Your patient is a 23-year-old female. She presents with coughing and wheezing which she stated started about three weeks ago. She is currently 25 weeks pregnant. Her last prenatal visit was one month ago in another state. She has an appointment with the prenatal care provider next week, however her respiratory symptoms brought her to your office today.
History – Chickenpox as a child. Asthma as a child, diagnosed at age 8 for which she used a SABA when needed. She has not had the need to use an inhaler since she was 19. She takes only her prenatal vitamin. No other acute or chronic problems. She advises you that she is up to date on all immunizations except she has not had a flu shot (it is October).
Social – Non-smoker, no drug use. She relocated to your state two weeks ago to get away from an abusive domestic situation. She has no support network in this area and has not yet found employment. She has no medical insurance.
HPA – Non-productive cough x 3 weeks. Wheezing audible from across the room. She states it is like this all day and wakes her from sleep every night. She reports that she is fatigued even in the morning. No other complaints.
PE/ROS – Pt appears disheveled but clean. Wheezing in all lung fields. T 98, P 82 regular, R 28 no stridor. FH 130 regular. The remainder of the exam is WNL.
02 98% and FEV 70%
Directions:
Healthcare providers face various challenges in diagnosing patients who come with different problems in the hospital. Nurses must perform a comprehensive assessment entailing detailed health history and physical examination for a definitive diagnosis. Some conditions have similar characteristics hence the need for careful review and consideration of differential diagnosis. More so, each disease has specific management depending on the cause and severity. Healthcare providers leverage both pharmacologic and non-pharmacologic treatment methods for better patient outcomes. This essay analyzes pharmacological and non-pharmacologic asthma management and community resources.
Wheezing is a persistent coarse whistling sound produced by the narrowed upper airways. It results from inflammation in the trachea or bronchi caused by allergic reactions, infections, or physical obstructions (such as a tumor or foreign body) of the larger upper airways. A diagnosis causing wheezing must thus be from an infectious or allergic cause causing swelling or narrowing of the upper airway. The patient reports a non-productive cough. Other symptoms such as sputum, a runny nose, malaise, and body ache associated with upper respiratory infections are absent. Barnes (2018) state that asthma and chronic obstructive pulmonary disease are the primary cause of recurrent wheezing. However, signs of inflammation are missing, thus ruling out infection.
The patient has a history of asthma diagnosed in childhood. She stopped taking her medications at 19. According to existing evidence, asthma relapses are common even after defeating at around 18. The major risk factors are weakened immunity (pregnancy or missed flu vaccination), traveling, and exposure to precipitating/ causative factors (Trivedi & Denton, 2019). The asthma signs and symptoms have been on and off since childhood, and this incident is a relapse. For this patient, the diagnosis is chronic mild intermittent asthma- an upper respiratory condition that causes narrowing of the airway, wheezing, disturbed sleep due to changes in breathing patterns, and fatigue associated with labored breathing (Stern et al., 2020).
Asthma is a chronic illness without a definitive cure. Although individuals, especially children, exhibit symptoms, the disease often relapses later in life. The nursing and medical management of asthma are symptomatic. Eliminating the causative agents can also help in managing asthma. The Global Initiative for Asthma (GINA) is the global strategy responsible for preventing and managing asthma. GINA works with public health officers and other professionals to reduce the global prevalence, morbidity, and mortality. It states that asthma management strategies aim at symptom control and risk reduction in asthma. These strategies also help prevent asthma exacerbation, mortality, and medication side effects (GINA, 2019). Asthma management also entails patient goals and initiatives. Management in pregnancy also entails cushioning the baby against asthma and its medications side effects. Asthma management entails pharmacologic and non-pharmacologic interventions.
Pharmacological treatment is low-dose regular ICS-Formoterol (maintenance and reliever). ICS-budesonide formoterol, SABA, or an inhaler with both ICS and SABA are optional asthma management therapies (GINA, 2019). According to Robijn et al. (2019), ICS-containing drugs have low risks for severe exacerbations such as status asthmaticus. GINA 2019 strategy changes remove SABA as a daily treatment because the drug has a high relapse rate. It will also help reduce reliance that develops when patients take SABA from the early development of the disease. Treatment in pregnancy increases intensity and aggressiveness, and asthma control surpasses any potential drug risk (Robijn et al., 2019). The absence of an ICS-formoterol calls for a SABA inhaler to prevent worsening of the symptoms. According to GINA, a low-dose maintenance therapy (200-500mcg) is integral.
There are various non-pharmacologic modalities for managing asthma. These methods are often underappreciated and include pulmonary rehabilitation, and focused breathing techniques (yoga and breath retraining) are the choice of non-pharmacologic interventions for this patient (Tan et al., 2020). Other interventions include vitamin B and C supplements, determining and avoiding allergens/ asthma triggers, and keeping warm. Pulmonary rehabilitation entails an exercise program that focuses on exercising to train the lung alveoli to open up adequately to support breathing. Exercises force open closed alveoli and promote bronchodilation, improving the integrity of the respiratory effort. It also reduces respiratory effort. It is also important to assess for occupation-related asthma exacerbation and advise on risk reduction.
Therapeutic patient communication is integral when handling the patient. It begins with understanding relevant patient data and creating a rapport and ends with making mutual goals and objectives. The communication plan will also include retraining in inhaler use. Establishing adherence is integral and entails pointing out the importance of adherence and the consequences of non-adherence to the drugs (GINA, 2019). Teaching about the side effects that are mild and self-limiting such as agitation and muscle and leg cramps, is equally crucial. Keeping warm is integral because cold exposure is a leading cause of asthma attacks. Wearing warm clothes and dressing according to the weather will help reduce exacerbations. GINA requires pregnant women with asthma exacerbation to attend a follow-up clinic after one week; hence booking a clinic after one week with the patient will be integral (GINA, 2019). A review every 3-4 weeks will also be necessary for this pregnant woman. It is vital to make the woman understand that she can come back to the clinic at any time if the symptoms persist.
The Asthma and Allergy Foundation of America (AAFA) Support Community connects patients, families, and caregivers (Cassalia, 2018). The community is an excellent online resource that allows families to interact with their care providers, discuss and consult on asthma problems, and garner support for all individuals. The community resource is available in all states because it is an online platform. The organization also works with local support groups in managing asthma. The community resource majorly works to identify gaps in asthma management and support the passage of laws that positively impact asthma patients and their families. It also focuses on drug availability and costs and new research on better patient management. The resource will help patients access other support groups that meet their specific needs depending on their differences. Other community resources include the asthma community network, online asthma community, Airnow, and Burnwise organizations, which are resources that target asthma risks and help individuals avoid them hence managing asthma.
Patient management requires proper physical assessment and history taking. Asthma is a chronic illness that causes narrowing of the upper airway hence wheezing, fatigue, and disturbed sleep patterns. Asthma is common in childhood, and individuals can acquire remission, but relapse is common, especially with SABA use. The global initiative for asthma is responsible for asthma management and recommends ICS-containing medications as a reliever and maintenance therapy. SABA is avoided due to its risk for relapse. Non-pharmacologic management interventions such as pulmonary rehabilitation are also integral in managing asthma symptoms. Healthcare providers can refer patients to community resources such as AAFA for further management and social support.
Barnes, P. J. (2018). Targeting cytokines to treat asthma and chronic obstructive pulmonary disease. Nature Reviews Immunology, 18(7), 454-466. https://doi.org/10.1038/s41577-018-0006-6
Beasley, R., Braithwaite, I., Semprini, A., Kearns, C., Weatherall, M., Harrison, T. W., … & Pavord, I. D. (2020). ICS-formoterol reliever therapy stepwise treatment algorithm for adult asthma. European Respiratory Journal, 55(1). https://doi.org/10.1183/13993003.01407-2019
Cassalia, M. (2018). AAFA and Allergy Standards Host Allergy Summit to Elevate Industry and Consumer Perspectives to Improve Products for Allergy Aware. Retrieved from https://www.globenewswire.com/news-release/2018/11/01/1640881/0/en/AAFA-and-Allergy-Standards-Host-Allergy-Summit-to-Elevate-Industry-and-Consumer-Perspectives-to-Improve-Products-for-Allergy-Aware-Consumers.html
Global Initiative for Asthma (GINA), (2019). A Pocket Guide for Asthma Management and Prevention (for adults and children above five years). Retrieved from https://ginasthma.org/wp-content/uploads/2019/04/GINA-2019-main-Pocket-Guide-wms.pdf
Robijn, A. L., Murphy, V. E., & Gibson, P. G. (2019). Recent developments in asthma in pregnancy. Current Opinion In Pulmonary Medicine, 25(1), 11-17. https://doi.org/10.1097/MCP.0000000000000538
Stern, J., Pier, J., & Litonjua, A. A. (2020, February). Asthma epidemiology and risk factors. In Seminars in Immunopathology (Vol. 42, No. 1, pp. 5-15). Springer Berlin Heidelberg. https://doi.org/10.1007/s00281-020-00785-1
Tan, D. J., Burgess, J. A., Perret, J. L., Bui, D. S., Abramson, M. J., Dharmage, S. C., & Walters, E. H. (2020). Non-pharmacological management of adult asthma in Australia: a cross-sectional analysis of a population-based cohort study. Journal of Asthma, 57(1), 105-112. https://doi.org/10.1080/02770903.2018.1545030
Trivedi, M., & Denton, E. (2019). Asthma in children and adults—what are the differences, and what can they tell us about asthma?. Frontiers in Pediatrics, 7, 256. https://doi.org/10.3389/fped.2019.00256
Part 1
Choose a drug that is used for the GI system. Write a legal prescription for the drug for a fictitious patient. You are the provider. Be sure your prescription includes all legally correct patient information, provider information, medication information as well as any special instructions to the pharmacist. Your writing Assignment should include all the legal elements of a prescription.
