Have you ever heard someone refer to himself or herself as a “social drinker” or “social smoker”?

Week 4Discussion: Compulsions and Addictions Have you ever heard someone refer to himself or herself as a “social drinker” or “social smoker”? Many people enjoy caffeine or alcohol, spend a little too much on a shopping trip, and even gamble in moderation. For the most part, individuals are capable of engaging in these and other activities in a controllable way. Almost any behavior has the potential to transform into a compulsion or addiction, however. Determining when a behavior is a compulsive or an addiction can be a challenging process. Although there are guidelines such as diagnostic criteria and statistics for both, there are few scientific rules regarding what constitutes a compulsion versus an addiction. Is one worse than the other? Is one more common than the other? Experts in the field of addictions typically determine what is considered healthy and normal and what is considered problematic. Addictions professionals recognize the signs of both compulsion and addiction in individuals and the difference between these two conditions. To prepare for this Discussion: Review Go Ask Alice! (2009). What’s the difference between an addiction and a compulsion? Retrieved from http://goaskalice.columbia.edu/whats-difference-between-addiction-and-compulsion Go Ask Alice! (2009). What’s the difference between an addiction and a compulsion? Retrieved from http://goaskalice.columbia.edu/whats-difference-between-addiction-and-compulsion Review the articles “What’s the Difference Between an Addiction and a Compulsion?,” “Internet Addiction: Definition, Assessment, Epidemiology and Clinical Management,” and “Pathological Gambling and Substance Use Disorders.” Review the list of behaviors provided below. When posting, try to choose a behavior that has not been discussed by one of your colleagues at the time that you post, or if all have been selected, be sure to include a new insight that has not been covered. Marijuana use Gambling Spending Hoarding Nail biting Technology/e-mail checking/Internet Hair picking By Day 4 Post a brief explanation of the difference between compulsion and addiction using one of the behaviors above. Then, explain why it is important to know the difference. Be specific and use the week’s Learning Resources in your response. By Day 6 Respond to two colleague: Offer polite disagreement with the colleague’s assessment of compulsion or addiction. Offer an insight from your experience. Offer another perspective. Submission and Grading Information

Medical Summary Report

PLEASE REVIEW ALL UPLOADS TO DO THIS CASE STUDY Medical Summary Report Template Use your agency’s letterhead and delete the guidance underneath each heading when submitting to DDS   [Insert DDS Address/Examiner if known] NAME:                                           SSN:                                                 DOB:                                                 Dear _________:     INTRODUCTION (The applicant’s physical description, including their behavior, mannerisms, and dress; all of the applicant’s physical and mental health diagnoses; information/observations that illustrate the applicant’s symptoms and functioning)               PERSONAL HISTORY (Including abuse/trauma history, educational history, and legal history as they relate to the applicant’s symptoms and functioning)               OCCUPATIONAL HISTORY (Employment and military history for the past 15 years; include all jobs, reasons for leaving, job skills, problems with task completion and relationships with supervisors and co-workers; describe how this relates to the applicant’s symptoms and functioning)                   SUBSTANCE USE (Substance use history and treatment, including reasons for use, impact of use, treatment history, and any periods of sobriety; describe the applicant’s symptoms while sober)                       PHYSICAL HEALTH HISTORY (Brief summary of the applicant’s symptoms and treatment for physical health conditions at all providers including context for treatment, diagnoses, medications and side effects)                       PSYCHIATRIC HISTORY (Brief summary of the applicant’s symptoms and treatment for mental health conditions at all providers including context for treatment, diagnoses, and medications and side effects)                       FUNCTIONAL INFORMATION (Address all four areas of functioning using detailed examples and quotes to describe how the applicant’s symptoms impact his/her ability to function)     Understand, Remember, or Apply Information         Interact with Others           Concentrate, Persist, or Maintain Pace           Adapt or Manage Oneself             SUMMARY (Brief summary of the evidence provided, restating diagnoses provided in the introduction)

Describe the monitoring techniques used to measure pulmonary mechanics such as negative inspiratory force (NIF) and maximum inspiratory pressure (MIP) .

