The Impact of Ethnicity on Antidepressant Therapy. I’m working on a Health & Medical question and need guidance to help me study.
Discussion: The Impact of Ethnicity on Antidepressant Therapy
Major depressive disorder is one of the most prevalent disorders you will see in clinical practice. Treatment for this disorder, however, can vary greatly depending on client factors, such as ethnicity and culture. As a psychiatric mental health professional, you must understand the influence of these factors to select appropriate psychopharmacologic interventions. For this Discussion, consider how you might assess and treat the individuals in the case studies based on the provided client factors, including ethnicity and culture.
To prepare for this Discussion:
Note: By Day 1 of this week, your Instructor will have assigned you to one of the following case studies to review for this Discussion. To access the following case studies, click on the Case Studies tab on the Stahl Online website and select the appropriate volume and case number.
Case 1: Volume 1, Case #1: The man whose antidepressants stopped working
Case 2: Volume 1, Case #7: The case of physician do not heal thyself
Case 3: Volume 1, Case #29: The depressed man who thought he was out of options
Review this week’s Learning Resources and reflect on the insights they provide.
Go to the Stahl Online website and examine the case study you were assigned.
Take the pretest for the case study.
Review the patient intake documentation, psychiatric history, patient file, medication history, etc. As you progress through each section, formulate a list of questions that you might ask the patient if he or she were in your office.
Based on the patient’s case history, consider other people in his or her life that you would need to speak to or get feedback from (i.e., family members, teachers, nursing home aides, etc.).
Consider whether any additional physical exams or diagnostic testing may be necessary for the patient.
Develop a differential diagnoses for the patient. Refer to the DSM-5 in this week’s Learning Resources for guidance.
Review the patient’s past and current medications. Refer to Stahl’s Prescriber’s Guide and consider medications you might select for this patient.
Review the posttest for the case study.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!
BY DAY 3
Post a response to the following:
Provide the case number in the subject line of the Discussion thread.
List three questions you might ask the patient if he or she were in your office. Provide a rationale for why you might ask these questions.
Identify people in the patient’s life you would need to speak to or get feedback from to further assess the patient’s situation. Include specific questions you might ask these people and why.
Explain what physical exams and diagnostic tests would be appropriate for the patient and how the results would be used.
List three differential diagnoses for the patient. Identify the one that you think is most likely and explain why.
List two pharmacologic agents and their dosing that would be appropriate for the patient’s antidepressant therapy based on pharmacokinetics and pharmacodynamics. From a mechanism of action perspective, provide a rationale for why you might choose one agent over the other.
For the drug therapy you select, identify any contraindications to use or alterations in dosing that may need to be considered based on the client’s ethnicity. Discuss why the contraindication/alteration you identify exists. That is, what would be problematic with the use of this drug in individuals of other ethnicities?
If your assigned case includes “check points” (i.e., follow-up data at week 4, 8, 12, etc.), indicate any therapeutic changes that you might make based on the data provided.
Explain “lessons learned” from this case study, including how you might apply this case to your own practice when providing care to patients with similar clinical presentations
The Impact of Ethnicity on Antidepressant Therapy
University of Delaware Home Blood Sugar Testing Article Discussion.
Choose a print or online health communication that targets a specific group defined by ethnicity, sexual orientation, age, geography, language, etc. This “communication” can be patient education materials or public health education materials (e.g., instructions on how to do a breast self-exam, proper condom use, safe food preparation). For this assignment, do not use a video; this must be a written piece in order to perform the M2 Reading Level Assignment. Please attach or include a link to this communication.Briefly critique the communication from the perspective of increasing a person’s health literacy regarding the topic. How clear is the message? Is the content clearly expressed? Is there a possibility of misunderstanding? What steps has the author taken to ensure the communication is thorough? Can the content be understood by a person reading at a sixth-grade level? What elements of this communication do you find to be successful? Do you have suggestions for improvement?In your response posts, share whether you agree or disagree with your classmates’ assessments. Please support your points with quality references and sound logic. You need to be able to state the case for your point of view. There are no right or wrong answers. What matters is how you state your point(s) and how you support it. 350 words
