PLEASE FOLLOW THE INSTRUCTIONS AS INDICATED BELOW:

ZERO (0) PLAGIARISM

5 REFERENCES NO LESS 5 YEARS

PLEASE SEE ATTACHED RUBRIC DETAILS.

For your Assignment, your Instructor will assign you one of the decision tree interactive media pieces provided in the Resources. As you examine the patient case studies in this module’s Resources, consider how you might assess and treat patients presenting symptoms of neurological and musculoskeletal disorders. 

 

To Prepare

• Review the interactive media piece assigned by your Instructor. 
• Reflect on the patient’s symptoms and aspects of the disorder presented in the interactive media piece.
• Consider how you might assess and treat patients presenting with the symptoms of the patient case study you were assigned.
• You will be asked to make three decisions concerning the diagnosis and treatment for this patient. Reflect on potential co-morbid physical as well as patient factors that might impact the patient’s diagnosis and treatment.

Write a 1- to 2-page summary paper that addresses the following:

• Briefly summarize the patient case study you were assigned, including each of the three decisions you took for the patient presented.
• Based on the decisions you recommended for the patient case study, explain whether you believe the decisions provided were supported by the evidence-based literature. Be specific and provide examples. Be sure to support your response with evidence and references from outside resources.
• What were you hoping to achieve with the decisions you recommended for the patient case study you were assigned? Support your response with evidence and references from outside resources.
• Explain any difference between what you expected to achieve with each of the decisions and the results of the decision in the exercise. Describe whether they were different. Be specific and provide examples.

Alzheimer’s Disease
76-year-old Iranian Male

BACKGROUND

Mr. Akkad is a 76 year old Iranian male who is brought to your office by his eldest son for “strange behavior.” Mr. Akkad was seen by his family physician who ruled out any organic basis for Mr. Akkad’s behavior. All laboratory and diagnostic imaging tests (including CT-scan of the head) were normal.

According to his son, he has been demonstrating some strange thoughts and behaviors for the past two years, but things seem to be getting worse. Per the client’s son, the family noticed that Mr. Akkad’s personality began to change a few years ago. He began to lose interest in religious activities with the family and became more “critical” of everyone. They also noticed that things he used to take seriously had become a source of “amusement” and “ridicule.”

Over the course of the past two years, the family has noticed that Mr. Akkad has been forgetting things. His son also reports that sometimes he has difficult “finding the right words” in a conversation and then will shift to an entirely different line of conversation.

SUBJECTIVE

During the clinical interview, Mr. Akkad is pleasant, cooperative and seems to enjoy speaking with you. You notice some confabulation during various aspects of memory testing, so you perform a Mini-Mental State Exam. Mr. Akkad scores 18 out of 30 with primary deficits in orientation, registration, attention & calculation, and recall. The score suggests moderate dementia.

MENTAL STATUS EXAM

Mr. Akkad is 76 year old Iranian male who is cooperative with today’s clinical interview. His eye contact is poor. Speech is clear, coherent, but tangential at times. He makes no unusual motor movements and demonstrates no tic. Self-reported mood is euthymic. Affect however is restricted. He denies visual or auditory hallucinations. No delusional or paranoid thought processes noted. He is alert and oriented to person, partially oriented to place, but is disoriented to time and event [he reports that he thought he was coming to lunch but “wound up here”- referring to your office, at which point he begins to laugh]. Insight and judgment are impaired. Impulse control is also impaired as evidenced by Mr. Akkad’s standing up during the clinical interview and walking towards the door. When you asked where he was going, he stated that he did not know. Mr. Akkad denies suicidal or homicidal ideation.

Diagnosis: Major neurocognitive disorder due to Alzheimer’s disease (presumptive)

RESOURCES

§ Folstein, M. F., Folstein, S. E., & McHugh, P. R. (2002). Mini-Mental State Examination (MMSE). Lutz, FL: Psychological Assessment Resources.

