Case Soap Note

Please see attachment 

R615

 

 Introduction

In today’s work environment, managers and team leaders are faced with the reality of a growing need for a remote workforce to remain competitive and economically viable. This need for a remote workforce has come about due to companies’ and multinational organizations’ quest to expand into emerging markets, make use of cost-effective opportunities in other regions, and their hunt for the best talents around the globe.  It is no surprise businesses are putting so much emphasis on human capital development compared to other areas in today’s work environment. According to a recent 2019 IWG study, 62% of remote work teams are comprised of workers that are three or more cultures around the world and only 15% of leaders have successfully managed a cross cultural remote team (Ferguson, 2022, June 22). In a separate citing Mesolu et al (2020), 80% of corporations remote work policies have shifted to virtual or mixed team of virtual collaboration and 64% of those virtual teams may likely remain permanent (Anthony, 2022, November 6). With these statistics in mind, I cannot overemphasize the dire need for team leaders to improve cross cultural remote team management in our global business climate.                                          Evaluation and Analysis of the Video

After a careful viewing of the video from Ricardo Fernandez, it’s fair to conclude that the most immediate issue team leaders face in managing a cross-cultural remote group is getting information across to team members effectively. And the best communication skills needed for success in managing this type of diverse remote team is understanding the context in which you communicate with your team members. The interaction between Ricardo and a team member from India where he (Ricardo saying “you’re killing it out there”) intended to commend his teammate (who understood it to mean “he’s not doing well”) clearly demonstrates the danger in not considering context of the cultural implications of one speech in a global setting. For example, you should avoid comparing other cultures to yours and understand that people from different cultures will have different communication styles – and so a leader must adjust their communication style to suit context. So, to effectively lead a global team and communicate effectively, managers and team members must have some cultural intelligence training to help leaders understand team members cultures – “One way is to visit foreign lands and talk with local people about their customs and social norms. Another way is to study the works of noted anthropologists and other social scientists. A third way is to consider the observations of people whose opinions we respect” (Steers & Nardon, 2014).

Another skill to communicate effectively is for a leader to avoid slang and jargon, but instead speak plain direct language that involves cultural nuances. (Bullock and Sanchez, 2021 March 22). Multilingualism (the ability of leaders to speak 2 or more languages) is also a vital skill needed in a global work environment. It is vital because it improves communication, builds relationships, and positively influences community building and networking. Diversity or inclusivity training is another skill to communicate.  This type of training helps managers deal with team members of diverse cultures more effectively by helping them understand the assumptions, values, and communication styles of the people that they may encounter in the workplace. “Language capabilities. Learning local languages facilitates learning local cultures. It also helps the manager develop close personal and business relationships abroad” (Steers & Nardo, 2014, p. 285). With this in place, managers are better prepared to be effective communicators in the workplace and understand the message of others and get their own message across as well.   

                                                                                                 Challenges

Managing these remote teams in cross cultural workplaces has numerous advantages if managers and team leaders do harness and utilize the necessary skills and tailor them to organizational goals. However, these success stories do come as enormous challenges that organizations must overcome to obtain their goals and success. As stated earlier, communication is the immediate hurdle in working with a diverse remote team but there are other difficulties that team members must overcome. To name a few of these challenges, team members face difficulties (i) communication and collaborating with each other, (ii) loneliness physically working solo, (iii) unable to unplug and focus, (iv) distractions at home as is mentioned in the video by Ricardo Fernandez, (v) different time zones which means some members must work odd hours making it hard to keep up, (vi) keeping motivated by oneself becomes harder when alone, (vii) taking some vacation – the work seems to follow you everywhere, (viii) no reliable internet – as is seen with Ricardo, poor internet or wi-fi hinders communication, and (ix) other cultural challenges as outlined in the graph below (Anthony, 2022).