3.1 Introduction This chapter will examine the Port of Durban from an economics perspective and will seek to expand on the general theory presented in the literature review and apply it specifically to the Port of Durban. This chapter will also serve as a foundation for the proceeding chapter which will analyse the various CBA options and data for Durban. The ports significance and impact will be examined in the context of the South African and local economy through its income and employment generating effect. Though the quantity of cargo moving through a port is important, of more interest is the type of cargo that a port focuses on. 3.2 The South African Port Sector Before examining the Port of Durban in isolation, it would be prudent to briefly discuss the South African Port scenario in a broader sense. In South Africa, ports are considered national assets and are managed by the government run recently by SAPO. South Africa is a major sea-trading nation comprising of approximately 8 trading ports, namely, Durban, Richards Bay, East London, Port Elizabeth, Mossel Bay, Cape Town, Saldanha and the under construction Coega. South Africa has evolved into a major sea-trading nation over the last four or so decades and in 2002 handled 3.6% of world sea trade by volume. In terms of ton miles or real activity, this figure increases to 6% of global trade, placing the country within the top 12 globally and resulting in a global maritime activity share that is more than 20 fold its global GDP share. Sea trade constitutes more than 90 percent of trade in South Africa and ports play a critical social and economic role both nationally and regionally. The majority of the port activity is concentrated on the east coast of South Africa. A stark illustration of this fact is that Durban and Richards Bay together make up 76% of sea trade in the country. Traffic growth in the 1990’s was derived from two primary regional points and sources, namely Durban from a general cargo perspective and Richard’s bay from a raw materials perspective. Richards Bay, which deals primarily in bulk goods, such as coal, ore and steel, has seen its annual tonnage increase from 55 million tons in 1989 to in excess of 90 million in 2000. Viewing perceived value in terms of tonnage is a flawed approach since in terms of economic linkages and value-adding, handling a ton of coal is not the same as handling a ton of refined goods. The figure below illustrates the breakdown of sea trade activity by port in South Africa. It can be seen clearly that Durban and Richards Bay are giants in comparison to the other ports. (Chasomeris, 2003 and Jones, 2002) Fig 17: Total Traffic Volume in South Africa Source: Department of Transport, 1998 and Jones, 2001 The South African Ports sector experienced significant capital intensive investment in the 1970’s and 1980’s, which was biased towards the bulk shipping sector. However, world trends have seen a migration towards containerisation and unitisation and South Africa is no exception, with the country utilising containers for the first time in1977. Up until 1990, the available capacity could cater for national traffic levels of approximately 1 million TEU’s level. The lack of adequate container capacity, combined with growing demand, brought with it a multitude of problems. On the demand side, South Africa became a democracy and re-entered the globalised world, resulting in a noticeable rise in seaborne container volumes, due to liner carriers returning to the South African trades and increased trade liberalisation. The upsurge in volumes produces inevitable negative consequences of delays and vessel queues. By 2000 the combined amount of annual TEUs handled in South African ports was 1.8 million and this was encompassed using with the same basic container quays that had been constructed in 1977. There was some limited capital investment in strategic area’s in the 1990’s, such as cargo extensions to bulk and neo-bulk facilities in Richards Bay. The new millennia brought with its bolder and more ambitious port investment initiatives. A new industrial hub status port in the Eastern Cape, which was earlier envisioned but never actioned upon, was now being constructed. Secondly, the Durban general cargo infrastructure has received significant upgrades and extensions such as extensions to landside facilities as well, deepening and extending cargo handling superstructure and infrastructure as well as deepening and widening the harbour entrance. Because of the age and mismatch of the cargo handling infrastructure, productivity has lagged that of international levels, resulting in congestion that is a constant feature of local ports. There were also supply side issues to deal with such as liner route becoming more specific and centred around hub status ports. As such, hub status ports have to provide capacity that exceeds national demand, making attainment of hub port status difficult in capacity constricted scenarios. This is compounded by the reluctance of ship-owners to migrate shorter routes such as Port Elizabeth in South Africa. South African ports relative competitive stance with their southern hemisphere counterparts can be gauged from the table below. Looking at both indicators, South African ports emerge as clear leaders on both the African and Southern Hemisphere front. Richards Bay is ranked first on the table in terms of total traffic, as it has a large amount of coal and other bulk cargoes passing through its doors. Durban, although ranked 3rd overall, is ranked 1st in the