Policy Analysis Paper

NURS 8100 Week 4 Assignment 3: Policy Analysis Paper [Major Assessment 2]

Policy Analysis Paper [Major Assessment 2]

In previous Discussions and Assignments, you have examined various aspects of the policy process: exploring the unintended consequences of policies, agenda setting, and analyzing policy recommendations. In this Assignment, you will have the opportunity to further develop your analysis skills by working through the policy analysis process. To be an effective agent for social change, you must be able to logically and critically analyze policy from multiple perspectives and contexts and then present your insights in a succinct and professional manner Policy Analysis Paper. This exercise will afford such an experience.

For this Assignment, you will examine a particular policy of interest to you (perhaps the one you selected for this week’s Discussion), and apply a policy analysis framework to understand the impact associated with the implementation of the policy. You will then develop a policy analysis paper, which is due the end of Week 11. This paper will also serve as your Major Assessment for this course.

To prepare for Policy Analysis Paper [Major Assessment 2]:

Select a health care policy and a policy analysis framework to utilize for this Assignment. You may use the policy and framework you identified in this week’s Discussion or change your selection. Policy Analysis Paper [Major Assessment 2]

To complete for Policy Analysis Paper [Major Assessment 2]:

Write an 8- to 10-page analysis paper (including references) in which you succinctly address the following:

• Part 1: Define the policy issue.
  • How is the issue affecting the policy arena?
  • What are the current politics of the issue?
  • At what level in the policy making process is the issue?
• Part 2: Apply a policy analysis framework to explore the issue using the following contexts:
  • Social
  • Ethical
  • Legal
  • Historical
  • Financial/economic
  • Theoretical underpinnings of the policy
  • Policy Analysis Paper
• Include in this section:
  • Who are the stakeholders of interest?
  • Is there a nursing policy/position statement on this health care issue? If so, who developed it?

    ORDER A FREE- PLAGIARISM PAPER HERE

• Part 3: Policy options/solutions
  • What are the policy options/solutions for addressing the issue? Include at least three levels of options/solutions: no change; partial change; radical change or maximum change.
  • What are the theoretical underpinnings of the policy options/solutions?
  • What are the health advocacy aspects and leadership requirements of each option?
  • How does each option/solution provide an opportunity or need for inter-professional collaboration?
  • What are the pros and cons of each suggested change?Policy Analysis Paper Include the cost benefits, effectiveness, and efficiency of each option along with the utility and feasibility of each option.
• Part 4: Building Consensus
  • Outline a plan for building consensus around your recommended option/solution for solving the policy issue.
• Part 5: References
  • Limit your references so this section is no more than 2 pages.

Your written assignments must follow APA guidelines. Be sure to support your work with specific citations from appropriate Learning Resources and additional scholarly sources as appropriate. Refer to the Publication Manual of the American Psychological Association to ensure that your in- text citations and reference list are correct. Policy Analysis Paper [Major Assessment 2]

By Day 7 of Week 11 of Policy Analysis Paper [Major Assessment 2]

This Assignment is due.

NURS 8100 Week 4 Assignment 1: Issues in Health Care Reform (Interview)

Continue to work on this Assignment, assigned in Week 2 and due in Week 9.

By Day 7 of Week 9

Submit this Assignment.

NURS 8100 Week 4 Assignment 2: Health Policy Proposal Analysis (Policy Brief)

Continue to work on this Assignment, assigned in Week 3 and due in Week 7.

By Day 7 of Week 7

Submit this Assignment.

NURS 8100 Week 4: Policy Analysis Frameworks

Consider the social contract between the nursing profession and consumers of health care. This social contract has long been demonstrated by nurses. For example, recall the nursing pioneer Lillian Wald who in the late 1800s worked to improve the health and welfare of the immigrant population in New York. How does engaging in the policy process assist nurses with fulfilling this social contract today? To better influence health and nursing policy, which seeks to improve health and quality outcomes, nurses need to develop their policy acumen. Utilizing a policy analysis framework can assist in this process.

This week continues the examination of the policy process addressed in Week 3. You will examine how frameworks from nursing and other disciplines can work together to inform policy analysis.

Learning Objectives

Students will:

• Propose a policy analysis framework for a specific policy issue
• Conduct a comprehensive policy analysis critically analyzing a health policy from multiple contexts

Photo Credit: [alphaspirit]/[iStock / Getty Images Plus]/Getty Images

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Blackman, V. S. (2005). Putting policy theory to work: Tobacco control in California. Policy, Politics, & Nursing Practice, 6(2), 148–155. doi: 10.1177/1527154405276289

Note: You will access this article from the Walden Library databases.