Description: A graph of a number of peopleDescription automatically generated with medium confidenceSource: Anthony (2022)

 Relationship Building in a Cross-Cultural Remote Team

To build a successful relationship for a remote team, leaders must be willing to listen more, get feedback from the teams and learn more about different cultures and their backgrounds. Leaders must understand what their team members want and provide them with the necessary tools to motivate them. For example, Ricardo Fernandez in his video “Managing Cross-Cultural Remotes Teams believes that the workforce of today which predominant are made of millennials –  “By 2029, more than 38.5 million people ages 35 to 44 are expected to fit that definition, outnumbering all other age groups in the labor force” (Torpey, 2020); want training and development, flexibility of work hours, cash bonuses, private health care, retirement schemes, vacation allowances, housing assistance, company transportation, higher wages over benefits, help with debts, and childcare (Fernandez, 2017). On the other hand, other generational diversities like baby boomers might prefer different things in a remote team to motivate them. Unlike millennials, baby boomers may want higher benefits to higher pay to be motivated for example. Understanding these needs not only promotes job satisfaction but is indeed part and parcel of relationship building in a cross-cultural team.

Adaptability is an integral part of relationship building in a remote team and a productive team is based on a leader’s ability to understand individual work styles and make the necessary adjustment skillfully blending one’s own leadership with the team cultural nuances. Remote team leaders must also have excellent Self-awareness skills to pick up constant changes around the cross-cultural teams they manage by constantly monitoring feedback to avoid, or promptly resolve conflicts when they arise. There is no “one size fits all’ in managing a culturally diverse team; team leaders must adapt to the group dynamics regarding age, gender, cultures, and other aspects when communicating or building relationships for organizational goals. For example, while it may be acceptable sending a contract proposal to a western millennial, it is risky or completely unacceptable sending the same contract proposal to a 60-year-old Japanese because of the diversity of their respective cultures. A western millennial is more tech savvy and flexible and will most likely see nothing wrong with the medium of communication. However, Japanese combine both non-verbal and verbal communication styles in communication and believe in bodily gestures to transmit respect avoiding eye contact – “Previous literature has found that, compared to Westerners, Japanese tend to rely more on vocal tones than verbal contents or facial expressions when inferring emotions. These findings point to the possibility that Japanese people tend to both express and perceive emotions through nonverbal vocal information to a greater degree than Westerners” (Yoshie & Sauter, 2020, p. 516).

As stated earlier, clear Articulation is a masterful tool for relationships building as it sends information to and from team members with little risk of miscommunication. Equally important as articulation is Writing Proficiently – leaders should always practice putting verbal meetings in writing so team members get all information including those that might have been lost in words or pronunciations (Ferguson, 2022).

Multilingualism, though an important and effective communication skill, is also a vital tool for relationship building in a global work environment. It is widely assumed that English is the preferred language in most international or global diverse team meetings which can be an advantage to English speaking team leaders, but at the same time it is a drawback when it comes to relationship building with other team members who speak other languages – “English speakers have an advantage in international English-speaking teams, but this apparent “political” advantage masks potential negative consequences” (Henderson, 2005, p. 77). Leaders who are multilingual and speak the local language of team members communicate efficiently and build trust and understanding that is way more efficient than leaders who don’t.

                                                                                      Conclusion

Human capital is now the sine qua non in all culturally diverse organizations in today’s business climate. That’s why it is vital for managers and team leaders to have the requisite training and cultural intelligence to successfully navigate the cultural and diversity hurdles in the global workplace to obtain organizational growth and sustainability. The workplace as we know it, is largely and gradually moving towards a virtual, remote, and culturally diverse global village and business must get prepare and gear up to meet the challenges that the global workforce is throwing at us.

