week 6 587

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With the consolidation of hospitals, clinics, and healthcare providers across the United States, leadership is delivered in many forms.  The importance of understanding and mastering online leadership (often referred to as virtual or E-leadership) is imperative.

How would you establish relationships with your team on-ground and from a distance? How would you create presence in a virtual team? Provide examples.

Expectations

Initial Post:

  • Due: Thursday, 11:59 pm PT
  • Length: 150 – 250 Words

Peer Responses:

Types of Shock

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It is very important to differentiate between the different types of shock since treatment may depend on this. Complete the Comparison Table on the different types of shock. 

Unit 9 peer response. ADHD Medications. 800W. APA. 4 references due 10-30-23

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Advanced Psychopharmacology and Health Promotion

Unit 9 peer response. ADHD Medications. 800W. APA. 4 references due 10-30-23.

Instructions:

Please read and respond to at least two of your peers' initial postings. You may want to consider the following questions in your responses to your peers:

· Compare and contrast your initial posting with those of your peers.  

· How are they similar or how are they different?

· What information can you add that would help support the responses of your peers?

· Ask your peers a question for clarification about their post.

· What most interests you about their responses? 

Please be sure to validate your opinions and ideas with citations and references in APA format.


Mihaela

Unit 9 – ADHD Medications

1.
What screening tools can be used to affirm your initial diagnosis that Mr. Deliver meets the criteria for ADHD?

One commonly used screening tool is the Adult ADHD Self-Report Scale (ASRS). The ASRS consists of a series of questions that evaluate both inattentive and hyperactive-impulsive symptoms (Anbarasan et al., 2020). Another useful screening tool is the Conners' Adult ADHD Rating Scales (CAARS), which assesses various domains affected by ADHD, such as attention problems, hyperactivity/impulsivity, and executive functioning (Smyth et al., 2019).

2.
Further assessment determines that Mr. Deliver does meet the criteria for ADHD, inattentive type. What is the current recommendation for pharmacological treatment for Mr. Deliver?

Once it is confirmed through further assessment that Mr. Deliver meets the criteria for ADHD, inattentive type, the current recommendation for pharmacological treatment would typically involve stimulant medications such as methylphenidate or amphetamine derivatives. These medications have consistently shown efficacy in improving attention, reducing impulsivity, and enhancing executive functions in adults with ADHD (Farhat et al., 2022). Non-stimulant options like atomoxetine or viloxazine (norepinephrine modulator) may also be considered if there are contraindications or intolerance to stimulants (Mechler et al., 2022). However, considering Mr. Deliver's concerns about stigma and psychotropic medications' risks, it may be worth discussing non-pharmacological interventions as well. Cognitive-behavioral therapy (CBT) has demonstrated efficacy in managing symptoms of adult ADHD. CBT can help Mr. Deliver develop strategies to improve organization skills, time management, and enhance his ability to focus on tasks (Young et al., 2020).

3.
Assume that instead of Mr. Deliver being 36 years old, Thomas is a 13-year-old male that also meets the diagnostic criteria for ADHD, hyperactive type (Thomas is not on any medications at this age). How will your pharmacological treatment change?

In the case of Thomas, a 13-year-old boy diagnosed with ADHD hyperactive type who is not currently taking any medications, the most probable treatment approach would involve the use of stimulant medications. According to the American Academy of Pediatrics (AAP), stimulant medications like methylphenidate are recommended as first-line treatment options for children and adolescents with ADHD, as they have been shown effective in reducing symptoms and improving functioning (Shrestha et al., 2020). However it is important to monitor growth and potential side effects in pediatric patients (Vertessen et al., 2023).

References

Anbarasan, D., Kitchin, M., & Adler, L. A. (2020). Screening for adult adhd. 
Current Psychiatry Reports, 
22(12). 

https://doi.org/10.1007/s11920-020-01194-9Links to an external site.

Farhat, L. C., Flores, J. M., Behling, E., Avila-Quintero, V. J., Lombroso, A., Cortese, S., Polanczyk, G. V., & Bloch, M. H. (2022). The effects of stimulant dose and dosing strategy on treatment outcomes in attention-deficit/hyperactivity disorder in children and adolescents: A meta-analysis. 
Molecular Psychiatry, 
27(3), 1562–1572. 

https://doi.org/10.1038/s41380-021-01391-9Links to an external site.

