Critiquing the validity and robustness of research

Critiquing the validity and robustness of research featured in journal articles provides a critical foundation for engaging in evidence-based practice. In Weeks 5 and 6, you explored quantitative research designs. In Week 7, you will examine qualitative and mixed methods research designs. For this Assignment you critique a quantitative and either a qualitative or a mixed methods research study and compare the types of information obtained in each.
To prepare:
· Select a health topic of interest to you that is relevant to your current area of practice. The topic may be your Course Portfolio Project or a different topic of your choice.
· Using the Walden Library, locate two articles in scholarly journals that deal with your portfolio topic: 1) Select one article that utilizes a quantitative research design and 2) select a second article that utilizes either a qualitative OR a mixed methods design. These need to be single studies not systematic or integrative reviews (including meta-analysis and metasynthesis). You may use research articles from your reference list. If you cannot find these two types of research on your portfolio topic, you may choose another topic.
· Locate the following documents in this week’s Learning Resources to access the appropriate templates, which will guide your critique of each article:
o Critique Template for a Qualitative Study
o Critique Template for a Quantitative Study
o Critique Template for a Mixed-Methods Study
· Consider the fields in the templates as you review the information in each article. Begin to draft a paper in which you analyze the two research approaches as indicated below. Reflect on the overall value of both quantitative and qualitative research. If someone were to say to you, “Qualitative research is not real science,” how would you respond?
To complete this Assignment:
· Complete the two critiques using the appropriate templates.
· Write a 2- to 3-page paper that addresses the following:
· Contrast the types of information that you gained from examining the two different research approaches in the articles that you selected.
o Describe the general advantages and disadvantages of the two research approaches featured in the articles. Use examples from the articles for support.
o Formulate a response to the claim that qualitative research is not real science. Highlight the general insights that both quantitative and qualitative studies can provide to researchers. Support your response with references to the Learning Resources and other credible sources.
· Reminder: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The School of Nursing Sample Paper provided at the Walden Writing Center provides an example of those required elements (available from the Walden University website found in this week’s Learning Resources). All papers submitted must use this formatting.
· Combine all three parts of this assignment into one Word document including both critique templates and the narrative with your references. Submit this combined document.
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Disorders of the Veins and Arteries – Pathophysiology of chronic venous insufficiency and deep venous thrombosis

Disorders of the Veins and Arteries – Pathophysiology of chronic venous insufficiency and deep venous thrombosis

Review the section “Diseases of the Veins” (pp. 598-599) in Chapter 23 of the Huether and McCance text. Identify the pathophysiology of chronic venous insufficiency and deep venous thrombosis. Consider the similarities and differences between these disorders.
Select a patient factor different from the one you selected in this week’s Discussion: genetics, gender, ethnicity, age, or behavior. Think about how the factor you selected might impact the pathophysiology of CVI and DVT. Reflect on how you would diagnose and prescribe treatment of these disorders for a patient based on the factor you selected.
Review the “Mind Maps—Dementia, Endocarditis, and Gastro-oesophageal Reflux Disease (GERD)” media in the Week 2 Learning Resources. Use the examples in the media as a guide to construct two mind maps—one for chronic venous insufficiency and one for venous thrombosis. Consider the epidemiology and clinical presentation of both chronic venous insufficiency and deep venous thrombosis.
To Complete
ORDER A PLAGIARISM-FREE PAPER NOW
Write a 3 page Disorders of the Veins and Arteries – Pathophysiology of chronic venous insufficiency and deep venous thrombosis paper that addresses the following:
Compare the pathophysiology of chronic venous insufficiency and deep venous thrombosis. Describe how venous thrombosis is different from arterial thrombosis.
Explain how the patient factor you selected might impact the pathophysiology of CVI and DVT. Describe how you would diagnose and prescribe treatment of these disorders for a patient based on the factor you selected.
Construct two mind maps—one for chronic venous insufficiency and one for deep venous thrombosis. Include the epidemiology, pathophysiology, and clinical presentation, as well as the diagnosis and treatment you explained in your Disorders of the Veins and Arteries – Pathophysiology of chronic venous insufficiency and deep venous thrombosis paper.
Please references should be within the last five years. All in text quotation should have paragraph number or page number. paper should have introduction and summary. Disorders of the Veins and Arteries – Pathophysiology of chronic venous insufficiency and deep venous thrombosis

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How you would set up the study to answer this question?