 

In this article, the author applies Kingdon’s multiple streams theory to agenda setting and the public policy issue of tobacco use. In addition, the author points out two limitations of Kingdon’s model—the need to build alliances and the varying power levels among stakeholders.

Craig, R. L., Felix, H. C., Walker, J. F., & Philips, M. M. (2010). Public health professionals as policy entrepreneurs: Arkansas’s childhood obesity policy experience. American Journal of Public Health, 100(11), 2047–2052.

Note: You will access this article from the Walden Library databases.

Fawcett, J., & Russell, G. (2001). A conceptual model of nursing and health policy. Policy, Politics, & Nursing, 2(2), 108–116. doi: 10.1177/152715440100200205

Note: You will access this article from the Walden Library databases.

 

Fawcett and Russell provide a five-level conceptual model of nursing and health policy, and diagram the relationship between the model and new health policies. Guidelines for health policy analysis and evaluation are also provided.

Hewison, A. (2007). Policy analysis: A framework for nurse managers. Journal of Nursing Management, 15(7), 693–6 99. doi: 10.1111/j.1365-2934.2006.00731.x

Initially, this article presents a broad analysis of policy making and then provides a specific framework of policy analysis for nurse managers. The author focuses on the necessity for nurses to become involved in health care policy making

Policy analysis: A framework for nurse managers. Journal of Nursing Management, 15(7) by Hewison, A. Copyright 2007 by BLACKWELL PUBLISHING – JOURNALS. Reprinted by permission of BLACKWELL PUBLISHING – JOURNALS via the Copyright Clearance Center.

Howie, W. O. (2009). Mandatory reporting of medical errors: Crafting policy and integrating it into practice. Journal for Nurse Practitioners, 5(9), 649–654. doi:10.1016/j.nurpra.2009.07.012

Note: You will access this article from the Walden Library databases.

John, P. (2003). Is there life after policy streams, advocacy coalitions, and punctuations: Using evolutionary theory to explain policy change? Policy Studies Journal, 31(4), 481–4 98. doi: 10.1111/1541-0072.00039

Note: You will access this article from the Walden Library databases.

 

This article advances the use of evolutionary theory as policy theory. The author proposes that aspects of evolutionary theory such as randomness, competition, and selection be applied to policy theory but cautions that more research regarding its applicability is needed.

Rawat, P., & Morris, J. C. (2016). Kingdon’s “Streams” model at thirty: Still relevant in the 21st century? Politics & Policy, 44(4), 608-638. doi: 10.1111/polp.12168

Note: You will access this article from the Walden Library databases.

Russell, G., & Fawcett, J. (2005). The conceptual model for nursing and health policy revisited. Policy, Politics, & Nursing, 6(4), 108–116. doi: 10.1177/1527154405283304

Note: You will access this article from the Walden Library databases.

 

In this article, Russell and Fawcett revise their 2001 conceptual model of nursing and health policy and provide guidelines for nursing-specific research.

Optional Resources

Bardach, E. (2004). Presidential address—The extrapolation problem: How can we learn from the experience of others? Journal of Policy Analysis and Management, 23(2), 205. doi: 613545361

NURS 8100 Week 4 Discussion: Selecting a Policy Analysis Framework

Selecting a Policy Analysis Framework

The goal of policy analysis is to provide in-depth, relevant, and evaluative information about a policy. Using a framework as a guideline for the analysis provides scaffolding for logically and carefully considering the policy issue. To select a framework, one should consider the focus of the policy being analyzed and whether the policy is intended to be predictive or prescriptive. For this Discussion, you will choose a policy issue that is important to you and after evaluating the frameworks described in the Learning Resources, select the framework most appropriate for analyzing the issue.

To prepare for Selecting a Policy Analysis Framework:

• Reflect on your understanding of the policy process: how policy is formulated, adopted, implemented, and evaluated.
• Review the various frameworks presented in this week’s Learning Resources and consider how they are applied to nursing and health policies. How do they assist you in understanding and shaping policy Policy Analysis Paper?
• Brainstorm a list of the issues that are most important to your practice (these can be issues at the institutional, local, state, national, or international level). Then identify a specific nursing or health care policy related to one key issue, and consider which of the frameworks you would use to examine the issue.

