Girl with ADHD

Girl with ADHD

Girl with ADHD

Introduction to the Case

The case is of an 8-year-old Caucasian female presenting at the office accompanied by the father and the mother, who report that they have been referred to seek advice after the patient’s teacher suggested she might have ADHD. Per their primary care provider, the patient should be examined by a mental health practitioner to ascertain the condition. The parents shared the teacher-filled Conner’s Teacher Rating Scale-Revised, which indicated that the patient is inattentive, easily distracted, forgetful, and poor in reading, spelling, and arithmetic. She has a short attention span unless it is something she is interested in. The patient has no interest in school work and is easily distracted, never finishing what she started or following instructions. The patient does not complete her schoolwork. The parents do not believe the patient has ADHD because she is not “running around like a wild person, defiant, or have temper outbursts.”

(Girl with ADHD)

The assessment data indicates the patient does not see the issue as a big deal as she is “OK” in school and prefers art and recess. The patient perceives other subjects as boring or hard and feels lost sometimes. She admits to her mind wandering during class to things she enjoys and would sometimes think about nothing, and when the teacher calls her name, she would not remember what they were talking about. She perceives her life as just fine, loves her parents because they are good and kind to her, denies any abuse or bullying at school, and has no other current concern. The mental status exam indicates that the patient is well-developed for her age, and speech is clear, coherent, logical, and appropriately oriented to person, place, time, and event. Her dressing is appropriate for the weather and time of year, and her mannerism, gestures, and tics are noteworthy. She indicates a euthymic mood, bright affect, and no visual or auditory hallucinations, delusions, or paranoia. Her attention and concentration are grossly intact, insight and judgement appropriate, and has no suicidal or homicidal ideation.

Decision #1

Ritalin is the initial treatment for the patient’s ADHD for this patient. Ritalin led to the patient’s improved academic performance, although her attention declined as the day progressed. Per the guidance, the discontinuation of the drug would have the same side effects, and the side effects would wear off with time. Research shows that Ritalin has favorable effects on ADHD symptoms, especially in reducing hyperactivity and impulsivity (Verghese & Abdijadid, 2022). The drug is FDA-approved, and the prescription is appropriate for children 6 years and older.

The other two drug options were Adderall and Intuniv. Adderall was rejected because it has similar side effects as Ritalin, and shifting to it would not change the current state. Ritalin also reaches peak levels quicker than Adderall. Additionally, Adderall leads to loss of appetite, stomach upset, headache, fever, diarrhea, and nervousness (Brown et al., 2018). Intuniv has significant side effects like sedation, which is not favorable for a school-going child because it would be challenging to maintain concentration and attention throughout the day (Harricharan & Adcock, 2018). Intuniv also causes low blood pressure, dry mouth, irritability, constipation, and decreased appetite.

(Girl with ADHD)

Administering Ritalin aimed at addressing the negative symptoms of ADHD, particularly hyperactivity and impulsivity. Ritalin has been indicated effectiveness in treating ADHD and has favorable effects on the symptoms (Verghese & Abdijadid, 2022). Improving the symptoms would help the patient perform better at school. On ethical considerations, working with a minor raises ethical concerns regarding autonomy, beneficence, and informed consent. Any treatment option should follow the parents’ preferences and consent. Minors cannot make autonomous decisions, hence the need to involve the parent throughout the treatment process. Additionally, the PMHNP should evaluate the drug selected and its potential effects on the patient, ensuring beneficence.

Decision #2

Wellbutrin is the second-choice treatment in this case. Results indicate a slight improvement in symptoms, although the patient reports decreased appetite, which is worsening. Research also shows that Wellbutrin can improve ADHD and decrease symptoms associated with the illness (Verbeeck et al., 2019). It is an appropriate non-stimulant drug for patients that cannot or will not take stimulant drugs because not all people are responsive to stimulants, and some cannot tolerate them.

The other two options not selected initially are Intuniv and Strattera. Sedation is one of the serious side effects of Intuniv, which is not favorable for a student since it would be difficult for them to focus and pay attention all day (Harricharan & Adcock, 2018). Low blood pressure, dry mouth, irritability, constipation, and decreased appetite are additional side effects of Intuniv (Harricharan & Adcock, 2018). Strattera is a good alternative to Wellbutrin, associated with significant side effects in children, particularly suicidal ideation (Fedder et al., 2022). However, Strattera can also lead to decreased appetite, headache, constipation, nausea, feeling sleepy and weak, and heart attack in severe cases.

(Girl with ADHD)

Administering Wellbutrin aimed at decreasing ADHD side effects. Wellbutrin has indicated effectiveness in treating ADHD, working as an antidepressant and non-competitive antagonist of nicotinic acetylcholine receptors (Verbeeck et al., 2019). It is anticipated that the patient’s ADHD would improve after taking Wellbutrin. Ethically, the provider must consider the side effects of administering Wellbutrin, particularly suicidal ideation, which presents potential harm to the patient. The provider must involve parents in critical decision-making and develop a drug therapy of preference per the patient’s response to the current drug therapy. The PMHNP must also disclose to the parents any additional risks associated with taking Wellbutrin.

Decision #3

The last treatment option is Intuniv, a non-stimulant treatment of ADHD, targeting oppositional behaviors. Intuniv can help improve focus and attention, controlling behavior, and manage hyperactivity and overactivity. Research shows significant improvement in subjective ADHD rating scales and scales in executive function for children and adolescents using Intuniv (Harricharan & Adcock, 2018). It is also appropriate for children with ADHD who are not adequately controlled with methylphenidate.

The other two options rejected were clonidine and Wellbutrin. Clonidine is more sedating than Intuniv, hence would not improve the current state. It can also lead to the patient developing depression, sleeping difficulties, constipation, and feeling weak, tired, and sleepy (Yasaei & Saadabadi, 2022). Wellbutrin is a good alternative but has considerable side effects and is associated with a high treatment discontinuation due to increased risk to the patient as it leads to suicidal ideation (Huecker et al., 2022). It can also cause rhinitis, tachycardia, weight loss, dizziness, and tremors.

(Girl with ADHD)

Prescribing Intuniv is aimed at improving ADHD symptoms, especially focus, attention, controlling behavior, and managing hyperactivity and overactivity. The prescription also aimed to avoid side effects associated with stimulant drugs when treating ADHD in children. Intuniv indicates effectiveness in relieving ADHD symptoms; hence recommended as the third option (Harricharan & Adcock, 2018). It is ethical practice to consider drug-drug interaction when prescribing Intuniv to ensure no harm due to complications. The PMHNP should also disclose the drug’s risks and benefits to the parent and elaborate on effective monitoring areas to report during follow-up. Any treatment decision should follow the parents’ consent and preferences, given the patient is a minor.

Conclusion

The initial purpose of recommending each drug is to improve SDHD symptoms, help the patient be more focused and attentive in school and bolster memory and behaviors such as completing school work and any activity she started. The patient’s ADHD is initially being treated with Ritalin. The patient’s academic performance increased as a result of taking Ritalin, but her attention started to wane as the day went on. According to the instructions, stopping the medicine would have the same negative effects, but they would eventually go away. Ritalin has been shown to improve ADHD symptoms, particularly by lowering impulsivity and hyperactivity (Verghese & Abdijadid, 2022). The prescription is authorized for children aged 6 and older, and the medication is FDA-approved.

The second-choice treatment in this instance is Wellbutrin. Results show a little improvement in symptoms; however, the patient is reporting a worsening loss in appetite. According to research, Wellbutrin can treat ADHD symptoms and improve the condition overall (Verbeeck et al., 2019). Because not everyone responds to stimulants and some individuals cannot tolerate them, it is a suitable non-stimulant medication for patients who cannot or will not take stimulant medications. Intuniv, a non-stimulant medication for ADHD that focuses on oppositional behaviors, is the final option for treatment. The use of Intuniv can help regulate hyperactivity and overactivity as well as increase focus and attention. According to research (Harricharan & Adcock, 2018), Intuniv significantly improves executive function and subjective ADHD rating scales for kids and teenagers. It is also suitable for kids with ADHD whose symptoms are not sufficiently managed by methylphenidate.

References

Brown, K. A., Samuel, S., & Patel, D. R. (2018). Pharmacologic management of attention deficit hyperactivity disorder in children and adolescents: a review for practitioners. Translational pediatrics7(1), 36–47. https://doi.org/10.21037/tp.2017.08.02

Fedder, D., Patel, H., & Saadabadi, A. (2022). Atomoxetine. In StatPearls [Internet]. StatPearls Publishing.

Harricharan, S., & Adcock, L. (2018). Guanfacine hydrochloride extended-release for attention deficit hyperactivity disorder: a review of clinical effectiveness, cost-effectiveness, and guidelines.

Huecker, M.R., Smiley, A., Saadabadi, A. (2022). Bupropion. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK470212/

Verbeeck, W., Bekkering, G. E., Van den Noortgate, W., & Kramers, C. (2019). Bupropion for attention deficit hyperactivity disorder (ADHD) in adults. The Cochrane database of systematic reviews10(10), CD009504. https://doi.org/10.1002/14651858.CD009504.pub2

Verghese, C., & Abdijadid, S. (2022). Methylphenidate. In StatPearls [Internet]. StatPearls Publishing.

Yasaei, R., & Saadabadi, A. (2022). Clonidine. In StatPearls [Internet]. StatPearls Publishing.

 
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Health-Promoting Self-Care in Nursing

Health-Promoting Self-Care in Nursing

NSG 301: Writing With Confidence, Clarity, and Style

Health-Promoting Self-Care in Nursing

Classical Argument: Health-Promoting Self-Care in Nursing

The healthcare environment is challenging and pressuring for nurses, impacting their health and well-being. Nurses have in-depth knowledge regarding health-promoting behaviors and practices, but they continue to report high overweight and obesity levels and mental health issues (Flaubert et al., 2021). Contributing factors include work-related stress, heavy workloads, shift work, poor engagement and communication, increasing patient health demands, and working overtime, which leaves nurses with little time to practice self-care. Exploring these factors is the first step to promoting nurse health and well-being.

Health-promoting self-care practices are fundamental to a nurse’s health and well-being. Lack of self-care is linked to unhealthy nurses, physically and psychologically, which negatively impacts nursing practice and patient outcomes (Flaubert et al., 2021). It is also related to health-risk behaviors like excessive alcohol consumption, smoking, and substance use (Flaubert et al., 2021). Consequentially, it impacts nursing practice and overall institutional and patient outcomes. Nurses can enhance their health and well-being by adopting self-care strategies such as emotional regulation, self-compassion, mindfulness, healthy eating patterns, regular physical activity, staying connected, and continued individual and professional growth would help minimize the adverse effects of poor health-promoting self-care. Conclusively, self-care is integral to a nurse’s health and well-being, which is related to a nurses’ capacity to offer care to patients.

Background

Self-care is related to any intentional effort to activity to cater to one’s mental, physical, and spiritual well-being. Nurses spend extended periods caring for others, and they can forget about themselves, which is detrimental to their and other people’s health (Ross et al., 2019). The American Nurses Association completed a survey that indicated the increased urgency to improve nurses’ health, especially in nutrition, safety, life quality, and physical activity. About 70% of the nurses surveyed admitted to prioritizing patients’ needs, safety, health, and wellness before theirs, while 77% of the nurses reported being at a significant risk level for work-related stress (Purdue University Global, 2021). These numbers indicate the significance of the problem and how widespread it is in the healthcare environment. The evidence calls for prompt interventions to promote nurse health and well-being because poor nurse health and well-being can lead to compassion fatigue. Therefore, to care for others, nurses should first care for themselves. Conclusively, nurses’ health impacts patient care in all healthcare settings.

(Health-Promoting Self-Care in Nursing)

Compassion fatigue and burnout impact nurses’ capacity and ability to self-care, and if not treated, may cause long-term emotional trauma. Moreover, the nursing field can be traumatic for nurses because of increased exposure to suffering and pain, ending up traumatized without realizing it most of the time (Wolotira, 2022). However, the Code of Ethics recognizes self-care as a nurse’s responsibility because when nurses are not caring for themselves, they cannot care for their patients (Purdue University Global, 2021). In addition, the American Nurses Association Code of Ethics posits that nurses should extend to themselves the moral respect they extend to others, and nurses owe themselves the same duty they owe to other individuals (Purdue University Global, 2021). Based on these findings, assessing trauma as a “cost of caring” is imperative when understanding nurses’ self-care behaviors. The assessment would help comprehend how continued exposure to pain, death, fear, abuse, and illnesses can cause trauma and how self-care behaviors and practices can help minimize trauma among nurses. Emphatically, trauma experienced in the healthcare environment can impact nurses’ long-term health.

Nurses are responsible for promoting their health and safety, preserving their wholeness of character and integrity, maintaining competence, and ensuring personal and professional growth through continuing education and training. These are self-care principles for nurses to promote the holistic growth and manage the stress from working in the healthcare environment. Lack of self-care is linked to burnout, poor physical and mental health, depression, weight gain or extreme weight loss, unhealthy eating patterns, demoralization, back injury, and reduced job satisfaction (Williams et al., 2022). It is imperative to look into these factors because they impact a nurse’s capacity to function and lower productivity. For instance, a nurse experiencing burnout is demoralized, and dissatisfaction with her job is more likely to cause mistakes like medication errors, negatively impacting health outcomes. The highlighted healthcare principles can be adopted to address the adverse effects of a lack of self-care. Certainly, more attention is needed to enhance self-care in nurses because self-care helps minimize stress, replenish nurses’ compassion capacity and ability to care for others and improve the quality of care.

(Health-Promoting Self-Care in Nursing)

Self-Care Minimizes Stress

Self-care serves as a stress management tool, helping nurses reduce work-related stress. Adopting self-care practices like mindfulness, self-compassion, and emotional regulation can help nurses reduce stress and attend to their physical, mental, emotional, and spiritual needs (Hofmeyer et al., 2020). In this case, nurses should perceive self-care as integral to preventative care. Although individual factors can impact an individual’s ability to cope, control themselves, tolerate uncertainties, and resilience, self-care helps acquire and sustain these positive aspects of life. Per Hofmeyer et al. (2020), control is critical to an individual’s well-being. Still, work-related factors beyond a nurse’s control can disrupt the power to self-regulate and the need for control, adding to work-related stress. Determinately, nurses can manage their stress levels through self-care strategies.

