Discussion Post Responses

Respond to two colleagues by doing all of the following:

• Identify      strengths of your colleagues’ analyses and areas in which the analyses      could be improved. 
• Address      his or her evaluation of the efficacy and applicability of the      evidence-based practice, his or her identification of factors that could      support or hinder the implementation of the evidence-based practice, and      his or her solution for mitigating those factors. 
• Offer      additional insight to your colleagues by either identifying additional      factors that may support or limit implementation of the evidence-based      practice or an alternative solution for mitigating one of the limitations      that your colleagues identified.
• Must contain at least 1      reference and citation. Can use the      referenced materials from the colleague’s original post.

Colleague #1 – Xebra

RE: Discussion – Week 2
 

Post an evaluation of the evidence-based practice that you selected for Jake. Describe the practice and the evidence supporting it. Explain why you think this intervention is appropriate for Jake.

In the Levy case, it is evident that Jakes psychological functioning has declined drastically due to his PTSD. As a result, he drinks more than he should and lacks involvement in his sons life. Although Jake is being prescribed medication for his symptoms, an evidence-based intervention I would rely on for Jake is cognitive processing therapy. [It] involves modifying maladaptive cognitive coping strategies related to traumatic events (Reich, Nemeth, Acierno, 2019). Studies utilizing this intervention have provided positive results is social adjustments, family relationships, psychosocial functioning etc. I believe that this will be an excellent intervention due it being the focus of dissemination mandates across the U.S. Department of Veteran Affairs health-care system. In addition, It would alleviate problems associated with his ptsd, such as his excessive drinking. With the appropriate skills to target his emotions and behavior this will would be beneficial. From recent studies CPT has been known to make improvements in the core PTSD symptom effortful avoidance (individual level factor), which was associated with an improvement in housework adjustment, but with a decline in extended family adjustment (Monson et al., 2012).  

Provide an explanation for the supervisor regarding issues related to implementation. Identify two factors that you believe are necessary for successful implementation of the evidence-based practice and explain why. 

In regards to implementing any evidence-based practice, it is essential to assess whether or not the evidence-based practice will work in the best interest of the client. Once this is established there are other major issues that would hinder implementation. For example, the cost to fund and evidence-based practice within an organization. Stakeholders are hesitant to support practices that they are unsure will produce positive result, especially if it is costly. In addition, another limitation might be that not enough research supports it. Another limitation that may come about is the stigma associated with it as well. To begin to implement a successful evidence-based practice, it is essential to manage the change process and accepting additional training and coaching. Coaching minimizes resistance, increases positive perceptions of the program and implementation, and enhances skills development; coaching also helps manage expectations and normalize the implementation (Substance Abuse & Mental Health Services Administration, 2012). The coaching aspect prepares professional to successfully deliver an intervention appropriately. For example, let’s say an intervention calls for a spiritual aspect of the intervention, it would be proactive to identify if there are any barriers that would hinder him/her from engaging in a particular intervention. 

Then, identify two factors that you believe may hinder implementation and explain how you might mitigate these factors

An obvious factor that might hinder implementation would be if the clinician decides to consider her wants and needs for the client versus actually acting in the best needs of the clients overall health. In addition, what can be considered to be some potential challenges that might hinder implantation lies in being resistant to change, unrealistic expectations, and program adaptations, lack of continued training tools, funding, lack of administrative support etc. To address these factor it is best to, improve services, linkages, support and infrastructure; evaluate fidelity to ensure the program is being skillfully delivered, use fidelity measures and indicators developed specifically for this purpose; Maintain integrated, fully functioning core program components (Substance Abuse & Mental Health Services Administration, 2012).