 Decision Point One

Select what you should do:

 Decision Point One

Begin Exelon (rivastigmine) 1.5 mg orally BID with an increase to 3 mg orally BID in 2 weeks

RESULTS OF DECISION POINT ONE

• Client returns to clinic in four weeks
• The client is accompanied by his son who reports that his father is “no better” from this medication. He reports that his father is still disinterested in attending religious services/activities, and continues to exhibit disinhibited behaviors
• You continue to note confabulation and decide to administer the MMSE again. Mr. Akkad again scores 18 out of 30 with primary deficits in orientation, registration, attention & calculation, and recall

 Decision Point One

: Begin Aricept (donepezil) 5 mg orally at BEDTIME

RESULTS OF DECISION POINT ONE

• Client returns to clinic in four weeks
• The client is accompanied by his son who reports that his father is “no better” from this medication
• He reports that his father is still disinterested in attending religious services/activities, and continues to exhibit disinhibited behaviors
• You continue to note confabulation and decide to administer the MMSE again. Mr. Akkad again scores 18 out of 30 with primary deficits in orientation, registration, attention & calculation, and recall

 Decision Point One

Begin Razadyne (galantamine) 4 mg orally BID

RESULTS OF DECISION POINT ONE

• Client returns to clinic in four weeks
• The client is accompanied by his son who reports that his father is “no better” from this medication
• He reports that his father is still disinterested in attending religious services/activities, and continues to exhibit disinhibited behaviors
• You continue to note confabulation and decide to administer the MMSE again. Mr. Akkad again scores 18 out of 30 with primary deficits in orientation, registration, attention & calculation, and recall

 Decision Point Two

Select what you should do next:

 Decision Point Two

Increase Razadyne to 24 mg extended release daily

RESULTS OF DECISION POINT TWO

• Client returns to clinic in four weeks
• The client’s son accompanies the client to his appointment today. The client is in a wheelchair and is somewhat agitated
• You are informed by the son that his father has not taken his medication since he got out of the hospital. Apparently, about 7 days after starting the Galantamine extended release, the client began having seizures which resulted in a fall and fractured hip. The son reports that his father is agitated with everyone and is asking for help in treating his agitation

 Decision Point Two

Discontinue Razadyne and begin Aricept (donepezil) 10 mg orally daily

RESULTS OF DECISION POINT TWO

• Client returns to clinic in four weeks
• The client is accompanied by his son for today’s appointment who informs you that he stopped giving his father the mew medication because after just a few doses, his father began experiencing appetite loss, followed by nausea, diarrhea, and vomiting

 Decision Point Two

Discontinue Razadyne and begin Exelon (rivastigmine) 1.5 mg orally BID

RESULTS OF DECISION POINT TWO

• Client returns to clinic in four weeks
• Client’s son reports that the client is tolerating the medication well, but is still concerned that his father is no better
• He states that his father is still not interested in attending religious services with the family, and he is still concerned that his father is still easily amused by things he once found serious

 Decision Point Three

Select what you should do next:

 Decision Point Three

Increase Exelon to 3 mg orally BID

Guidance to Student
Cholinesterase inhibitors can take months to demonstrate any stabilization in the degenerative course of Alzheimer’s disease. Since the client has had no side effects, it would be prudent to consider increasing the Exelon dose to 3 mg orally BID. Recall that the target dose of Exelon is 12 mg orally daily in divided doses, or a transdermal patch delivering 9.5 mg daily could be used. Slow titration of the drug toward a therapeutic dose will decrease the risk of side effects. These should be teaching points directed toward the client and his son.
You could maintain the current dose of Exelon and reevaluate at the next office visit, but since the client is having no side effects and the client has been on the current dose for at least 4 weeks, it would probably be advisable to increase at this time to facilitate the goal of arriving at a therapeutic dose of the medication.
It may be early to augment with Namenda. Maximization of the Exelon dose should first occur, then augmentation with an NMDA receptor antagonist would be appropriate, but Namenda should be started at 5 mg orally daily, and then titrated up to a maximum dose of 10 mg orally BID. Doses over 5 mg orally daily should be divided into two doses, or the drug can be switch to an extended release preparation.
Finally, it is important to note that changes in the MMSE should be evaluated over the course of months, not weeks. The absence of change in the MMSE after 4 weeks of treatment should not be a source of concern.

