solved Racism was just one more tool that was used to

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Racism was just one more tool that was used to highlight differences in culture and to keep the ruling class in power. The founding fathers were well aware of the contradiction that tested the very integrity of the declaration of independence. It would seem as though in efforts to preserve this power and out of fear they began to fuel ideas of white supremacy and superiority. While this was their intent all along to create a loyal group of subjects who all shared distinct features perhaps ignorance did play a small part in it. To back up my claim I will point to the words of Thomas Jefferson, one of the founding fathers who was very influential on the subject. On his notes to the state of Virginia Jefferson. The primary sources indicate that his understanding of the differences between humans of different races is very limited. Much of the scientific data that he uses to support his claim lacked accurate testing or validity. One claim that he made that is accurate is a human’s ability to withstand the sun based on skin pigmentation. This shows Jefferson thought he was approaching his claims rationally with the science that was available to him at the time. Unfortunately his beliefs become even more skewed when he introduces his own philosophy of man into his argument of white superiority. He did not believe a multi-race multi-culture society would do well because they would be divided on too many issues and only look after their own race or culture respectively. “It will probably be asked, Why not retain and incorporate the blacks into the state, and thus save the expense of supplying, by importation of white settlers, the vacancies they will leave? Deep rooted prejudices entertained by the whites; ten thousand recollections, by the blacks, of the injuries they have sustained; new provocations; the real distinctions which nature has made; and many other circumstances, will divide us into parties, and produce convulsions which will probably never end but in the extermination of the one or the other race. —To these objections, which are political, may be added others, which are physical and moral.”1 It is because of limited knowledge at the time that many of these conclusions went unchecked and ignorance ran rampant. Although this sentiment was commonly shared by Jefferson’s Peers that did not mean his Ideas went unchallenged. Among those to challenge him was a freed slave by the name of Benjamin Banneker. He argued That besides pigment men of different races were the same in both emotion and intelligence under the eyes of god. In his letter to Jefferson he acknowledges a respect towards Jefferson and considers him a fair voice among the many who stood against the plight of his people at least for the time period “Sir I hope I may Safely admit, in consequence of that report which hath reached me, that you are a man far less inflexible in Sentiments of this nature, than many others, that you are measurably friendly and well disposed toward us, and that you are willing and ready to Lend your aid and assistance to our relief from those many distresses and numerous calamities to which we are reduced”2 He then goes on to dismantle Jefferson’s argument in favor of freeing slaves and expelling them from Virgina. He does this by highlighting the hypocrisy of the declaration of independence and the treatment given to black people by practitioners of christianity. The quality of the letter itself also anecdotally supports Bennekers claim that men of color were every bit as capable as white men in the pursuit of knowledge and education.please respond to this and be as detailed as possible, thank you!!

