Three-Tier Intervention/Prevention Model

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Short Paper

One of the main models utilized to alleviate risk/problem behaviors is the three-tier intervention/prevention model. Describe the main differences between primary, secondary, and tertiary interventions. Use the Module One resources and the Module One Overview (see Wolfe & Jaffe article) as well as information from other (scholarly) sources.

Papers, at a minimum, should do the following:

·Answer the question or address the issue(s described in the instructions.

·Include your perspective, when applicable, and share your opinion or explain your rationale for your position.

·Be sure to support your responses with scholarly research, and include references and citations for material presented that is not your own original work. You can use first person to indicate your opinion (I, my, etc.) in lieu of listing yourself as a source.

Format: Short paper should follow these formatting guidelines: 2–4 pages, double spacing, 12-point Times New Roman font, one-inch margins, and citations in APA format

Article: Prevention of Mental Disorders

This article provides an overview of intervention and prevention strategies across cultures.

For this module, you will focus specifically on pages 15–37, which include the sections “Introduction: What Is Evidence-Based Prevention and Promotion In Mental Health?” though “Part III: Reducing Stressors and Enhancing Resilience.”

This resource will be used to complete the short paper.

Prevention/Intervention Strategies

There are three levels of fundamental prevention that are widely accepted in a multitude of settings, whether it’s a child who is acting out in school or an adolescent who is showing early signs of alcohol abuse. Implementing these three intervention techniques is the crux of exploring and educating the child and the people impacting that child’s environment. By targeting level-specific risk behaviors and preventing escalation of the behavior, we can often ensure effective intervention by promoting protective factors and reducing risk behaviors.

Primary prevention is meant to intervene when a child or adolescent is first showing signs of probable risky behavior. The purpose of primary prevention is to educate the child or adolescent exhibiting this behavior and to educate anyone in the child’s or adolescent’s environment. Strategies at the primary intervention level vary, but the key interventions to implement would be to have the child or adolescent set obtainable goals.

Another intervention is to educate the child or adolescent on developing a skill set of refusal and positive decision making; at times, the child or adolescent may simply not have the capacity and understanding of refusal. This can be particularly evident with children in the foster care system. These children are looking for acceptance in any shape or form, thus creating an open door for these children to follow suit with friends or family acting in a deviant manner. A primary intervention for these children would be to identify and participate in positive, meaningful activities. Lastly, primary prevention can be used to aid the child or adolescent in accepting self-responsibility.

Secondary prevention is to be used as an intervention strategy at the initiation of experimenting with a risky behavior or the development of a negative attitude. The primary goal of secondary prevention is to intervene and educate the child or adolescent on ways to eliminate experimenting with a risky behavior or to identify the root causes of negative attitudes. In order for this to happen, the adolescent or child would need help in identifying the consequence of a risky behavior. For example, if an adolescent is experimenting with drugs or alcohol, consider attending a drug- or alcohol-prevention program. By doing so, the adolescent could witness firsthand the possible consequences of underage drinking by hearing first-person accounts of the results of adolescent drinking. Secondary prevention could also be used by helping the adolescent set up personal goals, develop positive relationships with trusted adults, and capitalize on developing positive peer interactions. Secondary prevention should emphasize personal responsibility to the child or adolescent.

Tertiary prevention is used at the initiation of an already established risky behavior. The purpose of tertiary prevention is to educate the adolescent and others in his or her environment on ways to reduce the risky behavior. Continuing with the example of an adolescent experimenting with alcohol or drugs, strategies implemented in tertiary prevention might include fully participating in a drug or alcohol rehabilitation facility that would likely include participation in counseling. It is important to recognize and engage the entire family unit. Treating only the adolescent in a restricted environment will not likely address the entire issue, and research indicates this will yield a high probability of relapse.

Wolfe and Jaffe (1999) discuss the school environment. Examples of primary prevention involve activities aimed at increasing awareness and dispelling myths about issues such as relationship problems, alcohol and drug abuse, family and relationship violence, and teen pregnancy. Some possible activities include presentations involving videos, plays, professional theater groups, or speeches from domestic violence or teen dating violence survivors; classroom discussions facilitated by teachers or specific service professionals; and programs and curricula that encourage students to examine attitudes and behaviors that are specific to common behavioral issues.

