features of the Affordable Care Act

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Topic 1: The Affordable Care Act

Describe the features of the Affordable Care Act and explain how it will control costs and improve quality of care from the perspective of a cultural, economic, and ethnically diverse society. What are the limits of the Act? As an advanced practice nurse, what policy changes would you recommend to provide health coverage to those who remain uninsured? What effects does this act have on providers and consumers?

More than 100 words, more that 3 review peers references (nursing Journal) references less that 5 years, plese answer all questions

Hi, I need 2 and half pages of paper in APA format. It should be reflection paper about my feeling of my first week of capstone as a school nurse. I am doing my capstone in a school indistric 15 that have 1200 students : preschoolers through 8th grade. I want to write this reflection about how i was excited and at the same time a little nervous because i had no idea what should i expect. i found it so interesting since patients all were adorable, even sometimes the fake story they made to be out of class was intetresting to me. In the first week of my capstone hours, i learned how to repond to each student and how to intervene. since we are not allowed to use any medication even over the countermeds or cough drop. I tried to get to know students better and know about students that have any kind of medical issue. i attend 3 school days each week for 7 weeks. Each week i need this 2 and half pages paper with some refrences. There are 7 students with diabetes 1 that need accu check few times each day . They do all things for themselves and nurse just observe them. One student need straight cath, 2 times in each school day, he does for himself with supervision of the nurse. Also i want to write me second paper with consideration all these information, like in second week of being in school, students started to come to me as well as their regular nurse and talk about the reason they are in nursing office that moment. It is whole different situation being a nurse in school than in a hospital. It is refreshing to me to work with these population , since it took me to those years i was in school and I remembered all sweet memories again. The main cause that students come to the nursing office is complaining of headache and stomachache and i realized most of them don’t eat any breakfast at home, it can be a factor that associate to not feel well to start a schoolday. can you write 2 different reflection paper for 2 weeks? Each paper 2 1/2 pages with refrences andAPA format. the topic for both papers can be” my experience as a school nurse” . Who can help me? I want the person to be available for next 7 weeks to each week do this assignment. Thank you

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PPACA

1) Use your critical thinking skills to write a paper of 1,000–1,200 words that responds to the question, “Is the PPACA legislation an improvement or a liability to our health care delivery system?” Use examples to illustrate your points and include pros and cons of the changes.

2) Refer to the assigned readings to incorporate specific examples and details into your paper.

3) Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

4) This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.

Rubic

Demonstrates thorough knowledge of the principles of health care reform in the PPACA legislation. Clearly develops a strong analysis of the pros and cons. Introduces appropriate examples.

Supports main points with references, examples, and full explanations of how they apply. Thoughtfully analyzes, evaluates and describes major points of the criteria.

Thesis and/or main claim are comprehensive. The essence of the paper is contained within the thesis. Thesis statement makes the purpose of the paper clear.

Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative

Reading

The Patient Protection and Affordable Care Act

http://www.cms.gov/LegislativeUpdate/downloads/PPACA.pdf

What Are Accountable Care Organizations?

What are Accountable Care Organizations?

Creating Accountable Care Organizations

http://www.nejm.org/doi/full/10.1056/NEJMp1009040

Relationships and Expectations

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Module 2 – Case
Relationships and Expectations

Case Assignment
Read the case story about how a Nurse Manager helps her staff become more culturally competent. http://support.mchtraining.net/national_ccce/case0/case.html

After reading the case story, click on the Learning Activities link on the left side. Complete Activities 1, 2, and 4.

You may complete Activity 3 if you like, but it is not required.

In a paper:

Reflect upon what you learned after completing the Learning Activities.
Your comments should show thoughtful reflection about how you have assessed your own personal development as you strive for cultural competence.
Consider the following questions:
After reading about Christy’s situation, how have your thoughts about and/or expectations of other cultures changed, if at all?
What changed, if anything?
Describe how Christy can handle the situation better the next time she encounters a Romani patient.
Identify at least one thing an organization can do to improve cultural competence.
Assignment Expectations
Length: 3 pages (excluding the cover page and the reference list)

· Evaluate clients for treatment of mental health disorders

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Assign 3-WK4(A)
Assignment 1: Decision Tree

For this Assignment, as you examine the client case study1 (See Below) in this week’s Learning Resources, consider how you might assess and treat adult and older adult clients presenting symptoms of a mental health disorder.