solved Part 1: Watch the YouTube video, Sex & the Price

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Part 1: Watch the YouTube video, Sex & the Price of Masculinity, here: https://youtu.be/MOSU7B8iR-Q (Links to an external site.) and respond to 3 of the following questions:   What are some reactions you experienced, both positive and negative, while watching the video? Why do you think you had these experiences? How would you define sexual consent? From your understanding, is this situation common? Is this something that good people could do without even realizing it? Why or why not? How was compassion relevant in this story? Why do you think compassion is important in sexual situations? How do you think students overall could improve on clear sexual communication? 
Part 2: Respond to at least one of your classmate’s posts.
What are some reactions you experienced, both positive and negative while watching the video? Why do you think you had these experiences?
I did not like this video. I know that Dr. JennsDen is a sociologist and a sexologist, and she wants to raise awareness about sexual consent and “talking about it more and doing less.” However, going back to last week’s lecture on traditional values. I was raised with the values that if you are not willing to have sex with another person you should not allow intimate games. Moreover, a woman should never allow these intimate games if they are not in love with the other person. My cultural values are the reason why I felt that the video was a hypocrite because she gave her consent to have intimacy without intercourse. Obviously, she lost her mind when she did not even feel the penetration. We as a woman felt the difference between fingers or penis. Similarly, I learned this saying, “don’t play with fire because you can get burn.” On the other hand, I think she could get my attention if she talked about how to talk, express, identify, and report abuses when you are not consenting to be physically touched.
How would you define sexual consent?
Sexual consent for me can occur by verbally agreeing or when you allow your pattern, boyfriend, or husband to touch your body and you are not saying no, you are not covering yourself with your hands or other object or moving away.
From your understanding, is this situation common? Is this something that good people could do without even realizing it? Why or why not?
I am not sure if what happened to Dr. JennsDen is common or not. Especially because from my perspective she agreed to the intercourse from the moment that she allowed this person to touch her genitals. I do think sex can happen once you are interacting (willingly) in intimacy and a good person can advance to intercourse without even realized. I might be wrong, but I have the same assumption that Dr. JennsDen criticized that “when sexual interaction starts, we are on a sex train that no one can stop.” She proved it when she did not feel the penetration.
How was compassion relevant in this story? Why do you think compassion is important in sexual situations?
I think that compassion is important in this story because it was a mutual agreement on having intimacy without intercourse.
How do you think students overall could improve on clear sexual communication?
I feel that we need to learn more to communicate verbally to not create confusion. As Dr. JennsDen said, “we need to talk more and do less.” However, I believe that when we are in a relationship it is easy to see when someone wants to jump directly to intimacy or intercourse. We (women and men) need to learn to say “NO, I do not want this, we need to talk first.” Because as Dr. JennsDen said, having intercourse has consequences, such as social, physical, and financial.

solved Most of The work has already been done. You just

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Most of The work has already been done. You just have to click on each week (that weeks project assignment on each week 1-10)While pulling everything together if you see something that needs to be adjusted after review to make it better because I need a really good grade then change it please part one cognitive In Week 1 you began with choosing an experiment to complete. Over the last several weeks you have been working on your project in preparation to complete the work for this week. Your project should adhere to the following guidelines:For the main sections, it should have:A title pageAn abstract (not more than 250 words)An introductionA literature reviewMethodsResultsDiscussion or conclusionsReferencesIntroduction: This should be one to two pages in length. The introduction provides a brief overview of what will be covered and the purpose of the research.Literature review: The literature review is taken in part from what you researched from the scholarly journal articles. It is a synthesis of the material you found into a cohesive review of the literature on your chosen experiment.Methods: This section provides information on how the experiment was conducted.Results: The results section should explain your finding in the experiment in detail.Discussion and conclusions: The difference between a great research paper and a marginal one is the depth and originality of the discussion and conclusions section. This is where you bring together what you have learned through your research as well as through the course regarding your topic in the concluding remarks of your paper. The discussion and conclusions section should be one to two pages in length.PART TWO SOCIAL PSYCH same applies for part two the work has been completed in each week and needs to just be pulled together (once you click on each week in social psych each weeks project you’ll find the matching that they are looking for to pull all together)Adjust as you see fit while you compile them together to make it better the work that has been completed to make it better I need a really good grade. Research ProposalIn Weeks 1 through 9, you have created all the sections to be included in the research proposal. This week, you will collate all these sections and create the final draft. For this assignment take the opportunity to review all the feedback your instructor provided throughout the course on the various project assignments. Use that feedback to revise and improve your project for this final draft.Make sure your research proposal adheres to the following structure:Title pageAbstract (see APA guide for format)IntroductionLiterature ReviewMethodologyDiscussion and ConclusionReferencesIn addition, each section should include the following information:Abstract: An abstract is a summary of the paper. Review the abstracts of the articles used in your literature review for and example of a detailed abstract.Introduction: This section has been already created in Week 8.Literature Review: This section was created in Weeks 6 and should have been integrated into your introduction in Week 8. The literature review is not a copy of that material. Rather, it is a synthesis of the material you found into a cohesive review of the literature on your chosen topic. Make sure to include all the articles that you used in Weeks 2–5 for your literature review.Methodology: This section has been already created in Week 7.Discussion and Conclusion: This section has been already created in Week 9.References: In this section, you should include all articles you collected for the literature review. In addition, take care to put all the references in APA format.

