Visit http://www.aha.org/advocacy-issues/communicatingpts/pt-care-partnership.shtml and review the American Hospital Association’s Patients’ Bill of Rights. Discuss how health care professionals can ensure that patients’ rights are upheld and protected.

Instructions: 

  Word limit 500 word . Please make sure to provide citations and references (in APA, 7th ed. format) for  work. Please check plagiarism. 

tep 1 Read the case scenario.
You are part of an interprofessional team working on an evidence-based project to look at falls in patients with dementia in the long-term care setting. The team was brought together in response to a noted increase in the incidence of falls in residents with dementia over the past three months. One of the recent changes before the increase in falls was a mandate to no longer use physical restraints on residents. Several staff members feel that the use of restraints is a must, and they do not have time to use the restraint alternatives that have been suggested. They also feel they do not have enough time to continuously check on residents. This has caused major issues of concern and has compromised the quality and safety of the residents.

When the team meets together, one of the first items discussed is the clinical question. The team uses the PICO question format to develop the following question:

In patients with a diagnosis of dementia in the long-term care setting (P), how does the use of a comprehensive falls assessment prevention plan that includes restraint alternatives (I) compare with the use of a fall prevention protocol that includes the use of restraints (C) affect the number of falls that occur (O)?

Step 2 Post to the discussion forum.
In your initial response, address the following questions:

1. Determine the best resources to use when conducting a search on the topic. Consider these questions: What databases would be most appropriate? Where would you locate clinical practice guidelines that could be used in the EBP process for this issue?
2. Conduct a search using the resources you identified in Step 2a. What key search terms did you use? What filters did you use?
3. From your search, identify at least three articles that you would consider using in an EBP project such as the one described in the case scenario. If possible, suggest resources that meet the highest level (Level I) of evidence. Why would these sources be most appropriate in determining best practices and supporting clinical decision-making for this issue?

Unit 12 Discussion Impulsivity and Compulsivity. 800w. 4 references. Due 11-13-23.

1. Please describe the role of the mesolimbic dopamine pathway in the development or continuation of impulsive/compulsive behaviors. 

2. Please provide two examples of current research on interventions to reduce or eliminate compulsive/impulsive behavior related to addiction. 

3. Summarize the following article “Behavioral Functions of the Mesolimbic Dopaminergic System: an Affective Neuroethological Perspective” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2238694/

Responses need to address all components of the question, demonstrate critical thinking and analysis and include peer-reviewed journal evidence to support the student’s position.

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

1. Role of the mesolimbic dopamine pathway in the development or continuation of impulsive/compulsive behaviors. The mesolimbic pathway is the dopamine pathway. This pathway extends from the “VTA of the brainstem (mesencephalon) to the nucleus accumbens in the ventral striatum which is part of the limbic system (Stahl, 2021, p. 90). This pathway is important as it is involved in the regulating motivation and reward. Hyperactivity of the mesolimbic pathway called hyperdopaminergia, is significant in the display of positive symptoms seen in psychosis, schizophrenia, and depression and can result in impulse, agitation, hostile, and aggressive symptoms. In addition, the hyperactivity of the DA pathway can be because of various psychostimulants. Such as, cocaine and methamphetamine (Stahl, 2021, p.90). In terms of impulsivity and compulsivity Stahl (2020, p.541) states, “Impulsivity can be thought of as the inability to stop the initiation of actions and involves a brain circuit centered on the ventral striatum, linked to the thalamus (T), to the ventromedial prefrontal cortex (VMPFC), and to the anterior cingulate cortex (ACC). Compulsivity can be thought of as the inability to terminate ongoing actions and hypothetically is centered on a different brain circuit, namely the dorsal striatum, thalamus (T), and orbitofrontal cortex (OFC). Impulsive acts such as drug use, gambling, and obesity can eventually become compulsive due to neuroplastic changes that engage the dorsal habit system and theoretically cause impulses in the ventral loop to migrate to the dorsal loop.” 2. Two examples of current research on interventions to reduce or eliminate compulsive/impulsive behavior related to addiction. According to Hartney (2021), compulsions are considered obsessions with repeated thoughts that create a feeling of distress (Hartley, 2021). The person’s behavior reduces anxiety and fear. An example to consider is obsessive compulsive disorder. In this disorder, the obsession revolves around the need to wash their hands. In the case of addiction, the desire to use will far outweigh the reality that there may be negative consequences. Such as financial strains, health issues, social problems, legal problems and/or decreased self-esteem (Hartney, 2021). Hartney (2021), suggests for treatment of the OCD behavior should include antidepressant medications like serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs). These medications may be augmented with antipsychotics at the discretion of the provider. In terms of impulsivity, Kozak and her colleagues (2018) denote there are strong overlaps in the neural circuitry and functional mechanisms between impulsivity traits and addiction, which has directed treatment approaches. Therefore, it has been recommended, SUD treatment should include subjective and objective data and target the pharmacological, behavioral, and neurophysiological areas to individualize the patient’s care (Kozak et al., 2018). This study source was downloaded by 100000769192234 from CourseHero.com on 10-22-2023 17:11:39 GMT -05:00 https://www.coursehero.com/file/139195954/Discussion-12-ImpulsivityCompulsivitydocx/ For example: Alcohol use disorder – Naltrexone, Aripiprazole, and Topiramate were successful in decreasing impulsivity behaviors and Problem gambling – paroxetine was found to be successful in impulsivity (Kozak et al., 2018). References: Hartney, E. (2021). The difference between an addiction and a compulsion. Retrieved on March 30, 2022, from https://www.verywellmind.com/the-difference-between-an-addiction-and-acompulsion-22240 Kozak, K., Lucatch, A. M., Lowe, D., Balodis, I. M., MacKillop, J., & George, T. P. (2019). The neurobiology of impulsivity and substance use disorders: implications for treatment. Annals of the New York Academy of Sciences, 1451(1), 71–91. https://doi.org/10.1111/nyas.13977 Stahl, S. M. (2021). Stahl’s essential psychopharmacology: Neuroscientific basis and practical application (5th ed.). p. 90 & 54, Cambridge: Cambridge University Press.

