Week 5 Handout: Content Analysis of Focus Groups 1
Research Question 1: What are the barriers in implementing mental health services in the Asian
American community?
Research Design: Qualitative, Descriptive
Research Method: Focus groups
Patient Related Barriers
Social Stigma Associated with Mental Illness
“….but also a lot of my patients have a fear of going to psychiatrists because of the social
stigma ….” and most of them have financial difficulty and have to pay an additional fee
to pay for psychiatry. (DN, pg. 1)
Financial Difficulties
“….but also a lot of my patients have a fear of going to psychiatrists …. and most of
them have financial difficulty and have to pay an additional fee to pay for
psychiatry.” (DN, pg. 1)
Characteristics of the Asian patient
Mistrustful of mental health
“I found it easier sometimes to refer them to someone else because a lot of times
I find that the Chinese patients are unwilling to open up or trust.” (TPW, pg.
2)
“we have to see why Asians go to see a health care provider, forget about
whether the mental health profession, or even a regular clinician. Why does the
patient see the provider..is it because they have seen a chinese herbalist and have
failed and have used their last efforts to see a western doctor, that will put
tremendous expectations on this relationship, as opposed to someone who
comes to see the doctor for the first time and has faith that the Western
doctor.” (Anthony, pg. 7)
Don’t Ask for Assistance
“It is hard to get them ask for help and ….. “ (TPW, pg. 2)
Patient’s View of Mental Health Provider as Last Resort
“we have to see why Asians go to see a health care provider, forget about whether the
mental health profession, or even a regular clinician. Why does the patient see the
provider..is it because they have seen a chinese herbalist and have failed and have
used their last efforts to see a western doctor, that will put tremendous expectations on
this relationship, as opposed to someone who comes to see the doctor for the first time
and has faith that the western doctor.” (Anthony, pg. 7)
Week 5 Handout: Content Analysis of Focus Groups 2
Service Provider Related Barriers
“Despite all the training I have found that working with Chinese populations there are a lot of
barriers I am finding that it is not as easy working with them.” (TPW, pg. 2)
“Pass the Buck theme”
I found it easier sometimes to refer them to someone else because a lot of times I find that
the Chinese patients are unwilling to open up or trust. (TPW, pg. 2)
Lack of training/skills/expertise
“….and I find that I struggle with my own skills and I am trying to get some help in
being a better primary care provider and getting my skills more fine tuned for the
population that I work with.” (TPW, pg. 2)
“On the Western provider side, we noticed that when a provider is confronted ...
Week 5 Handout Content Analysis of Focus Groups 1 Resea.docxcockekeshia
Week 5 Handout: Content Analysis of Focus Groups 1
Research Question 1: What are the barriers in implementing mental health services in the Asian
American community?
Research Design: Qualitative, Descriptive
Research Method: Focus groups
Patient Related Barriers
Social Stigma Associated with Mental Illness
“….but also a lot of my patients have a fear of going to psychiatrists because of the social
stigma ….” and most of them have financial difficulty and have to pay an additional fee
to pay for psychiatry. (DN, pg. 1)
Financial Difficulties
“….but also a lot of my patients have a fear of going to psychiatrists …. and most of
them have financial difficulty and have to pay an additional fee to pay for
psychiatry.” (DN, pg. 1)
Characteristics of the Asian patient
Mistrustful of mental health
“I found it easier sometimes to refer them to someone else because a lot of times
I find that the Chinese patients are unwilling to open up or trust.” (TPW, pg.
2)
“we have to see why Asians go to see a health care provider, forget about
whether the mental health profession, or even a regular clinician. Why does the
patient see the provider..is it because they have seen a chinese herbalist and have
failed and have used their last efforts to see a western doctor, that will put
tremendous expectations on this relationship, as opposed to someone who
comes to see the doctor for the first time and has faith that the Western
doctor.” (Anthony, pg. 7)
Don’t Ask for Assistance
“It is hard to get them ask for help and ….. “ (TPW, pg. 2)
Patient’s View of Mental Health Provider as Last Resort
“we have to see why Asians go to see a health care provider, forget about whether the
mental health profession, or even a regular clinician. Why does the patient see the
provider..is it because they have seen a chinese herbalist and have failed and have
used their last efforts to see a western doctor, that will put tremendous expectations on
this relationship, as opposed to someone who comes to see the doctor for the first time
and has faith that the western doctor.” (Anthony, pg. 7)
Week 5 Handout: Content Analysis of Focus Groups 2
Service Provider Related Barriers
“Despite all the training I have found that working with Chinese populations there are a lot of
barriers I am finding that it is not as easy working with them.” (TPW, pg. 2)
“Pass the Buck theme”
I found it easier sometimes to refer them to someone else because a lot of times I find that
the Chinese patients are unwilling to open up or trust. (TPW, pg. 2)
Lack of training/skills/expertise
“….and I find that I struggle with my own skills and I am trying to get some help in
being a better primary care provider and getting my skills more fine tuned for the
population that I work with.” (TPW, pg. 2)
“On the Western provider side, we noticed that when a provider is confronted .
The Place of Arts Medicine in Diagnosis and Healing, Journal of Humanities Th...Diane Kaufman, MD
This document provides an overview of the role of arts in healthcare and medicine. It discusses the origins of integrating arts and healing from ancient myths and traditions. It then describes the author's personal and professional journey in developing an arts medicine practice, tracing influences from her family and how she came to integrate poetry, storytelling and expressive arts into her work as a child psychiatrist. It also outlines the development of an arts in healthcare program at a university hospital through collaboration between medical professionals interested in using arts to enhance patient care, recovery and healing.
The document summarizes the roles and responsibilities of a correctional mental health clinician. Key duties include risk management like suicide screenings, mental health assessments, referring inmates to medical practitioners, providing counseling and classes, and assisting with mental health commitments. It also discusses evaluating inmates, setting boundaries, collaborating with other staff, and providing training to officers. The overall role is to help inmates work through problems while prioritizing safety and following correctional procedures.
The document summarizes interviews conducted with 12 transgender individuals about their experiences with therapy. Common themes that emerged were fears of being open with others or themselves, concerns that therapists don't understand the transgender experience, and feeling needing to educate therapists rather than receive help. While some found therapy helpful, others had unsupportive experiences where therapists tried to change them or didn't understand their identity. The interviews highlighted the power therapists have and importance of not making assumptions.
The document summarizes interviews conducted with 12 transgender individuals about their experiences with therapy. Common themes that emerged were fears of being open with others or themselves, concerns that therapists don't understand the transgender experience, and feeling needing to educate therapists rather than receive help. While some found therapy helpful, others had unsupportive experiences where therapists tried to change them or didn't understand their issues. The interviews highlighted the power therapists have and importance of not making assumptions to avoid causing harm.
Student volunteers’ interprofessional learning experiences at an inner-city s...Stefanus Snyman
Background:
Trinity Health Services is a free inner-city clinic that serves a homeless community in Johannesburg. The clinic is run by pharmacy and medical students registered in the Faculty of Health Sciences at the University of the Witwatersrand. They are assisted by academic staff employed in the faculty. This setting provides an ideal space to document the interprofessional experiences between these two groups outside of formalized lectures or experiential learning activities. Therefore, the research question for this study was: What are the learning experiences of medical and pharmacy students working at an inner-city student-driven clinic?
Methodology:
A convenience sampling method was employed and all students who volunteered at the clinic were invited to participate in a discipline specific focus group. The recordings of the focus group discussions (FGDs) were transcribed verbatim and analyzed using thematic analysis to identify common themes. Ethics approval was attained from the Human Research Ethics Committee of the university (M161140).
Results:
Themes emerged related to serving of the community, interprofessional and peer-learning as well as working as a team in an environment conducive to learning. Both FGDs described the primary purpose of the clinic being to serve the community. Participants felt that they work synergistically in the clinic and have self-identified their clinical roles through understanding their scope of practice. They expressed their appreciation of working together and being able to learn with and from each other. Participants also described the interaction between students in different years of study within a discipline, providing a setting where they both learn from and teach fellow students. The clinic is seen as a safe learning environment where students can practice and apply concepts taught in lectures such as the biopsychosocial approach to patient care as well as practising communication and counselling skills.
Conclusion:
The importance of student-driven primary health care facilities was highlighted. This experience differs from their clinical exposures as students are submerged in the clinic helping to build their confidence as future pharmacists and doctors
Using the Cultural Formulation Interview to BuildCulturally .docxjessiehampson
Using the Cultural Formulation Interview to Build
Culturally Sensitive Services
Esperanza Díaz, M.D., Luis M. Añez, Psy.D., Michelle Silva, Psy.D., Manuel Paris, Psy.D., Larry Davidson, Ph.D.
As part of the development of DSM-5, the Cultural Formu-
lation Interview (CFI) was administered to 30 monolingual
Spanish-speaking adults at one site of a 2012 feasibility
study of the CFI. The authors identified salient themes in
data collected through use of the CFI, with a focus on
interventions that could lead to more culturally responsive
mental health services. Findings suggest that establishing
trust and focusing on the restoration of social ties while
attending to the impact of stigma and patients’ pressing
psychosocial needs are elements of culturally responsive
services for Hispanic persons. Routine use of the CFI can
help clinicians identify unique needs and preferences
by understanding an individual within his or her cultural
context.
Psychiatric Services 2017; 68:112–114; doi: 10.1176/appi.ps.201600440
Cultural sensitivity increases the probability of a therapeutic
relationship by enhancing trust and improving communi-
cation between clinicians and patients (1). Culturally re-
sponsive services effectively address health care disparities
and increase providers’ knowledge of diverse cultures. In-
troducing culturally responsive care increases service utili-
zation and reduces premature termination (2,3). However,
few examples exist that illustrate culturally responsive care
in routine practice beyond its positive effect on help seeking
and service utilization.
The revision of the Outline for Cultural Formulation from
the DSM-IV resulted in the Cultural Formulation Interview
(CFI) to elicit information about perceived cultural influ-
ences of care with a set of 16 questions included in the
DSM-5 (4). This personalized interview facilitates individ-
ualized assessments by clinicians instead of their relying on
preconceived or stereotypic notions about race-ethnicity or
country of origin (5). The CFI captures the patient’s voice
systematically and documents what is “at stake” for the
person (6). The CFI field trial provided an opportunity to
observe this innovative way to elicit information and to
clarify cultural versus idiosyncratic details. The CFI has a
unique role, even in mental health services that are focused
on racial-ethnic minority groups. In this column, we de-
scribe CFI-elicited information in one of the trial sites and
discuss potential ways for the CFI to improve care.
CFI Field Trial
From February to September 2012, we recruited 30 par-
ticipants for a CFI feasibility study that included an audio-
recorded interview. The participants were monolingual
Spanish-speaking adults ages 18–70 from several Latin
American countries and were receiving outpatient services
at the Hispanic Clinic of the Connecticut Mental Health
Center, which serves individuals regardless of legal status
and ability to pay. We obtained institutional ...
Health care settings for the social work.docxbkbk37
This document discusses medical social work in health care settings. It describes the role of social workers in assisting individuals and families dealing with loss, often the death of a loved one. Social workers in this context provide grief counseling and help guide clients through the grieving process. They also connect clients to additional resources in the community for support. The document emphasizes practicing within one's professional competencies and scope. It gives the example of hospice social work, where social workers provide psychosocial support and help families navigate end-of-life decisions and discharge planning.
Week 5 Handout Content Analysis of Focus Groups 1 Resea.docxcockekeshia
Week 5 Handout: Content Analysis of Focus Groups 1
Research Question 1: What are the barriers in implementing mental health services in the Asian
American community?
Research Design: Qualitative, Descriptive
Research Method: Focus groups
Patient Related Barriers
Social Stigma Associated with Mental Illness
“….but also a lot of my patients have a fear of going to psychiatrists because of the social
stigma ….” and most of them have financial difficulty and have to pay an additional fee
to pay for psychiatry. (DN, pg. 1)
Financial Difficulties
“….but also a lot of my patients have a fear of going to psychiatrists …. and most of
them have financial difficulty and have to pay an additional fee to pay for
psychiatry.” (DN, pg. 1)
Characteristics of the Asian patient
Mistrustful of mental health
“I found it easier sometimes to refer them to someone else because a lot of times
I find that the Chinese patients are unwilling to open up or trust.” (TPW, pg.
2)
“we have to see why Asians go to see a health care provider, forget about
whether the mental health profession, or even a regular clinician. Why does the
patient see the provider..is it because they have seen a chinese herbalist and have
failed and have used their last efforts to see a western doctor, that will put
tremendous expectations on this relationship, as opposed to someone who
comes to see the doctor for the first time and has faith that the Western
doctor.” (Anthony, pg. 7)
Don’t Ask for Assistance
“It is hard to get them ask for help and ….. “ (TPW, pg. 2)
Patient’s View of Mental Health Provider as Last Resort
“we have to see why Asians go to see a health care provider, forget about whether the
mental health profession, or even a regular clinician. Why does the patient see the
provider..is it because they have seen a chinese herbalist and have failed and have
used their last efforts to see a western doctor, that will put tremendous expectations on
this relationship, as opposed to someone who comes to see the doctor for the first time
and has faith that the western doctor.” (Anthony, pg. 7)
Week 5 Handout: Content Analysis of Focus Groups 2
Service Provider Related Barriers
“Despite all the training I have found that working with Chinese populations there are a lot of
barriers I am finding that it is not as easy working with them.” (TPW, pg. 2)
“Pass the Buck theme”
I found it easier sometimes to refer them to someone else because a lot of times I find that
the Chinese patients are unwilling to open up or trust. (TPW, pg. 2)
Lack of training/skills/expertise
“….and I find that I struggle with my own skills and I am trying to get some help in
being a better primary care provider and getting my skills more fine tuned for the
population that I work with.” (TPW, pg. 2)
“On the Western provider side, we noticed that when a provider is confronted .
The Place of Arts Medicine in Diagnosis and Healing, Journal of Humanities Th...Diane Kaufman, MD
This document provides an overview of the role of arts in healthcare and medicine. It discusses the origins of integrating arts and healing from ancient myths and traditions. It then describes the author's personal and professional journey in developing an arts medicine practice, tracing influences from her family and how she came to integrate poetry, storytelling and expressive arts into her work as a child psychiatrist. It also outlines the development of an arts in healthcare program at a university hospital through collaboration between medical professionals interested in using arts to enhance patient care, recovery and healing.
The document summarizes the roles and responsibilities of a correctional mental health clinician. Key duties include risk management like suicide screenings, mental health assessments, referring inmates to medical practitioners, providing counseling and classes, and assisting with mental health commitments. It also discusses evaluating inmates, setting boundaries, collaborating with other staff, and providing training to officers. The overall role is to help inmates work through problems while prioritizing safety and following correctional procedures.
The document summarizes interviews conducted with 12 transgender individuals about their experiences with therapy. Common themes that emerged were fears of being open with others or themselves, concerns that therapists don't understand the transgender experience, and feeling needing to educate therapists rather than receive help. While some found therapy helpful, others had unsupportive experiences where therapists tried to change them or didn't understand their identity. The interviews highlighted the power therapists have and importance of not making assumptions.
The document summarizes interviews conducted with 12 transgender individuals about their experiences with therapy. Common themes that emerged were fears of being open with others or themselves, concerns that therapists don't understand the transgender experience, and feeling needing to educate therapists rather than receive help. While some found therapy helpful, others had unsupportive experiences where therapists tried to change them or didn't understand their issues. The interviews highlighted the power therapists have and importance of not making assumptions to avoid causing harm.