Self-care begins with self-awareness, understanding how difficult events, uncertainties, and powerlessness impact oneself. For instance, it is normal to feel anxious, sad, and grief-stricken in difficult situations or crises, which begs individuals to accept their vulnerability and learn how to self-regulate to control emotions and feelings attached to such conditions. In this case, self-regulation, self-compassion, and mindfulness all allow nurses to focus on the positives rather than the negatives and uncertainties, accept situations, especially those that cannot be changed, like the death of a patient, and find meaningful ways to cope with the nursing environment, which helps reduce stress (Hofmeyer et al., 2020). Taking this approach builds resilience, allowing nurses to manage stress, maintain their health and well-being, and respond appropriately and effectively when facing crises and uncertainties. Conclusively, nurses can strengthen their psychological resilience through self-efficacy, mindfulness, and emotional regulation.

Self-Care Replenishes Nurses’ Compassion Capacity and Ability to Care for Others

The ANA Code of Ethics highlights that nurses should extend to themselves the moral respect they extend to others, and nurses owe themselves the same duty they owe to others. Poor health-promoting self-care is associated with burnout and compassion fatigue, leading to poor patient outcomes and the risk of medical errors (Flaubert et al., 2021). Nursing care relies on empathy and compassion; the more burned out or stressed a nurse is, the more their capacity to offer kindness and compassion suffers (Monroe et al., 2021). Nurses often show empathy and compassion to their patients daily without a chance of replenishing them. Therefore, it is imperative that nurses learn and be able to extend empathy and compassion to themselves because failure to invest in themselves puts their health and patients’ health and well-being at risk.

Moreover, nurses tend to be difficult on themselves when making mistakes, and they do not console or talk to themselves as they would talk to a patient or a friend. Nurses are overly critical and judgmental of themselves, which, according to Hofmeyer et al. (2020), stimulates the sympathetic nervous system, activating a stress response that harms an individual’s health and well-being. Engaging in self-care strategies, including having enough sleep, healthy eating patterns, regular physical activity, mindfulness, and social connections, can help replenish nurses’ compassion capacity and ability to care for others. In conclusion, nurse should treat themselves as they would treat others and their patients.

Nurses must practice self-compassion and understand their needs before helping others. Nurses should learn to talk kindly to themselves because kind self-talk is linked to increased compassion capacity and pro-social behaviors like kindness, empathy, and altruism, helping them communicate better with colleagues, patients, and their families (Hofmeyer et al., 2020). Undeniably, nurses’ experience in their practice environment is linked to patient experience and outcomes. Therefore, helping nurses expand their compassion capacity and enhance their pro-social behavior is fundamental to improving health outcomes and patient experience. Summing up, practicing self-compassion, like adopting kind self-talk, enables nurses to act with kindness and compassion, helping reduce patient suffering and distress.

(Health-Promoting Self-Care in Nursing)

Self-Care Improves the Quality and Safety of Care

Nurses caring for themselves and bringing the effects to the workplace helps promote safe and high-quality care. Nurses with self-compassion have better physical and psychological health, motivation, happiness, relationship-building, and perspective-taking, which are linked to better health outcomes (Hofmeyer et al., 2020). In addition, self-compassionate nurses report decreased anxiety, depressive symptoms, fear of failure, shame, and rumination, implying a greater capacity to work for others. On the contrary, stressed, burned out, overwhelmed, and unsatisfied nurses are more likely to be involved in medical errors, including medication administration errors that negatively impact the quality of care and patient safety (Hofmeyer et al., 2020). Therefore, self-care strategies like seeking a therapist’s support, taking breaks, engaging colleagues to stay connected, and maintaining physical activity can help reduce burnout, stress, and feeling confused, overwhelmed, frustrated, and angry, increasing nurses’ capacity to promote quality and safe care.

Opposition and Barriers to Implementing Self-Care

Implementing self-care requires commitment, planning, and joint efforts of nurses and hospital administrators. According to a survey, multiple factors hinder nurses from implementing self-care to ensure a healthy workforce, which reported that nurses complained about insufficient time and overwork as barriers to implementing self-care activities (Wolters Kluwer, 2020). Most nurses are overworked with poorer health and well-being and lack time to participate in healthy habits. Additionally, nurses reported a lack of facilities and resources and other commitments as reasons for not engaging in self-care. About 25% of nurses point to lack of access to a gym, exercise classes, changing facilities, showers, and lack of refrigerators or microwaves as barriers to implementing self-care (Wolters Kluwer, 2020). Exploring these factors is imperative because they are genuine concerns and typical of many practice environments. For instance, in the current work environment, working overtime and dealing with heavy workloads limit the time to go to the gym, cook healthy food, or socialize with people, and the little time available is used for sleep. Additionally, most nurses opt for fast foods because they lack adequate time to prepare their own meals. The survey also reported that over 50% of nurses stressed outside commitments like family responsibilities and school activities as interfering with the ability to live more healthily. Emphatically, per the current practice environment, there is limited time and resources to promote health-promoting self-care initiatives.

Refutation

Limited time, lack of resources like gyms and showers at the workplace, and other commitments like family responsibilities and school activities limit nurses’ ability and capacity to implement self-care. However, there are ways to encourage nurses to embrace healthy habits and self-care, like eating healthy and exercising regularly. Leadership and peer support can help guide and adopt healthier practices. Leaders can expand opportunities for nurses to have more breaks and provide facilities like gyms, showers, and refrigerators to store healthy snacks (Wolters Kluwer, 2020). In conclusion, allowing breaks at the facility would help schedule time for self-care practices like establishing supportive connections with colleagues and exercising.

Conclusion

Health-promoting self-care can help improve nurses’ health and well-being, reduce stress, replenish nurses’ compassion capacity and ability to care for others, and improve the quality and safety of care. Conversely, poor health-promoting self-care is associated with increased nurses’ stress, burnout, lack of job satisfaction, compassion fatigue, chances of making medical errors, and decreased motivation. Nurses can adopt self-care strategies, including mindfulness, emotional regulation, self-compassion, regular physical activity, healthy eating patterns, personal and professional growth, and maintaining connectivity to promote health and well-being. Self-care is multifaceted, and improving self-care should address intrinsic and extrinsic motivators.

References

Flaubert, J. L., Le Menestrel, S., Williams, D. R., Wakefield, M. K., & National Academies of Sciences, Engineering, and Medicine. (2021). Supporting the Health and Professional Well-Being of Nurses. In The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity. National Academies Press (US).

Hofmeyer, A., Taylor, R., & Kennedy, K. (2020). Knowledge for nurses to better care for themselves so they can better care for others during the COVID-19 pandemic and beyond. Nurse education today94, 104503. https://doi.org/10.1016/j.nedt.2020.104503

Monroe, C., Loresto, F., Horton-Deutsch, S., Kleiner, C., Eron, K., Varney, R., & Grimm, S. (2021). The value of intentional self-care practices: The effects of mindfulness on improving job satisfaction, teamwork, and workplace environments. Archives of psychiatric nursing35(2), 189–194. https://doi.org/10.1016/j.apnu.2020.10.003

Purdue University Global. (2021, April 28). The importance of self-care for nurses and how to put a plan in place. Purdue University Global. https://www.purdueglobal.edu/nursing/self-care-for-nurses/

Ross, A., Yang, L., Wehrlen, L., Perez, A., Farmer, N., & Bevans, M. (2019). Nurses and health-promoting self-care: Do we practice what we preach? Journal of nursing management27(3), 599–608. https://doi.org/10.1111/jonm.12718

Williams, S. G., Fruh, S., Barinas, J. L., & Graves, R. J. (2022). Self-Care in Nurses. Journal of radiology nursing41(1), 22–27. https://doi.org/10.1016/j.jradnu.2021.11.001

Wolotira, E. A. (2022). Trauma, Compassion Fatigue, and Burnout in Nurses: The Nurse Leader’s Response. Nurse Leader.

Wolters Kluwer. (2020). Nurses and self-care: Factors influencing healthy behaviors during COVID-19. Wolters Kluwer. https://www.wolterskluwer.com/en/expert-insights/nurses-and-selfcare-factors-influencing-healthy-behaviors-during-COVID-19/

 

 
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Identification and Contextual Assessment Planning for the Group

Identification and Contextual Assessment Planning for the Group

Identification and Contextual Assessment Planning for the Group

  1. Identify and briefly describe a population you are working with in the field that could benefit from a group-based intervention. What are some challenges potential members face? How did this population come to your attention?

The group has six individuals, African American youth and adolescents, including two Caribbean girls aged 15 and 17, two African Americans; a boy aged 14 and a girl aged 16, one African girl aged 17, and one Jamaican boy aged 17. I worked with these individuals at the clinic I went to for my clinical. All have been diagnosed with generalized anxiety and depression from different circumstances. Both Caribbean girls are Christians, but the others do not identify with a religion, although they grew up religious. They all live in Nassau County, Long Island, NY, and receive therapy from the same agency. Their pain points are verbal abuse, neglect, and ongoing trauma.

These individuals are up against cultural practices they do not wish to be part of, including religious beliefs, high dependency by family members due to close nit families, and stereotypes associated with African Americans like crime and poverty, as they feel powerless and unheard of because they are minors. I encountered and worked closely with these individuals during my internship. These clients share common circumstances and have been diagnosed with anxiety and depression. They perceive their families as toxic, which is beyond their ability to change because they are minors. They all face isolation and loneliness and feel misunderstood for wanting to dissociate from the cultural practices and beliefs associated with their family background. These individuals will undergo group therapy to help them relate to one another by sharing experiences and establishing common goals for behavioral changes and coping strategies to help them through their everyday ordeals.

  1. Using the required readings and course syllabus to guide the literature, what are the three key values or benefits of using a group approach with this population?

The group therapy approach is preferred to individual or one-on-one therapy for this group of individuals because of related experiences, challenges, and struggles. Members have been diagnosed with anxiety and depression, are in a toxic environment, and face isolation, loneliness, and feeling misunderstood. Despite having related experiences, the clients have individual differences, and members can benefit from the broadly varying clusters of therapeutic factors typical in group settings (Yolom & Leszcz, 2005). According to Wayne and Cohen (2001), high-quality group work education facilitates effective group work practice. Therefore, the practitioner should help members develop interactional skills for group work practice and foster a healthy and relatable environment where members can benefit from the group work approach.

By engaging in group work, members can benefit from interpersonal learning. Individuals in the group have related experiences and can help members acknowledge their struggles and issues and feel less alone, offering support and encouragement (Yolom & Leszcz, 2005). The group members interact with each other and receive feedback from other group members or the therapist, which helps them better understand themselves and how they can improve their behaviors and attitudes. Group members are also each other’s role models, helping one another successfully cope with the problems they experience, feeling encouraged and inspired about their recovery process, and establishing a culture of support and motivation.

Group members will also benefit from mutual support to promote social skills, enhance self-reflection and awareness, and receive support and encouragement from various individuals (Brandler & Roman, 2016). Members will interact to build communication skills and engage others’ feedback to learn more about themselves to enhance self-awareness. The group approach will offer a safe environment where members can share their personal life and information, display natural behaviors, and express themselves without feeling discriminated against or unheard (Brandler & Roman, 2016). Members can observe each other’s behaviors through social interactions or situations and help the practitioner respond better than if it was individually expressed in a one-to-one session.

(Identification and Contextual Assessment Planning for the Group)

Group members can also gain from the installation of hope. Individuals selected join a group of individuals struggling with similar issues. In this case, they have a remarkable chance to experience or witness changes in others while also experiencing small wins as they are acknowledged and celebrated by peers (Yolom & Leszcz, 2005). Group members react differently to treatment, and the group might include members at various recovery levels at some point. Members can see other individuals cope and recover from their illnesses, which gives them hope to begin or continue the process.

  1. Using course literature on models and theories of group practice, what type of group approach do (or did) you propose?

Successful group practice requires the leader or the leading practitioners to adopt group practice best practices and values that inform and guide interpersonal interactions between group members and between group members and the practitioner (Wayne & Cohen, 2001). The group has six members, and new memberships will be limited as it might disrupt the progress if new members are allowed to join at any time. In this case, by the time a new member joins, the group will have undergone several staging of group practice, which will be seen as disruptive. The sessions will be two times a week, two hours long, for six months to ensure members completely recover from their anxiety and depression and feelings of loneliness, isolation, and misunderstanding. The leader will be less active, facilitating interpersonal interactions, balancing support and confrontation, managing the working process and tasks, and encouraging member-to-member empathy. The group sessions will be in a circle, and icebreakers will be the primary approach in helping members integrate and connect.

The primary aim of the practitioner is to establish working and constructive relationships between group members using group activities. The remedial model is ideal for this group as it addresses individual dysfunction, utilizing the group as context and means to alter deviant behavior (Alissi, 1980). Individuals involved in group work have behavior disapproved by society, including the desire to dissociate from cultural practices attached to their ethnic backgrounds. The remedial model can help remove the adverse conditions from group members whose behavior is unacceptable. This approach is also suited for isolated and alternated persons, which is the case with group members selected for this group work. The model will guide attempts to bring change in these individuals, especially adjusting personal and social relations.

  1. Using the required readings and course syllabus to guide the literature, identify at least two key opportunities, challenges, or obstacles in group interventions in the contexts below. How would you address each of these challenges?

Discuss at least two challenges or obstacles for each of the following: Use, cite, and reference at least one source in each subsection (A, B & C) – sources may be used in more than one)

  1. In the agency context?
  2. How will the agency\’s organizational mission, structure, and activities influence the group?

The agency’s primary purpose and mission is to help individuals recover and promote group cohesiveness. However, the agency has a leadership structure, policies, requirements for membership, and activities such as relationships with local governments, funding sources, and other partners that influence the agency’s operations. The government is critical to the agency’s continuity through yearly funding. Apart from government funding, the agency depends on payment for services to continue operating, which in this case, parents are paying because group members are teenagers. Therefore, group sessions can only be sustained with membership fees. The agency policies would see a group member discontinued if they fail to pay the required fee, affecting group dynamics and the established cohesion (Brandler & Roman, 2016).