Learning Objectives

Students will:

· Evaluate clients for treatment of mental health disorders

· Analyze decisions made throughout diagnosis and treatment of clients with mental health disorders

THE ASSIGNMENT

Examine Case 1: You will be asked to make three decisions concerning the diagnosis and treatment for this client. Be sure to consider co-morbid physical as well as mental factors that might impact the client’s diagnosis and treatment.

(N: B. A CASE STUDY WITH ANSWER SAMPLE IS ATTACHED WITH THIS ASSIGNMENT

At each Decision Point, stop to complete the following:

Decision #1: Differential Diagnosis

· Which Decision did you select?

· Why did you select this Decision? Support your response with evidence and references to the Learning Resources.

· What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.

· Explain any difference between what you expected to achieve with Decision #1 and the results of the Decision. Why were they different?

Decision #2: Treatment Plan for Psychotherapy

· Why did you select this Decision? Support your response with evidence and references to the Learning Resources.

· What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.

· Explain any difference between what you expected to achieve with Decision #2 and the results of the Decision. Why were they different?

Decision #3: Treatment Plan for Psychopharmacology

· Why did you select this Decision? Support your response with evidence and references to the Learning Resources.

· What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.

· Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?

· Also include how ethical considerations might impact your treatment plan and communication with clients and their family.

Note: Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement.

PLEASE INCLUDE INTRODUCTION, CONCLUSION AND REFERENCES LESS THAN 5 YEARS OLD

Case #1 A woman with personality disorder

A woman with personality disorder

SUBJECTIVE

Rhonda is a 32-year-old Hispanic female who presents to your office for her initial appointment. When you ask what brought her to your office, she states: “I’m at the end of my rope, I don’t know what else to do.” She then bursts into tears. Rhonda explains that she has very few friends left, and everyone seems to have “abandoned” her. Rhonda explains that she goes out of her way to help other people, and to be nice to them, but this does not seem to help.

Rhonda then stands up and begins to pace around your office at times using wild hand gestures to explain the circumstances that led up to her making the appointment with you. She describes the recent breakup with her boyfriend as traumatic and explains “when we first met, he was the best guy in the world. He treated me really well. But he just became a complete monster! Even though he broke off the relationship with me, I was glad to see it end. I hate his guts!”

Rhonda explains that her current financial situation is also precarious. She states that she recently purchased an automobile, and is not certain how she is going to pay for it. She states that she had a car that was repossessed last year at that time, and that she borrowed some money from a friend to help pay for the car; the friend later turned around and accused her of theft. “It was my friend’s fault. She told me she would loan me the money and then backed out. I only took the money because she said she would loan it to me … people just can’t go back on their word like that when other people are counting on them.”

Rhonda reports that she was “always in trouble” as a kid. She states that people were always picking on her, to which she adds: “the other kids my age were just stupid. They didn’t know how to have fun.” She says “I have always been impulsive, but it’s fun. Sometimes people can be such prudes … you only go around life once, so you have to make the best of it.”

OBJECTIVE

Rhonda is currently single. She has no children. Educationally, she had completed two semesters toward her bachelor of arts degree in fine arts. Rhonda currently works as a waitress at a local restaurant. She has held this job for about 2 weeks. Prior to this, Rhonda worked as a housekeeper for a local hotel chain. She states that she was fired from this job because her coworkers were jealous of her and “planted” evidence of her stealing from hotel patrons. She was also arrested for cashing checks under an alias, for which she spent 120 days in jail.

Rhonda has a history of multiple incarcerations for offences ranging from larceny to possession of controlled substances to possession of an illegal firearm. She was also arrested several times for fighting and on at least one occasion, used a baseball bat to beat up a girl who she thought was trying to “set her up” with the police.

MENTAL STATUS EXAM

Rhonda is alert and oriented × 4 spheres. Her speech is clear, coherent, goal directed, and spontaneous. She reports her mood as “terrible!” Affect is labile and seems to change rapidly with the subject being discussed. Her eye contact is normal, but at times, she appears to stare at you. Rhonda is oriented to person, place, and time. She denies visual/auditory hallucinations, no overt paranoia or delusional thought processes noted. Rhonda denies any suicidal or homicidal ideation.