Nursing

10/22/23, 3:13 PM Module 5 Readings

https://stthomas.instructure.com/courses/67213/assignments/841164 1/2

Due Monday by 4:30pm Points 3 Submitting an external tool
Available Sep 19 at 4:30pm – Dec 15 at 4:30pm

This tool needs to be loaded in a new browser window

Module 5 Readings

Please note that you are required to submit Perusall annotations for this set of readings
(link below):

Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., &
Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many
of the leading causes of death in adults: The Adverse Childhood Experiences (ACE)
Study. American Journal of Preventive Medicine, 14, 245-258.
(https://stthomas.instructure.com/courses/67213/files/7392424?wrap=1)
(https://stthomas.instructure.com/courses/67213/files/7392424/download?download_frd=1)
(https://stthomas.instructure.com/courses/67213/files/7392541/download)

Cloitre, M., Cohen, L. R., Ortigo, K. M., Jackson, C., & Koenen, K. C. (2020). Chapter 3:
Development in the context of deprivation. In Treating Survivors of Childhood Abuse and
Interpersonal Trauma: STAIR Narrative Therapy. Guilford Publications.
(https://stthomas.instructure.com/courses/67213/files/7392425?wrap=1)
(https://stthomas.instructure.com/courses/67213/files/7392425/download?download_frd=1)

(https://stthomas.instructure.com/courses/67213/files/7392425?wrap=1) Pappas, S. (2022,
September). How to support patients who have experienced sexual assault. Monitor on
Psychology, 53(6). Retrieved from http://www.apa.org/monitor
(https://stthomas.instructure.com/courses/67213/files/7715946?wrap=1)
(https://stthomas.instructure.com/courses/67213/files/7715946/download?download_frd=1)
(https://stthomas.instructure.com/courses/67213/files/7392542/download)
(https://stthomas.instructure.com/courses/67213/files/7392540/download)

Please click the link below (i.e., “Load Module 5 Readings in a new window”) to access the
reading assignments for this module in Perusall. Instructions for using Perusall can be found
in Module 0 (https://stthomas.instructure.com/courses/67213/modules/375843) in the Required Texts
and Technology Tools section. Information regarding how Perusall assignments will be graded can
be found in the Course Syllabus
(https://stthomas.instructure.com/courses/67213/assignments/syllabus) .

Felitti et al. (1998) ACE
Study.pdf  (https://stthomas.instructure.com/files/7392424/download?downlo

Page 1 of 14 ZOOM

10/22/23, 3:13 PM Module 5 Readings

https://stthomas.instructure.com/courses/67213/assignments/841164 2/2

Load Module 5 Readings in a new window

Cancer Treatment Options-Discussion Post

 

Mrs. Williams is a 27-year-old female diagnosed with breast cancer. She is currently in pharmacy school. She does not have children, but hopes to have them someday. She has been tested and has a genetic predisposition for this disease.

  • What treatment options does she have?
  • What are the advantages and disadvantages of those treatment options?
  • What would you tell Mrs. Williams if she decided to refuse treatment?
  • Mrs. Williams really wants to have children before she starts treatment. What would you educate her about? Why? Remember that your posts must exhibit appropriate writing mechanics including using proper language, cordiality, and proper grammar and punctuation. If you refer to any outside sources or reference materials, be sure to provide proper attribution and/or citation.

Initial post requirement must be 250 words minimum. The 2 peer responses must be 150 words minimum each. 

Evidence based Practice

 

March 21, 2010, was not EBP’s date of birth, but it may be the date the approach “grew up” and left home to take on the world.

When the Affordable Care Act was passed, it came with a requirement of empirical evidence. Research on EBP increased significantly. Application of EBP spread to allied health professions, education, healthcare technology, and more. Health organizations began to adopt and promote EBP.

In this Discussion, you will consider this adoption. You will examine healthcare organization websites and analyze to what extent these organizations use EBP.

 Post a 1 Page description of the healthcare organization website you reviewed. Describe where, if at all, EBP appears (e.g., the mission, vision, philosophy, and/or goals of the healthcare organization, or in other locations on the website). Then, explain whether this healthcare organization’s work is grounded in EBP and why or why not. Finally, explain whether the information you discovered on the healthcare organization’s website has changed your perception of the healthcare organization. Be specific and provide examples.

Include 3 references

Diabetes

Using at least 4 current (within the past 5 years), relevant, peer-reviewed resources, create a literature review that does the following:

· Describes the project's topic, resources reviewed, and conclusions of each article.