YOU HAVE NOTICED A NURSING DILEMMA ON YOUR MEDICAL – SURGICAL NURSING UNIT.

 NO COMMENTS
You have noticed a nursing dilemma on your medical – surgical nursing unit. There is a piece of equipment that everyone has been trained to use. It is used to digitally weigh the patient in pounds and kilograms. It was determined that the patients weight would be recorded in pounds only by the nursing assistants as it was easier for them to understand. Recently, you have started taking dialysis patients whose weight must be recorded in Kilograms. The nursing assistants are told to weigh dialysis patient in both pounds and kilograms, record it and report it to the nurse. When you manually calculate the weight from pounds to kilograms, you notice that there seems to be a discrepancy as the weigh in pounds does not equal the weight in kilograms when manually calculated. This is happening with all of the dialysis patients. This has become a concern as the scale has been checked several times; it is weighing correctly. You speak to the nursing director and are given permission to determine the source of the problem. How would you set up the PICOT question (use all of the elements P-I-C-O-T)? How you would set up the study to answer this question?
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Lateral Marketing Strategy

Discussion
Please respond to the following: “Lateral Marketing Strategy”

  • Assess the value of target marketing as an effective health care marketing strategy. Appraise the degree to which vertical and traditional segmentation help marketing managers use target marketing strategies. Support your rationale with at least two (2) specific examples of target marketing within a health care organization with which you are familiar.
  • Evaluate the impact of lateral segmentation in encouraging marketing managers to look broadly at markets in order to identify previously overlooked opportunities. Provide at least one (1) specific example of quality initiatives within a health care organization
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 the strengths and weaknesses of healthcare delivery in the U.S.

Discussion Question:1
Based on your course readings in Module 1 and additional research, prepare and post to the Discussion Area the strengths and weaknesses of healthcare delivery in the U.S., as compared to other developed nations such as England or Australia. In addition discuss the factors that contribute to the strengths and weaknesses of healthcare delivery in the U.S. Justify your viewpoint using examples. Our current system is in disarray and needs repair. However, the fix for our system is highly debated. What do you think? Do we Reform or Not Reform?

Grading Criteria Maximum Points
Quality of initial posting, including fulfillment of assignment instructions 16
Quality of responses to classmates 12
Frequency of responses to classmates 4
Reference to supporting readings and other materials 4
Language and grammar 4
Total: 40

Discussion Question2
Primary care and secondary care are both provided in an outpatient setting, mostly in a doctor’s office. What are the benefits and risks in this provision of healthcare? Describe the difference between “primary” and “secondary” care in your response.
By the due date assigned respond to the discussion question assigned by the Faculty. Submit your response to the appropriate Discussion Area. Use the same Discussion Area to comment on your classmates’ submissions and continue the discussion through the end of module. Comment on how your classmates would address differing views.

Grading Criteria Maximum Points
Quality of initial posting, including fulfillment of assignment instructions 16
Quality of responses to classmates 12
Frequency of responses to classmates 4
Reference to supporting readings and other materials 4
Language and grammar 4
Total: 40

Discussion Question2
Primary care and secondary care are both provided in an outpatient setting, mostly in a doctor’s office. What are the benefits and risks in this provision of healthcare? Describe the difference between “primary” and “secondary” care in your response.? How do we view health care from a primary and secondary source? With this view, does it need to change to improve care?

By the due date assigned respond to the discussion question assigned by the Faculty. Submit your response to the appropriate Discussion Area. Use the same Discussion Area to comment on your classmates’ submissions and continue the discussion through the end of module. Comment on how your classmates would address differing views.

Grading Criteria Maximum Points
Quality of initial posting, including fulfillment of assignment instructions 16
Quality of responses to classmates 12
Frequency of responses to classmates 4
Reference to supporting readings and other materials 4
Language and grammar 4
Total: 40

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Ecology Research Assignment

Ecology Research Assignment
Choose one of the assignments described below. Research the required information and write a short paper on the topic. The paper should be at least 4 pages in length including title page and reference page, no larger than size 12 font, no more than 1.5 spacing between lines. Please properly cite your source(s). No plagiarizing!