solved In many ways, Western thought, perspective, and understanding dramatically changed

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In many ways, Western thought, perspective, and understanding dramatically changed at the end of the nineteenth century. This week we are going to look at some of those changes, which led the West into both the light and darkness of the 20th century. This is the age of more sophisticated industrialization and the onset of what scholars call “modernity.” One can see these dramatic changes in the thought of philosophers, the experiments of scientists, the era’s works of art, and ultimately, the tremendous shift in the way in which we understand the universe. In this era, we see monumental advances in technology that would shape and shift the very environment in which we live. We also see a certain recognition among some of the West’s most notable thinkers that perhaps we do not really live in the world of positivity and progress once dictated by the Enlightenment thinkers. Psychologist Sigmund Freud posits that while he tends to believe in the efficacy of reason, modern man suffers from many irrational tendencies. Friedrich Nietzsche embraces the irrational, concluding “God is dead” and those late-nineteenth-century human beings are on their own, with nothing but their “will to power” to guide them. Finally, Albert Einstein toppled many of the thinkers of the “Scientific Revolution” with his theory of relativity, in which space and time became one. We are going to focus on these three thinkers this week as well as the concept of modernity itself. This trio of thinkers had a tremendous influence on the ways in which we interpret the world and our own humanity. You might ask just what is irrational about human beings? In the coming weeks, we will ponder that, as we watch much of the world plummet into horrible bouts of war and destruction. In other words, the twentieth century.Our primary document will be different than stated on the syllabus this week. I am presenting you with a wide selection of quotations from Nietzsche’s Will to Power and asking you to select a single quote to comment on. Please read as much as you can before selecting a quote so you can gain a broader knowledge of what Nietzsche’s all about. He is often crudely interpreted, and I would like you to seriously think about his thoughts, so to speak.Part One I am asking you to choose one of the following topics to write about: Sigmund Freud’s psychology, Albert Einstein’s physics, Modern Art, or the topic of “Modernity” itself. If you choose one of the two thinkers, start your post out with some brief biographical material and then demonstrate how that thinker’s work broke with the past. In other words, these were revolutionary thinkers. In what ways were they revolutionary? If you choose Modern Art, or “Modernity” do something similar. How did either break with the past? What were the differences between pre-modern art and modern art? Or, how do you define “Modernity” and how did it break with the past? Must be 250 words or more. Part TwoBegin your post about Nietzsche with some biographical information. Then choose a quote from Will to Power to respond to. The lengths of the quotes vary but I am not concerned with the length of the quote you choose, just make sure to choose something that will enable you to write 250 words. The quotation itself will not be counted as part of your post. You must write 250 words about the quote itself.References: Western Civilization A Brief History, vol. II Since 1600. Eleventh Edition https://fnietzsche.com/friedrich-nietzsche-will-to… https://www.goodreads.com/work/quotes/25192319-der… https://help.kanopy.com/hc/en-us/articles/360026341194-Creating-a-Kanopy-account Watch “Inside Einsteins Mind”

