Explain how you took cultural factors and diversity into account when making the assessment and recommending interventions.

The sign of an effective clinician is the ability to identify the criteria that distinguish the diagnosis from any other possibility (otherwise known as a differential diagnosis). An ambiguous clinical diagnosis can lead to a faulty course of treatment and hurt the client more than it helps. In this Assignment, using the DSM-5 and all of the skills you have acquired to date, you assess a client.

This is a culmination of learning from all the weeks covered so far.

To prepare: Use a differential diagnosis process and analysis of the Mental Status Exam in “The Case of L” to determine if the case meets the criteria for a clinical diagnosis.

Then by Sunday night, Please submit a 4 to 5 page paper in which you:

  • Provide the full DSM-5 diagnosis. Remember, a full diagnosis should include the name of the disorder, ICD-10-CM code, specifiers, severity, and the Z codes (other conditions that may need clinical attention).
  • Explain the full diagnosis, matching the symptoms of the case to the criteria for any diagnoses used.
  • Identify 2–3 of the close differentials that you considered for the case and have ruled out. Concisely explain why these conditions were considered but eliminated.
  • Identify the assessments you recommend to validate treatment. Explain the rationale behind choosing the assessment instruments to support, clarify, or track treatment progress for the diagnosis.
  • Explain your recommendations for initial resources and treatment. Use scholarly resources to support your evidence-based treatment recommendations.
  • Explain how you took cultural factors and diversity into account when making the assessment and recommending interventions.
  • Identify client strengths, and explain how you would utilize strengths throughout treatment.
  • Identify specific knowledge or skills you would need to obtain to effe

Explain applicable federal/state/local laws and the current school and district policies related to teachers’ responsibilities to protect students’ rights and safety.

An important aspect of classroom management is keeping students safe. Student safety concerns include the use of technology and other classroom resources, maintaining students’ privacy, bullying, trauma, and child abuse. Teachers need to be aware of their legal and ethical responsibilities when it comes to protecting students in their classrooms.

For this assignment, prepare a 10-12 slide digital presentation  for an upcoming professional development for fellow teachers. Explain applicable federal/state/local laws and the current school and district policies related to teachers’ responsibilities to protect students’ rights and safety.

The presentation should include specific examples related to four of the following topics:

  • Digital citizenship (e.g., communication, literacy, etiquette, law, rights and responsibilities, and security)

Two additional topics from the list below:

  • Bullying/Harassment/Intimidation/Violence, on and off campus
  • Searches of students (e.g., drugs, weapons, cellphones)
  • Reporting requirements for suspected child abuse
  • FERPA and students’ privacy rights
  • Trauma or traumatic events (e.g., fire, bomb threat, evacuation)

One additional topic from the list below:

  • Extracurricular teacher assignments and responsibilities (e.g., playground supervision, coaching, club sponsoring)
  • Maintaining inclusion classrooms and compliance with IEPs for students with exceptionalities
  • Managing a classroom when 1:1 technology is present
  • Teachers’ professional behavior on and off campus, and online when communicating with the community, colleagues, and stakeholders

In addition, create a title slide, reference slide, and presenter’s notes.

Explain the benefits and drawbacks of renting versus owning a home.

Homes: Renting and Buying Worksheet

1. Complete the “Rent vs Buy” exercise on the SmartAsset website: https://smartasset.com/mortgage/rent-vs-buy#H5ktHGbUiE

Respond to each of the following in a minimum of 50 words:

· What was the recommendation?

· What were the factors that led to that recommendation?

· Do you agree or disagree with the recommendation? Why?

2. Consider how economic conditions affect your decision to buy or rent (i.e. interest rates, unemployment rate, and inflation).

Explain the benefits and drawbacks of renting versus owning a home.

3. Review Exhibit 7-4 in Ch. 7, p. 225 of Focus on Personal Finance.

Summarize in at least 100 words the steps in the home-buying process.

4. Review Exhibit 7-6 in Ch. 7, p. 230 of Focus on Personal Finance.

Estimate the affordable monthly mortgage payment, the affordable mortgage amount, and the affordable home purchase price for the following situation. Show your calculations in the table below.

· Monthly gross income: $2,950

· Other debt, monthly payment: $160

· Down payment to be made: 15% of purchase price

· Monthly property tax and insurance: $210

· 30-year mortgage at 6%

Design a detailed business plan for a new product, service, or business venture of your choice.