Topic Choices

*Invasive species

Choose an invasive species and research the following: What is the definition of invasive species? Name and describe your chosen species. What is its native country/area? What areas has it invaded? What is the result of this invasion (be specific)? Is there a plan to eradicate or control the species? Has the plan been successful?

*Keystone species

Choose a keystone species and research the following: What is the definition of keystone species? Name and describe your chosen species. Where does it live? Why is it considered a keystone species? What is its role in its community and what might happen if it was removed from this community?

*Rehabilitation/restoration of an ecosystem

Choose an ecosystem that has been disrupted by human activities and is now being (or has been) restored and research the following: Where is the ecosystem? What kind of ecosystem is it (desert, river, swamp, etc.)? What was it like before human disruption? What impact has the disruption had on the ecosystem (be specific)? What is being done to restore/rehabilitate the ecosystem? Has it been successful?

*Population control policies of Japan, Thailand, China, or India

Choose one of these countries and research the following: What are the population numbers in this country? What are the living conditions like? What is the population control policy, and how long has it been in effect? What results have they seen or do they hope to see? What attitudes do the citizens of the country have toward the policy?

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Incidence and Prevalence

Incidence and Prevalence

Centers for Disease Control and Prevention Epidemiology Program Office
Case Studies in Applied Epidemiology No. 891-903
Paralytic Illness in Ababo Student’s Guide
Learning Objectives After completing this case study, the participant should be able to:
G Define incidence, prevalence, and case-fatality rate;
G Define surveillance and identify the key features of a surveillance system;
G List the types of information that should be collected on a surveillance case report form;
G List the factors that can account for a change in the reported incidence of a disease;
G Define sensitivity of a surveillance system, and the effect of different case definitions on sensitivity.
This case study was originally developed by Nancy Binkin (EIS ’80) in 1989. The current version was revised and edited by Richard Dicker with input from EIS Summer Course instructors and students over the years
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service
CDC / EIS, 2003: Paralytic Polio in Ababo (891-903) – Student’s Guide Page 2
PART I It is the early 1990s. The World Health Organization is planning a program for the global eradication of polio by the year 2000. Likura, a fictitious nation in south-central Africa, may become one of the countries selected to test the effectiveness of WHO’s polio eradication strategies. Unfortunately, little is known about polio in Likura. The Minister of Health therefore assigned the task of assessing the polio situation to a Ministry worker who has recently
returned from an epidemiology course in Atlanta, and who is about to become the District Health Officer in the Ababo District. The Ababo District is a relatively poor, rural district with a single hospital and several health centers. The Ababo District has attempted to conduct surveillance on polio cases and deaths over the past five years. The hospital, health centers, and all health workers are supposed to report such cases to the District Health Officer.
Question 1: What is incidence?
One measure of the polio situation in a community is the prevalence of lameness in
children, since lameness is a common sequela of polio.
Question 2: What is prevalence?
CDC / EIS, 2003: Paralytic Polio in Ababo (891-903) – Student’s Guide Page 3
Question 3a: What data might you use (or collect) to determine the incidence of polio in the population?
Question 3b: What data might you use (or collect) to determine the prevalence of the sequelae of polio (lameness) in the population?
Question 4: What are the key elements included in the definition of public health surveillance?
Question 5: What is the difference between active and passive surveillance systems? Is the Ababo surveillance system for polio passive or active?
CDC / EIS, 2003: Paralytic Polio in Ababo (891-903) – Student’s Guide Page 4
PART II To characterize the incidence of polio over time, the new District Health Officer tabulated the routinely collected surveillance records for the past five years. In Ababo, the operational surveillance case definition for polio is acute onset of flaccid paralysis plus fever. The data are shown in Table 1.
The most recent census was conducted in 1986, when the population of the Ababo District was determined to be 360,000 persons. The population in Ababo is assumed to be growing at a constant rate of 3.8% per year.
Table 1. Polio Morbidity and Mortality, Ababo District, 1986-1990
Year #New Cases # Deaths
Midyear Population
Incidence Rate
Per 100,000
Mortality Rate
Per 100,000 Case-fatality
Rate (%)
1986 54 5 360,000
1987 56 7
1988 50 6
1989 68 8
1990 74 10
Question 6a: What is a case-fatality rate? What does it measure?
Question 6b: Complete Table 1 by calculating the annual midyear population estimates, polio incidence rates, disease-specific mortality rates, and case-fatality rates for each of the past five years.
Question 7: Plot the trends in incidence rates, mortality rates, and case-fatality rates. Interpret these data.
CDC / EIS, 2003: Paralytic Polio in Ababo (891-903) – Student’s Guide Page 5
The District Health Officer is concerned that the number of reported cases seems low. He is concerned that sensitivity may be one of
several weaknesses of the polio surveillance system.
Question 8a: Define sensitivity. If the sensitivity of the system is indeed low, can these data still be used to describe the trends?
Question 8b: In addition to sensitivity, what other attributes of a surveillance system should you evaluate in determining whether the system is meeting its objectives?
Question 9: What might account for the increase in the number of new cases observed during the two most recent years?
CDC / EIS, 2003: Paralytic Polio in Ababo (891-903) – Student’s Guide Page 6
To characterize the population that has come down with polio in Ababo, the District Health Officer went to the hospital to review the charts of all children admitted with polio during the past two years. To his surprise, he found more
cases with a discharge diagnosis of polio from the hospital in 1989 and 1990 than were reported from the whole district during the same years.
Question 10: How might you explain the discrepancy between the hospital cases and reported cases?
Recall that, in Ababo, the working surveillance case definition for polio was acute onset of flaccid paralysis plus fever. In reviewing the records, the Health Officer found that the data on signs and symptoms of children given the diagnosis of polio were not uniformly recorded.
On most charts it was noted that the child had fever and acute onset of flaccid paralysis. On about 1/3 of the charts, however, there was no notation of fever but only the acute onset of paralysis.
Question 11: What is the effect of including the children without fever status recorded on the chart in your case definition?
Returning to the office, the District Health Officer learns that the disease report forms have run
out. He sees this as an opportunity to design a new disease report form.
Question 12: What types of information would you ask for on the new polio report form?
CDC / EIS, 2003: Paralytic Polio in Ababo (891-903) – Student’s Guide Page 7
The hospital review identified a total of 150 cases of polio. Characteristics of the cases are provided in the following tables.
Table 2. Seasonal Distribution of Polio, Ababo District Hospital, 1989 and 1990 Month 1989 1990 Month 1989 1990 January 5 7 July 2 3 February 19 16 August 0 2 March 4 8 September 1 1 April 9 13 October 2 1 May 4 8 November 4 4 June 4 5 December 7 5
Question 13: Describe the seasonal occurrence of polio in Ababo. (Note that Ababo is in the Southern Hemisphere.)
Table 3. Age Distribution of Polio Cases, Ababo District Hospital, 1989 and 1990 Age (in years) Number Age (in years) Number
<1 34 5 2 1 50 6 3 2 25 7 2 3 27 $8 0 4 7
Question 14: Determine the median and mean age of cases.
CDC / EIS, 2003: Paralytic Polio in Ababo (891-903) – Student’s Guide Page 8
Table 4. Sex and Ethnic Distribution of Polio Cases, Ababo District Hospital, 1989 and 1990
Sex
Male Female
Zanu 73 53 126
Hanzu 12 2 14
Other 8 2 10
93 57 150
Question 15: What is the ratio of male to female cases?
Question 16: Review the ethnic distribution of cases. Can you conclude, based on these results, that being a member of the Zanu tribe is a risk factor for polio? Why or why not?
To gather information on polio prevalence, vaccine coverage, and risk factors for polio, the District Health Officer conducted a survey of
children in the district. Lameness was used as a surrogate for polio. The prevalence of lameness by vaccination status is shown in Table 5.
Table 5. Lameness by Vaccination Status among Children 12-23 Months of Age, Ababo District, 1991
Lame Normal Total
Polio Vaccine
$1 dose 1 242 243
0 doses 9 667 676
10 909 919
CDC / EIS, 2003: Paralytic Polio in Ababo (891-903) – Student’s Guide Page 9
Question 17a: What is the prevalence of polio (lameness) among vaccinated ($1 dose) children?
Question 17b: What is the prevalence of polio (lameness) among the unvaccinated children?
Question 17c: What is the vaccine coverage (at least one dose) in this population?
Question 17d: Interpret these data.
The District Health Officer plans to review the polio surveillance data each month. Knowing that part of a good surveillance system involves
disseminating the information to “those who need to know,” the District Health Officer begins to compile a list.
Question 18: To whom should surveillance information be disseminated? How might you disseminate this information?
CDC / EIS, 2003: Paralytic Polio in Ababo (891-903) – Student’s Guide Page 10
A few months after the hospital chart review was completed, the medical officer on the hospital pediatric service called the District Health
Officer. She has seen 12 and 34 cases in the months of January and February of 1991, respectively.
Question 19a: What is the expected number of cases for January and February?
Question 19b: In your opinion, is Ababo experiencing an epidemic of polio?
A meeting was held to discuss the situation. The results of the vaccine coverage survey
were reviewed, and the authorities decided to launch an intensive polio vaccination campaign.
CDC / EIS, 2003: Paralytic Polio in Ababo (891-903) – Student’s Guide Page 11
EPILOGUE
In 1988, the World Health Assembly launched a global initiative to eradicate polio by the end of the year 2000. This initiative was not without controversy. Some public health officials argued that polio, a potentially fatal or crippling disease, could be eradicated, so it should. In the long run, eradication would save billions of dollars. Others felt that the money and energy that would be expended in eradicating polio, a disease already of low prevalence in most countries, could be better spent on comprehensive public health interventions rather than a single disease, and that the eradication effort might divert time, attention, and resources from other programs.
From the inception of the Global Polio Eradication Initiative in 1988 to the end of 2002, the number of cases has fallen by over 99%, from an estimated more than 350 000 cases in 1988 to 1919 reported cases in 2002 (as of 16 April 2003). In the same time period, the number of polio-infected countries was reduced from 125 to 7. Polio is now found only in parts of Africa and south Asia. Meanwhile, polio surveillance is thought to have improved, with rates of detected acute flaccid paralysis (AFP) rising from 1.6 to 1.9 per 100,000 children <15 years of age between 2001 and 2002.
REFERENCES 1. CDC. Principles of Epidemiology, 2nd ed. Atlanta: CDC, 1992.
2. PAHO. Polio Eradication Field Guide, 2nd ed. Washington, DC, PAHO, 1994.
3. WHO. Poliomyelitis (Fact Sheet no. 114). Geneva: WHO, April 2003.
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Assessing and Treating Clients With Anxiety Disorders