Reference

Wolfe, D., & Jaffe, P. (1999). Emerging strategies in the prevention of domestic violence. The Future of Children, 9(3), 133-144. doi:10.2307/1602787

 

 

Article: Prevention of Mental Disorders (Also attached to post)

This article provides an overview of intervention and prevention strategies across cultures. The article is a valuable resource as you complete your milestone assignments and final project throughout the course, so refer back to this article for support.

For this module, you will focus specifically on pages 15–37, which include the sections “Introduction: What Is Evidence-Based Prevention and Promotion In Mental Health?” though “Part III: Reducing Stressors and Enhancing Resilience.” This resource will be used to complete the short paper.

Psychology Paper On Sigmung Freuds Book The Freud Reader

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Freud, Sigmund. The Freud Reader, edited by Peter Gay. New York: W.W. Norton, 1989.

THESE ARE THE ORIGINAL REQUIREMENTS

Write a concise 3-page expository essay that answers one of the following questions, using only the primary texts: “On Narcissism” or “Mourning and Melancholia”.  Of course, I encourage you to discuss the material with your classmates in a mutually-beneficial way.  Please do not use the internet or any secondary sources.  Do not simply rewrite your class notes, but rather demonstrate in your answers that you have read, understood, and thought about the material.  Write as if you are explaining Freud’s theory in your own words to someone who has not read Freud, and please avoid using first person (I feel…I think…”)

How does Freud understand the concept of “narcissism”?

How does Freud understand the concept of “mourning”?

I’m looking for thorough, coherent answers that demonstrate reflection on the assignments.  Please double-space, and type using size-12, Times New Roman font.  Please avoid using direct quotations on these short assignments, unless they are short and cited correctly (using either Chicago, MLA, or APA style).

An A-paper will show an excellent grasp of the material, and demonstrate that the student actively read the material, and has incorporated the lectures and discussion into thoughtful, comprehensive reflection on the material. It will also have minimal errors in spelling and grammar, and present coherent arguments.

Reflection Paper Topic: The Frivolity Of Evil

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he Frivolity of Evil 

Please use MLA format.

Words: 1000-1500

DO NOT USE ANY SOURCES OTHER THAN THE DALRYMPLE ARTICLE AND YOUR TEXTBOOK. 

 

Assessment:

Students should demonstrate that they can distinguish the relevant points that form a logically coherent argument. They should also be able to construct criticisms which effectively undermine, through the use of appropriate counter-examples, some premise of that argument.

 

you will type a 1000-1500 word response in which you address EACH of the following points IN YOUR OWN WORDS:

1) What is the author’s main argument?

2) How does he support his main argument (evidence, ancillary arguments, etc.)?

3) Do you agree or disagree with him?

4) Why or why not?

5) Apply the insights of at least two of the readings we have studied in this course (in chapters 1-9) to your analysis. Make sure to give a substantive explanation of how the philosophers’ insights are relevant to the topic you are discussing.

A WORD OF WARNING: These articles are rather long and complex. The author likes to make extensive use of his rather copious vocabulary, so I strongly urge you to have dictionary.com handy as you work your way through your chosen article. The purpose of this essay assignment is for you to demonstrate your ability to discuss, analyze, and evaluate complex philosophic arguments. I am confident that the reading assignments, tests, and discussion boards will have prepared you for this final, and no doubt challenging, essay assignment.

Note: I only allow one attempt on this assignment. Students who do not fully address all of the components of the assignment as stated in the instructions as well as the grading rubric below will have to be content with the grade they earned. 

Your paper will be graded according to the following rubric:

Grading Rubric:

The following standards are numbered in order of importance for grading.

1.Essay demonstrates an understanding of the material: The student has correctly grasped a philosophical problem or question, has explained it accurately, and on the basis of a substantially correct interpretation of any texts involved. Key terms are used correctly. The essay shows evidence of the student’s independent thought, and is written in his or her distinctive voice. Short (one sentence) quotations are used (comprising no more than 10% of the body of the paper), when appropriate, to support the writer’s analysis, and an explanation is offered for each quotation. The use of block quotations will result in a severe point deduction.

95 points

2.Essay has clear and coherent argument: There is a clearly stated thesis, and support for this thesis in the body of the paper. Each paragraph contributes to this argument, and follows logically from the paragraph before it. The argument presented is persuasive. The insights of two other philosophers are incorporated into the analysis.