Note: You may not select the Patient Protection and Affordable Care Act for this analysis.

By Day 3 of Selecting a Policy Analysis Framework

Post a cohesive response that addresses the following:

• Identify the policy you have selected.
• Describe the framework that you would use for this particular issue, and provide your rationale.
• At what other stages in the policy process might an analysis framework provide guidance?
• Policy Analysis Paper

Read a selection of your colleagues’ postings.

By Day 6 of Selecting a Policy Analysis Framework

Respond to at least two of your colleagues selecting postings for which you have an alternative framework suggestion and explain how that framework might affect the analysis.

Note: Please see the Syllabus and Discussion Rubric for formal Discussion question posting and response evaluation criteria.

Return to this Discussion in a few days to read the responses to your initial posting. Note what you learned and/or any insights you gained as a result of the comments made by your colleagues.

Be sure to support your work with specific citations from this week’s Learning Resources and any additional sources. Selecting a Policy Analysis Framework

Policy process – Agenda Setting

Discussion: Agenda Setting

A key aspect of the policy process is agenda setting. How do topics get on that agenda? Agenda setting requires the support of stakeholders to move the issue forward. In this week’s media presentation, Dr. Kathleen White outlines the policy process and discusses how to move issues into the policy arena through agenda setting. The ultimate goal is to gain the attention of leadership whether at the organizational, local, state, national, or international level.

To prepare for NURS 8100 Week 3 Discussion: Agenda Setting:

• Review this week’s media presentation, focusing on the insights shared by Dr. White and Dr. Stanley on agenda setting and identification of stakeholders. Policy process – Agenda Setting.
• Brainstorm clinical practice issues that you believe are worthy of being on your organization’s systematic agenda.

  ORDER A FREE- PLAGIARISM PAPER HERE

• Who are the stakeholders who would be interested in this clinical practice issue?

By Day 3 of NURS 8100 Week 3 Discussion: Agenda Setting

Post a cohesive response that addresses the following:

• In the first line of your posting, identify the clinical practice issue you would like to see on your organization’s systematic agenda.
• What strategies would you use to inform stakeholders and persuade them of the importance of your identified clinical practice issue?

Read a selection of your colleagues’ postings.

By Day 6 of NURS 8100 Week 3 Discussion: Agenda Setting

Respond to at least two of your colleagues providing additional strategies for informing and persuading stakeholders. Include additional research evidence that supports the importance of their identified clinical practice issue.

Note: Please see the Syllabus and Discussion Rubric for formal Discussion question posting and response evaluation criteria.

Return to this Discussion in a few days to read the responses to your initial posting. Note what you learned and/or any insights you gained as a result of the comments made by your colleagues.

Be sure to support your work with specific citations from this week’s Learning Resources and any additional sources.

NURS 8100 Week 3 Discussion: Agenda Setting Rubric Detail

Personality Disorders Decision Tree Case Study Assignment Example

Decision Tree: Personality Disorders

As described by the American Psychiatric Association (APA) (2013), ‘‘personality disorder is an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment’’. There are different types of personality disorders classified into three clusters. Cluster A individuals are described as the odd or eccentric, cluster B as the dramatic, emotional, or erratic and cluster C as the anxious or fearful. The purpose of this paper is to discuss the case study of a young woman with personality disorder. This Personality Disorders Decision Tree Case Study Assignment Example will explore threes decisions relating to differential diagnosis, psychotherapy and psychopharmacology based on the presented clinical manifestations.

ORDER A FREE- PLAGIARISM PAPER HERE

Decision One

The clinical manifestation presented in the case study are indicative of more than one personality disorder, specifically borderline personality disorder (BPD) and antisocial personality disorder (ASPD). Patients exhibits a fear of abandonment which aligns with BPD. The patient mentioned an interpersonal relationship involvement which she exhibited idolization for the man of her interest, and now is devaluing the man. This is also evident in BPD as outlined by diagnostic criteria set forth by the APA (2013).

My diagnosis for this patient is ASPD, because the client exhibits clinical manifestations of ASPD than BPD. One of the reasons that led me to the diagnosis of ASPD is the client’s lack of remorse. The client stole from a friend, instead of being sorry, client’s blames friend instead. Personality Disorders Decision Tree Case Study Assignment Example. Client exhibits lack of respect for social norm and failure to comply with the law as evidenced by more than one record of arrest. The client fails to upholding financial obligation and is deceitful. Client shows irresponsibility evidenced by inability to keep a job. These presentations are evident in clients with ASPD as outlined in the DSM-5.