Week 5: Anxiolytic Therapy & PTSD Treatment

“I’m no longer at the mercy of my PTSD, and I would not be here today had I not had the proper diagnosis and treatment. It’s never too late to seek help.”
—P.K. Philips, PTSD patient

For individuals suffering from posttraumatic stress disorder (PTSD) and other anxiety disorders, everyday life can be a constant challenge. Clients requiring anxiolytic therapy may present with anxiousness, depression, substance abuse issues, and even physical symptoms related to cardiovascular, respiratory, and gastrointestinal ailments. As a psychiatric mental health nurse practitioner, you must be prepared to address the many needs of individuals seeking treatment for PTSD and other anxiety disorders.
This week, as you study anxiolytic therapies and PTSD treatments, you examine the assessment and treatment of clients with PTSD and other anxiety disorders. You also explore ethical and legal implications of these therapies.

Photo Credit: [shironosov]/[iStock / Getty Images Plus]/Getty Images

Assignment: Assessing and Treating Clients With Anxiety Disorders

Common symptoms of anxiety disorders include chest pains, shortness of breath, and other physical symptoms that may be mistaken for a heart attack or other physical ailment. These manifestations often prompt clients to seek care from their primary care providers or emergency departments. Once it is determined that there is no organic basis for these symptoms, clients are typically referred to a psychiatric mental health practitioner for anxiolytic therapy. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with anxiety disorders.