Advanced Psychopharmacology and Health Promotion

Unit 7 Medications for Psychosis and Schizophrenia Related Disorders 600W. APA. 4 references due 10-17-23.

Answer the following questions:

Which antipsychotics are considered first-generation and why are they used less often than second generation antipsychotics? Are second-generation antipsychotics more effective?

Compare and contrast the following conditions: Tardive Dyskinesia, Acute Dystonia, Athetosis, and Tics.

Responses need to address all components of the question, demonstrate critical thinking and analysis and include peer-reviewed journal evidence to support the student’s position.

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

Use as a guide please do not copy this information. Also please use the textbook

1. Which antipsychotics are considered first-generation and why are they used less often than second generation antipsychotics? Are second-generation antipsychotics more effective? First generation antipsychotics, also referred to as “typical antipsychotics” were developed in the 1950s. Commonly prescribed first-generation antipsychotics include: Loxitane (loxapine); Mellaril (thioridazine); Moban (molindone); Navane (thiothixene); Prolixin (fluphenazine); Serentil (mesoridazine); Stelazine (trifluoperazine); Trilafon (perphenazine); and Thorazine (chlorpromazine). These first-generation antipsychotics are used less often than second generation antipsychotics because these medications have a high risk of side effects and some of those side effects can be severe. Second-generation antipsychotics, also known as “atypical antipsychotics,” were developed in the 1980s. Second-generation antipsychotics have more metabolic symptoms, including obesity, diabetes and hyperlipidemia (Heldt, 2017; Stahl et al., 2021). Side effects from first-generation antipsychotics include extrapyramidal effects, such as tardive dyskinesia, rigidity, tremors, and seizures. There is no evidence that second generation antipsychotics are significantly more effective than first generation antipsychotics in the treatment of cognitive and negative symptoms of schizophrenia (Stahl et al., 2021; Stroup, et al., 2003). 2. Compare and contrast the following conditions: Tardive Dyskinesia, Acute Dystonia, Athetosis, and Tics. Tardive dyskinesia is one of the symptoms of long-term use of a first -generation antipsychotic. It is a condition where there is constant or rhythmic involuntary movements that usually involves the muscles of the mouth. It can appear as lip smacking, chewing, excessive eye blinking, grimacing. These symptoms appear slowly over time. Tardive dyskinesia will not go away once the antipsychotic is stopped, it can become irreversible if present for too long. The risk of a patient developing tardive dyskinesia goes up with every year of continuous treatment. TD is specific to the use of antipsychotics (Heldt, 2017). Acute dystonia can develop within the first few hours of a patient receiving an antipsychotic. It is a sustained and painful involuntary contraction of a muscle group- usually involving the face or neck muscles. This is an easily reversible side effect and is managed with an anticholinergic drug such as Benadryl or Cogentin. This condition This study source was downloaded by 100000769192234 from CourseHero.com on 10-16-2023 17:34:58 GMT -05:00 https://www.coursehero.com/file/123197773/Discussion-7docx/ can resolve within a few minutes of proper medication and will not leave any long-term effects (Heldt, 2017). Athetosis is slow, involuntary, writhing movements of fingers, hands, toes and feet. Patients with this condition cannot maintain a stable or still position and when patients attempt to try to control the movements, symptoms can get worse. Athetosis is often a longterm symptom of continued use of first-generation antipsychotics (Holland, 2018). Tics are distinguished from EPS symptoms by the fact that tics are most commonly brief movements are able to be suppressed. Tics are sudden, rapid and repetitive movement (motor tics) or vocalizations (vocal tics). Those with tics feel the urge building up inside them before the tic appears, they these individuals report a feeling of relief after the tic is over. Although tics are involuntary, tics stop during sleep and patients can suppress the urge for short periods of time with effort (Martino, 2020). Heldt, J. P. (2017). Memorable psychopharmacology. Createspace Independent Publishing Platform. Holland, K. (2018, July 18). What Is Athetosis? Healthline; Healthline Media. https://www.healthline.com/health/athetosis Martino, D. (2020). Update on the Treatment of Tics in Tourette Syndrome and Other Chronic Tic Disorders. Current Treatment Options in Neurology, 22(4). https://doi.org/10.1007/s11940-020-0620-z Stahl, S., Muntner, N., & Grady, M. M. (2021). Stahl’s essential psychopharmacology: Neuroscientific basis and clinical applications (5th ed.). Cambridge University Press. Stroup, T. S., McEvoy, J. P., Swartz, M. S., Byerly, M. J., Glick, I. D., Canive, J. M., McGee, M. F., Simpson, G. M., Stevens, M. C., & Lieberman, J. A. (2003). The National Institute of Mental Health Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE)