Friday, May 17, 2019

Risk Prediction Presentation


Introduction
•    The use of violence risk assessment tools within criminal justice and forensic psychiatry has been on the rise in the recent past.
•    However, there is limited data that is relevant, reliable, and unbiased inaccurate prediction of risk.
•    There are several structured tools for the assessment of the risk of violence in criminal justice.
•    The tools help to inform decisions on detention, discharge, client management, and general psychiatry about violence.
•    This presentation is based on a review of case studies of Colleen M. and Xander L. using selected risk assessment devices.  
    
Brief review of cases
Case 1: Colleen
•    She is a 15-year old girl whose parents are irresponsible of taking care of her opting to live with an auntie.
•    She had a dispute a neighbor about her dog that resulted in her death and charged with involuntary manslaughter.
•    Colleen also tested positive for opiates, but she denied it.
Case 2: Xander l.
•    Is a 17-year old male known as a gang member and with a history of purse snatching, breaking, and drug possession?
•    He was arrested with a concealed weapon and has been in custody once and placed on probation twice.
•     Xander lives with his supportive mother who is not happy with his conduct.
Summary of the risk assessment
•    The choice of tools used in risk assessment is the Hare Psychopathy Checklist-Revised (PCL-R) and the Statistical Information on Recidivism Scale (SIR).
•    SIR tool combined 15 items in a scoring system and generated the probability estimates of re-offending within three years of release.
•    Each item measures the demographic/criminal history aspect
•    It uses positive and negative scores for individual items
•    The summation item score gives a total ranging from -30 (poor risk) to +27 (very good risk). The scores are then clustered in groups ranging from very good (4/5) to the poor (1/3 prediction of succeeding).    
Continuation of risk assessment
•    The PCL-R is a diagnostic tool used for rating individual psychopathic/antisocial tendencies.
•    It was originally used to assess persons accused or convicted of crimes.
•    It uses a 20-item symptom rating scale that allows examiners to compare the level of psychopathy with a prototype.
•    The maximum score in a PCL-R tool is 40, and any score above 30 implies a diagnosis for psychopathy. 
Comparison of results for each
•    For, Colleen, the score from the PCL-R tool was obtained as 21. 
•    The score from the SIR tool was obtained as 3 for the group cluster.
•    For, Xander, the score from the PCL-R too; was obtained to be 25. 
•    The score from the SIR tool was determined as four on the group cluster results.
•    A score of 21 on the PCL-R tool and three on the SIR tool shows that Colleen has not transited to a fully violent criminal, but her behavior seems to deteriorate with time.
Continuation of results comparison
•    The score of 25 on the PCL-R tool and four on the SIR tool results indicate that Xander is a repeat offender and has criminals’ traits that need to be reassessed.
•    The two assessments help to predict the level of violence demonstrated in the case studies.
•    Xander seems to be a more violent and repeat criminal in comparison to Colleen who finds herself in violent situations.
•    However, taking opiates complicates the matter, and it's easy to conclude that she is being oriented to criminal behavior.
Additional Information
•    The SIR tool predicts only recidivism for the released offenders and categorizes results from very good to poor.
•    On its part, PCL-R tool reviews an individual record and history of crime.
•    However, the two have limitations in assessing the risk of violence on particular individuals.
•    It would be appropriate to have additional information on the effect of relationship to criminal behavior, other underlying factors other than the physical criminal behavior, and the level of threat of risk to criminal behavior.
Continuation on additional information
•    The relationships between the offenders and their families play a critical role in predicting criminal behavior and the risk of violence, hence necessary to assess.
•    Other factors that I liked to have included the influence of the state of mind in engaging in criminal behavior which could not be comprehensively assessed through PCL-R tool.
•     It would be necessary to have details on the level of risk to criminal behavior from the two case studies which does not come out from the assessment tools.
Recommendation on correctional strategy for each
Colleen
•    She needs counseling on how she can accept the status of her dysfunctional family and strategies of moving on.
•    She should be taken to a rehabilitation center where she can be guided on how to deal with emotional challenges other than the use of opiates.
•    Colleen requires understanding how to deal with misunderstandings and conflicts without the use of violence and risky reactions. 
Continuation of recommendation
Xander
•    He needs support and counseling on how he can avoid drug abuse that probably has largely influenced his conduct.
•    He should be taken to a rehabilitation center to learn on how to live in peace with others, especially her mother.
•    Due to the possession of a concealed weapon, Xander ought to be punished legally to understand the consequences of his conduct.
Conclusion
•    Violence and criminal behavior risk assessment are crucial considerations in criminal justice.
•    The discussed assessment tools are PCL-R and SIR tools which have been found to be effective in risk assessment.
•    However, some limitations cannot be fully accounted for when using the tools.
•    Colleen is at lower risk of engaging in criminal activity and violence in comparison to Xander who is a serial offender with a history of criminal activities.
•     The two requires counseling, rehabilitation, and should understand the consequences of their behavior.      

References
•    Bonta, J. (2002). Offender risk assessment: Guidelines for selection and use. Criminal Justice and Behavior, 29(4), 355-379.
•    Desmarais, S., & Singh, J. (2013). Risk assessment instruments validated and implemented in correctional settings in the United States.
•    Douglas, T., Pugh, J., Singh, I., Savulescu, J., & Fazel, S. (2017). Risk assessment tools in criminal justice and forensic psychiatry: the need for better data. European Psychiatry, 42, 134-137.
•    Hare, R. D. (2003). The psychopathy checklist–Revised. Toronto, ON.
•    James, N. (2015). Risk and Needs Assessment in the Criminal Justice System. Congressional Research Service.