solved I need somebody to complete the following: 5-1 Review Question,

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I need somebody to complete the following: 5-1 Review Question, and 5-4 Mini Case Studies. Please use separate word documents.5-1 Review Questions:In your own words, answer the following questions in a Word document. Provide detailed explanations, including at least one example where indicated.How do liability loss exposures differ from property loss exposures with regard to assessment of maximum possible loss? Provide at least one example.How do aggregate limits of liability affect a commercial entity’s need for liability insurance? Provide at least one example.What is the basic difference between an excess liability policy and an umbrella policy?What are the differences between working layers and buffer layers of insurance? Provide at least one example.What underlying coverages are usually required by an umbrella insurer? Provide at least one example.How might organizations be exposed to cyber risk loss exposures? Provide specific examples.What are the benefits of a properly structured cyber risk security strategy?What disclosures does the Terrorism Risk Insurance Act require?What are the advantages and disadvantages associated with international package policies?5-4 Mini Case Studies Analyze the coverage amount under excess or umbrella liability insurance. Analyze the cyber risk loss exposures for an organization. Communicate analysis and/or conclusions concerning property and/or casualty insurance policies, coverage, limitations, and/or issuesAnswer the following questions in your own words in a Word document. Remember these are mini-case studies, not review questions, and as such your responses are to be in complete sentences and paragraphs, with at least 350 words for each question. Please restate the question in your document but do not count these words in your total response length.A general contractor has a commercial general liability (CGL) policy and an umbrella policy, each of which provides coverage on an occurrence basis. The CGL policy has an each occurrence limit of $1 million and a general aggregate limit of $2 million. The umbrella policy also has an each occurrence limit of $1 million and a general aggregate limit of $2 million. The policy periods of the CGL and umbrella policies are concurrent. The contractor has a covered loss for $800,000. How much will be paid under each policy for this loss?During the same policy period, the general contractor has another covered loss for $1.2 million. How much will be paid under each policy for this loss?The contractor experiences a third covered occurrence during the same policy period. This loss is $540,000. How much will be paid under each policy for this loss?Jim’s Country Furniture and Crafts is a small, one-person business. Jim builds his own designs of country-styled furniture and crafts and sells them in his shop. Most of Jim’s business is generated through referrals and repeat customers. Jim’s wife performs the business’s accounting tasks and other business-related record keeping. The business does not have a website. Jim believes that he does not have any cyber risk loss exposures. For each of the following scenarios, explain whether Jim has a cyber-risk loss exposure:Jim also designs architectural elements for homes, such as fireplace mantles, wall panels, and molding. To help in the design and assembly of large elements, Jim orders partially completed pieces from a supplier, who designs the pieces according to his specifications using computer-aided design (CAD) technology.Jim’s wife relies on a home business software program that requires periodic Internet updates to manage Jim’s accounts, billings, and other record keeping.

solved Developing Your Professional Identity Overview Because few undergraduate programs offer

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Developing Your Professional Identity
Overview
Because few undergraduate programs offer courses in counseling, one of the areas in which new counselors struggle is that of developing a professional identity. This course has provided the basic ideas and practice exercises that you need to begin developing your own professional identify. The purpose of this assignment is to provide you with the opportunity to describe the role and function you envision for yourself as a counselor, to distinguish yourself from other helping professions, and to explain how you will find the resources to assist you in continuing to develop your capabilities. Take advantage of this opportunity to think through where you are headed, both in your program and in your career.
While you are expected to support your ideas with evidence from the professional literature, it is understood that you are beginning a new professional journey, and there may be some areas in which research alone cannot determine your personal direction. Acknowledge any uncertainty in your personal direction and challenge yourself to express the reasons for that uncertainty.
Directions
Use the supplied assignment template and the other helpful links in Resources to write your paper. Organize your paper into the following topic areas:
Specialization within the field of counseling: State your specialization and explain how your role differs from counselors in other specializations. Take time to define, as specifically as possible, the areas in which you would like to focus your practice.
Counseling philosophy: As a counselor-in-training, describe how you integrate the concepts of wellness, resilience, and prevention into your approach in your identified specialization. Dig deeper, and explain the assumptions you are making that help you see a connection between counseling theory and your practice.

Licensing and certification: Describe what you have learned about state licensure and certification requirements for your specialization and explain how your coursework plan aligns with these requirements. Identify any areas in which you have found a state requirement that you are not certain will be met by your coursework, and describe how you will take action to resolve this uncertainty.
Ongoing professional development: Compare and contrast two professional counseling associations. Assess how these organizations can help you conceptualize your professional identity and assist you in continuing professional development. Be specific about your areas of interest, and provide examples of ways in which these associations can assist you.
Impact of technology: Evaluate how technology might affect your clinical specialization, including assisting you in creating more efficient formats to help your clients as well as raising ethical questions for you. As in other areas of the paper, provide specific examples.
Reflection on your interview and u02a1: Review the interview you conducted and your Preliminary Conceptualization of the Counseling Field assignment. How have your impressions of the field changed over the course? Explore specific concepts, terms, or areas of professional disposition that you have gained insight in.
In each case, support your ideas with evidence from professional literature, including the assigned articles and those you found related to professional identity, key philosophies, and technology within counseling. Include what you learned from your Internet research on state licensure or certification requirements.
Given the personal focus of this paper, it is appropriate to write in the first person (using the words I, me, and my, for example).

