-threatening events such as abuse, rape, violence, military combat, severe accidents, and natural disasters. Symptoms include having intrusive thoughts about or reliving the event(s), withdrawing from others, and experiencing anxiety or hyperarousal for weeks or months following the event(s). People with PTSD may turn to drugs or alcohol to help them cope, they may exhibit signs of depression, their relationships may deteriorate, and they may manifest physical symptoms.
PTSD has been studied intensiv ...
Running head PSYCHOLOGY1PSYCHOLOGY5Empirical res.docxSUBHI7
Running head: PSYCHOLOGY
1
PSYCHOLOGY
5
Empirical research on the prevalence of PTSD on servicemen and veterans from combat
Developments in combat zone medicine infer more aggrieved servicemen and veterans are surviving their injuries; though, numerous injuries are not as noticeable such as missing appendages and other bodily wounds, explicitly distressing cognitive damages and post-traumatic stress writhed by both soldiers and citizens in the way of relatives and friends. The frequency of these injuries can be, and still are, not clear-cut. Moreover, the categorizations of these injuries have transformed over the course of time, touching on the way in which the sum of the aggrieved is tallied over and above the interventions presented (Angkaw et.al, 2015). An editorial in The Economist on March 2013 centered on the upsurge in the figure of war veterans pursuing medical assistance as a result of post-traumatic stress symptoms. The rise was realized amongst the newly repatriated officers, albeit similarly among elderly veterans of prior wars, and had resulted to a surge in America`s disabled former soldiers count by nearly 45% from the year 2000. A lot of empirical research reinforces the assertion made in the Economist piece, and investigation correspondingly demonstrates the long-term overheads will be a reality for many nations involved in the cross-border wars (Beckham et.al, 2014). Internationally, a rise in number of war veterans looking for assistance for psychological signs that are every so often well-matched with PTSD disorder explicate that the number of troupers affected with PTSD in the year 2013 will grow to over 300,000 persons in the United States. A similar predisposition is noticed in other nation state, and a recent research from Europe (particularly United Kingdom) pronounces late onset indications among servicemen. Our test hypothesis will appraise the prevalence and frequency of PTSD in servicemen and veteran from the warzone. From the prevalence then apt interventions can be devised to help assist all those who served and are affected with disorder.
How is PTSD perceived in a health perspective?
PTSD is a mental disorder, which is described and defined in the ensuing two classifications; the International Classification of Diseases (ICD-10) established by the World Health Organization (WHO), together with the Diagnostic and Statistical Manual of Mental Disorders (DMMD) instigated by the American Psychiatric Association (DSM-5). The analytical measures in the two classifications are articulated somewhat differently, but overall they are seen as alike. The analytical criteria consist of the following: experiencing a traumatic situation or event, short or long lasting, in which the person is exposed to fears of loss of life, grim harm or sexual abuse. The exposure is a due to circumstances with unswervingly involves the distressing event or observes the traumatic happening personally (Angkaw et.al, 2015). The social-b ...
question 1The goal of the Six Sigma program is to achieve a leve.docxIRESH3
question 1
The goal of the Six Sigma program is to achieve a level of quality that is as close to perfection as possible. Sigma is actually a statistical term used to gauge how far a process deviates from perfection. Explain how the disciplines within Six Sigma can improve hospital efficiency and hospital profitability?
question 2
What is your personal definition of continuous quality improvement? How would you relate this definition to operations in a health care organization? How do we try to build new methods of practicing based on profound knowledge, most of which already is tacit in the organization, as well as the new knowledge that the CQI process generates?
question 3
What is the value of supply chain management? How does supply chain management impact the financial position of an organization?
question 4
Why would an organization need to measure the capacity (throughput) of the various resources (x-ray equipment, exam rooms, length of stay, etc.)? How does capacity management support decision-making?
Assignment 1
For this assignment, you are required to write a research paper (4-6 pages) on methods of quality measurement. Your paper must include the following:
1) Detailed summary of at least two different methods of quality measurement.
2) Examples of how the methods may be used to improve organizational effectiveness.
3) Evaluation of the methods.
4) At least four references.
Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
Assignment 2
For this assignment, you are required to write a reflection and self-evaluation of your understanding of health care business analyses. Your assignment should include a discussion of the following:
1) A summary of your understanding of health care business analyses: In your own words, why is it important? What does it entail?
2) What was the most significant concept you learned during the course? How did the course assignments assist in your understanding of this concept?
3) What questions do you still have about health care business analyses? Was there anything else you were expecting to learn that the course did not cover?
4) How would you rate your overall understanding of health care business analyses? What steps do you plan on taking to increase your knowledge and understanding?
PTSD
Post-traumatic stress disorder (PTSD) is a biopsychological condition associated with very stressful or life-threatening events such as abuse, rape, violence, military combat, severe accidents, and natural disasters. Symptoms include having intrusive thoughts about or reliving the event(s), withdrawing from others, and experiencing anxiety or hyperarousal for weeks or months following the event(s). People with PTSD may turn to drugs or alcohol to help them cope, they may exhibit signs of depression, their relationships may deteriorate, and they may manifest physical symptoms.
PTSD has been studied intensiv ...
Running head PSYCHOLOGY1PSYCHOLOGY5Empirical res.docxSUBHI7
Running head: PSYCHOLOGY
1
PSYCHOLOGY
5
Empirical research on the prevalence of PTSD on servicemen and veterans from combat
Developments in combat zone medicine infer more aggrieved servicemen and veterans are surviving their injuries; though, numerous injuries are not as noticeable such as missing appendages and other bodily wounds, explicitly distressing cognitive damages and post-traumatic stress writhed by both soldiers and citizens in the way of relatives and friends. The frequency of these injuries can be, and still are, not clear-cut. Moreover, the categorizations of these injuries have transformed over the course of time, touching on the way in which the sum of the aggrieved is tallied over and above the interventions presented (Angkaw et.al, 2015). An editorial in The Economist on March 2013 centered on the upsurge in the figure of war veterans pursuing medical assistance as a result of post-traumatic stress symptoms. The rise was realized amongst the newly repatriated officers, albeit similarly among elderly veterans of prior wars, and had resulted to a surge in America`s disabled former soldiers count by nearly 45% from the year 2000. A lot of empirical research reinforces the assertion made in the Economist piece, and investigation correspondingly demonstrates the long-term overheads will be a reality for many nations involved in the cross-border wars (Beckham et.al, 2014). Internationally, a rise in number of war veterans looking for assistance for psychological signs that are every so often well-matched with PTSD disorder explicate that the number of troupers affected with PTSD in the year 2013 will grow to over 300,000 persons in the United States. A similar predisposition is noticed in other nation state, and a recent research from Europe (particularly United Kingdom) pronounces late onset indications among servicemen. Our test hypothesis will appraise the prevalence and frequency of PTSD in servicemen and veteran from the warzone. From the prevalence then apt interventions can be devised to help assist all those who served and are affected with disorder.
How is PTSD perceived in a health perspective?
PTSD is a mental disorder, which is described and defined in the ensuing two classifications; the International Classification of Diseases (ICD-10) established by the World Health Organization (WHO), together with the Diagnostic and Statistical Manual of Mental Disorders (DMMD) instigated by the American Psychiatric Association (DSM-5). The analytical measures in the two classifications are articulated somewhat differently, but overall they are seen as alike. The analytical criteria consist of the following: experiencing a traumatic situation or event, short or long lasting, in which the person is exposed to fears of loss of life, grim harm or sexual abuse. The exposure is a due to circumstances with unswervingly involves the distressing event or observes the traumatic happening personally (Angkaw et.al, 2015). The social-b ...
Running Head: LITERATURE REVIEW
LITERATURE REVIEW 2
Improving Comprehensive Care for OEF and OIF Vets (Literature Review)
Ashlie Burnett
DHA 8015
5/24/15
As discussed by Vilens and Sher (2010), Post-traumatic stress disorder can be described as a psychological disorder that occurs due to exposure to frightening, stressful or distressing events. The dominant events that can lead to a person getting this disorder involve serious road accidents, prolonged violence or sexual abuse, terrorist attacks and military combat. The PTSD can develop immediately or after some time after an exposure to these events. Essentially, it has grown into a major concern since its diagnosis has become more difficult. Moreover, the patients with PTSD are diagnosed only after the manifested symptoms have persisted for more than one month. The patients at this time tend to show functionality impairment. It is crucial to improve the quality of comprehensive care that is administered to these patients; particularly the OEF and OIF veterans since they are the majority of those who suffer (Vilens & Sher, 2010).
The OEF and OIF veterans are known to be the most recognizable PTSD population. This is because during the First World War, it was hypothesized that the physiological damage to people was caused by the exploding shells with high air pressure. This was later renamed as the “shell shock” (Miller, 2000). With years passing by, the percentage of the population suffering from PTSD drastically increased. It is crucial that the clinicians and the health care providers accurately diagnose PTSD and administer proper treatment method since this will aid the patient to have a control over the physiological and psychological reaction to a stressful event encountered. Moreover, the appropriate referral of patients to the mental health facilities and well trained professionals plays a major role in their recovery process (Miller, 2000).
According to Yahyavi et al. (2014), post-traumatic stress disorder is a normal response mechanism by the body system. It is the psychopathological response to any strange stressors to the normal body functioning. Majorly, it is characterized by constant re-experience of distress, insistent avoidance of anything that is associated with a traumatic event and the individual at the same time tend to have constant psychological and physiological arousal. Personal vulnerability and severe trauma are the essential components of PTSD development. Essentially, an individual’s levels of vulnerability play a crucial role towards the development of PTSD. This is often influenced by the biological factors such as the hormonal patterns and the autonomic nervous system. Additionally, it is influenced by psychological factors that are majorly characterized by a cognitive schema (Yahyavi et al., 2014).
The war experience that the veterans face not only includes injury to oneself and threats, but also includes the acts performance that usually tran.