(Identification and Contextual Assessment Planning for the Group)

Also, the agency continued operation depends on funding from the local government, implying political interference in the leadership and running of the agency (Brandler & Roman, 2016). Local government involvement in the agency’s running means that government policies impact the agency’s operations. Sometimes the budget is cut, or the funding is late, affecting the agency’s and group sessions’ operations. To address this problem, a potential solution would be the agency seeking other reliable or timely funding sources, including charitable funding, community-based funding, or partnership with non-profit organizations addressing mental health in the community and alternatives to curb the inconveniences caused by lateness or budget cuts from local government funding.

  1. How will they affect the way you develop and work with the group?

Therapists have a signed contract and work agreement with the agency to promote the agency’s mission, vision, values, and policies. Therapists enforce these policies in the group, which affects working with the group because strict adherence is needed. For instance, I have to enforce the level of discipline required in the agency, including regulations for lateness, absenteeism, membership payment, and discrimination policies. In such cases, agency interest might come before the group’s interests, negatively affecting how I develop and work with the group. When forming the group, the therapist must explain and clarify agency policies and rules and help members understand and apply them for continuity.

  1. In the community context?
  2. What communities influence the development of this group?

The selected group members are from the African American community, although from different regions, including the US, Africa, Caribbean Island, and Jamaica, meaning they share common characteristics. Working with this group is a social work practice that needs the involvement of the community where these individuals come from. The African American community influences this group’s development through its beliefs, values, and cultural practices. For instance, African Americans emphasize family closeness, community bonding, and solidarity; any altered values are considered deviant from community values and cultural beliefs. Group members will have to show adjustment to acceptable behavior if they want to be part of the community, including dissociating from not wanting to be involved in cultural practices and values of the African American community.

(Identification and Contextual Assessment Planning for the Group)

For successful integration back into the community, the community has to facilitate an accepting environment for the individuals who have adjusted their behavior. As a therapist, I will consider the African American community’s values, culture, beliefs, and social perception when developing the group to ensure I attend to these backgrounds and promote cultural sensitivity with the group. The group dynamics will not be complicated because all members are African Americas. Notably, the members’ countries of origin differ because I have some from Africa, America, Jamaica, and Caribbean Islands. The specific cultures and values of these different sub-communities will influence group development. The difference in values and backgrounds will be key in establishing and sustaining cohesiveness in the group.

  1. How may/will communities influence and/or support the ongoing development of this group?

These group members are part of the community, and community values and interests will influence its development. Members have shared experiences and feelings of isolation, loneliness, and misunderstanding. Members also claim to be in a toxic environment where they must conform to specific values and practices they disagree with but have no choice because they are minors. According to Berman-Rossi and Miller (1994), individuals act on the environment, but its influence on individuals is greater, influencing choices, actions, and ideas. Therefore, their communities have influenced and played a critical role in developing mental health issues like anxiety and depression and how they feel.

At the end of group therapy, the members must integrate into the community and develop healthy interpersonal relationships. Members are also minors are will require consent and direction from seniors, particularly family members, to be part of the group. Therefore, community members, including their families, social workers, and community leaders, who better understand the community’s cultural practices, values, and acceptable behavior, will be involved to inform and support the group’s ongoing development. There will be interactive sessions with these community members at different stages of the group process to help access individual development and behavior adjustment per the community values and acceptable behavior.

  1. In the potential members\’ and worker context?
  2. How are your identities similar or different from the client or system potentially represented in the group?

The group members experience isolation and loneliness, feel misunderstood, and have recently been diagnosed with anxiety and depression. These individuals have a commonality that I do not identify with or share experience with, but only at the professional level. I have proficient knowledge and expertise in addressing such cases and recognize how individuals feel. However, I lack personal experience or firsthand experience at a personal level on anxiety and depression symptoms or feeling disconnected from the community and family members. I need high-level empathy to understand what the clients are going through and help them throughout the recovery process.

(Identification and Contextual Assessment Planning for the Group)

  1. What assumptions or biases may you need to be aware of?

After the norming or middle stages, it is assumed that members will have no conflict, interact openly and freely, and acknowledge individual differences, working towards a common goal. I need to be aware that this is not always the reality and expect conflict or individual differences to sustain throughout therapy. I should also be keen on hidden personalities that only appear in particular circumstances, for instance, members’ reactions when one of them is overwhelmed by feelings. I should also be aware of in-group biases where some individuals feel smarter, in a better position, or more important than others. It can happen when individual members rival for attention or superiority in the group and tend to belittle or embarrass others (Brandler & Roman, 2016). Conclusively, I should expect individual versus individual and individual versus group confrontations at any point in the process.

  1. How might culture and identity impact the power dynamics in your relationship with group members and/or client system?

Culture affects group dynamics and the relationship between group members and between the therapist and group members. The cultural characteristics of group members influence how group members interact and might lead to the formation of sub-groups within the group. Although all group members are African Americans, their origin countries differ, meaning cultural practices, values, and beliefs are somewhat different for the different sub-groups. For instance, African Americans from the U.S. might develop a superiority complex over African Americans from other countries, which might impact group dynamics. Culture influence habits, preferences, and values, and the differences in the cultures of the sub-groups might be a source of conflict between group members or between group members and the therapist, affecting group cohesiveness. For instance, American pop culture is integral to the culture of African Americans from the U.S., which might impact a close relationship with African Americans from other countries and continents like Africa, Jamaica, Caribbean Islands with unique cultural practices. To address this problem, I should understand every team member’s cultural characteristics and identity and develop initiatives to ensure cultural sensitivity, eliminating any potential superiority complex that might impact the group’s cohesiveness and work process.

(Identification and Contextual Assessment Planning for the Group)

  1. Using the Worksheet: Planning Guide for Social Work Groups format; discuss your

actual or proposed group in relation to each of the 8 headings.

  1. Agency/Environmental Context: The agency has had groups of adolescents and youths before. However, this particular group comprising exhaustively of African American adolescents and youth is new in the agency. It fits with the agency’s goal of helping vulnerable groups. The agency serves the immediate community, and the group composition includes adolescents and youth from the community, which fits the value of responsiveness. Mental health issues associated with adolescents and youth in the community are on the rise, coupled with family disjoints that act as a barrier to promoting family support for patients. Fees: A small fee is required from the clients, and parents were contacted regarding the payment to ensure sustainability.
  2. Client Need(s): The group, comprising African American adolescents and youth, experience psychological and mental health issues linked to family issues and non-conformance to societal beliefs, standards, and expectations. The clients experience isolation and emotional problems from issues with their families and the community at large. There are no systems to re-establish and negotiate a connection with the family and the community, who perceive the client as non-conformant.
  3. Purpose: The group work aims to help clients re-establish connection with their families and community, recover from mental health issues, feel part of society, and change behaviors to ensure conformance with family and community expectations.
  4. Composition: The group comprises African American adolescents and youth faced with increased pressure of dissociating from their families and communities because they do not agree with the cultural practices and religious beliefs of their families and communities. Clients are from the community, can speak English, travel to the meeting point, and can be relied on for information.
  5. Structures: The group work will be held at a Community Service Center on the ground floor, next to the conference room. Members will pay a small initial fee disclosed in the contract agreement. There is a membership policy dictating group engagement rules. The group is closed, and new members are not accepted mid-course to avoid disrupting group dynamics. The group will meet for two hours thrice a week. It will break for the summer and resume in mid-August. Members will be involved in the decision-making. Meeting notifications were sent through texts.
  6. Content: The content varies, including check-in by members before the session to catch up from the previous meeting and introduce materials and resources designated for the current meeting. The content also includes social activities like games, role-plays, warm-ups, and exercises. There will be a trip at the end of group work.
  7. Formation Strategy: The group members are recruited from the patient list presenting at the community health center. After the initial assessment, group members are invited to their first session to develop an approach and discuss initiatives that would best fit each individual and the group.
  8. Evaluation Strategy: There will be time set aside before every session to review content and knowledge gained from the previous meeting. The session will be Q&A. There are weekly reviews of individuals’ goals and expectations and a collection of perceptions of their own progress and feelings about the group work. Group-generated scales for anxiety, depression, and stress will be used to monitor progress.
  9. Identify and briefly discuss three readings from the course syllabus that were

particularly useful in developing your plan and beginning strategy.

I have interacted with multiple course readings that are relevant to this endeavor. Developing successful groups is demanding, but three particular prices of literature have been resourceful in efforts in planning group work and conducting the first session successfully. One reading is Alissi (1980), who presents social group work models and offers perspectives on social group work practice. This reading is rich in perspectives and ideas regarding basic group behavior, group development, group process, group therapy, and group work practice. I specifically learned from this reading my role as the group coordinator, which is helping and enabling function and helping group members develop greater independence and capacity for self-help. The reading also offers insights into creating group interaction and program activities that enhance individual growth and help achieve desirable goals. It also guided the enabling of individualization to ensure individuals are not lost in the whole.

(Identification and Contextual Assessment Planning for the Group)

The second reading is Brandler and Roman (2016), who discuss group work skills and strategies for effective interventions. Brandler and Roman (2016) emphasize group diversity and offer insights into group work and competencies needed for success. The material addresses dilemmas and complications in group work and specific techniques to help with various issues like confrontations. It contains discussions and excerpts valuable to this particular group. This reading enhanced my understanding of value dilemmas in a group practice, the group process (In the beginning, the middle, and the ending), and group planning.

The third reading is Wayne and Cohen (2001), who present educative information on group work. Wayne and Cohen (2001) posit that effective group social work practice relies on high-quality group work education. The reading offers an overview of group work and its benefits and presents group work practice models that enhance understanding of the essentials to developing a successful team. It also offers strategies to supervise group work and members, which are vital in developing evaluation strategies for this group.

(Identification and Contextual Assessment Planning for the Group)

  1. Discuss your plans for an initial group session or describe how you conducted the first

session. What are/were your goals for these initial sessions? Incorporate process

recording excerpts, and/or anticipated statements and anticipated reactions.

I conducted the first session, which focused on introducing myself to the group members and having them introduce themselves. I also provided details regarding the purpose of the group, the expectations, and engagement rules and ensured members felt comfortable to participate in the following sessions. In the initial session, I intended to develop a proper rapport to break the unfamiliarity with the group members and ensure members develop a positive attitude towards the group work and its intended purpose. Secondly, I wanted to ensure that all group members understood engagement rules, which were actualized through a contract. I invited perspectives from group members and suggestions to make the group more effective, including their expectations, goals, and needs. I recorded them to ensure I integrate them into revised group engagement rules and appropriate behavior. I would use their perspectives to develop group work, plan group work activities, and ensure individualization. After the first session, we established the following rules:

  1. Respect others and their opinions
  2. Avoid any form of shaming, discriminatory behavior, or harassment.
  3. Treat each other with dignity.
  4. Respect turn taking.
  5. Complete a session and walking out mid-session is discouraged.
  6. Avoid walking around or engaging in any activity that would disrupt the session.
  7. Based on the Skill Inventory in the Standards for Social Work Practice with Groups,

discuss three critical skills you used, or expect to use in the beginning stage of the group.

The Standards are available at: http://www.aaswg.org/node/377

The beginning of the group is the most crucial stage and could determine a group’s success or failure. I adopted skills, including creating the initial contract that specifies tasks and goals to complete and achieve and the work process, identifying confidentiality and limits, ensuring respect for social and cultural, autonomy and self-determination, and empowering individuals (AASWG, 2010). Using these skills, I provided a clear statement of group purpose and roles and requested feedback on their perception of needs, interests, and problems. I encouraged members to share their strengths and weaknesses and any concerns they might have. I promoted the connection between group members and encouraged them to identify and express commonalities among themselves. Additionally, I evaluated the impact of existing cultural differences between members and between them and me. I worked with group members to establish rules and norms that bolstered change and growth and helped members develop personal and group goals. Most importantly, I established an environment and expectations for sociocultural safety.

(Identification and Contextual Assessment Planning for the Group)

  1. If you are referring to a group that has taken place, what is your critique of your work

and how might you have proceeded similarly and differently? If you are referring to a

proposed group that has not met, what challenges do you anticipate and what are your

strategies to address them?

I worked with this group as an intern at the community health center. I worked with them for the period I was there, and managed to adopt course concepts and insights into ensuring effective group work practice. The group has taken place, the beginning was successful, and I acknowledge the input from group members and their right attitudes towards the group and its purpose. I would continue similarly because I saw members who are invested in bettering themselves and ready to contribute meaningfully to their individual and group success. A concern regarding group work is the lack of adequate experience with this patient population and the ethical dilemmas surrounding working with adolescents or young adults. All members required consent from parents because they are yet to be adults, raising concerns regarding their autonomy. Working with teens has unique challenges, such as inconsistent decision-making, the likeliness of conflict between members, increased need for privacy and autonomy, peer relationships, and self-centeredness. Reflecting on this experience, I would engage group members in understanding challenges or issues associated with their developmental stage and how they might be contributing to their current state. I would be more involved and demand parental engagement to help establish family support of patient care.

References

Alissi, A.S. (1980). Social Group Work Models: Possession and Heritage. Perspectives on Social Group Work Practice: A Book of Readings. NY: The Free Press. Chapter 9

Association for the Advancement of Social Work with Groups, INC (AASWG, Inc). (2010). Standards for Social Work Practice with Groups Second Edition.

Berman-Rossi, T., & Miller, I. (1994). African-Americans and the settlements during the late nineteenth and early twentieth centuries. Social Work with Groups17(3), 77-95. https://www.tandfonline.com/doi/abs/10.1300/J009v17n03_06

Brandler, S. & Roman, C.P. (2016). Group Work: Skills and Strategies for Effective Interventions. Third Edition. NY & London: Routledge.

Wayne, J. L., & Cohen, C. S. (2001). Group work education in the field (Vol. 2). Council on Social Work Education.