Part 2
Write a 250-300 word paper to describe the pharmacokinetics and pharmacodynamics of the drug as well as specific patient education about the chosen drug. Reference your work using correct APA formatting. Utilize correct professional writing including grammar, punctuation, and mechanics. Directions
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.
For the assignment, do the following:
There are various upper respiratory tract infections. They include common cold, influenza, allergic and vasomotor rhinitis, intranasal foreign body, and sinus. Thomas & Bomar (2021) note that influenza is a more acute condition with more severe symptoms, occurring and worsening within twenty hours. The child has had the mild symptoms for three days, ruling out influenza. Allergic and vasomotor rhinitis primarily manifest with inflammation of the nasal mucosal hence nasal drainage, itching, and nasal congestion are absent in Mr. Smith’s son (Meng, Wang, $ Zang, 2019). Intranasal foreign bodies present with rhinorrhea, pain, swelling, and no fever except in severe cases. The child presents with different symptoms ruling out the foreign bodies. Sinusitis is the inflammation of the membrane of the sinuses, and the presentations depend on the affected sinuses. They include nasal congestion, facial pain (sinus inflammation), and nasal congestion absent in this child, ruling out the diagnosis (Leung et al., 2020). Common cold is prevalent in children and is caused by a viral infection of the upper respiratory tract. The symptoms have an acute onset (less critical than influenza), ranging from mild to severe (Thomas & Bomar, 2021). They include nasal congestion, stuffiness, sore throat, cough, and fever.
Common cold is a mild healthcare condition that requires only supportive management. Decongestants and antiviral therapies in children below four years lack clinical trials showing their efficacy, and the FDA advises against their use (Thomas & Bomar, 2021). Symptomatic management using antipyretics and supportive therapy is the mainstay of treatment for Mr. Smith’s son. Ibuprofen 20mg/kg/day oral dosage will help reduce the fever. Nasal irrigation using saline nasal drops is another mainstay management to help dry secretions and congestion. Throat saline spray/irrigation will also help with the sore throat. Zinc sulfate supplement will help reduce the cold’s duration and reduce the severity of the symptoms. Minimizing exposure to a cold environment using warm jackets, gloves, and socks will help prevent severe common cold symptoms (Susan et al., 2022). These interventions will help manage the symptoms and reduce the severity and duration of the cold.
The family’s involvement in managing this patent is vital. The parent must understand the medications, dosages, importance, routes, and precautions. Nasa drops are instilled twice daily, in the morning and evening, and nasal saline sprays are used similarly (Susaman et al., 2022). Ensure the baby’s nostrils are clear before instilling three drops in each nose. The father also educates on why his child will not receive antibiotics because it is the common cold. Education will also entail follow-up if the cold does not resolve after a week. Common cold resolves independently, and the parent also needs to understand that. Teaching the parent will ensure they participate in care delivery and promote better patient outcomes. Reminding the father to help monitor the child by frequent handwashing and avoiding touching eyes and face will be necessary (Thomas & Bomar, 2020).
Various resources provide information about common cold, its causes, management, and prevention. Some resources also provide information on the management of common cold. The CDC investigates and releases reports on conditions and their management (CDC, 2021). It provides updated information on current common cold treatments for a common cold. The organization will also give more information to support my choices in managing the child’s cold.
Common cold in adults and children is a mild healthcare cond
MN605 Transition to Practice Unit 6 Midterm
Question 1 Currently in the U.S., medical treatments that result in injury or death is a:
Question options:
Question 2
Risk management is about analyzing the act of the individual provider versus the system the provider works in.
Question options:
Question 3
Medication errors that occur during prescribing, administering, or dispensing are one of the leading causes of malpractice claims against Nurse Practitioners (NP).
Question options:
Question 4 Today, the trend of malpractice suits against NPs in the U.S. are (select all that apply)
Question options:
Question 5 When courts are determining reasonable practice of a prudent NP, they consider :
Question options:
Question 6 For the NP, scope of practice , as issued by state boards or national professional standards, serve to:
set limitations of what the NP can do and not do.
Question options:
Question 7
Under Tort law, causation refers to:
Question options:
Question 8
For someone to claim malpractice the following need to have occurred except:
Question options:
Question 9
When determining deviation from standard of care, all of the following is considered except:
Question options:
Question 10
A successful malpractice claim against an NP is highly unlikely if (check all that apply) the NP:
Question options:
Question 11
A major source of severe penalties of malpractice claims against NPs are all except:
Question options:
Question 12
Daily patient workload may increase the risk of a malpractice claim.
Question options:
Question 13
Following clinical practice guidelines is one of the best ways to avoid malpractice litigation.
Question options:
Question 14
When a plaintiff proves a malpractice claim in court, the penalties for the defendant are always:
Question options:
Question 15 Punitive damages are awarded when it is proven that the gross malpractice is caused by the defendant. The amount of punitive damages is based upon the jury recommendations and jurisdictional limits.
Question options:
Question 1
Currently in the U.S., medical treatments that result in injury or death is a:
Question options:
Question 2
Risk management is about analyzing the act of the individual provider versus the system the provider works in.
Question options:
Question 3
Medication errors that occur during prescribing, administering, or dispensing are one of the leading causes of malpractice claims against Nurse Practitioners (NP).
Question options:
Question 4
Today, the trend of malpractice suits against NPs in the U.S. are (select all that apply)
Question options:
Question 5
When courts are determining reasonable practice of a prudent NP, they consider :
Question options:
Question 6
For the NP, scope of practice , as issued by state boards or national professional standards, serve to:
set limitations of what the NP can do and not do.
Question options:
Question 7
Under Tort law, causation refers to:
Question options:
Question 8
For someone to claim malpractice the following need to have occurred except:
Question options:
Question 9
When determining deviation from standard of care, all of the following is considered except:
Question options:
Question 10
A successful malpractice claim against an NP is highly unlikely if (check all that apply) the NP:
Question options:
Question 11
A major source of severe penalties of malpractice claims against NPs are all except:
Question options:
Question 12
Daily patient workload may increase the risk of a malpractice claim.
Question options:
Question 13
Following clinical practice guidelines is one of the best ways to avoid malpractice litigation.
Question options:
Question 14
When a plaintiff proves a malpractice claim in court, the penalties for the defendant are always:
Question options:
Question 15
Punitive damages are awarded when it is proven that the gross malpractice is caused by the defendant. The amount of punitive damages is based upon the jury recommendations and jurisdictional limits.
Question options:
MN605 Unit 6 Quiz Latest
Welcome to ENG-123: English Composition II! In this course, you will uncover the foundations of persuasive writing and explore the research process through analysis and evaluation of various sources.
In this first module, you’ll start by introducing yourself on the course-long discussion boards. Next, you’ll explore problem solving and persuasion with your classmates Module 1: The Keys to Persuasion. Finally, you’ll brainstorm and develop ideas for your persuasive essay (due in Module Seven) by submitting a journal entry to your instructor.
We encounter problems in every aspect of our lives. On a personal level, we are constantly working on such things as mending relationships with friends and family members, managing a hectic household, and addressing health concerns.
In our professional lives, we also encounter problems on a daily basis, both on a small and a large scale. For example, if you are a teacher, you may spend one class period managing poor student behavior and then spend the next class period scrambling to figure out how to finish your lesson plan before the bell rings.
There are also the larger-scale issues that you may deal with, particularly if you teach in a public school system, such as reconciling the tension between government-mandated initiatives and your own beliefs about what works well in the classroom Module 1: The Keys to Persuasion.
In response to these types of industry-specific problems, researchers are continually investigating ways to fix these issues. The results of such research will impact the types and availability of careers in various fields, while also impacting people’s personal lives Module 1: The Keys to Persuasion. For example, in the fast food industry, many companies are responding to society’s ever-growing interest in “eating clean” and “being green.”
Takeout containers are made with recycled materials, and many fast food chains are ceasing to use artificial colors and ingredients in their food. Individuals in the food industry now feel the pressure to join the “clean and green” movement in order to attract and maintain customers. And as with all change, debate follows. There will always be dissenters from every viewpoint.
Copyright © 2020 MindEdge Inc. All rights reserved. Duplication prohibited.