"Reintegrating Returning Warriors and The Subtleties of PTSD: Practice, Research and Policy"
by Col Jeffrey Yarvis, Chief of Soldier Behavioral Health Service, Carl R. Darnall Army Medical Center, Washington DC
REVIEW ARTICLEExploring positive pathways to care for memb.docxronak56
REVIEW ARTICLE
Exploring positive pathways to care for members of
the UK Armed Forces receiving treatment for PTSD:
a qualitative study
Dominic Murphy1*, Elizabeth Hunt1, Olga Luzon2 and Neil Greenberg1
1King’s Centre for Military Health Research, King’s College London, London, UK; 2Department of
Clinical Psychology, Royal Holloway University, London, UK
Objective: To examine the factors which facilitate UK military personnel with post-traumatic stress disorder
(PTSD) to engage in help-seeking behaviours.
Methods: The study recruited active service personnel who were attending mental health services, employed a
qualitative design, used semi-structured interview schedules to collect data, and explored these data using
interpretative phenomenological analysis (IPA).
Results: Five themes emerged about how participants were able to access help; having to reach a crisis point
before accepting the need for help, overcoming feelings of shame, the importance of having an internal locus
of control, finding a psychological explanation for their symptoms and having strong social support.
Conclusions: This study reported that for military personnel who accessed mental health services, there were a
number of factors that supported them to do so. In particular, factors that combated internal stigma, such as
being supported to develop an internal locus of control, appeared to be critical in supporting military
personnel to engage in help-seeking behaviour.
Keywords: Military health; PTSD; depression; pathways; stigma; barriers
*Correspondence to: Dominic Murphy, KCMHR, Weston Education Centre, Cutcombe Road, SE5 9PR
London, UK, Email: [email protected]
For the abstract or full text in other languages, please see Supplementary files under Article Tools online
Received: 17 June 2013; Revised: 4 October 2013; Accepted: 20 November 2013; Published: 17 February 2014
S
ince 2002, the UK and US military’s have con-
ducted highly challenging operations in Afghanistan
and Iraq. These military operations have been
the focus of a number of large-scale epidemiological re-
search studies, which have investigated the psychological
health of US and UK service personnel. Studies in the
United States have observed rates of post-traumatic stress
disorder (PTSD) in deployed personnel to be between
8 and 18% (Hoge et al., 2004; Smith et al., 2008). Further,
13% of participants met criteria for alcohol problems
and 18% for symptoms of anxiety and depression, with a
very high co-morbidity rate between these disorders and
PTSD (Riddle et al., 2007; Smith et al., 2008). This
increase in the rate of PTSD following deployment has
been replicated prospectively (Vasterling et al., 2006).
However, in the UK, the effects of the conflict upon the
mental health of service personnel have been quite
different.
The most extensive UK epidemiological studies of
service personnel since 2003 have been carried out at
King’s College London. This study is based o ...
A disorder characterised by failure to recover after experiencing or witnessing a terrifying event.
The condition may last months or years, with triggers that can bring back memories of the trauma accompanied by intense emotional and physical reactions.
Symptoms may include nightmares or flashbacks, avoidance of situations that bring back the trauma, heightened reactivity to stimuli, anxiety or depressed mood.
Treatment includes different types of psychotherapy as well as medications to manage symptoms.
Persistent PTSD among Patients with Fragile X Syndrome: Case Seriessemualkaira
Posttraumatic stress disorder (PTSD) affects
about 3.6% of the US population and has clear diagnostic criteria
and treatment modalities. Individuals with autism spectrum disorder (ASD) and intellectual disabilities (ID) are at an elevated
risk for exposure to trauma and development of PTSD. Fragile X
syndrome (FXS) is the most common inherited cause of ID, and
there is currently need for further research regarding presentation
of PTSD among these individuals.
Persistent PTSD among Patients with Fragile X Syndrome: Case Seriessemualkaira
Posttraumatic stress disorder (PTSD) affects
about 3.6% of the US population and has clear diagnostic criteria
and treatment modalities. Individuals with autism spectrum disorder (ASD) and intellectual disabilities (ID) are at an elevated
risk for exposure to trauma and development of PTSD. Fragile X
syndrome (FXS) is the most common inherited cause of ID, and
there is currently need for further research regarding presentation
of PTSD among these individuals.
Persistent PTSD among Patients with Fragile X Syndrome: Case Seriessemualkaira
Posttraumatic stress disorder (PTSD) affects
about 3.6% of the US population and has clear diagnostic criteria
and treatment modalities. Individuals with autism spectrum disorder (ASD) and intellectual disabilities (ID) are at an elevated
risk for exposure to trauma and development of PTSD. Fragile X
syndrome (FXS) is the most common inherited cause of ID, and
there is currently need for further research regarding presentation
of PTSD among these individuals.
Persistent PTSD among Patients with Fragile X Syndrome: Case Seriessemualkaira
Posttraumatic stress disorder (PTSD) affects
about 3.6% of the US population and has clear diagnostic criteria
and treatment modalities. Individuals with autism spectrum disorder (ASD) and intellectual disabilities (ID) are at an elevated
risk for exposure to trauma and development of PTSD. Fragile X
syndrome (FXS) is the most common inherited cause of ID, and
there is currently need for further research regarding presentation
of PTSD among these individuals.
Running head COMPREHENSIVE QUALITY CARE1COMPREHENSIVE QUALIT.docxjoellemurphey
Running head: COMPREHENSIVE QUALITY CARE 1
COMPREHENSIVE QUALITY CARE 10
Improving the Quality of Comprehensive Care for the OEF and OIF Veterans with Posttraumatic Stress Disorder (PTSD)
Ashlie Burnett
Capella University
2/15/15
Research Questions
1. How efficiently can quality of Comprehensive care be improved to ensure quality care to the OEF and OIF with posttraumatic stress disorder?
2. To what extent are the problems faced by the OEF and OIF with posttraumatic disorder matched by the available ways of serving them?
Research Objectives
1. The general objective of this research was to determine how efficiently quality of comprehensive care be improved to ensure quality care to the OEF and OIF with posttraumatic stress disorder.
2. The paper also sought to determine the extent to which the problems faced by the OEF and OIF with posttraumatic disorder matched by the available ways of serving them.
Sub-related questions
1. What are the most common problems facing the war veteran’s over the world?
2. What are the medical covers available for the victims of posttraumatic disorders?
3. What are the inefficiencies in the health care provision of the PSTD veterans?
Relevance of the Sub-related questions
The sub-related questions form the basis of finding the needed results for the general objectives of this paper. To find an effective measure of improving quality of health care for the victims of post traumatic disorder, the first question will help find the main problem to be addressed in order to avoid cases of mismatch of services and problems experienced. The second sub-related question on the will helps the available medical cover for the victims of posttraumatic disorder in order to help make any further recommendations on where and how to improve the services. Finally, the last sub-related question will assist in pointing the inefficiencies in the health care services offered to the PSTD veterans. Knowing these inefficiencies will help the researcher to make educated recommendations as per what measures can be taken to address them.
Important Information about the Issue and Types of Data to be collected
To understand the issue of quality of comprehensive care for the OEF and OIF veterans with posttraumatic stress disorder, the research must understand the kind of challenges these veterans go through in the battlefields. Also of importance is information on the available medical care options at the disposal of these veterans plus the number qualified personnel in this area. The data to be collected, on the other hand, will mostly be experiences and awareness of the victims. The research will also collect records of relevant institution that will be analyzed qualitatively.
Action Plan
The paper desired for a future in which medical programs offer the best possible financial and technical support to those who had sacrificed their comfort to help the OIF/OEF veterans. The policies must be able to authorize veterans to provide ...
After Combat Deployment Low Utilization of Mental Health Care and.docxdaniahendric
After Combat Deployment: Low Utilization of Mental Health Care and Reasons for Dropout
Charles W. Hoge
, M.D.,
Sasha H. Grossman
, B.A.,
Jennifer L. Auchterlonie
, M.S.,
Lyndon A. Riviere
, Ph.D.,
Charles S. Milliken
, M.D., and
Joshua E. Wilk
, Ph.D.
Published Online:1 Aug 2014https://doi-org.ezp.waldenulibrary.org/10.1176/appi.ps.201300307
Abstract
Objective
Limited data exist on the adequacy of treatment for posttraumatic stress disorder (PTSD) after combat deployment. This study assessed the percentage of soldiers in need of PTSD treatment, the percentage receiving minimally adequate care, and reasons for dropping out of care.
Methods
Data came from two sources: a population-based cohort of 45,462 soldiers who completed the Post-Deployment Health Assessment and a cross-sectional survey of 2,420 infantry soldiers after returning from Afghanistan (75% response rate).
Results
Of 4,674 cohort soldiers referred to mental health care at a military treatment facility, 75% followed up with this referral. However, of 2,230 soldiers who received a PTSD diagnosis within 90 days of return from Afghanistan, 22% had only one mental health care visit and 41% received minimally adequate care (eight or more encounters in 12 months). Of 229 surveyed soldiers who screened positive for PTSD (PTSD Checklist score ≥50), 48% reported receiving mental health treatment in the prior six months at any health care facility. Of those receiving treatment, the median number of visits in six months was four; 22% had only one visit, 52% received minimally adequate care (four or more visits in six months), and 24% dropped out of care. Reported reasons for dropout included soldiers feeling they could handle problems on their own, work interference, insufficient time with the mental health professional, stigma, treatment ineffectiveness, confidentiality concerns, or discomfort with how the professional interacted.
Conclusions
Treatment reach for PTSD after deployment remains low to moderate, with a high percentage of soldiers not accessing care or not receiving adequate treatment. This study represents a call to action to validate interventions to improve treatment engagement and retention.
Over two million service members have deployed to Iraq or Afghanistan since 2001, and these deployments have been strongly associated with an increased risk of mental health problems (1–4). A meta-analysis of studies found that the average post deployment prevalence of posttraumatic stress disorder (PTSD) was 13.2% for personnel assigned to operational infantry units and 5.5% for representative samples of total deployed forces (including support personnel) (3). These and other studies indicate that there will be a significant ongoing need for mental health care in this population.
Although a relatively high percentage of military personnel and veterans access mental health services (for example, one analysis of Army personnel showed that 21% had one or more clinical encounters during a ...
Please read the case Fraud at WorldCom in the book provided below .docxchristalgrieg
Please read the case Fraud at WorldCom in the book provided below (chapter 13) Page 310
And answer the following questions
1. What is the dilemma?
2. Do shareholders have de facto control over managers? What decisions do shareholders typically make? Please explain
One double-spaced page.
.