Mechler, K., Banaschewski, T., Hohmann, S., & Häge, A. (2022). Evidence-based pharmacological treatment options for adhd in children and adolescents. 
Pharmacology & Therapeutics, 
230, 107940. 

https://doi.org/10.1016/j.pharmthera.2021.107940Links to an external site.

Shrestha, M., Lautenschleger, J., & Soares, N. (2020). Non-pharmacologic management of attention-deficit/hyperactivity disorder in children and adolescents: A review. 
Translational Pediatrics, 
9(S1), S114–S124. 

https://doi.org/10.21037/tp.2019.10.01Links to an external site.

Smyth, A. C., & Meier, S. T. (2016). Evaluating the psychometric properties of the conners adult adhd rating scales. 
Journal of Attention Disorders, 
23(10), 1111–1118. 

https://doi.org/10.1177/1087054715624230Links to an external site.

Vertessen, K., Luman, M., Swanson, J. M., Bottelier, M., Stoffelsen, R., Bet, P., Wisse, A., Twisk, J. R., & Oosterlaan, J. (2023). Methylphenidate dose–response in children with adhd: Evidence from a double-blind, randomized placebo-controlled titration trial. 
European Child & Adolescent Psychiatry. 

https://doi.org/10.1007/s00787-023-02176-xLinks to an external site.

Young, Z., Moghaddam, N., & Tickle, A. (2016). The efficacy of cognitive behavioral therapy for adults with adhd: A systematic review and meta-analysis of randomized controlled trials. 
Journal of Attention Disorders, 
24(6), 875–888. 

https://doi.org/10.1177/1087054716664413Links to an external site.


Ruth

Unit 9: Initial Discussion ADHD Medications

What screening tools can be used to affirm your initial diagnosis that Mr. Deliver meets the criteria for ADHD?

Attention-Deficit/Hyperactivity Disorder (ADHD) is the most common neuropsychiatric disorder of childhood, with impairing symptoms persisting into adulthood in approximately 70% of cases. Several screening tools are available to help providers identify and diagnose ADHD. The World Health Organization (WHO) Adult ADHD Self-Report Scale Part A is the most commonly used screening tool for ADHD cases in adults. The tool is available in national and international ADHD guidelines.  The screening tool contains six questions that cover inattentive and hyperactive-impulsive symptoms. It also includes a threshold of four or more, which is used for probable ADHD.  The score is calculated according to the number of questions that meet the criteria: sometimes endorsing/often/very often for questions 1–3 and endorsing usually/very often for questions 4–6. However, this screening, even if the patient is positive, may not have an active diagnosis of ADHD; further evaluation is required to ensure symptoms are related to ADHD diagnosis (Chamberlain et al., 2021). 

Further assessment determines that Mr. Deliver does meet the criteria for ADHD, inattentive type. What is the current recommendation for pharmacological treatment for Mr. Deliver?

According to his age and diagnosis, the current recommendation for this patient will be amphetamine 12.5 mg daily. Recommend that the patient start CBT and encourage exercise. A study showed that ADHD drugs are more effective and tolerated by children and adolescents than adults; the reason for this discrepancy is unknown. Amphetamines, methylphenidate, atomoxetine, and modafinil cause weight loss in children, adolescents, and adults. Amphetamines and atomoxetine increased blood pressure in children and adolescents, and methylphenidate increased blood pressure in adults. Methylphenidate showed better symptom control with the most minor side effects for children and adolescents, and amphetamines produced the best results for adults (Gupta, 2018). 

Reference:

Chamberlain, S. R., Cortese, S., & Grant, J. E. (2021). Screening for adult ADHD using brief rating tools: What can we conclude from a positive screen? Some caveats. 
Comprehensive Psychiatry, 
106, 152224. https://doi.org/10.1016/j.comppsych.2021.152224

Gupta, S. (2018). Best First-Line ADHD Medications for Children, Adults: Study Results. 
Attitude. https://www.additudemag.com/adhd-drugs-methylphenidate-vs-amphetamine-treatment/

Mayo Clinic. (2023). Amphetamine (Oral Route). 

https://www.mayoclinic.org/drugs-supplements/amphetamine-oral-route/proper-use/drg-20150941Links to an external site.

Question on Discussion Post

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An individual is referred to your office by his parole officer.  This 19-year-old male, named Sam, was recently arrested for a “psychotic break” that caused him to throw a chair through the neighborhood drug store window.   Sam’s parents arrive and Sam agrees to have his parents present during the interview.