The two personality disorders which are classified as cluster B personality disorders by the APA (2013) have clinical manifestations which overlap, thus needs to be ruled out as differential diagnoses for each other. As described on the DSM-5 diagnostic criteria, BPD and ASD have similar features of impulsivity, aggression and manipulative behaviors, which client exhibits in the case study. The differing manifestation between the two  is that in BPD, clients seek out interpersonal relationship, while ASPD client is unable to form any attachment to relationship. Clients with BPD exhibit self-mutilating behaviors and self-aggression, while in  ASPD,  aggression is directed on others. In ASPD clients are egocentric (also seen in narcisstic personality disorder), while BPD clients have a poor image of self Personality Disorders Decision Tree Case Study Assignment Example.

Decision Two

Since the client exhibits symptoms which are synonymous with one more than personality disorder, specifically borderline and antisocial; the best decision is to opt to conduct a psychological testing. This will to further help the practitioner to decipher between the two diagnoses or conclude that patient indeed has the two personality disorders which is a possible occurrence Personality Disorders Decision Tree Case Study Assignment Example. Psychological testing can be in the form of rating scales which includes questionnaires, checklists e.t c. According to Sadock, Sadock and Ruiz (2014), these scales are useful for monitoring patient overtime or to provide a comprehensive assessment information that was not obtained during a routine clinical interview.

There is limited evidence from existing literatures on the effectiveness of medications to target the core symptoms of ASPD. Khalifa et al. (2010) mentions that pharmacological interventions are not to be considered as monotherapy but as adjunctive intervention to target associated symptoms of ASPD such as depression, aggression etc.  The option of Haldol, an antipsychotic medication can be used to address aggression but does not treat the core features of the disorder such as lack of remorse, deceitfulness. Furthermore, the plethora of side effects known to be caused by the medication can increase noncompliance. Psychotherapy can be beneficial, but psychodynamic is not appropriate for this patient because it may require patient to address emotional states. Personality Disorders Decision Tree Case Study Assignment Example. According to Hesse (2010), probing about ‘feeling states’ is unhelpful because the ASPD client may have difficulty accessing such state and may become aggressive when made to confront personal shortcoming.

Decision Three

In decision three, the recommendation is for a group-based cognitive therapy. Latuda an antipsychotic can be used to treat aggression but not the core symptoms of ASPD. Dialectical behavioral therapy will be more appropriate in the client with BPD than in ASPD. The most cited effective psychotherapeutic approach used in ASPD is cognitive behavioral therapy (CBT). Personality Disorders Decision Tree Case Study Assignment Example. This approach helps the client address distorted beliefs about self, others and the world. CBT can be used to enhance social and intrapersonal functioning.

A group setting may be beneficial for these clients as they may be able to learn from others experience or information shared about self. Psychotherapy for ASPD should be met with skepticism, but Hesse (2010) suggested that approaches that includes employing moral reasoning, cognitive behavioral approach, applying a social information processing approach, and planning for relapse prevention should be used. Additionally, the clients need a high level of external structure that includes supervision of the patient and reinforcement of positive social behaviors to yield increased outcomes for ASPD clients (Hesse, 2010). Personality Disorders Decision Tree Case Study Assignment Example.

Ethical and Legal Considerations

Due to the clinical manifestation of ASPD, some clinicians believe that it is hopeless to treat ASPD clients due to their clinical manifestation of aggression, deceitfulness and manipulation. Clients tends to be noncompliant, fueling the clinician’s pessimism. Existence of pessimism can hinder practitioners from upholding the ethical principles to do no harm and to do the best for the patient to full capacity. Hatchet (2015), implores clinicians to turn to published studies to become more aware of treatment options and to avoid expert opinions or clinical myths in regards to treating clients with ASPD.  For these clients, autonomy may be purposely compromised to prevent harm to the patient and to others. This is seen in cases where patient refuse to comply with treatment plan or ordered into treatment and remain in treatment until deemed fit to come out of treatment.

Conclusion

It is essential for the practitioner to be knowledgeable about personality s disorder to effectively care for the patient. The practitioner should explore various options of medication, used to target accompanied symptoms. Psychotherapy, even though some might argue of its effectiveness, should not be ruled out. Assessment tools should be used to guide the clinicians, in diagnosing, especially with disorders that have overlapping symptoms Personality Disorders Decision Tree Case Study Assignment Example.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders

(5th ed.). Washington, DC: Author.