Please read the below two discussion posts and provide the response .docxchristalgrieg
Please read the below two discussion posts and provide the response for each discussion in 75 to 100 words.
Post#1
Nowadays, there are numerous advancements in technology. As a result, the traditional workplace has gradually transformed with home offices and virtual workplaces where employees can hold meetings using video teleconferencing tools and communicate through email and other applications such as Slack (Montrief, et al., 2020). This makes the cloud more busy which brings up the need for improved cloud security.
Generally, in a public cloud, there exists a shared responsibility between the user and the Cloud Service Provider (CSP). Due to the rise of cyber-related crimes over the years, security for things like data classification, network controls and physical security need clear owners. The division of such responsibilities is called shared responsibility model for cloud security. “According to Amazon Web Services (AWS), security responsibility is shared by both CSP and CSC and they called it as Shared Security Responsible Model” (Kumar, Raj, & Jelciana, 2018). “While client and endpoint protection, identity and access management and application level controls are a shared responsibility the responsibility resides largely with the client organization” (Lane, Shrestha, & Ali, 2017). However, the responsibilities may vary depending on the cloud service provider and the cloud environment the user is using to operate. Nevertheless, despite the cloud services used, the burden of protecting data lays upon the user.
Normally, security is broken down into two broad categories: security of the cloud and security in the cloud. Security of the cloud is a section of the shared responsibility model handled by the cloud service provider. It comprises of hardware, host operating systems and physical security of the infrastructure. Most of these logistical challenges are offloaded when an organization moves its operations to the cloud. In contrast, security in the cloud is the security responsibility handled by the user. “The cloud service customer is responsible for securing and managing the applications that run in the cloud, the operating systems, data-at-rest, data-in-transit, policies and other responsibilities” (Bennett & Robertson, 2019). Since access to customer data remains the most critical component in cloud computing, it also determined the level of security in the cloud to be implemented by the customer.
The customer is responsible for the following components. First, the customer is responsible for data security. While the provider is responsible for automatically encrypting data in transit and in storage, the customer is expected to configure file system encryption and protection of network traffic. Secondly, the customer is responsible for physical security of computers and other devices used to access the cloud. Thirdly, the customer is responsible for application security. Security of manag.
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Running Head: LITERATURE REVIEW
LITERATURE REVIEW 2
Improving Comprehensive Care for OEF and OIF Vets (Literature Review)
Ashlie Burnett
DHA 8015
5/24/15
As discussed by Vilens and Sher (2010), Post-traumatic stress disorder can be described as a psychological disorder that occurs due to exposure to frightening, stressful or distressing events. The dominant events that can lead to a person getting this disorder involve serious road accidents, prolonged violence or sexual abuse, terrorist attacks and military combat. The PTSD can develop immediately or after some time after an exposure to these events. Essentially, it has grown into a major concern since its diagnosis has become more difficult. Moreover, the patients with PTSD are diagnosed only after the manifested symptoms have persisted for more than one month. The patients at this time tend to show functionality impairment. It is crucial to improve the quality of comprehensive care that is administered to these patients; particularly the OEF and OIF veterans since they are the majority of those who suffer (Vilens & Sher, 2010).
The OEF and OIF veterans are known to be the most recognizable PTSD population. This is because during the First World War, it was hypothesized that the physiological damage to people was caused by the exploding shells with high air pressure. This was later renamed as the “shell shock” (Miller, 2000). With years passing by, the percentage of the population suffering from PTSD drastically increased. It is crucial that the clinicians and the health care providers accurately diagnose PTSD and administer proper treatment method since this will aid the patient to have a control over the physiological and psychological reaction to a stressful event encountered. Moreover, the appropriate referral of patients to the mental health facilities and well trained professionals plays a major role in their recovery process (Miller, 2000).
According to Yahyavi et al. (2014), post-traumatic stress disorder is a normal response mechanism by the body system. It is the psychopathological response to any strange stressors to the normal body functioning. Majorly, it is characterized by constant re-experience of distress, insistent avoidance of anything that is associated with a traumatic event and the individual at the same time tend to have constant psychological and physiological arousal. Personal vulnerability and severe trauma are the essential components of PTSD development. Essentially, an individual’s levels of vulnerability play a crucial role towards the development of PTSD. This is often influenced by the biological factors such as the hormonal patterns and the autonomic nervous system. Additionally, it is influenced by psychological factors that are majorly characterized by a cognitive schema (Yahyavi et al., 2014).
The war experience that the veterans face not only includes injury to oneself and threats, but also includes the acts performance that usually tran.
"Reintegrating Returning Warriors and The Subtleties of PTSD: Practice, Research and Policy"
by Col Jeffrey Yarvis, Chief of Soldier Behavioral Health Service, Carl R. Darnall Army Medical Center, Washington DC
REVIEW ARTICLEExploring positive pathways to care for memb.docxronak56
REVIEW ARTICLE
Exploring positive pathways to care for members of
the UK Armed Forces receiving treatment for PTSD:
a qualitative study
Dominic Murphy1*, Elizabeth Hunt1, Olga Luzon2 and Neil Greenberg1
1King’s Centre for Military Health Research, King’s College London, London, UK; 2Department of
Clinical Psychology, Royal Holloway University, London, UK
Objective: To examine the factors which facilitate UK military personnel with post-traumatic stress disorder
(PTSD) to engage in help-seeking behaviours.
Methods: The study recruited active service personnel who were attending mental health services, employed a
qualitative design, used semi-structured interview schedules to collect data, and explored these data using
interpretative phenomenological analysis (IPA).
Results: Five themes emerged about how participants were able to access help; having to reach a crisis point
before accepting the need for help, overcoming feelings of shame, the importance of having an internal locus
of control, finding a psychological explanation for their symptoms and having strong social support.
Conclusions: This study reported that for military personnel who accessed mental health services, there were a
number of factors that supported them to do so. In particular, factors that combated internal stigma, such as
being supported to develop an internal locus of control, appeared to be critical in supporting military
personnel to engage in help-seeking behaviour.
Keywords: Military health; PTSD; depression; pathways; stigma; barriers
*Correspondence to: Dominic Murphy, KCMHR, Weston Education Centre, Cutcombe Road, SE5 9PR
London, UK, Email: [email protected]
For the abstract or full text in other languages, please see Supplementary files under Article Tools online
Received: 17 June 2013; Revised: 4 October 2013; Accepted: 20 November 2013; Published: 17 February 2014
S
ince 2002, the UK and US military’s have con-
ducted highly challenging operations in Afghanistan
and Iraq. These military operations have been
the focus of a number of large-scale epidemiological re-
search studies, which have investigated the psychological
health of US and UK service personnel. Studies in the
United States have observed rates of post-traumatic stress
disorder (PTSD) in deployed personnel to be between
8 and 18% (Hoge et al., 2004; Smith et al., 2008). Further,
13% of participants met criteria for alcohol problems
and 18% for symptoms of anxiety and depression, with a
very high co-morbidity rate between these disorders and
PTSD (Riddle et al., 2007; Smith et al., 2008). This
increase in the rate of PTSD following deployment has
been replicated prospectively (Vasterling et al., 2006).
However, in the UK, the effects of the conflict upon the
mental health of service personnel have been quite
different.
The most extensive UK epidemiological studies of
service personnel since 2003 have been carried out at
King’s College London. This study is based o ...
A disorder characterised by failure to recover after experiencing or witnessing a terrifying event.
The condition may last months or years, with triggers that can bring back memories of the trauma accompanied by intense emotional and physical reactions.
Symptoms may include nightmares or flashbacks, avoidance of situations that bring back the trauma, heightened reactivity to stimuli, anxiety or depressed mood.
Treatment includes different types of psychotherapy as well as medications to manage symptoms.
Persistent PTSD among Patients with Fragile X Syndrome: Case Seriessemualkaira
Posttraumatic stress disorder (PTSD) affects
about 3.6% of the US population and has clear diagnostic criteria
and treatment modalities. Individuals with autism spectrum disorder (ASD) and intellectual disabilities (ID) are at an elevated
risk for exposure to trauma and development of PTSD. Fragile X
syndrome (FXS) is the most common inherited cause of ID, and
there is currently need for further research regarding presentation
of PTSD among these individuals.
Persistent PTSD among Patients with Fragile X Syndrome: Case Seriessemualkaira
Posttraumatic stress disorder (PTSD) affects
about 3.6% of the US population and has clear diagnostic criteria
and treatment modalities. Individuals with autism spectrum disorder (ASD) and intellectual disabilities (ID) are at an elevated
risk for exposure to trauma and development of PTSD. Fragile X
syndrome (FXS) is the most common inherited cause of ID, and
there is currently need for further research regarding presentation
of PTSD among these individuals.
Persistent PTSD among Patients with Fragile X Syndrome: Case Seriessemualkaira
Posttraumatic stress disorder (PTSD) affects
about 3.6% of the US population and has clear diagnostic criteria
and treatment modalities. Individuals with autism spectrum disorder (ASD) and intellectual disabilities (ID) are at an elevated
risk for exposure to trauma and development of PTSD. Fragile X
syndrome (FXS) is the most common inherited cause of ID, and
there is currently need for further research regarding presentation
of PTSD among these individuals.
Persistent PTSD among Patients with Fragile X Syndrome: Case Seriessemualkaira
Posttraumatic stress disorder (PTSD) affects
about 3.6% of the US population and has clear diagnostic criteria
and treatment modalities. Individuals with autism spectrum disorder (ASD) and intellectual disabilities (ID) are at an elevated
risk for exposure to trauma and development of PTSD. Fragile X
syndrome (FXS) is the most common inherited cause of ID, and
there is currently need for further research regarding presentation
of PTSD among these individuals.
Running head COMPREHENSIVE QUALITY CARE1COMPREHENSIVE QUALIT.docxjoellemurphey
Running head: COMPREHENSIVE QUALITY CARE 1
COMPREHENSIVE QUALITY CARE 10
Improving the Quality of Comprehensive Care for the OEF and OIF Veterans with Posttraumatic Stress Disorder (PTSD)
Ashlie Burnett
Capella University
2/15/15
Research Questions
1. How efficiently can quality of Comprehensive care be improved to ensure quality care to the OEF and OIF with posttraumatic stress disorder?
2. To what extent are the problems faced by the OEF and OIF with posttraumatic disorder matched by the available ways of serving them?