Learning Objectives

Students will:
  • –Assess client factors and history to develop personalized plans of anxiolytic therapy for clients
  • –Analyze factors that influence pharmacokinetic and pharmacodynamic processes in clients requiring anxiolytic therapy
  • –Evaluate efficacy of treatment plans
  • –Analyze ethical and legal implications related to prescribing anxiolytic therapy to clients across the lifespan.

sample that can be audit and submit with plagiarism less than 15%
 
Assessing and Treating Clients with Anxiety Disorder
Assessing and Treating Clients with Anxiety Disorders.
Anxiety disorders are the most prevalent category of mental illness and are characterized by chronic anxiety causing distress and interference in the individual’s life. According to DSM-5, excessive anxiety and worry must cause significant distress or impairment and occurs on more days than not for at least six months for diagnostic criteria (Stein et al., 2015) The disorder can be effectively treated with medication, psychotherapy, or a combination of the two modalities.
This paper addresses the pharmacology approach in treating a 46 year- old white male who is experiencing anxiety, and the impact pharmacokinetic and pharmadynamic processes will be explored to guide for the appropriate treatment.
Case Scenario
A 46-year-old white male who initially presented to ER with a complaint of chest pain and cardiac work- up was negative, and a PMHNP consult was sought for psychiatric evaluation. The client ‘s Hamilton Anxiety Rating Scale( HAM-A) was 26 indicating moderate to severe anxiety phase. The PMHNP decides to start the client on medications.
Options: Zoloft 50 mg Po Daily, imipramine 25 mg po BID, buspirone 10 mg BID. 
Decision: Zoloft 50 mg PO daily.
Rationale: Selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs ) benzodiazepines, buspirone, and α2δ ligands such as pregabalin and gabapentin are recommended as first line treatments for anxiety disorders spectrum (Stahl, 2017) However,  SSRI and SNRIs are efficacious in the treatment of generalized anxiety disorder (GAD) and panic attack as in the case of our patient in the scenario. Additionally, in cases of co-occurring GAD and depression, a common comorbidity, SSRIs can provide effective treatment for both GAD and major depression ( Johnson & Coles, 2014) .
Selecting sertraline (Zoloft) was based on the fact it belongs to the family of SSRI, and well recognized in the treatment of GAD and panic attack. Secondly, possible side effects of Zoloft which include sexual dysfunction, gastrointestinal abnormalities (nausea and diarrhea), insomnia, weight gain, and agitation and/or hyperactivation (Kamo et al.,2016) were explored prior selecting Zoloft. The patient was overweight (15 lb), hence a healthy lifestyle will be important for education, and the rest of side effects can be monitored and managed early in treatment.
Sertraline affects the serotonin neurotransmitter in the synaptic cleft by blocking the serotonin transporter from returning the remaining serotonin to the presynaptic cell. Sertraline is well absorbed in gastrointestinal tract, highly protein bound, predominantly metabolized by CYP 450 system  with half-life of 24- 26 hrs and removed primarily  by kidneys ( Woo & Wayne, 2013).
Imipramine, a tricyclic antidepressant was not my first choice because its possible side effects: blurred vision, dry mouth, urinary retention, drowsiness, weight gain, hypotension, and seizures (Stahl,2017)
Buspirone (Buspar), a serotonin receptor partial agonist can be appropriate for augmentation but not as first line treatment of GAD. Additionally, Buspirone takes longer (2 – 4 weeks) to have a full effect, and due to its sedation side effect, it would not be appropriate in our patient who has history of increased alcohol intake.
The goals of treatment of anxiety disorders are resolution of symptoms and prevention of relapse.
The client returns in four weeks, responding well to medication, anxiety decreased HAM A 18 from 26.
Options : Increase dose to 75 mg daily, increase dose to 100 mg daily, no change in drug/ dosage
Decision # 2 Increase dose to 75 mg daily. 
Rationale: Sertraline dosing in panic, PTSD, and social anxiety begin with 25 mg/day; increase to 50 mg/day after 1 week thereafter, usually wait a few weeks to assess drug effects before increasing dose; maximum generally 200 mg/day; single dose (Stahl,2017).
Moreover, increasing dosage slowly will reduce the possibility of acquiring side effects from the medication (Stein et al., 2014)
The client returns in four weeks, reports further reduction in anxiety symptoms HAM- A 10 (mild anxiety)
Options: Maintain current dose, increase to 100 mg daily, add Buspirone. 
Decision: Maintain current dose
Rationale: Major errors in psychopharmacological treatment of anxiety disorders include not achieving full remission of symptoms but instead accepting partial response, and not providing an adequate trial of medications (8 to 12 weeks ) before switching, discontinuing, or augmenting ( Woo & Wayne, 2013) . The patient was responding pretty well to medication ( 50% reduction in symptoms) , and reported no side effects. Therefore, continuing the same dosage, providing regular follow up with the patient to ensure medication adherence would be appropriate to meet the goals of remission.
References
Johnson, E. M., & Coles, M. E. (2014). Failure and Delay in Treatment-Seeking Across Anxiety Disorders. Community Mental Health Journal, 49(6), 668-674. Retrieved from https://web-a-ebscohost-com.ezp.waldenulibrary.org/ehost/pdfviewer/pdfviewer?vid=29&sid=7eabbc3a-b3a4-4cbf-b934-aa75c2e5b6fd%40sessionmgr4007
Kamo, T., Maeda, M., Oe, M., Kato, H., Shigemura, J., Kuribayashi, K., & Hoshino, Y. (2016). Dosage, effectiveness, and safety of sertraline treatment for posttraumatic stress disorder in a Japanese clinical setting: a retrospective study. BMC Psychiatry, 16(1). Retrieved from https://web-b-ebscohost-com.ezp.waldenulibrary.org/ehost/pdfviewer/pdfviewer?vid=6&sid=2ee0b7c6-b1c7-44e7-9b93-42c3b9a745c3%40sessionmgr102
Stein, D. J., Craske, M. A., Friedman, M. J., & Phillips, K. A. (2014). Anxiety Disorders, Obsessive-Compulsive and Related Disorders, Trauma- and Stressor-Related Disorders, and Dissociative Disorders in DSM-5. American Journal of Psychiatry, 171(6), 611-613. Retrieved from https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.2014.14010003
Woo, T. M., & Wynne, A. L. (2013). Pharmacotherapeutics for nurse practitioner prescribers(3rd ed.). Philadelphia, PA: F.A. Davis Co.
 