In this course, you will practice the art of persuasion. You will think about a problem in your field of study/profession that has at least two clear arguable sides and compose a persuasive argument that clearly states your point of view on the issue.
Your goal is to convince the audience to adopt your viewpoint. In order to do this, you will make a claim—an assertion with which your audience might disagree—and then support that assertion with evidence Module 1: The Keys to Persuasion.
The word “argument” has a negative connotation, or suggested meaning. When people hear the word argument, they often assume it is a hostile conversation about a topic. But argument can also simply mean a well-reasoned point being made about a topic, done so in a respectful, logical way Module 1: The Keys to Persuasion. Arguments can occur between respectful parties who strongly disagree with one another’s argument, but it does not have to be hostile.
Let’s say you are sitting at Thanksgiving dinner, and you are a bit nervous because your uncle, who feels very differently about politics than you, will inevitably bring up the latest political hot topic. Knowing you have to be level-headed and reasoned in your conversation with him, in order to avoid any hostility, you choose an even tone, respectfully acknowledge what he is saying, but still hold your ground on your position toward the hot topic. Module 1: The Keys to Persuasion
Since it is different than his position, and you want to hold your own in this argument, you present him with reasons that are clear and logical. Although he may not agree with you, and you will likely not persuade him, he is more likely to at least listen to your point of view Module 1: The Keys to Persuasion. Making sure you do not slip into insulting language, eye rolling, or walking away when he disagrees with you are all important to having an effective argument.
In all aspects of our lives, we present arguments to those around us: to car salespeople, to our children when they don’t want to do something we know is good for them, to our partners when they want to spend more money than we do, or to our grandparents when we try to get them to see the benefits of using video chats. Whether we are writing or talking to people who matter to us, argument is all about drawing people in and persuading them to at least see our point of view, if not to adopt it.
The examples in the video show us how argument and persuasion can function successfully (or unsuccessfully) in everyday life. Although the examples provided are in the first person (since they are examples from everyday life), the premise in persuasive writing is the same. Module 1: The Keys to Persuasion
Be respectful of potentially opposing positions use logic to ground your stance be clear, concise, and precise in the presentation of your argument, using indicator words such as “must,” “should,” “support,” “because,” or “oppose” to present your core argument Module 1: The Keys to Persuasion
When making a persuasive argument, it is also important to factor in any counterarguments, or opposing viewpoints, and consider how to respond to them.
Most topics generate a variety of positions, not simply two positions that sit in direct opposition to each other. In fact, it is helpful to picture the potential positions on any given topic in a circular format rather than imagining two distinct points at opposite ends of a straight line Module 1: The Keys to Persuasion. Few topics lend themselves to such an oversimplified black and white division.
As most topics are complex and layered, some of the most potent arguments can be found in the grayer areas. The more complex issues give rise to multiple points of view along a continuum, something writers need to keep in mind.
Take, for example, the topic of sex education in public schools. One position on the topic is the “absolutely not” position held by some people due to their religious and/or moral ideologies. According to this position, sex education should never be taught in America’s public schools under any circumstances. Module 1: The Keys to Persuasion Opposing the “absolutely not” position are a range of positions, not just one. Here are only four of the many possibilities:
Yes, sex education should be taught in public schools, depending on what material is covered. Yes, if it concentrates on abstinence.
No, if it concentrates on abstinence. No, if it begins in elementary school.
If you are writing on sex education in public schools, you will have to be familiar with all of the positions on both sides of the argument. Additionally, you will need to understand the reasons people hold these positions Module 1: The Keys to Persuasion. Refuting any opposing position is impossible if you are unfamiliar with the issue as a whole.
The first step in composing a persuasive argument is to do a little preliminary research and brainstorm topics for your written piece. The next few pages in the module will help you get started.
This week, in your 1-6 Journal assignment, you’ll be asked to look at some issues related to your potential field or degree. Before you practice some brainstorming strategies, it might help to take a look at possible issues related to your field Module 1: The Keys to Persuasion. In module two, we’ll take a closer look at conducting keyword searches and gathering sources, but for now, to prepare for brainstorming and constructing your Journal submission this week, you can take a look at the freewriting instruction steps previously outlined— with that idea as your starting point.
Remember that the most important part of freewriting is reflecting on your writing. So, after your loop, be sure to ask yourself the same reflective questions you asked during your initial freewrite.
After you finish freewriting, read your writing carefully to decide which ideas are most worthy of exploration. As you read over your writing, ask yourself these questions:
Opinions can help point you toward an interest, but if your freewrite consists only of opinion, you may need to conduct another freewrite that focuses more on facts, you may want to conduct a preliminary search, or you may need to pick a new topic. Can I identify one or two questions that most of my freewrite responds to? If you can, you might have found yourself a research question.
If you’d like to compare a freewriting session against a looping session, compare the loops below to the freewrites from above.
Feeding America’s poor won’t be easy. Not with one out of seven of us living at the poverty level. It’s especially bad for kids. I mean, how can a kid concentrate on learning when he hasn’t eaten in two days? When you think about how much food goes to waste every single day in this country, you’d think there wouldn’t be a problem.
Just think about the food fights that go on in cafeterias all over the country. With that wasted food alone we could probably feed all the poor people. And I know a lot of people let vegetables sit in their refrigerators until they rot and then they have to throw out all that food. Also, just think about all the restaurants that throw away food every single day.
You’ve probably seen homeless people doing “dumpster digs.” I know I have. At least, they are getting some nourishment out of what’s being discarded, but who’d want to eat food that’s mixed with garbage? I think we should have more public service announcements to make people aware of what they are wasting. That would be a first step.
Maybe parents could also be advised not to put so much food on their kids’ plates at suppertime. That would solve two problems–the food waste problem and the obesity problem. Then, we could use the money that is saved to help the hungry more than we do. It’s true that some celebrities like Sandra Lee have started a campaign, but not everybody watches her on the food network channel. Module 1: The Keys to Persuasion
I guess we need more celebrities getting the word out. I know the President and First Lady are working on this and that’s helping a lot. But there’s really a lot to do. There are food banks, of course. But we really need more than famous people getting the word out. We need the average Joe thinking twice about waste.
ANSWER: I really did focus on the poor and how much food-waste there is in this country. I also talked about what famous people and ordinary people can do to solve the problem of people going hungry.
ANSWER: “Poor” (poverty), “food,” “waste,” “celebrities.”
ANSWER: There has to be a lot of data about poverty in America and also wasted food. I could also learn more about Sandra Lee and what people like her are doing to help.
ANSWER: What are celebrities doing to help the poor? What can the average person do?
Topic: Feeding the hungry
Research Question: What are the characteristics of an effective anti-hunger program?
What will I do to earn a living? Right now I’m studying liberal arts and there are a lot of possibilities in front of me, assuming I don’t change my major. There are a lot of things I know I wouldn’t do–no matter how much money I could make. Even if I was desperate, like Stephen King, I wouldn’t dig graves to earn money. Module 1: The Keys to Persuasion
I also wouldn’t do anything that would harm animals. And I would never steal from people the way Madoff did. But, as a liberal arts generalist, especially a generalist with some computer skills, I could probably enter any field I wanted to. There really are a lot of choices. Plus, I could always learn on the job. Most businesses have orientation and training programs that help new hires learn what they need in order to do a specific job.
And, a lot of places will actually pay for employees to take additional college courses. Of course, I could pay for further education myself if I had to. I could get a Master’s Degree or some other degree that would help me get promotions once I’ve started working. Module 1: The Keys to Persuasion
Plus, there’s always stuff I could learn about on my own by doing research on the Internet or by taking some online courses. Things are changing so fast that I’d probably have to take additional courses anyway. Take electrical engineers, for example. I read that by the time they graduate, half their knowledge is obsolete. So maybe I shouldn’t worry too much about what I’m learning right now. Instead, I should concentrate on getting a good solid academic base, rather than a narrow or too-specific body of knowledge.
Being able to communicate well is critical for career success, no matter what field I choose and I’ve always had A’s in my written and oral communications classes. Being a good problem-solver is important, too. I like challenges and have often been complimented on my analytical skills. Another thing that’s going to serve me well are my people skills. Module 1: The Keys to Persuasion
Everybody tells me I’m both a good leader and a great team player. So, I guess, now that I think about it, I won’t have to dig graves. I should be able to get any job I want…assuming the economy is better by the time I graduate.
ANSWER: I did stay on the topic of my future–work I’d like to do and work I definitely wouldn’t do.
ANSWER: “earn a living,” “money,” “job,” “learning”
ANSWER: I should be able to research jobs in general, especially those available to liberal arts majors. I’d also have to find out what skills are required for entry-level jobs in certain industries.
ANSWER: What jobs does a liberal arts degree lead to? How soon does knowledge become obsolete?
Topic: Job economy
Research Question: What can one do with a liberal arts degree?
Clustering is another method of brainstorming ideas. You can use it by itself, or you can organize some of the ideas you discovered during your freewrite. Watch the following video to learn more about the clustering method.