Research Objectives
1. The general objective of this research was to determine how efficiently quality of comprehensive care be improved to ensure quality care to the OEF and OIF with posttraumatic stress disorder.
2. The paper also sought to determine the extent to which the problems faced by the OEF and OIF with posttraumatic disorder matched by the available ways of serving them.
Sub-related questions
1. What are the most common problems facing the war veteran’s over the world?
2. What are the medical covers available for the victims of posttraumatic disorders?
3. What are the inefficiencies in the health care provision of the PSTD veterans?
Relevance of the Sub-related questions
The sub-related questions form the basis of finding the needed results for the general objectives of this paper. To find an effective measure of improving quality of health care for the victims of post traumatic disorder, the first question will help find the main problem to be addressed in order to avoid cases of mismatch of services and problems experienced. The second sub-related question on the will helps the available medical cover for the victims of posttraumatic disorder in order to help make any further recommendations on where and how to improve the services. Finally, the last sub-related question will assist in pointing the inefficiencies in the health care services offered to the PSTD veterans. Knowing these inefficiencies will help the researcher to make educated recommendations as per what measures can be taken to address them.
Important Information about the Issue and Types of Data to be collected
To understand the issue of quality of comprehensive care for the OEF and OIF veterans with posttraumatic stress disorder, the research must understand the kind of challenges these veterans go through in the battlefields. Also of importance is information on the available medical care options at the disposal of these veterans plus the number qualified personnel in this area. The data to be collected, on the other hand, will mostly be experiences and awareness of the victims. The research will also collect records of relevant institution that will be analyzed qualitatively.
Action Plan
The paper desired for a future in which medical programs offer the best possible financial and technical support to those who had sacrificed their comfort to help the OIF/OEF veterans. The policies must be able to authorize veterans to provide ...
After Combat Deployment Low Utilization of Mental Health Care and.docxdaniahendric
After Combat Deployment: Low Utilization of Mental Health Care and Reasons for Dropout
Charles W. Hoge
, M.D.,
Sasha H. Grossman
, B.A.,
Jennifer L. Auchterlonie
, M.S.,
Lyndon A. Riviere
, Ph.D.,
Charles S. Milliken
, M.D., and
Joshua E. Wilk
, Ph.D.
Published Online:1 Aug 2014https://doi-org.ezp.waldenulibrary.org/10.1176/appi.ps.201300307
Abstract
Objective
Limited data exist on the adequacy of treatment for posttraumatic stress disorder (PTSD) after combat deployment. This study assessed the percentage of soldiers in need of PTSD treatment, the percentage receiving minimally adequate care, and reasons for dropping out of care.
Methods
Data came from two sources: a population-based cohort of 45,462 soldiers who completed the Post-Deployment Health Assessment and a cross-sectional survey of 2,420 infantry soldiers after returning from Afghanistan (75% response rate).
Results
Of 4,674 cohort soldiers referred to mental health care at a military treatment facility, 75% followed up with this referral. However, of 2,230 soldiers who received a PTSD diagnosis within 90 days of return from Afghanistan, 22% had only one mental health care visit and 41% received minimally adequate care (eight or more encounters in 12 months). Of 229 surveyed soldiers who screened positive for PTSD (PTSD Checklist score ≥50), 48% reported receiving mental health treatment in the prior six months at any health care facility. Of those receiving treatment, the median number of visits in six months was four; 22% had only one visit, 52% received minimally adequate care (four or more visits in six months), and 24% dropped out of care. Reported reasons for dropout included soldiers feeling they could handle problems on their own, work interference, insufficient time with the mental health professional, stigma, treatment ineffectiveness, confidentiality concerns, or discomfort with how the professional interacted.
Conclusions
Treatment reach for PTSD after deployment remains low to moderate, with a high percentage of soldiers not accessing care or not receiving adequate treatment. This study represents a call to action to validate interventions to improve treatment engagement and retention.
Over two million service members have deployed to Iraq or Afghanistan since 2001, and these deployments have been strongly associated with an increased risk of mental health problems (1–4). A meta-analysis of studies found that the average post deployment prevalence of posttraumatic stress disorder (PTSD) was 13.2% for personnel assigned to operational infantry units and 5.5% for representative samples of total deployed forces (including support personnel) (3). These and other studies indicate that there will be a significant ongoing need for mental health care in this population.
Although a relatively high percentage of military personnel and veterans access mental health services (for example, one analysis of Army personnel showed that 21% had one or more clinical encounters during a ...
Please read the case Fraud at WorldCom in the book provided below .docxchristalgrieg
Please read the case Fraud at WorldCom in the book provided below (chapter 13) Page 310
And answer the following questions
1. What is the dilemma?
2. Do shareholders have de facto control over managers? What decisions do shareholders typically make? Please explain
One double-spaced page.
.
Please read the below two discussion posts and provide the response .docxchristalgrieg
Please read the below two discussion posts and provide the response for each discussion in 75 to 100 words.
Post#1
Nowadays, there are numerous advancements in technology. As a result, the traditional workplace has gradually transformed with home offices and virtual workplaces where employees can hold meetings using video teleconferencing tools and communicate through email and other applications such as Slack (Montrief, et al., 2020). This makes the cloud more busy which brings up the need for improved cloud security.
Generally, in a public cloud, there exists a shared responsibility between the user and the Cloud Service Provider (CSP). Due to the rise of cyber-related crimes over the years, security for things like data classification, network controls and physical security need clear owners. The division of such responsibilities is called shared responsibility model for cloud security. “According to Amazon Web Services (AWS), security responsibility is shared by both CSP and CSC and they called it as Shared Security Responsible Model” (Kumar, Raj, & Jelciana, 2018). “While client and endpoint protection, identity and access management and application level controls are a shared responsibility the responsibility resides largely with the client organization” (Lane, Shrestha, & Ali, 2017). However, the responsibilities may vary depending on the cloud service provider and the cloud environment the user is using to operate. Nevertheless, despite the cloud services used, the burden of protecting data lays upon the user.
Normally, security is broken down into two broad categories: security of the cloud and security in the cloud. Security of the cloud is a section of the shared responsibility model handled by the cloud service provider. It comprises of hardware, host operating systems and physical security of the infrastructure. Most of these logistical challenges are offloaded when an organization moves its operations to the cloud. In contrast, security in the cloud is the security responsibility handled by the user. “The cloud service customer is responsible for securing and managing the applications that run in the cloud, the operating systems, data-at-rest, data-in-transit, policies and other responsibilities” (Bennett & Robertson, 2019). Since access to customer data remains the most critical component in cloud computing, it also determined the level of security in the cloud to be implemented by the customer.
The customer is responsible for the following components. First, the customer is responsible for data security. While the provider is responsible for automatically encrypting data in transit and in storage, the customer is expected to configure file system encryption and protection of network traffic. Secondly, the customer is responsible for physical security of computers and other devices used to access the cloud. Thirdly, the customer is responsible for application security. Security of manag.
Please read the below discussion post and provide response in 75 to .docxchristalgrieg
Please read the below discussion post and provide response in 75 to 100 words
Post#1
Cloud security plays an important role in every field like business and personal world. With a large number of benefits it has some myths also. Cloud security is solely the cloud provider’s responsibility: a standard misconception is that the cloud provider automatically takes care of all the safety needs of the customer’s data and process while in the cloud. Password policies, release management for software patches, management of user roles, security training of staff, and data management policies are all responsibilities of the purchasers and a minimum of as critical because the security is done by the general public cloud provider. While users are hardening internal security, don’t assume that cloud provider backs up data and will be able to restore it just in case of a security breach. It is instrumental and important that users simply implement a backup solution that backs up data that's hosted on the cloud to an onsite backup or to a different cloud provider. In addition, in case of a security breach, user will get to restore data from backups. “There is indeed a good case to make for fair taxation and that uneven effective tax rates can distort competition and lead to smaller tax revenues” (Bauer, 2018).
Don’t get to manage the cloud: many people believe that since the cloud infrastructure is usually basically just a managed service, that the safety of the services is additionally managed. Many cloud based systems are left inadvertently unsecured because the customer doesn't know that they have to try to something to secure them, as they assume that the provider has done what an in-house staff would traditionally have done by default. Cloud security requires an equivalent discipline for security of any data center. Cloud data centers are as resilient as any, but the weakness comes if the policies, processes and tools aren’t regularly monitored by the IT operations staff responsible (Determann, 2016).
Ignore BYOD and be more secure: not supporting and implementing a BYOD policy does not mean an enterprise will be less at risk of a data breach, SVP of cloud and hosting sales. The BYOD movement is here to stay. Some experts recommend deploying a mobile content management (MCM) solution, as protecting the data will be what ultimately defines business’ security and compliance requirements. “Despite the Australian Federal Government's ‘cloud-first’ strategy and policies, and the Queensland State Government's ‘digital-first’ strategy, cloud services adoption at local government level has been limited—largely due to data security concerns” (Ali, Shrestha, Chatfield, & Murray, 2020). Cloud data isn’t saved on mobile devices: I still hear people speaking about cloud deployment as if using this service means users are not saving any enterprise data on mobile devices, which this might make device data protection a moot point. Apps that are connecting to de.
Please read the assignment content throughly Internet Resources .docxchristalgrieg
Please read the assignment content throughly
Internet Resources Chart [due Mon]
Assignment Content
Create
a chart of Internet-based resources for early childhood literacy development.
Include
at least two different resources for each of the following topics:
Oral language
Environmental print
Morphemic analysis
Spelling
Vocabulary
Summarize
each resource. A total of 700 words should be used in the chart.
Submit
your assignment.
.
Please read the article by Peterson (2004). Your responses to th.docxchristalgrieg
Please read the article by Peterson (2004). Your responses to the following questions must be typed. Please be sure to include an APA-style citation
1. What is the purpose of this review paper
2. Describe
Incidental teaching
Mand-model
Time delay
Milieu language teaching
How are they the same?
How are they different?
3. What is discrete trial training? How is naturalistic teaching different?
4. What is generalization in language acquisition? How does naturalistic teaching promote generalization in language acquisition?
5. What were the conclusions of this review?
6. Be sure to provide and APA-style source citation for Peterson (2004) at the end of your paper
.
Please read the article which appears below. Write and submit an.docxchristalgrieg
Please read the article which appears below. Write and submit an
600 word report.