Describe the monitoring techniques used to measure pulmonary mechanics such as negative inspiratory force (NIF) and maximum inspiratory pressure (MIP) Explain the clinical significance of static compliance, dynamic compliance, airway resistance and mean airway pressure Background Why do we care about lung mechanics during mechanical ventilation? We all should if we want to provide adequate ventilatory support with minimum adverse effects. It would be useful if we could easily measure lung compliance, airway resistance, functional residual capacity, and other pulmonary function parameters during mechanical ventilation. Unfortunately, it is difficult to conduct formal pulmonary function testing on critically ill patients who frequently require high airway pressures and flows and may be paralyzed or otherwise unable to cooperate with testing. We will explore a few simple bedside maneuvers that anyone can perform either with or without patient cooperation to assess lung mechanics.   Ventilatory mechanics can be assessed before intubation to determine the need for mechanical ventilation and prior to extubation to determine a patient’s readiness to wean from the ventilator. Ventilatory mechanics are used to assess a patient’s ability to protect their own airway, maintain adequate alveolar ventilation as well as determine respiratory muscle strength. There are many criteria used to assess muscle strength. The Maximum inspiratory pressure, MIP also referred to as NIF is the most negative or lowest pressure that is generated against an occluded airway during a forceful inspiratory effort. MIP is measured using a pressure manometer and  indicates the inspiratory muscle strength and reflects the strength of the diaphragm and other inspiratory muscles.  Tidal volume (VT) and vital capacity (VC) are measurements that can be obtained with bedside spirometers and provides an overall assessment of respiratory muscle function because it measures the patient’s ability to generate adequate volumes of air. The MEP is a static expiratory pressure measured by exhaling into a closed system. MEP reflects the strength of the abdominal and other expiratory muscles and is used to assess cough effort. A cough is a mechanism that protects the airway. A cough must be sufficient to clear the airways of secretions and thus the inability to effectively cough may indicate the need for mechanical ventilation. Determining a patient’s readiness to wean is best approached by a carefully supervised spontaneous breathing trial (SBT). During an SBT the patient’s ability to tolerate the trial can be assessed by calculating their rapid shallow breathing index (RSBI). RSBI is the ratio of respiratory rate to tidal volume and though there are many variables that indicate the patient’s tolerance of an SBT, RSBI is one of the best measured indicator’s of the patient’s success to wean. RSBI is a calculated measurement and is determined using the formula: RSBI = f/VT. A RSBI of <105 breaths/min/L indicates greater success of weaning. High respiratory rates and low spontaneous tidal volumes will result in a RSBI of greater than 105 indicating that the patient is not tolerating the SBT and is unlikely to wean. A RSBI > 105 indicates that the patient either needs more ventilatory support or needs to be returned to their previous mode of ventilation.   Ventilatory Mechanics Normal Acceptable    Minute ventilation (l/min)    5 to 6     <15 Respiratory rate    12 to 22   Respiratory Muscle Strength    Tidal volume (ml/kg)    5 to 8   > 5 Vital Capacity (ml/kg)  65 to 75    > 15 MIP (cmH2O)   -50 to -100-20 or greater Cough EffortMEP (cmH2O)  >40 Readiness to Wean  RSBI    < 105   Lung mechanics provide highly valuable information in the management of mechanically ventilated patients. Lung mechanics assist respiratory therapists in determining the need for mechanical ventilation, how well it is being tolerated by the patient, and when mechanical ventilation can be discontinued. In addition to lung mechanics that help us determine respiratory muscle strength we also reviewed lung mechanics such as airway resistance, dynamic and static compliance and their contribution to the normal physiology of our lungs. If you recall, airway resistance can be estimated by dividing the difference between peak and plateau airway pressures by the mean inspiratory flow rate. Some ventilators have an inspiratory flow rate setting that you can read for an estimate of delivered flow rate while others give an inspiratory time setting where you have to divide the tidal volume by the inspiratory time to determine the inspiratory flow rate. An alternative way of determining airway resistance is to calculate a nonsense parameter known as the dynamic compliance. The dynamic compliance is the result of dividing the delivered tidal volume by the peak airway pressure. Since peak airway pressure is determined by a combination of the lung compliance, the airway resistance, inspiratory flow rate, and the tidal volume, this value does not really give a quantitative estimate of airway resistance itself but can be used to detect changes in the airway resistance if all other factors are held constant. This makes the value useful for comparing measurements on a single patient over a short period of time but it is too much to ask to expect that all of the other variables affecting peak airway pressure will stay the same from day to day or certainly from patient to patient. Because of the limitations of dynamic compliance measurements, it makes more sense to just follow the peak pressure to plateau pressure gradient since it requires less math and is just as useful as the dynamic compliance calculation.  Prompt For this assignment, you will provide detailed responses to the following question and provide detailed responses to the case study. A patient with fibrotic lung disease is on a volume control ventilator at a CMV rate of 8 breaths/min. The respiratory care practitioner notices it is taking more and more pressure to ventilate the patient. What would you recommend? Why? Over several hours the RCP notices that Cstat and Cdyn are decreasing. What is the most likely nature of the problem (Restrictive or Obstructive)? Explain your answer. Review the data below regarding your patient and interpret the data. Hint: Is the airway resistance and/or compliance increasing or decreasing? Why? or why not?            0800 hrs.1200 hrs. Delivered VT800 ml  800 ml PEEP   5 cmH2O 5 cmH2O Peak Pressure55 cmH2O   65 cmH2O Plateau Pressure  45 cmH2O 55 cmH3O Peak Flow  60 l/m    60 l/m                                        Submit your answers in at least 500 words on a Word document. You must cite at least three references in IWG format to defend and support your position.

how might you use such knowledge with respect to your own health?

