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  Discussion Board Post: Ronald Reagan Medical Centre history homework: history homework

 

Discussion Board Post: Ronald Reagan Medical Centre

 

 

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                                Discussion Board Post: Ronald Reagan Medical Centre

The Ronald Reagan medical center’s clinicians and staff have raised the concern about implementing the patient care and affordable Act.  As the administrator of this facility, it took me to make a list of the leading implementation concerns that will affect the facility, patients and employees in the coming year. The implementation concerns that I highlighted in the list include; expanding access to insurance, improving the system’s health quality and performance, expanding the health workforce, controlling the rising health care costs, and improved access to prescription drugs. The main aim of the patient care and affordable Act is to extend health insurance coverage program to the large American population that is not insured. Employers are required to cover their workers or pay penalties with the exception that one is a small employer. Medicaid is expanded to cover people with low-income sources (Holderness et al., 2019). ). This is achieved by following the federal poverty procedures. The Ronald medical facility should enact the protection of customers to enable them retain their insurance coverage.

The next implementation emphasizes on improving quality and the general system performance. This is achieved by conducting comparative research to examine the effectiveness of different medical treatments (Sterbenz & Chung, 2017). To enhance this, the medical facility should collect data annually and report the mechanisms that deal with health disparities among the people regarding their gender and geographic location. The third implementation focuses on promoting health workforce development.The patient care and affordable Act addresses this issue by supporting nurses’ training platforms and providing loans to the less fortunate people who desire to pursue nursing studies.

Nevertheless, this Act provides aspects that aim at addressing the rising health costs, it suggests that health insurance premiums and practices should be given direct oversight.  The Ronald medical center should implement Medicare payment reforms. Lastly, the patient care and affordable Act has expanded the coverage of drugs to ensure that people access prescription drugs. On top of that, Ronald Reagan Medical Centre should use biologic medicines to treat their patients, these drugs are fundamentally analogous to other generic versions of branded drugs.

 

References

Holderness, H., Angier, H., Huguet, N., O’Malley, J., Marino, M., Springer, R., & DeVoe, J. (2019). Where do Oregon Medicaid enrollees seek outpatient care post-affordable Care Act Medicaid expansion? Medical Care, 57(10), 788-794. https://doi.org/10.1097/mlr.0000000000001189

Sterbenz, J. M., & Chung, K. C. (2017). The Affordable Care Act and its effects on physician leadership. Quality Management in Health Care, 26(4), 177-183. https://doi.org/10.1097/qmh.0000000000000146

 

The Story of Darrin the fifteen year old. us history essay help

Case 1

Darrin is a young fifteen-year-old teenager who is suffering from traumatic stress impulses. He is physically aggressive, truant, and suffers from substance abuse. He has thrived in a harsh environment where insults were hurled at him due to inefficiencies in his father’s performance or execution of various tasks. Born by a mum who was in her early teenage years and due to the cultural castigation slithered at young girls because of early marriages, the pregnancy was hidden and forsaken by the mum and denied the motherly love “secret mission” between the two parents. Traumatic experiences haunt Darrian that sparks anger and rage that is then passed to his peers and those in his surrounding environs. The Diagnostic and Statistical Manual of Manual Disorders (DSM) is used to leverage the middle ground through which mental disorders are communicated. According to DSM-5, Darrian might be suffering from Disruptive Mood Dysregulation Disorder (DMDD) (under Depressive Disorders) code 296.99(F34.8).

Disruptive Mood Dysregulation Disorder (DMDD) Description

DMDD strives to combine bipolar disorder that is most common with children with oppositional behavior. It is associated with recurrent temper outbursts that are extensively out of proportion in either intensity or duration to the situation. It occurs on an average of three or more times a week for a year or so. The critical feature of DMDD is chronic irritability present in between episodes of anger or temper tantrums. A diagnosis requires symptoms to be present in at least two settings for 12 or more months. The onset of the disorder must occur before age 10, and a child must be at least six years old to receive a diagnosis.