There is no right or wrong answer. Your report will be graded on your understanding of the problem of teenagers in high school having babies - and the attitude of the teens - whether you agree or disagree it is a good idea for the school to open a day care center to help these mothers (tell us why you agree or disagree), whether you agree or disagree with the teacher who wrote this article - tell us why you agree or disagree - why sociologists might want to study problems like this one, what sociologists might be able to contribute to solving problems like the one described . Link your answer to material we are studying. How well you express yourself - grammatical construction - spelling - is important. Maybe you can't make up your mind about this article. That's OK too. But it is important that you explain WHY.
Material you studied about agents of social change, primary and secondary groups in the chapters on
Culture - Socialization- Social Interaction - Social Structures - Groups and Organizations- should give you lots of ideas for your assignment.
They're Having Babies. Are We Helping?
By Patrick Welsh
The girls gather in small groups outside Alexandria's T.C. Williams High School most mornings, standing with their babies on their hips, talking and giggling like sorority sisters. Sometimes their mothers drop the kids (and their kids) off with a carefree smile and a wave. As I watch the girls carry their children into the Tiny Titans day-care center in our new $100 million building, I can't help wondering what Sister Mary Avelina, my 11th-grade English teacher, would have thought.
Okay, I'm an old guy from the 1950s, an era light-years from today. But even in these less censorious times, I'm amazed -- and concerned -- by the apparently nonchalant attitude both these girls and their mothers exhibit in front of teachers, administrators and hundreds of students each day. Last I heard, teen pregnancy is still a major concern in this country -- teenage mothers are less likely to finish school and more likely to live in poverty; their children are more likely to have difficulties in school and with the law; and on and on.
But none of that seems to register with these young women. In fact, "some girls seem to be really into it," says T.C. senior Mary Ball. "They are embracing their pregnancies." Nor is the sight of a pregnant classmate much of a surprise to the students at T.C. anymore. "When I was in middle school, I'd be shocked to see a pregnant eighth-grader," says Ball. "Now it seems so ordinary that we don't even talk about it."
Teenage pregnancy has been bright on American radar screens for the past year: TV teen starlet Jamie Lynn Spears's pregnancy caused a minor media storm last December. The pregnant-teen movie "Juno" won Oscar nods. And there was Bristol Palin, daughter of Alaska Gov. Sarah Palin, bringing the issue front and center d.
Please Read instructions Role Model LeadersChoose one • 1 .docxchristalgrieg
Please Read instructions
Role Model Leaders
Choose one • 1 point
In a study by Kouzes and Posner, who was identified as the person that the majority of people would select as their most important role model for leadership?
Teacher or coach
Business leader
Family member
Community or religious leader
QUESTION 2
Five Practices
Choose one • 1 point
Which of the following is
not
one of the Five Practices of Exemplary Leadership?
Model the Way
Leave a Legacy
Encourage the Heart
Enable Others to Act
QUESTION 3
Organizational Behavior
Choose one • 1 point
Organizational Behavior is a defined business function that has nothing to do with human behavior.
True
False
QUESTION 4
Leader and Constituents
Choose one • 1 point
What strengthens and sustains the relationship between leader and constituents is that leaders are:
Obsessed with what is best for others, not themselves
Obsessed with what is best for making the most money for themselves
Obsessed with what is best for themselves, not others
Obsessed with what is best for the business, not others
QUESTION 5
The Most Fundamental Truth
Choose one • 1 point
According to Kouzes and Posner, which of the Ten Truths about Leadership is the most fundamental truth of all?
Credibility is the Foundation of Leadership
Challenge is the Crucible for Greatness
You Can’t Do It Alone
You Make a Difference
QUESTION 6
Credibility
Choose one • 1 point
A culture of leadership ______________ and ______________ is created when people at all levels genuinely expect each other to be credible, and they hold each other accountable for the actions that build and sustain credibility.
Excellence and integrity
Independence and coerciveness
Confidence and charisma
Dissatisfaction and distrust
QUESTION 7
Organizational Behavior
Choose one • 1 point
The study of Organizational Behavior helps us to understand organizational culture, power, and political behavior.
True
False
QUESTION 8
Organization’s vision and values
Choose one • 1 point
Who is the person that has the most influence over your desire to stay or leave an organization, and your commitment to the organization’s vision and values?
CEO
Co-workers
Board of Directors
Your most immediate manager
QUESTION 9
Willingly Follow
Choose one • 1 point
In a survey by Kouzes and Posner, which of the following characteristics scored the highest that people looked for in someone that they would be willing to follow:
Independent
Supportive
Honest
Straightforward
QUESTION 10
Expectation of Leaders
Choose one • 1 point
In addition to the three factors that measure source credibility, the vast majority of constituents have one other expectation of leaders. They expect leaders to be:
Admired
Forward-looking
Independent
Enthusiastic
QUESTION 11
Leadership is a Relationship
Choose one • 1 point
Leadership is a relationship between those who aspire to lead and those who are learning to lead
.
Tru.
Please read each attachment for instructions, please answer each q.docxchristalgrieg
Please read each attachment for instructions, please answer each question all 8 with an answer after reading each attachment. Do not answer each question in a running paragraph. question/answer in at least 200 -300 word detailed with references from attachments and one extra where needed.
I do not have a second chance to correct
Activity: Counseling Immigrants
Instructions:
This activity is composed of three parts. In order to complete part I, you must read the article “Counseling Haitian Students and their Families: Issues and Interventions.” In order to complete part II, you must read the “APA Immigration Report Executive Summary,” and in order to complete part III, you must read “Counseling Model for Immigrants.”
Part I
1) Explain the differences between what parents are expected to do in American schools and what parents are expected to do in Haitian schools.
2) Why did Jean’s parents did not seek contact with teachers?
3) Haitian students face significant prejudice from teachers and classmates based on their race, the negative image of voudou, their former classification as a high-risk group for AIDS, and the violence and corruption of Haiti’s domestic politics. Name the interventions suggested by Joseph (1984).
Part II
1. The United States today has approximately _______ million immigrants—the largest number in its history. As a nation of immigrants, the United States has successfully negotiated larger proportions of newcomers in its past (______% in 1910 vs. _____% today). Notably, nearly _________ ____________of the foreign-born are naturalized citizens or authorized noncitizens.
2. Nearly a ___________ of children under the age of 18 have an immigrant __________.
3. One third of the foreign-born population in the United States is from ________, and a total of _______% originate from Latin America (U.S. Census Bureau, 2010).The four states with the largest numbers of immigrants (California, __________, New Mexico, and _________) have already become “majority/minority” (______ than ________% White) states (U.S. Census Bureau, 2011a).
4. Immigrants arrive in the United States with varied levels of education. At one end of the spectrum are highly educated immigrant adults (Portes & Rumbaut, 2006) who comprise a ___________ of all U.S. __________, ________% of the nation’s __________ and ____________ workers with bachelor’s degrees, and _______% of scientists with ______________.
5. An estimated ________ languages are currently spoken in homes in the United States.
6. Psychological acculturation refers to the dynamic process that immigrants experience as they __________ to the culture of the new country.
7. The constellation of presenting issues for immigrants tends to fall within the areas of _________________- based presenting problems, __________-based presenting problems, and _________________, ____________, and ______________–based problems.
8. To increase the accessibility and efficacy of services, clinicians and p.
PLEASE READ BEFORE STARTING! 500 WORD PAPER ONLY USING THE NOTES I.docxchristalgrieg
**PLEASE READ BEFORE STARTING! 500 WORD PAPER ONLY USING THE NOTES I HAVE PROVIDED BELOW. ESSAY QUESTION IS RIGHT BELOW AS WELL.**
Three common approaches to understanding leading – traits, behaviors, and situational or contingency approaches - may or may not be effective in leading/managing a healthcare program. Briefly summarize each and its appropriateness for healthcare management.
Health Program Management (Longest, 2015)
“Leading effectively means influencing participants to make contributions that help accomplish the mission and objectives established for a program.” (Longest, 2015, p. 139)
Traits approach
“Based on the proposition that traits - encompassing skills, abilities, or characteristics - inherent in some people explain why they are more effective at leading than others.” (Longest, 2015, p. 140)
Kirkpatrick and Locke (1991, 48) stated, “Key leader traits include: drive (a broad term which includes achievement, motivation, ambition, energy, tenacity, and initiative); leadership, motivation (the desire to lead but not to seek power as an end in itself); honesty and integrity; self-confidence (which is associated with emotional stability); cognitive ability; and knowledge.” (as cited in Longest, 2015, p. 140)
Behaviors approach
“Traits cannot fully explain effectively leading, is based on the assumption that particular behaviors or sets of behaviors that make up a style of leading might be associated with success in leading.” (Longest, 2015, p. 140)
Planning, clarifying, monitoring, problem solving, supporting, recognizing, developing, empowering, advocating change, envisioning change, encouraging innovation, facilitating collective learning, networking, external monitoring, representing (Longest, 2015, p. 142)
Tannenbaum and Schmidt’s continuum of leader styles model: (Longest, 2015, p. 147)
Autocratic leaders - makes decisions and announces them to other participants
Consultative leaders - convince other participants of the correctness of a decision by carefully explaining the rationale for the decision and its effect on the other participants and on the program
Participative leaders - present tentative decisions that will be changed in other participants can make a convincing case for different decisions
Democratic leaders - define the limits of the situation and problem to be solved and permit other participants to make the decision
Laissez-faire leaders - permit other participants to have great discretion in decision making
“Leaders must adapt and change styles to fit different situations.” (Longest, 2015, p. 147)
“An autocratic style might be appropriate in certain clinical situations in programs where work frequently involves a high degree of urgency. But this style could be disastrous in other situations, such as when a manager must decide how to offer a new service in a program or improve communication with participants.” (Longest, 2015, p. 147)
Situational/Contingency approach
“.
Please read Patricia Benners Five Stages of Proficiency. Explai.docxchristalgrieg
Please read Patricia Benner's Five Stages of Proficiency. Explain the importance of this theory through a nurse's perspective. No references are required. Your summary should be at least 300 words using good spelling and grammar. Can be single or double spaced.