solved Ameritrade 1. Title 2. Ticker symbols and full Historical Graph

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Ameritrade 
1. Title
2. Ticker symbols and full Historical Graph
3.Organizational Chart
4. Countries of Operations and location 5. Countries of Operation and location.6.Biggest Competitor and top competitor 7.Caculate ratios for company 8.Balance sheet 9.Income statement 10. Statement of cash flow 11. Stock holder equity 12.Immediaite implication of ratios analysis 13.CT Implication of ratios analysis 14.Immediate implication of peer ratios analysis 15.CT Implication of peers ratios Analysis 16.Stock Analysis 17. Ratios Analysis Stock prices 18.Type of financial risk 19.Short Terms bonds 20.Long Terms bonds 21.Stock Valuation 22.Overalll summary of Year and recommendation APA.                                                                                                                                                                                                                                     Part 2 of assignment:                                                                                                                                                                          

Calculate the figures for your company.  
Use all of the formulas from Table 4.2 only.  (Page 123 analysis of a financial statement) Please remember if your company doesn’t sell products but rather services, you will not have inventory and thus will be unable to calculate the inventory ratios.  All other ratios are REQUIRED. You must calculate ratios (do not get them from a website as this does not demonstrate proficiency in the subject matter).  4.2 will contain quite a few ratios.  In addition to the industry average, you may also want to include the competitor for comparison purposes.  
Financial Statements (graphic and link)
What do the ratios tell you immediately about the company? 
What are some potential problems (uses and limitations) with the information received from the ratios? 
What about what the ratios tell you compared to peer firms?  
Based on this analysis of the ratios of both your company and the peer, which do you think will fair in the long term and why? 
Does the change in stock price reflect the changes over the last year that have occurred in the markets as compared to the Dow Jones Industrial Average (DJIA)? 
Do you expect the price of the stock to increase or decrease based on your ratio analysis?

I have provided the formula
Ratio Formula
1.Liquidity Current assets/current liabilities
Quick Current assets-inventories/current liabilities
2.Assest Management
Inventory turnover sales/inventory
Days sales outstanding receivable/annual sales/365
Fixed assets turnover sales/total sales
Total assets turnover sales/total assets
3. Debt Management
Total debt to capital total debt/total capital
Time interest earned earning before intrest and taxes (EBIT)/interest charges
4. Probability
operating margin operating income/sales
profit margin net income/sales
return of total assets net income/total sales
return on common equity net income/common equity
return on invested capital EBIT(1-)/TOTAL INVESTMENT CAPITAL
Basic earing power earning before interest and taxes/total assets
5. Market value
price/earning price per share/earning per share
market book market price per share/book value per share