The criterion that Determines if one is suffering from DMDD

Severe recurrent temper outbursts manifested verbally (e.g., verbal rages) and or behaviorally (e.g., physical aggression) that are grossly out of proportion in intensity or duration to the situation or provocation.
The temper outbursts are inconsistent with developmental level.
The temper outbursts occur, on average, three or more times per week.
The mood between temper outbursts is persistently irritable or angry most of the day, nearly every day, and it is observable by others.
The above symptoms have been consistent in the patient for a year and have not had lived without the symptoms above for a period not exceeding three months.
A-d criteria are present in more than one setting, be it at home school, home, or with peers, and in at least one of the settings, the behavior expresses itself more severely.
The diagnosis ought not to be executed for the first time before six years or after eight years.

One other essential criterion to determine if one is suffering from DMDD is that the symptoms are not attributable to the physiological effects or another medical or neurological condition.

Post-Traumatic Stress Disorder

However, the behavior depicted by Darian may be attributed to a different disorder, Post-traumatic Stress Disorder (PTSD, under Trauma- and Stressor-Related Disorders).DSM-5 criteria for PTSD differ significantly from those in DSM-IV for children and adolescents. The arousal cluster includes irritability or angry outbursts and reckless behaviors. The preschool PTSD subtype excludes symptoms such as negative self-beliefs and blame. According to the DSM-5, PTSD can develop at any age after variant years of age. Children’s loss of a parent is experienced as traumatic events. It is associated with the following characteristics:

Exposure to actual or threatened death in one or more of the following ways:
Directly experiencing the traumatic event(s).
In person, witnessing the event(s) as it occurred to others, especially primary caregivers.
 Learning that the traumatic event(s) occurred to a parent or caregiving figure.
Presence of one or more of the following intrusion symptoms associated with the traumatic event(s), which begin immediately after the occurrence of the traumatic event(s) :
Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s). Spontaneous intrusive memories are of utmost distressing.
Recurrent distressing dreams in which the content and/or effect of the dream are related to the traumatic event
Dissociative reactions in the form of flashbacks that the persona feels or acts as if the traumatic event(s) were recurring. The reactions may occur on a continuum, with the most extreme expression being a complete loss of awareness of present surrounding occurrences. The trauma reenactment may, at times, occur in play.
Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or prevalently resemble an aspect of the traumatic event(s).
Marked psychological reactions to reminders of the traumatic event(s)
One or even more of the following symptoms that represent either persistent avoidance of stimuli associated with the traumatic event may also occur. Negative alterations in cognitions and mood associated with the traumatic event, is ever-present, beginning after the traumatic event or situation worsening after the event.

Persistent Stimuli Avoidance

Avoidance of or strives to avoid places or physical reminders that arouse recollections of the traumatic event. It also encompasses avoidance of or efforts to avoid people, conversations, or interpersonal situations that arouse the traumatic event(s).

Negative alterations in Cognition

Significantly increased frequency of negative emotional states that revolves around fear, guilt, sadness, shame, and confusion. Markedly diminished interest or participation in significant activities, including constriction play, is one other trait associated with people suffering from PTSD. Finally, they tend to perpetuate a social withdrawal behavior and more often experience persistent redundancy in positive emotions and withdrawal behavior.

Arousal and reactivity alterations that are often associated with the traumatic events, commencement or worsening after the occurrence of the traumatic event as evidenced by either two or more of the following:
Frequent sleep disturbances may encompass restlessness or lack of sleep.
Irritable conduct consequentially associates with angry outbursts with meager or even no provocation at all. The irritation is often verbally expressed or through physical aggression subjected to people or objects. It is encompassed with temperamental tantrums.
Tremendous struggle with concentration.
Hyper-vigilance
Embroidered startle responses.
Disturbance duration is more than a month.
The disturbance sparks clinically substantial impairments and distresses in relationships with peers, caregivers, parents, siblings, and a sought of extremist behavior in school.

Specifications

With dissociative symptoms: The person’s symptoms meet PTSD criteria, additionally stressor’s responses, there is a persistent or frequent experience of the following symptoms.