Sherry Roberts is the author of this paper. A senior editor at MeldaResearch.Com in essay writing services. If you need a similar paper you can place your order from cheap assignment writing service services.

Therapeutic Mediations for Clients with Severe Anxiety or Panic


Describe a client from your clinical setting or work who experienced severe anxiety or panic.
Anxiety is a vague feeling of uneasiness or dread; it entails the activation of the nervous system in response to internal/external stimuli that may have physical, emotional, cognitive, or behavioral symptoms. The patient to whom I attended presented the signs of abrupt panic that could last even up to 10 minutes. After a panic attack, she experienced a fast heartbeat, shortness of breath, sweating, and trembling.

Include a brief history and three most pertinent medications.
I learned that this problem had begun in young adulthood and continued occurring throughout her life. She would occasionally experience distress over time leading to the impairment of her daily routines, social life, and occupational functioning. The treatment of this condition a three-pronged approached that help the patient to overcome this disorder. They include education, medication, and psychotherapy.
Describe the assessment process for this patient
There was a physical examination followed by a medical and personal history of the patient.  Because extreme anxiety or panic accompanies many medical conditions, I had to uncover any medical issues that might underlie the anxiety attacks. I then let the patient describe any occurrence of panic disorders in her family and asked her to mention other contributing factors if any, such as stressful events, caffeine use, or recent life changes.
Identify at least one effective and one non-effective nursing intervention. Why did they work? What didn't work?
One effective nursing intervention is one suggested by Mennin (2006) involving the implementation of relaxation skills to reduce anxiety and manage anxiety symptoms. I thought her about progressive muscle relaxation, biofeedback, cue-controlled relaxation, and mindful breathing, and how to apply these skills in her daily lives. I assigned the client homework after each session, and this intervention seemed to work well.  I also applied Jongsma Jr’s (2016) strategy of limiting the relation between different settings and worry, postponing the worry until some designated “worry time.” The latter failed to work.
Name and describe two stress reduction techniques you have used and whether they were helpful or not in reducing stress
The two stress reduction techniques include positive reframing and decatastrophizing. Positive reframing involves helping the client to turn the negative messages into positive ones whereas decatastrophizing entails using questions (what if) to realistically appraise the situation.
References
Jongsma Jr, A. E. (2016). Adult psychotherapy homework planner. John Wiley & Sons.
Mennin, D. S. (2006). Emotion regulation therapy: An integrative approach to treatment-resistant anxiety disorders. Journal of Contemporary Psychotherapy, 36(2), 95-105.

Sherry Roberts is the author of this paper. A senior editor at MeldaResearch.Com in essay writing services. If you need a similar paper you can place your order from cheap assignment writing service services.

Clostridium difficile


Clostridium difficile or C.diff and Clostridium difficile infection (CDI) are terms used to describe a condition which results from a bacterium found in the intestines and stool some people and animals. According to Kassam and colleagues (2013), C.diff is the major cause of health care related infectious diarrhea. Even though bacteria are good for our bodies, some bacteria in our bodies may sometimes cause illnesses such as C.diff. The most common cause of C.diff is the use of antibiotics. The antibiotics work by killing bacteria. Because they cannot differentiate between good and bad bacteria, they may kill good bacteria thereby opening an opportunity for C.diff to thrive and cause illness (Dubberke et al., 2014). C.diff can be spread via the failure to wash hands properly after using washrooms and touching that comes into contact with another person’s mouth. Health care workers can also spread C.diff if they fail to wash their hands in between caring for patients properly.

There are various precautions a health worker should take protect oneself and the patients. As a health worker, one of the precautions is to wash my hands after caring for a patient thoroughly. This will prevent C.diff from spreading from one patient to another. The other thing I will do is to put on gloves and a gown over my clothing when handling a patient with C.diff. I will also ensure that I remove the gloves and gown as I wash my hands before leaving the room where I have been caring for the patient.  The other precaution to take is to ensure that the medical equipment and the patient rooms are thoroughly cleaned using an effective product once they have been used by other patients (Burnham & Carroll, 2013). I will also make sure only to use once or use disposable towels for drying my hands.
References
Burnham, C. A. D., & Carroll, K. C. (2013). Diagnosis of Clostridium difficile infection: an ongoing conundrum for clinicians and for clinical laboratories. Clinical Microbiology Reviews, 26(3), 604-630.
Dubberke, E. R., Carling, P., Carrico, R., Donskey, C. J., Loo, V. G., McDonald, L. C., ... & Gerding, D. N. (2014). Strategies to prevent Clostridium difficile infections in acute care hospitals: 2014 update. Infection Control & Hospital Epidemiology, 35(S2), S48-S65.
Kassam, Z., Lee, C. H., Yuan, Y., & Hunt, R. H. (2013). Fecal microbiota transplantation for Clostridium difficile infection: systematic review and meta-analysis. The American Journal of Gastroenterology, 108(4), 500-508

Sherry Roberts is the author of this paper. A senior editor at MeldaResearch.Com in essay writing services. If you need a similar paper you can place your order from cheap assignment writing service services.

Thursday, May 16, 2019

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