At the end of his presentation, Mike did not know the answers to the questions his audience asked. He felt embarrassed, a negative emotion. If Mike often feels this way at work, he will probably be less effective. The correct answer is A-negative.
Any emotion that makes you unhappy and wretched is referred to as a negative emotion. These feelings cause you to despise both yourself and other people, which lowers your level of self-assurance, self-worth, and overall life pleasure. The emotions of hate, rage, jealousy, and melancholy can all turn negative. Mike is experiencing embarrassment, which is a negative emotion. If Mike often feels this way at work, it can impact his confidence and effectiveness.
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what are 5 symptoms of wernicke's encephalopathy? (ACOSU)
Answer:
- Mental confusion.
- Vision problems.
- Coma.
- Hypothermia.
- Low blood pressure.
heroin and lysergic acid diethylamide (LSD) are what schedule drugs?
Heroin and lysergic acid diethylamide (LSD) are both classified as Schedule I drugs. This means that they are considered to have a high potential for abuse and no currently accepted medical use in treatment. Schedule I drugs are considered to be the most dangerous of all the drug schedules and are heavily regulated by the government.
Possession, distribution, and use of these drugs can result in severe legal consequences, including imprisonment and fines. The use of these drugs can also result in serious physical and psychological harm, including addiction, overdose, and long-term damage to the brain and other organs. It is important for individuals to understand the risks associated with the use of these drugs and to seek help if they or someone they know is struggling with addiction. There are many resources available for those seeking help with drug addiction, including counseling, therapy, support groups, and medication-assisted treatment.
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The client is admitted to the emergency department with hypertensive crisis. Which finding requires immediate action by a nurse?
Weakness in left arm
Jugular vein distension
Crackles at the lung bases
Lower extremity pitting edema
When a client is admitted to the emergency department with hypertensive crisis, the nurse must prioritize assessments to identify any immediate needs. One finding that requires immediate action by a nurse is jugular vein distension. Jugular vein distension indicates that the client's blood pressure is dangerously high and may lead to complications such as heart failure or pulmonary edema.
Therefore, it is essential to monitor the client's blood pressure regularly and administer antihypertensive medications as ordered. Although other findings such as weakness in the left arm, crackles at the lung bases, and lower extremity pitting edema are also significant, they do not require immediate action as jugular vein distension does. Weakness in the left arm may indicate a cerebrovascular accident, which requires urgent medical attention. Crackles at the lung bases and lower extremity pitting edema may indicate fluid overload and heart failure, which also require prompt interventions, but not as urgently as jugular vein distension. In summary, jugular vein distension is a critical finding that requires immediate action by a nurse when a client is admitted to the emergency department with hypertensive crisis. The nurse must assess and monitor the client's blood pressure closely and administer antihypertensive medications as ordered to prevent complications.
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are stage theories or continuous theories are more useful for understanding development across the lifespan
Yes, Stage theories are useful for understanding development across the lifespan because it breaks down development into distinct stages and explains how development progresses from one stage to another.
For example, psychoanalyst Erik Erikson's psychosocial theory outlines eight stages of development and how individuals progress from infancy to adulthood.
On the other hand, continuous theories are also useful for understanding development across the lifespan because it does not break down development into distinct stages, but rather looks at development as a continuous progression.
For example, Jean Piaget's cognitive development theory looks at how individuals acquire knowledge over time and how their cognitive abilities develop as they age.
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why is bupropion helpful for tobacco withdrawal?
Bupropion is a medication that is commonly used to help individuals quit smoking by reducing the symptoms of nicotine withdrawal. upropion is an important medication for those looking to quit smoking and can significantly increase their chances of success.
Nicotine withdrawal can cause symptoms such as irritability, restlessness, anxiety, and difficulty sleeping, which can make quitting smoking extremely challenging. Bupropion works by increasing the levels of dopamine and norepinephrine in the brain, which can help to alleviate these withdrawal symptoms and reduce the cravings for tobacco.
In addition to helping with nicotine withdrawal, bupropion can also help to reduce the overall urge to smoke, making it an effective tool for smoking cessation.
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A nurse is examining an infant in a clinic. Which nursing assessment for the infant is most valuable in the identification of serious visual defects?
Cover test
Visual acuity
Red reflex test
Pupil response to light
When examining an infant in a clinic, the most valuable nursing assessment in the identification of serious visual defects is the red reflex test.
The red reflex test is performed by shining a light into the infant's eye to check for the red reflection that occurs when light passes through the lens and reflects off the retina. Absence of a red reflex may indicate serious visual abnormalities such as cataracts or retinoblastoma.
While the cover test assesses for ocular alignment, visual acuity measures the clarity of vision, and pupil response to light tests the function of the iris, the red reflex test is the most important in identifying serious visual defects in an infant. Early detection and treatment of visual abnormalities in infants is crucial for preventing long-term vision impairment or loss. Therefore, nurses should prioritize performing the red reflex test during routine infant exams in the clinic.
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50 yo M presents with right shoulder pain after falling onto his outstretched hand while skiing. He notice deformity of his shoulder and had to hold his right arm. What the diagnose?
The patient is a 50-year-old male who experienced right shoulder pain after falling onto his outstretched hand while skiing. Based on the provided information, including the observed shoulder deformity and need to support his right arm, the most likely diagnosis for this patient is a shoulder dislocation or a proximal humerus fracture.
A shoulder dislocation occurs when the head of the humerus (upper arm bone) is forced out of the shoulder socket. This injury often results from falls or direct impacts to the shoulder, like in this case. Patients typically experience pain, swelling, and limited range of motion. The shoulder joint may appear visibly deformed, and the patient might need to hold their arm in a particular position to alleviate discomfort. A proximal humerus fracture involves a break in the upper part of the humerus, close to the shoulder joint. This type of fracture is also common in falls and can cause similar symptoms to a dislocation, including pain, swelling, and difficulty moving the shoulder.