95 points

3.Essay fulfills assigned task: The essay addresses the entire assigned question or topic, elaborating on important ideas in satisfactory depth, but without bringing in anything extraneous or irrelevant. The introduction of the essay focuses and provides clarity for the paper. Important terms are clearly and accurately defined. Each paragraph conveys a coherent, organized thought. Short (one sentence) quotations are occasionally used, when appropriate, to support the writer’s analysis, and an explanation is offered for each quotation. No more than 10% of paper is made up of direct quotes. No block quotations.

40 points

4.Essay obeys standards for good persuasive writing: the writer shows that he or she is comfortable using philosophical language, and the prose is clear, not awkward. The structure of the sentences reflects the relationships between/among the ideas discussed.

40 points

5.Essay is technically correct: The essay has been carefully and thoughtfully proofread. The argument is written in complete sentences, with punctuation that does not mislead the reader. There are no mistakes in spelling, grammar, word choice, and punctuation.

 30 points

Medical coding ICD 10 PCS Coding assignment

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M132 Module 08 Coding Assignment

 

Build the correct ICD 10 PCS code based on the documentation in the Operative Report documentation given under each Case Study.

 

1. Case #1

 

PREOPERATIVE DIAGNOSES:

1. A 37 weeks intrauterine pregnancy.

2. Previous cesarean section with rupture of membranes.

 

POSTOPERATIVE DIAGNOSES:

1. A 37 plus weeks gestation.

2. Previous cesarean section with spontaneous rupture of membranes.

3. Pelvic adhesions.

 

ANESTHESIA: Spinal.

 

PROCEDURE PERFORMED: Repeat low-transverse cesarean section.

 

FINDINGS: Male infant, 6 pounds, 5 ounces. Apgars 9 and 9.

 

ESTIMATED BLOOD LOSS: 800 mL.

 

The patient’s condition after surgery, the patient tolerated the procedure well.

 

PERTINENT HISTORY AND PHYSICAL: The patient is a 20-year-old black female, gravida 2, para 1-0-0-1, last normal menstrual period 08/02/2006, EDC 05/08/2007, 37-5/7th weeks gestation, she presented to L D with spontaneous rupture of membranes, history of previous cesarean section in 2009 for CPD.

 

PAST MEDICAL HISTORY: She denies allergies.

 

MEDICATIONS: She is on prenatal vitamins.

 

MEDICAL SURGICAL: She denies any significant history except for C-section in 2006.

 

SOCIAL HISTORY: She denies ethanol, tobacco, or drugs.

 

PSYCHIATRIC HISTORY: Noncontributory.

 

FAMILY HISTORY: Noncontributory.

 

PHYSICAL EXAMINATION: Vital Signs: Temperature, the patient is afebrile, pulse 94, respiratory rate 20, BP 97/50, fetal heart tone was 140 to 145. HEENT was within normal limits. Neck is supple. Chest: Cardiovascular, Sl and S2 regular without gallop or murmur. Lungs: Clear both fields. Breasts: No masses or tenderness. Abdomen: Gravid. Pelvic: Cervix was 50% effaced, 1 to 2 cm dilated, presenting part was vertex at -2 station, there was gross fluid, clear and Nitrazine was positive. The patient was therefore taken to the operating room for a repeat low-transverse cesarean section.

 

OPERATIONAL TECHNIQUE: The patient was brought to the operating room and under spinal anesthesia, was prepped and draped in the usual manner for a gynecologic abdominal operation. Through the old suprapubic Pfannenstiel skin incision, the abdominal cavity was entered into after much difficulty because of the pelvic abdominal adhesion. Following entry into the abdominal cavity, the bladder peritoneum was identified, reflected down. Following that, a midline low-transverse incision was made at the lower uterine segment with a knife and carried down into the uterine cavity without any difficulty. The incision was then extended to the level of the round ligament on both sides. Following which a male infant in vertex position was delivered with vacuum and handed over to the nursery staff in attendance. Birth weight was 6 pounds 5 ounces. Apgar was 9 and 9. Placenta was manually delivered. After remnants of the placental membranes have been removed from the uterine cavity, the uterine cavity was then closed with #1 chromic continuous interlocking suture. Hemostasis was verified and found to be adequate. The ovaries and tubes were inspected and found to be within normal limits. The abdominal cavity was copiously irrigated. The abdominal cavity was then closed in layers. The pyramidal muscle was closed with 2-0 interrupted suture, the fascia was closed with #1 Vicryl continuous suture in two halves and the skin was closed with staples. The patient tolerated the procedure well and left the operating room, awake, conscious, and in excellent condition.