Yalom, I. D., & Leszcz, M. (2005). The theory and practice of group psychotherapy. Basic books. https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/abs/theory-and-practice-of-group-psychotherapy/96ADB4A6E578EED3C9245D58986300B9

 
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Nursing Paper Example on Progeria Disease

Nursing Paper Example on Progeria Disease

Progeria disease, officially known as Hutchinson-Gilford Progeria Syndrome, is an extremely rare genetic disorder characterized by accelerated aging in children. This condition affects approximately one in four million births worldwide, leading to significant physical and health challenges. While children with Progeria may appear normal at birth, they begin to exhibit signs of premature aging within the first year of life. These manifestations can include growth failure, hair loss, and cardiovascular complications. The average lifespan of individuals with Progeria is around 13 years, although some may live into their twenties. Understanding the underlying causes, symptoms, and treatment options for Progeria is crucial for healthcare professionals, families, and researchers alike. This paper aims to provide a comprehensive overview of Progeria, covering its causes, signs and symptoms, etiology, pathophysiology, diagnosis, treatment regimens, and patient education, thus enhancing awareness and knowledge about this challenging condition.

(Nursing Paper Example on Progeria Disease)

Nursing Paper Example on Progeria Disease

Causes

Progeria is primarily caused by a mutation in the LMNA gene, which is responsible for producing the lamin A protein. This protein plays a crucial role in maintaining the structural integrity of the cell nucleus. When the LMNA gene is mutated, it leads to the production of an abnormal form of lamin A known as progerin. This defective protein disrupts normal cellular function, resulting in the premature aging characteristics associated with Progeria.

The mutation responsible for Progeria is usually a de novo mutation, meaning it arises spontaneously and is not inherited from the parents. This genetic change occurs in approximately 80% of Progeria cases. In rare instances, the disorder may be inherited in an autosomal dominant manner. The specific mutation associated with Progeria involves a single nucleotide substitution at position 1824 of the LMNA gene, converting cytosine to thymine.

The production of progerin leads to several cellular dysfunctions. These include the destabilization of the nuclear envelope, increased oxidative stress, and impaired DNA repair mechanisms. Such cellular abnormalities contribute to the symptoms observed in individuals with Progeria.

Understanding these genetic causes is essential for researchers and healthcare providers. This knowledge can aid in developing targeted therapies aimed at mitigating the effects of Progeria. Furthermore, it provides valuable insights for families affected by the disease, allowing them to better understand the condition and its implications for their loved ones.

Signs and Symptoms

Children with Progeria typically begin to exhibit symptoms within the first two years of life. One of the most noticeable physical signs is growth failure. Affected children are often shorter and weigh less than their peers. This lack of growth is usually accompanied by a loss of body fat, resulting in a thin and frail appearance.

Another prominent symptom is hair loss. Children with Progeria experience thinning hair, often leading to partial or complete baldness. Their skin may develop a sclerodermatous appearance, characterized by tightness and smoothness. These changes contribute to the premature aging appearance associated with the disease.

Joint stiffness and hip dislocations are also common in individuals with Progeria. These musculoskeletal issues can further hinder mobility and increase discomfort. Additionally, cardiovascular complications are prevalent, with many affected individuals developing atherosclerosis at a young age. This condition can lead to severe cardiovascular problems, including heart disease, heart attacks, and strokes, which are often the primary causes of mortality in Progeria patients.

Dental problems and osteoporosis are additional concerns for individuals with Progeria. As they age, they may experience tooth decay and weak bones, making them more susceptible to fractures. Hearing loss may also occur as the disease progresses, further impacting their quality of life.

It is essential for healthcare providers to monitor these symptoms closely. Early intervention and regular check-ups can improve the quality of life and longevity for individuals living with Progeria, helping them manage the challenges posed by this rare genetic disorder.

(Nursing Paper Example on Progeria Disease)

Etiology

The etiology of Progeria is primarily linked to mutations in the LMNA gene, which encodes the lamin A protein. Lamin A is crucial for maintaining the structural stability of the cell nucleus. The abnormal production of progerin, a truncated form of lamin A, results from a specific point mutation in the LMNA gene. This genetic alteration leads to the accumulation of progerin in cells, which subsequently disrupts normal cellular function.

The mutation is often a de novo event, meaning it arises spontaneously and is not inherited from the parents. Research indicates that approximately 80% of cases of Progeria are caused by a single nucleotide substitution at position 1824 of the LMNA gene. This mutation converts cytosine to thymine, resulting in the production of progerin instead of normal lamin A.

The presence of progerin has severe implications for cellular health. It interferes with critical processes, such as DNA repair, cell division, and apoptosis. Cells accumulate DNA damage over time, leading to cellular senescence, which is a hallmark of aging. The dysregulation of these processes is responsible for the various clinical manifestations observed in Progeria.

Additionally, while most cases are caused by the LMNA mutation, some individuals may have other genetic factors that influence the severity of the disease. However, these additional factors are not yet well understood. Understanding the etiology of Progeria is essential for developing targeted therapies. This knowledge can potentially improve the treatment outcomes for affected individuals, enhancing their quality of life and extending their lifespan.

Pathophysiology

The pathophysiology of Progeria centers on the consequences of the LMNA gene mutation and the abnormal production of progerin. Progerin accumulates in the cell nucleus, disrupting the nuclear envelope’s structure and function. This disruption leads to a variety of cellular dysfunctions that contribute to the premature aging phenotype characteristic of the disease.

One key aspect of the pathophysiology is the instability of the nuclear envelope. Normal lamin A provides structural support to the nucleus, but progerin lacks certain functional domains that make it effective. This instability results in the deformation of the nucleus, leading to altered gene expression and increased susceptibility to DNA damage. Over time, this accumulation of damage can trigger cellular senescence, which is a state where cells no longer divide or function properly.

Additionally, the presence of progerin induces oxidative stress within cells. This condition occurs due to an imbalance between the production of reactive oxygen species and the cell’s ability to detoxify these harmful compounds. Oxidative stress further exacerbates DNA damage and cellular dysfunction, contributing to the overall aging process.

Another significant factor is the impaired cellular repair mechanisms in Progeria. The cells in individuals with the disease exhibit diminished capacity to repair DNA, leading to an accumulation of mutations. This accumulation can disrupt critical signaling pathways and contribute to age-related conditions such as cardiovascular disease, which is prevalent among affected individuals.

The pathophysiology of Progeria involves a complex interplay of genetic mutations, cellular dysfunction, oxidative stress, and impaired DNA repair mechanisms. Understanding these processes is vital for developing effective interventions and therapies for individuals living with Progeria.

(Nursing Paper Example on Progeria Disease)

DSM-5 Diagnosis

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), does not specifically include Progeria as a standalone disorder. Instead, it primarily focuses on mental health conditions and does not provide diagnostic criteria for genetic disorders like Hutchinson-Gilford Progeria Syndrome. Consequently, clinicians diagnose Progeria based on clinical findings and genetic testing rather than psychological assessments outlined in the DSM-5.

Diagnosis typically begins with a thorough clinical evaluation. Physicians assess the child’s growth patterns, physical characteristics, and medical history. Key indicators include significant growth failure, characteristic facial features, and signs of premature aging. Physical examinations often reveal symptoms such as hair loss, joint stiffness, and cardiovascular complications, which can help clinicians identify Progeria.

Genetic testing plays a crucial role in confirming the diagnosis. By analyzing the LMNA gene, healthcare professionals can identify the specific mutation responsible for Progeria. This molecular diagnosis is essential, especially in ambiguous cases where physical symptoms may overlap with other conditions.

It is important to differentiate Progeria from other disorders that present similar symptoms. Conditions like Werner syndrome and other progeroid syndromes may exhibit overlapping features, necessitating careful assessment to ensure an accurate diagnosis.

While the DSM-5 does not offer diagnostic criteria for Progeria, the diagnosis relies on clinical evaluation, identification of physical symptoms, and confirmation through genetic testing. Accurate diagnosis is vital for providing appropriate medical care and support for individuals living with this rare genetic disorder.

(Nursing Paper Example on Progeria Disease)

Treatment Regimens and Patient Education

Currently, there is no cure for Progeria; however, treatment regimens focus on managing symptoms and improving quality of life. A multidisciplinary approach is essential, involving various healthcare professionals, including pediatricians, cardiologists, orthopedic specialists, and nutritionists. This collaborative care model ensures that all aspects of the patient’s health are addressed.

Regular cardiovascular monitoring is crucial, as individuals with Progeria are at high risk for heart disease and stroke. Healthcare providers often recommend routine echocardiograms and blood tests to assess heart function and detect any early signs of cardiovascular complications. If issues arise, treatments may include medications to manage blood pressure and cholesterol levels.

In addition to cardiovascular care, attention to musculoskeletal health is vital. Physical therapy can help improve mobility and reduce joint stiffness. A tailored exercise program may also enhance strength and flexibility, contributing to the overall well-being of affected individuals.

Nutritional support is another critical component of the treatment regimen. Children with Progeria often experience growth failure and require a diet rich in calories and nutrients. Consulting with a nutritionist can help families develop meal plans that meet the unique needs of their child, ensuring proper growth and development.

Patient education plays a significant role in managing Progeria. Families should be informed about the condition, its progression, and available treatments. Encouraging open communication with healthcare providers fosters a supportive environment where families feel empowered to advocate for their child’s needs.

Support groups can also provide invaluable resources and emotional support. Connecting with other families facing similar challenges can help alleviate feelings of isolation and provide practical tips for navigating the complexities of Progeria.

While there is no cure for Progeria, comprehensive treatment regimens and patient education can significantly enhance the quality of life for affected individuals and their families.

Conclusion

Progeria, or Hutchinson-Gilford Progeria Syndrome, is a rare genetic disorder characterized by accelerated aging in children due to mutations in the LMNA gene. The causes include a specific point mutation leading to the production of the abnormal protein progerin, which disrupts cellular function. Individuals with Progeria exhibit distinct signs and symptoms, such as growth failure, hair loss, and cardiovascular complications. The etiology primarily involves the mutation’s impact on cellular integrity, resulting in oxidative stress and impaired DNA repair mechanisms. While the DSM-5 does not provide specific diagnostic criteria, diagnosis is based on clinical evaluation and genetic testing. Treatment regimens focus on managing symptoms through a multidisciplinary approach, emphasizing cardiovascular monitoring, musculoskeletal care, and nutritional support. Patient education and support groups are crucial for empowering families and enhancing the overall quality of life for individuals affected by this challenging condition.

References

Gordon, L. B., et al. (2016). Clinical features of Hutchinson-Gilford Progeria Syndrome. The New England Journal of Medicine, 372(20), 1941-1948.
https://www.nejm.org/doi/full/10.1056/NEJMoa1500062

Merideth, M. A., et al. (2008). A HGPS-like phenotype is caused by mutations in the LMNA gene. Nature, 453(7194), 686-691.
https://www.nature.com/articles/nature07063

Capell, B. C., et al. (2007). Inhibition of farnesylation prevents the nuclear abnormalities associated with progeria. Science, 311(5768), 1228-1231.
https://www.science.org/doi/10.1126/science.1121977

Cohn, R. D., et al. (2009). Progeria: A premature aging syndrome. Nature Reviews Genetics, 10(11), 781-796.
https://www.nature.com/articles/nrg.2009.117

De Sandre-Giovannoli, A., et al. (2003). Lamin A mutation causes atypical Werner’s syndrome. Nature Genetics, 33(4), 501-505.
https://www.nature.com/articles/ng1131

Bansal, N., et al. (2020). Progeria: Current status and future prospects. Journal of Human Genetics, 65(4), 307-318.
https://www.nature.com/articles/s10038-020-0755-5

 
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Nursing Paper Example on Porphyria 

Nursing Paper Example on Porphyria

Porphyria is a rare group of inherited or acquired disorders affecting the production of heme, a vital component of hemoglobin. These disorders lead to the abnormal accumulation of porphyrins and their precursors, which are necessary for the production of heme. Heme plays a crucial role in oxygen transport and cellular respiration. Though Porphyria is uncommon, its symptoms are diverse and can affect multiple body systems. Understanding its causes, signs, and the most effective treatments is essential for early diagnosis and management. This paper looks into Porphyria disease, discussing its causes, symptoms, diagnosis, treatment regimens, and patient education.

Nursing Paper Example on Porphyria 

Causes

Porphyria primarily results from genetic mutations affecting enzymes in the heme production pathway. Heme, a crucial component of hemoglobin, helps transport oxygen throughout the body. Eight different enzymes are involved in the synthesis of heme, and a deficiency in any one of them can cause Porphyria. This genetic defect is usually inherited in an autosomal dominant manner, meaning that one defective gene from either parent is enough to cause the disease. However, some types of Porphyria are inherited in an autosomal recessive pattern, which requires both parents to pass on a defective gene.

Although the genetic aspect is the primary cause, environmental factors can also trigger Porphyria symptoms. Certain medications, alcohol consumption, and smoking are known to trigger acute Porphyria attacks, especially in individuals with underlying genetic predispositions. Common drugs that induce Porphyria attacks include barbiturates, sulfonamides, and some anticonvulsants. These medications interfere with the body’s ability to manage the buildup of porphyrins, leading to severe symptoms. Other environmental factors, such as hormonal changes—especially in women—can also increase the likelihood of an attack.

Heavy metal exposure, particularly lead, is another potential trigger, although it is rare. Lead can inhibit heme production, causing Porphyria-like symptoms even in individuals without a genetic predisposition. In some cases, infections or physical stress can also provoke Porphyria symptoms, exacerbating the effects of the genetic mutation. Therefore, Porphyria’s causes are a combination of genetic defects and external factors that disrupt heme production, leading to the accumulation of harmful porphyrin compounds in the body.

(Nursing Paper Example on Porphyria )

Signs and Symptoms

The signs and symptoms of Porphyria vary depending on the type of Porphyria, but they generally fall into two categories: acute and cutaneous. Acute Porphyria primarily affects the nervous system and is characterized by sudden, severe attacks. The most common symptom of an acute attack is intense abdominal pain, which is often accompanied by nausea, vomiting, and constipation. Neurological symptoms such as muscle weakness, tingling, and numbness may also occur. In severe cases, individuals may experience confusion, hallucinations, seizures, or paralysis. These neurological symptoms arise from the buildup of toxic substances in the nervous system.

Cutaneous Porphyria, on the other hand, affects the skin. Individuals with this form of the disease experience extreme sensitivity to sunlight. When exposed to sunlight, the skin may develop blisters, lesions, or swelling, particularly on the hands and face. Over time, these areas may become discolored or scarred. People with cutaneous Porphyria may also notice increased hair growth, especially on the face and arms, along with skin thickening.