Attached Files:
Dr. Patricia Benner is a nursing theorist who first developed a model for the stages of clinical competence in her classic book “From Novice to Expert: Excellence and Power in Clinical Nursing Practice”. Her model is one of the most useful frameworks for assessing nurses’ needs at different stages of professional growth. She is the Chief Faculty Development Officer for Educating Nurses, the Director of the Carnegie Foundation for the Advancement of Teaching National Nursing Education and honorary fellow of the Royal College of Nursing.
Dr. Benner was born in Hampton, Virginia, and received her bachelor’s degree in Nursing from Pasadena College in 1964, and later a master’s degree in Medical-Surgical Nursing from the University of California, Berkeley. After completing her doctorate in 1982, she became an Associate Professor in the Department of Physiological Nursing at the University of California, San Francisco. Dr. Benner is an internationally known lecturer and researcher on health, and her work has influenced areas of clinical practice as well as clinical ethics.
This nursing theory proposes that expert nurses develop skills and understanding of patient care over time through a proper educational background as well as a multitude of experiences. Dr. Benner’s theory is not focused on how to be a nurse, rather on how nurses acquire nursing knowledge – one could gain knowledge and skills (“knowing how”), without ever learning the theory (“knowing that”). She used the Dreyfus Model of Skill Acquisition as a foundation for her work. The Dreyfus model, described by brothers Stuart and Hubert Dreyfus, is a model based on observations of chess players, Air Force pilots, army commanders and tank drivers. The Dreyfus brothers believed learning was experiential (learning through experience) as well as situation-based, and that a student had to pass through five very distinct stages in learning, from novice to expert.
Dr. Benner found similar parallels in nursing, where improved practice depended on experience and science, and developing those skills was a long and progressive process. She found when nurses engaged in various situations, and learned from them, they developed “skills of involvement” with patients and family. Her model has also been relevant for ethical development of nurses since perception of ethical issues is also dependent on the nurses’ level of expertise. This model has been applied to several disciplines beyond clinical nursing, and understanding the five stages of clinical competence helps nurses support one another and appreciate that expertise in any field is a process learned over time.
Dr. Benner’s Stages of Clinical Competence
Stage 1 Novice: .
***************Please Read Instructions **************
OBJECTIVES:
Use personal influence with a group or team.
Identify the behaviors that exemplify the leadership truths.
Understand the stages of team development.
Explain how motivation impacts performance.
GOAL:
The purpose of this assignment is to provide an opportunity to express understanding of content associated with the chapters covered in Week Two (
Values Drive Commitment
,
Focusing on the Future Sets Leaders Apart
, and
You Can't Do It Alone
). For this assignment, you must use the Full Sail Online Library resources for at least one source in answering the questions. Make sure you clearly indicate which source(s) are from the online library. To access the Full Sail Library sources, go to Connect/Departments/Library. You will see a list of databases available. The library is open Monday-Friday 8:00 am - 9:00 pm and Saturday 8:00 am - 5:00 pm and can be reached at x8438.
Chapter Five
discusses the importance of
working in teams
and the
importance of emotional intelligence
in both your personal and social skills. How well are you in these areas? The goal of this week's discussion is to use the resources from this week to
develop, create, and implement a team activity with you being the leader.
INSTRUCTIONS:
First Post – due Thursday by 11:59pm EST *Due date extended due to the nature of the activity. Use this time to create an amazing activity!
Persuade at least four to eight people to do some notable activity together for at least two hours
that they would not otherwise do without your intervention. Your only restriction is that you cannot tell them why you are doing this.
The group can be any group of people: friends, family, teammates, club members, neighbors, students, or work colleagues
. It can be almost any activity
except for
watching television, eating, going to a movie, or just sitting around talking. It must be more substantial than that. Some options include a party, an organized debate, a songfest, a long hike, a visit to a museum, or volunteer work such as picking up litter, visiting a nursing home, or helping on a community project.
After completing your leadership activity, be prepared to discuss:
1. What was the activity selected?
Use specifics to describe your activity including
who attended (friends, family, co-workers, etc), location, and date. What did it feel like to make something happen in the world that would not have happened otherwise without you?
2.
Emotional Intelligence (EQ)
is important to develop to build relationships with others. How did you use EQ to empower others, listen to individual needs, and build relationships?
3. With this act of leadership,
what values did you exemplify
? (Use the
Values Drive Commitment c
hapter
concepts in your response.)
4. Were your members a group or a team? Using the
stages of team development
(Forming, Storming, Norming, Performing), describe the specific behaviors that de.
Please react to this student post. remember references and plarigari.docxchristalgrieg
Please react to this student post. remember references and plarigarism
Descending Spinal Tract
Corticospinal, reticulospinal, and vestibulospinal
Sends impulses from the brain to muscle groups
Control muscle tone, posture, and motor movements
Efferent
A
scending Spinal Tract
Spinothalamic and spinocerebellar
Sends sensory signals to accomplish complex tasks
Ascending tracts recognize exact stimulus and location
Contains fibers that discriminate rough from light touch, temperature and pain
Afferent
If the spinal cord is completely severed, then complete loss of function below the point if injury is expected (Ball, Dains, Flynn, Solomon & Stewart, 2015).
The nervous system is a group of nerves and neurons that transmit messages to different parts of the body. It is in charge of coordinating and controlling the body (Ball et al., 2015). The nervous system is divided into the central and the peripheral nervous system, further subdivided into autonomic, sympathetic and parasympathetic. The central nervous system is comprised of the brain. The peripheral nervous systems is comprised of the cranial and spinal nerves and the ascending and descending pathways (Ball et al., 2015). With all parts functioning properly the nervous system is able to receive and identify stimuli, control voluntary and involuntary body functions (Ball et al., 2015).
The three major units of the brain are the cerebrum, the cerebellum and the brainstem (Ball et al., 2015).
The difference between the ascending and descending tracts is that the ascending is sensory (afferent) because it delivers information to the brain and the descending tract delivers motor (efferent) information to the periphery (Ball et al., 2015)
The pituitary gland regulates metabolic processes and controls growth, lactation, and vasoconstriction through hormonal regulation (Ball et al., 2015).
The fourth cranial nerve is called trochlear and it is in charge of the downward and inward movement of the eye (Ball et al., 2015).
Risk factors for cerebrovascular accidents include hypertension, obesity, sedentary lifestyle, smoking, stress, high cholesterol/triglycerides/lipoproteins, congenital conditions and family history of cerebrovascular accidents (Ball et al., 2015).
The 5.07 monofilament test is used to test sensation in different parts of the foot in patients suffering from diabetes mellitus or peripheral neuropathy (Ball et al., 2015).
The 0 to 4+ scale is used to grade the response when testing the reflex. 0 indicates no response and 4+ indicates hyperactive reflex (Ball et al., 2015).
Older adults may be taking medication for other conditions that can affect their balance, mental status and coordination and it is important know this in order to rule out whether a symptom is due to a side effect or a cause for concern (Ball et al., 2015).
Meningitis that occurs during the first year may cause epilepsy later on in life, also any infection in the first year of life can impa.
Please provide the following information about your culture which is.docxchristalgrieg
Please provide the following information about your culture which is the ANCIENT EMPIRE:
Content
Introduction with a thesis statement
Provide a brief history of your culture
Explain how your chosen culture is represented in the United States
Is your culture individualistic or collectivistic? Provide at least one example
What are some of the artistic (art, music, architecture, dance) contributions of your culture?
What are some values of your culture? Provide at least three examples
Discuss your culture’s religion(s)? Include name and basic belief system of at least one of the major faiths
What are some of the sex and gender role differences in your culture? Provide at least three examples
Discuss what we would need to know to acculturate into your culture (if it is a culture from the past, what would we need to do in order to fit in during that timeframe). Provide at least one concrete suggestion
Conclusion
Specific Paper Requirements:
Four-page minimum: six-page maximum (Times New Roman, 1-inch marginsm 12-pt. font, double-spaced)
Quality of writing: Must contain in-text citations in APA format
Spelling and Grammar
Correct APA style format
A minimum of three or more credible sources (books, journal articles, magazine/newspaper articles, etc.)
Paper Outline:
Introduction
History
Cultural Context
Represented in the United States
Individualistic/Collective
Artistic
Values
Religion
Sex and Gender Roles
Acculturation
Conclusion
References
.
Please proof the paper attached and complete question 6 and 7..docxchristalgrieg
Please proof the paper attached and complete question 6 and 7.
Moore Plumbing Supply Company
Capital Structure
Mort Moore founded Moore Plumbing Supply after returning from duty in the South Pacific during World War II. Before joining the armed forces, he had worked for a locally owned plumbing company and wanted to continue with that type of work once the war effort was over. Shortly after returning to his hometown of Minneapolis, Minnesota, he became aware of an unprecedented construction boom. Returning soldiers needed new housing as they started families and readjusted to civilian life. Mort felt that he could make more money by providing plumbing supplies to contractors rather than performing the labor, and he decided to open a plumbing supply company. Mort’s parents died when he was young and was raised by his older brother, Stan, who ran a successful shoe business during the 1920’s. Stan often shared stories about owning his own business and in particular about a large expansion that was completed just before the market collapsed. Because of the economic times, Stan lost the business but was lucky to find employment with the railroad. He dutifully saved part of each paycheck and was so thankful that his brother returned home safely that he decided to use his sizable savings to help his brother open his business. Mort kept in mind his brother’s failed business and vowed that his company would operate in such a way that it would minimize its vulnerability of general business downturns.
Moore’s extensive inventory and reasonable prices made the company the primary supplier of the major commercial builders in the area. In addition, Mort developed a loyal customer base among the home repair person, as his previous background allowed him to provide excellent advice about specific projects and to solve unique problems. As a result, his business prospered and over the past twenty years, sales have grown faster than the industry. Because of the large orders, the company receives favorable prices from suppliers, allowing Moore Plumbing Supply to remain competitive with the discount houses that have sprung up in the area. Over the years, Mort has kept his pledge and the company has remained a very strong financial position. It had a public sale of stock and additional stock offers to fund expansions including regional supply outlets in Milwaukee, Wisconsin and Sioux City, Iowa.
Recently, Stan decided that the winters were too long and he wanted to spend the coldest months playing golf in Florida. He retired from the day-to-day operations but retained the position of President and brought in his grandson, Tom Moore, to run the company as the new Chief Executive Officer. Tom was an excellent choice for the position. After graduating summa-cum-laud with a degree in communications from the University of Wisconsin, he worked in the Milwaukee operation where he was quickly promoted to manager. In ten years, sa.