Khalifa, N., Duggan, C., Stoffers, J., Huband, N., Völlm, B. A., Ferriter, M., & Lieb, K. (2010). Pharmacological interventions for antisocial personality disorder. The cochrane database of systematic Reviews, (8). Doi: 10.1002/14651858.CD007667.pub2

Hatchett, G. T. (2015). Treatment guidelines for clients with antisocial personality disorder. Journal of mental health counseling, 37(1). Retrieved from Walden University Database

Hesse, M. (2010). What should be done with antisocial personality disorder in the new edition of the diagnostic and statistical manual of mental disorders (DSM-V)? Biomed central medicine, 8(66). DOI: 10.1186/1741-7015-8-66

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.

Assignment: Decision Tree

For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat pediatric clients presenting symptoms of a mental health disorder.

The Assignment:

Examine Case 2: 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.

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 families.

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.

Case #2
Anxiety disorder, OCD, or something else?

BACKGROUND

Tyrel is an 8-year-old black male who is brought in by his mother for a variety of psychiatric complaints. Shaquana, Tyrel’s mother, reports that Tyrel has been exhibiting a lot of worry and “nervousness” over the past 2 months. She states that she notices that he has been quite “keyed up” and spends a great deal of time worrying about “germs.” She states that he is constantly washing his hands because he feels as though he is going to get sick like he did a few weeks ago, which kept him both out of school and off the playground. He was also not able to see his father for two weekends because of being sick. Shaquana explains that although she and her ex-husband Desmond divorced about 2 years ago, their divorce was amicable and they both endeavor to see that Tyrel is well cared for.

Shaquana reports that Tyrel is irritable at times and has also had some sleep disturbances (which she reports as “trouble staying asleep”). She reports that he has been more and more difficult to get to school as he has become nervous around his classmates. He has missed about 8 days over the course of the last 3 weeks. He has also stopped playing with his best friend from across the street.

His mother reports that she feels “responsible” for his current symptoms. She explains that after he was sick with strep throat a few weeks ago, she encouraged him to be more careful about washing his hands after playing with other children, handling things that did not belong to him, and especially before eating. She continues by saying “maybe if I didn’t make such a big deal about it, he would not be obsessed with germs.”

Per Shaquana, her pregnancy with Tyrel was uncomplicated, and Tyrel has met all developmental milestones on time. He has had an uneventful medical history and is current on all immunizations.

OBJECTIVE

During your assessment of Tyrel, he seems cautious being around you. He warms a bit as you discuss school, his friends at school, and what he likes to do. He admits that he has been feeling “nervous” lately, but when you question him as to why, he simply shrugs his shoulders.

When you discuss his handwashing with him, he tells you that “handwashing is the best way to keep from getting sick.” When you question him how many times a day he washes his hands, he again shrugs his shoulders. You can see that his bilateral hands are dry. Throughout your assessment, Tyrel reveals that he has been thinking of how dirty his hands are; and no matter how hard he tries to stop thinking about his “dirty” hands, he is unable to do so. He reports that he gets “really nervous” and “scared” that he will get sick, and that the only way to make himself feel better is to wash his hands. He reports that it does work for a while and that he feels “better” after he washes his hands, but then a little while later, he will begin thinking “did I wash my hands well enough? What if I missed an area?” He reports that he can feel himself getting more and more “scared” until he washes his hands again.

MENTAL STATUS EXAM

Tyrel is alert and oriented to all spheres. Eye contact varies throughout the clinical interview. He reports his mood as “good,” admits to anxiety. Affect consistent to self-reported mood. He denies visual/auditory hallucinations. No overt delusional or paranoid thought processes were apparent. He denies suicidal ideation.

Lab studies obtained from Tyrel’s pediatric nurse practitioner were all within normal parameters. An antistreptolysin O antibody titer was obtained for reasons you are unclear of, and this titer was shown to be above normal parameters. Personality Disorders Decision Tree Case Study Assignment Example.

Decision Point One

BASED ON THE INFORMATION PROVIDED IN THE SCENARIO ABOVE, WHICH OF THE FOLLOWING DIAGNOSES WOULD THE PMHNP GIVE TO TYREL?

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.