1-5 Activity: Brainstorming Ideas (UNGRADED)
Now it’s time to put into practice one of the brainstorming exercises discussed in the previous page. Please select one of the two UNGRADED brainstorming activities below.
You may want to choose a topic that is related to your career or degree, since you will be completing a journal assignment on the next page with that focus.
1-6 Journal: From Issue to Persuasion This assignment does not contain any printable content.
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Use this document to complete the evaluation table requirement of the Module 4 Assessment, Evidence-Based Project, Part 4A: Critical Appraisal of Research
Full APA formatted citation of selected article.Article #1Article #2Article #3Article #4Evidence-based practice, step by step: a critical appraisal of the evidence: Part III by Ellen Fineout-Overholt, Betnadette Mazurek Melnyk, Susan Stilwell, and Kathleen Williamson. (2010)Evidence-based practice, step by step: a critical appraisal of the evidence: Part I by Ellen Fineout-Overholt, Betnadette Mazurek Melnyk, Susan Stilwell, and Kathleen Williamson (2010) Critical Appraisal Tools and Reporting Guidelines for Evidence-Based PracticeRobin Buccheri Claire Sharifi Evidence-based practice, step by step: a critical appraisal of the evidence: part II: digging deeper–examining the “keeper” studies was written by Ellen Fineout-Overholt, Betnadette Mazurek Melnyk, Susan Stilwell, and Kathleen WilliamsonEvidence Level *(I, II, or III)IIIIIIIIIIIConceptual Framework
Describe the theoretical basis for the study (If there is not one mentioned in the article, say that here).**
This study is a follow up to part II of the same research study. The researchers wanted to find out how unplanned admissions to the ICU and the number of cardiac arrest is affected by rapid response team and no rapid response teamIn this study, the researchers wanted to find out how unplanned admissions to the ICU and the number of cardiac arrest is affected by rapid response team and no rapid response teamThe purpose of this paper is to help healthcare workers-in particular nurses, to understand and be able to locate the appropriate tools for critical appraisal.This article is a continuation of the article Evidence-based practice, step by step: a critical appraisal of the evidence by Ellen Fineout-Overholt, Betnadette Mazurek Melnyk, Susan Stilwell, and Kathleen Williamson.The purpose of this edition is to acquire skills and knowledge essential in implementing EBP.Design/MethodDescribe the design and how the study was carried out (In detail, including inclusion/exclusion criteria).
The researchers have a well-articulated plan of how to carry out an appraisal of research. Using the hypothetical nurse scenario, a synthesis table is created from which data is extracted to compare the similarities and differences from the study. From the synthesis table, the researchers the team of researchers can deduce data with higher-level evidence and those with lower-level evidence. The authors use the hypothetical staff nurse to discuss and answer the question “In hospitalized adults (P), how does a rapid response team (I) compared with no rapid response team (C) affect the number of cardiac arrests (O) and unplanned admissions to the ICU (O) during a three-month period (T) Fineout-Overholt, et al., 2010). Through the help of the hospital librarian, Carlos and fellow staff nurses searched three reputable databases- PubMed, the Cumulative Index of Nursing, and Allied Health Literature to acquire information about their PICOT question. A total of 79 studies were chosen by Carlos and her team-18 from PubMed, 6 from CINAHL, and 1 from the Cochrane Database of the systematic review.The authors conducted a systematic search to find the tools that are commonly used in critical appraisal as well as reporting the guidelines for Evidence-based practice.The authors created a hypothetical trial group to discuss what makes a good research and to determine the worth of a studySample/SettingThe number and characteristics of
patients, attrition rate, etc.
The sample used by the researchers is sufficient. The research used between 218 and 662 hospital beds across the studies. In my opinion, this sample is adequate for the research because it spanned across several types of hospitals- 4 teaching, 4 community, 4 no mention, 2 acute care hospitals, and 1 public hospital. These are more than adequate to get desired results.The number of hospital beds ranged from 218 and 662. Several types of hospitals were represented in the interview as follows: 4 teaching hospitals, 4 community hospitals, 4 no mention, 2 acute care hospital, and 1 public hospital.A total of 150 nurses across different types of hospitals and professions were used in the study as they met the inclusion criteria. Having the skills to select the appropriate tool or guideline is an essential part of meeting EBP competencies for both practicing registered nurses and advanced practice nursesIn this article, the authors use a hypothetical nursing scenario. Rebecca R., the hypothetical staff nurse, Carlos A., her hospital’s expert EBP mentor, and Chen M., Rebecca’s nurse colleague, collected the evidence to answer their clinical question: “In hospitalized adults (P), how does a rapid response team (I) compared with no rapid response team (C) affect the number of cardiac arrests (O) and unplanned admissions to the ICU (O) during a three-month period (T)Major Variables StudiedList and define dependent and independent variables
The variables studied are unplanned ICU admissions, the effect of RRTs-Rapid Response Teams and no RRTsunplanned ICU admissions, the effect of RRTs-Rapid Response Teams and no RRTsCritical appraisal tools and reporting guidelinesunplanned ICU admissions, the effect of RRTs-Rapid Response Teams and no RRTsMeasurementIdentify primary statistics used to answer clinical questions (You need to list the actual tests done).
Two articles having level-VI evidence, a study and a project, had statistically significant (less likely to occur by chance, P < 0.05) reductions in HMR, which increases the reliability of the results.The team begins to divide the 26 studies into categories according to study design. To help in this, Carlos provides a list of several different study designs. Rebecca, Carlos, and Chen work together to determine each study’s design by reviewing its abstractNine commonly used critical appraisal tools and eight reporting guidelines were found and are described in this manuscript. Specific steps for selecting an appropriate tool as well as examples of each tool’s use in a publication are provided.The first section of every RCA checklist addresses the validity of the study. Some of the critical questions here include: did the researchers use sound scientific methods to obtain their study results? Rebecca asks why validity is so important. Carlos replies that if the study’s conclusion can be trustedData Analysis Statistical orQualitative findings(You need to enter the actual numbers determined by the statistical tests or qualitative data).
When evidence-based practice is delivered in the context of supportive organizational culture and care, patient outcomes and quality care is achieved.It is not the number of studies or projects that determines the reliability of their findings, but the uniformity and quality of their methods. Participants were clustered into groups who discussed the evolving patterns regarding evidence-based practice. The identified patterns were recorded in a table. From the three systematic reviews (the ones with higher-level evidence) showed some bias since they included studies only from the control group. In short, these studies did not favor the initiation of RRT.Research began by first analyzing studies with highest level of evidence to see the most reliable sources/evidenceFindings and RecommendationsGeneral findings and recommendations of the research
Using the hypothetical nurse case scenario, to help the team better discuss the evidence, Carlos suggests that they refer to all projects or studies as the body of evidence. They don’t want to get confused by calling them all studies, as they aren’t, but at the same time continually referring to studies and projects is cumbersome (Fineout-Overholt, 2010). He goes on to say that, as part of the synthesis process, it’s important for the group to determine the overall impact of the intervention across the body of evidence.The team found that to determine the appropriate level of evidence, it was necessary to divide the studies into groups based on their study design. The team also included some descriptive studies that did not actively answer the PICOT question but contained critical information on the same. For example, from the studies chosen, there are many expert opinions and guidelines. Having the skills to select the appropriate tool or guideline is an essential part of meeting EBP competencies for both practicing registered nurses and advanced practice nursesDetermining the appropriate level of evidence required the researchers divide the studies into groups based on their study design. Besides, some descriptive studies that did not actively answer the PICOT question but contained critical information on the same were included in the study. For example, from the studies chosen, there are many expert opinions and guidelines. Appraisal and Study Quality
Describe the general worth of this research to practice.
What are the strengths and limitations of study?
What are the risks associated with implementation of the suggested practices or processes detailed in the research?
What is the feasibility of use in your practice?
This research provides valuable information how RRTs impact on the number of cardiac arrest as well as the number of ICU admissionsThe limitation of the study is that it relies heavily on other studies thus it does not provide any new information on critical appraisal of research.
This article provides information on the impact of Rapid response Time-RRT on ICU admissions and the number of cardiac arrests in patients.The limitation of this article is that it is a review of existing literature, it adds no new information to the field of critical appraisal of research.
The major strength of this article is that the systemic search of the commonly used critical appraisal tools and reporting guidelines for EBP in nursing is new information that could be explored further to find evidence that supports its role in EBPThis article provides information on the impact of Rapid response Time-RRT on ICU admissions and the number of cardiac arrests in patients.Key findings
Rapid response Time-RRT impacts on the number of ICU admissionsRapid response Time-RRT impacts on the number of ICU admissionsCritical appraisal tools and reporting guidelines are essential in evidence-based practice.Rapid response Time-RRT impacts on the number of ICU admissions
Outcomes
The faster the response time, the lower the cases of ICU admission and vice versaHealthcare facilities with improved RRTs avoided high numbers of ICU admissions.Practicing registered nurses and advance practice nurses are able to critically appraise and disseminate evidence in order to meet EBP competenciesCaregiving facilities with improved RRTs avoided high numbers of ICU admissions.General Notes/CommentsThe article is reliable because of its sample choice and size as well as an effective systematic review approach adoptedThis article is detailed enough to warrant reliability.While the article is not adequately-detailed, it provides enough information/data to back up the hypothesis.
