Categories
Medicine

Chronic traumatic encephalopathy (CTE) is a brain condition thought to be linked

Chronic traumatic encephalopathy (CTE) is a brain condition thought to be linked to repeated head injuries and blows to the head. PLEASE READ ALL ATTACHED DOCUMENTS FOR PAPER INSTRUCTIONS ***There are 2 due dates: Abstract, Thesis Statement and Literature Review are due Feb. 7th and the final research paper is due Feb. 12th. Please confirm you understand the deadlines.

Categories
Medicine

A 42-year old male on a high calcium diet has complained of dull persistent pain

A 42-year old male on a high calcium diet has complained of dull persistent pain in the lower back and flank regions for several days. He exercises daily but fails to replenish water lost through urination and perspiration on a regular basis. This morning he awakened with intense pain in the abdomen. A routine urinalysis reveals a significant level of hematuria.
-Explain what may be a likely diagnosis
-Include what helped you to draw these conclusions
-Discuss any potential treatment options.

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Medicine

Leadership & Emotional Intelligence Introduction: The advanced-level nurse must

Leadership & Emotional Intelligence
Introduction: The advanced-level nurse must be able to demonstrate intentional engagement in dynamic interprofessional teams to optimize patient can population-centered care, enhance the healthcare experience, and strengthen outcomes. S/he must demonstrate self-reflection, flexibility and personal and professional growth to sustain leadership capacity and lifelong personal well-being. S/he must be aware of, control, and express one’s emotions. These behaviors will allow the nurse leader to handle interpersonal relationships judiciously and empathetically. Understanding the components of emotional intelligence will allow the nurse to grow personally and professionally in how their own emotions affect leadership situations. This module will focus on the components of emotional intelligence and guide the nurse in applying emotional intelligence to their leadership development.

Objectives:
Define emotional intelligence and the components that affect interpersonal communication.
Demonstrate understanding of behaviors that support or discourage emotional intelligence.
Explore strategies for the use of emotional intelligence in leadership.
Student Learning Outcomes
Translate evidence from nursing science as well as other sciences into practice.
Synthesize knowledge form nursing and other disciplines to inform education, practice, and research.
Use diverse sources of evidence to inform practice.
Lead the translation of evidence into practice.
Model ethical behaviors in practice and leadership roles.
Facilitate communication that promotes an interdisciplinary approach.
Foster a practice environment that promotes accountability for care outcomes.
Foster strategies that promote a culture of civility across a variety of settings.
Identify opportunities to lead with moral courage to influence team decision.
Model respect for diversity, equity, and inclusion of all team decision.Mentor others in their development of professional growth and accountability.

Reading and Lectures:
Required Reading
Dugué, D., Sirost O., & Dosseville, J. (2021). A literature review of emotional intelligence and nursing education. Nurse Education in Practice, (54)103124,
ISSN 1471-5953,
https://doi.org/10.1016/j.nepr.2021.103124.
Carragher, J., & Gormley, K. (2017). Leadership and emotional intelligence in nursing and midwifery education and practice: A discussion paper. Journal of Advanced Nursing, 73(1), 85-96. doi:10.1111/jan.13141
George, J. M. (2000). Emotions and leadership: The role of emotional intelligence. Human Relations, 53(8), 1027-1055. doi:10.1177/0018726700538001
Gerardi, D. (2015). Conflict engagement: Emotional and social intelligence. AJN, American Journal of Nursing, 115(8), 60-65. doi:10.1097/01.NAJ.0000470407.66800.e8

Suggested Lectures on You Tube:
Strategies to Become more Emotionally Intelligent: Daniel Goleman
Most leaders don’t even know the game they are in: Simon Sinek
Websites to View:
Self awareness https://www.skillsyouneed.com/ps/self-awareness.html
Self regulation https://www.skillsyouneed.com/ps/self-management.html
Motivation https://www.skillsyouneed.com/ps/self-motivation.html
Empathy https://www.skillsyouneed.com/ips/empathy.html
Social Skills https://www.skillsyouneed.com/ips/social-skills-emotional-intelligence.html
Discussion Forum Assignment:
Emotional Intelligence (EI) Infographic Due February 16, 2023
This is a group assignment.
After completing the reading, create an infographic poster related to your assigned element of Emotional Intelligence using PowerPoint. This poster should be of professional academic quality that a nurse leader might post/share with staff/colleagues and demonstrate application of the student learning outcomes listed above..
Faculty will make the assignment of the EI element after you have created your groups in the Discussion Forum.
Complete a ONE-slide infographic poster that demonstrates the emotional intelligence (EI) element/domain assigned. Use the Downstate powerpoint template or its colors and logo.
Posters should be concise and include the following components as they relate to DNP Leadership practice:
Define emotional intelligence
Name and definition of the emotional intelligence element/domain
DNP leader actions/behaviors that demonstrate (3-5) the EI element/domain.
DNP leader actions/behaviors that are inconsistent (3-5) with EI/Domain
Team results/outcomes (3-5) that may be realized when the leadership actions/behaviors are implemented.
Include an interesting, unique, creative quote, motto ,mantra, quote (perhaps from the leader you are going to do a book report on).
Scholarly references in APA should be included on a second slide.
Each group member should comment in the DF on one other poster with a different element/domain.
Be sure to proofread your Poster for spelling/grammar and consistency in presentation of the required component. The poster/infographic should be academic quality, using the Downstate powerpoint template or the Downstate colors and logo. Include the list of all group members at the bottom of the Poster for proper recording of the completed assignment and grading.