 **needs to be same person doing PART 1-outline** 

This is Part II of the assignment you submitted in Week 6.

Using the case outline (Part I: How the Courts Address or Respect Our Rights as Citizens) you submitted in Week 6, prepare and submit a presentation, which will either be a narrated PowerPoint, a Kaltura Video, or some other format as approved by your instructor. Be sure to verify the presentation format with your instructor before starting work on this assignment.

The presentation Point presentation will need to include:

• Name the case
• Discuss the facts of the case
• Discuss the history of the case (what laws or legal action was taken)
• Discuss the issues or the facts of the case and legal questions the court must decide
• Discuss if the court’s decision or holdings was for the plaintiff or for the defendant and what were the reasons for the decision?
• Discuss the concurring and dissenting opinions from the judge or if a jury trial, the jury.

Important: In this assignment, you are expected to elaborate the points you made in the prior assignment in Week 6. This assignment will be graded on your strength to elaborate and explain the facts of the case and proper use of visual aids, good narration, and presenting to the case and how well you stick to the case. For example, if you are using the PowerPoint, you are also expected to include proper visuals that are relevant to the case. Do not copy-paste the outline into this and call it complete.

This assignment is worth 250 points.

Writing Requirements (APA format)

• Length: The presentation must be 10-15 slides long if using PowerPoint (excluding cover and reference pages) or 3-5 minute long if using a video presentation.
• 1-inch margins
• Double spaced
• 12-point Times New Roman font
• Title page
• References page (minimum of 2 scholarly sources in addition to textbook if cited)

I will narrate the powerpoint** Just need the power point made**

As a special education teacher, you will be expected to provide support and guidance to administration, teachers, and staff regarding issues that may arise concerning how to meet the needs of individuals with disabilities outlined in IEPs. Serving as a collaborative resource to colleagues promotes the well-being of individuals with disabilities, the main goal of a special education teacher. Additionally, it is vital to provide support and guidance for students in the inclusion setting who will be working and collaborating with non-exceptional peers and general education teachers.

Read the case study to inform the assignment that follows.

John is currently a ninth-grade student who has been identified as having an emotional/behavioral disorder, specifically in the area of obsessive-compulsive disorder (OCD). During his annual IEP meeting, John’s IEP team reviewed recent test scores and determined he qualified for the gifted program in the area of English language arts (ELA). John will continue to participate in the inclusion classroom for the remainder of his courses, and be placed in the gifted classroom for ELA in the second semester of the school year.

As John continues to be successful in all of his inclusion classes, he is having difficulty in his new ELA class. The gifted teacher, Ms. Griedl, was not able to be present during the IEP meeting, and John is the first student with an IEP she has had in her class. John has stated that being the only Hispanic student in Ms. Griedl’s gifted class has made him feel uncomfortable at times. He says Ms. Griedl does not include him in the classroom conversations and when she speaks to him, it is abruptly. John says she does not treat the other students in the same manner.

After one month of John being in the gifted class, Ms. Griedl has requested that a paraprofessional be present to support John. The IEP team determined that this was not necessary and that John should be able to be successful in the gifted classroom without a paraprofessional. The principal, Mr. Fleming, did a walk through observation of Ms. Griedl’s gifted classroom and he did notice that John was isolated in a corner, and the teacher and other students in the class did not interact with him. In addition, Mr. Fleming received a phone call from John’s parents who reported that Ms. Griedl had told John she felt he did not belong in the gifted class. John no longer wants to be in the class because he does not feel welcome.  

Use the “Collaboration and Communication Action Plan Template” to complete this assignment.