Design a detailed business plan for a new product, service, or business venture of your choice. This could be an idea you have been contemplating or a product presently being marketed, but your business plan must reflect the uniqueness of the idea. For example, it might involve the modification of a certain product based on the unique needs of your community or peer group. Follow the business plan outline provided in Table 8.1 of the course textbook. Be sure to include:

  • Title page
  • Table of contents
  • Executive summary
  • Description of product, service, or business
  • Description of industry or industry closest to your product or service
  • Marketing plan
  • Financial plan
  • Production plan
  • Organizational plan
  • Operational plan
  • Summary
  • Appendices (exhibits)

According to the AAFP/CDC Guidelines, what antifungal medication(s) should this patient be prescribed, and for how long?

Chief complaint:  “ My right great toe has been hurting for about 2 months and now it’s itchy, swollen and yellow. I can’t wear closed shoes and I was fine until I started going to the gym”.

HPI: E.D a 38 -year-old Caucasian female presents to the clinic with complaint of pain, itching, inflammation, and “yellow” right great toe. She noticed that the toe was moderately itching after she took a shower at the gym. She did not pay much attention. About two weeks after the itching became intense and she applied Benadryl cream with only some relief.  She continued going to the gym and noticed that the itching got worse and her toe nail started to change color. She also indicated that the toe got swollen, painful and turned completely yellow 2 weeks ago. She applied lotrimin  AF cream and it did not help relief her symptoms. She has not tried other remedies.

Denies associated symptoms of fever and chills.

PMH: Diabetes Mellitus, type 2.

Surgeries: None

Allergies: Augmentin

Medication: Metformin 500mg PO BID.

Vaccination History:  Immunization is up to date and she received her flu shot this year.

Social history: College graduate married and no children. She drinks 1 glass of red wine every night with dinner. She is a former smoker and quit 6 years ago.

Family history:Both parents are alive. Father has history of DM type 2, Tinea Pedis. mother alive and has history of atopic dermatitis, HTN.

ROS:

Constitutional: Negative for fever. Negative for chills.

Respiratory: No Shortness of breath. No Orthopnea

Cardiovascular: Regular rhythm.

Skin: Right great toe swollen, itchy, painful and discolored.

Psychiatric: No anxiety. No depression.

Physical examination:

Vital Signs

Height: 5 feet 5 inches Weight: 140 pounds BMI: 31 obesity, BP 130/70 T 98.0, P 88 R 22, non-labored

HEENT: Normocephalic/Atraumatic, Bilateral cataracts; PERRL, EOMI; No teeth loss seen. Gums no redness.

NECK: Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement.

LUNGS: No Crackles. Lungs clear bilaterally. Equal breath sounds. Symmetrical respiration. No respiratory distress.

HEART: Normal S1 with S2 during expiration. Pulses are 2+ in upper extremities. 1+ pitting edema ankle bilaterally.

ABDOMEN: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses.

GENITOURINARY: No CVA tenderness bilaterally. GU exam deferred.

MUSCULOSKELETAL: Slow gait but steady. No Kyphosis.

SKIN: Right great toe with yellow-brown discoloration in the proximal nail plate. Marked periungual inflammation. + dryness. No pus. No neuro deficit.

PSYCH: Normal affect. Cooperative.

Labs: Hgb 13.2, Hct 38%, K+ 4.2, Na+138, Cholesterol 225, Triglycerides 187, HDL 37, LDL 190, TSH 3.7, glucose 98.

Assessment:

Primary Diagnosis: Proximal subungual onychomycosis

Differential Diagnosis:  Irritant Contact Dermatitis, Lichen Planus, Nail Psoriasis

Special Lab:

Fungal culture confirms fungal infection.

As an NP student, you need to determine the medications for onychomycosis.

1. According to the AAFP/CDC Guidelines, what antifungal medication(s) should this patient be prescribed, and for how long? Write her complete prescriptions using the prescription writing format in your textbook.

2.  What labs for baseline and follow up of therapy would you order for this patient? Give rationale.

Write a report (select 2 games) on the gaming software purpose, and its utility in public policy formulation and education.

Visit these gaming websites that are listed in your textbook and join some for free (do not pay, just explore).