*These levels are from the Johns Hopkins Nursing Evidence-Based Practice: Evidence Level and Quality Guide
Experimental, randomized controlled trial (RCT), systematic review RTCs with or without meta-analysis
Quasi-experimental studies, systematic review of a combination of RCTs and quasi-experimental studies, or quasi-experimental studies only, with or without meta-analysis
Nonexperimental, systematic review of RCTs, quasi-experimental with/without meta-analysis, qualitative, qualitative systematic review with/without meta-synthesis
Respected authorities’ opinions, nationally recognized expert committee/consensus panel reports based on scientific evidence
Literature reviews, quality improvement, program evaluation, financial evaluation, case reports, nationally recognized expert(s) opinion based on experiential evidence
**Note on Conceptual Framework
After the appraisal of the evidence-based research journals chosen, the best evidence-based practice that I choose for infertility is In Vitro fertilization-IVF. IVF is a series of procedures used to help infertile couples to conceive (Amorim, 2018). In this method, eggs that are mature are harvested from a woman’s ovaries and then fertilized by a male sperm in the laboratory. The fertilized eggs are then transferred to the woman’s uterus
I chose IVF as the best intervention for infertility because it the most effective form of assisted reproduction. A couple can use their own eggs and sperm or they can use ones donated by a donor. The advantage with IVF is that it can be used to intervene in numerous types of infertility such as low sperm count, problems with ovulation, poor egg quality, and infertility caused by the inability of a sperm to penetrate the egg among many other types of infertility (Pan, Le, & Jin, 2018). IVF involves the testing of ovarian reserve and semen analysis to evaluate the chances of conception. Besides, testing for infectious diseases is also done when performing an IVF. This is to ensure that the resulting embryo is not affected by such infectious diseases. While IVF has some risks, it remains the most effective approach of dealing with infertility.
Also Read: Nursing Informatics Paper Discussion
PCOS develops in early puberty. It involves neuroendocrine, metabolic and ovarian dysfunction in females. It is indicated by menstrual abnormalities and increased amounts of androgens. Hirsutism and hyperandrogenism are manifestations of overproduction of androgens. Hyperandrogenism is demonstrated by elevated levels of unbound testosterone in circulation. Hyperandrogenism plays a key role in the pathophysiology of PCOS. The high androgen levels suppress sex hormone-binding globulin (SHBG) concentrations. This contributes to higher free testosterone levels. The common denominator in PCOS is therefore ovarian hyperandrogenism (Witchel et al., 2019).
Insulin resistant hyperinsulinism is an aggravating factor in the pathophysiology. Hyperandrogenism and hyperinsulinism leads to obesity and LH excess. Ovarian hyperandrogenism accounts for oligo-anovulation, hirsutism and polycystic ovaries. Hyperinsulinemia affects the ovaries where it synergizes with LH to upregulate androgen production. these actions aggravate hyperandrogenism and anovulation.
Insulin resistant hyperinsulinemia also promotes the deposition of adipose tissue which further exacerbates insulin resistance. Excessive androgens can cause secondary LH elevation by interfering with the negative feedback of progesterone at the hypothalamus. LH alone however cannot cause ovarian hyperandrogenism due to the homologous desensitization of the ovary when exposed to high to excessive LH.
PCOS affects fertility by affecting ovulation. PCOS causes oligo-anovulation which causes women with PCOS to ovulate intermittently, which, according to Cooney and Dokras (2018), makes it harder to conceive.
PID is an inflammation of the female upper genital tract. The upper genital tract is usually sterile compared to the lower genital tract which includes the vagina. Most women have a variety of potentially pathogenic bacteria as part of their vaginal flora. These pathogenic bacteria are prevented from entering into the upper genital tract by the endocervical canal which acts as a barrier. PID cases are usually due to sexually transmitted infections (STIs).
The most common pathogens are Neisseria gonorrhoeae and Chlamydia trachomatis (Low & Broutet, 2017). Infection with STIs can interfere with the endocervical barrier. Disruption of the barrier provides bacteria with access to the upper genital tract which leads to ascending infection from the cervix.
Infection of the genital tract leads to inflammatory damage. Infection can either be subclinical i.e., due to Chlamydia trachomatis or can present as severe pelvic inflammatory disease as in the case of Neisseria gonorrhoeae infection. As Jennings and Krywko (2021) note, subclinical PID can still have long-term consequences even if no symptoms are present. Inflammation of the uterus and fallopian tubes leads to scarring and formation of adhesions.
Scarring and adhesion leads to loss of cilia in the fallopian tubes lining thereby affecting the motility of ova. Ovum transport is impaired as a result. Repeated infections can lead to total obstruction of the fallopian tubes. Infertility and an increased risk for ectopic pregnancy are the possible consequences of impaired motility. Adhesions can lead to chronic pelvic pain.
Syphilis is a bacterial infection that is caused by the spirochete Treponema pallidum. The progression of syphilis occurs through four stages. Many organs can be affected by syphilis. These are primary syphilis, secondary syphilis, latent syphilis, and tertiary syphilis (Peeling et al., 2017). The classic presentation of primary syphilis is a solitary genital chancre on the genitals. The chancre is usually non-tender. The chancre is usually a response to T. pallidum invasion. The chancres are lesions that occur with direct contact with infected lesions.
They are accompanied by lymphadenopathy. Primary syphilis can progress to secondary syphilis if left untreated. Secondary syphilis is due to hematological dissemination and presents as macular rash, headache, diffuse lymphadenopathy hepatosplenomegaly, myalgia etc. both primary and secondary syphilis can resolve without treatment. The patient then goes into the latent phase where no clinical manifestations are present. Some patient may progress into the tertiary phase which is characterized multiple organ system involvement
The movie ‘We Were Children’ derives its outline from a true story. The story is about over 150,000 native Indian children living in Canada who were removed from their homes ad forced to attend Catholic Indian Residential Schools in the 1850s. The facilitators claimed that the act was to help assimilate the children into Canadian society.
Lyna Hart and Glen Anaquod are the main actors in this story. These children were forcefully separated from their parents and put in a residential catholic school. These residential schools were run mostly by nuns and priest. To ensure this undertaking’s success, the parents who did not comply and were reluctant to let their children go were arrested and jailed.
It later emerged that the children in these residential schools were physically and sexually abused, as Lyna and Greg narrate in the film. These children were radicalized and stripped of their cultural, spiritual beliefs and family love. The children lost their original identity and picked new identities where they were referred to using numbers.
Lyna revealed her number as 39, while Greg failed to share his new identity. Their cultural beliefs were altered, and they were taught and made to believe that they are savages, and that their ancestors were also savages and thus were in hell. The children were taught new languages, English and French, emphasizing English, which the nuns and priests referred to as “God’s language”.
In her synoptic review of the movie, Weldon (2012) notes that several scenes in the movie depict how traumatic experiences one goes through in childhood affect adulthood. These children were separated from their families at a tender age. They were not allowed to visit their families and had very minimal communication with their families. This had a considerable impact on their psychological state and caused a high-stress level, especially on the younger children.
What is more, the nuns took their personal property away from them, they cut their hair and gave them new number names. As Lyna narrated in the interview, she felt that “Lyna” stopped existing and that the nuns and priests had wholly stripped her of her identity. The most outstanding features are the scenes that portray abuse and violence. One such scene is when Lyna refused to eat and was taken to the infirmary. Our expectation, in this case, is that Lyna would be handed over to a very compassionate person to address her problems.
What we see is quite different. The nurse force-fed Lyna, and when she refuses to eat still yet, she receives quite a hot slap and insults. The nurse harshly comments that she did not care whether Lyna ate or not, and even if Lyna died, she still did not care. In the infirmary, Lyna witnessed a rape case of a male student. Unfortunately for her, between the ages of four to six, she also became a victim of rape, which was no different for other children in the schools.
Glen was also severely abused. He narrates an incident when he requested to visit his parents but instead received a thorough beating and went ahead to be locked in a dark room for over a week. Glen was put in the infirmary for over a week after receiving a beating for attempting to run away from the school. The traumatic events are still fresh in these children’s minds.
The movie scenes raise many concerns and questions regarding why the schools were allowed to continue abusing and neglecting children for over a hundred years. Why were the abuse reports from the children ignored? Another issue causing alarm is that when investigations were undertaken, and staff found guilty, they were only relocated to other schools where they continued with the abuse and the allegations were covered.
Another issue of major concern is the Canadian government’s reaction after learning of the unfair treatment of the children. Why did it issue just a general apology? It is our duty as a society to protect our children, and as such, what can we do to prevent further abuse of the children?