  • Decision #1
    • Which decision did you select?
    • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
    • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
    • Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
  • Decision #2
    • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
    • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
    • Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
  • Decision #3
    • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
    • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
    • Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
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Applying and Sharing Evidence to Practice

Applying and Sharing Evidence to Practice
After the data have been analyzed, conclusions are made regarding what the findings mean. Then, this information must be shared with your healthcare team.

  1. Choose one of the articles from the Week 5 RRL assignment, and discuss the findings. Would you apply the evidence found to your practice? Explain your answer.
  2. Translating research into practice is the final and most important step in the research process. Review information you found your nursing clinical issue and explain ways in which you would share the research-based evidence with your peers.

Applying and Sharing Evidence to Practice

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 Structure And Functions Of Organs

 Structure And Functions Of Organs

Identify an organism that lives within 50 miles of your home.
Write a 1,050- to 1,400-word paper about how the organism has adapted to survive in their specific environment. Include the following points in your paper:

  • Briefly describe the environment (temperature, landscape, food sources, etc.) and describe the organism’s role in the environment. Determine which organism your chosen organism would be most closely related to using a phylogenetic tree.
  • Identify the structures and functions of the main organs found in your selected organism.
  • Explain how the organism has evolved physiologically to become suited to its environment.
  • Explain how things would change if the organism were to be transplanted to a significantly different environment:
  • Would their organ system still be as efficient? Why or why not?
  • Would the organism survive in this new environment? Why or why not?

Include the diagram and other appropriate pictures in your paper and make sure to provide a full reference for the images in your reference section.
Format your paper consistent with APA guidelines including references and in-text citations. Your paper should include a well written introduction and conclusion. Use only academic research sources.

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