This discussion is prompted by two articles. The first article entitled “Genetic variation in chromosome Y regulates susceptibility to influenza A virus infection” by Krementsov et al. introduces the genetic components of human susceptibility to Influenza A virus. The second paper by Lindor et al discusses questions surrounding the increasing genome sequencing information available to healthy individuals. Several issues arise from the availability of detailed health information including concerns about discrimination and stigmas, as well as the impact on the psychological well-being of those found to be at increased risk for infections, diseases, or conditions. Such sensitive health information also poses ethical, legal, and social challenges for the management of such information (who has access, who is allowed to view such information). The applications of personalized genome information require care and expertise in interpreting genetic data and implementing, for example, changes in lifestyle and behavior. The background reading includes first, an article titled “Ethical Consequences of Full Human Genome Testing” which discusses privacy concerns over the handling of such genomic information (which may include the quality of individual responses to disease treatment, their health susceptibilities, predictions of their future disease likelihood, their carrier status for certain genetic disease alleles, etc.). Second, an issue brief regarding workplace wellness health screening programs and the rights of workers regarding this information titled “Changing Rules for Workplace Wellness Programs: Implications for Sensitive Health Conditions”. DISCUSSION PROMPTS After receiving personalized genomic information, how might you use such knowledge with respect to your own health? Would a genetically tested family member providing children or other family members with information regarding genetic information (such as carrier status) be desirable? Might such testing be used as a prerequisite for employment, spousal selection, marriage, adoption, or IVF embryo implantation? READINGS Changing Rules for Workplace Wellness Programs – Implications for Sensitive Health Conditions 2017.pdf Ethical Consequences Of Full Human Genome Testing 2017.pdf Genetic variation in chromosome Y regulates susceptibility to influenza A virus infection 2017.pdf Whole-Genome Sequencing in Healthy People 2018.pdf Grading: Your first post must be a complete response to the prompt. Subsequent posts will not count as the initial post and will not be graded as such. AMA cited.

Describe your interviewee’s situation, including his or her interests, preferences, personality, skills, and values.

You will also need to examine your interview findings through the lens of cultural influences and ethical concerns. You are expected to integrate the feedback that you receive on your Unit 2 and Unit 6 assignments into your Unit 9 assignment. Your paper should include the following elements: Describe your interviewee’s situation, including his or her interests, preferences, personality, skills, and values. You do not need to address all five of these aspects, but you should address at least two. (From your Unit 6 assignment.) Interpret your interviewee’s work and life career history and development within the framework of at least two career development theories presented in the course. (Choose from Holland, theory of work adjustment, Super, Gottfredson, the relationship approach, or SCCT.) Evaluate the cultural influences and unplanned unique career and professional development events affecting the work and life career history and career development of your interviewee. Evaluate potential ethical concerns if the interviewee became a personal career counseling client. Describe how the application of career counseling theory may assist the interviewee in managing career development. Analyze current trends in the field supported by the scholarly literature that may be beneficial to the interviewee, given his or her context.

Write a cause and Effect Essay of Globalization.

In this essay you will provide a close examination of the causes behind, the effects of, or a combination thereof one of the following topics: Globalization Donald Trump’s presidency Concussions and football Rising college costs Consumer spending and debt Climate change Students will base their essays on facts and research, bearing in mind that personal opinion might either affirm or contradict the findings. When in doubt, follow the facts and research. Successful essays will be thesis-driven and seek to say something significant about the factors that led to one of these subjects and/or the aftermath, both immediate and distant.

After the case is dismissed, Bob sues Elaine for malicious prosecution. What result?

Week 3 Writing Assignment Elaine arrives home one night to find that her home has been burglarized. She calls the police. When questioned by the police, she says she does not know who did it, but that her uncle Bob recently threatened to harm her. The police conduct an investigation of Bob. He is indicted for burglary. At his trial, Elaine testifies that he once threatened her. The jury is deadlocked, and a mistrial is declared. The district attorney (D.A.) is unsure whether to re-prosecute him. By this time, Elaine is convinced Bob is guilty of the burglary. She urges the D.A. to retry Bob for the burglary. She constantly calls the D.A. Once she carries a sign outside the D.A.’s office urging prosecution. The D.A.’s decision, however, is to drop the charges. After the case is dismissed, Bob sues Elaine for malicious prosecution. What result? Make sure you discuss and analyze each of the elements of the applicable torts.