solved The Renaissance and the Reformation were quite similar in some

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The Renaissance and the Reformation were quite similar in some ways and quite different in others. Most important similarity: The Renaissance (1350-1600) and the Reformation (1517-1648) both served to buck against traditional authorities of Church and State, break down feudalism, and bring about the modern age. Oftentimes, Church and State were one and the same as becomes obvious in the case of Renaissance Italy, where many of the Renaissance popes came from families that made their fortunes off-trade. The Medicis, whom Machiavelli writes about in The Prince, is a prime example of a family of merchants turned bankers who were also important figures in the hierarchy of what had become a highly corrupt Catholic Church. We may most associate the Renaissance with fine arts and architecture these days, but what underlay the sheer beauty that was created during this period was trade between the West and the East. Merchants formerly looked down upon in the hierarchy of feudalism (see text and slides), came to rule the cities, or more specifically the City-States of Italy. They bought positions in the Church (Catholic means Universal, by the way), and most importantly, they pointed society in a secular direction. Italian merchants like the Medicis became so rich they established banks that funded lavish architectural projects not only in the Italian city-states but in other parts of Europe that were highly influenced by the Italian Renaissance. Of course, they transformed society in the process. Then, along came the Reformation. When Martin Luther, a Catholic priest, rebelled against the corruption within the Church in 1517, he essentially set off a revolution in faith that would shake most of Europe. Protestantism was born (note the root word in Protestantism = Protest). It shattered the Catholic Church, and the feudal states, which were often ruled by the Church. German princes, among others, decided to adopt Protestantism and impressed it upon their subjects. The renowned Henry VIII of England separated from the Church. These were not benign separations. They often meant war, and religious warfare plagued European states well into the 17th Century. After the wars subsided, the Catholic Church was no longer the only game in town. I could go on but I want you to discover the Renaissance and the Reformation on your own through the text and the materials provided in this folder. Both paved the way for the modern, secular society that we presently live in. When you have absorbed these materials, turn to “Discussions” on Blackboard and respond to this week’s two discussion questions. One will be a general discussion question based on some aspects of the text and the materials and the other will be based on this week’s primary document, which is excerpts from Machiavelli’s, The Prince. The brief book, which in some ways was meant to be a guidebook for rulers like the Medicis and practically marks the invention of modern political science, is without a doubt, still in use. Not surprisingly, many of our current leaders have apparently absorbed its content.Both the Renaissance and the Reformation fostered increased individualism, undermined the power of the Catholic Church in Europe, and paved the way toward modernity. In challenging existing authorities they were somewhat alike. But what set the two social movements apart? With this question please explore some of the likenesses and some of the differences between the Renaissance and the Reformation. How did both lead to a more secular society? Must be 250 words or more.Other text: Western Civilization A Brief History, vol. II Since 1600. Eleventh Edition

solved Annotated Bibliography [WLOs: 3] [CLOs: 1, 2, 3, 4, 5]

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Annotated Bibliography
[WLOs: 3] [CLOs: 1, 2, 3, 4, 5]
Prior to beginning work on this assignment, read Chapters 4 and 5 from the text. It is also recommended that you review the upcoming assignments in Weeks 2 and 3, along with your Capstone Paper in Week 5. An Annotated Bibliographyis a great way to organize your research and prepare you for completing the Capstone Paper Outline in Week 2, the Capstone Paper Rough Draft in Week 3, and your Solution Proposal Capstone Paper in Week 5. The purpose of an annotated bibliography is to find, summarize, and critique scholarly and/or credible sources that you will use to complete your Capstone Paper. You will also use the information gained from the required readings this week to complete this assignment.
The Capstone Paper requires you to address five specific areas of your program of study and the learning objectives for the social and criminal justice program. Like the Capstone Paper, your annotated bibliography will consist of five various topics, each aligning with the first five course learning outcomes for this class, which are also the areas for examination in the Capstone Paper.
In your Annotated Bibliography
Analyze criminal justice issues within the systems of law enforcement, the judiciary, and corrections (CLO 1).
Evaluate the application of the social justice principles of equality, solidarity, and human rights toward building a just society (CLO 2).
Examine cultural sensitivity’s and diversity awareness’ impact on social and criminal justice (CLO 3).

Deconstruct the relationship between law enforcement, the judiciary, and corrections (CLO 4).
Interpret the relationship between social justice and criminal justice (CLO 5).
For each of your five separate critical analyses of your sources for the Course Learning Outcomes listed above, complete the following:
Summarize each source’s thesis and/or main points in one paragraph.
Evaluate the relevance of the data used to support the thesis of the source.

Provide the formal APA reference entry for each source.
Briefly critique (as defined in Chapter 5) the accuracy, acceptability, strengths and weaknesses, and overall soundness of the article.

