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Natural/un-medicated delivery

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Doula/midwife

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To Prepare:

Review the Resources and identify one change that you believe is called for in your organization/workplace.
This may be a change necessary to effectively address one or more of the issues you addressed in the Workplace Environment Assessment you submitted in Module 4. It may also be a change in response to something not addressed in your previous efforts. It may be beneficial to discuss your ideas with your organizational leadership and/or colleagues to help identify and vet these ideas.
Reflect on how you might implement this change and how you might communicate this change to organizational leadership.

Resources:
https://medcom.uiowa.edu/annsblog/wp-content/uploads/2012/10/JONA-FINAL-Cullen-2012.pdf
https://www.ijhpm.com/article_3183_5015382bcf9183a74ef7e79b0a941f65.pdf?_action=showPDF&article=3183&_ob=5015382bcf9183a74ef7e79b0a941f65
https://www.youtube.com/watch?v=owU5aTNPJbs

The Assignment (5-6-minute narrated PowerPoint presentation):

Change Implementation and Management Plan

Create a narrated PowerPoint presentation of 5 or 6 slides with video that presents a comprehensive plan to implement the change you propose.

Your narrated presentation should be 5–6 minutes in length.

Your Change Implementation and Management Plan should include the following:

An executive summary of the issues that are currently affecting your organization/workplace (This can include the work you completed in your Workplace Environment Assessment previously submitted, if relevant.)
A description of the change being proposed
Justifications for the change, including why addressing it will have a positive impact on your organization/workplace
Details about the type and scope of the proposed change
Identification of the stakeholders impacted by the change
Identification of a change management team (by title/role)
A plan for communicating the change you propose
A description of risk mitigation plans you would recommend to address the risks anticipated by the change you propose

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Read the patient case studies below. List 3 differential diagnosis for each and why you believe these to be solid options that should be considered by the provider. Copy and paste the patient scenarios into a word document and use bullet points below each patient for your differential diagnosis, and then upload the assignment. Below is an example.

Patient X: 7-year-old Hispanic male with a cough and temperature of 99.9F

Differential Dx:
Allergic rhinitis
URI
Pneumonia
Patients
Patient 1: 28-year-old woman with opioid use disorder; uses IV heroin; has PTSD; no other medical problems or medications. She currently is single, lives with several roommates, and has a history of legal problems (with some jail time). Sexually active with men and women; inconsistent use of protection.

Patient 2: 70-year-old man with a history of CHF, COPD, and HTN; currently smokes one pack of cigarettes daily; takes Lisinopril, Digoxin, and Symbicort daily. Married to wife of 30 years and is retired (previously an accountant), is supported by adult children, and lives with his wife at home.

Patient 3: 40-year-old woman with a history of breast cancer that was successfully treated with Tamoxifen for several months. Otherwise healthy, with no other issues at this time. She is a successful businesswoman in a high-profile career with much stress. Married to wife of four years; relationship is rocky at times. Denies any substance use; travels frequently.

Symptoms are the same for all 3 patients:

Shortness of breath
Chest pain
Flank pain
Fever

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What are the major types of membranes in body? Pick 2 membrane discuss its functions and location

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how does the use of Porter’s Five Forces framework help to identify the major competitive factors in the service area? Explain using examples.

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Restriction Analysis of DNA

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Adult nursing voices and choices. Principles of personalized care

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This proposal asks the extent to which Coronavirus (Covid19) gradually influence political behavior. The idea that pandemic and other natural factors (weather and climate) impose a fundamental impact on politics has discussed in classical and modern political thought for a long time. The Coronavirus and its consequence on the global order, has pushed the scholars to lead more social-scientific analysis in understanding the impact of the epidemic on political behavior. This research proposal hypothesis that there is a link between the Coronavirus pandemic and global political order. This research provides several hypotheses to guide our analysis of the worldwide impact of the coronavirus pandemic: This virus will reshape the world. The political and economic balance will shift; the world will run by more than one superpower. For most countries, life will never return as it was before the pandemic. The world that we know until now will end, and, could the crisis mark a new beginning.

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The report must be at least 2 pages (maximum of 5 pages) in APA format. Be sure to double-space your document. The title page and references do not count in the page minimum or maximum.
It must have three sources cited (the textbook counts as one), and Wikipedia does not count.
The topic covered is: 

Pick an organ system you like and tell a stranger about it. Assume the stranger is someone that has no idea what you are talking about. In other words, try to explain it to someone with zero medical experience or background.