· Summarizes the principal findings of the research and their relevance to the project's proposed outcomes.

This paper should be at least 2 pages in length and reference

Week 2—2 Peer Response 800w. due9-15-23

Week 2—2 Peer Response 800w. due9-16-23

Instructions:

Please read and respond to the two peers' initial postings for week 2 below. Consider the following questions in your responses.

Compare and contrast your initial posting with those of your peers.  

1. How are they similar or how are they different?

2. What information can you add that would help support the responses of your peers?

3. Ask your peers a question for clarification about their post.

4. What most interests you about their responses? 

5. Summaries at least 1 evidence based article that supports there point.

Please be sure to validate your opinions and ideas with citations and references in APA format.

·
Response 1 400 words

·

·
Week 2 Discussion: Neurotransmitters

Describe the chemical and electrical processes used in neurotransmission.

        The central and peripheral nervous system both have a very complex and precise structure. The brain has trillions of specialized nerve cells called neurons. Neurons are connected to each other via synapses. Each neuron is connected to thousands of other neurons. Synapses serve as specialized centers that direct communication between neurons via a mechanism known as neurotransmission (Masoli et al., 2022). In other words, neurotransmission means how an impulse moves through one neuron to another neuron. Pulses can move through neurons electrically or chemically.

        Electrical process involves cell membranes. Each neuron has a cell membrane that separates intracellular space from extracellular space and has electrical charge (ions). When a signal arrives to the cell membrane, the ion channels both voltage-sensitive sodium channels (VSSCs) and voltage-sensitive calcium channels (VSCCs ) open and NA+  ions can transfer through these channels and create electrical signals (action potential). This electrical signal will move through axons to reach to the axon terminal (presynaptic nerve terminal) and opens calcium channels.

        According to Huang et al. (2022), in the nervous system, the functioning of brain circuits depends on the accurate integration of synaptic vesicles filled with neurotransmitters at a region known as the presynaptic active zone. When an action potential reaches these vesicles and calcium ions are transferred, the neurotransmitters are released from these vesicles. In other words, electrical impulses within the neuron are then transformed into chemical messengers, a process known as Excitation–Secretion Coupling. When these messengers (neurotransmitters) are released, they activate the receptors on a postsynaptic neuron. Communication within a neuron is electrical, while communication between neurons is chemical (Stahl, 2021). A single synapse can have many communication lines, each using its own neurotransmitter, and each neurotransmitter can be understood by a different set of receptors. This complex setup allows for rich and diverse communication between nerve cells (Agnati et al., 2023).

Why are depolarizations referred to as excitatory postsynaptic potentials and hyperpolarization as inhibitory postsynaptic potentials?

        The neurotransmitter can affect the postsynaptic neuron's cell membrane in two different ways. If the neurotransmitter binds to the receptors on the postsynaptic neuron and reduces the negative charge of the cell membrane, causing slight depolarization, the postsynaptic neuron will reach the threshold to initiate an action potential and transmit signals further along the neural pathway. This process is called Excitatory Postsynaptic Potentials (EPSP). In other words, when the neurotransmitter depolarizes the postsynaptic cell membrane, it is termed excitatory because it initiates an action potential (Stahl, 2021).

        On the other hand, if the neurotransmitter binds to the postsynaptic cell membrane and creates a more negative charge, hyperpolarization occurs. In this case, the postsynaptic neuron receives an inhibitory signal, which means the neuron moves further away from the threshold for initiating an action potential. This pathway is referred to as Inhibitory Postsynaptic Potentials (IPSP). The balance between EPSP and IPSP regulates the activity of neurons (Stahl, 2021).

What are the differences between absolute and relative refractory periods?

        When a neuron has been depolarized and an action potential has been created, this neuron is not anymore able to start another action potential for a limited amount of time. The duration, lasting approximately 1-2 milliseconds, beginning with the initiation of the action potential and extending just beyond the spike potential. This period is referred to as the Absolute Refractory Period (ARP). It's important to note that, even in response to stronger or supra threshold stimuli, no additional action potentials can be generated during the ARP. During this period, sodium channels are closed and sodium ions are not able to flow and create another action plan (Kartik et al., 2023). This is because the system prefers to create one-directional manner and prevent backward transmission of signals along the neuron's axon.