Student volunteers’ interprofessional learning experiences at an inner-city s...Stefanus Snyman
Background:
Trinity Health Services is a free inner-city clinic that serves a homeless community in Johannesburg. The clinic is run by pharmacy and medical students registered in the Faculty of Health Sciences at the University of the Witwatersrand. They are assisted by academic staff employed in the faculty. This setting provides an ideal space to document the interprofessional experiences between these two groups outside of formalized lectures or experiential learning activities. Therefore, the research question for this study was: What are the learning experiences of medical and pharmacy students working at an inner-city student-driven clinic?
Methodology:
A convenience sampling method was employed and all students who volunteered at the clinic were invited to participate in a discipline specific focus group. The recordings of the focus group discussions (FGDs) were transcribed verbatim and analyzed using thematic analysis to identify common themes. Ethics approval was attained from the Human Research Ethics Committee of the university (M161140).
Results:
Themes emerged related to serving of the community, interprofessional and peer-learning as well as working as a team in an environment conducive to learning. Both FGDs described the primary purpose of the clinic being to serve the community. Participants felt that they work synergistically in the clinic and have self-identified their clinical roles through understanding their scope of practice. They expressed their appreciation of working together and being able to learn with and from each other. Participants also described the interaction between students in different years of study within a discipline, providing a setting where they both learn from and teach fellow students. The clinic is seen as a safe learning environment where students can practice and apply concepts taught in lectures such as the biopsychosocial approach to patient care as well as practising communication and counselling skills.
Conclusion:
The importance of student-driven primary health care facilities was highlighted. This experience differs from their clinical exposures as students are submerged in the clinic helping to build their confidence as future pharmacists and doctors
Using the Cultural Formulation Interview to BuildCulturally .docxjessiehampson
Using the Cultural Formulation Interview to Build
Culturally Sensitive Services
Esperanza Díaz, M.D., Luis M. Añez, Psy.D., Michelle Silva, Psy.D., Manuel Paris, Psy.D., Larry Davidson, Ph.D.
As part of the development of DSM-5, the Cultural Formu-
lation Interview (CFI) was administered to 30 monolingual
Spanish-speaking adults at one site of a 2012 feasibility
study of the CFI. The authors identified salient themes in
data collected through use of the CFI, with a focus on
interventions that could lead to more culturally responsive
mental health services. Findings suggest that establishing
trust and focusing on the restoration of social ties while
attending to the impact of stigma and patients’ pressing
psychosocial needs are elements of culturally responsive
services for Hispanic persons. Routine use of the CFI can
help clinicians identify unique needs and preferences
by understanding an individual within his or her cultural
context.
Psychiatric Services 2017; 68:112–114; doi: 10.1176/appi.ps.201600440
Cultural sensitivity increases the probability of a therapeutic
relationship by enhancing trust and improving communi-
cation between clinicians and patients (1). Culturally re-
sponsive services effectively address health care disparities
and increase providers’ knowledge of diverse cultures. In-
troducing culturally responsive care increases service utili-
zation and reduces premature termination (2,3). However,
few examples exist that illustrate culturally responsive care
in routine practice beyond its positive effect on help seeking
and service utilization.
The revision of the Outline for Cultural Formulation from
the DSM-IV resulted in the Cultural Formulation Interview
(CFI) to elicit information about perceived cultural influ-
ences of care with a set of 16 questions included in the
DSM-5 (4). This personalized interview facilitates individ-
ualized assessments by clinicians instead of their relying on
preconceived or stereotypic notions about race-ethnicity or
country of origin (5). The CFI captures the patient’s voice
systematically and documents what is “at stake” for the
person (6). The CFI field trial provided an opportunity to
observe this innovative way to elicit information and to
clarify cultural versus idiosyncratic details. The CFI has a
unique role, even in mental health services that are focused
on racial-ethnic minority groups. In this column, we de-
scribe CFI-elicited information in one of the trial sites and
discuss potential ways for the CFI to improve care.
CFI Field Trial
From February to September 2012, we recruited 30 par-
ticipants for a CFI feasibility study that included an audio-
recorded interview. The participants were monolingual
Spanish-speaking adults ages 18–70 from several Latin
American countries and were receiving outpatient services
at the Hispanic Clinic of the Connecticut Mental Health
Center, which serves individuals regardless of legal status
and ability to pay. We obtained institutional ...
Health care settings for the social work.docxbkbk37
This document discusses medical social work in health care settings. It describes the role of social workers in assisting individuals and families dealing with loss, often the death of a loved one. Social workers in this context provide grief counseling and help guide clients through the grieving process. They also connect clients to additional resources in the community for support. The document emphasizes practicing within one's professional competencies and scope. It gives the example of hospice social work, where social workers provide psychosocial support and help families navigate end-of-life decisions and discharge planning.
Most patients with mental health disorders are not aggressive. H.docxhelzerpatrina
Most patients with mental health disorders are not aggressive. However, it is important for nurses to be able to know the signs and symptoms associated with the five phases of aggression, and to appropriately apply nursing interventions to assist in treating aggressive patients. Please read the case study below and answer the four questions related to it.
Aggression Case Study
Christopher, who is 14 years of age, was recently admitted to the hospital for schizophrenia. He has a history of aggressive behavior and states that the devil is telling him to kill all adults because they want to hurt him. Christopher has a history of recidivism and noncompliance with his medications. One day on the unit, the nurse observes Christopher displaying hypervigilant behaviors, pacing back and forth down the hallway, and speaking to himself under his breath. As the nurse runs over to Christopher to talk, he sees that his bedroom door is open and runs into his room and shuts the door. The nurse responds by attempting to open the door, but Christopher keeps pulling the door shut and tells the nurse that if the nurse comes in the room he will choke the nurse. The nurse responds by calling other staff to assist with the situation.
1. What phase of the aggression cycle is Christopher in at the beginning of this scenario? What phase is he in at the end the scenario? (State the evidence that supports your answers).
2. What interventions could have been implemented to prevent Christopher from escalating at the beginning of the scenario?
3. What interventions should the nurse take to deescalate the situation when Christopher is refusing to open his door?
4. If a restrictive intervention (restraint/seclusion) is used, what are some important steps for the nurse to remember?
.
MotivationExplain your motivation for applying to this prog.docxhelzerpatrina
Motivation:
Explain your motivation for applying to this program. How does the content of this study abroad program relate to your future academic and professional goals?
Goals(REQUIRED)
List and explain three concrete goals related to living and studying abroad that you will set for yourself to get the most out of this opportunity.
.
Most public policy is made from within government agencies. Select a.docxhelzerpatrina
Most public policy is made from within government agencies. Select an agency to review for this assignment:
1) Go to
https://www.usa.gov
to begin your search.
2) Next, click on the menu tab labelled “Government Agencies and Elected Officials.”
3) Then, click on “A-Z Index of U.S. Government Agencies.”
4) Select one of the large federal agencies, and review one of its major policies, laws, or regulations.
What is the primary mission of the agency? Select a problem that the agency is attempting to solve. Research the major policy process as it has evolved and identify its major stakeholders. Identify what major factors have contributed to policy ineffectiveness. Is the bureaucracy now too large to provide adequate oversight and future development? Be sure to integrate lessons learned and policy concepts discussed throughout the class. Examples may include security at airports, immigration, education (No Child Left Behind), welfare support, Social Security, health care, etc. Identify government subsidies, tools, and regulations the agency uses to meet its policy goals. Pinpoint supporting agencies, groups, or businesses that would be most interested in these policies, and describe the potential conflicts of interest.
Your APA style paper should be three pages in length, not counting the title and reference pages. Provide at least three peer-reviewed or professional references. Be sure your paper is double-spaced and uses 12-point font and one-inch margins. Use your own words, and include citations and references as needed to avoid plagiarism. All sources used must be referenced; paraphrased and quoted material must have accompanying citations and be cited per APA guidelines.
.
Mr. Smith brings his 4-year-old son to your primary care office. He .docxhelzerpatrina
Mr. Smith brings his 4-year-old son to your primary care office. He states the boy has been ill for three days. Mr. Smith indicates that he would like antibiotics so he can send his son back to pre-school the next day.
History - Child began with sneezing, mild cough, and low grade fever of 100 degrees three days ago. All immunizations UTD. Father reports that the child has had only two incidents of URI and no other illnesses.
Social - non-smoking household. Child attends preschool four mornings a week and is insured through his father’s employment. No other siblings in the household.
PE/ROS -T 99, R 20, P 100. Alert, cooperative, in good spirits, well-hydrated. Mildly erythemic throat, no exudate, tonsils +2. Both ears mild pink tympanic membrane with good movement. Lungs clear bilaterally. All other systems WNL.
Do not consider COVID-19 for this patient diagnosis.
.
Mrs. Walsh, a woman in her 70s, was in critical condition after rep.docxhelzerpatrina
“Mrs. Walsh, a woman in her 70s, was in critical condition after repeat coronary artery bypass graft (CABG) surgery. Her family lived nearby when Mrs. Walsh had her first CABG surgery. They had moved out of town but returned to our institution, where the first surgery had been performed successfully. Mrs. Walsh remained critically ill and unstable for several weeks before her death. Her family was very anxious because of Mrs. Walsh’s unstable and deteriorating condition, and a family member was always with her 24 hours a day for the first few weeks.
The nurse became involved with this family while Mrs. Walsh was still in surgery, because family members were very anxious that the procedure was taking longer than it had the first time and made repeated calls to the critical care unit to ask about the patient. The nurse met with the family and offered to go into the operating room to talk with the cardiac surgeon to better inform the family of their mother’s status.
One of the helpful things the nurse did to assist this family was to establish a consistent group of nurses to work with Mrs. Walsh, so that family members could establish trust and feel more confident about the care their mother was receiving. This eventually enabled family members to leave the hospital for intervals to get some rest. The nurse related that this was a family whose members were affluent, educated, and well informed, and that they came in prepared with lists of questions. A consistent group of nurses who were familiar with Mrs. Walsh’s particular situation helped both family members and nurses to be more satisfied and less anxious. The family developed a close relationship with the three nurses who consistently cared for Mrs. Walsh and shared with them details about Mrs. Walsh and her life.
The nurse related that there was a tradition in this particular critical care unit not to involve family members in care. She broke that tradition when she responded to the son’s and the daughter’s helpless feelings by teaching them some simple things that they could do for their mother. They learned to give some basic care, such as bathing her. The nurse acknowledged that involving family members in direct patient care with a critically ill patient is complex and requires knowledge and sensitivity. She believes that a developmental process is involved when nurses learn to work with families.
She noted that after a nurse has lots of experience and feels very comfortable with highly technical skills, it becomes okay for family members to be in the room when care is provided. She pointed out that direct observation by anxious family members can be disconcerting to those who are insecure with their skills when family members ask things like, “Why are you doing this? Nurse ‘So and So’ does it differently.” She commented that nurses learn to be flexible and to reset priorities. They should be able to let some things wait that do not need to be done right away to give the family some.
Much has been made of the new Web 2.0 phenomenon, including social n.docxhelzerpatrina
Much has been made of the new Web 2.0 phenomenon, including social networking sites and user-created mash-ups. How does Web 2.0 change security for the Internet? Your submission should be between 500 words with references and following APA reference style. Please do not include a title page
.
MSN 5550 Health Promotion Prevention of Disease Case Study Module 2.docxhelzerpatrina
MSN 5550 Health Promotion: Prevention of Disease Case Study Module 2 Instructions: Read the following case study and answer the reflective questions.
Please provide rationales for your answers. Make sure to provide a citation for your answers. Deadline: CASE STUDY:
An Older Immigrant Couple: Mr. and Mrs. Arahan Mr. and Mrs. Arahan, an older couple in their seventies, have been living with their oldest daughter, her husband of 15 years, and their two children, ages 12 and 14. They all live in a middle-income neighborhood in a suburb of a metropolitan city. Mr. and Mrs. Arahan are both college educated and worked full-time while they were in their native country. In addition, Mr. Arahan, the only offspring of wealthy parents, inherited a substantial amount of money and real estate. Their daughter came to the United States as a registered nurse and met her husband, a drug company representative. The older couple moved to the United States when their daughter became a U.S. citizen and petitioned them as immigrants. Since the couple was facing retirement, they welcomed the opportunity to come to the United States. The Arahans found life in the United States different from that in their home country, but their adjustment was not as difficult because both were healthy and spoke English fluently. Most of their time was spent taking care of their two grandchildren and the house. As the grandchildren grew older, the older couple found that they had more spare time. The daughter and her husband advanced in their careers and spent a great deal more time at their jobs. There were few family dinners during the week. On weekends, the daughter, her husband, and their children socialized with their own friends. The couple began to feel isolated and longed for a more active life. Mr. and Mrs. Arahan began to think that perhaps they should return to the home country, where they still had relatives and friends. However, political and economic issues would have made it difficult for them to live there. Besides, they had become accustomed to the way of life in the United States with all the modern conveniences and abundance of goods that were difficult to obtain in their country. However, they also became concerned that they might not be able to tolerate the winter months and that minor health problems might worsen as they aged. They wondered who would take care of them if they became very frail and where they would live, knowing that their daughter had only saved money for their grandchildren’s college education. They expressed their sentiments to their daughter, who became very concerned about how her parents were feeling. This older couple had been attending church on a regular basis, but had never been active in other church-related activities. The church bulletin announced the establishment of parish nursing with two retired registered nurses as volunteers. The couple attended the first opening of the parish clinic. Here, they met one of the registered nur.
MSEL Strategy Mid-term Instructions Miguel Rivera-SantosFormat.docxhelzerpatrina
MSEL Strategy Mid-term Instructions Miguel Rivera-Santos
Format of the Mid-term
· You will find three recent newspaper articles describing a strategic move or a strategic decision in this document. Choose two out of these three articles and, for each of the two articles you have selected, answer the following two questions:
· Q1: What is (are) the issue(s) for the main company in the article? How do you assess the company’s strategic decision(s)? What additional information and what specific analyses would you conduct to fully understand the issue(s) and the decision(s)?
· Q2: What alternative recommendation would you consider in response to the issue(s)? What additional information/analyses would you need for this alternative recommendation? How could it be implemented?
· For each article, the combined answers to these two questions should be no longer than 2 single-spaced pages, in 12-point Times New Roman, with a 1-inch margin all around.
You can add as many appendices as you feel necessary, but remember that the page limitfor the mid-term (excluding exhibits) is 4 pages, i.e., 2 pages per newspaper article.
· You do not need to seek additional information beyond what is provided in the articles.
GOOD LUCK!
Geely to build satellites for self-driving cars - Financial Times (US), 3/4... https://digital.olivesoftware.com/Olive/ODN/FTUS/PrintArticle.aspx?d...
Automobiles
CHRISTIAN SHEPHERD — BEIJING
Geely is aiming to be the first China carmaker to design and build satellites to support its autonomous driving programme, the latest step by founder Li Shufu in his bid to build an industry leader.
Geely, which owns Swedish brand Volvo Cars, Malaysia’s Proton, and a stake in Mercedes-Benz owner Daimler, will invest Rmb2.27bn ($325m) in a new development centre and factory to manufacture satellites this year, the company said yesterday.
The announcement makes Geely the first known Chinese carmaker with plans to build its own satellites. Mr Li’s move sparked comparisons in China media with Elon Musk, founder of electric carmaker Tesla and private space exploration company SpaceX.
Last month Geely drew comparisons with Volkswagen when Mr Li’s holding group announced plans to merge Geely Automobile and Volvo Cars, moving the company towards becoming the first global Chinese carmaker.
