Janie Douglas is a 14-year-old Caucasian female brought for an initial evaluation by her father, Alexander Douglas, age 38. Mr. Douglas found a roach clip and a bong in Kylie’s room. When confronted, Janie admitted she has been smoking cannabis every day for a year. She also has been smoking half a pack of cigarettes per day since age 12. Janie states that she has tried beer and vodka but she “doesn’t drink much.” She also admitted to taking ecstasy once at a party.
Mr. Douglas wants Janie admitted to the hospital immediately. He states Janie is failing in school, has been breaking her curfew, and has been constantly fighting with her mother, who was too upset to come to the appointment today. Janie is irritable, sleeps 10–12 hours per day, and has a decreased appetite. She is well-groomed and polite to you during the interview.
Answer the following questions from your perspective as her psychiatric nurse practitioner.
1. How you would approach this interview and situation with Kylie and her father?
2. Based on the DSM-5, identify a possible diagnosis and a differential diagnosis for Kylie. Provide a rationale for your answer.
3. What level of care would you recommend to Kylie and why?
4. What pharmacological and/or nonpharmacologic interventions would suggest for Kylie and her family?
5. What challenges you would anticipate in working with Kylie and her family?
This paper gives a basic appraisal of a level 3 affect assessment that was alloted in 2012. The investigation picked was the “Kansas City Gun Experiment” which was attempted by Sherman and Rogan (1995). This paper examinations how well the chose think about tended to the issues of dependability of estimation, inner legitimacy of causal deductions, outside legitimacy of conclusions to the full populace the investigation tested and the lucidity of the strategy ramifications of applying the outcomes in policing. This article is separated into six regions. Right off the bat, a synopsis of the Kansas City Gun Experiment was displayed. This rundown gives a short record of the historical backdrop of the test and in addition depicts the criminological speculations to which the examination was based, the methodological procedures of the investigation and a concise portrayal of the discoveries of the analysis. Following the rundown the paper borderlines onto the principle evaluation of the examination. Initially the unwavering quality of estimation of the investigation is evaluated by looking at its test-retest dependability and its inside consistency. Furthermore the inner legitimacy of causal derivations was surveyed to decide if the causal connections between the two factors were legitimately illustrated. The outside legitimacy of conclusions to the full populace the examination inspected was then surveyed took after by the lucidity of the strategy ramifications of applying the outcomes in policing. Rundown The Kansas City Gun Experiment, did for 29 weeks, from July seventh 1992 to Jnuaray 27th, 1993, was a police watch venture that was gone for decreasing weapon savagery, drive-by shootings and crimes in the U.S.A. It depended on the start that seizure of firearms and weapon wrongdoing are contrarily relative. This theory depended on the speculations of discouragement and weakening. The Kansas City Police Department ( KCPD) actualized more prominent proactive police watches in hotspots where weapon wrongdoings were pervasive. The investigation of these watches were contemplated by Sherman and Rogan 1995) utilizing the utilization of semi exploratory outline. Two territories were decided for the test. Beat 144, the objective zone, was picked because of hoisted rates of savage wrongdoings including crimes and drive-by shootings. Beat 242 was picked as the correlation territory or control amass because of comparable numbers in drive-by shootings. The control bunch which was utilized to expand the dependability of results was left untreated implying that no exceptional endeavors or additional watches were done. Interestingly beat 144 was dealt with a few distinct procedures for expanding firearm seizures. A portion of the procedures utilized included stop and inquiry and wellbeing searches. Officers working additional time, from 7pm to 1 am, 7 days seven days, were pivoted in sets to give watches concentrated exclusively on the recognition and seizure of weapons. These officers did not react to whatever other calls that were not firearm related. A portion of the information gathered to be investigated included number of weapons seized, number of wrongdoings submitted, number of firearm related calls and capture records before inception of the trial, amid and after finish, for both exploratory and control gatherings. The contrasts between the exploratory and control assemble were then thought about utilizing a distinction of means test (t-test). Firearm violations in the 52 weeks when the watches in both the exploratory and control amass were looked at utilizing autoregressive moving midpoints (ARIMA) MODELS. There was to be sure a 65% expansion in weapon seizure and a diminishing in firearm wrongdoing by 49% in the objective region. In the control gathering, firearm seizures and weapon violations remained generally unaltered. Likewise, there was no critical relocation of weapon wrongdoings to territories encompassing the objective zone. These outcomes were likewise comparable for murders and drive-by shootings. Resident reviews additionally uncovered that the greater part of the overall population were less frightful of wrongdoing when contrasted with those in control gatherings. Unwavering quality OF MEASUREMENT The consequences of this