container category it is clear that Durban is the leading multi-purpose port in South Africa and the Southern Hemisphere. (Jones, 2003; Jones, 1997; Department of Transport, 1998 and Lawrence, 2000) Figure 18: African and Southern Hemisphere Port Traffic Port Total Port Traffic (m tons) Rank Container Traffic (TEUs 000s) Rank Richards Bay 91.5 1 5 15 Newcastle 73.9 2 9 14 Durban 49.7 3 1291 2 Santos 43.1 4 945 4 Sydney 24.6 5 999 3 Melbourne 22.3 6 1322 1 Casablanca 19.8 7 311 9 Abidjan 14.6 8 434 7 Auckland 13.3 9 561 6 Cape Town 11.8 10 395 8 Lagos 9.1 11 1782 11 Mombasa 8.9 12 219 10 Buenos Aires 7.8 13 716 5 Dakar 7.2 14 149 13 Port Louis 4.7 15 161 12 Source: ISL, Bremen, 2001, Jones 2003 (Selected ports, 2000) 3.3 History of the Port of Durban The port is situated on the east coast of South Africa at coordinates 31o 02’E in longitudinal and at 290 52’S in latitudinal terms. Trading activities in the port of Durban can be traced back since 1824, with the port quickly gaining a favoured status among seafarers amd traders due to it being a natural harbour. Interest in Durban Bay grew tremedously in the early years of its operations, with imports doubling between 1849 and 1850. This, coupled with larger vessels, resulted in a much needed expansion to the harbour entrance. Over a century later, Durban has 63 berths and 6 repair berths, which can be broadly seperated into five main segments of the port. The first segments has two piers and has a multipurpose function thats handles general, parcel and unitised cargo. The second segment of the port is located by Salisbury Island and Island View. A third segment is the Maydon Wharf area, which contains private terminals as well as terminals controlled by Transnet. The Point terminal area and the Bayhead area’ are the fourth segment and fifth segment respectively. Below is a picture of the port of Durban that illustrates the five segments discussed. Figure 19: The Current Layout of Durban Port Source: Google Earth, 2010 3.4 Economic Significance of the Port of Durban As, can be seen in figure 17 above, the logistical strength of the national shipping infrastructure, rests primarily in KZN. The port of Durban, like all other public ports in South Africa, is an example of a port under national jurisdiction, its official name being the National Ports Authority (NPA), thereby allowing centralised planning. Durban is a port of choice because of its infrastructure in place enabling it to be a full service general cargo and container port . In addition to this, durban is well serviced by an adequete rail and road infrastructure, which links it to the economic hub of South Africa, Gauteng. In addition to this, the KZN region is a large economic region in itself and is second only to Gauteng in South Africa. Figure 21 below, illustrates a snapshot of the South African port sector for 2009. In terms of total cargo tonnes handled, Durban has 20% of the market and is dwarfed by Richards which has more than double Durban’s tonnage handled, at more than 40%. Richards Bay, which was constructed in the 1970’s, has had an enormous impact on Durban’s port planning and functions. The primary reason for its existence was to serve as high-mass export point for raw materials such as coal. Richards Bay also diversified its goods base to include, at a lower cost, goods types that were traditionally the domain of Durban such as neo-bulk cargo like steel, alloys and forest type products. At the time of Richards Bay construction, Cape-sized bulk vessels were too large to enter Durban. (Jones, 2003 and Stats SA, 2010) Figure 21: Port Cargo and Vessel Statistics in South African Ports RICHARDS BAY DURBAN CAPE TOWN SALDANHA BAY TOTAL SA PORTS Durban as a % of Total TOTAL CARGO HANDLED: 77,631,154 37,419,282 3,058,601 56,475,625 182,735,369 20% GENERAL CARGO VESSELS: 247 705 220 373 1,648 43% BULK VESSELS: 1257 930 320 921 3,603 26% CONTAINER VESSELS: 42 1883 897 784 4,233 44% TANKERS: 184 646 159 344 1,542 42% VESSEL TOTAL: 1874 4848 2440 3489 15,879 31% TOTAL TEUS HANDLED: 6,273 2,395,175 1,382,052 NA 4,334,612 55% Source: NPA, 2009 (Note table has been edited) Looking again at figure 21 above, it can be observed that even though Durban lags other ports in gross tonnage of cargo, it still has by far the most number of vessels docking. One of the major reasons for this was the emerging dominance of Richards Bay, which forced Durban to concentrate on lower-volume bulk, break-bulk and liquid-bulk. This enabled great diversity within the port in terms of cargo type as well vessel type and quantity. Additionally, vessels that carry break bulk are traditionally far smaller than that of traditional bulk, thus explaining why more vessel docking are in Durban than Richards Bay for the same amount of cargo ceterus paribus. With reference to the figures above, it can be observed that Durban has 43% of total general cargo vessels, 42% of total tankers and 44% of total container vessels. The most important figure, in relation to Durban, is that of TEU’s handled since this is where its dominance and significance come to the fore. Durban has the ideal structure to handle containers and since Richards Bay has inadequate structure for containers, Durban’s dominance in containers was from the outset. Jones (2003) show that a growing international trend of shipping lines with regards to containers is to organise trade and activities around so called “hub” ports which meet and cross at “sub-regional