Che Jun, Communist party boss of China’s eastern Zhejiang province, where Geely is based, said that the complex would be built in Taizhou city and that construction had begun.
The centre will design, test and manufacture low-orbit communication satellites, purpose-built to improve geolocation of vehicles and to support their connected functions, Geely said.
Geely has been pouring money into new technologies from self-driving cars to flying taxis, spending Rmb20bn on research and development in the past year.
The investments are part of the group’s spend on global expansion, such as buying a $9bn stake in Daimler.
The announcement comes as the coronavirus outbre.
Much of the focus in network security centers upon measures in preve.docxhelzerpatrina
Network security focuses on preventing intrusions and handling security events, but there is debate around proactive measures an organization should take. Practical proactive measures could include monitoring for suspicious activity and strengthening access controls. Biblical principles suggest taking reasonable precautions against probable threats, though excessive measures may violate ethics of non-aggression or forgiveness.
Mt. Baker Hazards Hazard Rating Score High silic.docxhelzerpatrina
Mt. Baker
Hazards
Hazard Rating Score
High silica content of eruptive products, >60% (andesite/dacite/rhyolite)
Major explosive activity within last 500 years
Major explosive activity within last 5000 years
Pyroclastic flows within last 500 years
Mudflows (lahars) within the last 500 years
Destructive tsunami within last 500 years
Occurrence of frequent volcano-seismic crises (volcanic earthquake swarms)
Occurrence of significant ground deformation within last 50 years
SCORE
Risk
Risk Rating Score
Population at risk >100
Population at risk >1,000
Population at risk >10,000
Population at risk >100,000
Population at risk >1,000,000
Historical fatalities
Evacuation as a result of historical eruption(s)
SCORE
TOTAL SCORE ___________
For each of the above queries to which the answer is yes, score 1. For an answer of no, score 0.
If no information is found, assume the answer is no and score 0.
Mt. Hood
Hazards
Hazard Rating Score
High silica content of eruptive products, >60% (andesite/dacite/rhyolite)
Major explosive activity within last 500 years
Major explosive activity within last 5000 years
Pyroclastic flows within last 500 years
Mudflows (lahars) within the last 500 years
Destructive tsunami within last 500 years
Occurrence of frequent volcano-seismic crises (volcanic earthquake swarms)
Occurrence of significant ground deformation within last 50 years
SCORE
Risk
Risk Rating Score
Population at risk >100
Population at risk >1,000
Population at risk >10,000
Population at risk >100,000
Population at risk >1,000,000
Historical fatalities
Evacuation as a result of historical eruption(s)
SCORE
TOTAL SCORE ___________
For each of the above queries to which the answer is yes, score 1. For an answer of no, score 0.
If no information is found, assume the answer is no and score 0.
Mt. Rainier
Hazards
Hazard Rating Score
High silica content of eruptive products, >60% (andesite/dacite/rhyolite)
Major explosive activity within last 500 years
Major explosive activity within last 5000 years
Pyroclastic flows within last 500 years
Mudflows (lahars) within the last 500 years
Destructive tsunami within last 500 years
Occurrence of frequent volcano-seismic crises (volcanic earthquake swarms)
Occurrence of significant ground deformation within last 50 years
SCORE
Risk
Risk Rating Score
Population at risk >100
Population at risk >1,000
Population at risk >10,000
Population at risk >100,000
Population at risk >1,000,000
Historical fatalities
Evacuation as a result of historical eruption(s)
SCORE
TOTAL SCORE ___________
For each of the above queries to which the answer is yes, score 1. For an answer of no, score 0.
If no information is found, assume the answer is no and score 0.
Mt. St. Helens
Hazards
Hazard Rating Score
High.
Motivation and Cognitive FactorsQuestion AAlfred Hit.docxhelzerpatrina
Motivation and Cognitive Factors
Question A
Alfred Hitchcock reputedly said, “When an actor comes to me and wants to discuss his character, I say, “It’s in the script.” If he says, “But what’s my motivation,” I say, “Your salary.” Discuss motivation based on extrinsic rewards in comparison to that motivated by intrinsic rewards. Are different types of motivations preferable for different tasks? Remember to explain and cite educational sources to support the ideas within the post.
Question B
Social cognitive theory suggests that our beliefs and feelings influence our behavior. What beliefs (cognitive factors) might be related to the specific behavior of going to college? Remember to explain and cite educational sources to support the ideas within the post.
OR
Select one of the personality tests from
Similar Minds
. Take the test, read your results and reproduce them in your journal. What parts of the results ring true to you? What do not? Remember to explain and cite educational sources to support the ideas within the post.
View your discussion
rubric
.
13
.
Motivation in OrganizationsMotivation i.docxhelzerpatrina
Motivation in Organizations
*
Motivation in Organizations
Chapter 7
Chapter 7 Preview:
Motivation in OrganizationsWhat do individuals need to do to meet a personal goal? What are the most important sources of work motivation (e.g., money? recognition? other?)What do you think makes for effective goal-setting? What happens when people feel that they are underpaid compared to their peers? What do people need to believe about a possible reward, in order for it to be motivating?
Components of motivation: What are the basic components of motivation? Page Ref: 214
Motivation: What motivates people to work? What are the most important sources of work motivation? Page Ref: 215
Guidelines for setting effective performance goals: What are they? Page Ref: 220-223
Equity Theory: What are some possible reactions to inequity? Page Ref: 226-227
Expectancy Theory: What are the three types of beliefs that people have, and what do they mean? Page Ref: 230
Copyright
Learning ObjectivesDefine motivation and explain its importance in the field of organizational behavior.Identify and explain the conditions through which goal setting can be used to improve job performance.
Learning ObjectivesDescribe equity theory and how it may be applied to motivating people in organizations.Describe expectancy theory and how it may be applied in organizations.
*
Today’s AgendaMotivationGoal SettingEquity TheoryExpectancy Theory
*
Today’s AgendaMotivationGoal SettingEquity TheoryExpectancy Theory
*
The set of processes thatarousedirect, and maintain
human behavior toward attaining some goal
Motivation
*
Motivation Components
*
Motivation
Key PointsMotivation and job performance are not synonymousMotivation is multifacetedPeople are motivated by more than just money
*
What Motivates You to Work?
*
What Motivates People to Work?
*
Today’s AgendaMotivationGoal SettingEquity TheoryExpectancy Theory
*
Goal Setting
*
Goal Setting
Do you have goals?Have you been successful in meeting them?What do you think are important characteristics of attainable goals?How does it make you feel to achieve goals?
*
Goal Setting Guidelines
For ManagersAssign specific goalsAssign difficult, but acceptable, performance goalsstretch goalsProvide feedback on goal attainment
*
Today’s AgendaMotivationGoal SettingEquity TheoryExpectancy Theory
*
Equity TheoryPeople strive to maintain ratios of their own outcomes (rewards) to their own inputs (contributions) that are equal to the outcome / input ratios of others with whom they compare themselves
*
Equity Theory
Possible Reactions to Inequity
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Equity Theory
Managerial ImplicationsAvoid underpaymentAvoid overpaymentBe honest and open with employees
*
Equity Theory
Pay Practices in the NewsPay Practices at Reddit, Google and Gravity Payments
*
Equity Theory
Pay Practices in the NewsQuestions to co.
Motivations to Support Charity-Linked Events After Exposure to.docxhelzerpatrina
Motivations to Support Charity-Linked Events After Exposure to
Facebook Appeals: Emotional Cause Identification and Distinct
Self-Determined Regulations
Kaspar Schattke
Université du Québec à Montréal
Ronald Ferguson and Michèle Paulin
Concordia University
Nonprofit organizations are increasingly dependent on the involvement of Millennial
constituencies. Three studies investigated their motivations to support charity-linked
events: emotional identification with a cause, self-determination theory (SDT) regula-
tions, and context-related Facebook promotions. This article addresses the recent call to
expand SDT research from a simple analysis of autonomous versus controlled moti-
vation, to studying the effects of all the regulations in the SDT continuum, in particular,
the inclusion of the tripartite dimensions of intrinsic motivation and integrated moti-
vation. Results demonstrated that the greater the emotional identification with the
cause, the stronger was the tendency to support the charity-linked event. Also, the
results in these social media contexts revealed that specific intrinsic dimensions (e.g.,
experience stimulation) are motivators of online and offline support, as is the personal
value nature of integrated regulation. Whereas only autonomous motivational regula-
tions predicted support for the two events organized specifically a for charitable causes,
both autonomous and controlled regulations predicted support of a for-profit event
organized with a charitable cause as an adjunct. These findings can assist practitioners
in designing more effective social media communications in support of charity-linked
events.
Keywords: social media, self-determination theory, integrated regulation, tripartite
model of intrinsic motivation, charitable causes
Supplemental materials: http://dx.doi.org/10.1037/mot0000085.supp
Social media is a new domain offering excit-
ing opportunities to investigate research ques-
tions in social psychology (Greitemeyer, 2011;
Kende, Ujhelyi, Joinson, & Greitemeyer, 2015).
Our research examined motivation to support
charity-linked events of nonprofit organizations
that are currently faced with increased compe-
tition for resources and declining government
support (Paulin, Ferguson, Jost, & Fallu, 2014;
Reed, Aquino, & Levy, 2007; White & Peloza,
2009). Presently, they depend on an ageing set
of traditional supporters (Urbain, Gonzalez, &
Le Gall-Ely, 2013). However, their future suc-
cess lies in ensuring the sustainable involve-
ment of the Millennial generation (Fine, 2009),
distinguished from other generations by their
intense exposure at an early age to interactive
technology and social media (Bolton et al.,
2013).
Facebook, the most detailed social media, is
used primarily to maintain or solidify existing
offline relationships allowing people to develop
a public or semipublic profile and to emotion-
ally participate with those whom they can share
This article was published Online First December .
Mrs. Walsh, a woman in her 70s, was in critical condition after.docxhelzerpatrina
“Mrs. Walsh, a woman in her 70s, was in critical condition after repeat coronary artery bypass graft (CABG) surgery. Her family lived nearby when Mrs. Walsh had her first CABG surgery. They had moved out of town but returned to our institution, where the first surgery had been performed successfully. Mrs. Walsh remained critically ill and unstable for several weeks before her death. Her family was very anxious because of Mrs. Walsh’s unstable and deteriorating condition, and a family member was always with her 24 hours a day for the first few weeks.
The nurse became involved with this family while Mrs. Walsh was still in surgery, because family members were very anxious that the procedure was taking longer than it had the first time and made repeated calls to the critical care unit to ask about the patient. The nurse met with the family and offered to go into the operating room to talk with the cardiac surgeon to better inform the family of their mother’s status.
· One of the helpful things the nurse did to assist this family was to establish a consistent group of nurses to work with Mrs. Walsh, so that family members could establish trust and feel more confident about the care their mother was receiving. This eventually enabled family members to leave the hospital for intervals to get some rest. The nurse related that this was a family whose members were affluent, educated, and well informed, and that they came in prepared with lists of questions. A consistent group of nurses who were familiar with Mrs. Walsh’s particular situation helped both family members and nurses to be more satisfied and less anxious. The family developed a close relationship with the three nurses who consistently cared for Mrs. Walsh and shared with them details about Mrs. Walsh and her life.
· The nurse related that there was a tradition in this particular critical care unit not to involve family members in care. She broke that tradition when she responded to the son’s and the daughter’s helpless feelings by teaching them some simple things that they could do for their mother. They learned to give some basic care, such as bathing her. The nurse acknowledged that involving family members in direct patient care with a critically ill patient is complex and requires knowledge and sensitivity. She believes that a developmental process is involved when nurses learn to work with families.
· She noted that after a nurse has lots of experience and feels very comfortable with highly technical skills, it becomes okay for family members to be in the room when care is provided. She pointed out that direct observation by anxious family members can be disconcerting to those who are insecure with their skills when family members ask things like, “Why are you doing this? Nurse ‘So and So’ does it differently.” She commented that nurses learn to be flexible and to reset priorities. They should be able to let some things wait that do not need to be done right away to give the famil.
MOVIE TITLE IS LIAR LIAR starring JIM CARREYProvide the name o.docxhelzerpatrina
MOVIE TITLE IS LIAR LIAR starring JIM CARREY
Provide the name of the movie, television series, or streaming series you chose, including a summary of the content, and explain why you selected it.
What are your impressions of the environments (include graphic elements)?
Pay attention to the relationships and communication occurring in the movie. How are people greeting each other? How are people interacting? Do you think you can tell the relationships of the people based on their verbal and nonverbal behaviors? Why or why not?
What are the cultural verbal cues that you notice in the movie?
What are the cultural nonverbal cues that you notice in the movie?
Describe two of the characters' use of language including word arrangement, word choice, and intended meaning.
Summarize how your content choice provided sufficient detail allowing you to describe the roles of verbal and nonverbal elements in communication and how the two forms of communication work in conjunction.
.
mple selection, and assignment to groups (as applicable). Describe.docxhelzerpatrina
The document outlines the process and procedures for a research project. It discusses obtaining informed consent from participants, analyzing demographic and other collected data through descriptive statistics, and addressing each research question or PICOT question through specific inferential statistics. It also covers ensuring the data meets assumptions for the statistics used and setting an alpha level. Finally, it addresses considering and dealing with any ethical issues regarding methodology, design, data collection, anonymity, confidentiality, informed consent, and conflicts of interest in line with the Belmont Report.
More and more businesses have integrated social media into every asp.docxhelzerpatrina
More and more businesses have integrated social media into every aspect of their communication strategies and there are many recent examples of employees being fired from their jobs for personal social media postings. Discuss the benefits and pitfalls of using social media within businesses and if you think it is ethical for business to fire employees for personal use of social media. How can you monitor and control your own social media activities to prevent such a professional conflict?
.
Module Five Directions for the ComparisonContrast EssayWrite a.docxhelzerpatrina
The document provides directions for writing a five paragraph comparison/contrast essay on NASA's past Apollo missions to the Moon and planned future missions to Mars. Students are asked to use MLA style with sources cited and include photos/illustrations to document the similarities and differences between the two missions. NASA.gov is listed as a primary source for quotations and the works cited page, along with other sources from the library databases or Google. A sample outline is provided with an introduction, paragraphs on similarities/differences, and a conclusion.
Monica asked that we meet to see if I could help to reduce the d.docxhelzerpatrina
Monica asked that we meet to see if I could help to reduce the differences between them. When the time came, she started the conversation by saying that Richard wasn’t saving any money at all. They hadn’t started implementing. She said he spent a good deal of time buy- ing and selling stocks. He seemed to be influenced by the weekly ups and downs of the market. At least temporarily, however, he had raised the quality of the stocks he was buying.
Richard seemed a little annoyed and said that Monica never wanted to sell any securities. She almost always told him to wait. She said the shares would come back. When I asked what money meant to them, Richard said an opportunity to gamble and Monica replied a chance to lose what you’ve accumulated. As far as their long-term goals were concerned, Richard said he had no real long-term goals. The future was too fickle. He said who knew what fate had in store for them. Monica’s goal was to feel secure. I had the feeling that her remark was in response to Richard’s behavior. She wouldn’t allow herself to think of anything beyond security until Richard’s activities could be controlled.
Case Application Questions
1. What should be done about Richard’s spending?
2. What kind of investment behavior is Richard demonstrating?What can be done about it? 3. What is Monica’s investment behavior called? How can it be helped?
4. Contrast their two views of money. Do you have any recommendations?
5. How can Monica’s fears be dealt with?
.