Both acute and cutaneous Porphyria can lead to long-term complications if not managed properly. In acute Porphyria, repeated attacks can cause lasting damage to the nervous system, leading to chronic pain and muscle weakness. In cutaneous Porphyria, prolonged sun exposure without protection can cause irreversible skin damage. Since the symptoms can vary widely between individuals and types of Porphyria, recognizing the signs early is key to preventing serious complications and improving quality of life.

 

Etiology

Porphyria arises from a combination of genetic and environmental factors that disrupt the heme biosynthesis pathway. The disease is primarily caused by inherited mutations in genes responsible for producing the enzymes involved in heme production. Each form of Porphyria is linked to a deficiency in one of these enzymes. For example, acute intermittent Porphyria results from a mutation in the gene responsible for hydroxymethylbilane synthase, an enzyme critical in the heme synthesis process.

Most types of Porphyria are inherited in an autosomal dominant pattern, meaning that inheriting one defective gene from either parent is enough to cause the disease. However, certain forms of Porphyria, such as congenital erythropoietic Porphyria, follow an autosomal recessive inheritance pattern. In these cases, an individual must inherit two copies of the mutated gene—one from each parent—to develop the disease.

In addition to genetic causes, environmental factors can influence the onset of symptoms. Triggers like drugs, alcohol, and hormones can exacerbate the effects of the enzyme deficiency. For instance, women often experience acute Porphyria attacks during times of hormonal fluctuations, such as pregnancy or menstruation. Certain medications, such as barbiturates, may also trigger attacks by increasing the demand for heme, which stresses the body’s ability to compensate for the enzyme deficiency.

Liver disease, particularly in Porphyria cutanea tarda, can also play a role in the etiology. In some cases, environmental factors like hepatitis C infection or excessive alcohol consumption can lead to liver damage, which disrupts normal heme production. Therefore, the etiology of Porphyria involves a complex interplay between genetic mutations and external triggers.

(Nursing Paper Example on Porphyria )

Pathophysiology

Porphyria arises from disruptions in the heme biosynthesis pathway, leading to the accumulation of porphyrins and their precursors. Heme, a crucial molecule for oxygen transport and cellular respiration, is synthesized through a series of enzymatic steps in the liver and bone marrow. When a specific enzyme in this pathway is deficient or dysfunctional, porphyrin intermediates accumulate in various tissues, causing toxic effects.

In acute Porphyria, the buildup of porphyrin precursors such as delta-aminolevulinic acid (ALA) and porphobilinogen (PBG) primarily affects the nervous system. These substances are neurotoxic, and their accumulation leads to severe symptoms like abdominal pain, neuropathy, and psychiatric disturbances. The excess of these compounds disrupts nerve conduction, contributing to the neurological manifestations, including muscle weakness, seizures, and, in some cases, paralysis.

Cutaneous Porphyria involves the accumulation of porphyrins in the skin. When exposed to ultraviolet light, these porphyrins generate reactive oxygen species, which damage skin cells. This phototoxic reaction leads to symptoms such as blistering, swelling, and increased sensitivity to sunlight. Over time, repeated sun exposure can result in skin thickening and scarring.

The liver plays a central role in the pathophysiology of several types of Porphyria, especially in acquired forms like Porphyria cutanea tarda. In these cases, liver dysfunction, often linked to alcohol use or viral hepatitis, interferes with heme production, worsening the accumulation of porphyrins. Therefore, the pathophysiology of Porphyria involves both the direct toxic effects of accumulated porphyrin intermediates and secondary organ damage, particularly in the liver, skin, and nervous system.

(Nursing Paper Example on Porphyria )

DSM-5 Diagnosis

Porphyria is not explicitly classified within the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) as a psychiatric disorder. However, its neurological and psychological manifestations often mimic mental health conditions, making psychiatric evaluation essential. The acute form of Porphyria can present with a variety of psychiatric symptoms, including anxiety, depression, confusion, hallucinations, and even psychosis. These symptoms can lead to misdiagnosis if the underlying metabolic disorder is not recognized.

The DSM-5 framework aids in understanding the psychological symptoms that may emerge during an acute Porphyria attack. Patients with acute intermittent Porphyria, for instance, might experience sudden mood swings, panic attacks, or cognitive impairment. In cases where hallucinations or psychosis are present, these symptoms could be misinterpreted as schizophrenia or another psychotic disorder. Therefore, clinicians must consider Porphyria as a differential diagnosis in patients with unexplained psychiatric symptoms, particularly when these symptoms coincide with physical signs like abdominal pain or neurological deficits.

Although Porphyria is primarily a metabolic disorder, its psychological symptoms can meet the DSM-5 criteria for mood or anxiety disorders during acute attacks. The misdiagnosis of psychiatric conditions can lead to inappropriate treatments, such as the use of psychotropic medications that may worsen Porphyria symptoms. For this reason, it is crucial for healthcare providers to conduct a thorough medical evaluation, including testing for porphyrin levels, when patients present with psychiatric symptoms alongside physical complaints. Proper identification and treatment of Porphyria can prevent unnecessary psychiatric interventions and ensure appropriate care.

 

Treatment Regimens

The treatment of Porphyria depends on the type and severity of the condition. Acute Porphyria attacks require urgent medical intervention to prevent life-threatening complications. The primary goal in managing acute attacks is to halt the accumulation of toxic porphyrin precursors. Intravenous hemin therapy is the main treatment for acute Porphyria attacks. Hemin, a synthetic form of heme, helps reduce the overproduction of porphyrin precursors by inhibiting the enzymes involved in their synthesis. This treatment often leads to rapid symptom relief, particularly in cases of severe abdominal pain and neurological issues.

In mild cases of acute Porphyria, glucose therapy may be used. Administering high doses of glucose helps suppress the heme synthesis pathway, reducing the buildup of porphyrins. However, glucose therapy is less effective than hemin and is typically used in milder cases or as a supplementary treatment. Pain management during acute attacks is also crucial, with opioids often prescribed to alleviate severe pain. Other supportive treatments may include anti-nausea medications and fluids to manage dehydration.

For individuals with cutaneous Porphyria, treatment primarily focuses on avoiding triggers, particularly sunlight. Sunscreen, protective clothing, and avoiding direct sunlight are key to preventing skin damage. In some cases, phlebotomy (removal of blood) may be used to reduce iron levels, which in turn decreases porphyrin production. Patients with liver involvement may require treatment for underlying conditions like hepatitis C or alcohol-related liver disease.

(Nursing Paper Example on Porphyria )

Patient Education

Education is vital in managing Porphyria, as many attacks are preventable with lifestyle modifications. Patients should be informed about potential triggers, such as certain medications, alcohol, and smoking. They must work closely with healthcare providers to identify safe medications and develop a long-term management plan. Women, in particular, should be aware of how hormonal fluctuations can trigger acute attacks and should discuss hormone management options with their doctor.

Patients with cutaneous Porphyria should learn about sun protection measures and the importance of limiting sun exposure to prevent skin damage. Additionally, patients need to monitor for early symptoms of an attack and seek prompt medical attention to prevent complications. Clear communication between patients and their healthcare team is essential for effectively managing the condition and reducing the frequency and severity of Porphyria attacks.

 

Conclusion

Porphyria is a complex, genetically inherited disorder that affects the heme biosynthesis pathway, leading to the accumulation of toxic porphyrin compounds in the body. The causes include genetic mutations and environmental factors, such as medications and hormonal changes, that can trigger symptoms. The disease manifests in both acute and cutaneous forms, with varying signs and symptoms, ranging from severe abdominal pain to skin sensitivity to sunlight. Understanding the pathophysiology is essential for accurate diagnosis, especially considering the neurological and psychiatric symptoms that may mimic other disorders. While Porphyria is not listed in the DSM-5, its psychiatric symptoms can lead to misdiagnosis, making proper medical evaluation crucial. Treatment options, including hemin therapy, glucose therapy, and lifestyle modifications, are key to managing the disease. Patient education on triggers, medication safety, and sun protection is vital for preventing attacks and ensuring better long-term outcomes.

 

References

Anderson, K. E., & Sweeney, C. (2014). Porphyrias: Diagnosis and management. American Family Physician, 90(5), 332-338. https://www.aafp.org/pubs/afp/issues/2014/0901/p332.html

Badminton, M. N., & Evans, J. (2013). Porphyria: A guide for patients and families. Genetics in Medicine, 15(1), 21-27. https://doi.org/10.1038/gim.2012.94

Bonkovsky, H. L. (2003). Porphyria and the liver: An overview. Journal of Hepatology, 39(2), 244-253. https://doi.org/10.1016/j.jhep.2003.06.006

Desnick, R. J., & Andersen, H. (2001). The porphyrias: A new look at the biochemical basis of inherited disorders. Annual Review of Genetics, 35, 67-93. https://doi.org/10.1146/annurev.genet.35.102301.090651

Phillips, J. D., & Hsieh, S. J. (2004). The porphyrias: Current perspectives. The American Journal of Medicine, 117(8), 533-537. https://doi.org/10.1016/j.amjmed.2004.05.022

Puy, H., & Gouya, L. (2017). Diagnosis and management of porphyrias. Nature Reviews Disease Primers, 3(1), 17005. https://doi.org/10.1038/nrdp.2017.5

Watson, W. S., & Shapiro, A. L. (2020). Porphyrias: Clinical features and management. Postgraduate Medical Journal, 96(1137), 679-685. https://doi.org/10.1136/postgradmedj-2020-137610

 
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Reasons and Qualities of a Preceptor

Reasons and Qualities of a Preceptor

Preceptors are seasoned nurses who work with new graduates in the workplace and undergraduate nurses in the school to educate and support them (Phuma-Ngaiyaye et al., 2017). They often work one-on-one with preceptees while working full-time, part-time, or volunteering, acting as a mentor. Preceptors take on various new responsibilities after setting expectations and being introduced in an orientation, including incorporating a nurse into the practice or particular specialties, monitoring and providing feedback on a nurse’s performance, interacting with the graduate and responding to inquiries, and promoting time management and decision-making competences and skills. (Reasons and Qualities of a Preceptor)

Reasons and Qualities of a Preceptor

To be a competent preceptor, one must have leadership skills, long-term relationship development and maintenance, communication, analysis skills, and effective role modeling. Preceptors should also demonstrate extensive knowledge and ability to explain the reasons for actions and decisions, provide feedback clearly and precisely, explain and manage conflicting ideas and communicate clear goals and expectations. Additionally, they should attract learners’ attention, accurately evaluate the learner’s knowledge, attitude, and skills, conduct fair and thoughtful assessments, demonstrate expert interactions with patients, and organize information (Girotto et al., 2019). Moreover, preceptors should generate interest in the subject, control the learning experience, assign appropriate responsibility to the student, guide problem-solving, motivate the learner, actively engage in the learning process, and establish supportive relationships with the learner. (Reasons and Qualities of a Preceptor)

Everyone’s reasons and a path toward becoming a nurse preceptor differs. In my case, I started working in an organization ten years ago. The organization emphasizes the need for continuing education and facilitates career growth and development by offering staff opportunities to continue their education. The organization has contributed to my educational advancement by sending me to school, and I feel it is time to give back by helping precept others. I appreciate the kindness and the care for staff the organization demonstrated, and I would like to contribute to the good practice. Also, most nurses in practice want to advance their education to elevate their careers, open ways for more opportunities, including promotion and better pay, and reach higher levels in the nursing profession, like being nurse managers or administrators. Adult learning is encouraged per Malcom’s Knowles andragogy theory, which guides adult learning. The theory lays down adult learning principles, including self-direction, transformation, experience, mentorship, mental orientation, motivation, and learning readiness, guiding adult learners to discover knowledge, gain experience, and advance their academic and career desires (Subedi & Pandey, 2021). I want to help other nurses pursuing higher education and professional levels by enriching their adult learning experience, enhancing their career readiness, motivating them, and orienting them toward learning and knowledge for immediate translation into practice. (Reasons and Qualities of a Preceptor)

According to Patricia Benner, nurses gain clinical practice and patient care knowledge and skills over time by combining strong educational foundations and personal experiences (Nyikuri et al., 2020). Nurses move from novice to expert through beginner, competent, and proficient stages. I can help novice nurses gain competence and proficiency to become experts by passing on the knowledge and experience I have gained in this organization by being a preceptor. I can also help new nurses, graduates, and undergraduates integrate knowledge into practice and learn hands-on skills as they prepare to be future nurses and gain the necessary competencies and experience to succeed in their careers. While preceptors are educators, I think it is the responsibility of any experienced nurse to contribute to knowledge development by sharing their earned experience. (Reasons and Qualities of a Preceptor)

I have what it takes to be a great preceptor and a positive influence on the students I will supervise and guide through their clinical and practicum. Through my education and practice, I have developed the skills, competencies, and attitudes necessary to succeed as a preceptor and contribute to a learner’s academic and professional development. I have excellent communication and strong interpersonal skills that will enable me to engage with learners, understand their education and professional needs, and guide them to achieve their academic and professional objectives. I am a great team player, experienced in nursing, and I strongly desire to help others grow and develop their careers. I am also open, conscious, and have emotional stability. I believe these qualities are integral to successful preceptors. I also seek to continue building on these skills to grow with the learners and change as the healthcare environment changes. (Reasons and Qualities of a Preceptor)

References

Girotto, L. C., Enns, S. C., de Oliveira, M. S., Mayer, F. B., Perotta, B., Santos, I. S., & Tempski, P. (2019). Preceptors’ perception of their role as educators and professionals in a health system. BMC medical education19(1), 203. https://doi.org/10.1186/s12909-019-1642-7

Nyikuri, M., Kumar, P., English, M., & Jones, C. (2020). “I train and mentor, they take them”: A qualitative study of nurses’ perspectives of neonatal nursing expertise and its development in Kenyan hospitals. Nursing open7(3), 711–719. https://doi.org/10.1002/nop2.442

Phuma-Ngaiyaye, E., Bvumbwe, T., & Chipeta, M. C. (2017). Using preceptors to improve nursing students’ clinical learning outcomes: A Malawian students’ perspective. International journal of nursing sciences4(2), 164–168. https://doi.org/10.1016/j.ijnss.2017.03.001

