Case study Josh Wallace

Demographic data

Josh Wallace is an indigenous 20-year-old second-year university student. He likes to write music and plays several musical instruments, including the didgeridoo. He is studying music at university and hopes to compose music for orchestras. Josh works part-time as a barista in a coffee shop and performs with an indigenous dance group. He lives in the city with his mother’s sister, her three teenage children, and Uncle Bill, the brother of his grandmother. Josh’s parents live in a large regional town. His parents are teachers who work in a ‘Flexi- school’. He has two younger siblings. His parents are very active in the local indigenous community.

Past Medical-Surgical and Psychiatric history.

At the age of 14, Josh experienced mental health issues because of problems at home. Firstly, his uncle, a man in his early 50’s, completed suicide. And then both his parents experienced illness. His mother was diagnosed with depression several months after his father recovered from a life-threatening illness. After Josh returned to school where he was a boarder, he found himself crying in his room at night because he felt sad all the time. He began to self-harm. He didn’t want to talk to his friends because he thought he might be considered weak, and he didn’t want to worry his family. His Year 9 Coordinator, Mr. Adams, noticed a change in Josh, who was usually an outgoing and active participant in the school community. Mr. Adams arranged a meeting, and at that time he noted the cuts on Josh’s arms. Josh was referred to the school counselor and the school nurse, and he was eventually referred to as Child and Youth Mental health services (CYMHS). He was seen on a regular basis by a team including a mental health nurse. He was prescribed Fluoxetine 20 mg. With support from family, the school, and CYMHS, he put in place strategies to benefit his recovery. He was discharged from CYMHS when he turned 18. He decided to accept support from the services offered at Headspace and attended three appointments over a 6 - month period when he was 19. Mid last year, Josh has experienced the death by completed suicide, of his 21-year-old cousin Luke. His cousin lived in a regional area, and Josh was unable to join family members because of his study commitments. At present, he is enrolled in a summer intensive unit, because he failed a unit in the second semester. The teacher is dismissive of students who do not speak up, and Josh has been targeted for comments on several occasions. Josh is the only indigenous student in the tutorial group, and he does not know anyone else. Josh also misses his girlfriend Aimee. She is on placement for four weeks, and Josh does not have a car to visit her. Josh has experienced shortness of breath and chest pain during rehearsals with his dance group. He hadn’t told anyone, believing it was probably muscle pain. Last night he experienced chest pain prior to leaving the house to attend rehearsals. It became so bad he thought he was going to die and alerted his Aunt Alice for help. He was transported to the local emergency department for assessment. Josh is told he has experienced a panic attack. No physical abnormalities were detected in ECG or blood, and he will be referred to his GP, and to Headspace for follow up appointments.

Presenting History

Josh arrives for his appointment at Headspace. He is accompanied by his Aunt Alice. Josh is unkempt, disheveled, and looks sad. His voice is monotone and flat, and he has poor eye contact. He tells you “I am sorry to worry everyone, it was just a panic attack- I can never get things right.” He says he feels worried and on edge all the time, and has difficulty concentrating. His Aunt tells you Josh has been isolating himself Faculty of Health | School of Nursing, Midwifery & Paramedicine in his room, and has missed a couple of shifts at the coffee shop and some tutorials on campus. He also becomes easily irritated, yelling at his cousins and his Aunt. This is not his usual behavior.

Q. What historical and cultural issues need to be considered when caring for Josh?

II. What are the signs and symptoms of depression? Considering the case study, describe the different types of behavior and verbal responses, that may indicate Josh may be experiencing depression?

III. What is meant by culturally safe practice and what are the key skills that nurses need to develop to provide culturally safe practice for Josh?

IV. Identify the psychotropic medication previously prescribed for the treatment of the symptoms of depression experienced by Josh, and consider the importance of effective monitoring, consumer experiences (side effects) and safety factors;

1.1 Leishmaniasis is a vector-transmitted protozoal complex disease caused by variety of Leishmania species:

Write explationary notes on how this disease is transmitted to both animals and humans.In your answer include aspects such as clinical, diagnosis ,management and control.

Question 4

After. reportedly swimming in a stream infested with snails breeding sites,several teenage boys visted a local clinic presenting with fever,abdominal discomfort and blood in their urine:

4.1 Suggest the possible etiological agent and provide a detailed life cycle of the parasite.

4.2 What management and control measures shouls the clinician advise the community to take to prevent further spread of the disease.