Please prepare PPT( 5 Slides and 1 citation slide) and also explain .docxchristalgrieg
Please prepare PPT( 5 Slides and 1 citation slide) and also explain all slides in word format about 300 words to give presentation
Types of Stakeholders:
Suppliers - Sandeep
Owners - Sandeep
Employees - Sandeep
Stakeholder Impact of Ethics on Stakeholders – Ravi/Rushil/Sandeep/Krishna
References
.
Please prepare a one-pageProject Idea that includes the .docxchristalgrieg
Please prepare a
one-page
Project Idea
that includes the following:
1. What type of project
would you like to do: develop a proposal for a new business; develop a plan to green an existing business; creative project; or research project?
2. What is the big idea
that you would like to pursue? (1-2 sentences)
3. Why
did you decide on this idea? (2-3 sentences)
4. If working in a team
, please list each team member and include either one specific role that they will play in the project or one link to a helpful resource that they have found that will inform the team’s project.
If doing an individual project
, please list at least one resource that will inform your thinking.
5. Develop a
proposed timeline
for the project (including the deliverables below, plus additional steps needed to produce the deliverables).
See the project guidelines under Course Documents or linked
here
for more information.
.
Please prepare at least in 275 to 300 words with APA references and .docxchristalgrieg
Please prepare at least in 275 to 300 words with APA references and citation.
1) Please describe the meaning of diversification. How does diversification reduce risk for the investor?
2) What is the opportunity cost of capital? How can a company measure opportunity cost of capital for a project that is considered to have average risk?
.
Please provide references for your original postings in APA form.docxchristalgrieg
Please provide references for your original postings in APA format.
1. Discuss the types of backup locations, per the text and Powerpoint presentation raeadings for the week.
2. Would a single backup location be adequate or should a combination be used? What combination would you recommend?
.
Please provide an update to include information about methodology, n.docxchristalgrieg
Please provide an update to include information about methodology, new literature discovered, or even questions regarding current progress. Topic selection is Cyber Security in Industry 4.0: The Pitfalls of Having Hyperconnected Systems can be found at https://www.jstage.jst.go.jp/article/iasme/10/1/10_100103/_pdf. APA citation is the following. Dawson, M. (2018). Cyber Security in Industry 4.0: The Pitfalls of Having Hyperconnected Systems. Journal of Strategic Management Studies, 10(1), 19-28. (250 words)
.
Please provide an evaluation of the Path to Competitive Advantage an.docxchristalgrieg
Please provide an evaluation of the Path to Competitive Advantage and Motivation and
Feedback and answer the following questions:
1. How can managers enhance employee motivation through performance management
techniques?
2. It is well known that individuals on international assignments operate under unique
contextual and cultural realities. How would motivation differ in such environments?
*********
1 page follow APA 7 citation.
.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
This is a presentation by Dada Robert in a Your Skill Boost masterclass organised by the Excellence Foundation for South Sudan (EFSS) on Saturday, the 25th and Sunday, the 26th of May 2024.
He discussed the concept of quality improvement, emphasizing its applicability to various aspects of life, including personal, project, and program improvements. He defined quality as doing the right thing at the right time in the right way to achieve the best possible results and discussed the concept of the "gap" between what we know and what we do, and how this gap represents the areas we need to improve. He explained the scientific approach to quality improvement, which involves systematic performance analysis, testing and learning, and implementing change ideas. He also highlighted the importance of client focus and a team approach to quality improvement.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
Instructions for Submissions thorugh G- Classroom.pptxJheel Barad
This presentation provides a briefing on how to upload submissions and documents in Google Classroom. It was prepared as part of an orientation for new Sainik School in-service teacher trainees. As a training officer, my goal is to ensure that you are comfortable and proficient with this essential tool for managing assignments and fostering student engagement.
Palestine last event orientationfvgnh .pptxRaedMohamed3
An EFL lesson about the current events in Palestine. It is intended to be for intermediate students who wish to increase their listening skills through a short lesson in power point.
Ethnobotany and Ethnopharmacology:
Ethnobotany in herbal drug evaluation,
Impact of Ethnobotany in traditional medicine,
New development in herbals,
Bio-prospecting tools for drug discovery,
Role of Ethnopharmacology in drug evaluation,
Reverse Pharmacology.
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
The French Revolution Class 9 Study Material pdf free download
THE UNIVERSITY OF MEMPHIS POST TRAUMATIC STRESS DISORDER.docx
1. THE UNIVERSITY OF MEMPHIS
POST TRAUMATIC STRESS
DISORDER
EARLY INTERVENTION FOR OUR SOLDIERS
LESLIE JAYROE
4/25/2011
HPRO 7720
Post Traumatic Stress Disorder and Our Soldiers- Providing
Earlier Intervention
History
There is a significant amount of information out there on post
traumatic stress disorder and the
military, and this is mostly due to the fact that our combat
soldiers were the ones observed over
time to determine the effects war has had on them. Post
traumatic stress disorder (PTSD) can
be thought of as a "young" diagnosis. PTSD has been around for
centuries, but it was n~t until
2. 1980 that it was made an official disorder. However, throughout
history, people have
recognized that exposure to combat situations can have an
intensely negative impact on the
people who are involved in these situations. (Mathew Tull,
2009) PTSD has previously been
described ia-410J e ~s "combat fatigue," "shell shock," or "war
neurosis," and is defined by the
American Psychiatric Association as an anxiety (emotional)
disorder which stems from a
particular incident evoking significant stress. (Bentley, 2005)
PTSD is not limited to combat
soldiers but can also be found among survivors of the
Holocaust, of car accidents, of sexual
assaults, and of other traumatic experiences. War has always
had a severe psychological effect
on people, and with the war our country is currently in, more
and more of our soldiers are
suffering from PTSD. After a traumatic experience, the mind
and the body are in shock, but as
the victim makes sense of what happened and processes his/her
emotions, healing takes place
leading toward normal function once again. With PTSD, one
remains in psychological shock.
3. The memory of what happened and their feelings about it are
disconnected. In order to move
on, it's important to face and feel those memories and emotions.
One effective approach is
through counseling. (Mathew Tull, 2009)
The symptoms of PTSD can occur all of a sudden,
progressively, come and go over time, or
appear out of nowhere. Sometimes, symptoms are triggered by
something that reminds a
31 Page
person of the original traumatic event, such as a noise, an
image, certain words, or a smell.
While everyone experiences PTSD differently, there are three
main types of symptoms:
(Bentley, 2005)
1. Re-experiencing the traumatic event
2. Avoiding reminders of the trauma
3. Increased anxiety and emotional arousal
According to the Graffiti of War Project, in 2007, the number of
diagnosed cases in the military
jumped 50%. One in every five military personnel returning
4. from Iraq and Afghanistan has
PTSD, and 20% of the soldiers who've been deployed since
2001 have PTSD which is over
300,000. More troops are serving their second, third or fourth
tours of duty, which dramatically
increases stress according to medical heath experts. Also,
extended tour lengths from 12
months to 15 months were done to provide enough troops for
buildup, but is another factor that
has caused extra emotional strain. {The Graffiti of War Project,
2007)
Statement of Purpose
The purpose of this paper is to provide an early intervention for
first time deploying soldiers from
Arkansas by applying the Precede/Proceed Model in hopes of
preventing post traumatic stress
disorder brought on by combat. The Precede/Proceed Model
consists of 9 phases which were
applied for the sack of this intervention. The first five phases
are within the Precede part of the
model: 1) social assessment 2) epidemiological assessment 3)
behavioral and environmental
assessment 4) educational and ecological assessment 5)
administrative and policy assessment.
5. The last four phases are within the Proceed part of the model: 6)
implementation of the program
7) process evaluation 8) impact evaluation 9) outcome
evaluation. (Edberg, 2009) By following
these phases in order, I was able to create a successful
intervention while applying the Theory
41 Page
of Planned Behavior. The Theory of Planned Behavior, simply
stated, is about the associ
of attitudes and behaviors.
Phase 1: Social Assessment
A person's quality of life is greatly impacted by post traumatic
stress disorder, and can cause
serious social, emotional, and psychological problems for
soldiers returning to the civilian life .
Twenty soldiers made up the study group for this program. They
were selected through the
recruitment office in Little Rock, Arkansas at random and had
to meet the following criteria:
• First-time deploying soldier
• An Arkansas resident
6. Age, sex, and ethnicity were not deciding factors for being part
of the study. The main social
problems that were documented in medical and work records
from this group of soldiers after
post-deployment were an increased number of absences from
work, lack of sleep, and domestic
problems. Prior to their first deployment, they were each
assessed for any social disorders, work
records were noted, and medical records were evaluated so a
baseline could be established for
the study. There were no soldiers before deployment with these
issues. This information was
obtained through the recruitment office in Little Rock, Arkansas
to determine each soldier's
deployment status and medical records from their personal
physicians as well as former
employee records were used for the sake of the intervention.
Phase 2: Epidemiological Assessment
Of the twenty soldiers being studied, the most common health
problems documented from
medical records were alcohol abuse, the use of narcotics, and
post traumatic stress disorder.
The pre-assessment also evaluated them for these issues before
7. the first deployment, and
SI Page
again, none of the soldiers exhibited these issues before the
deployment. Of the three issues,
post traumatic stress disorder is the most important and most
changeable for the given
population. If PTSD can be prevented, then the other issues
should also resolve. Pre and post
deployment medical records were used to make this evaluation
for these soldiers and a national J
health database was used for comparison as well as reviewing
the literature on this particular
issue.
Phase 3: Behavioral and Environmental Assessment
There are behavioral and environmental factors that contribute
to PTSD in soldiers .