References:

Reich, K., Nemeth, L., & Acierno, R. (2019). Evidence-based psychotherapy interventions to improve psychosocial functioning in veterans with PTSD: An integrative review. Journal of Psychosocial Nursing & Mental Health Services, 57(10), 24-33. doi:http://dx.doi.org.ezp.waldenulibrary.org/10.3928/02793695-20190531-04 

Monson, C.M., Macdonald, A., Vorstenbosch, V., Shnaider, P., Goldstein, E.S.R., Ferrier Auerbach, A.G., & Mocciola, K.E. (2012). Changes in social adjustment with cognitive processing therapy: Effects of treatment and association with PTSD symptom change. Journal of Traumatic Stress, 25, 519-526. doi:10.1002/jts.21735

Substance Abuse and Mental Health Services Administration. (2012). A road map to implementing evidence-based programs. Retrieved from http://web.archive.org/web/20151010063916/http://www.nrepp.samhsa.gov/Courses/Implementations/resources/imp_course.pdf

Colleague #2 – Upsidetowns

RE: Discussion – Week 2

Post an evaluation of the evidence-based practice that you selected for Jake. Describe the practice and the evidence supporting it. Explain why you think this intervention is appropriate for Jake.

             The evidence-based practice that this writer selected for Jake ultimately was Eye Movement Desensitization and Reprocessing (EMDR). The use of EMDR in patients/clients who are suffering from Post-Traumatic Stress Disorder (PTSD) involves allowing clients to process within a short time frame, the negative or traumatic thoughts, emotions, and memories from past events/incidents. EMDR involves no homework assignments for the client and the reprocessing sessions promotes more of an associative process that reveals connections of triggered memories by current life experiences rather than having an extended focus on the traumatic event, which is typically seen in Cognitive Behavioral Therapy (Shapiro, 2014). This writer believes that this intervention is best for Jake due to his onset of PTSD following his tour in Iraq. EMDR can assist Jake because it utilizes brief moments of him reliving the traumatic event while the clinician directs his eye movements, causing him to focus his attention on something else, which has been shown to be less emotionally upsetting (Gotter, 2019).

Then provide an explanation for the supervisor regarding issues related to implementation. Identify two factors that you believe are necessary for successful implementation of the evidence-based practice and explain why.

             Explanation for the supervisor would consist of acknowledging that EMDR is controversial due to the many interpretations that it may have; however, EMDR has proven to have positive results in clients with PTSD because it alters the emotions, thoughts and responses that has occurred from the traumatic event (Shapiro, 2007).

Then, identify two factors that you believe may hinder implementation and explain how you might mitigate these factors. Be sure to include APA citations and references.

             Two factors that this writer believes may hinder implementation would be the controversial opinions about the therapy and possibly being able to fund this treatment. Ways to mitigate would be to utilize strong advocacy skills, coupled with research findings that has proven results and securing the use of this treatment to be funded through the state or insurance.

References

Shapiro F. (2014). The role of eye movement desensitization and reprocessing (EMDR) therapy in medicine: addressing the psychological and physical symptoms stemming from adverse life experiences. The Permanente journal, 18(1), 71–77. https://doi.org/10.7812/TPP/13-098

Gotter, A. (2019). EMDR Therapy: What you need to know. https://www.healthline.com/health/emdr-therapy

Shapiro, F. (2007). EMDR, adaptive information processing, and case conceptualization. Journal of EMDR Practice and Research, 1, 68–87.

Bottom of Form

 

PROMPT: Choosing one of the films from the list below, discuss your understanding of the work’s meaning from a political perspective, and evaluate the formal choices and filmmaking methods that you think contribute most to conveying that meaning. 

1. Daisies, Vĕra Chytlová, 1966, Czechoslovakia
2. Born in Flames, Lizzie Borden, 1983, USA
3. Perfumed Nightmare, Kidlat Tahimik, 1977, Philippines
4. The Emperor’s Naked Army Marches On, Kazuo Hara, 1987, Japan
5. Lumumba, Death of the Prophet, Raoul Peck, 1990, France/Haiti