Some scenes in We Were Children, especially those that involved Lyna, require therapeutic consideration. In her narration, she recalls several incidences where she was forced to use imagination to protect herself from the emotional, physical and mental trauma that she was facing. She narrates how she used to focus her thoughts on her family land during times of significant stress. The movie portrays a scene where she could not speak English well and was forced to hold her tongue in the classroom for more than thirty minutes. Another scene identified in the movie is when the priest raped her.
Lyna explained that in her imagination, she felt safe as nobody could intrude into her imagination and know what was happening in there. This process is commonly referred to as dissociation, and it serves to avoid stress. From another perspective, dissociation is adaptive for adolescents and children who want to cope in situations involving violence (Shin, Goldstein & Pick 2019). Shin et al. (2019) further argue that dissociation brings about emotional numbness, which helps one cope in emotional torture situations. It, however, adversely affects the individual’s response to positive stimuli.
Focusing on Lyna’s rape incidence, the incident must have been the most traumatic in her life since she was incredibly young at the time. This, however, does not demean the scene of the classroom incident as it is equally traumatic. At that time, she could only resolve to dissociation to have emotional relief. As a therapist, I would employ several measures to aid in her recovery. I would use cultural competencies, acknowledging and respecting her culture during the therapy sessions.
This step ensures I build trust that was not present in the schools as the nuns and priests did not respect her culture. I would provide psychoeducation to Lyna and let her know the effects of the trauma she experienced as a child on her childhood and adulthood exerperiences. During her childhood, I would have administered a test to determine her trauma level using the UCLA Post Traumatic Stress Disorder Reaction Index.
I would also recommend Trauma-Focused Behavior Therapy (TF-CBT). Cohen, Deblinger and Mannarino (2018) contend that the main objective of TF-CBT is to disrupt the psychological development process. The therapy empowers youngsters and their families in overcoming and learning from traumatic experiences. TF-CBT helps teach relaxation and coping skills. A therapist would recognize and let Lyna know that her dissociation use was to ensure she copes with the trauma around her and go further to explain that additional skills are necessary to ensure long-term coping.
Using TF-CBT, I would let her know that the rape incidence was wrong, and most importantly, it was not her fault, and she had no control over it. I would be empathetic and emotionally supportive and provide a safer environment to enhance the therapeutic process. Effective management using psychological therapy could prove critical in ensuring Lyna copes effectively and overcomes the traumatic experiences.
When individuals are entrusted with children’s care and well-being, and they horrifically abuse them, I must admit as a clinician dealing with abused children it is difficult to watch it all go away. As Weldon (2012) reports, more than 150,000 children suffered traumatic experiences at an early age, some as early as two. Trauma has a vast effect on the development of a child. Furthermore, the children were not offered an environment where they could grow and learn effectively despite being taught in Catholic Residential Schools that offered catholic education.
Instead, the environment only brought chaos and trauma to these youngsters. The movie focused on the children, but we cannot demean that the parents must have also undergone a great deal of psychological trauma. As a parent, I would live with guilt, pain and anger of having to let my child be taken away from me at the expense of going to jail. It is traumatic to live knowing you gave away your four or 3-year-old child out of fear of going to prison.
We Were Children raises several concerns to me as a mental health practitioner. It is heartbreaking to know that there were no ethical guidelines that guided the treatment of mental health issues for many years. Additionally, caregivers, practitioners, teachers and others were allowed to harm children without facing any legal consequences. It is paramount that counsellors induce no pain or harm to study participants (Kaplan et al., 2017). The film depicts the importance of applying rules and regulations regarding the professional care of participants.
The film validates the idea that childhood abuse often goes unreported, unnoticed and many times overlooked. The instance of Glen, for example, shows that attempts to report abuse by the victims largely went unaddressed. Glen, at some point, ran away from the school to her aunt’s place.
The aunt called the school and returned him there, claiming that she did not want him to destroy his future. She did not know that the poor boy was ruthlessly punished and put in a dark room for attempting to escape the traumatic environment. Children who reported having been raped by the priests were shunned down and told that priests would not carry out such heinous acts. The parents blocked their attempt to get help.
My view as a clinician is in line with Wekerle and Kerig’s (2017) finding that reports from children, especially those involving sexual violence, should be received and treated as urgent. The traumatic experiences had implications on their adulthood. Lyna says she doubted God and the church for a long time while Glen resolved to alcohol and, at some point, contemplated suicide. The events remind us to be constantly mindful and kind to others, for we do not know what trauma they are going through. More so, people we encounter daily have hidden traumatic experiences that we know little about, and we should be cautious about how we treat them.
Watching We Were Children from a therapist’s point of view, there are a few scenes which I find palatable. Only in a few instances did the staff of the residential school properly conduct themselves. The writer discusses different instances, among them, when a young nun also tried to empathize with Lyna by consoling her. It was frightening for her to have someone, except her mother, touch her. Secondly, the scene where nun tried to show compassion to children by cuddling them, only for the priest to tell her that it was not beneficial.
When Glen was found locked in a dark room for one week, a nun helped him out, bathed him and tried to protect him. She also confronted the priest who had locked him. Yet we realize that the nun was sent away following her intervention. Towards the end, Lyna and another child are taken to the kitchen and fed by a nun who found Lyna trying to feed the baby. Taking care of children who have been through traumatic experiences helps build their trust.
In the film, the children were neither allowed to speak in their languages nor practice any of their beliefs, something that only amount to identity deprivation. The school staff also eradicated their original Indian beliefs. Furthermore, the children were ridiculed, and sexually and physically abused. Besides, they were deprived of Maslow’s basic biological and physiological needs, air, food, shelter and warmth (Hopper, 2019). It could be difficult for these children to do well in school and advance when their caretakers took no steps to meet these needs. It is vital to meet the basic needs of a child before considering anything else.
It is most likely that children who grow in residential schools carry into adulthood the scary experiences they encounter there. The effect of attempting to eliminate “the Indian child” amounted to violence, drove the victims to suicide and resulted in shattered families. The film does an excellent job in depicting the plight of children under the guardianship of Catholic Indian Residential Schools.
It offers a historic perspective of the traumatic events that characterized the lives of children during the said era, but one which is relatable to contemporary events regarding childcare and guardianship. From a psychologist’s point of view based on the film, it is essential to understand the clients past to provide compassion and empathy and work from a culturally sensitive perspective, especially when such a client has a past history of physical and sexual abuse as depicted in the film.
Why movies and not just books alone? This question I will think of it as subjective. Many people will say that it is their hobby, some as a way of spending their leisure time while others as a source of entertainment. Most importantly, every movie has a message in the form of a theme that the producer wants to communicate. In this piece of writing am going to reflect on the movie titled “Islam In America” that was released on February 25th, 2018 by Aljazeera. In the movie, Rageh Omaar seeks to gain insight on the history of Islamic faith in America. He travels across the United states interviewing various Muslim Americans with the aim of understanding what it means to be a Muslim in America, a topic covered by a lot of prejudices.
Many like Rageh Omaar thought that America and Islam are in a dynamic conflict type of relationship. This belief was exacerbated by the election of President Donald Trump in 2016 who later banned travel into the United States from six Muslim nations (Khan et al., 2019). However, as the movie reveals, Islam is the fastest growing religion in America. For the past two centuries, Muslim Americans have enshrined their story into larger American history. From the movie, 30% of the first African slaves in America were Muslims (Diouf, 2021).
They settled in the southern state of Mississippi. However, deprived of their right to worship freely, they converted to Christianity. In 1865, slave trade was abolished, and the former laborers and slaves were freed. They moved to the northern state of Chicago, escaping the segregation, racism and bigotry that characterized the south. Chicago offered a diversity of respect, opportunities, freedom of expression and made them feel at home. Over the years, the Islam religion began to thrive, leading to the emergence of such charismatic leaders and personalities as Malcom X and Mohammed Ali.
In my opinion from the movie, American Muslims are happy to be in America. The various respondents in the movie strongly acknowledge America as their home. Abdi Mohammed, for example, considers America first and would sacrifice his life in defending it. Keith Ellison beats all the odds to become the first Muslim congressman having garnered votes overwhelmingly from Jewish and Christian communities.
However, living in America as a Muslim comes with challenges (Al Jazeera English, 2018); for instance, the voice of a Muslim woman has not been heard for over 1400 years. Further, Muslims have been the victims of distrust and hate following the heinous 9/11 terror attack of the twin towers. Moreover, Professor Rula Jebreal argues that Muslims are under-represented in political arena and media (Al Jazeera English, 2018).
From this excerpt, Islamic indeed is a fast-growing religion as evidenced by majority of them being converts including prisoners after serving their jail term. Furthermore, the Muslims are part of America and they enjoy their freedom according to the united states constitution and therefore can participate in the democratic processes. I will give the movie a score of 80%. The movie has successfully presented its theme by exploring the views of Muslims living in America. In addition, the movie has given the world another view of the Islamic faith despite the preformed prejudices and preconceptions. I will recommend other viewers to watch the movie.