His parents state Sam recently withdrew from college after experiencing a “resounding moment” in which he changed his major from engineering to philosophy and increasingly had reduced his sleep, spending long hours engaging individuals in the commons in conversations about the nature of reality and how he is gaining an appreciation “for all life”. He had been convinced about the importance of his ideas, stating frequently that he was more learned and advanced than all his professors. He told many that “I should be the one teaching these courses, after all, I understand it much better than my professors”. Sam has also increased the number of high-risk behaviors – drinking and engaging in sexual relations in a way that was unlike his previous history.  He also has spent a considerable sum of money on “projects to help the world” – unfortunately, he has never completed a project.

Sam’s parents also state that Sam was diagnosed previously by his PCP with MDD and GAD.  “These new behaviors are just that – new – since he went to college”.

Further discussions with Sam and his parents reveal that he has never experienced hallucinations and you believe that he currently is not experiencing any delusions.  Sam states “I am what I am”.

  1. What diagnosis do you believe may apply to this individual?
  2. What classifications of medications can be used to treat this disorder?  Which medication do you recommend and why?

Nursing module 3 assignment

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please follow all directions 

Nursing Assignment Golden Age and Macromolecules

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Golden Age of Microbiology: Use the given active learning template (ALT) to connect Scientists with their discoveries in 1-2 sentences. (Slide 1; 2.5 points)

Carolus Linnaeus

Antoni van Leeuwenhoek

Alexander Fleming

Joseph Lister

Ignaz Semmelweis

Robert Koch:
(Slide 2; 3 points)

Summary of Key Work:

Organisms Studied:

Other Findings:

Postulates:

Louis Pasteur:
S-shaped Flask experiment
(Slide 3; 2 points)

Hypothesis:

Experimental Design:

Results:

Conclusion:

Note for students: Macromolecules is a review from prior courses. This topic may or may not be covered in-class or online. You may use your textbook or books from prior courses for this ALT. (Slide 4; 2.5 points)

Complete the following table by describing the terms in1-2 sentences with their function and examples

Carbohydrates Functions and Examples
Monosaccharides
Disaccharides
Polysaccharides
Lipids Functions and Examples
Triglycerides
Phospholipids
Level of protein structure Structural organization
Primary  
 
Secondary  
 
Tertiary  
 
Quaternary  
 

Complete the following Table by adding information on bonds that participate in creating certain level of protein structure and if biological activity is present in that level of structure (Slide 5; 2 points)

Give an example of a disease that occurs due to errors in protein folding: ___________________________________

Type of NA Composition of the nucleotide Location, Function and types Structure and sugars
DNA
 		      
RNA
 		      

The two types of Nucleic acids ________________ and ______________

Role of ATP _________________________________________________________

Complete the following table about the composition, structure and functions of Nucleic acids (NA).

(Slide 6; 3 points)

MSN5300 reply 2

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 Reply with 200 words and reference

Differences And Similarities Between Quantitative, Qualitative and Mix Methods Research Studies

Quantitative research study uses numerical gathering and analyze numerical data to establish patterns and relationships between the study variables (Fain, 2020). Through this, the research can test hypotheses and develop casual relationships. Some data collection methods employed in this study included experiments, surveys, and observation using questionnaires or other standard techniques. Since the data is collected and coded numerically, it is analyzed through statistical methods such as ANOVA. Generally, this type of study includes a large sample size, representing the whole population linked to the study problem. This concept helps promote validity and applicability of the findings and taxation into clinical practice. According to Hong et al. (2018), when conducting the critical appraisal of quantitative studies, the researcher can consider the sample size, sampling method, data collection method, study methods, and ethical considerations.  

In contrast qualitative research studies analyze patient expenses and perspectives about phenomena, thus developing a better understanding of the study problem (Fain, 2020). Data is mainly collected through focus groups, interviews, and observation to collect textual data presented as a description of the native. Additionally, this study mainly involves a small sample size since the focus is an overview of individuals’ perspectives on the study problem. Since data is presented in textual or visual forms, it is analyzed through categorizing and coding to identify themes and patterns; qualitative study provides useful data on quality improvement, which can be incorporated into clinical practice. By analyzing patient experiences and perspectives, the researcher can pinpoint areas in clinical practice that equips improvement. The critical appraisal focuses on determining the credibility of a qualitative study by analyzing adherence to ethical considerations, sampling methods, theoretical framework and the possibility of evidence translation into clinical practice.