 Choosing one of the films from the list below, discuss your understanding of the work’s meaning from a political perspective, and evaluate the formal choices and filmmaking methods that you think contribute most to conveying that meaning.  Please note that this is a two-part prompt. You are being asked (1) to advance an overall textual interpretation that takes the film as a whole into consideration and (2) to write critically about cinematic form and method. The assignment asks you to pick out aspects of form and method based upon your view of their overall significance to the film’s meaning. The reasoning behind your specific areas of focus should come through in the way you set forth your points. Be sure to state your thesis clearly and build an argument for it using concrete evidence and lucid reasoning. As before, write as though the reader has not seen the film, but focus on what is necessary and relevant when summarizing narrative events. You do not need to conduct outside research, but if you do, please be sure to cite your sources. You may wish to make references to the assigned readings, which should also be cited if used. You do not need to cite content from the course lectures or from the quiz review handouts, but please spell out in detail your own understanding of that material if you refer to it. Film Choices: Daisies, Vĕra Chytlová, 1966, Czechoslovakia Born in Flames, Lizzie Borden, 1983, USA Perfumed Nightmare, Kidlat Tahimik, 1977, Philippines The Emperor’s Naked Army Marches On, Kazuo Hara, 1987, Japan  Lumumba, Death of the Prophet, Raoul Peck, 1990, France/Haiti Word Count: 450 (maximum 600)  

 

Universal Bank is a relatively young bank growing rapidly in terms of overall customer acquisition. The majority of these customers are liability customers (depositors) with varying sizes of relationship with the bank. The customer base of asset customers (borrowers) is quite small, and the bank is interested in expanding this base rapidly to bring in more loan business. In particular, it wants to explore ways of converting its liability customers to personal loan customers (while retaining them as depositors).

A campaign that the bank ran last year for liability customers showed a healthy conversion rate of over 9% success. This has encouraged the retail marketing department to devise smarter campaigns with better target marketing. The goal is to use k-NN to predict whether a new customer will accept a loan offer.
This will serve as the basis for the design of a new campaign.

The file UniversalBank.xls contains data on 5000 customers. The data include customer demographic information (age, income, etc.), the customer’s relationship with the bank (mortgage, securities account, etc.), and the customer response to the last personal loan campaign (Personal Loan). Among these 5000 customers, only 480 (= 9.6%) accepted the personal loan that was offered to them in the earlier campaign.

Transform categorial predictors with more than two categories into dummy variables, then, partition the data into training (60%) and validation (40%) sets.

1. Consider the following customer_Age=40, Experience = 10, Income = 84, Family = 2, CCAvg = 2, Education_1 = 0, Education_2 = 1, Education_3 = 0, Mortgage = 0, Securities Account = 0, CD Account = 0, Online = 1, and Credit Card = 1. Perform a k-NN classification with all predictors except ID and ZIP code using k = 1. Specify the success class as 1 (loan acceptance), and use the default cutoff value of 0.5. How would this customer be classified?
2. What is a choice of k that balances between overfitting and ignoring the predictor information?
3. Show the classification matrix for the validation data that results from using the best k.
4. Consider the following customer: Age = 40, Experience = 10, Income = 84, Family = 2, CCAvg = 2, Education_1 = 0, Education_2 = 1, Education_3 = 0, Mortgage = 0, Securities Account = 0, CD Account = 0, Online = 1 and Credit Card = 1. Classify the customer using the best k.
5. Repartition the data, this time into training, validation, and test sets (50% : 30% : 20%). Apply the k-NN method with the k chosen above. Compare the classification matrix of the test set with that of the training and validation sets. Comment on the differences and their reason.

NOTE:   completed excel spreadsheet used answer the problem parts must also be submitted.

Instructions:

• This assignment carries 15% of the grade. • You can purchase the case, ‘Magic timber and steel: Investment evaluation with Net Present Value’ search (9B16N010) (you can choose digital download) at https://www.iveycases.com. • Update: The cost of new machine Delta is 135,000 instead of 140,000 given in the case.

 Report Submission Instruction: • Maximum 4 pages excluding Reference/Appendix. You may consider using Refernce/Appendix section to include your research references, calculations, relevant graphs, charts, illustrations, and tables.

 • Report due date and time: 6 June 2021 23:59 Hour Pacific Standard Time • Report must be submitted in Week 9 Turn-it-in link “Assignment 2, Due 6 th June – Submit here”. • A separate link ‘Assignment 2 – Submit Excel File here (if any)’ will be provided if you want to submit your excel file, if any available. Report submission by email will not be accepted. • Please include the statement with your signature in your paper: “I agree that the work in this assignment is my own work and that I have given credit to all sources of information used in my assignment by including citations and references in the APA format. I acknowledge that I am expected to exercise the utmost academic integrity in all work submitted for this course. SIGNATURE: Your name” Report Expectation: You will be reading the case, research relevant facts, perform analysis, and document your findings, analysis, and recommendation in a written report to John Davidson to assist in the decision of whether to buy the new machine or maintaining the existing one. 