        Relative refractory period usually follows absolute refractory period. Some neurons acquire their abilities to create another action potential little by little, however, the signal should be stronger to depolarize the neurons. Following the inactivation of the sodium (Na) channels, the opening of potassium (K) channels leads to the efflux of K ions. Subsequent recovery of the Na channels from their inactivated state permits the generation of a second action potential. However, due to the sustained efflux of K ions, there is a natural resistance to further depolarization. As a result, a stimulus stronger than the norm is required to start a second action potential (Kartik et al., 2023). This period, lasting approximately 3-4 milliseconds after the absolute refractory period, during which a second action potential can be fired with stronger stimuli due to the recovery of Na channels. The reason of this period is that some ion channels have been recovered and now are able to open their channels and let the sodium ions to flow and create action plan. The relative refractory period is usually longer that absolute refractory period. These refractory periods help to ensure proper timing in neural circuits (Stahl, 2021). 

References

Agnati, L. F., Guidolin, D., Cervetto, C., Guido, M., & Marcoli, M. (2023). Brain structure and function: Insights from chemical neuroanatomy.
 Life, 13(4), 940. 
https://doi.org/10.3390/life13040940Links to an external site.

Huang, S., Piao, C., Beuschel, C. B., & Zhao, Z. (2022). A brain-wide form of presynaptic active zone plasticity orchestrates resilience to brain aging in Drosophila.
 PLoS Biology, 20(12) 
https://doi.org/10.1371/journal.pbio.3001730Links to an external site.

Kartik, S., Hrudini, D., Aparna, J., Navya, T., & Chelliah, S. (2023). “Knowing it before blocking It,” the ABCD of the peripheral nerves: Part A (Nerve anatomy and physiology).
 Cureus, 15(7) https://doi.org/10.7759/cureus.41771

Masoli, S., Rizza, M. F., Tognolina, M., Prestori, F., & D’Angelo, E. (2022). Computational models of neurotransmission at cerebellar synapses unveil the impact on network computation.
 Frontiers in Computational Neuroscience,

 
https://doi.org/10.3389/fncom.2022.1006989Links to an external site.

Stahl, S. M. (2021). 
Stahl’s essential psychopharmacology: Neuroscientific basis and practical application (5th ed.). 

Response 2. 400 words

Describe the chemical and electrical processes used in neurotransmission.

Neurons which are nerve cells can communicate with each other through electrical and chemical signals. Communication occurs at the synapses; this is the site where chemical transmission occurs (Lovinger, 2008). Presynaptic neurons release neurotransmitters which are then received by the postsynaptic neuron also referred to as the neurotransmitter receptor protein (Lovinger, 2008). Neurotransmitter molecules bind to the receptor protein thus changing its function. Electrical signals also called action potential on the other hand are a result of charged particles that create rapid conduction from one end of the cell through the axon and to the next, its speed is dependent on the myelin sheath (Lall, 2023)

Why are depolarizations referred to as excitatory postsynaptic potentials and hyperpolarization as inhibitory postsynaptic potentials?

Depolarizations are referred to as excitatory postsynaptic potentials and hyperpolarization as inhibitory postsynaptic potentials due to the synaptic response that is facilitated by the Ligand-gated ion channels. In other words, the response of the postsynaptic neurons determines if it is excitatory (fires an action potential) or inhibitory (doesn’t fire an action potential) (Lovinger, 2008). Depolarization refers to the opening of sodium ion channels allowing an influx of sodium to enter the cell membrane increasing the likelihood of an action potential. This is followed by resting potential and rapid repolarization (Grider, 2023).

What are the differences between absolute and relative refractory periods?