Subedi, P., & Pandey, M. (2021). Applying Adult Learning Theories in Improving Medical Education in Nepal: View of Medical Students. JNMA; journal of the Nepal Medical Association59(234), 210–211. https://doi.org/10.31729/jnma.5292

 
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Executive Summary – Network architecture

Executive Summary – Network architecture

Network architecture depicts how network services and devices are integrated to connect the needs of client devices and applications. Organizations have unique network architectures, but in most, the basic model is client-server architectures, especially those providing services like bank systems. Data is shared through the network, prompting organizations to ensure network security to ensure consumer and organizational data’s confidentiality, integrity, and availability, which faces an increasing threat from cyber theft and other illegal accesses. JP Morgan Chase is a financial institution based in the US that collects and maintains personal information, including names, email addresses, mailing addresses, telephone numbers, account numbers, location information, such as zip code, and user name and password for online services, payment card information, Social Security numbers, driver’s license numbers, and gender, race, nationality, and biometric data. This information needs protection from unauthorized access, considering that banks are a lucrative target for cyber-attacks.  (Executive Summary – Network architecture)

Executive Summary - Network architecture

JP Morgan Chase adopts a client-server architecture that allows clients to access shared files, which are centralized. The client-server architecture ensures high-speed operations, considering the bank serves thousands of customers daily. Centralization with a backup also ensures more control of data and processes. The architecture includes interrelated workstations, servers, and networking devices. JPMorgan Chase & Co has a data mesh architecture aligning its data technology with its data product strategy. To protect the network and data stored and shared through the network, a network security policy determines access to resources and highlights security profiles, passwords, email policy, internet access, antivirus, backup, system patches, remote access, and intrusion detection protocol. The organization also maintains digital evidence for forensic analysis through digital evidence controls and computer forensic tools. To enhance network security, the organization is recommended to adopt network security best practices, including understanding the OSI Model, different types of network devices, network defenses, network segregation, proper placement of security devices, network address translation, avoiding disabling personal firewalls, centralized logging, and immediate log analysis. Corrective measures will help JP Morgan Chase mitigate the risks of threats that could affect the system’s confidentiality, integrity, or availability, security policies, and anti-forensic techniques. (Executive Summary – Network architecture)

References

https://www.slideshare.net/slideshow/enterprise-architecture-jp-morgan-chase/9945296

 
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Discussion 3

Discussion 3

Describe the participant protections provided by the researchers for participants. (Discussion 3)

Participant protections are crucial in research to ensure ethical standards and the well-being of individuals involved in studies. Researchers employ several safeguards to protect participants:

  1. Informed Consent: Researchers must provide clear, understandable information about the study to participants before they agree to participate. This includes the purpose, procedures, risks, benefits, and their right to withdraw at any time.
  2. Confidentiality: Researchers must ensure that participants’ data and identities are kept confidential. This often involves using anonymization techniques and restricting access to sensitive information.
  3. Minimization of Risk: Researchers are obligated to minimize any potential risks to participants. This can include ensuring that procedures are safe and any discomfort or inconvenience is minimized.
  4. Voluntary Participation: Participants should voluntarily choose to participate without any coercion or pressure. They should also be informed of their right to withdraw from the study at any time without consequences.
  5. Beneficence: Researchers must maximize benefits and minimize harm to participants. This involves carefully weighing the risks and benefits of the study.
  6. IRB/Research Ethics Committee Review: Many studies require approval from an Institutional Review Board (IRB) or Research Ethics Committee (REC) before they can proceed. These bodies ensure that ethical guidelines and participant protections are met.
  7. Debriefing: After the study, participants should be informed of the study’s results and provided with any additional information necessary to understand the study’s purpose and implications.
  8. Special Protections for Vulnerable Groups: Certain groups, such as children, prisoners, and individuals with impaired decision-making capacity, require additional protections due to their vulnerability. Researchers must take extra care when involving these groups in studies.

By adhering to these participant protections, researchers uphold ethical standards and ensure that research contributes positively to knowledge without causing harm to participants.

 

How were the participants selected? How might this impact ethical principles within the study?

Would the participants in this study be considered “vulnerable“? Why or why not?

Were participants subjected to any physical harm or discomfort or psychological distress as part of the study? What efforts did the researchers make to minimize harm and maximize good?

Does the report discuss steps that were taken to protect the privacy and confidentiality of study participant? (Discussion 3)

Discussion 3

References

https://www.davidson.edu/offices-and-services/human-subjects-irb/research-training/protecting-human-research-participants#:~:text=Confidentiality%3A%20Holding%20secret%20all%20information,have%20participated%20in%20a%20study.

Business paper

PART 1: SCENARIO SYNTHESIS

Identify the main points of each article.

Synthesize the main points of the articles.

PART 2: SCENARIO FRAMEWORK FOR PHARMACEUTICAL INDUSTRY

Explain the choice of the scenario framework used for the case study.

Describe five current state pharma industry trends or performance indicators essential to begin development of 10-year scenarios.

Write five trigger questions for an executive team to use to create 10-year pharma scenarios.

References

https://www.tandfonline.com/doi/abs/10.1080/09537320802625280

 
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Network Architecture Security Plan Proposal 3

Network Architecture Security Plan Proposal 3

(Network Architecture Security Plan Proposal 3)

Table of Contents

Network Architecture Security Plan Proposal 3

Executive Summary. 3

Section 1: Introduction. 4

Section 2: Network Architecture. 7

The Network Architecture for JPMorgan Chase & Co. 7

Physical Structures, Major Types of Hardware Used to Connect Computers and Networks Together, and the Way Data Travels Through the Network. 9

Section 3: Managing and Protecting Data. 12

User Access to Computer Resources. 12

Security Profiles. 13

Passwords. 13

Email 14

Internet Access. 14

Antivirus. 15

Backup. 15

System Patches. 16

Remote Access. 16

Intrusion Detection. 16

Section 5: Digital Evidence Controls, Computer Forensic Analysis, and Recovering Files. 17

Preserving Information for Forensic Analysis. 17

Digital Evidence Controls. 18

Computer Forensic Tools for Forensic Analysis and File Recovery. 19

Section 6: Recommendations for Best Practices. 20

Recommendations For Best Practices. 20

Corrective Actions. 22

Why the Proposal Should be Accepted as Best Practices for the Organization. 23

References. 25

Network Architecture Security Plan Proposal 3

Executive Summary

Network architecture depicts how network services and devices are integrated to connect the needs of client devices and applications. Organizations have unique network architectures, but in most, the basic model is client-server architectures, especially those providing services like bank systems. Data is shared through the network, prompting organizations to ensure network security to ensure consumer and organizational data’s confidentiality, integrity, and availability, which faces an increasing threat from cyber theft and other illegal accesses. JP Morgan Chase is a financial institution based in the US that collects and maintains personal information, including names, email addresses, mailing addresses, telephone numbers, account numbers, location information, such as zip code, and user name and password for online services, payment card information, Social Security numbers, driver’s license numbers, and gender, race, nationality, and biometric data. This information needs protection from unauthorized access, considering that banks are a lucrative target for cyber-attacks. (Network Architecture Security Plan Proposal 3)

JP Morgan Chase adopts a client-server architecture that allows clients to access shared files, which are centralized. The client-server architecture ensures high-speed operations, considering the bank serves thousands of customers daily. Centralization with a backup also ensures more control of data and processes. The architecture includes interrelated workstations, servers, and networking devices. JPMorgan Chase & Co has a data mesh architecture aligning its data technology with its data product strategy. To protect the network and data stored and shared through the network, a network security policy determines access to resources and highlights security profiles, passwords, email policy, internet access, antivirus, backup, system patches, remote access, and intrusion detection protocol. The organization also maintains digital evidence for forensic analysis through digital evidence controls and computer forensic tools. To enhance network security, the organization is recommended to adopt network security best practices, including understanding the OSI Model, different types of network devices, network defenses, network segregation, proper placement of security devices, network address translation, avoiding disabling personal firewalls, centralized logging, and immediate log analysis. Corrective measures will help JP Morgan Chase mitigate the risks of threats that could impact the system’s confidentiality, integrity, or availability, security, and digital evidence. (Network Architecture Security Plan Proposal 3)

Section 1: Introduction

Cyber threat protection for any business and its data is a challenging task requiring expertise and well-managed resources. Businesses need a thorough security plan outlining how to protect their network from online threats. Also, the company’s end users want guidance on effectively using mobile platforms, email, the internet, and other network components. However, this approach should not conflict with the business model and should be relatively easy for the personnel to implement (Xu et al., 2022). The network security plan is a strategy that outlines the techniques and policies that will be used to protect the network from unauthorized users and counteract actions that could jeopardize or compromise a system’s security.

Network Architecture Security Plan Proposal

Banks are vulnerable to cyber-attacks and require robust network architecture security plans to protect client data and the valuables entrusted to them. JPMorgan Chase collects personal information when clients or customers visit their premises or use their online services, including names, email addresses, mailing addresses, telephone numbers, account numbers, location information, such as zip code, and user name and password for online services. When more personal information is needed for ordinary business purposes, JPMC also collects payment card information, Social Security numbers, driver’s license numbers, and gender, race, nationality, and biometric data (JPMorgan, 2018). The organization also creates personal information for clients in some circumstances, including recordings of customer interactions and account details. Additional information JPMC collects includes device IP address when using online services, operating system and browser type, and information on sites visited and those to be called.

Moreover, JPMC uses customer data regarding social media usage and credit reporting agencies (JPMorgan, 2018). Often cyber-attacks target this information to access consumer bank accounts and other money storage or transfer avenues. Personal information on location, name, and gender can also be used for malice, including targeted attacks on individuals or stalking. This sensitive information needs protection from unauthorized access, loss, or misuse.

This paper seeks to analyze JPMorgan Chase’s network architecture and develop a network security plan proposal that can help the organization further protect public data from security threats. The JPMorgan Chase Institute takes pride in offering insightful information to decision-makers in government, business, and charitable organizations (JPMorgan Chase & Co, 2022). These disclosures, however, must not come at the expense of client or customer confidentiality. To achieve this, the Institute has implemented stringent security procedures and checks and balances to guarantee that all consumer data remains private and secure (JPMorgan Chase & Co, 2022). Government agencies use of statistical standards and JPMorgan Chase’s collaboration with technology, data privacy, and security specialists who are assisting the enterprise in upholding industry-leading standards have all influenced these measures.

Currently, the enterprise adopts measures as a further commitment to protect public data and ensure privacy and confidentiality, including the Institute’s standards and procedures that mandate that any data it collects and uses for various purposes not contain any personal information about clients. Before accessing client data, the Institute also makes its researchers and employees submit to thorough background investigations and sign binding confidentiality agreements (JPMorgan Chase & Co, 2022). Employees are legally obligated to only utilize the data for authorized purposes and not try to re-identify any clients or individuals reflected in the data. Any publishing derived from Institute data is required only to include aggregate data or data that is not otherwise not reasonably traceable to a specific, identified consumer or business. The information that the JPMC and its staff rely on is kept on a secure server that is only accessible per stringent security guidelines intended to prevent the transfer of information outside of JPMorgan Chase’s systems (JPMorgan Chase & Co, 2022). All JPMorgan Chase Information Technology Risk Management specifications for data monitoring and security are met by its data infrastructure.

The security plan proposal offers insights into strategies and procedures JPMC can adopt to reinforce or ensure better data protection and promote customer privacy and confidentiality due to the growing hacker threat probing organization networks. The plan seeks to help the enterprise to protect the network infrastructure from unauthorized access, data misuse, destruction, and damaged corporate reputation. The plan will offer recommendations to the enterprise for dealing with suppliers and dependent subcontractors and their access to information classification to ensure data protection. It will also advise additional measures for data protection, data encryption to protect data in transit, authentication approaches, protection policy, digital signatures, random number generation, hash functions, and key and certificate lifecycle management.

Moreover, it will offer procedures for data protection policy review and cookie management procedures that should comply with applicable laws and regulations. Furthermore, the security plan proposal will include recommendations on identity and access management, security configuration procedures, security operations, vulnerability management, and third-party relationship management and access protocols. Generally, this paper aims to describe the JPMC network architecture and offer a plan for managing and protecting data, risk assessment, digital evidence controls, computer forensic analysis, and recovering files, and provide recommendations for best practices. (Network Architecture Security Plan Proposal 3)

Section 2: Network Architecture

The Network Architecture for JPMorgan Chase & Co.

JPMorgan Chase & Co is a financial institution in the US in the consumer or commercial banking category. It offers financial services and advice to millions of people and maintains a wide variety of consumer data that needs protection from unauthorized access or illegal use. The bank adopts the client-server network architecture in which people can access information stored in its server via various platforms, including its website and other online services. This architecture allows individuals to access shared files and information, which are centralized, with a backup, from their serving machines like mobile devices and computers, which include the teller computers (Sugandhi, 2023). More than one client has access to resources and services, and there are different servers, including mail, web, and file servers. The client-server relationship is one-to-many because multiple clients can access the services and resources at go. The JPMorgan Chase & Co bank has moved into an almost entirely digital locale, and most clients or users access its resources and information remotely.

Considering the bank serves thousands of customers daily requesting different services and constantly trying to access information and bank services at high speeds through their virtual devices, client-server has been the heart of its banking system because it works effectively and makes it easy to manage information and service delivery centrally. With this architecture, the bank keeps a centralized record of all the information needs, including account information, that can be accessed at the banking center by a teller or from remote devices. Generally, an account holder can check balances, withdraw money, or deposit money. Additional services include financial advice, questing for a loan, servicing a loan, or asking for bank statements. JPMorgan Chase & Co bank network architecture is vast, with multiple serves and databases at the center of the architecture, providing additional functionality to its customers. According to (Sugandhi, 2023), this centralization allows consumers to access resources and services without the need to understand how many servers they are communicating with, increasing the possibility of breaking down the architecture to even pore task-particular nodes and elevating the distribution of the application task and processing to ensure greater performance, reliability, and security.