Categories
Medicine

Effects of virtual reality rehabilitation training on gait and balance. Specific

Effects of virtual reality rehabilitation training on gait and balance. Specifically when comparing VR rehabilitation to conventional rehabilitation.
I attached a file that has resources of studies from pubmed.
File Format: Font Size 12, Times New Roman, Double Space, One-inch margin on all sides, 5-10 pages, references in APA format.
Criteria
Introduction/Background:
Purpose of the paper. Give an overview of your research topic and what prompted it. i.e., incidence, prevalence, mortality rate (if applicable)
Methods:
Identify the appropriate research methodology. Describe step by step how you performed your evaluation. Sample size. Articles included and excluded.
Discussion:
In-depth evaluation and synthesis of the material. Summarize material. Comparisons between studies. Present results. Questions for future research.
Conclusion:
Summary of your analysis and evaluation of reviewed work.
Bibliography/References:
Information is cited properly and in APA format.

Categories
Medicine

Effects of virtual reality rehabilitation training on gait and balance. Specific

Effects of virtual reality rehabilitation training on gait and balance. Specifically when comparing VR rehabilitation to conventional rehabilitation.
I attached a file that has resources of studies from pubmed.
File Format: Font Size 12, Times New Roman, Double Space, One-inch margin on all sides, 5-10 pages, references in APA format.
Criteria
Introduction/Background:
Purpose of the paper. Give an overview of your research topic and what prompted it. i.e., incidence, prevalence, mortality rate (if applicable)
Methods:
Identify the appropriate research methodology. Describe step by step how you performed your evaluation. Sample size. Articles included and excluded.
Discussion:
In-depth evaluation and synthesis of the material. Summarize material. Comparisons between studies. Present results. Questions for future research.
Conclusion:
Summary of your analysis and evaluation of reviewed work.
Bibliography/References:
Information is cited properly and in APA format.

Categories
Medicine

Leadership & Emotional Intelligence Introduction: The advanced-level nurse must

Leadership & Emotional Intelligence
Introduction: The advanced-level nurse must be able to demonstrate intentional engagement in dynamic interprofessional teams to optimize patient can population-centered care, enhance the healthcare experience, and strengthen outcomes. S/he must demonstrate self-reflection, flexibility and personal and professional growth to sustain leadership capacity and lifelong personal well-being. S/he must be aware of, control, and express one’s emotions. These behaviors will allow the nurse leader to handle interpersonal relationships judiciously and empathetically. Understanding the components of emotional intelligence will allow the nurse to grow personally and professionally in how their own emotions affect leadership situations. This module will focus on the components of emotional intelligence and guide the nurse in applying emotional intelligence to their leadership development.

Objectives:
Define emotional intelligence and the components that affect interpersonal communication.
Demonstrate understanding of behaviors that support or discourage emotional intelligence.
Explore strategies for the use of emotional intelligence in leadership.
Student Learning Outcomes
Translate evidence from nursing science as well as other sciences into practice.
Synthesize knowledge form nursing and other disciplines to inform education, practice, and research.
Use diverse sources of evidence to inform practice.
Lead the translation of evidence into practice.
Model ethical behaviors in practice and leadership roles.
Facilitate communication that promotes an interdisciplinary approach.
Foster a practice environment that promotes accountability for care outcomes.
Foster strategies that promote a culture of civility across a variety of settings.
Identify opportunities to lead with moral courage to influence team decision.
Model respect for diversity, equity, and inclusion of all team decision.Mentor others in their development of professional growth and accountability.