Depersonalization- Recurrent or persistent detachment feelings from, and as if an individual were just an outside observer of mental and body processes ( an unreality feeling sense or feeling as though one is in a dream)
Derealization- Its the recurrent or persistent encounters of surrounding unrealities. More frequently, the individual experiences the world as distorted, unreal, distant, or dreamlike. In applying this subtype, the associative symptoms should not be attributable to a substance’s physiological effects such as blackouts or other premeditated medical conditions such as complex partial seizures.

NOTE: With expression delays: If the overhaul diagnostic criteria are not attained until at least six months after the event’s occurrence (though some of the symptoms’ onset and expression may occur immediately)

 

 

Trauma Case Conceptualization

One vital criterion that implicitly determines if one is suffering from PTSD is direct exposure to a traumatic event. At the age of five, Darrin witnessed his dad being shot at the head when a rogue drug deal went wrong. In addition to these mind bogging events, Darrin, with his bare eyes and at his tender age, witnessed domestic violence between his father and grandmother. He came to be when his mother was in her teenage years. He was denied motherly love that profoundly ascertains a sense of belonging and worth-living for a young being. The family neglected his mother. In the strive to scrap off and mitigate thoughts of torture of dejection, having a child, and forthwith incapacitation to cater to his needs, she immersed herself in substance abuse. While striving to make ends meet, the father engaged in strenuous hazardous activities that put his life at a bleak of survival. All these occurrences happened under the watch of this little boy. The events engraved themselves in his brain, and the memories were forever inerasable thick-inked in his medulla oblongata. These can be ascertained by the frequent seizures he frequently encountered in his foster home.

While striving to catapult the predicament him, his grandfather, and father were in, he began to seek handouts. His necessitation and huger to offer aid did not go unnoticed and scoped a chance at a foster home for six months where his needs were fully catered for. Despite the availability of all his wants, frequent disturbances instigated by the tribulations and the traumas he encountered back at home frequently attacked him. Peace of mind incapacitations was so enormous that his foster parent would find him sitting at the bathtub in the middle of the night, holding a pillow. Darrin’s conglomeration of thoughts sparked a convoluted chain of convulsions that demined his worth of existence. In the criterion that determines whether one is suffering from PTSD, Darrin presented most of these symptoms as indicated in his behavioral expressions indicated above.

Why not DDMD?

Darrin imperatively depicted symptoms relative to DDMD. He frequently had temper outbursts which, apparently were inconsistent with his developmental age. However, DDMD is less associated with traumatic events and does not indicate the actual triggers of irritation. It is thus not sufficient to assert that Darrin is suffering from DDMD. Yet, most of his mental disturbances were triggered by traumatic and mental disturbing events in his developmental stage.

Cognitive Processing Therapy for PTSD Treatment

Treatment starts with psycho-education concerning PTSD’s thoughts and emotions. The patient takes cognition of thoughts and emotional relationships and starts to identify “automatic thoughts” that continuously propagate PTSD symptoms. Darrin is to be instructed to write down the traumatic event and the impact the occurrence has had on him. He is to then formalizes the processing of the trauma. He writes down a detailed account of his worst traumatic experience, which he is to read in the next session. The essentiality of reading out will be to break the pattern of avoiding thoughts and feelings associated with the trauma. The therapist will modify any maladaptive thinking which such as self-blaming thoughts, by use of Socratic questioning. Once he develops skills to identify and address the unhelpful thoughts, he will imperatively apply those skills to continuously evaluate and modify related to the traumatic event. At this juncture, the therapist will help Darrin develop the aptitude to use these adaptive approaches outside treatment to enhance overall functioning and ascertain quality of life.

Treatment Inefficacies and Associative Interventional Steps

However, the efficacies of CPT treatment may be encompassed with numerous hurdles. Darrin may be unwilling to open up on precise issues attributing to his behavior. This tremendously minimizes the chances of treatment success. The patient may also be emotive on recounting the traumatic occurrences and may begin being hyper-reactive or begin crying. The therapist may opt to halt the treatment for a while, divert the discussion topic, or even go out for some adventure. This gives the patient time to internalize and have a relaxed mood, calming down the traumatic event’s emotions. If the situation gets worse, the therapist may opt to schedule a different date for the session. This imperatively creates a bond between the patient and therapist, which consequently enhances a sense of comfort for the patient. Due to the high sensitivity stature of the issues at hand, it will be of profound essentiality if no signs of biasness arise in the interaction. The aftermath of these intricate steps is fostering confidence, which subsequently fortifies the patient and therapist’s engagement.