 

ESTIMATED BLOOD LOSS: 800 mL

 

ICD-10-PCS Code: Click here to enter text.

 

 

 

2. Case Study #2

Electroencephalogram

 

 

Description: This is an 18-channel digital EEG recording done on this 79-year-old male with a chief complaint of altered mental status .This patient is also on insulin for diabetes.

 

There is diffuse slowing and disorganization in the background consisting of medium-voltage theta rhythm at 4-6 Hz seen from all head areas. There was faster activity at beta range from the anterior. Eye movements and muscle artifacts are noted. EKG artifacts at 76 per minute were noted. Hyperventilation and Photic stimulation were not completed.

 

Findings: This is a moderately abnormal record due to diffuse slowing and disorganization of the background, with the slowing being at theta range. There is indication of a moderate encephalopathic condition. Clinical correlation is required to rule out a structural lesion.

 

ICD-10-PCS Code: Click here to enter text.

 

 

3. Case #3

 

PREOPERATIVE DIAGNOSIS: Cardiogenic shock.

 

POSTOPERATIVE DIAGNOSIS: Cardiogenic shock.

 

PROCEDURE PERFORMED: Insertion of extracorporeal membrane oxygenation circuit.

 

ANESTHESIA: General.

 

OPERATIVE INDICATIONS: The patient a 52-year-old African American male who previously had placement of a HeartMate II left ventricular assist device. The device seems to be nonfunctional at this time despite multiple pressor support. He has continued to develop cardiogenic shock and multisystem organ failure. ECMO circuit is indicated to help stabilize him prior to a planned device exchange.

 

OPERATIVE TECHNIQUE: The patient was placed on the OR table in the supine position. General anesthesia was induced. He was prepped and draped in the usual sterile fashion. A small transverse incision was made in the right groin and right femoral artery and vein isolated. A 10-mm Hemashield graft was then sewn end to side to the common femoral artery after administration of intravenous heparin. The Hemashield graft was then tunneled subcutaneously to

exit the skin in the upper thigh. A 29-French percutaneous venous cannula was then placed in the femoral vein without difficulty. The cannula was then attached to the ankle circuit and flow initiated. There was excellent flow with excess of 6 liters per minute. Transesophageal echo showed good cannula placed in the right atrium. There was significant coagulopathic bleeding from the femoral artery which took in excess of 2 hours to control with various hemostatic agents. Eventually, hemostasis was assured and the wound closed in layered closure of Vicryl and subcuticular stitch for skin. The patient was returned to the ICU in critical condition.

 

 

ICD-10-PCS Code: Click here to enter text.

 

 

 

4. Case Study #4

 

Report of Operation

Preoperative Diagnosis: Retained products of conception

Postoperative Diagnosis: Retained products of conception

Procedure: Suction and D and C

Estimated blood loss: 50 cc

Fluids: 150 cc LR

Urine Output: 10 cc clear

Anesthesia: Spinal

Specimens: Products of Conception

Complications: None

Condition: Stable to Recovery Room

 

Procedure: The patient was taken to the operating room where spinal anesthesia was found to be adequate. She was prepped and draped in the normal sterile fashion and placed in the dorsal supine position lithotomy. A bivalve speculum was placed in the vagina. The cervix was adequately visualized. The anterior cervix was grasped with a one-tooth tenaculum and uterus was gently pulled forward. The uterus was gently sounded to approximately 7 cm and dilated to 10 mm. A 10 mm suction curet was then gently advanced into the uterus. The suction device was attached and suction was started and suction dilation and curettage was performed gently without difficulties. Some products of conception were obtained through the suction canister. Three passes were done with the suction curet. Excellent hemostatsis was noted. The one-tooth tenaculum was removed from the anterior lip of the cervix. The patient was noted to be hemostatic. All instruments were removed. The patient tolerated the procedure well and was taken to the recovery room in stable condition.

 

 

ICD-10-PCS code: Click here to enter text.