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Risk factors and ACES

o identify risk factors and ACES, 2) to track the possible
influence of these over time by identifying associated developmental outcomes occurring in the short
and long term, and 3) to identify protective factors and signs of resilience.
The assignment has two parts. First, review the Kristopher case study and create a chart of a) risk factors,
ACES, and other concerns, b) immediate and longer developmental outcomes related to the risk factors
and ACES, and c) protective factors and evidence of resilience. Then, compose a 4-page paper identifying
additional, realistic, protective factors or supports that could positively influence Kristopher’s future
development and level of resilience.
Part 1 – Chart of Factors and Related Outcomes: When reading the following case study about 14-yearold Kristopher, keep in mind Berk (2018) chapters 1-6 and the unit discussion about childhood abuse,
neglect, and other ACEs. Starting at the beginning of Kristopher’s life, develop a table or chart identifying:

  1. Risk factors and/or ACES Kristopher experienced, and other concerns you have about Kristopher’s
  2. More immediate and longer-term developmental outcomes (e.g., developmental delays, difficulty
    progressing through Erikson’s stages, attachment difficulties) displayed by Kristopher that are
    associated with the risk factors, ACES, and concerns.
  3. Protective factors or signs of resilience.
    Notes: A sample chart is included in the assignment. Also, be sure to link the risk factors and ACES to
    more immediate and longer-term developmental outcomes. For example, consider a person who
    abuses alcohol and other substances; was s/he
  4. Born to parents who abuse substances;
  5. Living in a home where substances are accessible;
  6. Around other adults or youth modeling that usage;
  7. Then, did s/he become part of a peer group that uses

Sample Solution

tioning to allow the surgical area to heal.1 The hope through this approach would be to lower the impact of surgical stress on the patient post-operative from their physiologic and physiological responses. This is done through enhancing the hospital organization to embrace to best practices and develop a team that works and communicates from start to finish instead of departments that the patient flows through (clinic, surgery, anesthesiology, intensive care).2 The team consists of the pre-operative and post-operative team, nursing, the surgeon and the surgical team, anesthesiologist, and dietitian. The original use of ERAS was developed for colorectal patients, however, this is expanding to various kinds of major surgery as methods are perfected for gastrointestinal surgeries, hence why this is such a pertinent feature to understand in the clinical nutrition world.2 There have been multiple journals published with evidence pinpointing that ERAS’ multimodal approach has evidence-based benefits ‘ decreasing length of stay, decreasing the use of analgesics, cost, and increasing comfort of patient.2 Specific ERAS components that the ERAS Society has approved of across all ERAS protocol include the following procedures for each stage. The first stage is the pre-admission where the surgeon or dietitian may suggest pre-operative nutritional support for a malnourished patient complete cessation of smoking and supplement usage by the patient, with the team suggesting medical optimization and information available for the patient.(figure 1) Preoperative preparation for the patient is the usage of a bowel cleanser, preoperative carbohydrates up to 2 hours before surgery, and antibiotic prophylaxis medications. Intra-operative measures are with minimally invasive techniques and minimal drainage, regional analgesia and minimal opioid use, as well as balanced control of temperature and fluids. Post-operative is removal of drains and tubes and cessation of intravenous fluids, no usage of nasogastric tubes, minimal opioid-based pain control with reliance on other medications, early mobilization of the patient, and early oral intake of fluids and calories for initial g

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