Module 6 AssignmentPlease list and describe four types of Cy.docxhelzerpatrina
Module 6 Assignment
Please list and describe four types of Cyber crime.
Rubric for Assignment submission
Criterion
Description
Points possible
Content
Student posts and describes four types of Cyber crimes
40
Word count
500 words
10
Total Points possible
50
.
THE SACRIFICE HOW PRO-PALESTINE PROTESTS STUDENTS ARE SACRIFICING TO CHANGE T...indexPub
The recent surge in pro-Palestine student activism has prompted significant responses from universities, ranging from negotiations and divestment commitments to increased transparency about investments in companies supporting the war on Gaza. This activism has led to the cessation of student encampments but also highlighted the substantial sacrifices made by students, including academic disruptions and personal risks. The primary drivers of these protests are poor university administration, lack of transparency, and inadequate communication between officials and students. This study examines the profound emotional, psychological, and professional impacts on students engaged in pro-Palestine protests, focusing on Generation Z's (Gen-Z) activism dynamics. This paper explores the significant sacrifices made by these students and even the professors supporting the pro-Palestine movement, with a focus on recent global movements. Through an in-depth analysis of printed and electronic media, the study examines the impacts of these sacrifices on the academic and personal lives of those involved. The paper highlights examples from various universities, demonstrating student activism's long-term and short-term effects, including disciplinary actions, social backlash, and career implications. The researchers also explore the broader implications of student sacrifices. The findings reveal that these sacrifices are driven by a profound commitment to justice and human rights, and are influenced by the increasing availability of information, peer interactions, and personal convictions. The study also discusses the broader implications of this activism, comparing it to historical precedents and assessing its potential to influence policy and public opinion. The emotional and psychological toll on student activists is significant, but their sense of purpose and community support mitigates some of these challenges. However, the researchers call for acknowledging the broader Impact of these sacrifices on the future global movement of FreePalestine.
Most patients with mental health disorders are not aggressive. H.docxhelzerpatrina
Most patients with mental health disorders are not aggressive. However, it is important for nurses to be able to know the signs and symptoms associated with the five phases of aggression, and to appropriately apply nursing interventions to assist in treating aggressive patients. Please read the case study below and answer the four questions related to it.
Aggression Case Study
Christopher, who is 14 years of age, was recently admitted to the hospital for schizophrenia. He has a history of aggressive behavior and states that the devil is telling him to kill all adults because they want to hurt him. Christopher has a history of recidivism and noncompliance with his medications. One day on the unit, the nurse observes Christopher displaying hypervigilant behaviors, pacing back and forth down the hallway, and speaking to himself under his breath. As the nurse runs over to Christopher to talk, he sees that his bedroom door is open and runs into his room and shuts the door. The nurse responds by attempting to open the door, but Christopher keeps pulling the door shut and tells the nurse that if the nurse comes in the room he will choke the nurse. The nurse responds by calling other staff to assist with the situation.
1. What phase of the aggression cycle is Christopher in at the beginning of this scenario? What phase is he in at the end the scenario? (State the evidence that supports your answers).
2. What interventions could have been implemented to prevent Christopher from escalating at the beginning of the scenario?
3. What interventions should the nurse take to deescalate the situation when Christopher is refusing to open his door?
4. If a restrictive intervention (restraint/seclusion) is used, what are some important steps for the nurse to remember?
.
MotivationExplain your motivation for applying to this prog.docxhelzerpatrina
Motivation:
Explain your motivation for applying to this program. How does the content of this study abroad program relate to your future academic and professional goals?
Goals(REQUIRED)
List and explain three concrete goals related to living and studying abroad that you will set for yourself to get the most out of this opportunity.
.
Most public policy is made from within government agencies. Select a.docxhelzerpatrina
Most public policy is made from within government agencies. Select an agency to review for this assignment:
1) Go to
https://www.usa.gov
to begin your search.
2) Next, click on the menu tab labelled “Government Agencies and Elected Officials.”
3) Then, click on “A-Z Index of U.S. Government Agencies.”
4) Select one of the large federal agencies, and review one of its major policies, laws, or regulations.
What is the primary mission of the agency? Select a problem that the agency is attempting to solve. Research the major policy process as it has evolved and identify its major stakeholders. Identify what major factors have contributed to policy ineffectiveness. Is the bureaucracy now too large to provide adequate oversight and future development? Be sure to integrate lessons learned and policy concepts discussed throughout the class. Examples may include security at airports, immigration, education (No Child Left Behind), welfare support, Social Security, health care, etc. Identify government subsidies, tools, and regulations the agency uses to meet its policy goals. Pinpoint supporting agencies, groups, or businesses that would be most interested in these policies, and describe the potential conflicts of interest.
Your APA style paper should be three pages in length, not counting the title and reference pages. Provide at least three peer-reviewed or professional references. Be sure your paper is double-spaced and uses 12-point font and one-inch margins. Use your own words, and include citations and references as needed to avoid plagiarism. All sources used must be referenced; paraphrased and quoted material must have accompanying citations and be cited per APA guidelines.
.
Mr. Smith brings his 4-year-old son to your primary care office. He .docxhelzerpatrina
Mr. Smith brings his 4-year-old son to your primary care office. He states the boy has been ill for three days. Mr. Smith indicates that he would like antibiotics so he can send his son back to pre-school the next day.
History - Child began with sneezing, mild cough, and low grade fever of 100 degrees three days ago. All immunizations UTD. Father reports that the child has had only two incidents of URI and no other illnesses.
Social - non-smoking household. Child attends preschool four mornings a week and is insured through his father’s employment. No other siblings in the household.
PE/ROS -T 99, R 20, P 100. Alert, cooperative, in good spirits, well-hydrated. Mildly erythemic throat, no exudate, tonsils +2. Both ears mild pink tympanic membrane with good movement. Lungs clear bilaterally. All other systems WNL.
Do not consider COVID-19 for this patient diagnosis.
.
Mrs. Walsh, a woman in her 70s, was in critical condition after rep.docxhelzerpatrina
“Mrs. Walsh, a woman in her 70s, was in critical condition after repeat coronary artery bypass graft (CABG) surgery. Her family lived nearby when Mrs. Walsh had her first CABG surgery. They had moved out of town but returned to our institution, where the first surgery had been performed successfully. Mrs. Walsh remained critically ill and unstable for several weeks before her death. Her family was very anxious because of Mrs. Walsh’s unstable and deteriorating condition, and a family member was always with her 24 hours a day for the first few weeks.
The nurse became involved with this family while Mrs. Walsh was still in surgery, because family members were very anxious that the procedure was taking longer than it had the first time and made repeated calls to the critical care unit to ask about the patient. The nurse met with the family and offered to go into the operating room to talk with the cardiac surgeon to better inform the family of their mother’s status.
One of the helpful things the nurse did to assist this family was to establish a consistent group of nurses to work with Mrs. Walsh, so that family members could establish trust and feel more confident about the care their mother was receiving. This eventually enabled family members to leave the hospital for intervals to get some rest. The nurse related that this was a family whose members were affluent, educated, and well informed, and that they came in prepared with lists of questions. A consistent group of nurses who were familiar with Mrs. Walsh’s particular situation helped both family members and nurses to be more satisfied and less anxious. The family developed a close relationship with the three nurses who consistently cared for Mrs. Walsh and shared with them details about Mrs. Walsh and her life.
The nurse related that there was a tradition in this particular critical care unit not to involve family members in care. She broke that tradition when she responded to the son’s and the daughter’s helpless feelings by teaching them some simple things that they could do for their mother. They learned to give some basic care, such as bathing her. The nurse acknowledged that involving family members in direct patient care with a critically ill patient is complex and requires knowledge and sensitivity. She believes that a developmental process is involved when nurses learn to work with families.
She noted that after a nurse has lots of experience and feels very comfortable with highly technical skills, it becomes okay for family members to be in the room when care is provided. She pointed out that direct observation by anxious family members can be disconcerting to those who are insecure with their skills when family members ask things like, “Why are you doing this? Nurse ‘So and So’ does it differently.” She commented that nurses learn to be flexible and to reset priorities. They should be able to let some things wait that do not need to be done right away to give the family some.
Much has been made of the new Web 2.0 phenomenon, including social n.docxhelzerpatrina
Much has been made of the new Web 2.0 phenomenon, including social networking sites and user-created mash-ups. How does Web 2.0 change security for the Internet? Your submission should be between 500 words with references and following APA reference style. Please do not include a title page
.
MSN 5550 Health Promotion Prevention of Disease Case Study Module 2.docxhelzerpatrina
MSN 5550 Health Promotion: Prevention of Disease Case Study Module 2 Instructions: Read the following case study and answer the reflective questions.
Please provide rationales for your answers. Make sure to provide a citation for your answers. Deadline: CASE STUDY:
An Older Immigrant Couple: Mr. and Mrs. Arahan Mr. and Mrs. Arahan, an older couple in their seventies, have been living with their oldest daughter, her husband of 15 years, and their two children, ages 12 and 14. They all live in a middle-income neighborhood in a suburb of a metropolitan city. Mr. and Mrs. Arahan are both college educated and worked full-time while they were in their native country. In addition, Mr. Arahan, the only offspring of wealthy parents, inherited a substantial amount of money and real estate. Their daughter came to the United States as a registered nurse and met her husband, a drug company representative. The older couple moved to the United States when their daughter became a U.S. citizen and petitioned them as immigrants. Since the couple was facing retirement, they welcomed the opportunity to come to the United States. The Arahans found life in the United States different from that in their home country, but their adjustment was not as difficult because both were healthy and spoke English fluently. Most of their time was spent taking care of their two grandchildren and the house. As the grandchildren grew older, the older couple found that they had more spare time. The daughter and her husband advanced in their careers and spent a great deal more time at their jobs. There were few family dinners during the week. On weekends, the daughter, her husband, and their children socialized with their own friends. The couple began to feel isolated and longed for a more active life. Mr. and Mrs. Arahan began to think that perhaps they should return to the home country, where they still had relatives and friends. However, political and economic issues would have made it difficult for them to live there. Besides, they had become accustomed to the way of life in the United States with all the modern conveniences and abundance of goods that were difficult to obtain in their country. However, they also became concerned that they might not be able to tolerate the winter months and that minor health problems might worsen as they aged. They wondered who would take care of them if they became very frail and where they would live, knowing that their daughter had only saved money for their grandchildren’s college education. They expressed their sentiments to their daughter, who became very concerned about how her parents were feeling. This older couple had been attending church on a regular basis, but had never been active in other church-related activities. The church bulletin announced the establishment of parish nursing with two retired registered nurses as volunteers. The couple attended the first opening of the parish clinic. Here, they met one of the registered nur.
MSEL Strategy Mid-term Instructions Miguel Rivera-SantosFormat.docxhelzerpatrina
MSEL Strategy Mid-term Instructions Miguel Rivera-Santos
Format of the Mid-term
· You will find three recent newspaper articles describing a strategic move or a strategic decision in this document. Choose two out of these three articles and, for each of the two articles you have selected, answer the following two questions:
· Q1: What is (are) the issue(s) for the main company in the article? How do you assess the company’s strategic decision(s)? What additional information and what specific analyses would you conduct to fully understand the issue(s) and the decision(s)?
· Q2: What alternative recommendation would you consider in response to the issue(s)? What additional information/analyses would you need for this alternative recommendation? How could it be implemented?
· For each article, the combined answers to these two questions should be no longer than 2 single-spaced pages, in 12-point Times New Roman, with a 1-inch margin all around.
You can add as many appendices as you feel necessary, but remember that the page limitfor the mid-term (excluding exhibits) is 4 pages, i.e., 2 pages per newspaper article.
· You do not need to seek additional information beyond what is provided in the articles.
GOOD LUCK!
Geely to build satellites for self-driving cars - Financial Times (US), 3/4... https://digital.olivesoftware.com/Olive/ODN/FTUS/PrintArticle.aspx?d...
Automobiles
CHRISTIAN SHEPHERD — BEIJING
Geely is aiming to be the first China carmaker to design and build satellites to support its autonomous driving programme, the latest step by founder Li Shufu in his bid to build an industry leader.
Geely, which owns Swedish brand Volvo Cars, Malaysia’s Proton, and a stake in Mercedes-Benz owner Daimler, will invest Rmb2.27bn ($325m) in a new development centre and factory to manufacture satellites this year, the company said yesterday.
The announcement makes Geely the first known Chinese carmaker with plans to build its own satellites. Mr Li’s move sparked comparisons in China media with Elon Musk, founder of electric carmaker Tesla and private space exploration company SpaceX.
Last month Geely drew comparisons with Volkswagen when Mr Li’s holding group announced plans to merge Geely Automobile and Volvo Cars, moving the company towards becoming the first global Chinese carmaker.
Che Jun, Communist party boss of China’s eastern Zhejiang province, where Geely is based, said that the complex would be built in Taizhou city and that construction had begun.
The centre will design, test and manufacture low-orbit communication satellites, purpose-built to improve geolocation of vehicles and to support their connected functions, Geely said.
Geely has been pouring money into new technologies from self-driving cars to flying taxis, spending Rmb20bn on research and development in the past year.
The investments are part of the group’s spend on global expansion, such as buying a $9bn stake in Daimler.
The announcement comes as the coronavirus outbre.
Much of the focus in network security centers upon measures in preve.docxhelzerpatrina
Network security focuses on preventing intrusions and handling security events, but there is debate around proactive measures an organization should take. Practical proactive measures could include monitoring for suspicious activity and strengthening access controls. Biblical principles suggest taking reasonable precautions against probable threats, though excessive measures may violate ethics of non-aggression or forgiveness.
Mt. Baker Hazards Hazard Rating Score High silic.docxhelzerpatrina
Mt. Baker
Hazards
Hazard Rating Score
High silica content of eruptive products, >60% (andesite/dacite/rhyolite)
Major explosive activity within last 500 years
Major explosive activity within last 5000 years
Pyroclastic flows within last 500 years
Mudflows (lahars) within the last 500 years
Destructive tsunami within last 500 years
Occurrence of frequent volcano-seismic crises (volcanic earthquake swarms)
Occurrence of significant ground deformation within last 50 years
SCORE
Risk
Risk Rating Score
Population at risk >100
Population at risk >1,000
Population at risk >10,000
Population at risk >100,000
Population at risk >1,000,000
Historical fatalities
Evacuation as a result of historical eruption(s)
SCORE
TOTAL SCORE ___________
For each of the above queries to which the answer is yes, score 1. For an answer of no, score 0.
If no information is found, assume the answer is no and score 0.
Mt. Hood
Hazards
Hazard Rating Score
High silica content of eruptive products, >60% (andesite/dacite/rhyolite)
Major explosive activity within last 500 years
Major explosive activity within last 5000 years
Pyroclastic flows within last 500 years
Mudflows (lahars) within the last 500 years
Destructive tsunami within last 500 years
Occurrence of frequent volcano-seismic crises (volcanic earthquake swarms)
Occurrence of significant ground deformation within last 50 years
SCORE
Risk
Risk Rating Score
Population at risk >100
Population at risk >1,000
Population at risk >10,000
Population at risk >100,000
Population at risk >1,000,000
Historical fatalities
Evacuation as a result of historical eruption(s)
SCORE
TOTAL SCORE ___________
For each of the above queries to which the answer is yes, score 1. For an answer of no, score 0.
If no information is found, assume the answer is no and score 0.