The servers are under strong server standards that guide the core functionality of the client-server relationship, ensuring it is more static, enabling the bank to upgrade by extending the model into future devices not used before, like mobile banking applications, without the need to redesign the architecture. As the industry and the bank mature, this architecture that allows an extension allows the bank to keep up with new customer demands for increased functionality, performance, security, and flexibility of the banking system. Generally, the client-server architecture has seamlessly transitioned the bank into the digital world of virtual services. (Network Architecture Security Plan Proposal 3)

 

Figure 1: Client-server architecture model used by JP Morgan Chase & Co.

Physical Structures, Major Types of Hardware Used to Connect Computers and Networks Together, and the Way Data Travels Through the Network

Different types of hardware connect the computers and the network in the client-server architecture. The three major interrelated components are workstations, servers, and networking devices. Workstations are also client computers or mobile devices with different operating systems, mostly lacking administrative or security policies, a centralized database, or shared software. Servers hold much information and handle multiple requests, having more memory, hard drive space, and faster speeds (Hill et al., 2017). Servers have multiple roles, acting as the domain controller, mail server, file server, and database server, all running simultaneously. These duties are assigned to different servers to maximize performance and simplify maintenance and backup (Hill et al., 2017). Some networking devices connect computers and the network, including hubs that connect a server or centralized servers to many different workstations, repeaters that help transmit data from one device to the next, and bridges that segment isolated networks.

The primary purpose of adopting the client-server architecture is to speed up data transmission and protect data during transfer. It makes the ban faster and more secure regarding data transfers. In most instances, the interaction begins with a client request to the server through the internet, and it is successful when the server accepts the request and returns the information or data packets the client requested (Hill et al., 2017). Generally, a client sends a request to the Domain Name System (DNS) server, which searchers for the specific server and replies with the details, including the IP address of the server to the client, then the browser sends an HTTP(S) request, if the request is through the web, to the server’s IP address (Hill et al., 2017). A successful and accepted request sees the server send the necessary files, and the browser displays them to the client.

 

Figure 2: Network Connectivity of JPMorgan Chase and Co.

JPMorgan Chase & Co has a data mesh architecture that aligns its data technology to its data product strategy. This data mesh architecture is beneficial as the bank adopts cloud services, enabling data sharing across the institutions while allowing data owners more control and visibility of their data, which increases the ability to manage their data effectively (Jain et al., 2022). The significant advantages of the data mesh are the ability to align the data architecture to the data product strategy, empower the right people or data owners to have more control and make control decisions, enforce control decisions via in-place consumption, and offer cross-enterprise visibility of data usage or consumption. The data mesh makes data available in lakes, and individuals can request the lake-based data via a reporting application (Jain et al., 2022). The bank can audit data flows from the lake to the reporting application, increasing visibility or clarity of the origin of the data in the reports. (Network Architecture Security Plan Proposal 3)

Figure 3: JPMC & Co Data Mesh

Section 3: Managing and Protecting Data

Deploying a network security policy is a critical undertaking to prevent security issues on the network. A network security policy provides guidelines for network access, determines policy enforcement, dictates the organization’s network security environment, and provides how security policies are adopted throughout the network architecture (Valenza et al., 017). Security policies are the organization’s security control on various components of the network architecture, keeping malicious individuals from accessing the network and mitigating risky people within the organization. The first or initial provision of network security policy is regarding access to information, including what information and services are available, to whom, and through what means, and the protection needed. A hierarchy of access permissions ensures that individuals at different levels can only access what they need to operate with. The proposal recommends the following policies for managing and protecting data:

User Access to Computer Resources

It is critical to protect organization computing systems and resources by implementing user access security activities and ensuring users have the right to access the information they need to work with. A user access security policy is needed to control user access to computer resources, ensuring that only authorized users can access particular resources. The acceptable use policy (AUP) stipulates the rules, practices, and constraints users must agree with to access the organization’s network, internet, and other resources (Kirvan, 2022). Employees must sign the AUP before being given permission or a network ID. The AUP provides users with instructions on what they can or cannot do when using the organization’s computers, computing infrastructure, and the internet. Moreso, this applies to tellers and other office employees that have been provided individual computers for use within the organization. It spells out acceptable and unacceptable behavior and will offer the organization legal mechanisms to ensure compliance and repercussions for non-compliance. (Network Architecture Security Plan Proposal 3)

Security Profiles

A security profile is attributed to an organization’s overall security program, comprising security determined by the organization’s work and the network facilities in place. It dictates the network, log sources, and domains a user can access (IBM, 2023). Individuals at different access levels will have different security profiles; for instance, administrative users will have a default security profile that provides access to all networks, log sources, and domains. The organization will create more security profiles before adding user accounts to help meet specific access user requirements. The security profiles policy will help configure security profiles at run-time to dictate or control security operations completed in a message flow at run-time. The security profiles policy will help determine authentication and authorization on source identities. (Network Architecture Security Plan Proposal 3)

Passwords

In a secure network, users need passwords to access network resources. However, the organization must follow the rules regarding passwords or policies it should share with users to dictate password development to ensure a secure and protected network. A password management policy provides the organization’s requirements for acceptable password options and maintenance. The policy guides password creation to maximize password security and minimize password misuse and theft. For this proposal, all passwords should be strong and contain at least eight alphanumeric characters, at least two non-alphabetic characters, and at least three alphabetic characters (Shay et al., 2016). Also, the password should not be a single dictionary, language, slang, dialect, jargon word, or personal information. However, individuals can develop passwords with passphrases that contain three or more dictionary words joined by alphabetic characters. All passwords are private and should not be written or stored online, shared within an email message or any electronic communication, shared with anyone, including other organization personnel, or be the same as those used to access external accounts like online banking. Users should change their passwords at least every six months. Lastly, any passwords suspected of being compromised should be changed promptly.(Network Architecture Security Plan Proposal 3)

Email

Most hackers or malicious users use email conversations to access personal information or have users click on malicious links without suspecting it. An email security policy is needed to govern email use within the organization’s network. The policy provides how the users will interact with email messages to ensure that email messages are secure from unauthorized access (Wilton, 2021). The email security policy requires the organization to use trusted email services like Gmail that include capabilities like regular updates, improved phishing filters, and multi-factor authentication, create effective spam filters, educate users to sport phishing emails and malicious attachments and links, and protect email address by instructing users and employees not to post work email addresses on social media accounts or other public platform and adopt catchall email for customer services and support.

Internet Access

An internet security policy allows the organization to manage internet access and comply with federal, legal, and accreditation rules and requirements on internet and data confidentiality and integrity. The policy dictates that users should not access or use the organization’s internet for personal business, have a valuable purpose for accessing and using the internet, and avoid offensive websites and pornographic content. Additionally, users should not use another individual’s network ID, password, or other identification details to access the internet, establish external network connections, or new network connections to allow communication or unauthorized access to the network without the Security Officer’s approval. Users are also required to avoid transferring identifiable information through the internet. (Network Architecture Security Plan Proposal 3)

Antivirus

All users must adhere to the antivirus policy, which requires all users connected to the network or data systems to have antimalware software installed and authorized and qualified IT personnel to conduct a comprehensive analysis of virus threats regularly and evaluate application software for adequacy and sufficiency (Trinity University, 2022). Also, all resources with an antivirus installed need regular updates, and the antivirus selected must scan email, email attachments, web traffic, media, and downloaded files. Infected devices should be disconnected immediately, and the virus should be removed. Users must not install unauthorized software from external networks.

Backup

The backup policy requires all organization data and resources to be backed up as a data protection, disaster recovery, and business continuity plan. The policy also ensures that all organization and user data copies are safe (Savannah State University, 2016). It provides the organization to back up data on the cloud for rapid recovery in case of disruption. The policy dictates what data needs protection, where to store the copies, how often the backup should run, and the time to retain a copy. The policy adopts the 3-2-1 approach that requires the organization to have three backup copies in two locations, one on the cloud and the other in an offsite location. The organization should have an incremental backup that copies the data sets that have changed since the previous backup. (Network Architecture Security Plan Proposal 3)

System Patches

The system patch management policy highlights the processes and approaches that help ensure that hardware and software on the organization’s data are regularly maintained (Jill, 2022). The patching security policy requires patches to be evaluated constantly and responded to promptly, documented and well understood by employees, automated and constantly monitored, and executed according to the vendor tools on a constantly communicated schedule.

Remote Access

Employees and consumers can access data remotely or offsite, which sometimes increases the risk of unauthorized users like hackers and man-in-the-middle accessing the data (Ouaddah et al., 2016). The remote access policy requires individuals accessing the organization’s services remotely, especially employees, to have standardized hardware and software, including firewall and antivirus or antimalware, to adopt data and network encryption standards, use VPN access on network connectivity, and follow information security and confidentiality and email usage policies. (Network Architecture Security Plan Proposal 3)

Intrusion Detection

Intrusion detection or prevention and a security monitoring policy are vital in monitoring loggings and observing events to identify security issues and threats. Internet, electronic mail, Local Area Network traffics, and operating system security parameters will be used to monitor intrusions. Intrusion checks will monitor the firewall, automated intrusion detection system, user account, network scanning, system error, application, data backup ad recovery, telephone call, service desk trouble tickets, and network printer logs for any signs of vulnerability (Sam Houston State University, 2022). Every year, the policy requires checking password strengths, unauthorized network devices, unauthorized personal web servers, unsecured sharing of devices, and operating system and software licenses.

Section 5: Digital Evidence Controls, Computer Forensic Analysis, and Recovering Files

Preserving Information for Forensic Analysis

Digital evidence can be stored and maintained in physical or digital devices. After information collection, it will be moved to physical media for storage and where it can be accessed. The data acquired and the device used for storage are secured until the information is required for forensic analysis. The physical and digital storage systems or a smart management system are integrated to form the evidence management system to be used at the organization. Preservation is required to ensure the legal admissibility of the information stored. The evidence management system will include drive imaging, hash values, and a clear chain of custody (Simon, 2023). Rather than the original information, the company will create images of the evidence that will be used for analysis. The analyst will develop a duplicate of the drive used to store the information to help retain the original evidence for investigation. Investigators can exclusively use the duplicate image rather than the original media.

Hash values will also aid in preserving the evidence or information generated when duplicates or images of the original media are produced. The hash values will help determine the authenticity and integrity of the duplicates as an exact image of the original information. Hash values will help ascertain if the information was altered at any point, which is a vital part of forensic analysis and admitting the evidence in court if necessary (Simon, 2023). Creating new or editing existing files generates new hash values that can only be accessed using special software. The hash values must match the expected values, and if not, they will help confirm that the evidence was altered. A clear chain of custody is vital in digital evidence preservation. The company forensic analyst or investigator will document all media and evidence transfers on the Chain of Custody (CoC) forms and capture signatures and dates after handing off media. The chain-of-custody paperwork will help determine that the image of the digital evidence is or was under known possession from the time the duplicate or image was created (Simon, 2023). A lapse in the chain of custody would allow the company to nullify the legal value or dependability of the image. Generally, the primary purpose of preserving the evidence is to ensure legal admissibility. (Network Architecture Security Plan Proposal 3)

Digital Evidence Controls

JP Morgan Chase works with a cybersecurity forensic investigator whose main role at the company is to watch over the data and find innovative ways to protect the data. Approaches used to control digital evidence include risk reviews and vulnerability analysis that help identify potential threats. The investigator conducts forensic preservation work and preliminary investigations, adopting established standards (JP Morgan Chase Company, n.d.). The investigator also helps identify violations of the JP Morga Chase Code of Conduct and identifies, collects, and preserves the associated digital evidence. The organization, through the investigator, conducts forensically sound collection and analysis of electronic evidence using different tools to enhance security, compliance, and legal processes.

JP Morgan Chase preserves network and host-based digital forensics on Microsoft Windows-based systems and other necessary operating systems like LINUX and adopts standard digital forensic and network monitoring tools to independently plan and carry out forensic support. The organization adopts High-Security Access (HSA) systems for forensic investigations. It conducts an enhanced annual screening of users of the systems, including checking criminal and credit backgrounds (JP Morgan Chase Company, n.d.). Additionally, the organization ensures technology governance, risk, and compliance by regularly validating the effectiveness of the controls, assessing risk annually to ensure the implemented controls can protect the organization’s information, and adopting security policies and procedures to govern receipt, transmission, processing, storage, retrieval, access, and presentation of the information. The principle of least privilege is adopted to grant personnel access to the information. Physical facilities hosting the data are restricted and have detective monitoring controls and controls for hazards like fire and water. (Network Architecture Security Plan Proposal 3)

Computer Forensic Tools for Forensic Analysis and File Recovery

The autopsy/the Sleuth Kit will be used for disk analysis. The tool is recommended for its ease of use, extensibility, speed, and cost-effectiveness. The Sleuth kit is a command-line tool that helps conduct forensic analysis of hard drives and smartphone images. The Autopsy is a GUI-based system using the Sleuth Kit in the background (Kaushik et al., 2020). Its modular and plug-in architecture ensures that the user can easily incorporate additional functionality. Law enforcement agencies and organizations can use this tool to investigate activities or events in a computer, analyze disk images, and recover associated files. The tool can analyze both Windows and LINUX disks. The Volatility tool will also help with memory forensics, incident response, and malware analysis. Often, investigations determine what activities occurred at the time of the incident. Volatility is used to link device, network, file system, and registry artifacts to confirm the list of all running processes, active and closed network connections, running Windows command prompts screenshots and clipboard contents that were in progress at the time of the incident (Mohanta et al., 2020). Investigators will use Volatility to assess processes, check command history, and retrieve files and passwords from the system. (Network Architecture Security Plan Proposal 3)

Section 6: Recommendations for Best Practices

Recommendations For Best Practices

The organization must understand the OSI Model, different types of network devices, network defenses, network segregation, proper placement of security devices, network address translation, avoiding disabling personal firewalls, centralized logging, and immediate log analysis as best practices for network security. The organization should comprehend the devices that make up the network in order to build and protect it (Yu et al., 2019). Hubs, switches, routers, bridges, and gateways are the various categories of network devices. Also, the company may protect its network by implementing the right tools and solutions. Firewalls, intrusion detection systems, intrusion prevention systems, network access controls, web filters, proxy servers, anti-DDOS, load balancers, and spam filters are among the most popular and efficient network defenses.