Explain, in one to two sentences, how each source supports your thesis and/or resolution.
The paper must be 750 to 1250 words in length, excluding title and reference pages, and formatted according to APA style. You must use at least five scholarly and/or credible sources, which includes the source you are reviewing, two sources that support or contradict the initial article, and any other sources that support your analysis. Visit the University of Arizona Global Campus Library to review the Criminal Justice Research Guide which may help in your research. You may also find the University of Arizona Global Campus Library Quick N’ Dirty tutorial, The Research Processtutorial, and the Advanced Search Techniques tip sheet helpful as you conduct your research. As you conduct your research, the University of Arizona Global Campus Library also provides the RefWorks tool that will help you organize your research, create APA reference entries and citations, and more. Creating a RefWorks Account will assist you in creating an account in order to start using the tool.
Cite your sources within the text of your paper and on the reference page. Use the Annotated Bibliography Template, available in the Writing Center to help you complete this assignment. For information regarding how to complete an Annotated Bibliography, visit the Writing Center. There you will find a video tutorial and sample Annotated Bibliography.
The Annotated Bibliography assignment,

solved Topic: Diagnostic ReasoningClinical decision making is the process by which

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Topic: Diagnostic ReasoningClinical decision making is the process by which we determine who needs what and when. While not exactly arbitrary, this exercise can be quite subjective. Each provider compiles their own data (hence the emphasis on learning to perform an accurate H&P) and then constructs an argument for a particular disease state based on their interpretation of the “facts.” The strength of their case will depend on the way in which they gather and assemble information. There may then be no single, right way of applying diagnostic and therapeutic strategies to a particular case. Medicine involves playing the odds, assessing the relative chance that a patient is/is not suffering from a particular illness. Codifying the way in which providers logically approach problems and deal with this uncertainty is a difficult task. Relying solely on the classic features of a disease may be misleading. That is because the clinical presentation of a disease often varies: the symptoms and signs of many conditions are non-specific initially and may require hours, days, or even months to develop.Generating a differential diagnosis; that is, developing a list of the possible conditions that might produce a patient’s symptoms and signs, is an important part of clinical reasoning. It enables appropriate testing to rule out possibilities and confirm a final diagnosis.This case portrays a poor patient outcome after a misdiagnosis.Case scenarioA previously healthy 35-year-old lawyer presents to a primary care office with a chief complaint of chest pain and a non-productive cough. The pain started suddenly 2 hours prior to coming to the office while the patient was sitting at his desk. The patient describes the pain as sharp in nature, constantly present but made worse with inspiration and movement, and with radiation to the base of the neck. His blood pressure in the right arm and other vital signs are normalOn physical examination, the only findings of note are chest wall tenderness and a faint cardiac murmur. The ECG in the office is normal. The patient is observed for an hour in the office and assessed. He is diagnosed with viral pleurisy and sent home on non-steroidal analgesics.The following day the patient collapses at home and cannot be resuscitated by the paramedic service. An autopsy reveals a Type 1 aortic dissection with pericardial tamponade.Discussion Assignment:Developing a list of possible conditions that might produce a patient’s symptoms and signs is an important part of clinical reasoning.As an NP in primary care, what would you have done differently?Discuss the importance of creating a list of differentials for this patient. How could it have changed this outcome?If a serious diagnosis comes to mind based on a patient’s symptoms:Ask yourself: Have you considered the likelihood of a serious diagnosis and whether it needs to be ruled out by testing or referral?Because many serious disorders are challenging to diagnose, have you considered ruling out the worst-case scenario?Ask yourself: Do you have a sufficient understanding of the clinical presentation to offer an opinion on the diagnosis?What other diagnoses could it be? How might the treatment to date have altered the patient’s outcome?What other diagnostic and laboratory or imaging was needed in order to make a complete differential list? What support tools would you consider using in helping to create a differential diagnosis list?Are you familiar with the current clinical practice guidelines for the investigation of a suspected condition such as chest pain?Please support with up-to-date evidence-based standard of care guidelines.