 Generalized Anxiety Disorder (GAD)

 Obsessive Compulsive Disorder

 Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (“PANDAS”)

ANSWER CHOOSEN: Obsessive Compulsive Disorder

Decision Point Two

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

Begin Zoloft 50 mg orally daily

Begin Fluvoxamine immediate release 25 mg orally at bedtime

Begin Fluvoxamine controlled release 100 mg orally in the morning

Discontinue Zoloft and begin Fluvoxamine controlled release 100 mg orally every morning In terms of an actual diagnosis, the child’s main symptoms are most consistent with obsessive-compulsive disorder. There may also be an element of social phobia developing, but at this point, the PMHNP has not assessed the nature of the school avoidance—that is, why is the child avoiding school. Notice that nothing in the scenario tells us that the PMHNP has assessed this. Zoloft is FDA-approved to treat OCD in children. However, between ages 6 and 12, it should be started at 25 mg orally daily. If starting doses are too high, the child may experience side effects that he associates with the medication and as such, may refuse to take the medication. Starting at too high a dose can result in unfavorable side effects (gastrointestinal side effects are notable in this drug), and we can see that Tyrel is experiencing nausea and decreased appetite. In this case, it is recommended to wait to see if the side effects dissipate. Decreasing the dose to 12.5 mg orally daily for about 3 or 4 days, then going back to 25 mg orally daily may help to overcome the unfavorable side effects. If side effects persist, the PMHNP may need to consider switching to a different medication. Personality Disorders Decision Tree Case Study Assignment Example. Fluvoxamine controlled release is not FDA-approved for use in children with OCD (see “Special Populations: Children and Adolescents” in the Fluvoxamine monograph of Stahl’s Prescriber’s Guide for further details). Fluvoxamine 100 mg orally daily may not be tolerated in the morning secondary to the drug’s sigma-1 antagonist properties, which can cause sedation. Dosing of Fluvoxamine should be such that the larger dose is given in the evening to minimize daytime sedation. Personality Disorders Decision Tree Case Study Assignment Example It is also worth noting that nothing in the scenario tells us that the Zoloft will not be effective.

ANSWER CHOOSEN: Begin Fluvoxamine immediate release 25

mg orally at bedtime

• Client returns to clinic in four weeks
• Upon return to the clinic, Tyrel’s mother reported that he has had some decrease in his symptoms. She states that the frequency of the handwashing has decreased, and Tyrel seems a bit more “relaxed” overall. Personality Disorders Decision Tree Case Study Assignment Example.
• She also reports that Tyrel has not fully embraced returning to school, but that his attendance has improved. She reported that over this past weekend, Tyrel went outside to play with his friend from across the street, which he has not done in a while.

RESULTS OF DECISION POINT TWO

• Client returns to clinic in four weeks
• Upon return to the clinic, Tyrel’s mother reported that he has had some decrease in his symptoms. She states that the frequency of the handwashing has decreased, and Tyrel seems a bit more “relaxed” overall.
• She also reports that Tyrel has not fully embraced returning to school, but that his attendance has improved. She reported that over this past weekend, Tyrel went outside to play with his friend from across the street, which he has not done in a while.

Decision Point Three

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

Increase Fluvoxamine to 50 mg orally at bedtime

Augment with an atypical antipsychotic such as Abilify

Augment treatment with cognitive behavioral therapy

 ANSWER CHOOSEN: Increase Fluvoxamine to 50 mg orally at

bedtime

Guidance to Student

In terms of an actual diagnosis, the child’s main symptoms are most consistent with obsessive-compulsive disorder. There may also be an element of social phobia developing, but at this point, the PMHNP has not assessed the nature of the school avoidance—that is, why is the child avoiding school. Notice that nothing in the scenario tells us that the PMHNP has assessed this. Personality Disorders Decision Tree Case Study Assignment Example.

Fluvoxamine immediate release is FDA-approved for the treatment of OCD in children aged 8 years and older. Fluvoxamine’s sigma-1 antagonist properties may cause sedation and as such, it should be dosed in the evening/bedtime.

At this point, it would be appropriate to consider increasing the bedtime dose, especially since the child is responding to the medication and there are no negative side effects.

Atypical antipsychotics are typically not used in the treatment of OCD. There is also nothing to tell us that an atypical antipsychotic would be necessary (e.g., no psychotic symptoms). Personality Disorders Decision Tree Case Study Assignment Example Additionally, the child seems to be responding to the medication, so there is no rationale as to why an atypical antipsychotic would be added to the current regimen.

