Category: Health Care

Question: Explain and discuss how goals should factor into improvement efforts. Please fully support your answer with references.
Rubric:
Content: Comprehensive coverage of topic. Critical analysis of topic. Assumptions explicit.
Critical Thinking: “Digs deep” into topic. Considers alternatives.
References: Peer-reviewed sources. Minimum of 5 references.
Writing: “Journal article” quality writing.
Book: The Healthcare Quality Book Fifth Edition
Login information will be provided to the assigned writer.

Please respond to these two discussion posts:
Post 1:
Drug Assignment
Part one: Drug narrative
Bupropion Perphenazine Imipramine
Generic Name • Bupropion hydrochloride
• Zyban
• Wellbutrin IR
• Wellbutrin SR
• Wellbutrin XL. • Piperazinyl phenothiazine
• Trilafon® • Tofranil
• Imipramine pamoate
Drug Classification • Norepinephrine and Dopamine Reuptake Inhibitors (NDRI)
• Noncompetitive inhibitor of nicotine α4β2 receptor
(Costa et al., 2019) • Antipsychotic Agent
• Tricyclic antidepressants (TCAs)
Mental Health Uses • Treatment of depressive disorder • Schizophrenia
• Mania
• Agitated behaviour
• Severe anxiety • Second-line treatment of depression
Oral Dosing Range • A dose not exceeding 450 mg per day for patients with high chances of seizures
• Double dosage of 150mg per day
(Khan et al., 2016)
• 4 to 16 mg for two to three times per day (NLM, 2020) • 75mg per day (Fayez & Gupta, 2020)
Cost for a one-month supply 60 tablets of 150mg Bupropion XL 139.61$ 60 tablets of 4mg Perphenazine 30.06$ 30 capsules of Imipramine pamoate 161.47$
High-Risk Info • Contraindicated in patients with seizures, bulimia or anorexia nervosa
• Contraindicated in patients under abrupt alcohol use termination.
• Toxic to the neurological and cardiac systems is dose is exceeded by 5g
• Interactions drugs that are inhibitors or inducers of CYP2B6.
(Costa et al., 2019) • Contraindicated with liver damage, hypersensitivity and severe central nervous depression
(Hartung et al., 2015 & NLM, 2020) • Contraindicated in hypersensitivity to the drug, linezolid or IV methylene blue
Common Side Effects • Seizures
• Sleep disorders
• Tension
• Headaches
• Dry mouth • Drowsiness
• Headache
• Blurry vision
• Dry mouth
• Muscle spasms
(Hartung et al., 2015 & NLM, 2020 • Dizziness
• Sedation
• Seizures
• Increased appetite
• Weight gain
Part Two: Article Summary
The article by Charntikov et al., 2018 seeks to develop new insights on the likelihood for use of N-acetylcysteine (NAC) and bupropion in managing substance use disorders arising from methamphetamine. The researchers conduct trails on female rats to assess how they respond to the administration of NAC and bupropion. Results from the study reveal potential use of bupropion in treating methamphetamine use disorder by antagonizing the reward system for methamphetamine and sucrose. An assessment on the relapse outcomes after administration methamphetamine is also highlighted in the study. Charntikov et al., 2018 show that bupropion hinders restoration of methamphetamine n female rats. Overall, this study reveals the potential for us of bupropion in treating methamphetamine addiction in human subjects.
Conventional use of bupropion is the management of depression and tobacco use addiction. However, there is potential off-label use of bupropion in the treatment of other mental problems, such as methamphetamine addiction and relapse. The results of this study align with earlier studies on this topic using male rats that repotted bupropion reduces the response to methamphetamine (Charntikov et al., 2018). More so, researchers show that female rats have a higher sensitivity to locomotor effects when bupropion is used to manage methamphetamine response. This has implications for dose levels in females. Therefore, the drug has therapeutic benefits in treating addiction symptoms among methamphetamine addiction patients. However, this is a lab experiment with non-human subjects. The researchers did not sufficiently show whether the reduced locomotion activities in the female rats after pretreating with bupropion is as a resultant effect of the drug on the methamphetamine’s hyperlocomotion activity (Charntikov et al., 2018). This has an impact on safety concerns. While this research presents potential applications, there are research gaps. Thus, when prompted to prescribe this medication for the management of substance use disorder, it would be done with utmost caution. Additional clinical research is needed to confirm the efficacy of bupropion in pharmacotherapy against substance abuse disorders on human samples.
 