Barriers in Treatment

The biggest hurdle in PTSD treatment is avoidance and trauma disclosure. PTSD patients frequently suffer from avoidance symptoms. Those with PTSD symptoms often avoid trauma reminders and tremendously avoid disclosing their traumatic experiences, making them reluctant to seek help. The aftermath of secrecy results in health care services avoidance, even in the availability of evidence-based treatment. Therapist are to

 

Ethical Considerations in PTSD treatment

The aftermath of traumatic stress is moral conflict. During PTSD treatment, providers have often faced with the question of moral commentary or positions’ roles. It may be both advantageous and disadvantageous to maintain a neutral stance on the patient’s expressed issues. Neutrality allows further exploration of the exact causes of anger beyond the presenting complaint. Neutrality also aids the therapist to avoid being judgmental. Neutrality is profoundly important since if the patient sees a clinician’s biasness in one context; he automatically concludes biasness on other treatment aspects.

 

The Strategies for Improving Metacognition history assignment help and resources: history assignment help and resources

 

Strategies for Improving Metacognition

 

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Strategies for Improving Metacognition

Philosophers have always been intrigued with the development of self-awareness in human beings, which is the ability of people to understand who they are in the world around them. Self-awareness evolves in childhood, and its development is connected to the metacognitive process of the brain. Metacognition plays an essential role in the experiences of life and the general process of learning. When students attain awareness of their mental state beyond academic learning, they start to answer essential questions concerning their lives. Therefore, some of the strategies have to be put in place to improve metacognition, and they include; facilitating reflective thinking, teach learners how their brains were wired for growth, and make students do a lot of practice, thus recognize what they do not understand.

Facilitating reflective thinking entails letting the learners reflect on a particular situation and critically analyze it to make their conclusion. Reflective thinking creates reflexivity, which is ideal for learners. Reflexivity is one of the metacognitive processes in which one becomes aware of their biases. They relate to prejudices, which deter one from getting healthy development (Adichie, 2009). Tutors can come up with a classroom culture that had deeper learning and a sense of reflexivity by encouraging a kind of dialogue, which challenges both societal and human biasness. When students indulge in conversations or write up essays concerning moral dilemmas and biasness related to liberty, racism, justice, poverty, and many others, they can reflect on their perceptions and come up with a deduction according to their point of view. The more they work on such topics, the more they solve problems; as Rose puts it, “To work is to solve problems” (Rose, 2009).

The other strategy is teaching learners how their brains were wired for growth. The beliefs which learners carry concerning learning and their minds affect their performance. Learners tend to stick to the knowledge they acquire in class from their tutors and make assumptions from them (Kenyon, 2016). Students can tell the difference between a growth mindset and a fixed one, and when they develop the two, they engage in reflective thinking concerning their process of learning and growing (Kenyon, 2016). Every day is a learning experience, and the activities that the tutors make learners participate in creating room for their growth. The strategy of teaching learners concerning the science of metacognition is an empowering tool. This strategy helps learners to understand how they will broaden their thinking and grow their brains.

The third strategy is making learners do a lot of practice. The act of getting confused and recognizing an individual’s lack of knowledge and understanding is a crucial aspect of developing self-awareness. At the end of any challenging class, learners or the tutor needs to take time and find out the most confusing part of the activity they faced (Rose, 2009). This helps to jumpstart metacognitive processing and create a classroom culture, acknowledging confusion as an essential part of learning. Practice motivates reasoning and brings about narratives concerning “oneself, and ideas about the social order” (Rose, 2009).

Therefore, the strategies used for the metacognitive process are essential for the development of learners. These strategies include; facilitating reflective thinking, teach learners how their brains were wired for growth, and make students do a lot of practice, thus recognize what they do not understand. If tutors initiate them well in their teachings, the learners will have a good experience because of the role that metacognition plays in the learning process.