transhipment nodes”. This arrangement is biased for the existence of a single hub type port on the eastern shores of the Southern region of Africa. Since, Durban is the country’s major container port, is well frequented by major shipping lines, has terminal and hub status, it is quite reasonable for it to remain South Africa’s primary container port. The other alternatives on the eastern sea board are not really competitors when it comes to containers. Richards Bay is primarily a bulk port and does not have the adequate infrastructure to extend its activities beyond this scope. Maputo has large deviation costs from traditional shipping lines as well as limited depth and capacity. Port Elizabeth has weak land side links to Gauteng as well as having limited local demand to justify a major port there. (Suykens, 1984; Jones, 2001 and Jones, 2003) Even though Durban lags Richards Bay in terms of pure tonnage, this in itself is a poor yardstick of economic impact and significance since no account is taken of cargo value or employment propensities of infrastructure required. Generally, in terms of economic and employment impacts, general cargo provides the most followed by dry-bulk cargo and lastly liquid-bulk. Bearing this in mind, comparing two ports only on the basis of tonnage is frivolous and more specifically in Durban’s case it can be seen that from a ports perspective, it handles higher valued cargo than Richards Bay. This is especially evident when one considers one job is created per 47000 tonnes of cargo handled at Richards Bay, whereas in Durban, one job is created per 7500 tonnes of cargo handled. Figure 22 below further illustrates the economic richness and opportunity that containers present. Additionally, in 2004 an average container vessel spent R2.94 million per port call, far exceeding the R1.8 million for a breakbulk cargo vessel as well as exceeding the R1.3 million for a bunker vessel. (Suykens, 1984; Jones, 2001, Tempi, 2006 and Jones, 2003) Figure 22: Port of Fremantle’s Economic impact by Cargo Type Cargo Type Output ($m) Value Added ($m) Household Income ($m) Employment (no.) Direct Effects Containers 177 121 73 1331 Other General Cargo 45 30 18 340 Liquid Bulk 35 20 8 158 Dry Bulk 83 44 25 459 Other 1 1 0 7 Total 341 215 124 2294 Direct Indirect Effects Containers 382 240 125 3195 Other General Cargo 96 59 31 800 Liquid Bulk 67 38 17 441 Dry Bulk 181 100 50 1339 Other 2 1 1 19 Total 728 440 223 5792 Source: Bureau of Economic Transport Economics Australia, 2000 As is the case with South African ports, the port of Freemantle in Australia, shown in figure 22 above, derives the most economic prosperity from containers from both a direct and indirect perspective. Even though containers account for only 13% of activity in the port, they contribute 55% to economic activity. Consequently, containers have the greatest employment generating effects, followed by dry bulk and the liquid bulk. Though dynamics differ from port to port in terms of infrastructure, administration, socioeconomics and geography, a broad consensus can be reached from the figure above encompassing a kind of “rule of thumb” approach. As such, containers offer the most economic opportunity for a port and since Durban already focuses on this area, it would be prudent to continue with this trend. Thus, it is quite evident that both the present and future comparative advantage of Durban port rests in the realm of containerised cargoes due to reason shown above. Also, since the port is so aptly designed for and dependant on containerised cargo, the removal of this great economic magnifying source would be particularly devastating on the Durban region as a whole. (Jones, 2001 and Jones, 2003) Looking at figure 23 below, it can be seen that the Durban port has seen an extraordinary increase in containers, with annualised growth of between 8% and 10% for the last decade. As was shown above, containers form an integral cog in the Durban port machine from an economics and social perspective since they provide a source of trade, income and employment. Container growth has been driven by a range of factors such as rising volumes of world trade and reduced trading barriers, the migration of cargo to containers from other handling systems, South Africa’s improved economic performance and rising per capita incomes. The facets examined below are containers landed, shipped and empty and as the diagram shows, all three categories have increased from 2002-2007. The growth between 2002 and 2007 is nothing short of spectacular, but this growth has not come without costs and constraints. However, needing containers and providing adequate space for them are two entirely different things and this will be explored below. Also, we have seen that general cargo is the richest form of cargo and has the largest employment benefits. South Africa needs extended general cargo capabilities and in this respect, Durban’s needs are similar to national needs. It is thus clear that Durban needs the container industry for continued survival and prosperity, but whether the container industry needs Durban as much remains to be seen. (Jones, 2003) Figure 23: Total TEUs Landed, Shipped
University of Delaware Home Blood Sugar Testing Article Discussion
Physics homework help