Mt. Rainier
Hazards
Hazard Rating Score
High silica content of eruptive products, >60% (andesite/dacite/rhyolite)
Major explosive activity within last 500 years
Major explosive activity within last 5000 years
Pyroclastic flows within last 500 years
Mudflows (lahars) within the last 500 years
Destructive tsunami within last 500 years
Occurrence of frequent volcano-seismic crises (volcanic earthquake swarms)
Occurrence of significant ground deformation within last 50 years
SCORE
Risk
Risk Rating Score
Population at risk >100
Population at risk >1,000
Population at risk >10,000
Population at risk >100,000
Population at risk >1,000,000
Historical fatalities
Evacuation as a result of historical eruption(s)
SCORE
TOTAL SCORE ___________
For each of the above queries to which the answer is yes, score 1. For an answer of no, score 0.
If no information is found, assume the answer is no and score 0.
Mt. St. Helens
Hazards
Hazard Rating Score
High.
Motivation and Cognitive FactorsQuestion AAlfred Hit.docxhelzerpatrina
Motivation and Cognitive Factors
Question A
Alfred Hitchcock reputedly said, “When an actor comes to me and wants to discuss his character, I say, “It’s in the script.” If he says, “But what’s my motivation,” I say, “Your salary.” Discuss motivation based on extrinsic rewards in comparison to that motivated by intrinsic rewards. Are different types of motivations preferable for different tasks? Remember to explain and cite educational sources to support the ideas within the post.
Question B
Social cognitive theory suggests that our beliefs and feelings influence our behavior. What beliefs (cognitive factors) might be related to the specific behavior of going to college? Remember to explain and cite educational sources to support the ideas within the post.
OR
Select one of the personality tests from
Similar Minds
. Take the test, read your results and reproduce them in your journal. What parts of the results ring true to you? What do not? Remember to explain and cite educational sources to support the ideas within the post.
View your discussion
rubric
.
13
.
Motivation in OrganizationsMotivation i.docxhelzerpatrina
Motivation in Organizations
*
Motivation in Organizations
Chapter 7
Chapter 7 Preview:
Motivation in OrganizationsWhat do individuals need to do to meet a personal goal? What are the most important sources of work motivation (e.g., money? recognition? other?)What do you think makes for effective goal-setting? What happens when people feel that they are underpaid compared to their peers? What do people need to believe about a possible reward, in order for it to be motivating?
Components of motivation: What are the basic components of motivation? Page Ref: 214
Motivation: What motivates people to work? What are the most important sources of work motivation? Page Ref: 215
Guidelines for setting effective performance goals: What are they? Page Ref: 220-223
Equity Theory: What are some possible reactions to inequity? Page Ref: 226-227
Expectancy Theory: What are the three types of beliefs that people have, and what do they mean? Page Ref: 230
Copyright
Learning ObjectivesDefine motivation and explain its importance in the field of organizational behavior.Identify and explain the conditions through which goal setting can be used to improve job performance.
Learning ObjectivesDescribe equity theory and how it may be applied to motivating people in organizations.Describe expectancy theory and how it may be applied in organizations.
*
Today’s AgendaMotivationGoal SettingEquity TheoryExpectancy Theory
*
Today’s AgendaMotivationGoal SettingEquity TheoryExpectancy Theory
*
The set of processes thatarousedirect, and maintain
human behavior toward attaining some goal
Motivation
*
Motivation Components
*
Motivation
Key PointsMotivation and job performance are not synonymousMotivation is multifacetedPeople are motivated by more than just money
*
What Motivates You to Work?
*
What Motivates People to Work?
*
Today’s AgendaMotivationGoal SettingEquity TheoryExpectancy Theory
*
Goal Setting
*
Goal Setting
Do you have goals?Have you been successful in meeting them?What do you think are important characteristics of attainable goals?How does it make you feel to achieve goals?
*
Goal Setting Guidelines
For ManagersAssign specific goalsAssign difficult, but acceptable, performance goalsstretch goalsProvide feedback on goal attainment
*
Today’s AgendaMotivationGoal SettingEquity TheoryExpectancy Theory
*
Equity TheoryPeople strive to maintain ratios of their own outcomes (rewards) to their own inputs (contributions) that are equal to the outcome / input ratios of others with whom they compare themselves
*
Equity Theory
Possible Reactions to Inequity
*
Equity Theory
Managerial ImplicationsAvoid underpaymentAvoid overpaymentBe honest and open with employees
*
Equity Theory
Pay Practices in the NewsPay Practices at Reddit, Google and Gravity Payments
*
Equity Theory
Pay Practices in the NewsQuestions to co.
Motivations to Support Charity-Linked Events After Exposure to.docxhelzerpatrina
Motivations to Support Charity-Linked Events After Exposure to
Facebook Appeals: Emotional Cause Identification and Distinct
Self-Determined Regulations
Kaspar Schattke
Université du Québec à Montréal
Ronald Ferguson and Michèle Paulin
Concordia University
Nonprofit organizations are increasingly dependent on the involvement of Millennial
constituencies. Three studies investigated their motivations to support charity-linked
events: emotional identification with a cause, self-determination theory (SDT) regula-
tions, and context-related Facebook promotions. This article addresses the recent call to
expand SDT research from a simple analysis of autonomous versus controlled moti-
vation, to studying the effects of all the regulations in the SDT continuum, in particular,
the inclusion of the tripartite dimensions of intrinsic motivation and integrated moti-
vation. Results demonstrated that the greater the emotional identification with the
cause, the stronger was the tendency to support the charity-linked event. Also, the
results in these social media contexts revealed that specific intrinsic dimensions (e.g.,
experience stimulation) are motivators of online and offline support, as is the personal
value nature of integrated regulation. Whereas only autonomous motivational regula-
tions predicted support for the two events organized specifically a for charitable causes,
both autonomous and controlled regulations predicted support of a for-profit event
organized with a charitable cause as an adjunct. These findings can assist practitioners
in designing more effective social media communications in support of charity-linked
events.
Keywords: social media, self-determination theory, integrated regulation, tripartite
model of intrinsic motivation, charitable causes
Supplemental materials: http://dx.doi.org/10.1037/mot0000085.supp
Social media is a new domain offering excit-
ing opportunities to investigate research ques-
tions in social psychology (Greitemeyer, 2011;
Kende, Ujhelyi, Joinson, & Greitemeyer, 2015).
Our research examined motivation to support
charity-linked events of nonprofit organizations
that are currently faced with increased compe-
tition for resources and declining government
support (Paulin, Ferguson, Jost, & Fallu, 2014;
Reed, Aquino, & Levy, 2007; White & Peloza,
2009). Presently, they depend on an ageing set
of traditional supporters (Urbain, Gonzalez, &
Le Gall-Ely, 2013). However, their future suc-
cess lies in ensuring the sustainable involve-
ment of the Millennial generation (Fine, 2009),
distinguished from other generations by their
intense exposure at an early age to interactive
technology and social media (Bolton et al.,
2013).
Facebook, the most detailed social media, is
used primarily to maintain or solidify existing
offline relationships allowing people to develop
a public or semipublic profile and to emotion-
ally participate with those whom they can share
This article was published Online First December .
Mrs. Walsh, a woman in her 70s, was in critical condition after.docxhelzerpatrina
“Mrs. Walsh, a woman in her 70s, was in critical condition after repeat coronary artery bypass graft (CABG) surgery. Her family lived nearby when Mrs. Walsh had her first CABG surgery. They had moved out of town but returned to our institution, where the first surgery had been performed successfully. Mrs. Walsh remained critically ill and unstable for several weeks before her death. Her family was very anxious because of Mrs. Walsh’s unstable and deteriorating condition, and a family member was always with her 24 hours a day for the first few weeks.
The nurse became involved with this family while Mrs. Walsh was still in surgery, because family members were very anxious that the procedure was taking longer than it had the first time and made repeated calls to the critical care unit to ask about the patient. The nurse met with the family and offered to go into the operating room to talk with the cardiac surgeon to better inform the family of their mother’s status.
· One of the helpful things the nurse did to assist this family was to establish a consistent group of nurses to work with Mrs. Walsh, so that family members could establish trust and feel more confident about the care their mother was receiving. This eventually enabled family members to leave the hospital for intervals to get some rest. The nurse related that this was a family whose members were affluent, educated, and well informed, and that they came in prepared with lists of questions. A consistent group of nurses who were familiar with Mrs. Walsh’s particular situation helped both family members and nurses to be more satisfied and less anxious. The family developed a close relationship with the three nurses who consistently cared for Mrs. Walsh and shared with them details about Mrs. Walsh and her life.
· The nurse related that there was a tradition in this particular critical care unit not to involve family members in care. She broke that tradition when she responded to the son’s and the daughter’s helpless feelings by teaching them some simple things that they could do for their mother. They learned to give some basic care, such as bathing her. The nurse acknowledged that involving family members in direct patient care with a critically ill patient is complex and requires knowledge and sensitivity. She believes that a developmental process is involved when nurses learn to work with families.
· She noted that after a nurse has lots of experience and feels very comfortable with highly technical skills, it becomes okay for family members to be in the room when care is provided. She pointed out that direct observation by anxious family members can be disconcerting to those who are insecure with their skills when family members ask things like, “Why are you doing this? Nurse ‘So and So’ does it differently.” She commented that nurses learn to be flexible and to reset priorities. They should be able to let some things wait that do not need to be done right away to give the famil.
MOVIE TITLE IS LIAR LIAR starring JIM CARREYProvide the name o.docxhelzerpatrina
MOVIE TITLE IS LIAR LIAR starring JIM CARREY
Provide the name of the movie, television series, or streaming series you chose, including a summary of the content, and explain why you selected it.
What are your impressions of the environments (include graphic elements)?
Pay attention to the relationships and communication occurring in the movie. How are people greeting each other? How are people interacting? Do you think you can tell the relationships of the people based on their verbal and nonverbal behaviors? Why or why not?
What are the cultural verbal cues that you notice in the movie?
What are the cultural nonverbal cues that you notice in the movie?
Describe two of the characters' use of language including word arrangement, word choice, and intended meaning.
Summarize how your content choice provided sufficient detail allowing you to describe the roles of verbal and nonverbal elements in communication and how the two forms of communication work in conjunction.
.
mple selection, and assignment to groups (as applicable). Describe.docxhelzerpatrina
The document outlines the process and procedures for a research project. It discusses obtaining informed consent from participants, analyzing demographic and other collected data through descriptive statistics, and addressing each research question or PICOT question through specific inferential statistics. It also covers ensuring the data meets assumptions for the statistics used and setting an alpha level. Finally, it addresses considering and dealing with any ethical issues regarding methodology, design, data collection, anonymity, confidentiality, informed consent, and conflicts of interest in line with the Belmont Report.
More and more businesses have integrated social media into every asp.docxhelzerpatrina
More and more businesses have integrated social media into every aspect of their communication strategies and there are many recent examples of employees being fired from their jobs for personal social media postings. Discuss the benefits and pitfalls of using social media within businesses and if you think it is ethical for business to fire employees for personal use of social media. How can you monitor and control your own social media activities to prevent such a professional conflict?
.
Module Five Directions for the ComparisonContrast EssayWrite a.docxhelzerpatrina
The document provides directions for writing a five paragraph comparison/contrast essay on NASA's past Apollo missions to the Moon and planned future missions to Mars. Students are asked to use MLA style with sources cited and include photos/illustrations to document the similarities and differences between the two missions. NASA.gov is listed as a primary source for quotations and the works cited page, along with other sources from the library databases or Google. A sample outline is provided with an introduction, paragraphs on similarities/differences, and a conclusion.
Monica asked that we meet to see if I could help to reduce the d.docxhelzerpatrina
Monica asked that we meet to see if I could help to reduce the differences between them. When the time came, she started the conversation by saying that Richard wasn’t saving any money at all. They hadn’t started implementing. She said he spent a good deal of time buy- ing and selling stocks. He seemed to be influenced by the weekly ups and downs of the market. At least temporarily, however, he had raised the quality of the stocks he was buying.
Richard seemed a little annoyed and said that Monica never wanted to sell any securities. She almost always told him to wait. She said the shares would come back. When I asked what money meant to them, Richard said an opportunity to gamble and Monica replied a chance to lose what you’ve accumulated. As far as their long-term goals were concerned, Richard said he had no real long-term goals. The future was too fickle. He said who knew what fate had in store for them. Monica’s goal was to feel secure. I had the feeling that her remark was in response to Richard’s behavior. She wouldn’t allow herself to think of anything beyond security until Richard’s activities could be controlled.
Case Application Questions
1. What should be done about Richard’s spending?
2. What kind of investment behavior is Richard demonstrating?What can be done about it? 3. What is Monica’s investment behavior called? How can it be helped?
4. Contrast their two views of money. Do you have any recommendations?
5. How can Monica’s fears be dealt with?
.
Module 6 AssignmentPlease list and describe four types of Cy.docxhelzerpatrina
Module 6 Assignment
Please list and describe four types of Cyber crime.
Rubric for Assignment submission
Criterion
Description
Points possible
Content
Student posts and describes four types of Cyber crimes
40
Word count
500 words
10
Total Points possible
50
.
THE SACRIFICE HOW PRO-PALESTINE PROTESTS STUDENTS ARE SACRIFICING TO CHANGE T...indexPub
The recent surge in pro-Palestine student activism has prompted significant responses from universities, ranging from negotiations and divestment commitments to increased transparency about investments in companies supporting the war on Gaza. This activism has led to the cessation of student encampments but also highlighted the substantial sacrifices made by students, including academic disruptions and personal risks. The primary drivers of these protests are poor university administration, lack of transparency, and inadequate communication between officials and students. This study examines the profound emotional, psychological, and professional impacts on students engaged in pro-Palestine protests, focusing on Generation Z's (Gen-Z) activism dynamics. This paper explores the significant sacrifices made by these students and even the professors supporting the pro-Palestine movement, with a focus on recent global movements. Through an in-depth analysis of printed and electronic media, the study examines the impacts of these sacrifices on the academic and personal lives of those involved. The paper highlights examples from various universities, demonstrating student activism's long-term and short-term effects, including disciplinary actions, social backlash, and career implications. The researchers also explore the broader implications of student sacrifices. The findings reveal that these sacrifices are driven by a profound commitment to justice and human rights, and are influenced by the increasing availability of information, peer interactions, and personal convictions. The study also discusses the broader implications of this activism, comparing it to historical precedents and assessing its potential to influence policy and public opinion. The emotional and psychological toll on student activists is significant, but their sense of purpose and community support mitigates some of these challenges. However, the researchers call for acknowledging the broader Impact of these sacrifices on the future global movement of FreePalestine.
A Free 200-Page eBook ~ Brain and Mind Exercise.pptxOH TEIK BIN
(A Free eBook comprising 3 Sets of Presentation of a selection of Puzzles, Brain Teasers and Thinking Problems to exercise both the mind and the Right and Left Brain. To help keep the mind and brain fit and healthy. Good for both the young and old alike.
Answers are given for all the puzzles and problems.)
With Metta,
Bro. Oh Teik Bin 🙏🤓🤔🥰
How to Setup Default Value for a Field in Odoo 17Celine George
In Odoo, we can set a default value for a field during the creation of a record for a model. We have many methods in odoo for setting a default value to the field.