Suppose a bank would like to develop a regression model to predict a? person's credit score based on his or her? age, weekly?income, highest education level? (high school, bachelor? degree, graduate? degree), and whether or not he or she owns or rents his or her primary residence. The accompanying table provides these data for a random sample of customers. Complete parts a through d below

Credit_Score   Income_($)      Age      Education        Residence

592                              1,383   55        Bachelor         Own

702                              1,707   65        Bachelor         Rent

663                              801      44        High School    Own

634                              694      42        Bachelor         Own

595                              1,156   35        High School    Rent

598                              1,555   38        Graduate         Rent

673                              895      25        Graduate         Own

610                              1,246   40        Bachelor         Own

754                              1,076   33        Bachelor         Own

620                              1,554   41        High School    Own

690                              719      42        Bachelor         Own

573                              558      41        Bachelor         Rent

699                              1,227   35        Bachelor         Own

651                              1,343   44        Bachelor         Own

807                              1,400   52        Graduate         Own

599                              1,273   51        High School    Rent

735                              1,513   55        Bachelor         Own

698                              1,801   52        High School    Own

696                              1,163   51        Bachelor         Rent

739                              1,294   41        Bachelor         Own

671                              1,404   50        Bachelor         Rent

694                              1,879   49        Bachelor         Own

580                              762      33        High School    Own

682                              1,154   34        Bachelor         Own

617                              1,121   45        High School    Rent

675                              992      45        Bachelor         Rent

621                              615      33        Bachelor         Rent

556                              1,087   34        High School    Own

621                              1,177   57        High School    Own

681                              1,813   46        High School    Own

536                              1,019   28        High School    Rent

635                              1,380   38        High School    Own

621                              1,852   33        Bachelor         Rent

642                              1,090   49        Bachelor         Own

635                              777      55        Bachelor         Own

657                              921      43        Bachelor         Rent

784                              1,435   60        Bachelor         Own

718                              1,577   54        High School    Own

639                              913      52        Bachelor         Rent

687                              1,097   46        Graduate         Rent

a. Using? technology, construct a regression model using all of the independent variables.? (Let variable Ed1 be one of the dummy variables for the education level. Assign a 1 to a bachelor degree for this variable. Let Ed2 be another dummy variable for the education level. Assign a 1 to a graduate degree for this variable.? Also, let variable Res be the dummy variable for the Residence variable. Assign a 1 if the person owns his or her primary? residence.)

Complete the regression equation for the model? below, where

y=Credit Score,

x 1x=Income?,

x2=Age,

x3=Ed 1,

x4=Ed2?,

and

x5=Res

y^= _ + (_)x1 + (_)x2 + (_)x3 +(_)x4 + (_)x5

?(Round to two decimal places as? needed.)

b. Interpret the meaning of each of the regression coefficients for the dummy variables. Select the correct choice below and fill in the answer boxes to complete your choice.

?(Round to the nearest integer as? needed.)??

A.

Bachelor degree holders average credit scores that are _ points higher than people with only a high school degree.

Graduate degree holders average credit scores that are _ points higher than people with only a high school degree.

People who own their primary residence average credit scores that are _ points higher than renters.

B.

Bachelor degree holders average credit scores that are _ points higher than people with only a high school degree.

Graduate degree holders average credit scores that are _ points higher than people with only a bachelor degree.

People who rent their primary residence average credit scores that are _ points higher than owners.

c. A test for the significance of the overall regression model shows that it is significant using

alpha =.05

Using the? p-values, identify which independent variables are significant with .05

A.Ed 1

B.Ed 2

C.Res

D.Age

E.Income

D. Construct a regression model using only the significant variables found in part c and predict the average credit score for a 40?-year-old

person who earns 1,200 per? month, has a

graduate degree, and owns his or her residence.

The predicted average credit score is

Universidad Ana G Méndez

Recinto Gurabo

Asignación #4

Cyd Mary Alicea Cora

#S01011727

Prof: Juan Valera

Stat-555

Solve each problem.

1. Boys of a certain age are known to have a mean weight of μ = 88 pounds. A complaint is

made that the boys living in a municipal children's home are underfed. As one bit of

evidence, n = 36 boys (of the same age) are weighed and found to have a mean weight

of x¯ = 81.94 pounds. It is known that the population standard deviation σ is 12 pounds.

Based on the available data, what should be concluded concerning the complaint?

Ho: μ = 88

Ha: μ < 88

Z= (x- μ) / (σ/sqrt (n))

= (81.94-88) / (12/sqrt(36))

= -3.03

Critical value at 5% is Z0.05 =1.645

-3.03 < -1.645, podemos rechazar a Ho y así concluir que tenemos pruebas

suficientes para respaldar la queja formulada. De que los niños que viven en un

hogar municipal de niños están infestados.

2. It is assumed that the mean systolic blood pressure is μ = 118 mm Hg. In the Caguas

Heart Study, a sample of n = 81 people had an average systolic blood pressure of 127

mm Hg with a standard deviation of 20 mm Hg. Is the group significantly different (with

respect to systolic blood pressure!) from the regular population? (Remember that σ is

unknown).