An absolute refractory period is a period that follows an action potential in which a second action potential cannot occur due to the inactivation of the voltage-gated sodium channel (Grider, 2023). Whereas the relative refractory period is the duration of time in which a second action potential can occur. During this time sodium channels move from an inactive state to a closed state, however, in order for an action potential to happen a larger amount of stimulation is needed (Grider, 2023).

 

References

Grider, M. H. (2023, May 8). 
Physiology, action potential. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK538143/#:~:text=In%20neurons%2C%20the%20rapid%20rise,opening%20of%20potassium%20ion%20channels.

Lall, S. (2023, May 24). 
How do neurons communicate (so quickly)? – MIT McGovern Institute. MIT McGovern Institute. https://mcgovern.mit.edu/2019/02/28/ask-the-brain-how-do-neurons-communicate/

Lovinger, D. M. (2008). 
Communication Networks in the Brain: Neurons, Receptors, Neurotransmitters, and Alcohol. PubMed Central (PMC). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3860493/#:~:text=Nerve%20cells%20(i.e.%2C%20neurons),the%20cell%20to%20the%20other.

 ReplyReply to Comment

·

Nursing Homework

Preparing the assignment

1) Follow these guidelines when completing this assignment. Speak with your faculty member if you have questions.

a. Select a scholarly nursing or research article, published within the last five years, related to mental health nursing. The content of the article must relate to evidence-based practice.

· You may need to evaluate several articles to find one that is appropriate.

b. Ensure that no other member of your clinical group chooses the same article, then submit your choice for faculty approval.

c. The submitted assignment should be 2-3 pages in length, excluding the title and reference pages.

2) Include the following sections (detailed criteria listed below and in the Grading Rubric must match exactly).

a. Introduction

· Establishes purpose of the paper

· Captures attention of the reader

b. Article Summary

· Statistics to support significance of the topic to mental health care

· Key points of the article

· Key evidence presented

· Examples of how the evidence can be incorporated into your nursing practice

c. Article Critique

· Present strengths of the article

· Present weaknesses of the article

· Discuss if you would/would not recommend this article to a colleague

d. Conclusion

· Provides analysis or synthesis of information within the body of the text

· Supported by ides presented in the body of the paper

· Is clearly written

e. Article Selection and Approval

· Current (published in last 5 years)

· Relevant to mental health care

· Not used by another student within the clinical group

· Submitted and approved as directed by instructor

f. APA format and Writing Mechanics

1

· Correct use of standard English grammar and sentence structure

· No spelling or typographical errors

· Document includes title and reference pages

· Citations in the text and reference page

Dietitian vs Nutritionist

Careers in Pharmacy and Dietetics

The lecture from our registered dietician touched on the point that a dietician and a nutritionist are very different in terms of their training and educational background. More specifically anyone can call themselves a nutritionist, there is no formal license or standard certification process for this designation.  However, as you now know, the path to become a registered dietician is much more complicated and comes with extensive educational, training and licensure/certification requirements.  Most people are surprised to find this out!

I’d like you to reflect on the difference and address each of the following questions:  (a) Did this information surprise you or did you already know the difference between the two designations?  (b) Have you or someone close to you had any personal experience with a nutritionist that you now question? (c) Will you look more closely at what kind of professional endorses the supplements, vitamins, etc. that you consider taking? Feel free to post any other thoughts related to this topic. Responses may be only one paragraph, but no more than two.

After posting your response, read your peers’ thoughts and reply to at least one classmate.

Be sure to review requirements for discussion board posts from the syllabus. Don’t forget to review the rubric prior to writing your post. 

PLEASE READ LECTURE TRANSCRIPTS ATTACHED

disc1

answer those two questions. The first is to give an example that is related to cannabis and alcohol and mental health as depression, anxiety or ADHA the second related to Caucasian….. references at least 2

1. What is the role of patient education strategies in reducing the use of substances (cannabis and alcohol) as a coping mechanism in patients with mental health (depression, anxiety, ADHD?

2. How does cultural factors (caucasian) and the perception of mental disorders affect the patient’s compliance to a treatment plan?