Information and Communication Technology in EducationMJDuyan
(𝐓𝐋𝐄 𝟏𝟎𝟎) (𝐋𝐞𝐬𝐬𝐨𝐧 2)-𝐏𝐫𝐞𝐥𝐢𝐦𝐬
𝐄𝐱𝐩𝐥𝐚𝐢𝐧 𝐭𝐡𝐞 𝐈𝐂𝐓 𝐢𝐧 𝐞𝐝𝐮𝐜𝐚𝐭𝐢𝐨𝐧:
Students will be able to explain the role and impact of Information and Communication Technology (ICT) in education. They will understand how ICT tools, such as computers, the internet, and educational software, enhance learning and teaching processes. By exploring various ICT applications, students will recognize how these technologies facilitate access to information, improve communication, support collaboration, and enable personalized learning experiences.
𝐃𝐢𝐬𝐜𝐮𝐬𝐬 𝐭𝐡𝐞 𝐫𝐞𝐥𝐢𝐚𝐛𝐥𝐞 𝐬𝐨𝐮𝐫𝐜𝐞𝐬 𝐨𝐧 𝐭𝐡𝐞 𝐢𝐧𝐭𝐞𝐫𝐧𝐞𝐭:
-Students will be able to discuss what constitutes reliable sources on the internet. They will learn to identify key characteristics of trustworthy information, such as credibility, accuracy, and authority. By examining different types of online sources, students will develop skills to evaluate the reliability of websites and content, ensuring they can distinguish between reputable information and misinformation.
How to Manage Reception Report in Odoo 17Celine George
A business may deal with both sales and purchases occasionally. They buy things from vendors and then sell them to their customers. Such dealings can be confusing at times. Because multiple clients may inquire about the same product at the same time, after purchasing those products, customers must be assigned to them. Odoo has a tool called Reception Report that can be used to complete this assignment. By enabling this, a reception report comes automatically after confirming a receipt, from which we can assign products to orders.
🔥🔥🔥🔥🔥🔥🔥🔥🔥
إضغ بين إيديكم من أقوى الملازم التي صممتها
ملزمة تشريح الجهاز الهيكلي (نظري 3)
💀💀💀💀💀💀💀💀💀💀
تتميز هذهِ الملزمة بعِدة مُميزات :
1- مُترجمة ترجمة تُناسب جميع المستويات
2- تحتوي على 78 رسم توضيحي لكل كلمة موجودة بالملزمة (لكل كلمة !!!!)
#فهم_ماكو_درخ
3- دقة الكتابة والصور عالية جداً جداً جداً
4- هُنالك بعض المعلومات تم توضيحها بشكل تفصيلي جداً (تُعتبر لدى الطالب أو الطالبة بإنها معلومات مُبهمة ومع ذلك تم توضيح هذهِ المعلومات المُبهمة بشكل تفصيلي جداً
5- الملزمة تشرح نفسها ب نفسها بس تكلك تعال اقراني
6- تحتوي الملزمة في اول سلايد على خارطة تتضمن جميع تفرُعات معلومات الجهاز الهيكلي المذكورة في هذهِ الملزمة
واخيراً هذهِ الملزمة حلالٌ عليكم وإتمنى منكم إن تدعولي بالخير والصحة والعافية فقط
كل التوفيق زملائي وزميلاتي ، زميلكم محمد الذهبي 💊💊
🔥🔥🔥🔥🔥🔥🔥🔥🔥
220711130082 Srabanti Bag Internet Resources For Natural Science
Week 5 Handout Content Analysis of Focus Groups 1 Resea.docx
1. Week 5 Handout: Content Analysis of Focus Groups 1
Research Question 1: What are the barriers in implementing
mental health services in the Asian
American community?
Research Design: Qualitative, Descriptive
Research Method: Focus groups
Patient Related Barriers
Social Stigma Associated with Mental Illness
“….but also a lot of my patients have a fear of going to
psychiatrists because of the social
stigma ….” and most of them have financial difficulty and have
to pay an additional fee
to pay for psychiatry. (DN, pg. 1)
Financial Difficulties
“….but also a lot of my patients have a fear of going to
psychiatrists …. and most of
2. them have financial difficulty and have to pay an additional fee
to pay for
psychiatry.” (DN, pg. 1)
Characteristics of the Asian patient
Mistrustful of mental health
“I found it easier sometimes to refer them to someone else
because a lot of times
I find that the Chinese patients are unwilling to open up or
trust.” (TPW, pg.
2)
“we have to see why Asians go to see a health care provider,
forget about
whether the mental health profession, or even a regular
clinician. Why does the
patient see the provider..is it because they have seen a chinese
herbalist and have
failed and have used their last efforts to see a western doctor,
that will put
tremendous expectations on this relationship, as opposed to
someone who
comes to see the doctor for the first time and has faith that the
Western
doctor.” (Anthony, pg. 7)
Don’t Ask for Assistance
“It is hard to get them ask for help and ….. “ (TPW, pg. 2)
3. Patient’s View of Mental Health Provider as Last Resort
“we have to see why Asians go to see a health care provider,
forget about whether the
mental health profession, or even a regular clinician. Why does
the patient see the
provider..is it because they have seen a chinese herbalist and
have failed and have
used their last efforts to see a western doctor, that will put
tremendous expectations on
this relationship, as opposed to someone who comes to see the
doctor for the first time
and has faith that the western doctor.” (Anthony, pg. 7)
Week 5 Handout: Content Analysis of Focus Groups 2
Service Provider Related Barriers
“Despite all the training I have found that working with Chinese
populations there are a lot of
barriers I am finding that it is not as easy working with them.”
(TPW, pg. 2)
“Pass the Buck theme”
I found it easier sometimes to refer them to someone else
because a lot of times I find that
the Chinese patients are unwilling to open up or trust. (TPW,
pg. 2)
4. Lack of training/skills/expertise
“….and I find that I struggle with my own skills and I am trying
to get some help in
being a better primary care provider and getting my skills more
fine tuned for the
population that I work with.” (TPW, pg. 2)
“On the Western provider side, we noticed that when a provider
is confronted with a
Western patient they are reluctant to enter areas because they
are not really sure if that
behavior is natural to that culture so that while they know
pathology on the one
hand they are not sure if what they are seeing is pathological. I
remember one indian
psychiatrist said that a schizophrenic in india is the same
schizophrenic in NY but you
know there are excuses sometimes and avoidance so educating
the general provider
concerning what really can be expected is very important.”
(MAC, pg. 8)
“My comment is very similar, there are very big knowledge
gaps for providers and
what providers bring to the situation…” (JK, pg. 8)
Cultural Assumptions
5. “well what you have to think about is other areas, our own
cultural biases. There are
certain things that I make assumptions on without even knowing
it just because of
what I know growing up or and I think these are areas we need
to address.”
(Ernesto, pg. 7)
Systems Barriers
Primary Care is the Access Point for Patients with Mental
Disorders
“….primary care as sort of the gatekeeper those are the guys
that are picking up
the symptoms and so I sort of see that this is a good project to
enhance our
understanding of this population.” (AN, pg. 2)
Changing Financial Systems
“Another issue is that there are financial issues that primary
physicians often see that
there is cost shifting going on that psychiatry or whomever else
is telling us to do this
new activity that is really shifting a responsibility” (LR, pg. 4)
6. Week 5 Handout: Content Analysis of Focus Groups 3
Changing of Responsibilities
“Another issue is that there are financial issues that primary
physicians often see that
there is cost shifting going on that psychiatry or whomever else
is telling us to do this
new activity that is really shifting a responsibility” (LR, pg. 4)
Professional Medical/Psychiatry Culture
Differing Cultures and Ideologies Within Medical Profession
“one major barrier is that there is a difference in physician
culture that an internalist
perceives a different way of treating a patient than a family care
doctor and the
pediatrician looks at it differently than an internalist and that
certain cultures when they
have certain specialty referral systems will feel differently
when they specialty referral
system is used less frequently, and we have found them being
treated much differently”
(LR, pg.4)
7. Miscellaneous
“we tend to forget that the mental health problems are a
spectrum, they may not be
necessarily psychosis or dementia, manic depression, they may
not be a DSM 4 diagnosis,
they may be life style related , they are a state of flux it is a
spectrum, when a women is having
infertility when a women loses a pregnancy when a women
delivers a baby and it is another girl
but she wanted a boy, or when she delivers a baby it is what she
wanted but the constraints, but
the burden is too much, so it can gyn issues it could be ob
issues but they are not dsm categories
and I think that a barrier is that we do not acknowledge the
existence of these kinds of things…”
(IH, pg. 6)
“The other big thing that I think of is the other side of the
spectrum which is when we do see
these patients and when we do have the luxuries of identifying
these issues that I have just
outlined that we try to squeezed these people into the diagnoses
that I just described so we
make it into an anxiety disorder or we make it into a depression
when it could be just life style
related or cultural related..” (IH, pg. 6)
Week 5 Handout: Content Analysis of Focus Groups 1
8. Research Question 1: What are the barriers in implementing
mental health services in the Asian
American community?
Research Design: Qualitative, Descriptive
Research Method: Focus groups
Patient Related Barriers
Social Stigma Associated with Mental Illness
“….but also a lot of my patients have a fear of going to
psychiatrists because of the social
stigma ….” and most of them have financial difficulty and have
to pay an additional fee
to pay for psychiatry. (DN, pg. 1)
Financial Difficulties
“….but also a lot of my patients have a fear of going to
psychiatrists …. and most of
them have financial difficulty and have to pay an additional fee
to pay for
psychiatry.” (DN, pg. 1)
9. Characteristics of the Asian patient
Mistrustful of mental health
“I found it easier sometimes to refer them to someone else
because a lot of times
I find that the Chinese patients are unwilling to open up or
trust.” (TPW, pg.
2)
“we have to see why Asians go to see a health care provider,
forget about
whether the mental health profession, or even a regular
clinician. Why does the
patient see the provider..is it because they have seen a chinese
herbalist and have
failed and have used their last efforts to see a western doctor,
that will put
tremendous expectations on this relationship, as opposed to
someone who
comes to see the doctor for the first time and has faith that the
Western
doctor.” (Anthony, pg. 7)
Don’t Ask for Assistance
“It is hard to get them ask for help and ….. “ (TPW, pg. 2)
Patient’s View of Mental Health Provider as Last Resort
“we have to see why Asians go to see a health care provider,
forget about whether the
10. mental health profession, or even a regular clinician. Why does
the patient see the
provider..is it because they have seen a chinese herbalist and
have failed and have
used their last efforts to see a western doctor, that will put
tremendous expectations on
this relationship, as opposed to someone who comes to see the
doctor for the first time
and has faith that the western doctor.” (Anthony, pg. 7)
Week 5 Handout: Content Analysis of Focus Groups 2
Service Provider Related Barriers
“Despite all the training I have found that working with Chinese
populations there are a lot of
barriers I am finding that it is not as easy working with them.”
(TPW, pg. 2)
“Pass the Buck theme”
I found it easier sometimes to refer them to someone else
because a lot of times I find that
the Chinese patients are unwilling to open up or trust. (TPW,
pg. 2)
Lack of training/skills/expertise
“….and I find that I struggle with my own skills and I am trying
to get some help in
11. being a better primary care provider and getting my skills more
fine tuned for the
population that I work with.” (TPW, pg. 2)
“On the Western provider side, we noticed that when a provider
is confronted with a
Western patient they are reluctant to enter areas because they
are not really sure if that
behavior is natural to that culture so that while they know
pathology on the one
hand they are not sure if what they are seeing is pathological. I
remember one indian
psychiatrist said that a schizophrenic in india is the same
schizophrenic in NY but you
know there are excuses sometimes and avoidance so educating
the general provider
concerning what really can be expected is very important.”
(MAC, pg. 8)
“My comment is very similar, there are very big knowledge
gaps for providers and
what providers bring to the situation…” (JK, pg. 8)
Cultural Assumptions
“well what you have to think about is other areas, our own
cultural biases. There are
certain things that I make assumptions on without even knowing
it just because of
what I know growing up or and I think these are areas we need
to address.”
12. (Ernesto, pg. 7)
Systems Barriers
Primary Care is the Access Point for Patients with Mental
Disorders
“….primary care as sort of the gatekeeper those are the guys
that are picking up
the symptoms and so I sort of see that this is a good project to
enhance our
understanding of this population.” (AN, pg. 2)
Changing Financial Systems
“Another issue is that there are financial issues that primary
physicians often see that
there is cost shifting going on that psychiatry or whomever else
is telling us to do this
new activity that is really shifting a responsibility” (LR, pg. 4)
Week 5 Handout: Content Analysis of Focus Groups 3
Changing of Responsibilities
13. “Another issue is that there are financial issues that primary
physicians often see that
there is cost shifting going on that psychiatry or whomever else
is telling us to do this
new activity that is really shifting a responsibility” (LR, pg. 4)
Professional Medical/Psychiatry Culture
Differing Cultures and Ideologies Within Medical Profession
“one major barrier is that there is a difference in physician
culture that an internalist
perceives a different way of treating a patient than a family care
doctor and the
pediatrician looks at it differently than an internalist and that
certain cultures when they
have certain specialty referral systems will feel differently
when they specialty referral
system is used less frequently, and we have found them being
treated much differently”
(LR, pg.4)
Miscellaneous
“we tend to forget that the mental health problems are a
spectrum, they may not be
necessarily psychosis or dementia, manic depression, they may
not be a DSM 4 diagnosis,
14. they may be life style related , they are a state of flux it is a
spectrum, when a women is having
infertility when a women loses a pregnancy when a women
delivers a baby and it is another girl
but she wanted a boy, or when she delivers a baby it is what she
wanted but the constraints, but
the burden is too much, so it can gyn issues it could be ob
issues but they are not dsm categories
and I think that a barrier is that we do not acknowledge the
existence of these kinds of things…”
(IH, pg. 6)
“The other big thing that I think of is the other side of the
spectrum which is when we do see
these patients and when we do have the luxuries of identifying
these issues that I have just
outlined that we try to squeezed these people into the diagnoses
that I just described so we
make it into an anxiety disorder or we make it into a depression
when it could be just life style
related or cultural related..” (IH, pg. 6)
Research Article
Cultural Adaptation of Interventions
in Real Practice Settings
Flavio F. Marsiglia1 and Jamie M. Booth2
Abstract
15. This article provides an overview of some common challenges
and opportunities related to cultural adaptation of behavioral
interventions. Cultural adaptation is presented as a necessary
action to ponder when considering the adoption of an evidence-
based
intervention with ethnic and other minority groups. It proposes
a roadmap to choose existing interventions and a specific
approach
to evaluate prevention and treatment interventions for cultural
relevancy. An approach to conducting cultural adaptations is
proposed, followed by an outline of a cultural adaptation
protocol. A case study is presented, and lessons learned are
shared as
well as recommendations for culturally grounded social work
practice.
Keywords
evidence-based practice, literature
Culture influences the way in which individuals see themselves
and their environment at every level of the ecological system
(Greene & Lee, 2002). Cultural groups are living organisms
with members exhibiting different levels of identification with
their common culture and are impacted by other intersecting
identities. Because culture is fluid and ever changing, the
process
of cultural adaptation is complex and dynamic. Social work and
other helping professions have attempted over time to integrate
16. culture of origin into the interventions applied with ethnic
minorities and other vulnerable communities in the United
States and globally (Sue, Arredondo, & McDavis, 1992). In
an ever-changing cultural landscape, there is a renewed need
to examine social work education and the interventions social
workers implement with cultural diverse communities.
Culturally competent social work practice is well established
in the profession and it is rooted in core social work practice
principles (i.e., client centered and strengths based). It strives
to work within a client’s cultural context to address risks and
protective factors. Cultural competency is a social work ethical
mandate and has the potential for increasing the effectiveness
of interventions by integrating the clients’ unique cultural
assets
(Jani, Ortiz, & Aranda, 2008). Culturally competent or
culturally
grounded social work incorporates culturally based values,
norms, and diverse ways of knowing (Kumpfer, Alvarado,
Smith, & Bellamy, 2002; Morano & Bravo, 2002).