Reading and Lectures:
Required Reading
Dugué, D., Sirost O., & Dosseville, J. (2021). A literature review of emotional intelligence and nursing education. Nurse Education in Practice, (54)103124,
ISSN 1471-5953,
https://doi.org/10.1016/j.nepr.2021.103124.
Carragher, J., & Gormley, K. (2017). Leadership and emotional intelligence in nursing and midwifery education and practice: A discussion paper. Journal of Advanced Nursing, 73(1), 85-96. doi:10.1111/jan.13141
George, J. M. (2000). Emotions and leadership: The role of emotional intelligence. Human Relations, 53(8), 1027-1055. doi:10.1177/0018726700538001
Gerardi, D. (2015). Conflict engagement: Emotional and social intelligence. AJN, American Journal of Nursing, 115(8), 60-65. doi:10.1097/01.NAJ.0000470407.66800.e8

Suggested Lectures on You Tube:
Strategies to Become more Emotionally Intelligent: Daniel Goleman
Most leaders don’t even know the game they are in: Simon Sinek
Websites to View:
Self awareness https://www.skillsyouneed.com/ps/self-awareness.html
Self regulation https://www.skillsyouneed.com/ps/self-management.html
Motivation https://www.skillsyouneed.com/ps/self-motivation.html
Empathy https://www.skillsyouneed.com/ips/empathy.html
Social Skills https://www.skillsyouneed.com/ips/social-skills-emotional-intelligence.html
Discussion Forum Assignment:
Emotional Intelligence (EI) Infographic Due February 16, 2023
This is a group assignment.
After completing the reading, create an infographic poster related to your assigned element of Emotional Intelligence using PowerPoint. This poster should be of professional academic quality that a nurse leader might post/share with staff/colleagues and demonstrate application of the student learning outcomes listed above..
Faculty will make the assignment of the EI element after you have created your groups in the Discussion Forum.
Complete a ONE-slide infographic poster that demonstrates the emotional intelligence (EI) element/domain assigned. Use the Downstate powerpoint template or its colors and logo.
Posters should be concise and include the following components as they relate to DNP Leadership practice:
Define emotional intelligence
Name and definition of the emotional intelligence element/domain
DNP leader actions/behaviors that demonstrate (3-5) the EI element/domain.
DNP leader actions/behaviors that are inconsistent (3-5) with EI/Domain
Team results/outcomes (3-5) that may be realized when the leadership actions/behaviors are implemented.
Include an interesting, unique, creative quote, motto ,mantra, quote (perhaps from the leader you are going to do a book report on).
Scholarly references in APA should be included on a second slide.
Each group member should comment in the DF on one other poster with a different element/domain.
Be sure to proofread your Poster for spelling/grammar and consistency in presentation of the required component. The poster/infographic should be academic quality, using the Downstate powerpoint template or the Downstate colors and logo. Include the list of all group members at the bottom of the Poster for proper recording of the completed assignment and grading.

Categories
Medicine

Work from the Brown and Goldstein lab provided insights into cholesterol homeost

Work from the Brown and Goldstein lab provided insights into cholesterol homeostasis that were used to develop several of the LDL cholesterol-lowering therapies, including statins that remain in use today. However, in some patients, statins were not as effective as expected, suggestive of additional mechanisms regulating the LDL receptor. After reading CH. 13 and the provided articles, Investigate other LDL cholesterol-lowering therapies (other than PCSK-9 inhibitors), select 1, and compare and contrast the mechanisms of action between the class of drug you select and statins. Include side effects for both types of drugs and information on their efficacy.
RESOURCES:
https://cdn.bc-pf.org/resources/biology/Molecular_biology/Wilson-Molecular_Biology_of_The_Cell_The_Problem_Book_6th_Edition.pdf
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC427113/pdf/pnas00137-0094.pdf
2nd article linked as pdf attachment

Categories
Medicine

Peer review comments were:

Proposal is already written but needs improvement in logical flow, scientific reasoning, and methodological accuracy. This is a qualitative study proposal for PhD grant.
Peer review comments were:
The knowledge gap is weak
Aims need to be more open-ended since it is a focused ethnography. Be specific about why focused ethnography is being used (study of culture sharing group). Be more specific, consistent, when presenting rationale or evidence for an statement or argument.