Environmental factors: (Corporation, 2008)
• combat
• deployments longer than 12 months at a time
• multiple deployments
• suicide bombers
8. Behavioral factors:
• Worried about medication side effects
• Feel that friends and family can help more than counseling
• Fear that there will be damage to career
• Fear of peers lacking confidence in him/her
The environmental factors cannot be changed for soldiers at war
unless they change
cC)reers, but the behavioral factors can be changed. With more
education on PTSD, and the
acceptance of the disorder by the military, soldiers could
alleviate the behavioral barriers.
fii P;:lP'P
Goal and Objectives
Goal: The goal of this program is to provide early intervention
to twenty Arkansas soldiers
before their first deployment to Afghanistan as to prevent the
development of post traumatic
stress disorder before and after their second deployment with
success rate set at 85% after 48
months of the start of the intervention. /
9. Objective 1: To increase awareness of post traumatic stress
disorder among twenty soldiers by I
100% within two weeks before their first deployment to
Afghanistan.
Objective 2: To provide four sessions of post deployment
counseling to the twenty soldiers aft/
each deployment, at 85% counseling attendance rate.
Phase 4: Educational and Ecological Assessment
For this phase, three areas are looked at: Predisposal,
Reinforcing Factors, and Enablers .
Predispose: Unlike major depression and other psychological
disorders, PTSD shows
biochemical changes in the brain and body. Individuals
diagnosed with PTSD have a higher
response to a dexamethasone suppression test than individuals
diagnosed with clinical
depression. Most people with PTSD also show a low secretion
of cortisol and high secretion of
catecholamines in urine, with a norepinephrine/cortisol ratio
compared to people who do not
have the disorder. Low cortisol levels may predispose
individuals to PTSD. Because cortisol is
important in restoring homeostasis after the stress response,
trauma survivors with low cortisol
10. tend to be distressed more over the situation(s) and suffer from
it longer, setting the stage for
PTSD. (RWMC, 201 0) Each soldier was evaluated for low
cortisol levels through a urine test
before deployment. Of the twenty soldiers, only one showed a
markedly low level.
71 PrJilP
Reinforce: Factors that are reinforced for the possible
development of PTSD include the
environment that these soldiers are placed in and also the
military's policies on length of time
and redeployment. The environment that they are in puts them
under a great deal of stress and
most of which can't be altered . Combat, suicide bombers, long
hours without sleep, lack of
communication with loved ones, the loss of fellow soldiers, and
the possibility of killing innocent
people are all part of what they have to go through on a daily
bases while deployed . The
military policy for deploying soldiers for longer than 12 months
at a time and multiple
deployments are factors that could be altered.
11. Enable: Enabling factors include a lack of knowledge of what
exactly post traumatic stress
disorder is , lack of counseling for the disorder either due to
lack of knowledge or not seeking
treatment because the military tends to look down upon soldiers
with PTSD, and also the lack of
healthcare facilities where these soldiers can go to receive help.
The military does administer
post deployment testing to determine if a soldier has any
physical or psychological problems I
once they are back, but some cases still go undiagnosed .
Soldiers know that if they answer
certain questions honestly, it may keep them from getting to go
home sooner.
Phase 5: Administration and Policy Assessment
With Arkansas not having a program established for the
prevention of Post Traumatic Stress
Disorder for soldiers prior to this intervention, policies and
administration had to be developed .
With the help of Veterans Affairs, personnel from the military
recruitment office in Little Rock,
and The University of Arkansas for Medical Sciences Hospital
(UAMS), a board was appointed ,
polices were made and presented to the House for approval.
12. The program took place at The University of Arkansas for
Medical Sciences Hospital (UAMS) in
Little Rock. With the administrative and financial support
provided by this hospital, an office with
81 Page
a conference room, counseling rooms , secretary, counselors,
computers, printers, office
supplies, educational material, and office furniture were all
provided, and 1 was appointed as the
Director of the program .
Once the staff was hired, policies and procedures were reviewed
by all, and everyone
underwent post traumatic stress disorder training in order to
have an understanding of the
people they would be working with .
Phase 6: Implementation of the Program
Along with the application of the Precede/Proceed Model, I will
apply the Theory of Planned
Behavior (TPB). TPB is a theory about the link between
attitudes and behavior. The attitude
toward a particular behavior is determined by a person's
13. assessment of what the consequences
of their actions are. If the consequences are negative, the less
chance there is for a person to
behave a certain way. In regards to this intervention, if a soldier
feels that they may lose their
job, lose respect, or be treated differently for admitting they
have PTSD and receive treatment
for it, they are less likely to admit they have a problem and seek
help.
In order to select soldiers for this program , the recruitment
office in Little Rock, Arkansas was
asked for referrals . Once the twenty soldiers were selected
based on their deployment status,
they were evaluated by a counselor to determine any underlying
psychological disorders.
These initial evaluations were added to their charts .
A test was given at the beginning of the program to determine
the knowledge these soldiers had
on PTSD before starting the program. Afterwards, educational
material was distributed and
reviewed two weeks before initial deployment. Educational
material consisted of handouts ,
DVDs, and guest speakers who discussed with the soldiers their
experience with PTSD. During
14. I Pae:e
I
this time, the soldiers were also introduced to the counselors
they would be working with upon
completion of the deployment.
Counseling sessions will start once post deployed soldiers
return from their first tour of duty.
Every three months they are required to meet with the
counselors on staff at UAMS, and
express their feelings and emotions. If additional sessions are
recommended by the counselor,
the soldier will submit to treatment, and continue individual
counseling sessions until the
counselor feels that the soldier is no longer at risk for PTSD.
Content of Counseling Sessions:
The sessions will take place during a specified three day
weekend every three months for a total
of four sessions (totaling 12 months). Every three months, the
soldiers will return to UAMS for
the counseling sessions and the same structure will be followed.
15. Day 1: Counseling will begin as a group therapy session the
first day where each
soldier talks about his/her experiences from the deployment.
The purpose of starting
with group sessions is for the soldiers to have a support group,
hear other soldier's
stories that might bring back memories they may have tried to
block, and to get them
talking about the issues they are dealing with after their first
deployment. The
counselors will be present and leading the session which will be
recorded for
documentation purposes and evaluation. The session will last
four hours with two 30
minute breaks incorporated within that time . Participants will
sit in a circle and the
group sessions will be conducted in a casual atmosphere.
Day two: Each soldier will meet with a counselor individually
in a professional setting
and will be encouraged to express their feelings and emotions
through discussion.
10 I Pari e
I
16. The individual session will last two hours, and the counselor
will keep records during /
the meeting which will be placed in the soldier's program
intervention file. V
Day 3: The weekend counseling session will conclude with
questionnaires that will
assist in determining if there were any changes mentally,
socially, or psychologically,
j and then be compared to the questionnaires given before
deployment. Waiting until
day three for the questionnaires will allow for a more accurate
evaluation, allowing for
incidences that were previously blocked to surface . Review of
the questionnaires,
counseling session, and group session will establish if there is a
need for further
treatment.
After the second tour of duty, each soldier will undergo four
more counseling sessions which will
also be held on a specified three day weekend every three
months (total of 12 months). If
additional sessions are recommended, soldiers will submit to
additional treatment which will be
17. individual counseling sessions where they will continue to
express feelings and emotions until
the counselor feels that the soldier is no longer at risk for
developing PTSD.
Content of Counseling Sessions:
Day 1: Like the first post-deployment sessions, day one will
consist of group
counseling where each soldier will share their experiences from
the previous
deployment. Counselors will be present as before, and they will
be in charge of
leading the session while it is being recorded for documentation
purposes and
evaluation. This session will last four hours total with two 30
minute breaks
implemented in.
Day 2: The second day will be devoted to individual counseling
sessions where each
soldier will meet with a counselor and express their feelings and
emotion through
111 P;JP'P
discussion. The individual session will last two hours, and the
18. counselor will record
information to add to the soldier's program intervention file.
Day 3: It will be devoted to the questionnaires that evaluate
social, psychological , and
emotional changes, and these will be compared to the previous
questionnaires as
well as the group and individual counseling sessions in order to
determine if
additional counseling is needed.
Phase 7: Process Evaluation
Process evaluation was done by examining the program's
components and if they were carried
out the way they were stated initially. Before each soldier's
initial deployment, they were each
educated on post traumatic stress disorder, the signs and
symptoms, and the need for
I
J
treatment if he/she or someone they knew started to develop any
of the symptoms. Four
counseling sessions were completed after each deployment by
each soldier that remained in
the program, and the counselors along with the medical exam
19. staff completed documentation of
changes in the soldiers with particular regard to psychological
changes.
Phase 8: Impact Evaluation
The impact evaluation shows the program's effectiveness by
observing the objectives that were
set for the program. Soldier's medical records, counseling
records, and work records were
reviewed periodically and at the completion of the 48 months .
Objectives for this intervention
were:
Objective 1: To increase awareness of post traumatic stress
disorder among twenty soldiers
by 100% within two weeks before their first deployment to
Afghanistan.
12 I P a Q e
Objective 2: To provide four sessions of post deployment
counseling to the twenty soldiers after
each deployment, at 85% counseling attendance rate.
Objective one was at 100%. The twenty soldiers all received
education on PTSD two weeks prior
20. to being deployed, and there was a 100% increase of awareness
among the soldiers of this
disorder which was determined by comparing pre and post
PTSD testing.
Objective two was met at 90% which was 5% above the goal
set. Of the twenty soldiers who
participated in the program, one was killed in action during the
first tour of duty, and another
soldier was killed in action during the second tour of duty. Of
the eighteen soldiers remaining,
1 00% compliance was met with the counseling sessions over
the 48 months.
Phase 9: Outcome Evaluation
The overall goal of this program was to provide early
intervention to twenty Arkansas soldiers
before their first deployment to Afghanistan as to prevent post-
traumatic stress disorder from
developing before and after their second deployment with the
success rate set at 85% after 48
months of the start of the intervention. Upon completion of the
48 month intervention, the
outcome evaluation revealed that our goal and objectives were
met. Of the twenty soldiers who
began the program, eighteen completed the program, two lost
21. their life in combat, and one
developed PTSD. 85% of the 20 soldiers in the program did not
develop PTSD after the 48
months which met the goal of the intervention.
With the program's success, UAMS has decided to continue this
intervention program and offer
it to more first time deploying soldiers in Arkansas. The
recruitment office will still be
responsible for referrals, and an assistant director will be
appointed to assist with the
implementation of the future programs.
Sources:
Bentley, S. (2005, March/April). Helpguide.org. Retrieved from
A Short History of PTSD : From
Thermopylae to Hue Soldiers Have Always Had A Disturbing
Reaction To War :
http:/
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