You may consider the following guided questions to prepare your report. If you have made assumption(s) as part of the case analysis, please include them in the report. • Using NPV analysis, should Magic Timber and Steel (Magic) purchase the new Delta finishing machine? • What other quantitative and/or qualitative factors (see below) need to be taken into consideration? • Sensitivity analysis (e.g., different discount rates, different selling prices, change in maintenance cost) • You may assume discount rate as 11% and tax rate as 30%. Cash Flows: Matrix: • Salvage value, Repair, Maintenance, Scheduled service, Machine Sales Delta: • Machine investment, Labour savings, Electricity savings, Maintenance, Salvage value, Profit/Loss from sale Non-Cash Flows: Matrix: • Depreciation (given in case) Delta: • Depreciation (10% per year of cost $135,000) Tax Impact relevant Cash Flows: Which of the above cash flows and non-cash flows could impact the cash flow for tax saving/payment? • Savings (+ taxable income), Costs (- taxable income), Depreciation (Matrix, Delta), Profit/Loss from Sale Cash Flows for NPV: Which of the above cash flows (including tax impact relevant cash flows) are relevant for purchase of Delta decision? 

 Topic 2 DQ 1

Abuse can come in many forms. Abuse can be physical, emotional, neglect, or sexual (Prevent Child Abuse America, 2019). Child abuse also include physical, sexual, or psychological abuse, or a combination of any of the three. As part of a comprehensive exam or holistic assessment, nurses must also assess for signs and symptoms of abuse (Faulkner, 2018). Child abuse can happen at any age and it is important that nurses know how to assess in each age group. Child abuse can be emotionally hard for nurses to deal with. They can understand disease and illness and how to assess and treat, but abuse is something they cannot often understand.

A common type of abuse seen in infants is physical abuse. Warning signs may include unexplained bruises, scars, cuts, welts and burns in different stages of healing especially to the abdomen, back, tops bottoms of feet. There are also times where there are no visible physical signs of abuse. Bruises should almost never be seen on someone who is non mobile. Non mobile infants (those who can’t move on their own) get bruises only from external sources. Shaken baby syndrome or abusive head trauma is one of the most common forms of physical abuse in an infant. It can result in death or permanent disability. Signs and symptoms may include irritability, poor eating, vomiting, pale or bluish skin, seizures and difficulty staying awake. Child abuse, although unfortunate, is a real problem and it can happen to anyone anywhere. A fractured bone is another common sign of physical abuse but often goes unseen unless the infant has an x-ray.

There are several different cultural rituals that can be mistaken for abuse. Cupping (wet or dry) is one ritual that can be misunderstood due to the rings and broken blood vessels it causes bruises when using suction cups. Understanding cultural variations of health practices is important as a nurse because it can be easily misinterpreted as child abuse. Wet cupping also involves cuts to the skin. Cupping is used to decrease inflammation and remove toxins in the body. Cupping is used in the Middle East, Asia, Latin America, and Eastern Europe. In the United States, this technique is practiced primarily by Russian immigrants (Killion, 2017). Coining is another ritual that can be mistaken for child abuse it is a dermabrasion therapy, which involves intense rubbing of the skin is used by Vietnamese, Cambodians, and Laotians to treat a variety of illnesses (Killion, 2017). Coining is an example of an ancient healing practice still being practiced, today. A nurse can expect to see red marks that resemble bruises in the areas that have been scrapped.

In my state New York, a report of suspected child abuse, neglect, exploitation or abandonment is a responsible attempt to protect a child. New York law requires certain persons who suspect that a child has received non-accidental injury or has been neglected to report their concerns to 311 in NY city or the New York state central register (SCR)  or local law enforcement . YOU may be a child’s only advocate at the time you report the possibility of abuse or neglect. Children often tell a person with whom they feel safe about abuse or neglect.

Respond using 200-300 APA format with references supporting the discussion