Categories
Medicine

What drug therapy would you prescribe?

please respond to the following discussion post at the end of the instructions. Please use your in text citation and also reference according to the APA guidelines. Use your own words, do not use direct quotes on this order. Use scholarly peer reviewed references within the last 5 years to support your response. please avoid using consumer level resources such as drugs. com or mayoclinic.com. please use the appropriate sources this is professional level course. respond the following discussion board post using peer reviewed scholarly sources to support your answer: Bacterial Vaginosis Case Study
1. List specific goals of treatment for this patient.
This week the case study is about R.S. is a 32-year-old White woman who seeks treatment for a vaginal discharge that she has had for the past month. This patient states that she is sexually active and has had the same partner for the past 6 months. Her signs and symptoms include an odor, especially after sexual intercourse. Her history reveals that she has been using a commercial douche on a bi-weekly basis during the past year for hygienic purposes in an attempt to prevent vaginal infections. Although the patient denies any other associated symptoms, her vaginal PH is higher than normal at 5.5. the normal vaginal pH is between 3.5 – 5.0 (Jones 2019) The goals of treatment for R.S. include relieving the symptoms such as the vaginal odor and discharge, preventing complications that arise from the condition, and normalizing vaginal pH (Jones, 2019).
2. What drug therapy would you prescribe? Why?
I would prescribe Metronidazole (Flagyl) 750 mg extended-release tablet once daily for seven days or 500 mg twice daily for seven days for treatment of bacterial vaginosis. (Jones 2019) This drug is available in other forms such as an oral pill or cream that can be inserted into the vaginal canal (Woo & Robinson, 2020G). Metronidazole (Flagyl) is an antibiotic that diffuses into bacteria and inhibits protein synthesis by binding onto DNA and causing strand breakage, preventing protein synthesis, and inhibiting growth (Ceruelos, Romero-Quezada, Ledezma & Contreras, 2019). Growth inhibition is key in treating BV, as the condition is caused by the overgrowth of anaerobic bacteria. Therefore, the drug is effective against Gardnerella vaginalis, the organism that is commonly implicated in causing Bacterial Vaginosis (BV) (Jones, 2019).
3. What are the parameters for monitoring the success of the therapy?
The parameters for monitoring the success of the therapy include assessing for the effectiveness by obtaining a sample of the patient’s vaginal secretions to assess for smell and to determine whether these secretions contain clue cells. The absence of clue cells will indicate the success of the treatment (Jones, 2019). Secondly, testing the vaginal pH by placing a pH test strip in the patient’s vagina can indicate the treatment’s success. A pH reading of 4.5 and higher indicates BV, with a reduced value from the baseline value (5.5) indicating the treatment’s success (Jones, 2019).
4. Discuss specific patient education based on the prescribed therapy.
The specific patient education base on Metronidazole therapy will include avoiding any sexual intercourse during therapy to prevent reducing the strength of the medication. Avoid consumption of any alcohol products during the treatment period and encourage patient to wait at least a couple of days after completion of therapy to resume drinking alcohol. I chose the extended-release form for a easy admission as patients tend to for miss doses if they are prescribed multiple times during the day. I would educate R.S to take medication as prescribed, maintain proper vaginal hygiene, continue to monitor for odor and secretion amount, report to the provider if the symptoms have not resolved after seven days.
5. List one or two adverse reactions for the selected agent that would cause you to change therapy.
Metronidazole is one of the drugs that cause a Disulfiram-like effect (Woo & Robinson, 2020G). Disulfiram is a drug used to treat chronic alcohol addiction by producing sensitivity to ethanol. Therefore, Metronidazole would cause the body to be unable to process the ethanol in alcohol, causing side effects such as abdominal pain, nausea, and vomiting (Ceruelos et al., 2019). The severe side effects that would cause discontinuation of the drug include easy bleeding and bruising, and painful urination.
6. What would be the choice for second-line therapy? Provide rationale?
An appropriate second-line therapy option for the patient’s condition is Clindamycin ovules 100 mg intravaginally once daily at bedtime for three to seven days (Jones 2019). Clindamycin is a bacteriostatic antibiotic that inhibits protein synthesis by binding to the 50S ribosomal subunit (Jones, 2019). The drug is effective in managing anaerobic bacterial overgrowth in BV.
7. What OTC or alternative medications would be appropriate for this patient?
The appropriate OTC alternative medication would be Tinidazole 2 gram once daily for two days or 1 gram once daily for five days. Tinidazole is an antiprotozoal OTC medication that is active against BV. The drug has a longer half-life than Metronidazole, allowing it to be used for a shorter period in treating the condition.
8. What dietary or lifestyle changes should be recommended?
I would advise the patient to avoid the douching she has been doing with the commercial products on a bi-weekly basis. Douching strips, the vaginal canal of essential bacteria that are necessary to maintain a balance between aerobic and anaerobic vaginal bacteria (Jones, 2019). Stripping away these bacteria causes the symptoms that the patient is currently experiencing. Other lifestyle pointers I would provide include wiping from front to back, not using soap to clean the vaginal canal, and using unscented pads and tampons (Jones, 2019).
9. Describe one or two drug–drug or drug–food interaction for the selected agent.
Apart from the reaction with ethanol (alcohol) noted above, Metronidazole also interacts with Omeprazole and other proton pump inhibitors (PPIs). These drugs reduce the acidic concentration of the stomach and are used in managing peptic ulcer disease (Shah & Gossman, 2019). However, Metronidazole requires acidic conditions to facilitate absorption; therefore, these drugs reduce Metronidazole’s absorption (Shah & Gossman, 2019).