Cognitive behavioral therapy is the psychotherapy of choice for treating OCD. The PMHNP should augment medication therapy with CBT. If further assessment determines that Tyrel has social anxiety disorder, CBT is effective in treating this condition as well.

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 31, “Child Psychiatry” (pp. 1253–1268)

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

• “Anxiety Disorders”

American Academy of Child & Adolescent Psychiatry (AACAP). (2012a). Practice parameter for the assessment and treatment of children and adolescents with obsessive-compulsive disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 51(1), 98–113. Retrieved from http://www.jaacap.com/article/S0890-8567(11)00882-3/pdf

McClelland, M., Crombez, M-M., Crombez, C., Wenz, C., Lisius, M., Mattia, A., & Marku, S. (2015). Implications for advanced practice nurses when pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) is suspected: A qualitative study. Journal of Pediatric Health Care, 29(5), 442–452. doi:10.1016/j.pedhc.2015.03.005

Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York, NY: Cambridge University Press.

To access information on the following medications, click on The Prescriber’s Guide, 5th Ed. tab on the Stahl Online website and select the appropriate medication.

SEE ATTACHECD DECISION TREE ASSIGNMENT EXAMPLE

• Client returns to clinic in four weeks
• Upon return to the clinic, Tyrel’s mother reported that he has had some decrease in his symptoms. She states that the frequency of the handwashing has decreased, and Tyrel seems a bit more “relaxed” overall.
• She also reports that Tyrel has not fully embraced returning to school, but that his attendance has improved. She reported that over this past weekend, Tyrel went outside to play with his friend from across the street, which he has not done in a while. Personality Disorders Decision Tree Case Study Assignment Example.

• Client returns to clinic in four weeks
• Upon return to the clinic, Tyrel’s mother reported that he has had some decrease in his symptoms. She states that the frequency of the handwashing has decreased, and Tyrel seems a bit more “relaxed” overall.
• She also reports that Tyrel has not fully embraced returning to school, but that his attendance has improved. She reported that over this past weekend, Tyrel went outside to play with his friend from across the street, which he has not done in a while. Personality Disorders Decision Tree Case Study Assignment Example.

Public Health Law Short Report Midterm Project

“A Public Health Law Short Report”

Title of Midterm Project: “A Public Health Law (Short Report)”:

You will pick a US public health law – a law at the federal, state, country or city level that is designed to protect the health of the public. You will do a literature search and write a report about the law and how it has impacted the health of the public.  Note that this is a “short” report – only 1,000 words Public Health Law Short Report Midterm Project.

The public health law must be from one of the following three topic areas:

ORDER A FREE- PLAGIARISM PAPER HERE

1) Lead

2) Smoking

3) Immunization

Important tips on writing your midterm report:

Once you choose you main topic (lead, smoking or immunization), you should choose a law that addresses that topic that has been in effect at least for a few years. Search literature first to make sure that the law’s impact has been evaluated. For instance, “an evaluation study found that 5 years after the introduction of an anti-smoking law, smoking prevalence and incidence of asthma declined” Public Health Law Short Report Midterm Project.

Also, the law has to be very specific – for instance, “The Clean Indoor Air Act of NYS of 2003 (Public Health Law, Article 13-E)” instead of “Anti-smoking law in NYS”.

 The content of your midterm report should cover the following points:

1. Background

• Why was the law enacted?  Health, social, economic, and other contextual backgrounds

2. Description of the law

• Explain the law:  What, When, Where, How and Who

3. Evidence of the law’s impact on health

• Summarize evidence gathered from scientific studies and government reports that evaluated the law’s impact.

1. Brief concluding statement

• Include your own assessments including critiques of the law (lessons learned), and any limitations to report.

Format Requirements:

• Public Health Law Short Report Midterm Project Top of the first page: Title, your name, date of submission, and word count of the text*
• Abstract: up to 200 words to summarize your report
• Text: 1 inch margins, page numbered (lower right), single spaced, 12 point font.
• Citation Style:  The JAMA style is preferred (see attached guide). Other established styles (APA, Chicago, etc.) are acceptable.
• Bibliography/Citations: A minimum of 3 peer reviewed journal articles or credible government reports. All online materials should have URLs, and the date that you accessed them.
• Appendix (optional): graphs, tables, and photos. Limit: one page total. They should supplement, but not duplicate, your writing. All materials need proper citations or disclosure of sources.