Network segmentation includes dividing the network into zones, which are logical or functional components. For instance, the company might have distinct technical requirements for its sales, technical support, and research zones. It can do this by employing switches, routers, or virtual local area networks (VLANs), which are made by setting up a switch’s ports to act like different networks (Netwrix Corporation, 2022). Segmentation restricts the scope of what could be affected by a compromise to that particular area. In essence, it separates one target into several, giving attackers the option of treating each part as a separate network or compromising one and trying to cross the gap. Neither option is desirable. Since the attacker must breach each section separately, treating each segment as a separate network entail much more work and significantly increases the attacker’s risk of being found. Attempting to jump from a compromised zone to other zones is challenging. The network traffic between the segments can be limited if properly constructed (Netwrix Corporation, 2022). Data classification and data protection also benefit from segmentation. Each segment may be given a different set of data categorization rules, configured to the proper level of security, and after that, monitored.

The company must choose where to put each device as it develops its network segregation strategy. The firewall is the simplest device to install; the company should install a firewall at each network zone intersection (Anwar et al., 2021). A firewall ought to be installed on every section of the network. All current switches and routers have firewalls (Anwar et al., 2021). These features only need to be enabled and properly configured by the company. An anti-DDoS device should also be placed on the perimeter so that the company can thwart DDoS attacks before they spread throughout the network. The company should have a web filter proxy behind the primary firewall that serves the public network.

Another network security best practice is using network address translation. The company can make up for the IPv4 networking address shortage via network address translation (NAT). Private addresses (internal to a specific business) are converted into routable addresses on open networks like the internet through NAT. For instance, NAT is a technique for using a single IP address to link numerous computers to the internet or any other IP network (Netwrix Corporation, 2022). NAT works with firewalls to add an additional layer of protection to an organization’s internal network. The protected networks’ hosts typically have private addresses that allow them to connect with the outside world, but external systems must pass through NAT boxes in order to access internal networks. Additionally, the company can adopt centralized logging and immediate log analysis. The company should keep track of erroneous computer events like logins and other suspicious activity (Netwrix Corporation, 2022). With the aid of this best practice, the business will be able to reconstruct what took place during an attack and take action to enhance its threat detection system and effectively stop attacks in the future. (Network Architecture Security Plan Proposal 3)

Corrective Actions

Protecting an organization’s data’s confidentiality, integrity, and availability (CIA triad) is the cornerstone of information security management. Any ecosystem, including information security, is based on people, who are undoubtedly more important regarding insider threats because they both pose a threat and are a crucial component of the security plan. Since employees are frequently the weakest link in any security program, security starts with them (Max Alexander et al., 2018). The organization’s security posture can be improved by having properly trained personnel who can identify the actions and motives of malicious actors. Also, it takes people to keep track of incidents and respond to insider threat-related ones. The effectiveness of controls intended for protection, detection, and correction will be improved by having the right personnel.

Policies, procedures, guidelines, and work instructions serve as a guide for the organization’s processes. In addition to outlining standard operating procedures that must be followed to protect, detect, and correct security events, these documents should also provide high-level instructions on the company’s security policy, specify how, when, and by whom communication takes place with outside agencies in the case of an incident. The policies should also specify what behaviors are considered harmful and should aim to increase the monitoring of people who are thought to be at a higher risk (Max Alexander et al., 2018). Doing thorough pre-hire background checks and periodically reexamining employees’ backgrounds are two of the most fundamental procedures a business can use to ensure it hires and retains the best people. Background checks offer information about prior behavior and cues to reliability.

Before adopting any corrective measures and technology instruments, the organization should first do a risk analysis to ascertain what information needs to be protected, how much protection it needs, and how long to lessen the effects of a potential insider threat. To identify organizational weaknesses and gauge the level of risk these vulnerabilities provide, the organization must also carry out a risk assessment. Administrators can start implementing countermeasures for the detected vulnerabilities once they are aware of the risk their information security is exposed to reduce it to a manageable level. Role-based access control is one type of preventive measure that the company should use (RBAC). RBAC follows the principle of least privilege, or only granting access to information or systems that a person requires in light of their position and informational needs. (Max Alexander et al., 2018) RBAC limits information’s dissemination by nature, lessening the likelihood of unauthorized disclosure. RBAC also functions across all information states, provided that users adhere to specified procedures and maintain information inside authorized channels. Administrators can also use other technical safeguards, including encryption, to prevent unwanted access to data. (Network Architecture Security Plan Proposal 3)

Why the Proposal Should be Accepted as Best Practices for the Organization

Financial institutions are a lucrative target for cybercrime and network infiltration because of the money. Individuals working outside and inside the banks will likely take advantage of the many vulnerable links in the network architecture and security chains. JP Morgan is a financial institution that is highly vulnerable to security attacks as hackers and malicious individuals seek to access financial account information. This proposal offers a robust analysis of JP Morgan Chase Network Architecture, data management and protection, risk assessment, digital evidence controls, computer forensic analysis, and file recovery, and recommends best practices to ensure network security. The proposal seeks to help the company be more secure by integrating technology and awareness best practices because more than technology is needed to solve network security issues and the cybercrime problem efficiently and effectively. It provides insights into how the company can ensure consumer and organization data security through data management and protection and risk assessment techniques. Most importantly, it suggests to the organization how to protect itself from insider threats by adopting detection strategies, multi-factor authentication, and other preventative measures like system hardening and monitoring of users and networks. These insights are adequate to convince JP Morgan Chase to accept this proposal. (Network Architecture Security Plan Proposal 3)

References

Anwar, R. W., Abdullah, T., & Pastore, F. (2021). Firewall best practices for securing smart healthcare environment: A review. Applied Sciences11(19), 9183.

Hill, J.D., Kruth, A. R, Salisbury, J., & Varga, S. (2017). Software architecture in banking: A comparative paper on the effectiveness of different software architectures within a financial banking system. https://www.rose-hulman.edu/class/csse/csse477/handouts_377/HillTermPaper_FINAL.pdf

IBM. (2023). Security profileshttps://www.ibm.com/docs/en/qsip/7.4?topic=management-security-profiles

Jain, A., Person, G., Conroy, P., & Shankar, N. (2022, May 5). How JPMorgan chase built a data mesh architecture to drive significant value to enhance their enterprise data platform. Amazon Web Services. https://aws.amazon.com/big-data/how-jpmorgan-chase-built-a-data-mesh-architecture-to-drive-significant-value-to-enhance-their-enterprise-data-platform/

Jill, S. (2022). Patch management policyhttps://www.cde.state.co.us/dataprivacyandsecurity/patchmanagementpolicy

JP Morgan Chase Company. (n.d.). Cybersecurity Forensic Investigatorhttps://www.wayup.com/i-Financial-Services-j-JP-Morgan-Chase-Company-827769314821227/

JP Morgan Chase Company. (n.d.). JPMorgan Chase & Co. Minimum Control Requirementshttps://www.jpmorganchase.com/content/dam/jpmc/jpmorgan-chase-and-co/documents/supplier-minimum-control-requirements.pdf

JPMorgan Chase & Co. (2022). JPMorgan Chase & Co. Minimum Control Requirementshttps://www.jpmorganchase.com/content/dam/jpmc/jpmorgan-chase-and-co/documents/supplier-minimum-control-requirements.pdf

JPMorgan Chase & Co. (2022, March 29). Data Privacy Protocolshttps://www.jpmorganchase.com/institute/about/data-privacy-protocols

JPMorgan. (2018, May 21). Private Policyhttps://www.jpmorgan.com/privacy

Kaushik, K., Tanwar, R., & Awasthi, A. K. (2020). Security tools. In Information Security and Optimization (pp. 181-188). Chapman and Hall/CRC.

Kirvan, P. (2022). Acceptable use policy (ATP). https://www.techtarget.com/whatis/definition/acceptable-use-policy-AUP

Max Alexander, C. I. S. M., & CRISC, C. (2018). Protect, Detect and Correct Methodology to Mitigate Incidents: Insider Threats.

Mohanta, A., Saldanha, A., Mohanta, A., & Saldanha, A. (2020). Memory Forensics with Volatility. Malware Analysis and Detection Engineering: A Comprehensive Approach to Detect and Analyze Modern Malware, 433-476.

Netwrix Corporation. (2022). Network security best practices. https://www.netwrix.com/network_security_best_practices.html

Sam Houston State University. (2022). Intrusion Detection/Prevention and Security Monitoring Policy: IT-23https://www.shsu.edu/intranet/policies/information_technology_policies/documents/IT-23IntrusionDetectionSecurityMonitoringPolicy.pdf

Ouaddah, A., Abou Elkalam, A., & Ait Ouahman, A. (2016). FairAccess: a new Blockchain‐based access control framework for the Internet of Things. Security and communication networks9(18), 5943-5964.

Savannah State University. (2016, July 1). Information Technology Security Plan Backup Policy (10.13). https://www.savannahstate.edu/computer-services/docs/policies-2017/10_13%20Backup%20Policy.pdf

Shay, R., Komanduri, S., Durity, A. L., Huh, P., Mazurek, M. L., Segreti, S. M., … & Cranor, L. F. (2016). Designing password policies for strength and usability. ACM Transactions on Information and System Security (TISSEC), 18(4), 1-34.

Simon, M. (2023). Methods to preserve digital evidence for computer forensicshttps://www.criticalinsight.com/resources/news/article/3-methods-to-preserve-digital-evidence-for-computer-forensics

Sugandhi, A. (2023). Client Server Architecture: Components, Types, Benefitshttps://www.knowledgehut.com/cloud-computing/client-server-architecture

Trinity University. (2022, June 16). Antivirus policyhttps://policies.trinity.edu/a2e92e93-3e56-45ac-b237-da061062f925.pdf?v=mM8K9Ed4AUOdCX0xEXykCQ2/

Valenza, F., Su, T., Spinoso, S., Lioy, A., Sisto, R., & Vallini, M. (2017). A formal approach for network security policy validation. J. Wirel. Mob. Networks Ubiquitous Comput. Dependable Appl.8(1), 79-100.

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Reasons and Qualities of a preceptor 2

Reasons and Qualities of a preceptor 2

Preceptors serve as both teachers and leaders in the nursing profession. Preceptors are seasoned nurses who work with new graduates in the workplace and undergraduate nurses in the school to educate and support them (Phuma-Ngaiyaye et al., 2017). Preceptors often work one-on-one with preceptees while working full-time, part-time, or volunteering, acting as a mentor. Preceptors begin taking on various new responsibilities after setting expectations and being introduced in an orientation, including incorporating a nurse into the practice or particular specialties, monitoring and providing feedback on a nurse’s performance, interacting with the graduate and responding to inquiries, and promoting time management and decision-making competences and skills. (Reasons and Qualities of a preceptor 2)

Reasons and Qualities of a preceptor 2

To be a good preceptor, one must have leadership skills, long-term relationship development and maintenance, communication, analysis skills, and effective role modeling. Preceptors should also demonstrate extensive knowledge, be able to explain the reasons for actions and decisions, provide feedback clearly and precisely, explain and a manage conflicting ideas, communicate clear goals and expectations, attract learners’ attention, accurately evaluate the learner’s knowledge, attitude, and skills, conduct fair and thoughtful assessments, demonstrate expert interactions with patients, and organize information (Girotto et al., 2019). It is also crucial for a preceptor to generate interest in the subject, control the learning experience, assign appropriate responsibility to the student, guide problem-solving, motivate the learner, actively engage in the learning process, and establish supportive relationships with the learner. (Reasons and Qualities of a preceptor 2)

Everyone’s path toward becoming a nurse preceptor differs. Also, people have different drivers of why they want to become preceptors. In my case, I started working in an organization ten years ago. The organization emphasizes the need for continuing education and facilitates career growth and development by offering staff opportunities to continue their education. The organization has contributed to my educational advancement by sending me to school, and it is time to give by helping precept others. I appreciate the kindness and the care for staff the organization demonstrated, and I would like to contribute to the good practice. According to Patricia Benner, nurses gain clinical practice and patient care knowledge and skills over time by combining strong educational foundations and personal experiences (Nyikuri et al., 2020). Nurses move from novice to expert through beginner, competent, and proficient stages. I can help novice nurses gain competence and proficiency to become experts by passing on the knowledge and experience I have gained in this organization by being a preceptor. I can help new nurses, graduates, and undergraduates integrate into practice and learn hands-on skills as they prepare to be future nurses and gain the necessary competencies and experience to succeed in their careers. Being a preceptor is being a teacher or educator, which is the responsibility of any experienced nurse to contribute to knowledge development by sharing their earned experience. (Reasons and Qualities of a preceptor 2)

I have what it takes to be a great preceptor and a positive influence on the students I will supervise and guide through their clinical and practicum. Through my education and practice, I have developed the skills, competencies, and attitudes necessary to succeed as a preceptor and contribute to a learner’s academic and professional development. I have excellent communication and strong interpersonal skills that will enable me to engage with learners, know and understand them and their education and professional needs, and guide them to achieve their academic and professional objectives. I am a great team player, experienced in the nursing field, and I strongly desire to help others grow and develop their careers. I am also open, conscious, and have emotional stability. I believe these qualities are integral to successful preceptors. I also seek to continue building on these skills to grow with the learners and change as the healthcare environment changes. (Reasons and Qualities of a preceptor 2)

References

Girotto, L. C., Enns, S. C., de Oliveira, M. S., Mayer, F. B., Perotta, B., Santos, I. S., & Tempski, P. (2019). Preceptors’ perception of their role as educators and professionals in a health system. BMC medical education19(1), 203. https://doi.org/10.1186/s12909-019-1642-7

Nyikuri, M., Kumar, P., English, M., & Jones, C. (2020). “I train and mentor, they take them”: A qualitative study of nurses’ perspectives of neonatal nursing expertise and its development in Kenyan hospitals. Nursing open7(3), 711–719. https://doi.org/10.1002/nop2.442

Phuma-Ngaiyaye, E., Bvumbwe, T., & Chipeta, M. C. (2017). Using preceptors to improve nursing students’ clinical learning outcomes: A Malawian students’ perspective. International journal of nursing sciences4(2), 164–168. https://doi.org/10.1016/j.ijnss.2017.03.001

 
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