17. Despite the awareness about the importance of implementing
culturally competent approaches, practitioners often struggle
with how to integrate the client’s worldview and the application
of evidence-based practices (EBPs). When selecting and
implementing social work interventions, practitioners often
continue to unconsciously place themselves at the center of
the provider–consumer relationship. Being unaware of their
power in the relationship and undervaluing the clients per-
spective in the selection of EBPs tends to result in a type
of social work practice that is culturally incompetent and
nonefficacious (Kirmayer, 2012). This ineffectiveness can
be experienced and interpreted by practitioners in several
ways. In instances when clients do not conform to the content
and format of existing interventions, they are easily labeled as
being resistant to treatment (Lee, 2010). In other cases, when
clients fail to adapt to a given intervention that does not feel
comfortable to them, the relationship is terminated or the
client simply does not return to services. Thus, terms such
18. as noncompliance and nonadherence may hide deeper issues
related to cultural mismatch or a lack of cultural competency
in the part of the practitioner.
Culturally grounded social work challenges practitioners to
see themselves as the other and to recognize that the responsi-
bility of cultural adaptation resides not solely on the clients but
involves everyone in the relationship (Marsiglia & Kulis,
2009). In order to do this, practitioners need to have access
to interventions or tools that are consistent with the culturally
grounded approach. A culturally grounded approach starts with
assessing the appropriateness of existing evidence-based inter-
ventions and adapting when necessary, so that they are more
1
Southwest Interdisciplinary Research Center (SIRC), School of
Social Work,
Arizona State University, Phoenix, AZ, USA
2 School of Social Work, University of Pittsburgh, Pittsburgh,
PA, USA
Corresponding Author:
Jamie M. Booth, School of Social Work, University of
Pittsburgh, 2117
19. Cathedral of Learning, 4200 Fifth Avenue, Pittsburgh, PA
15260, USA.
Email: [email protected]
Research on Social Work Practice
2015, Vol. 25(4) 423-432
ª The Author(s) 2014
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relevant and engaging to clients from diverse cultural back-
grounds, without compromising their effectiveness. This process
of assessment, refinement, and adaptation of interventions will
lead to a more equitable and productive helping relationship.
The ecological systems approach provides a structure for
understanding the importance of cultural adaptation in social
work practice. Situated on the outer level (macro level) of
the ecological system, culture frames the norms, values, and
behaviors that operate on every other level: individual beliefs
20. and behaviors (micro level), family customs and communica-
tion patterns (mezzo level), and how that individual perceives
and interacts with the larger structures (exo level), such as
the school system or local law enforcement (Szapocznik &
Coatsworth, 1999). In this approach, the relationships between
individuals, institutions, and the larger cultural context within
the ecological framework are bidirectional, creating a dynamic
and rapidly evolving system (Bronfenbrenner, 1977; Gitterman,
2009). The bidirectional nature of relationships is an important
concept to consider when discussing the cultural adaptation
of social work interventions for two reasons: (1) regardless
of the setting, in social work practice, the clients and the
social workers engage in work partnerships in which both par-
ties must adapt to achieve a point of mutual understanding and
communication and (2) culture is in constant flux, as individ-
uals interact with actors and institutions which either maintain
or shift cultural norms and values over time.
Although culturally tailoring prevention and treatment
21. approaches to fit every individual may not be feasible, cultu-
rally grounded social work may require the adaptation of
existing interventions when necessary while maintaining the
fidelity or scientific merit of the original evidence-based
intervention (Sanders, 2000). This article discusses the need
for cultural adaptation, presents a model of adaptation from
an ecological perspective, and reviews the adaptations con-
ducted by the Southwest Interdisciplinary Research Center
(SICR) as a case study. The recommendations section con-
nects the premises of this article with the existing literature
on cultural adaptation and identifies some specific unresolved
challenges that need to be addressed in future research.
Empirically Supported Interventions (ESIs) in
Social Work Practice
EBP has become the gold standard in social work practice and
involve the ‘‘conscientious’’ and ‘‘judicious’’ application of
the best research available in practice (Sackett, 1997, p. 2).
It is commonly believed that utilizing EBP simply requires the
22. practitioner to locate interventions that have been rigorously
tested using scientific methods, implement them, and evaluate
their effect; however, EBP acknowledges the role of individ-
uals and relationships in this process. EBP requires the inte-
gration of evidence and scientific methods with practice
wisdom, the worldview of the practitioner, and the client’s
perspectives and values (Howard, McMillen, & Pollio, 2003;
Regehr, Stern, & Shlonsky, 2007). The clinician’s judgment and
the client’s perspective are not only utilized in the selection of
the EBP intervention; they are also influential in how the inter-
vention is applied within the context of the clinical interaction
(Straus & McAlister, 2000). Achieving a balance between both
the client and the practitioner’s perspective in the application of
ESIs is essential for bridging the gap between research and
prac-
tice (Howard et al., 2003). However, the inclusion of the clini-
cian’s judgment and the client’s history potentially muddles
the scientific merit of the intervention being implemented. This
is the fundamental tension and challenge when implementing
23. EBP and a key reason why the gap between research and prac-
tice exists (Regehr et al., 2007).
The attraction of EBP is clear; locating and potentially
utilizing empirically tested treatment and prevention inter-
ventions allow social workers to feel more confident that they
will achieve the desired outcomes and provide clients with
the best possible treatment, thereby fulfilling their ethical
responsibility (Gilgun, 2005). Despite this clear rationale, the
utilization of EBP is limited (Mullen & Bacon, 2006) and
when it is applied, research-supported interventions may not
be implemented in the manner the authors of the intervention
intended.
This lack of treatment fidelity when implementing EBP
may be due to practitioner’s awareness that the evidence
generated by randomized control trials (RCTs) may not be
applicable to the diverse needs of their clients or adequately
address the complexity of the clients’ life (Webb, 2001;
Witkin, 1998). Practitioners have natural tendency to adapt
24. interventions to better fit their clients (Kumpfer et al.,
2002). Some adaptations are made consciously, but others are
made quickly during the course of implementation and based
on clinical judgment (Bridge, Massie, & Mills, 2008; Castro,
Barrera, & Martinez, 2004). ESIs, however, can only be
expected to achieve the same results as those observed when
originally tested, if they are implemented with fidelity or
strict adherence to the program structure, content, and dosage
(Dumas, Lynch, Laughlin, Phillips Smith, & Prinz, 2001;
Solomon, Card, & Malow, 2006). Although adaptations are
typically made in response to a perceived need, when they
are not done systematically, based on evidence and with the
core elements of the intervention preserved, the efficacy that
was previously achieved in the more controlled environment
may not be replicated (Kumpfer et al., 2002). Informal adap-
tation has the potential for compromising the integrity of
the original intervention, thus negating the value of the accu-
mulated evidence that supports the intervention’s effective-
25. ness. This tension between fidelity and fit has generated a
need for strategies to create fit while insuring fidelity.
Cultural Adaptation
The primacy of scientific rigor over cultural congruence may
be a limitation in applying ESIs and a standard that should not
be maintained in culturally competent social work practice.
When working with real communities, both must be satisfied
to the highest degree possible (Regehr et al., 2007). One solu-
tion to tension between using culturally relevant practices and
424 Research on Social Work Practice 25(4)
ESIs is locating interventions that have been designed for and
tested with a given cultural group. However, the limited avail-
ability of culturally specific interventions with strong empiri-
cal support may create barriers to this approach. Despite the
progress that has been made to date, most ESIs are developed
for and tested with middle-class White Americans, with the
assumption that evidence of efficacy with this group can be
26. transferred to nonmajority cultures, which may or may not
be the case (Kumpfer et al., 2002).
For example, a prevention intervention with Latino parents
found that assimilated, highly educated Latino parents were
responsive to the prevention interventions presented to them,
while immigrant parents with less education were less likely
to benefit (Dumka, Lopez, & Jacobs-Carter, 2002). This high-
lights the differential effects of an intervention based on culture
as well as a clear need for a more culturally relevant interven-
tion for immigrant parents. Despite a clear need for adaptation
in some circumstances, there is a strong risk of compromising
the effectiveness of the ESI when unstructured cultural adapta-
tions are implemented in response to perceived cultural incon-
gruence (Kirk & Reid, 2002; Kumpfer & Kaftarian, 2000;
Miller, Wilbourne, & Hettema, 2003; Solomon et al., 2006).
For that reason, when culturally and contextually specific inter-
ventions exist with strong evidence, it is certainly preferable to
select that intervention; however, in the absence of an ESI
27. designed and tested for the population being served, adaptation
may be a more viable and cost-effective option for scientifi-
cally merging a client’s cultural perspectives/values and the
ESI (Howard et al., 2003; Steiker et al., 2008). Systematically
adapting an intervention may increase the odds that the treat-
ment will achieve similar results than those found in more
controlled environments by minimizing the amount of sponta-
neous adaptations that the practitioner feels that they must
make to communicate within the client cultural frame
(Ferrer-Wreder, Sundell, & Mansoory, 2012).
Cultural adaptation may not only preserve the ESI’s effi-
cacy but also enhance the results attained in clinical trials
(Kelly et al., 2000). Culturally adapted interventions have the
potential to improve both client engagement in treatment and
outcomes and might be indicated when either rates fall below
what could be expected based on previous evidence (Lau,
2006). In an evaluation of a culturally adapted version of
the Strengthening Families intervention, there was a 40%
28. increase in program retention in the culturally adapted version
of the intervention (Kumpfer et al., 2002). Although outcomes
were not found to be significantly better in the adapted version
of the intervention, the increase in retention is a significant
improvement. Improving retention expands the intervention’s
potential to reach and impact individuals who would not
typically remain in treatment. Despite the lack of difference
in outcomes in the Strengthening Families intervention, some
evidence has emerged that culturally adapted interventions
not only increase retention but are also more effective. In a
recent meta-analysis, culturally adapted treatments had a
greater impact than standard treatments, produced better out-
comes, and were most successful when they were culturally
tailored to a single ethnic minority group (Smith, Domenech
Rodrı́guez, & Bernal, 2010).
Adapting interventions in partnership with communities also
enhances the community’s commitment to the implementation
and the chances that the program will be sustained overtime
29. (Castro et al., 2004). For example, efforts to adapt HIV pre-
vention programs by modifying the messages and protocols
in order for them to sound and feel natural or familiar intellec-
tually and emotionally to individuals, families, groups, and
communities have improved the communities’ receptiveness,
retention, outcomes, and overall satisfaction, in addition to
retaining high levels of fidelity (Kirby, 2002; Raj, Amaro,
& Reed, 2001; Wilson & Miller, 2003).
Finally, cultural adaptation is advantageous because it
allows the social worker to address culturally specific risk
factors and build on identified protective factors. In the case
of Latino families, differential rates of acculturation between
parents and youth appear to be a risk factor for substance use
and delinquency among youth, indicating that family-based
interventions may be the most culturally relevant intervention
(Martinez, 2006). In addition to a source of risk, cultural
norms that place a high value on family loyalty are protective
factors against a variety of negative outcomes (German,
30. Gonzales, & Dumka, 2009; Marsiglia, Nagoshi, Parsai, &
Castro, 2012). Identifying risk and protective factors unique
to a community and addressing these within an intervention
have the potential to increase the efficacy of the intervention.
The importance of EBP and culturally competent practice
has created tension in the field of social work. Evidence
has landed support to both claims: (1) interventions are more
effective when implemented with fidelity (Durlak & DuPre,
2008) and (2) interventions are more effective when they are
culturally adapted because they ensure a good fit (Jani et al.,
2008). These different perspectives highlight the tension in
the field between implementing manualized interventions
exactly as they were written versus to adjusting them to fit the
targeted population or community (Norcross, Beutler, &
Levant, 2006). Although this debate is far from resolved, the-
ories of adaptation have been developed that allow the
researcher/practitioner to adjust the fit without compromising
the integrity of the intervention (Ferrer-Wreder et al., 2012).
31. If the cultural adaptation is done systematically, it has the
potential for maximizing the benefit of the fit, as well as the
benefit of the ESI, thus providing a strategy that addresses
many of the concerns surrounding EBP’s applicability in
social work practice (Castro et al., 2004).
An Emerging Roadmap for Cultural Adaptation
Cultural adaptation is an emerging science that aims at
addressing these challenges and opportunities to enhance the
effectiveness of interventions by grounding them in the lived
experience of the participants. Strategies and processes to sys-
tematically adapt interventions while insuring a more optimal
cultural fit without compromising the integrity of scientific
merit have been proposed and are beginning to be tested
Marsiglia and Booth 425
(La Roche & Christopher, 2009). The first step in all adaptation
models is determining that the cultural adaptation of an
interven-
tion should be perused. Adaptation of an ESI is indicated when
32. (1) a client’s engagement in services falls below what is
expected, (2) expected outcomes are not achieved, and (3) iden-
tified culturally specific risks and/or protective factors need to
be incorporated into the intervention (Barrera & Castro, 2006).
Once the determination is made to conduct an adaptation,
there are a variety of models that one could follow all of which
fall into two categories: content and process (Ferrer-Wreder
et al., 2012). Although most current adaptation models have
merged the discussions regarding the content that should be
modified and process by which this modification takes place,
it is useful to consider them separately.
Content models identify an array of domains that may be
crucial to address when conducting an adaptation. The ecolo-
gical validity model, for example, focuses on eight dimensions
of culture: language, persons, metaphors, content, concepts,
goals, methods, and social context (Bernal, Jiménez-Chafey,
& Domenech Rodrı́guez, 2009). The cultural sensitivity model,
also a content model, identifies two distinct content areas: deep
33. culture, which includes aspects of culture such as thought pat-
terns, value systems, and norms, and surface culture, which
refers
to elements, such as language, food, and customs (Resnicow,
Soler, Braithwaite, Ahluwailia, & Butler, 2000). Proponents of
the cultural sensitivity model argue that both aspects of culture
should be assessed and potentially addressed if areas of conflict
or incongruence between the culture and the intervention are
identified (Resnicow et al., 2000). Surface adaptations allow the
participants to identify with the messages, potentially enhancing
engagement; while, deep culture adaptations ensure that the
outcomes are impacted (Resnicow et al., 2000).
Castro, Barrera, and Martinez (2004) and Castro, Barrera,
and Steiker, 2010 have proposed a content model that identifies
a set of specific dimensions—at the surface and deep levels—
that are essential to consider in the adaptation process: cogni-
tive, affective, and environmental. Cognitive adaptations are
considered when participants cannot understand the content
34. that is being presented due to language barriers or the use of
information that is not relevant in an individual’s cultural
frame. Vignettes given by the original intervention, for exam-
ple, may not be relevant to the participants or may be offensive
due to spiritual or religious taboos. The content may create a
negative reaction from the participants which in turn may block
their ability to hear and integrate the message. It is that content
that needs to be modified while the core elements of the inter-
vention are respected. Affective-motivational adaptations are
indicated when program messages are contrary to cultural
norms and values, creating a resistance to change within the
individual (Castro, Rawson, & Obert, 2001). Environmental
factors (later referred to as relevance) make sure that the con-
tents and structure are applicable to the participants in their
daily lived experience (Castro et al., 2010).