*Word count: 1,000 words maximum, excluding the title section, abstract, bibliography, and appendix. Public Health Law Short Report Midterm Project.

Submission:

You will submit your midterm report in a Microsoft WORD document (uploading instructions are provided in the MIDTERM PROJECT SUBMISSION link below).

Due Date: Sunday 3/31 (11:59 PM at night)

Quality of report will be graded based on the following criteria:

• Compliance with the format requirements
• Quality of information (scientific value, accuracy)
• Organization of materials (clarity and consistency)
• Originality (of conclusion & interpretation)
• Citations (minimum of 3 citations from peer reviewed journals or credible government reports)

This assignment will be reviewed for plagiarism using SafeAssign. Review the syllabus for the full policy on Academic Dishonesty and plagiarism.

Resource:  NYS Lead Laws

https://www.health.ny.gov/regulations/public_health_law/article_13/title_10/index.htm#prevention Public Health Law Short Report Midterm Project

PCN 605 Case Study of Tina Essay Assignment

Case Study: Tina

PCN 605 Case Study of Tina

Tina is a 17-year-old Navajo female who is brought into a counselor’s office for symptoms of depression; her family has noticed that she is more withdrawn than usual and she is often observed crying and talking to herself. Through the intake interview, the counselor learns that Tina hears voices daily that command her to perform certain acts of hygiene (showering, combing her hair, etc.) PCN 605 Case Study of Tina Essay Assignment. She further reveals that she believes these voices to be the result of witchcraft that her boyfriend is using to control her. Tina also states that she has used methamphetamines heavily for the past several months. She and her mother ask the counselor to work with Tina for the depression, but claim that they wish to see a medicine man for hearing voices.

Where does the counselor begin with this client? Tina is clearly demonstrating symptoms of psychoses, yet it is difficult to determine what has caused them. Is she experiencing a severe depressive episode with psychotic features? Have the voices been induced by excessive drug use? Alternatively, should the counselor take into account the cultural acceptance of witchcraft and let the medicine man exclusively treat Tina? This case study is but one example of the way different cultures deviate in concept of mental illness as it presents itself in the counselor’s office.

ORDER A FREE- PLAGIARISM PAPER HERE

Viewing clients as devoid of their cultural backgrounds because notions of health and wellness differ greatly by who is defining them are unethical and unwise. In order to be as receptive as possible to a client’s position, counselors must constantly deconstruct and be aware of their own beliefs regarding psychopathology. This process of exploring a belief system has been given many names, one of which is social constructionism (Lemma, 2011).

Social constructionism is the concept that reality is formed and defined by the individual experience of it; the perceptions of any given society are constantly in flux as trends and knowledge shifts. PCN 605 Case Study of Tina Essay Assignment As such, the concept of psychology changes to meet the needs of each given culture. Ruder & Guterman (2007) state that “social constructionism is, itself, a social construction that is always changing and subject to reconstruction” (p. 387).

PCN 605 Case Study of Tina References

Rudes, J. & Guterman, J. (2007). The value of social constructionism for the counseling profession: A reply to Hansen. Journal of Counseling & Development,85(4), 387-392

PCN 605 Case Study of Tina Paper Details

Review the diagnostic criteria on pages 99-100; 160-161; 561-562 of the DSM-5.

A counselor’s own perception of psychopathology is extremely important in the diagnostic process.

Using the case study of “Tina”, write a 500-750 word essay in which you examine your thought process about her presenting issues. Include the following in your paper:

• Discuss the historic and cross-cultural perspectives of psychopathology that could potential impact the diagnosis and treatment of Tina.
• After reviewing the several diagnoses that could pertain to Tina from the latest version of the DSM, what is your diagnostic impression?
• Substantiate your diagnostic impression with appropriate criteria from the current version of the DSM. PCN 605 Case Study of Tina Essay Assignment.
• Discuss how historic misconceptions of psychopathology could potentially impact the treatment of this client. As part of this discussion, you may include a diagnosis, any referrals that you would make, and a general course of treatment. At least five scholarly references in addition to the textbook in your paper.

Prepare this PCN 605 Case Study of Tina assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. PCN 605 Case Study of Tina Essay Assignment.

This PCN 605 Case Study of Tina assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this PCN 605 Case Study of Tina assignment to Turnitin. Refer to the directions in the Student Success Center. PCN 605 Case Study of Tina Essay Assignment.