investigation propose that there might be clear ramifications for different urban communities wishing to decrease their firearm wrongdoing. Be that as it may, how legitimate are these conclusions? How dependable would they say they are? All estimations may contain some component of mistake. All together for the estimations recorded amid the Kansas City Gun examination to be sound, they should be free of inclination and twisting. Unwavering quality and legitimacy subsequently are vital in such manner. Dependability can be viewed as the degree to which an estimation technique is reliable. Unwavering quality of a measure can be depicted as when a measure yields steady scores or perceptions on a given marvel on various events ( Bachman and Schutt 2007, p.87). It alludes right off the bat to the degree to which a technique for estimation delivers similar outcomes for a similar case under similar conditions alluded to as test-retest unwavering quality and besides the degree to which reactions to the individual things in a different thing measure are steady with each other known as inside consistency. A measure that isn’t dependable can’t be substantial. Would it be able to be said that the estimations utilized as a part of the Kansas City Gun try were solid and legitimate? This can be evaluated by right off the bat by taking a gander at its test-retest unwavering quality and after that furthermore, its inside consistency. Test-retest unwavering quality As financing ran out the investigation was never rehashed under similar conditions in beat 144, in this way entirely talking there was never a chance to test whether the same or comparative outcomes would have been gotten over a proportional period some time later. Inward consistency The measures utilized as a part of this examination included separate accounting and an on location University of Maryland evaluator who went with the officers on 300 long periods of problem areas watch and coded each move action story for watch time and implementation all through the zone. Property room information on firearms seized, modernized wrongdoing reports, calls for benefit information, and capture records were broke down for the two territories under the investigation. Sherman and Rogan (1995) at that point investigated the information utilizing four unique models. The essential investigations accepted that the weapon wrongdoing checks were freely inspected from the beats analyzed when the mediation. This model treated the before– amid contrast in the mean week after week rates of weapon wrongdoing as a gauge of the size of the impact of the problem areas watches, and surveyed the measurable hugeness of the distinctions with the standard two-followed t– tests (Sherman and Roagn (1995)). A second model expected that the week by week weapon wrongdoing information focuses were not free but rather were related serially, and in this manner required a Box– Jenkins ARIM (autoregressive coordinated moving normal) trial of the impact of a sudden mediation in a period arrangement. A third model inspected rate occasions (manslaughter and drive-by shootings) amassed in half year adds up to on the presumption that those checks were free, utilizing one-path examination of change (ANOVA) tests. A fourth model likewise accepted autonomy of perceptions, and contrasted the objective and the control beat in a before– amid chi-square-test. The t– tests looked at week after week weapon violations for each of the 29 weeks of the stage 1 watch program (July, 7, 1992, through Jan. 25, 1993) with the 29 weeks going before stage 1, utilizing contrast of-implies tests. The ARIM models stretched out the week after week tallies to an entire 52 weeks when the start of stage 1. The ANOVA show included one more year before stage 1 (all of 1991) and additionally 1993, the year after stage 1 (Sherman and Rogan (1995)). It is presented that Sherman and Rogan (1995) utilization of the four unique models portrayed above endeavored to guarantee that a satisfactory level of triangulation and all things considered, inside consistency was accomplished given the way that the program plan itself did not fit the scientist having information and an open door with the end goal that reactions to the individual things in a numerous thing measure could be checked for consistency. Unwavering quality might be viewed as an essential for legitimacy. Consequently the way that there was never any chance to rehash the investigation, there was never any chance to analyze whether the same or comparable outcomes would have been acquired in beat 144 over a proportional period some time utilizing the same policing strategies. As such would it be able to be securely said that the utilization of an indistinguishable measures from specified above, i.e., the on location University of Maryland evaluator who went with the officers on 300 long periods of problem areas watch together with Property room information on firearms seized, electronic wrongdoing reports, calls for benefit information, and capture records would have yielded comparative outcomes? The basic answer is no as it was never done. It is to be noticed that the evaluator went with the officers on 300 long periods of problem areas watch out of 2,256 (expecting that the 300 alluded to watch auto hours). Is this number factually adequate to decrease the event of arbitrary mistakes which happen because of over-estimation and under-estimation of accounts? It is in like manner presented that the level of unwavering quality of estimation is restricted to the occurrence of this investigation as there is no chance to get of testing its solidness shy of rehashing it.>