(1) NationStates—create your own country http://www.nationstates.net
(2) CItyOne http://www-01.ibm.com/software/solutions/soa/innov8/cityone/index.html
(3) Breakaway (Disaster Management-Incident Commander) http://www.breakawayltd.com
(4) Budget Hero http://www.marketplace.org/topics/economy/budget-hero
(5) World Without Oil http://worldwithoutoil.org
(6) 2050 Pathways https://www.gov.uk/2050-pathways-analysis
(7) The Social Simulator http://www.socialsimulator.com
(8) Democracy http://www.positech.co.uk/democracy

Please, write a report (select 2 games) on the gaming software purpose, and its utility in public policy formulation and education.

Compare the number of discharges in 2010, 2012, and 2015 in all states. Are there significantly more discharges in 2015 versus 2010 in all states?

MODULE 5:  TOPIC: Quantitative Methods of Inquiry

This topic helps you develop a basic understanding of quantitative methods of inquiry. In this assignment, you will have the opportunity to use the SPSS program. SPSS makes it easy to analyze data using specific tests. This assignment will give you practice with means, medians, and modes.

General Requirements:

Use the following information to ensure successful completion of the assignment:

· Review the Topic Material videos, A Brief Comparison of Qualitative and Quantitative Research Methods and Quantitative vs Qualitative Research, before undertaking this practice.

· Doctoral learners are required to use APA style for their writing assignments.

· You are required to submit this assignment to LopesWrite.

Directions:

After you have completed the assigned readings and viewed the assigned videos, write a 500-750 word paper that addresses quantitative methods of inquiry. Use the data provided in the Topic Material, “H Cup State Inpatient Databases (SID) File Composition – Number of Discharges by Year,” and appropriate statistics to address the following:

1. Describe the different quantitative methods of inquiry.

2. Describe the mean, median, and mode of discharges by state in 2014.

3. Compare the number of discharges in 2010, 2012, and 2015 in all states. Are there significantly more discharges in 2015 versus 2010 in all states?

4. Compare the number of discharges in 2011 in northwestern states (Washington, Oregon, Idaho, Montana, Wyoming), southwestern states (California, Nevada, Utah, Arizona, New Mexico, Oklahoma, and Texas), central states (North Dakota, South Dakota, Nebraska, Kansas, Missouri, Iowa, Minnesota, Wisconsin, Illinois), southeastern states (West Virginia, Virginia, North Carolina, South Carolina, Georgia, and Florida), and northeastern states (Maine, Vermont, New Hampshire, Massachusetts, Rhode Island, Connecticut, Washington D.C., New York, New Jersey, Pennsylvania, Delaware, and Maryland).

5. Summary of the paper.

You are required to complete your assignment using real-world application. Real-world application requires the use of evidence-based data, contemporary theories, and concepts presented in the course. The culmination of your assignment must present a viable application in a current practice setting.

Develop an IT planning process for ModMeters to accomplish the demands as set out.

Brian Smith, CIO of ModMeters, groaned inwardly as he listened to CEO John Johnson wrapping up his remarks. “So our executive team thinks there are real business oppor- tunities for us in developing these two new strategic thrusts. But before I go to the board for final approval next month, I need to know that our IT, marketing, and sales plans will support us all the way,” Johnson concluded.

Brian mentally calculated the impact these new initiatives would have on his orga- nization. He had heard rumors from his boss, the COO, that something big was coming down. He had even been asked his opinion about whether these strategies were techni- cally doable, theoretically. But both at once? Resources—people, time, and money—were tight, as usual. ModMeters was making a reasonable profit, but the CFO, Stan Abrams, had always kept the lid screwed down tightly on IT spending. Brian had to fight for every dime. How he was going to find the wherewithal to support not one but two new strategic initiatives, he didn’t know.

The other VPs at this strategy presentation were smiling. Taking ModMeters global from a North American operation seemed to be a logical next step for the com- pany. Its products, metering components of all types, were highly specialized and in great demand from such diverse customers as utility companies, manufacturers, and a host of other industries. Originally founded as Modern Meters, the firm had grown steadily as demand for its metering expertise and components had grown over the past century or so. Today ModMeters was the largest producer of metering components in the world with a full range of both mechanical and, now, digital products. Expanding into meter assembly with plants in Asia and Eastern Europe was a good plan, thought Brian, but he wasn’t exactly sure how he was going to get the infrastructure in place to support it. “Many of these countries simply don’t have the telecommunications and equipment we are going to need, and the training and new systems we have to put in place are going to be substantial,” he said.