The movie “Beautifully Broken” (2018) is based on a true story, and it is the epitome of struggle, pain, and love. The movie, directed by Eric Welch, has a robust Christian worldview and is very inspiring. The film is about three families who undergo sexual assault and war trauma. The families’ common ground is that they have common challenges and have shared views of God’s healing power, reconciliation, and forgiveness in all their traumatic experiences (Woodbury, 2020). The cohesiveness herein is impressive.
The families are from different cultures, religions, and social-economic backgrounds, but that does not deter them from working together to overcome their flaws. The film is seen as a haven for broken hearts to repair, where painful, traumatic underserving experiences are forgotten and a new and better life sprouts. From a Christian worldview, the movie Broken and “beautiful” solidifies to the believers the meaning of the verse Psalms 103:10 “He does not treat us as our sins deserve or repay us according to our iniquities” (NIV).
The movie’s first scene is the initial days of the brutal pursue and murder of the Tutsi tribe in the Rwandan Genocide, 1994. Vicious militia troops wielding guns and machete perform the hot pursue. William Mwizerwa (Benjamin A. Onyango) is one of the dads in the three families depicted in the movie and one of those who survived the attack. He is a spiritual Tutsi man, a devoted father, and a husband who managed a local coffee shop. After missing death narrowly after an encounter with the Hutu militia troops, he manages to escape with his family.
Hutu Mugenzi (Bonko Khoza) is another dad whose life follows a different storyline. He is a sharecropper and is forced to make a callous decision in his life. At times, life can be so unfair, but we have to be brave enough to survive. He is forced to join one of the militia troops to keep his wife and daughter breathing. Many people died during the genocide, and among them was Benjamin’s mother, who was killed by her nephew. After the war regressed, Benjamin migrated to the US.
Benjamin made the hard decision to leave his family behind to find a better life for all of them, and he believed going to the US was an excellent opportunity to do it. Partying with his family was not easy, and he left behind two sullen faces. In the US, he meets Randy, his wife, and her daughter, Andrea. Randy is an American who works extra hard to provide for his family. Andrea and Umuhoza (Bonko’s daughter) become pen pals through a sponsorship program. Bonko Khoza had been imprisoned for a while, leaving her daughter under the care of her mother before being released and reunited with his family. Benjamin became a migrant at Randy’s church, and these three families become intertwined. Benjamin missed his family a lot and tried to have his family join him abroad in vain. He is a man of faith and keeps the faith that he shall be reunited with his family someday.
Benjamin, not losing hope, embarks on a project helping foreigners settle in the US. Lucky for him, his faith does not fail him, and his family finally joins him in the United States. Benjamin’s and Randy’s families are united and form close bonds. This was basically due to their love for God and the presence of two teen daughters. Randy’s daughter, Andrea, just like Benjamin’s daughter, was traumatized. Randy had been so busy providing for the physiological needs of his family that he had no time for spiritual and emotional support that her daughter needed. Andrea would play loud music, shut the door to her room and leave home without permission and her mother was concerned about these behaviors.
Andrea has her little secrets. She was raped at the age of 12, but she did not tell anyone except her very supportive pen pal. The incidence of sexual assault must have led to a decrease in self-esteem and self-worth. She used to share her traumatic experiences with Umuhoza, who in turn used to be a great source of encouragement to her. She used to remind Andrea always that she is precious and worthy. Umuhoza was Andrea’s mentor before she becomes rebellious to her parent, even when petty things happened. Andrea developed a pattern of anger outbursts and social withdrawal, especially from those people who loved her. All along, Umuhoza was a great pillar in Andrea’s life.
Umuhoza uses her traumatic life experiences to serve as a source of hope and strength for Andrea. After four years, Andrea experiences a traumatic experience that unearths all her hidden traumas. They become unbearable. It all happens when she goes out with her boyfriend, who tries to force himself on her. The plot does not work, and he revenges by framing her for drugs found in his car. The parents were concerned about her fate and blame themselves for not seeing the red flags and acting accordingly. They had neglected her emotional and spiritual needs due to their busy schedule. Her mother sensed that things are not okay but could not communicate to the husband effectively.
During this time, Randy became very supportive and helped her daughter overcome the traumatic experience effectively. He becomes a spiritually and emotionally supportive dad. Randy is moved by Umuhoza’s help to Andrea and promised Andrea that he would take her to meet her pen pal (She knew Andrea’s secret, hid it all along, and helped her accordingly). Benjamin and Randy arrange a trip back to Rwanda to Umuhoza.
During the tour, several things happen. Benjamin learns that it is Bonka who spared his life during the attack by the militia troops. At the same time, he forgives his aunt for killing his mother and washes her feet as a sign that he had wholly forgiven her. The themes of forgiveness and reconciliation, which are a significant component of the Christian worldview, are depicted at this moment. Randy and Benjamin decided to pay off Umuhoza’s kindness by giving her a scholarship to further her studies. Randy and Benjamin’s families embark on their journey back to the United States.
The movie exhibits several therapeutic interventions. Many individuals use various issues to provide trauma care directly or indirectly. Peculiar to the Christians is the display of the fruits of the Holy Spirit, “Love, joy, peace, patience, meekness, goodness, faithfulness, humility and self-control,” (Galatians 5: 22-23, NIV). Benjamin portrays these qualities as a manifestation of the Holy Spirit in him and displays trust, excellent listening skills, and kind-heartedness when working on the migrant project. This character helped migrants settle and have less troubling lives in the US.
Listening to people narrate their traumatic experiences is very therapeutic (Kirtane, 2018). Umuhoza utilized this measure. She was a listener and had built trust with Andrea. She would open up and tell her secrets, such as the sexual assault. For an individual to be open, they need to trust you, and trust is earned. You reinforce it in an individual. One requires to be dependable, confident, non-judgmental, and respectful of others.
Trust is a prerequisite to any effective counseling. Studies show that people shall tend to speak up all inner secrets and details if only they can trust you (Ernst & Maschi, 2018). Building the trust requires accommodating a horde of emotions as anger outbursts, emotional breakdowns, helplessness, hopelessness, and enabling the victims to release these incapacitating emotions. Handling the emotions with concern and offering better outcomes is essential in this therapeutic measure.
Umuhoza and Andrea’s relationship, when contrasted to Andrea and Randy’s relationship, shows a considerable difference. Several communication barriers exist between Andrea and Randy. Different levels of communication determine the extent of intimacy, trust and information shared in relationships (Liberman and Shaw, 2018). Trauma can be traumatic, especially that which involves sexual assault, and sharing could be pretty difficult.
The therapist should hence strive to build trust with the client. Andrea and Umuhoza had created a bond such that she would react to her parents but communicate openly with Umuhoza about her traumatic experiences. It is solemnly essential to listen to people and respond empathetically. From the Christian worldview, listening is better than talking, and the Bible urges us to be better listeners. Proverbs 18:13 “If one gives an answer before he hears, it is his folly and shame” (NIV). The scriptures also add in Proverbs 18:2, “A fool takes no pleasure in understanding, but only in expressing his own” (NIV).
Another therapeutic implication is empathetic listening. Empathetic listening means listening and acknowledging the individual’s feelings, wills, ideas, and opinions and empowering them. This is a mandatory skill for counselors. It allows an individual to be more open and kindhearted towards other people’s ideas. Empathetic listening probes an individual to be considerate and give well-thought-out responses (McKenna et al., 2020). In return, it helps create a bond and build trust, which is very important in the counseling process.
Trauma victims require careful handling. In the movie, Andrea is left to battle with traumatic experiences alone by her parents, who are too busy even to recognize it until it has gone too far. She loses connection with the family. Adolescence is a susceptible age, and at this time, children require a lot of counseling and bond formation. Families should provide a conducive environment for the holistic development of their children.
Every parent or caregiver should be alert at this stage to advise their children accordingly to enhance coping (McKenna et al., 2020). Trauma at this stage affects the physical aspect and the emotional, intellectual, and spiritual well-being of an individual (Denton et al., 2017). Restoring their emotional, physical and behavioral well-being requires the collaborative efforts of the family, friends, and counselors.
The movie is a replica of what goes on in the world. Most of the scenes are much relatable to my life. Harassment, being deprived of parental love, and being sexually harassed happen virtually every other day. I can relate to how the children feel when their parents had to leave them. Benjamin left home with good intentions of looking for greener pastures, but maybe the child’s developmental levels could not allow her to comprehend that. I remember my dad left home to a far region after being posted by the government there.
He was a high school teacher, but I could not fathom why he had to leave us behind. Spending days before I could see him almost made him a stranger to me until he was reposted to a school nearby. I had so many questions within me, and most of the things he would have taught me I learned through experience and difficulties. Like Andrea, I was sexually assaulted, but I had nobody to report to. I could only share it with a friend of mine and even developed a phobia of going to that neighborhood where I was assaulted. I wanted to talk about it, but there was nobody to help me out.
I faced a lot of worthlessness and, at times, performed very poorly in school, majorly due to low self-esteem. The offender had reaped me of the joy of belonging, safety, and happiness. Every child requires parental love and parental presence. It must have been traumatic for Umuhazo to imagine that her father was in the militia and more so went to jail and had to be away for some time. Parents need to realize that it is not enough to provide physiological needs and stop there. Children need emotional and spiritual needs too, and parents should address that.