You must answer at least THREE of these questions: 
Explain in detail the anatomy of the system you choose
Explain the physiology of the system
Explain how it maintains homeostasis
What type of cells and tissues is the system constructed with
What major organs make up the system

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Topic: Depression and Anxiety
Read the following case and answer the questions using EBP.
Chief Complaint
Mary Williams is a 48-year-old African American female who presents to the clinic for her 6-week follow-up of hypothyroidism and depression therapy. At that time, she was prescribed Prozac 20mg daily for mild depressive disorder and levothyroxine 100 mcg daily for hypothyroidism. She was also diagnosed as being perimenopausal at that time based on symptoms and FSH level, but she declined HRT therapy because “I don’t want all of that stuff in my system if I don’t really need it.” Her chief complaint today is that “I still feel down in the dumps and can’t seem to get it together…the Prozac and levothyroxine are not helping.” She also verbalizes worsening “hot flashes,” and difficulty sleeping, and irritability. She denies feelings of hopelessness or suicidal ideations. She verbalizes feeling “successful in this phase of life, but just can’t shake this ‘down in the dumps’ feeling.” She denies having a menstrual cycle since her last visit.
Past Medical History
Hypertension: diagnosed age 40.
Perimenopause (stage -1) diagnosed 6 weeks ago as evidenced by: FSH >60, skipped 2-3 menstrual cycles this year and vasomotor symptoms present (ASRM, 2008).
Hypothyroidism diagnosed 6 weeks ago.
Depression diagnosed 6 weeks ago.
Medications
Diovan (valsartan 160/ HCTZ 12.5): 1 tablet daily.
Prozac 20mg daily.
Levothyroxine 100mcg daily.
Multivitamin once a day. Denies any other supplements.
Social History
Single: divorced 1 year ago and lives alone.
Occupation: retired as an elementary school teacher 7 months ago after teaching for 25 years.
Sexual habits: Denies having had intercourse or any sexual desire for intercourse or masturbation for “over a year.”
Physical Exam
Remarkable for the following:
BP: 118/72 HR: 78 Respirations: 15 Temp: 97.8 SPo2: 99% 
WT: 135 pounds; an increase from 131 pounds four weeks ago.
Skin and hair: Skin is dry, but texture has improved. Nails chipped and brittle in appearance. Hair thin, less brittle.
HEENT: Appropriate affect. Eyebrows thin. No thyroid enlargement or nodules palpated. Thyroid nontender to palpation. Speech: Normal rate and enunciation.
Musculoskeletal: No hyporeflexia or bradykinesia. Reflexes within normal limits.
Additional Disease-related History
Her initial TSH result was 11.4 and is now 0.8 mIU/mil. Her free T4 was 4.8 and is now 11.9. At her last visit her FSH >60 u/L (normal <22u/L). She scored a 13 on the Hamilton Depression Rating Scale at her initial visit, indicating a borderline mild to moderate depression. Mary’s HAMD score was fairly unchanged at 12 today.
Questions:
What symptoms are concerning to you as a practitioner?
How will you treat Mary’s complaints or address her concerns?
What education would you provide this patient regarding their diagnosis and treatment?
What treatment options are available to Mary both pharmacologic and non-pharmacologic?
For any additional or missing information, you may make up any missing data according to how you think it may have presented.
Please support all decisions with evidence via guidelines and peer-reviewed articles (a minimum of 3).

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Independent Variables are things you can NOT change such as gender, age, grade, ethnicity, SES etc.  This is the “cause”.  In non-experimental research when cause cannot be determined, this variable is often referred to as the Predictor variable.

Dependent Variables are things you CAN change (or at least have an effect on) such as aptitude, test scores, attitudes etc.  This is the “effect”. In non-experimental research when the cause/effect relationship cannot be determined, this is often referred to as the Criterion variable.

Variables can appear as categorical variables or continuous variables. 

Categorical variables appear as nominal or ordinal scales.

Nominal scales define types or names of categories, such as Red or White  or Male or Female.  When there are only two choices, these are also called dichotomous variables.  Nominal scales can include more than two choices such as Candidate Party (Democrat, Republican or Independent). 

Ordinal scales define categories that appear in a specific order, such as levels of Karate belt (White, Yellow, Brown, Black) or  BMI Weight classification (Underweight, Healthy, Overweight, Obese, Extremely Obese) . 



Continuous Variables appear on a continuous interval or ratio scale.

An Interval Scale includes zero that does not mean the absence of what is being measured. For example, temperature can appear on a range above and below zero, where zero has a value. 

A Ratio Scale includes zero, meaning the absence of what is being measured. For example, the number of minutes spent exercising can appear as 0 (meaning no minutes) upwards.