But it was the second strategic thrust that was going to give him nightmares, he predicted. How on earth did they expect him to put direct-to-customer sales in place so they could sell “green” electric meters to individual users? His attention was jerked back to the present by a flashy new logo on an easel that the CEO had just unveiled.

“In keeping with our updated strategy, may I present our new name—MM!” Johnson announced portentously.

“Oh, this is just great,” thought Brian. “Now I have to go into every single applica- tion and every single document this company produces and change our name!”

Because of its age and scientific orientation, ModMeters (as he still preferred to call it) had been in the IT business a long time. Starting back in the early 1960s, the

4 Smith, H. A., and J. D. McKeen. “IT Planning at ModMeters.” #1-L05-1-008, Queen’s School of Business, September 2005. Reproduced by permission of Queen’s University, School of Business, Kingston, Ontario, Canada.

 

IT Planning at ModMeters

company had gradually automated almost every aspect of its business from finance and accounting to supply chain management. About the only thing it didn’t have was a fancy Web site for consumers, although even that was about to change. ModMeters currently had systems reflecting just about every era of computers from punch cards to PCs. Unfortunately, the company never seemed to have the resources to invest in reengineering its existing systems. It just layered more systems on top of the others. A diagram of all the interactions among systems looked like a plate of spaghetti. There was no way they were going to be able to support two new strategic thrusts with their current budget levels, he thought as he applauded the new design along with the others. “Next week’s IT budget meeting is going to be a doozy!”

Sure enough, the following week found them all, except for the CEO, back in the same meeting room, ready to do battle. Holding his fire, Brian waited until all the VPs had presented their essential IT initiatives. In addition to what needed to be done to support the new business strategies, each division had a full laundry list of essentials for maintaining the current business of the firm. Even Abrams had gotten into the act this year because of new legislation that gave the firm’s outside auditors immense scope to peer into the inner workings of every financial and governance process the organization had.

After listening carefully to each speaker in turn, Brian stood up. “As many of you know, we have always been cautious about how we spend our IT budget. We have been given a budget that is equal to 2 percent of revenues, which seriously limits what we in IT have been able to do for the company. Every year we spend a lot of time paring our project list down to bare bones, and every year we make do with a patchwork of infra- structure investments. We are now at the point where 80 percent of our budget in IT is fixed. Here’s how we spend our money.” Brian clicked on a PowerPoint presentation showing a multicolored pie chart.

“This large chunk in blue is just about half our budget,” he stated. “This is simply the cost of keeping the lights on—running our systems and replacing a bare minimum of equipment. The red chunk is about 30 percent of the pie. This is the stuff we have to do—fixing errors, dealing with changes mandated by government and our own indus- try, and providing essential services like the help desk. How we divide up the remain- der of the pie is what this meeting is all about.”

Brian clicked to a second slide showing a second pie chart. “As you know, we have typically divided up the remaining IT budget proportionately, according to who has the biggest overall operating budget. This large pink chunk is you, Fred.” Brian gestured at Fred Tompkins, head of manufacturing and the most powerful executive in the room. It was his division that made the firm’s profit. The pink chunk easily took up more than half of the pie. Tompkins smiled. Brian went on, pointing out the slice that each part of the firm had been allotted in the previous year. “Finally, we come to Harriet and Brenda,” he said with a smile. Harriet Simpson and Brenda Barnes were the VPs of human resources and marketing, respectively. Their tiny slivers were barely visible— just a few percent of the total budget.

“This approach to divvying up our IT budget may have served us well over the years”—Brian didn’t think it had, but he wasn’t going to fight past battles—“however, we all heard what John said last week, and this approach to budgeting doesn’t give us any room to develop our new strategies or cover our new infrastructure or staffing needs. Although we might get a little more money to obtain some new applications and buy some more computers”—Abrams nodded slightly—“it won’t get us where we need to go in the future.”