Most importantly, parents should ensure that they create good bonds with their children to ensure effective communication between them and their children. With effective communication, situations like this of Andrea could be recognized early and acted upon promptly. Parents should also ensure that they provide their children a conducive environment for holistic growth.
It is imperative to be supportive of others even during our distress.
The Bible teachings have played a role in reinforcing that aspect in me. I have helped others like Umuhazo did even when I am in distress. The Bible in Isaiah 43: 18-20 encourages me to forgive, heal, forget and move on. “Forget the former things, do not dwell on the past. See, I am doing a new thing! Now it springs up…” (NIV). The Bible urges us to actually forget our past traumas and focus on the good in the future.
‘Beautifully broken’ is a movie where the themes of forgiveness, reconciliation, and hope are seen across three different families al throughout the film. The movie reinforces my desire to help others regardless of the situation, background, race, nor ethnicity like Umuhazo did because eventually it pays just like the scriptures say; Colossians 3:23-24 “Whatever you do, work at it with all your heart as working for the Lord, not for human masters, since you know that you will receive an inheritance from the Lord as a reward” (NIV) Romans 2:6 “God will repay each person according to what they have done” (NIV).
From the movie, it is clear that everyone is prone to trauma, be it sexual assault or from war. Any therapist should yearn to understand how trauma one has suffered impacts on their life holistically. More so, a therapist can provide specific trauma-informed care to these victims. The families in the movie suffer trauma from different foci, but the trauma is equally destructive. It is also imperative to understand the pathophysiology of trauma and its effects on various systems to manage it effectively.
Management should involve practical adolescent maturity and trauma-informed practices that are holistic and all-inclusive (family included) to foster healing (Ernst & Maschi, 2018). Early recognition and management of trauma can prevent the long-lasting effects that often occur. Trauma can alter brain development and the achievement of developmental milestones in children (Denton et al., 2017). Children often maladapt to traumatic experiences.
They may not speak up but end up exhibiting maladaptive behaviors in other forms that further complicate their lives. These behaviors include drug abuse, anxiety, depression, low self-esteem, frustrations, and helplessness (Thege et al., 2017, Moya, 2018). There are no specific approaches to management, and the therapist chooses their most suitable method.
Spiritual assistance coupled with therapeutic interventions can be reinforcing (Cook and White, 2018). Trauma-Focused Cognitive Behavioral Therapy has been effective in treating the psychosocial effects of trauma in children and adults. The approach is rather holistic, encompassing major cohorts such as worry, despair, and specific disorders (Enhlers et al., 2021). Spirituality acts as a source of strength, hope, and resilience to overcome trauma (Cook and White, 2018). Faith and spiritual practices are the driving forces in Christians.
Drawing from the scripture, “Do not fear, for I am with you; do not anxiously look about you, for I am your God…” (Isaiah 40:10, NIV). Spirituality cannot be overlooked in the recovery of trauma patients. Victims can tap from spirituality and an enormous amount of strength to overcome trauma. The film has a strong Christian worldview, and one can learn that forgiveness and reconciliation encompassed in spirituality can help cope with significant mishaps of life. Psalsm46:1-3 “God is our refuge and strength, an ever-present help in trouble…” (NIV). Proverbs 18:10 “The name of the Lord is a strong tower; the righteous run into it and are safe” (NIV). Nehemiah 8:10 “Do not grieve, for the joy of the Lord is your strength” (NIV).
‘Beautifully Broken’ expounds on war and sexual assault trauma. It sensitizes the viewers that trauma can occur to anyone and under any circumstances, and parents should be at the frontline in the recognition and management of trauma victims. We should prioritize children’s safety and provide them with a conducive environment for their holistic development. From a Christian worldview, we learn that God can intertwine families regardless of race, ethnicity, or background to mold them and aid in their healing.
Isn’t He an awesome God? Recovery from a traumatic experience requires a holistic approach, and parents and other family members should be involved. Parents should be keen when dealing with their children and adolescents to recognize danger signs early and act accordingly. As seen above, early treatment enhances mental development and reverses potential long-lasting trauma effects.
MPH509 Community-Based Participatory Research All Modules Discussions
Concepts of Dialogue
Why is dialogue, as described by Freire, a critical component of CBPR? How might Freire’s concept of dialogue relate to your understanding of self-reflection?
Case Study Reflection
Review the article on Henry Clark from Module 2 Readings and look at the Richmond Environmental Justice Movement Case Study MPH509 Community-Based Participatory Research All Modules Discussions.
Case Study: Richmond, CA Environmental Justice Movement: http://richmondconfidential.org/2012/12/06/henry-clark-and-three-decades-of-environmental-justice/ (Links to an external site.)
Respond to the following questions after reading the article.
Jones attributes institutional racism to historical events that established socioeconomic inequities between Whites and people of color MPH509 Community-Based Participatory Research All Modules Discussions. Jones does not explicitly state what these “discrete historical events” are.
What are some historical events that might have contributed to current structural and systemic factors that continue to reinforce socioeconomic inequity?
What kind of racial microaggression do you think Henry Clark might experience and why? What role could “alternative epidemiology” play in Richmond’s environmental justice efforts? MPH509 Community-Based Participatory Research All Modules Discussions
Community Assessment Tools
Choose either the Santilli et al or Crabtree et al article from the assigned readings. How did the authors use community assessment tools to tackle a public health issue relevant to the community? What role did local knowledge play in the implementation of the project and its outcomes?
Trust, Collaboration, and Community-Based Participatory Research
Describe the influence of trust in community-based participatory research (CBPR). What role does race play in influencing relationships and partnerships in CBPR projects? What strategies could be employed to strengthen collaborations and improve participation in CBPR projects? MPH509 Community-Based Participatory Research All Modules Discussions
Emerging Participatory Perspective
Action researchers are concerned with contributing to “the ongoing revision of the Western disposition…and to move toward an emerging participatory perspective.” What does it mean to have an emerging participatory perspective?
CBPR Outcomes and Evaluation
Please review the readings and prepare the following discussion:
Choose three propositions that fit the best with the project’s outcomes. Label the subject of your initial post using the reading selection and your first/last name.
As part of your initial post, answer the following questions.
Why did you choose these propositions?
How do they relate to the study and its outcomes?
Create a 2 x 2 table. Label the top of the table, Internal Evaluation and External Evaluation. Label the side of the table, Participatory Evaluation and Non-Participatory Evaluation. (See sample table below, and review page 388 from the Israel et al reading.) MPH509 Community-Based Participatory Research All Modules Discussions
Use this 2 x 2 table as a decision matrix to help you decide what kind of evaluation you would conduct for this study.
In your initial post, address the following.
List the pros and cons for each kind of evaluation.
Articulate why you chose the kind of evaluation that you did.
How does your choice of evaluation relate to the propositions that you chose?
Attach your 2 x 2 table as a PowerPoint slide for the rest of the class to view with your initial post.
When responding to classmates’ posts, find those classmates who chose the same article as you. Please review their proposition choices, 2 x 2 tables, and related discussions. Then, respond to each other’s commentary about your work. The idea for this assignment is to create dialogue and shared learning about CBPR outcomes and evaluation. In your review of their work, please address the following questions.
How were their decisions similar to or different from yours?
When your classmates’ proposition choices and evaluation decisions differed from yours, how would you resolve these differences (as if you were in a real-life CBPR project) to reach consensus and still have meaningful propositions and a robust evaluation process?
In instances where you reached the same conclusions, how would you work together to expand the propositions and evaluation processes?
What else could you include in the propositions and the evaluation process?
CBPR Reflection
Reflect and share your perspective on the following questions.
Why is it important that CBPR projects/programs become involved in policy advocacy and change? Please use examples from the readings where CBPR approaches supported community-based policy advocacy and change.
What are some of the tensions between the community and the academy in advocating for policy change? How does CBPR help communities consider or think differently about problems affecting them?
In reviewing the readings, what are some of the strategies used by the CBPR projects to address the opposition to their work/policy advocacy? Please describe the effectiveness of these strategies. (Please pick three projects to discuss.)
Group Policy Activity: Part 5 – Mock Legislative Visit Presentation Reflection
Review your classmates’ presentations posted in Module 7 Group Policy Part 5 Mock Legislative Visit Discussion. Consider the following questions and share your responses here. Only an initial post is required, but responses to other classmates’ posts are encouraged. MPH509 Community-Based Participatory Research All Modules Discussions
How did your classmates’ presentations help you better understand the policy issue they addressed? What kinds of strategies and processes did they use to make the case for their policy?
What questions or concerns do you have regarding this policy change?
Play the devil’s advocate: What would your argument be against this policy? Then, consider the alternative: How would you help your classmates argue against the opposition?
How feasible is it to implement this policy? What unintended consequences do you see as a result of this policy? What are the fiscal implications and political viability of this policy? MPH509 Community-Based Participatory Research All Modules Discussions