Part 1: Action Plan

Mr. Fleming has come to you, the special education teacher, for assistance with the situation. To assist the principal, create a 750-1,000 word action plan. The action plan should include one long-term goal and a minimum of four short-term goals to help reach the long-term goal.

For each short-term goal, identify the following information related to implementation:

• At least 1-2 implementation activities/strategies
• Resources needed
• Timeline: To include measuring progress and implementing strategies
• Persons Responsible: To include measuring progress and implementing strategies
• Evidence of Success: How is this measured, or the desired outcomes to demonstrate success

Keep in mind the following when you outline your goals and implementation steps:

• John’s abilities and interests, the learning environments, and cultural and linguistic factors.
• How you will incorporate collaboration to help the action plan be successful.
• Your role as a coach and resource for John and Ms. Griedl.

Part 2: Rationale

Support your action plan with a 500-750 word rationale that incorporates researched best practices on collaboration and communication when working with colleagues, administration, and families.

Your rationale should address the following considerations:

• Theories or elements of effective collaboration you utilized in your action plan.
• How diversity is a part of families, cultures, and schools, and how complex human issues can interact with the delivery of special education services.
• The importance of supporting individuals with disabilities in all settings to help them reach their optimal potential and allow them to flourish academically and behaviorally.

Support your findings with 2-3 scholarly resources.

 Forecasting
Overview
Using the Northern College Health Services visit volume in  Appendix 6-1 on page 113 of the textbook, for this assignment, you will  be providing a forecast of the number of clinic visits for November 2008  using the average change, confidence interval, average percent change,  moving averages, and exponential smoothing forecasting methods. Use the  Internet or Strayer Library to research at least two examples of the  forecasting methods being used in health services organizations.
Instructions
Write a 2–3 page paper in which you:
 

1. Explain each step in the forecasting process for each method.
2. Provide a brief summary of your researched health services organizations implementing the forecasting methods.
3. Provide a forecast of the number of clinic visits for November 2008 using each method of the forecasting process.
4. Conclude which forecasting method provides the best forecast, and provide a rationale for your conclusion.
5. This course requires the use of Strayer Writing Standards. For  assistance and information, please refer to the Strayer Writing  Standards link in the left-hand menu of your course. Check with your  professor for any additional instructions.
   The specific course learning outcome associated with this assignment is:
    

• Prepare a forecast for a health services organization that uses each method of the forecasting process.
• By submitting this paper, you agree: (1) that you are  submitting your paper to be used and stored as part of the SafeAssign™  services in accordance with the Blackboard Privacy Policy;  (2) that your institution may use your paper in accordance with your  institution’s policies; and (3) that your use of SafeAssign will be  without recourse against Blackboard Inc. and its affiliates.  

1. One of the key topics we have been learning about is ensuring that all users are aware of security threats.  Email phishing is a common threat that a user may face.  Using email phishing tests are a very good way to train users.  Now is your chance to try one for yourself.  Take the email phishing test at the link below:

   https://www.sonicwall.com/en-us/phishing-iq-test

   Once you have completed the test,  write at least 1-page reflection on your experience. Be sure to follow APA format for your paper and don’t forget to double-space your assignment.   Answer the following questions in your paper:
   1.  How well did you do on the test and what did you learn?
   2.  How could you use this test to train employees about phishing?
   3.  What controls would you suggest to mitigate the risk of email phishing? 

   In this assignment,  I am looking for your reflection on this assignment and how you will apply what you learned in your career. Your paper should be about what you learned and not a research paper about email phisihing.  

   This assignment will be checked for plagiarism using SafeAssign.

2. By submitting this paper, you agree: (1) that you are submitting your paper to be used and stored as part of the SafeAssign™ services in accordance with the Blackboard Privacy Policy; (2) that your institution may use your paper in accordance with your institution’s policies; and (3) that your use of SafeAssign will be without recourse against Blackboard Inc. and its affiliates.