References
Charntikov, S., Pittenger, S. T., Pudiak, C. M., & Bevins, R. A. (2018). The effect of N-acetylcysteine or bupropion on methamphetamine self-administration and methamphetamine–triggered reinstatement of female rats. Neuropharmacology, 135, 487-495.
Costa, R., Oliveira, N. G., & Dinis-Oliveira, R. J. (2019). Pharmacokinetic and pharmacodynamic of bupropion: an integrative overview of relevant clinical and forensic aspects. Drug metabolism reviews, 51(3), 293-313.
Fayez, R., & Gupta, V. (2020). Imipramine. https://europepmc.org/article/NBK/nbk557656
Hartung, B., Sampson, S., & Leucht, S. (2015). Perphenazine for schizophrenia. Cochrane database of systematic reviews, (3).
Hower, M. R., Karlapati, S. K., Bachu, A. K., & KARLAPATI, S. K. (2024). Perphenazine in Treatment-Resistant Schizophrenia. Cureus, 16(1).
Khan, S. R., Berendt, R. T., Ellison, C. D., Ciavarella, A. B., Asafu-Adjaye, E., Khan, M. A., & Faustino, P. J. (2016). Bupropion hydrochloride. Profiles of drug substances, excipients and related methodology, 41, 1-30.
National Library of Medicine (NLM). (2020). PerphenazinE. ncbi.nlm.nih.gov https://www.ncbi.nlm.nih.gov/books/NBK548366/
Pose 2:
1

The study “Comparing the effect of prazosin and hydroxyzine on sleep quality in patients suffering from posttraumatic stress disorder” explored the effectiveness of hydroxyzine and prazosin on sleep quality in PTSD patients. The research found both medications improved sleep and reduced nightmares, with prazosin showing the greatest improvement. Hydroxyzine also led to reductions in PTSD symptoms. The evidence suggests these medications could benefit sleep disorders and nightmares in PTSD patients (Ahmadpanah et al., 2014). Based on this study, hydroxyzine appears to be an off-label option for improving sleep in PTSD, although it is not FDA-approved for this specific use. The study’s conclusions support considering hydroxyzine for PTSD-related sleep disturbances, but clinical judgment should be applied when prescribing off-label. As such, based solely on this article, I would not feel comfortable prescribing these medications for off-label mental health use without more evidence to ensure patient safety and efficacy.
References
Stahl, M., S., Grady, M., M., Muntner, & Nancy. (n.d.). Stahl’s Essential Psychopharmacology. Retrieved from https://platform.virdocs.com/read/1733715/67/#/4[CT-bp-60]/2/2,/3:0,/3:0
Havican, & Billingsley. (2021). Hydroxyzine (Vistaril): Uses, Side Effects, Dosage & Reviews. GoodRx. https://www.goodrx.com/hydroxyzine-pamoate/what-is#basics
Williams, T., Phillips, N. J., Stein, D. J., & Ipser, J. C. (2022). Pharmacotherapy for post traumatic stress disorder (PTSD). Cochrane Database of Systematic Reviews, 2022(3). https://doi.org/10.1002/14651858.cd002795.pub3

Part 1 Review the four recommendations in the IOM report The Future of Nursing: Leading Change, Advancing Health and find your state’s action coalition. >Discuss your state’s action coalition’s work as it aligns with these four recommendations. Is each recommendation being addressed? >Based on your analysis of the website, how would you describe your state’s progress toward meeting the IOM recommendations? Part 2 In a Microsoft Word document of 3 pages formatted in APA style, you will answer three questions related to your opportunity as a nurse and an advocate. The first two questions relate to influencing a bill that is traveling through the legislative process. The third question refers you to the social determinants of health and asks you to think specifically on your role as a nurse in influencing social determinants of health. Answer the following questions: >What parts of the lawmaking process does a nurse have an opportunity to influence the final bill passage? >List at least two ways that this influence can take place. In your opinion, would one way be preferable over the other? >Reviewing the social determinants of health, select one to respond to this question: >>>What role can nurses play in promoting health status through policy changes directly affecting this social determinant?

Create a PowerPoint presentation that responds to the following question: Think about the scenario created in Discussion 5 (Week 8): a context of big corporations that bring huge facilities/factories to poor areas and how it changes the dynamics of the population/community. Create a presentation that illustrates a real case and propose solutions to the problems you discussed in Week 8. Address the health problems caused by the change in the environment and the health care conditions of these marginalized populations. Overview: Use PowerPoint to create your presentation. DO NOT request notes at the bottom of the slides. Requirements: Add a title slide at the beginning and a sources slide at the end (minimum of 5 sources) Each presentation must have a minimum of 15 slides not counting the first (title) and last slides (sources). Feel free to exceed this number. Create as many slides as necessary. Each presentation must have a minimum of 1 pertinent youtube video. At least one slide must explain the relevance of your embedded YouTube video to the larger theme. Students should work to make the most aesthetically pleasing presentation possible. Minimize unnecessary “spins” and “rotations.” However, do show relationships between concepts, historical situations, etc. Upload the PowerPoint file to Canvas

Develop and submit a personal leadership philosophy that reflects what you think are characteristics of a good leader. Use the scholarly resources on leadership you selected to support your philosophy statement. Your personal leadership philosophy should include the following: 2-3 pages assignment Identify two to three scholarly resources, that evaluate the impact of leadership behaviors in creating healthy work environments (the hospital). A description of your core values. A personal mission and vision statement. An analysis of your CliftonStrengths Assessment summarizing the results of your profile A description of two key behaviors that you wish to strengthen. A development plan that explains how you plan to improve upon the two key behaviors you selected and an explanation of how you plan to achieve your personal vision. Be specific and provide examples.