3. The president of a large electric utility claims that 85 percent of his 2,000,000 customers

are very satisfied with the service they receive. To test this claim, the local newspaper

surveyed 200 customers, using simple random sampling. Among the sampled customers,

77 percent say they are very satisfied. Based on these findings, can we reject the

president's hypothesis that 85% of the customers are very satisfied? Use a 0.05 level of

significance.

4. A rental car company claims the mean time to rent a car on their website is 65 seconds

with a standard deviation (σ) of 30 seconds. A random sample of 49 customers

attempted to rent a car on the website. The mean time to rent was 77 seconds. Is this

enough evidence to contradict the company's claim?

5. According to the ACME, the mean height of adults ages 21 and older is about 67 inches.

Let's test if the mean height of our sample data is significantly different than 66.5 inches

using a one-sample t test.

Our sample is:

x=c(61,72,75,70,63,69,73,60,59,69,67,64,65,71,70)

In Japan, where consumers find it difficult to say “snap, crackle, and pop,” Kellogg changed its slogan for Rice Crispies to “patchy, pitchy, putchy.” Kellogg also needed to change the name of “Bran Buds” cereal in Sweden, where the name roughly translates to “burned farmer.”

In some countries, colors used on products and in ads have to be changed because white is a mourning color (Japan), purple equates to death (much of Latin America), and green equals jungle sickness or malaria (Malaysia).

Despite these rather dramatic examples of promotional adaptation, the big question still remains: Is it better to standardize global advertising or is it better to adapt, and why? Discuss (and give at least one good example from your readings or research. Keep your comments thoughtful and substantial, but preferably no more than 200 words.

The nurse manager of an ambulatory care clinic has noted an increased number of visits by patients from different countries and cultures, including patients from Mexico and other Latin American countries. Concerned about meeting the needs of this culturally diverse population, the nurse manager convenes a staff meeting to discuss this change in patient demographics, and to query the staff about any learning needs they have related to the care of these patients. (Learning Objective 3) What strategy to avoid stereotyping clients from other cultures should the nurse include in this meeting? Identify culturally sensitive issues to be discussed in the staff meeting. One technician on the staff complains that some patients never make eye contact, and this makes it difficult for him to complete his work. How should the nurse respond?

A 23-year-old woman was admitted to your institution with abdominal pain with nausea and vomiting for the past 2 weeks. She immigrated to the United States 1 year ago from a Latin American country, has limited English skills, and has not been able to work. As her nurse, you attempt to engage her in conversation. She rarely makes eye contact and has a flat affect. You note that she is holding onto a rosary

1. What pertinent data can you gather based on available patient information?
2. What factors should the nurse consider to be related to this patient’s access to health care?
3. What questions should you ask yourself when caring for this patient?
4. How might the human dimensions guide the nurse for this patient’s care plan?

The nurse manager of an ambulatory care clinic has noted an increased number of visits by patients from different countries and cultures, including patients from Mexico and other Latin American countries. Concerned about meeting the needs of this culturally diverse population, the nurse manager convenes a staff meeting to discuss this change in patient demographics, and to query the staff about any learning needs they have related to the care of these patients. ( Learning objective 3).
a. What strategy to avoid stereotyping clients from other cultures should the nurse include in this meeting?
b. Identify culturally sensitive issues to be discussed in the staff meeting.
c. One technician on the staff complains that some patients never make eye contact, and this makes it difficult for him to complete his work. How should the nurse respond?

Problem 4. Chloe likes to read Latin American fiction: Fuentes, Vargas Llosa, Garcia Marquez, Carbajal, you name it. Though she prefers longer novels than shorter ones, she sometimes has trouble telling books apart. In particular, she is indifferent between any two novels that have the same number of pages. But she also is indifferent between two novels when the difference in the number of pages is greater than ten (> 10) and less than twenty (< 20).
(a) Is Chloe’s strict preference relation complete and transitive? Explain or give a counterexample.

(b) Is Chloe’s indifference relation complete and transitive? Explain or give a counterexample.

(c) Is Chloe’s weak preference relation complete and transitive? Explain or give a counterexample

(subject research methodology)

answer true or false and explain why or why not:

1. A social constructivist is interested in understanding how people share their experiences and give meaning to different phenomena through the medium of language.

2. An inductive methodology always starts with a generic proposition and then, through logical steps, arrives at specific statements.

3. a positivist believes that there is only one single truth about reality, and the way to inquire about that reality is through impersonal and objective methods.

4. Secondary data is data created by research with the specific aim of answering the researcher’s questions

exercise 2: imagine you wanted to conduct research on the effect of high inflation on poverty in Latin America countries. Pose a potential hypothesis and enumerate data you would collect in order to test it.