 

 

 

 

 

 

 

References

Adichie, C, M. (2009). The Danger of A Single Story” Adichie TED Talk

Dunning, D. (2014). We are all Confident Idiots. Retrieved from https://www3.nd.edu/~ghaeffel/ConfidentIdiots.pdf

Kenyon, G. (2016). The Man who Studies Ignorance. Retrieved from http://www.bbc.com/future/story/20160105-the-man-who-studies-the-spread-of-ignorance

Robinson, K. (2019). Do Schools Kill Creativity?” Robinson TED Talk

Rose, M. (2009). Blue Collar Brilliance

Blue-Collar Brilliance

 

The History of Federal Governments history assignment help australia

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From the late 1870s to the late 1930s, the U.S. operated under dual federalism. State and federal governments exercised authority at clearly defined levels. This came about due to Supreme Court rulings restricting the national and state governments from getting in the way of each other. Government involvement in industrial development was detested by the economic philosophy of the time.  Present-day federalism is based on increasing administrative efficiency by decentralizing policies that improve policy outcomes (OpenStax 86). The two federalism types are different in that dual federalism has clearly divided programs and authority between the national and state governments. In contrast, present-day federalism has a mixture of functions between the two levels of government. Changes in federalism were motivated by the need to accommodate diverse viewpoints and encourage political participation.

The presidential powers have increased because each new president adds orders and directives that increase the presidency’s management. This expansion was done without any oversight (Hooker 11). The president cannot become a threat to democracy because, regarding domestic policy, the Constitution only gives him the veto power and the power to appoint principal officers subject to senatorial advice and consent (Calabresi and Lindgren 2613). A powerful president would not be held accountable, and as a result, the congress’s powers would be stifled. The size of the U.S. government would reduce to minimize interference to the president’s rule.

The Constitution states that the Supreme Court justices, court of appeals judges, and district court judges are nominated by the president and confirmed by the U.S. Senate by majority vote (OpenStax 500). The president, at times, chooses from a candidate list maintained by the American Bar Association. The nominee’s debate is done in the Senate Judiciary Committee, and then a majority vote of the full Senate approves his appointment. Senators greatly influence judges’ selection in their state, especially when the president seeks their advice. A proposed nominee can be prevented from becoming a judge by a senator voicing his or her opposition (OpenStax 501). As a confirmed nominee serves a lifetime appointment, the courts’ presidential nominee usually reflects the president’s ideological position.

Political socialization is a process where people, from a young age, learn and get to know a country’s politics. It starts by watching parents and guardians or seeing politicians speak in the media. Some political socialization agents are a person’s parents, school, the media, and social groups such as friends and religious institutions. The parent’s role is significant in introducing an individual to politics because children hear adult conversations and know how their parents will vote. In school, the children are formally introduced to politics in a broad and general manner. The specific controversies and problems connected with historical political figures and events are not discussed. In religious institutions, religious leaders may consider morality issues, such as abortion, which can be seen as political issues. Friendship networks are based on trust, and information is readily accepted in these networks. The media plays a significant role in socialization because if it covered a political event, it had happened in the general public’s eyes. It also chooses how political information is presented. Ideologies that are on the right prioritize government control over personal freedoms and include fascism and conservatism. Fascism promotes a country’s total control by the ruling party. Conservatism promotes traditional social institutions to grow the nation’s sense of responsibility. Ideologies on the left put equality at the forefront and include liberalism and socialism. Liberalism supports equality promoting societal involvement by the government. Socialist governments promote socio-economic equality using their authority. Communism advocates for joint property ownership by the community, and a person’s contribution depends on his ability (OpenStax 208).

 

Works Cited

Calabresi S. G. and Lindgren J. “The president: lightning rod or king?” The Yale Law Journal (2006): 2611 – 2622.

Hooker J. “Presidential power and its expanding influence: suggestions on how to strengthen checks and balances.” Grand Valley State University (2019).

OpenStax. “American government” Rice University (2016).