Physics homework help. You are Lee Gates, Property Manager of Downer Woods, which is a three-story multi-use building. The first floor is rented to businesses, and the two floors above are for residential use. Due to the close proximity to the university, undergraduate and graduate students rent apartments in the building, which is currently at full capacity.ÿÿThe competitive job environment has promoted more students to be serious about their studies, and they need extended quiet study times when they are not on campus.ÿAs the manager of Downer Woods, you must respond to one of the tenants, Charles Jordan, who is enrolled in a challenging program at the university. Mr. Jordan has begged you to evict one of the tenants who plays loud music throughout the day, interfering with Mr. Jordan?s concentration when he is studying. The noisy tenant, Wilson Brady, operates an entertainment booking agency and spends long hours in his office. He often works at the times that Charles Jordan wants to study.You know that you can?t evict Mr. Brady. As a legal, commercial tenant, he is entitled to conduct his business to allow him to succeed. As an alternative to eviction, you might consider moving him to a vacant office away from Mr. Jordan?s apartment. Another possibility is to add soundproofing, an expense that you would prefer to share with Mr. Brady. You might also discuss limiting the time of day for noisemaking, although he is not violating a sound ordinance. When you searched the Internet for information about eviction, you learned that you have very few options. However, Mr. Jordan is a reliable tenant who pays his rent on time; he is respectful of the property; and, he contributes to a positive learning environment for his neighbors at Downer Woods.Your TaskUsing principles of communicating negative news, write a one-page letter in the full-block letter style with company letterhead to Mr. Jordan denying his request to evict Mr. Brady. Explain how you plan to resolve the problem and demonstrate goodwill.Address your letter to: Mr. Charles Jordan/2134 E. Edgewood Avenue/Apt. 208/Milwaukee, WI 53211ÿThe property rental company that you work for is: Lake Michigan Realty/7689 N. OaklandÿAvenue/Milwaukee, WI 53202. Include this information, along with a telephone number and website address, in the company letterhead.Physics homework help
Go to the website: https://epic.org/privacy/litigation/ which focuses on civil rights issues and privacy. Pick a case. Using WORD, in you OWN WORDS, write an ORIGINAL brief essay of 300 words or more
best assignment help Go to the website: https://epic.org/privacy/litigation/ which focuses on civil rights issues and privacy. Pick a case. Using WORD, in you OWN WORDS, write an ORIGINAL brief essay of 300 words or more. I’m trying to study for my Computer Science course and I need some help to understand this question.
Go to the website: https://epic.org/privacy/litigation/ which focuses on civil rights issues and privacy. Pick a case.
Using WORD, in you OWN WORDS, write an ORIGINAL brief essay of 300 words or more :
Summarize the case
Give your opinion of the decision.
Describe how the case deals with the material in this chapter
Note your Safe Assign score. Continue submitting until your Safe Assign score is less than 25. You have two attempts to complete your assignment.
Go to the website: https://epic.org/privacy/litigation/ which focuses on civil rights issues and privacy. Pick a case. Using WORD, in you OWN WORDS, write an ORIGINAL brief essay of 300 words or more
Fire code administration
Fire code administration. I don’t know how to handle this Writing question and need guidance.
On each answer try to explain why.
In Chapter 1, Scope and Administration, what Section and specific code gives the and code official the authority to enforce the fire code?Write out full specific Code Section.
In Chapter 1, Scope and Administration, Section 104 General Authority and Responsibilities, what is the Code Section and language that allows a code official to enter a building at a reasonable time to inspect? Write out full specific Code Section.
In Chapter 1, Scope and Administration, Section 104 General Authority and Responsibilities, if a fire code offical is not allowed entry onto the premises, what does the Code allow next? Write out full specific Code Section.
In Chapter 1, Scope and Administration, Section 104 General Authority and Responsibilities, what is a Code Official required to carry during inspections? Write out full specific Code Section.
Fire code administration
Formal, in depth case analysis
Formal, in depth case analysis.
A formal, in-depth case analysis requires you to utilize the entire strategic management process. Assume that you are a consultant asked by Under Armour to analyze its external/internal environment and make strategic recommendations. You will be expected to make exhibits to support your analysis and recommendations. The case analysis should encompass 10-12 pages plus the exhibits and cover page. The cover page should include the company name, your name, and the date of submission. The matrices should not be part of the analysis body but exhibits/attachments. The completed case should include: Executive Summary Existing mission, objectives, and strategies Five-Forces Analysis Strategic Group Maps to Assess Market Position of Key Competitors Prepare Forecasted Ratios SWOT Analysis Competitive Strengths Assessment Industry Attractiveness Assessment List alternative strategies, giving advantages and alternatives for each. Recommend specific strategies and long-term objectives. Present an action timetable/agenda
Formal, in depth case analysis