 Mixed method studies involve elements from quantitative and qualitative studies, thus analyzing the strength of each approach in providing a solution to the study problem (Grove & Gray, 2018). Since this design employs  two methods, data is collected from the same participants in textual and numerical form. This helps promote a better understanding of the study findings and draw a strong conclusion. Ata is then analyzed separately, and the findings are integrated when developing a conclusion. The sampling method in mixed-method studies can vary depending on the researcher’s choice and preference. The evidence gathered from these studies can be translated into clinical practice, thus promoting improved patient outcomes. Critical appraisal of these types of studies may involve analyzing how quantitative and qualitative studies have been integrated, the theoretical framework, ethical consideration, presentation of data in textual and numerical form, and the method of sampling used to involve others.

clinical ethics

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Apply this model (table 2-1) to a challenging situation in your nursing career that required you to consider the ethical dimensions of the patient case and the role you played in providing care. Specifically apply and address the questions within each topic area as they pertain to your situation.

In your conclusion, discuss the impact of the Four Topics process. Did applying these principles shape your decision making in any way?  Does this seem like a valid process for you to apply in your practice? 

TABLE 2-1 Four Topics Method for Analysis of Clinical Ethics Cases

Medical Indications: The Principles of Beneficence and Nonmaleficence

1. What is the patient’s medical problem? Is the problem acute? Chronic? Critical? Reversible? Emergent? Terminal?

2.  What are the goals of treatment?

3.  In what circumstances are medical treatments not indicated?

4.  What are the probabilities of success of various treatment options?

5.  In sum, how can this patient be benefited by medical and nursing care, and how can harm be avoided?

Patient Preferences:  The Principle of Respect for Autonomy

1. Has the patient been informed of benefits and risks, understood this information, and given consent?

2.  Is the patient mentally capable and legally competent, and is there evidence of incapacity?

3.  If mentally capable, what preferences about treatment is the patient stating?

4.  If incapacitated, has the patient expressed prior preferences?

5.  Who is the appropriate surrogate to make decisions for the incapacitated patient?

6.  Is the patient unwilling or unable to cooperate with medical treatment? If so, why?

Quality of Life: The Principles of Beneficence and Nonmaleficence and Respect for Autonomy

1.  What are the prospects, with or without treatment, for a return to normal life, and what physical, mental, and social deficits might the patient experience even if treatment succeeds?

2.  On what grounds can anyone judge that some quality of life would be undesirable for a patient who cannot make or express such a judgment?

3.  Are there biases that might prejudice the provider’s evaluation of the patient’s quality of life?

4.  What ethical issues arise concerning improving or enhancing a patient’s quality of life?

5.  Do quality-of-life assessments raise any questions regarding changes in treatment plans, such as forgoing life-sustaining treatment?

6.  What are plans and rationale to forgo life-sustaining treatment?

7.  What is the legal and ethical status of suicide?

Contextual Features: The Principles of Justice and Fairness

1.  Are there professional, interprofessional, or business interests that might create conflicts of interest in the clinical treatment of patients?

2.  Are there parties other than clinicians and patients, such as family members, who have an interest in clinical decisions?

3.  What are the limits imposed on patient confidentiality by the legitimate interests of third parties?

4.  Are there financial factors that create conflicts of interest in clinical decisions?

5.  Are there problems of allocation of scarce health resources that might affect clinical decisions?

6.  Are there religious issues that might influence clinical decisions?

7.  What are the legal issues that might affect clinical decisions?

8.  Are there considerations of clinical research and education that might affect clinical decisions?

9.  Are there issues of public health and safety that affect clinical decisions?

10.  Are there conflicts of interest within institutions and organizations (e.g., hospitals) that may affect clinical decisions and patient welfare?

Week 3 Project

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HUM 1050 – Introduction to Literature

Assignment #1: Analytical Essay – Initial Submission

Write an APA-formatted essay of 1000 words on (a) Chopin's biography; (b) analysis of “The story of an hour” (Chopin, 2023); and (c) a critical review of the story. 

This essay should:

· be 1000 words long

· have an explicit thesis statement, with the main idea (the topic of the paper) and a controlling idea (what you, as the author, is saying about the topic)

· include an integrated, direct quote from the text to support the thesis in each of the body paragraphs

· be written using APA formatting guidelines

· use APA guidelines for citation, both in-text and on a References page

· write in 3rd-person only

· be submitted as a MS Word .docx file

Plagiarism will result in a zero for the assignment.

Reference

Chopin, K. (2023). The story of an hour. https://www.katechopin.org/story-hour/