Short paragraph responses (min 5 sentences each)
Chapter 5
Discuss Hawa’s “crime” and your reaction to the first three pages of chapter 5. Discuss Dina’s story. Discuss your thoughts on the quote, “one of the great failings of the American educational system….” Include references to suggestions made in the chapter and Harper’s experiences and ideas. Chapter 6
Discuss Mahabouba’s story. Include in your discussion issues surrounding the treatment of fistulas. Discuss the author’s point about statistics versus individual stories. Do you agree? Include a reference to Simeesh’s story. Conclusion: How did the documentary “The E-Team” and chapters in Half the Sky influence your thoughts about health in developing countries? Referring to the film and book chapters, evaluate the impact of globalization, in historical and/or present-day context, on issues, such as, but not limited to social justice, human rights and equality.

Details are attached below: Steps for completion and the appraisal tool.
PICO Question: Early interventional use of vasopressors in the management of septic shock patients
Main article: Evans, L., Rhodes, A., Alhazzani, W., Antonelli, M., Coopersmith, C. M., French, C., Machado, F. R., Mcintyre, L., Ostermann, M., Prescott, H. C., Schorr, C., Simpson, S., Wiersinga, W. J., Alshamsi, F., Angus, D. C., Arabi, Y., Azevedo, L., Beale, R., Beilman, G., Belley-Cote, E., … Levy, M. (2021). Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. Critical care medicine, 49(11), e1063–e1143. https://doi.org/10.1097/CCM.0000000000005337

PART A-______After reviewing the article, respond to the following questions. • Which factor do you feel has the most impact on family members? • Support your response with examples from readings. • What are some of the reasons it is important to include the support persons in the plan of care? ARTICLE URL IS ATTACHED!!!_________________________PART B-_______ Identify one person from the illness group you chose in Week 1 to interview. The person should not be a patient at the facility in which you work. You can use friends, family members, or coworkers. Do not use the person’s name in the paper, only initials. Administer the questionnaire you created in Week 1 to that person and address the following: • Compile the data and analyze the responses to better illustrate where this person, his or her family, and friends are in relation to accepting the diagnosis in relation to the standard health or illness definitions. • The analysis should also include coping skills, treatment, and support aspects of the illness. • Explain how this information will direct care plan development for the chosen illness group. • Include a copy of the interview you created with the responses from the person interviewed in an Appendix. Support your responses with examples and information from library resources, textbook and lectures.

How have public health occupations in Saudi Arabia changed over the last 50 years? How will public health occupations look in the next 20 years in Saudi Arabia? What do you think will drive the changes and why? Please address the topic below: Background facts and important milestones that mark the evolution of public health occupations in the Kingdom Types of occupations that play a critical role in public health (at least 2) The future public health needs (10-20 years from now) of Saudi Arabia and what public health occupations will be in demand Your recommendations to ensure that the Kingdom’s health force is equipped to meet these demands Your paper should meet the following structural requirements: ** 5 pages in length, not including the cover sheet and reference page. ** Formatted according to APA 7th edition writing standards ** Provide support for your statements with in-text citations from a minimum of 4 scholarly articles.

(1) discuss the assumptions of parametric statistical testing versus the assumptions of nonparametric tests. Discuss why a researcher would select a nonparametric approach based on the data and when they would select parametric tests for their data set. Does it matter what type of variables have been collected in the dataset? Embed course material concepts, principles, and theories (which require supporting citations) in your initial response along with at least one scholarly, peer-reviewed journal article. Keep in mind that these scholarly references can be found in the Saudi Digital Library by conducting an advanced search specific to scholarly references. Use Saudi Electronic University academic writing standards and APA style guidelines. (2) Locate an article which addresses the prevalent healthcare fraud and abuse issues in the Kingdom of Saudi Arabia. Discuss the three of the most prevalent healthcare fraud and abuse issues in the Kingdom of Saudi Arabia. What regulatory and governmental efforts are in place to reduce fraud and abuse? Support your statements with logic and argument, citing any sources referenced. Post your initial response early and check back often to continue the discussion. Embed course material concepts, principles, and theories (which require supporting citations) in your initial response along with at least one scholarly, peer-reviewed journal article. Keep in mind that these scholarly references can be found in the Saudi Digital Library by conducting an advanced search specific to scholarly references. Use Saudi Electronic University academic writing standards and APA style guidelines