Categories
Medicine

The combination of doxycycline or fluoroquinolone with metronidazole can also be used in those with a b-lactam allergy.

please respond to the following discussion post at the end of the instructions. Please use your in text citation and also reference according to the APA guidelines. Use your own words, do not use direct quotes on this order. Use scholarly peer reviewed references within the last 5 years to support your response. please avoid using consumer level resources such as drugs. com or mayoclinic.com. please use the appropriate sources this is professional level course. respond the following discussion board post using peer reviewed scholarly sources to support your answer. G.M: Skin and soft-tissue infections (SSTI) can involve one or many layers of skin including the muscle and fascia. Bacterial SSTIs are classified as primary or secondary infections. Human bite wounds are considered secondary infections. SSTIs can also be classified as complicated or uncomplicated; complicated SSTIs can involve surgical intervention. The skin is the primary defense against infections unless it is penetrated among other factors. SSTIs have diverse etiologies. Hand SSTIs are the third frequent type of bites with dog bites being first and cat bites second. Infection in hand SSTIs occurs in 10%-50% of patients. Human bites, especially closed-fist injuries, are more serious than animal bites. The force of a punch can break the metacarpophalangeal joint causing a direct entry for the bacteria to enter in either the joint or bone. The severity of the infection depends on the type of microorganism involved, the patient’s immune status, and the location of injury. Microorganisms seen in human bite wounds include: Eikenella corrodens, S. aureus, streptococci, Corynebacterium spp., Bacteroides spp., and Peptostreptococcus spp. Most hand infections are polymicrobial. The diagnostic criteria of SSTIs are warmth, swelling, erythema, tenderness, pain, dysfunction, and presence of drainage. Severe SSTIs can include systemic symptoms (DiPiro et al., 2020; Ki & Rotstein, 2008).
Most patients do not seek help in a hand SSTI until infection is already present. For a hand SSTI, diagnostic evaluation may include having blood cultures, swab and culture, needle aspiration, x-ray, and an ultrasound. Cultures should be obtained from the infected wound; wounds >24 hours after injury that show no signs of infection do not need to be cultured. Before swabbing, the wound should be cleaned with normal saline or sterile water irrigation. It should be washed with soap or povidone-iodine. Radiologic tests should be performed if bone or joint damage is suspected. Needle aspiration is useful in patients with fluid-filled vesicles. An x-ray is useful in detecting bone involvement and air in the tissues. An ultrasound is useful in detecting crepitus, an abscess, or fascial inflammation. Debridement and exploration may be done depending on the severity of the wound (AAP, 2021). A thorough assessment is needed to prevent loss of function in the hand. The hand should be immobilized depending on the seriousness of the injury. If edema is present, the arm should be elevated until resolved. HIV, hepatitis B and C could be transmitted through a bite, therefore, any information on the biter is useful. Virus-containing blood in the saliva is what can make HIV transmissible; those exposed may be given antiretroviral therapy. A tetanus toxoid and antitoxin may be given as well. Primary closure of a human bite is generally not recommended (AAP, 2021; DiPiro et al., 2020; Ki & Rotstein, 2008). Since a close-fist injury is severe, the patient should be admitted for 2-3 days for close observation (Ki & Rotstein, 2008).
Prophylactic antibiotic treatment is dependent on wound severity and the patient’s immune status, however, those with a hand or face injury are given treatment regardless of status. Prophylactic treatment is generally for 3-5 days. Those with a clenched-fist bite injury are treated differently; they are generally given IV antibiotics. They are given ampicillin-sulbactam or piperacillin-tazobactam. The pediatric dose of piperacillin-tazobactam is 250-350 mg/kg/day IV in three to four divided doses. If the patient is allergic to penicillin, they can be given extended spectrum cephalosporin or trimethoprim-sulfamethoxazole plus clindamycin (AAP, 2021; DiPiro et al., 2020). The combination of doxycycline or fluoroquinolone with metronidazole can also be used in those with a B-lactam allergy. Therapy is usually given for 7-14 days. No improvement seen in 24 hours warrants a debridement. The patient should also be seen by physical therapy to prevent loss of function in the hand (DiPiro et al., 2020).