Managed Care and  Long-Term Care 
Write an Initial Post of 300 words (total) which incorporates your analysis of the assigned reading (Chapter 9 & Chapter 10) into the prompts below:
1) Has the quality of health care gone down as a result of managed care? Explain.
2) What is meant by quality of life? (Briefly discuss the five main features of this multifaceted concept.) What are some challenges in trying to apply quality of life standards? In the end, Conclude your post with a “discussion question” with the goal of sparking further conversations and analyses about the chapter.

Psychotherapy Notes for Patients 
Needed are Individual Psychotherapy Notes on 26 different patients, each one page long, all
notes must cover the following
o Date of service (Jan 30 – Mar 24)
o Age/Sex (18-55)
o Diagnoses – This is a drug and alcohol treatment program. Required diagnoses should
include: Alcohol use disorder; Cannabis use disorder; Opioid use disorder; Sedative, Hypnotic, or
Anxiolytic Disorder; Stimulant use disorder; Some may also be dual diagnosis with one or more
of the aforementioned required disorders, in conjunction with a Depression, anxiety, or bipolar
disorder.
o The time spent providing face-to-face psychotherapy with the patient (45min – 1 hour)
o The type of therapeutic intervention (for example, insight oriented, supportive, behavior
modification etc..)
o Target symptoms (cravings, seeking behaviors, low motivation, low energy, ect..) (depression,
or anxiety related symptoms, ect..)
o Progress toward achievement of treatment goals (decreasing cravings, anxiety, thoughts of
helplessness/worthlessness, ect..)
o The degree of patient interaction with the therapist
o The reaction of the patient to the therapy session
o Any changes in the patient’s symptoms or behavior as a result of the therapy session

Concepts of Neurological and Musculoskeletal Disorders 
An understanding of the neurological and musculoskeletal systems is a critically important component of disease and disorder diagnosis and treatment. This importance is magnified by the impact that that these two systems can have on each other.
A variety of factors and circumstances affecting the emergence and severity of issues in one system can also have a role in the performance of the other. Effective analysis often requires an understanding that goes beyond these systems and their mutual impact. For example, patient characteristics such as, racial and ethnic variables can play a role.
Photo Credit: jijomathai – stock.adobe.com An understanding of the symptoms of alterations in neurological and musculoskeletal systems is a critical step in diagnosis and treatment. For APRNs this understanding can also help educate patients and guide them through their treatment plans.
In this Assignment, you examine a case study and analyze the symptoms presented. You identify the elements that may be factors in the diagnosis, and you explain the implications to patient health.
Case Study Week 8 Case Study Scenario 1: 74-year-old male with a history of hypertension and smoking, is having dinner with his wife when he develops sudden onset of difficulty speaking, with drooling from the left side of his mouth, and weakness in his left hand. His wife asks him if he is all right and the patient denies any difficulty. His symptoms progress over the next 10 minutes until he cannot lift his arm and has trouble standing. The patient continues to deny any problems. The wife sits the man in a chair and calls 911. The EMS squad arrives within 5 minutes. Upon arrival in the ED, patient‘s blood pressure was 178/94, pulse 78 and regular, PaO2 97% on room air. Neuro exam – Cranial nerves- Mild left facial droop. Motor- Right arm and leg extremity with 5/5 strength. Left arm cannot resist gravity, left leg with mild drift. Sensation intact. Neglect- Mild neglect to left side of body. Language- Expressive and receptive language intact. Mild to moderate dysarthria. Able to protect airway.
In your Case Study Analysis related to the scenario provided, explain the following: Both the neurological and musculoskeletal pathophysiologic processes that would account for the patient presenting these symptoms.
Any racial/ethnic variables that may impact physiological functioning.
How these processes interact to affect the patient.

Original Research Article Critique Related to Nursing
A research critique demonstrates your ability to critically evaluate an investigative study. Choose
an original or primary research study related to nursing or medicine. The purpose of this
assignment is to review a research study in-depth and to decide whether or not it is a valid
research study that can be used in practice. It is your written evaluation of the study, not just a
summary of the study. References must be w/in 5 years (2015-2020)
The body of your paper should follow APA Style guidelines, and it should 4 pages double-spaced
plus a cover page and reference list.
The full article must be attached to the critique for credit.
Note: Because submission of the article is part of the assignment requirements and is necessary
for grading, any assignment submitted without the accompanying article will be considered
incomplete.
Articles used for one assignment cannot be used for the other assignments. (Students should
find new research articles for each assignment.)
The selected articles should be ORIGINAL RESEARCH STUDIES Review articles, concept
analysis, meta-analysis, meta-synthesis, integrative review, and systemic review should not be
used.
Mixed-methods studies should not be used.
Your critique should include the following:
1. Research Problem/Purpose
Describe the problem as it is presented in the study.
State the purpose of the research.
Have the investigators placed the study problem within the context of existing nursing or
healthcare knowledge?
Will the study solve a problem relevant to nursing?
2. Review of the Literature (may be part of the author’s introduction or conclusion)
Identify the concepts explored in the literature review.
Are the references current in relation to the publication date of the study? If not, what are the
possible reasons for using older sources?
3. Theoretical Framework
Do the authors identify their overall assumptions or a theoretical framework for the study? Are
these assumptions appropriate for the study?
Does the research draw only on nursing theory, or does it draw on theory from other disciplines?
If a formal theory is not identified, suggest one (preferably a nursing theory) that might be
suitable for the study. Various nursing theories can be found at http://www.nursingtheory.org/theories-and-models/
4. Variables/Hypotheses/Questions/Assumptions
What is the research question or the hypothesis? Is it clearly stated or implied?
What are the independent and dependent variables in the hypothesis or research question?
Are the variables clearly defined so that the reader understands the researchers’ interpretation of
the variables?
Is the dependent variable concrete and measurable?
5. Methodology
What type of design (quantitative, qualitative) was used in this study?
Was inductive or deductive reasoning used in this study?
State the sample size and study population, sampling method, and study setting.
Did the investigator choose a probability or non-probability sample?
Describe how the independent variable was tested or surveyed in the study.
Describe how the dependent variable was measured.
Discuss the reliability and the validity (quantitative) or the credibility (qualitative) of the
measurement tools.
How were ethical considerations addressed? What ethical considerations were necessary for this
type of study?
6. Data Analysis
What data analysis method was used?
How were the results in the study presented to the reader?
Discuss at least one (1) finding from the authors’ results and relate it to the dependent variable of
the study.
7. Summary/Conclusions, Implications, and Recommendations
What are strengths and limitations of the study other than those stated by the authors?
Can the researcher generalize the findings to other populations? Explain.
What is the significance of the findings and conclusions for you in your personal nursing
practice? For nursing as a profession?
The body of your paper should be 4 pages double-spaced plus a cover page and a reference
page. The critique must be attached to the article and follow APA Style guidelines. References
used must be w/in 5 years 2015-2020