Decision Point One

BASED ON THE INFORMATION PROVIDED IN THE SCENARIO ABOVE, WHICH OF THE FOLLOWING DIAGNOSES WOULD THE PSYCHIATRIC/MENTAL HEALTH NURSE PRACTITIONER (PMHNP) GIVE TO RHONDA?

In your write-up of this case, be certain to link specific symptoms presented in the case to DSM–5 criteria to support your diagnosis.

Borderline Personality Disorder

Histrionic Personality Disorder

Antisocial Personality Disorder

Answer Chosen:

Antisocial Personality Disorder

Decision Point Two

BASED ON THIS DIAGNOSIS, SELECT YOUR CHOICE OF ACTIONS:

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6670/03/mm/decision_tree/img/pill-red.pngRefer to psychologist for psychological testing

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6670/03/mm/decision_tree/img/pill-blue.pngBegin Haldol 5 mg orally daily

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6670/03/mm/decision_tree/img/pill-yellow.pngRefer for psychodynamic psychotherapy

Answer Chosen:

Refer to psychologist for psychological testing

RESULTS OF DECISION POINT TWO

· Client returns to clinic in four weeks

· The psychologist’s report indicates that a comprehensive psychological battery was performed for the purposes of diagnostic clarification. The end result suggested that Rhonda has traits of multiple personality disorders, but scores highest in antisocial personality traits, suggesting antisocial personality disorder.

· When Rhonda returns to the office, you review the psychologist’s report with her. Rhonda seems upset, but also states “well, that’s why I am here, to get better … what do I need to do?”

Decision Point Three

BASED ON THE ABOVE INFORMATION, SELECT YOUR NEXT ACTION. BE CERTAIN TO DISCUSS THE RATIONALE FOR YOUR DECISION.

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6670/03/mm/decision_tree/img/pill-red.pngRefer to group-based cognitive behavior therapy

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6670/03/mm/decision_tree/img/pill-blue.pngBegin Latuda 40 mg orally daily

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6670/03/mm/decision_tree/img/pill-yellow.pngRefer for dialectical behavior therapy

Answer Chosen:

Refer to group-based cognitive behavior therapy

Some Guidance and Rationale for Answer to Chosen

Rhonda has APD; however, as you can see, she has signs/symptoms of other personality disorders. In many cases, individuals with personality disorders can demonstrate features of several personality disorders.

Referral to a psychologist was appropriate for the purposes of diagnostic clarification. Psychological tests can help tease out the actual personality disorder that Rhonda has. In this case, Rhonda’s symptoms are most consistent with antisocial personality disorder, but as you can see, she has signs/symptoms of other personality disorders.

There are currently no FDA-approved medications to treat APD, thus Risperdal would not be useful. Also, prescribing medications to someone with antisocial personality disorder could lead to misuse or diversion.

Of the available choices, group-based cognitive behavior therapy may be useful in treating individuals with this personality disorder, but all “improvement” in signs/symptoms should be met with great skepticism.

Beginning Latuda is not appropriate, as there are currently no FDA-approved medications to treat APD. Also, prescribing medications to someone with antisocial personality disorder could lead to misuse or diversion.

Learning Resources

Required Readings

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

· Chapter 4, “Theories of Personality and Psychopathology” (pp. 151–191)

· Chapter 22, “Personality Disorders” (pp. 742–762)

· Chapter 13, “Psychosomatic Medicine” (pp. 451–464)

Gabbard, G. O. (2014). Gabbard’s treatment of psychiatric disorders (5th ed.). Washington, DC: American Psychiatric Publications.

· Chapter 68, “Paranoid, Schizotypal, and Schizoid Personality Disorders”

· Chapter 69, “Antisocial Personality Disorder”

· Chapter 70, “Borderline Personality Disorder”

· Chapter 71, “Histrionic Personality Disorder”

· Chapter 72, “Narcissistic Personality Disorder”

· Chapter 73, “Cluster C Personality Disorders

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

· “Personality Disorders”

Perry, J. C., Presniak, M. D., & Olson, T. R. (2013). Defense mechanisms in schizotypal, borderline, antisocial, and narcissistic personality disorders. Psychiatry: Interpersonal & Biological Processes, 76(1), 32–52. doi:10.1521/psyc.2013.76.1.32

Rees, C. S., & Pritchard, R. (2015). Brief cognitive therapy for avoidant personality disorder. Psychotherapy, 52(1), 45–55. doi:10.1037/a0035158

.

Required Media

Laureate Education. (2017a). A woman with personality disorder [Interactive media file]. Baltimore, MD: Author. (See Case 1 (Rhonda)Above)

Kernberg, O. (n.d.). Psychoanalytic psychotherapy for personality disorders: An Interview with Otto Kernberg, MD. [Video file]. Mill Valley, CA: Psychotherapy.net

#775822 Topic: Sexual abuse under slavery

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#775822 Topic: Sexual abuse under slavery Number of Pages: 6 (Double Spaced) Number of sources: 6 Writing Style: MLA Type of document: Essay Category: History Order Instructions: The purpose of the review essay is to interpret how various scholars have approached a particular topic in the history of sexuality. Scholarly work is not just facts but rather interpretation of facts, and so, scholars may disagree about the meaning of particular conditions, ideas, or events of the past. These disagreements, however, help us to see a topic from all sides, and to decide what is of most interest. They also expose the context of the times when the historian was writing. Classtime will be set aside to consult with the instructor about this review essay. The review essay with a maximum length of eight double-spaced typed pages will be based upon secondary resources, and it will take into consideration the comments, critique, and additional information suggested by the instructor in the assessment of the annotated bibliography. The essay will be succinct with a clearly presented argument. It will be proofread before submission. The opening paragraph conveys both your topic and intentions to the reader. The main body of the paper is where you develop your thesis and argument in as many paragraphs as you need. Please cite all sources, using either footnotes/endnotes (or MLA if you requested it). Please remember all information should be cited, not just the quotations used in the essay. Please avoid using too many quotations, particularly lengthy block quotations, as this can often disrupt the flow of an essay. The conclusion is as important as the introduction, as it brings together all the observations made in the paper, and returns to the main points of your introduction. YOU MUST USE THIS REFERENCES AND ADD THREE MORE ACADEMIC JOURNALS AND NOT SCHOLARLY PEER-REVIEWED; Elder, R. (2012). A Twice Sacred Circle: Women, Evangelicalism, and Honor in the Deep South, 1784-1860. The Journal of Southern History, 78(3), 579-614. Foster, T. (2011). The sexual abuse of black men under American slavery. Journal of the History of Sexuality, 20(3), 445-464. Wriggins, J. (1983). Rape, racism and the law. Harv. Women’s LJ, 6, 103. ( did Wringgin talk about sexual abuse against slavery the same way foster did. use this journal to examine early writing on slavery sexual abuse Please find three more academic journals and not scholarly peer-reviewed

most common statistical test in nursing research

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Select one (1) of the most common statistical test in nursing research. State which statistic you selected. What level of measurement is required for using your selected statistics? Provide an example of how your selected statistic would be used in a nursing research study.

Implementing a Performance Management Communication Plan at Accounting

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Assignment 11 – 502 DS

Review “Case Study 7-1: Implementing a Performance Management Communication Plan at Accounting, Inc.”. Respond to the following questions:

· After evaluating Accounting, Inc.’s communication plan, does it answer all of the questions that a communication plan should answer?

· Which questions are left unanswered?

· How would you provide answers to the unanswered questions?

· Be 2 pages in length, not including the required cover and reference pages

· Formatted according to APA writing guidelines

· Provide support for your statements with in-text citations from a minimum of three scholarly articles from peer-reviewed journal articles.

Due date 27th of march

CASE STUDY 7-1

Implementing a Performance Management Communication Plan at Accounting, Inc.

Accounting, Inc. is a consulting and accounting firm headquartered in Amsterdam, the Netherlands. Recently, Accounting, Inc. implemented a performance management system. The first step in the implementation of the new system was the development of a set of core competencies that would be used to evaluate most employees regardless of function or level. In addition, each employee was evaluated using more job-specific performance dimensions.

As the first step in the communication plan, the employees received individual e-mail messages asking them to define what the core competencies meant to them and to give descriptions and examples of how each of the core competencies played out in their specific positions. Next, thecompany held meetings, handed out frequently asked questions (FAQs) sheets, and placed posters around the company detailing how the core competencies were related to the organization’s strategic priorities and how performance scores would be related to monetary rewards. In these communications, Accounting, Inc. detailed how the performance system worked, how the raters were chosen, how performance feedback was used, and other details about the system. The information also outlined the benefits employees could expect from the new system as well as employees’ responsibilities regarding the system.

Please evaluate Accounting, Inc.’s communication plan. Specifically, does it answer all of the questions that a good communication plan should answer? Which questions are left unanswered? How would you provide answers to the unanswered questions (if any)? Source: Adapted from P. Brotherton, “Meyners Pays for Performance: Changing a Compensation System Is a Sensitive Undertaking; Here’s How One Firm Handled It,” Journal of Accountancy, 196 (2003): 41–46.

various aspects of strategic planning

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Assignment 13 DS – 502

This week our readings explored the various aspects of strategic planning, including the mission and vision of the organization. Respond to the following:

· What are the dangers of a flawed mission statement?

· How does a flawed statement affect the development of a unit’s mission statement and subsequent individual job descriptions and goals? Why?

· Describe the unique features of organizational development that make it different from other change initiatives.

· Be 2 pages in length, not including the required cover and reference pages

· Formatted according to APA writing guidelines

· Provide support for your statements with in-text citations from a minimum of three scholarly articles from peer-reviewed journal articles.

·

we examine exceptions to informed consent for treatment purposes.

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Assignment 12 DS – 515

For this discussion, we examine exceptions to informed consent for treatment purposes.

Research a situation where a patient was unable to properly relay his or her understanding of a treatment procedure and agree to the procedure.

Include a specific example. What do law and ethics say about proceeding with treatment in this situation?

Support your statements with logic and argument, citing any sources referenced.

· Be 2 pages in length, not including the required cover and reference pages

· Formatted according to APA writing guidelines

· Provide support for your statements with in-text citations from a minimum of three scholarly articles from peer-reviewed journal articles.

Diagnosis And Management Of Skin Disorders

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Dermatologic disorders can present due to an actual skin problem or as the result of a systemic problem that manifests in the skin. Depending on the type of disorder, the presentation might be unique, making a quick diagnosis possible. However, some disorders have similar presentations in terms of symptoms and appearance, making diagnosis more difficult. Skin color and tone can also contribute to difficulty in diagnosis, making it important to consider cultural variations during assessments. In this Discussion, you examine the following case studies of skin disorders.

Case Study 1
An adolescent presents to your office with a complaint of an itchy, red rash that first appeared on his lower legs 1 week ago after he returned from a camping trip. The rash has since spread to the upper legs, trunk, and groin. He denies fever or other systemic symptoms.

Case Study 2
An 8-month-old presents to your office with a rash on both cheeks that has progressively worsened over the last week. Mom first noticed the rash after his 6-month checkup. He has generalized dry skin and rubs at his cheeks often.

Case Study 3
A 24-month-old presents with a red rash that began on his trunk yesterday and has now spread to the face and upper extremities. His grandmother reports that earlier in the week, the toddler had intermittent fevers up to 101.5°F without other symptoms. The fever broke approximately 48 hours ago and the rash began a few hours later.

Case Study 4:
You see a 9-year-old male who presents with a white, scaly patch on the back of his head. There is some alopecia in the area with hair breakage noted at the scalp.

To prepare:

Review the DermNet NZ and Dermnet Skin Disease Atlas websites in this week’s Learning Resources.
Select one of the four case studies of skin disorders. Analyze the skin disorder in the case you selected including lesion type, lesion distribution, color, and any ancillary findings.
Consider a differential diagnosis for the skin disorder in the case study you selected. Determine the most likely diagnosis for the patient.
Think about a treatment and management plan for this disorder. Consider appropriate dosages for any recommended treatments.
By Day 3
Post an explanation of the skin disorder in the case study you selected. Include in your explanation the lesion type, lesion distribution, color, and any ancillary findings. Then, present a differential diagnosis and explain which is the most likely diagnosis for the patient and why. Finally, explain a treatment and management plan for the patient’s skin disorder, including appropriate dosages for any recommended treatments.