A third graph went up on the screen, showing the next five years. “If we don’t do something now to address our IT challenges, within five years our entire IT budget will be eaten up by just operations and maintenance. In the past we have paid mini- mal attention to our infrastructure or our information and technology architecture or to reengineering our existing systems and processes.” A diagram of the “spaghetti” flashed on. “This is what you’re asking me to manage in a cost-effective manner. It isn’t pretty. We need a better plan for making our systems more robust and flexible. If we are going to be moving in new directions with this firm, the foundation just isn’t there. Stan, you should be worried that we won’t be able to give our auditors what they ask for. But you should also be worried about our risk exposure if one of these systems fails and about how we are going to integrate two new business ventures into this mess.”

Tompkins looked up from his papers. It was clear he wasn’t pleased with where this presentation was headed. “Well, I, for one, need everything I’ve asked for on my list,” he stated flatly. “You can’t expect me to be the cash cow of the organization and not enable me to make the money we need to invest elsewhere.”

Brian was conciliatory. “I’m not saying that you don’t, Fred. I’m just saying that we’ve been given a new strategic direction from the top and that some things are going to have to change to enable IT to support the whole enterprise better. For example, until now, we have always prioritized divisional IT projects on the basis of ROI. How should we prioritize these new strategic initiatives? Furthermore, these new ventures will require a lot of additional infrastructure, so we need to figure out a way to afford this. And right now our systems don’t ‘talk’ to the ones running in other divisions because they don’t use the same terminology. But in the future, if we’re going to have systems that won’t cost increasing amounts of our budget, we are going to have to simplify and integrate them better.”

Tompkins clearly hadn’t considered the enterprise’s needs at all. He scowled but said nothing. Brian continued, “We are being asked to do some new things in the com- pany. Obviously, John hopes there’s going to be a payback, but it may take a while. New strategies don’t always bear fruit right away.” Now looking at Abrams, he said point- edly, “There’s more to IT value than short-term profit. Part of our business strategy is to make new markets for our company. That requires investment, not only in equipment and product but also in the underlying processes and information we need to manage and monitor that investment.”

Harriet Simpson spoke for the first time. “It’s like when we hire someone new in R&D. We hire for quality because we want their ideas and innovation, not just a warm body. I think we need to better understand how we are going to translate our five key corporate objectives into IT projects. Yes, we need to make a profit, but Stan needs to satisfy regulators and Brenda’s going to be on the hot seat when we start marketing to individuals. And we haven’t even spoken about Ted’s needs.” As the VP of R&D, Ted Kwok was tasked with keeping one or more steps ahead of the competition. New types of products and customer needs would mean expansion in his area as well.

Abrams cleared his throat. “All of you are right. As I see it, we are going to have to keep the cash flowing from Fred’s area while we expand. But Brian’s got a point. We may be being penny wise and pound foolish if we don’t think things through more

carefully. We’ve put a lot of effort into developing this new strategy, and there will be some extra money for IT but not enough to do that plus everything all of you want. We need to retrench and regroup and move forward at the same time.”

There was silence in the room. Abrams had an annoying way of stating the obvious without really helping to move the ball forward. Brian spoke again. “The way I see it, we have to understand two things before we can really make a new budget. First, we need to figure out how each of the IT projects we’ve got on the table contri- butes to one of our key corporate objectives. Second, we need to figure out a way to determine the value of each to ModMeters so that we can prioritize it. Then I need to incorporate a reasonable amount of IT regeneration so that we can continue to do new projects at all.”

Everyone was nodding now. Brian breathed a small sigh of relief. That was step one accomplished. But step two was going to be harder. “We have a month to get back to the board with our assurances that the IT plan can incorporate the new strategies and what we’re going to need in terms of extra funds to do this. As I said earlier, this is not just a matter of throwing money at the problem. What we need is a process for IT planning and budgeting that will serve us well over the next few years. This process will need to accomplish a number of things: It will need to take an enterprise perspective on IT. We’re all in these new strategies together. It will have to incorporate all types of IT initiatives—our new strategies, the needs of Fred and others for the new IT to oper- ate and improve our existing business, Stan’s new auditing needs, and our operations and maintenance needs. In addition, we must find some way of allocating some of the budget to fixing the mess we have in IT right now. It must provide a better way to con- nect new IT work with our corporate objectives. It must help us prioritize projects with different types of value. Finally, it must ensure we have the business and IT resources in place to deliver that value.”

Looking at each of his colleagues in turn, he asked, “Now how are we going to do this?”

Discussion Question 

1. Develop an IT planning process for ModMeters to accomplish the demands as set out above.