While content models of adaptation tell adaptors where to
look for cultural mismatch, process models provide a frame-
work for making systematic assessments of cultural match,
35. adjustments to the original intervention, and tests of the adap-
tations effectiveness. At a minimum adaption process, models
follow two systematic steps: (1) identifying mismatches
between the original intervention and the client’s culture and
(2) testing/evaluating changes that have been made to rectify
these disparities (Ferrer-Wreder et al., 2012).
Most process models of adaptation begin with building a
partnership or coalition with members of targeted community
(Castro et al., 2010; Harris et al., 2001; Wingood & DiCle-
mente, 2008). Sometimes the ESI that will be adapted is
selected at this stage; however, more information is often gath-
ered about the targeted population before selecting the inter-
vention that would provide the best fit (Kumpfer, Pinyuchon,
Teixeriade de Melo, & Whiteside, 2008; Mckleroy et al.,
2006; Wingood & DiClemente, 2008). Whether the interven-
tion has yet to be selected, extensive formative research is con-
ducted to assess the etiology of the social problem that is the
target of the intervention, possible population-specific risks
36. and protective factors, and measurement equivalence to insure
and accurate evaluation of intervention outcomes (Harris et al.,
2001). Some information about the target community may be
gained by reviewing relevant literature; however, interviews,
focus groups, and surveys are also used to collect primary data
about the social and cultural context that may impact the out-
come of the intervention or conflict with the program’s mes-
sages/implementation strategies.
At this point in the process, some adaptation models recom-
mend making changes based on the formative research
(Domenech-Rodriguez & Wieling, 2004; Harris et al., 2001),
while
others suggest implementing the intervention with minimal
changes and assessing the need for further adaption. In an
innova-
tive approach, the Planned Intervention Adaptation model
suggests
making significant changes to one version of the intervention
while making minimal changes to another and implementing
them
37. both simultaneously to test the differential effects (Castro et al.,
2010; Ferrer-Wreder et al., 2012; Kumpfer et al., 2008).
Regardless of the level of adaptation, the modified inter-
vention is pilot tested and based on the outcomes subsequent
adaptations are made (Ferrer-Wreder et al., 2012). Once a
final adaptation has been made, further testing takes place
in effectiveness trials. Across all theories of adaptation, the
process is iterative with refinements made to the intervention
at every stage based on the evidence generated in the prior
stage (Domenech-Rodriguez & Wieling, 2004). Regardless
of the depth of changes made, the adapted intervention must
be rigorously tested to ensure that the effects of the original
ESI are preserved after changes have been made.
Case Study: Adaptations of Keepin’it REAL
(KiR), the Southwest Interdisciplinary
Research Center (SIRC) Approach
Over the past 10 years of health disparities research, the SIRC
has developed a process of cultural adaptation that includes
most of the elements outlined previously. The specific
38. 426 Research on Social Work Practice 25(4)
adaptation model utilized at SIRC is an expanded version
of the Barrera and Castro (2006) model as illustrated by
Figure 1.
KiR is the flagship empirically supported treatment SIRC
(Marsiglia & Hecht, 2005). KiR is a manualized school-
based substance abuse prevention program for middle school
students. It was designed to (a) increase drug resistance skills
among middle school students, (b) promote antisubstance use
norms and attitudes, and (c) develop effective drug resistance
and communication skills (Gosin, Dustman, Drapeau, &
Harthun, 2003). It was created and evaluated in Arizona
through many years of community-based research funded by
the National Institutes on Drug Abuse of the National Insti-
tutes of Health. It is a model program listed under Substance
Abuse and Mental Health Services Administration’s National
Registry of Evidence-Based Programs and Practices. There is
39. strong evidence about the efficacy of the intervention with
middle school Mexican American students (Marsiglia, Kulis,
Wagstaff, Elek, & Dran, 2005), however the community-
identified need to reach out to younger students and to stu-
dents of other ethnic groups generated a set of adaptation
efforts summarized in Figure 2.
As Figure 2 illustrates, KiR was adapted for fifth-grade stu-
dents (Harthun, Dustman, Reeves, Marsiglia, & Hecht, 2009)
following the SIRC adaptation model and an RCT was con-
ducted to test whether the effects of the intervention increased
by intervening earlier (fifth grade vs. seventh grade). Students
who received the intervention in both the fifth and seventh
grade were no different in their self-reported use of alcohol
and other drugs than students who received the intervention
only on the seventh grade (Marsiglia, Kulis, Yabiku, Nieri,
& Coleman, 2011). This effort did no yield the expected
results but provided evidence from a developmental perspec-
tive that starting earlier was not cost effective.
40. The second adaptation presented in Figure 2 was also
community-generated and supported from the evidence gath-
ered during the initial RCT of KiR. Urban American Indian
(AI) youth were not benefiting from KiR as much as other
children (Dixon et al., 2007). Following the principles of
community-based participatory research, a steering group,
including leaders from the local urban AI community and
school district personnel in charge of AI programs, was
formed to guide the adaptation process. In addition to enga-
ging community members and setting up a structure to ensure
a collaborative partnership, before beginning the adaptation
process, formative information was collected by consulting
the literature to identify culturally specific risks and protec-
tive factors and focus groups. Focus groups were conducted
with both Native American adults and youth to explore cultu-
rally specific drug resistance strategies that were frequently
applied by urban Native American youth (Kulis & Brown,
2011; Kulis, Dustman, Brown, & Martinez, 2013).
41. Based on this information, collected in conjunction with
four Native American curriculum development experts, KiR
was adapted, and while maintaining its core elements, the
content and structure were changed to be more culturally rel-
evant to Native American youth (Kulis et al., 2013). Changes
to the curriculum included (1) new drug resistant strategies
that were identified by the AI youth as being more culturally
relevant to them, (2) lesson plans designed to teach strategies
in a more culturally relevant way, (3) more comprehensive
content focusing on ethnic identity (a protective factor identi-
fied in the literature), and (5) a narrative approach in teaching
content (Kulis et al., 2013). In the initial pilot test of the
intervention, results showed an increase in the use of REAL
strategies indicating a promising effect. Based on pilot test
feedback, the intervention has been further adapted and
implemented on a larger scale through an RCT. The research
team at SIRC is currently in the process of developing a
Identification
of EBP with
43. trial: EBP
N = 6,035
(1997-2002)
Adapted with Jalisco-Mexico
middle schools
N = 431
(2011-2013)
Adapted with Phoenix urban American
Indian middle schools
N = 247
(2007-2012)
Adapted with Phoenix 5th graders
N = 3,038
(2003-2008)
Figure 2. The SIRC family of adapted interventions.
Note. SIRC ¼ Southwest Interdisciplinary Research Centre.
Marsiglia and Booth 427
parenting component to this intervention using the processes
that were established in the development of the youth version.
Implementing and adapting KiR for the Mexican context is
the most recent adaptations done at SIRC. Collaborators in
44. Jalisco-Mexico identified Keepin’ it as an ESI suitable for
Mexico. The initial review of the intervention resulted in a
‘‘surface’’ adaptation consisting mostly of translating the
manuals from English to Spanish and changing some of the
vignettes that were not appropriate for Mexico. The Jalisco
team recruited two middle schools to participate in a pilot
study of the initial adapted version of KiR. The schools were
randomized to control and experimental conditions. Imple-
menters (teachers) and student participants participated in
the regular classroom-based intervention for 10 weeks and
were also a part of a simultaneous intensive review process
of the intervention through focus groups. The overall level
of comfort and satisfaction with the intervention was high and
the pre- and posttest survey results were also favorable. The
main concern for teachers and students was the videos that
illustrate the REAL resistance strategies. The original videos
were dubbed into Spanish, but the story lines, the music, and
even the clothing felt foreign to the youth in Jalisco. As a
45. result, new scripts and new videos were produced by and for
youth in Jalisco. This method of adaptation did not change the
core elements of the original intervention but did address
aspects of deep culture (Steiker et al., 2008). Because the
youth wrote and acted in the videos, they were able to con-
struct scenarios that accurately reflected their cultural norms
and values.
The results of the pilot also provided additional feedback to
edit the content and format of the manuals. See Figure 3 for
the pilot results on alcohol, cigarette, and marijuana use.
The results of the pilot were very promising and identified
female students at a greater risk. Females in the control group
(not receiving the intervention) reported the greatest increase in
substance use between the pre- and posttest. The pilot results
illustrate the need for the cyclical and continuous adaptation
process. This case study highlights the need to conduct a gender
adaptation in addition to an ethnic or nation of origin adapta-
tion. With the adapted manual and the new videos, the bina-
46. tional team of researchers is applying for funding to conduct
an RCT in Mexico of the revised intervention now called
‘‘Mantente REAL.’’
Adaptation in Social Work Practice
The previously discussed models, including the SIRC model,
are based on collaborations between practitioners and research-
ers, where researchers take the lead in the formative assess-
ments, adaptations, and evaluations of effectiveness. In many
social work practice settings, this process might look different,
although it is recommended that regardless of the setting, a
partnership with the intervention designers is developed if
significant modifications are going to be made to the original
intervention. The Centers for Disease Control and Prevention
(CDC) has devised a set of practical guidelines for practitioners
adopting an ESI and strongly discourages adaptors to change
the deep structures of the intervention (McKleroy et al., 2006).
In the CDC model, as in the SIRC model, the adaptation
process starts with the selection of an ESI that best matches the
47. population and context (Solomon et al., 2006). The selection of
an intervention is based on an initial assessment of the targeted
population and an exploration of possible intervention varia-
tions (Ferrer-Wreder et al., 2012). Assessments of the pop-
ulation can be made through a review of the literature and by
conducting interviews with key informants or focus groups
with potential participants. The initial assessment of the popu-
lation should go beyond potential participants’ ethnicities to
include multiple and intersecting identities. Cultural adaptation
frequently starts and stops with the identification of race, with-
out examining how age, gender, sexual orientation, religion,
acculturation, and geography shape culture. The lack of such
identification information could potentially impact the partici-
pants’ experience with the intervention (Wilson & Miller,
2003). A thorough assessment includes consideration for both
deep and surface culture, as well as population-specific risks
and protective factors (Solomon et al., 2006). During this initial
0
49. 0.45
Cigarette Frequency
Male (E)
Male (C)
Female (E)
Female (C)
0
0.05
0.1
0.15
0.2
0.25
0.3
0.35
0.4
0.45
Cigarette Amount
Male (E)
Male (C)
Female (E)
Female (C)
Figure 3. Pilot results of ‘‘Mantente REAL.’’
428 Research on Social Work Practice 25(4)
50. phase, social workers strive to find the best possible fit because
the fewer modifications they make, the less likely the fidelity of
the intervention will be compromised in the adaptation process.
After the intervention is selected, the practitioner thoroughly
evaluates the theoretical underpinnings of the intervention and
assesses the intervention in light of the cultural norms and
values
of the clients being served (Green & Glasgow, 2006). The
practitioner then systematically works to reconcile any mis-
matches between the intervention and the participants’ lived
experiences without altering the core components of the inter-
vention or features of the intervention that are responsible for
the intervention’s effectiveness (Green & Glasgow, 2006;
Kelly et al., 2000; Solomon et al., 2006). When it is deter-
mined that elements of deep culture need to be changed and
these changes have the potential of altering core elements of
the curriculum, the evidence previously found for effective-
ness may be negated indicating the need to retest the interven-
51. tion in an RCT (see Figure 4 ).
Although some interventionists have explicitly identified
core components that must be preserved to ensure effective-
ness, others have not. In the case when they are not explicitly
stated, it becomes the implementer’s responsibility to uncover
aspects of the intervention that cannot be changed or removed.
Identifying the theory of change (i.e., cognitive behavioral
theory, reasoned action, and communication competency) is
the most practical way of identifying core elements, although
contacting the authors and conducting experiments are also
possibilities (Solomon et al., 2006).
After the intervention has been adapted to reconcile any
conflicting mismatches, a pilot test is recommended of the
adapted intervention with a small group of participants (at
least N ¼ 10) using pre- or postsurveys and focus groups
(McKleroy et al., 2006). Any information gleaned from this
data will be used to further incorporate any adaptations into
the intervention.
The extent of adaptation must be determined by the level of
52. mismatch between the intervention and the population being
served (Barrera & Castro, 2006). Frequently, cultural adapta-
tions only address surface aspects of culture while neglecting
the deeper messages being communicated in the intervention.
This is not necessarily bad practice. It is possible that chang-
ing the language, photographs, and the scenarios in an inter-
vention is all that is needed to make it culturally relevant.
There are, however, situations in which this is not sufficient
(Resnicow et al., 2000). As mentioned previously, surface
adaptation allows participants in the program to identify
themselves with the intervention, but it could fail to address
the larger cultural norms that may be impacting the target
behaviors or decision-making process. If it is determined that
significant and/or deep changes are needed, the developers of
the intervention need to be contacted and asked to assist the
social worker in the process. It should be remembered that any
changes have the potential to compromise the intervention’s
effectiveness and need to be implemented with extreme cau-
53. tion. Social workers adapting interventions should document
all changes made to the original intervention and systemati-
cally evaluate the outcomes in order to ensure that the desired
results are being achieved.
Recommendations
Social work ethics clearly instruct social workers to provide
culturally competent practice and to implement interventions
with the best possible evidence of efficacy. Due to the vast
diversity in the human family, these imperatives can be in con-
flict. This conflict highlights many of the questions that still
linger in the discussion of the value of implementing social
work interventions with fidelity versus adapting them to better
achieve a cultural fit. It has been suggested that one way to rec-
tify this tension is to adapt interventions in a systematic manner
based on scientifically validated methods. Despite the apparent
clarity of this task, the adaptation process can be challenging.
The theories of adaptation that have emerged in several differ-
ent fields put forward similar processes of adaptation. These
54. may require an extensive assessment of the etiology of social
problems, an understanding of the deep theoretical structure
of the original intervention, and rigorous evaluation that may
be beyond the capacity of individual practitioners. To this end,
more work needs to be done to build the capacities of social
workers and social work agencies for utilizing and conducting
Figure 4. The continuum of adaptation: Balancing the fidelity
and fit.
Marsiglia and Booth 429
rigorous research that would enable them to reliably adapt
social work research theories and practices. In the absence of
needed resources, social workers are encouraged to build
relationships with research institution that can help them sys-
tematically assess and adapt interventions, so that they can
provide the most culturally competent services. When adapta-
tions cannot be reliably implemented, efforts need to be made
to identify interventions that have been previously adapted
55. and tested with a given population, such as those in the SIRC
model, and implement them with fidelity. With the ever
expanding number of rigorously tested, culturally specific,
and culturally grounded interventions, it may seem feasible
at some point to have an ESI for every population in every
context; however, the dynamic nature of culture and the vast
diversity among humans ensure that cultural adaptation will
continue to be a likely necessity in the future.
Authors’ Note
This article was previously presented at the conference on
Bridging
the Research and Practice gap: A Symposium on Critical
Considera-
tions, Successes and Emerging Ideas, sponsored by the
University of
Houston Graduate College of Social Work, Houston, TX, April
5–6,
2013. This article was invited and accepted by the Guest Editor
of this
special issue, Danielle E. Parrish, PhD The content of this
article is
56. solely the responsibility of the authors and does not necessarily
repre-
sent the official views of NIMHD or the NIH.
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with
respect to
the research, authorship, and/or publication of this article.
Funding
The authors disclosed receipt of the following financial support
for the
research, authorship, and/or publication of this article: This
research
was supported by the National Institute on Minority Health and
Health
Disparities (NIMHD) of the National Institutes of Health (NIH
Grant
P20MD002316-05, to Flavio F. Marsiglia, principal
investigator).
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