In both cases, the patient should seek immediate medical attention to confirm the diagnosis through physical examination and imaging studies, such as X-rays or CT scans. Treatment options will depend on the severity and type of injury and may include immobilization, pain management, physical therapy, or surgery.
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60 yo M presents with nocturia, urgency, weak stream, and terminal dribbling. He denies any weight loss, fatigue, or bone pain. He has had two episodes of urinary retention that required catheterization.What the diagnose?
Based on the information provided, the patient is a 60-year-old male presenting with nocturia, urgency, weak stream, and terminal dribbling.
He has also experienced urinary retention requiring catheterization. The most likely diagnosis for this patient is Benign Prostatic Hyperplasia (BPH). BPH is a common condition in older men where the prostate gland enlarges and causes urinary symptoms. The enlarged prostate can compress the urethra, leading to symptoms like nocturia (frequent urination at night), urgency (sudden urge to urinate), weak urine stream, and terminal dribbling (inability to completely empty the bladder). The patient's history of urinary retention requiring catheterization is also consistent with BPH.
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Which muscle is the agonist and which is the antagonist in bicep curls?
The agonist is the biceps muscle, and the antagonist is the triceps muscle in biceps curls.
What is the biceps muscle?Positioned in the front of the upper arm, with two heads that connect to the scapula and humerus bone respectively, is a sizeable muscle known as the biceps.
Rather than being simply an aesthetic attribute or point of pride for weightlifters and bodybuilders, this muscle serves crucial functionality relating to elbow flexion, forearm rotation, and daily activities requiring upper body strength.
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Complete question:
Which muscle is the agonist and which is the antagonist in biceps curls?
O The agonist is the biceps muscle, and the antagonist is the deltoid muscle.
O The antagonist is the biceps muscle, and the agonist is the triceps muscle.
O The antagonist is the biceps muscle, and the agonist is the deltoid muscle.
O The agonist is the biceps muscle, and the antagonist is the triceps muscle.
An infant with spina bifida may have a meningocele and neurological deficits and may experience seizures.
True
False
An infant with spina bifida may have a meningocele and neurological deficits and may experience seizures is True.
Spina bifida is a neural tube defect that can affect the development of the spinal cord and brain. In some cases, an infant with spina bifida may have a meningocele, which is a sac-like protrusion of the protective covering of the spinal cord and brain. This can cause neurological deficits, such as muscle weakness, numbness, or paralysis. Additionally, infants with spina bifida are at a higher risk for developing seizures.
Therefore, it is true that an infant with spina bifida may have a meningocele and neurological deficits and may experience seizures.
Spina bifida is a condition that occurs when the neural tube, which is a structure that eventually develops into the brain and spinal cord, fails to close properly during early embryonic development. As a result, the spinal cord and brain may not develop properly, leading to a range of physical and neurological symptoms.
One type of spina bifida is called a meningocele, which is a sac-like protrusion of the protective covering of the spinal cord and brain. This can cause neurological deficits, such as muscle weakness, numbness, or paralysis. The severity of these deficits can vary depending on the size and location of the meningocele.
In addition to neurological deficits, infants with spina bifida are also at a higher risk for developing seizures. Seizures are caused by abnormal electrical activity in the brain and can manifest as convulsions, muscle spasms, or loss of consciousness. The exact cause of seizures in infants with spina bifida is not fully understood, but it is thought to be related to the abnormal development of the brain and nervous system.
it is true that an infant with spina bifida may have a meningocele and neurological deficits and may experience seizures. However, it is important to note that the severity of these symptoms can vary widely depending on the individual case. Early diagnosis and treatment can help manage symptoms and improve outcomes for infants with spina bifida.
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All of the following are an example of a physical hazard except:
A. Pesticide on the food prep counter
B. Metal shavings from a can opener
C. Gemstone from a ring
D. Broken glass in the ixe
C. Gemstone from a ring is an example of a foreign object hazard, not a physical hazard. The other options are all examples of physical hazards that can cause harm or injury.
A. Pesticide on the food prep counter. The reason is that a pesticide is a chemical hazard rather than a physical hazard. Physical hazards involve solid objects or particles that could contaminate food or cause harm, while chemical hazards are substances that could be toxic or harmful if ingested. The other options (B, C, and D) all involve solid objects that could potentially cause harm, making them examples of physical hazards.
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What type of diet is Bittman advocating? Why does he think that the USDA ""is not our ally""?
Bittman is in favour of a plant-based diet, which consists mostly of grains, legumes, fruits, and vegetables. He contends that consuming less meat while consuming more entire, plant-based meals is beneficial for everyone's health as well as the environment.
Bittman feels that the USDA is not our ally since the meat and dairy industries have too much of an influence on the organisation. He contends that the USDA has traditionally prioritised supporting the interests of these companies over the health of the American people in its dietary recommendations.
Additionally, he encourages following the USDA's advice on protein intake. Therefore, Mark Bittman is the first Bittman. People consume too much food, too little plant material, and too much meat, according to Bittman.
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Despite availability of a vaccine, measles still causes many deaths worldwide. This is due to: (Check all that apply)
A) subacute sclerosing panencephalitis (SSPE)
B) crowded populations
C) waterborne transmission
D) animal reservoirs
E) ineffectiveness of the vaccine
F) low levels of herd immunity
The factors contributing to measles-related deaths worldwide are crowded populations (B) and low levels of herd immunity (F).
Here are the factors from the provided options:
A) Subacute sclerosing panencephalitis (SSPE) - This is not a direct cause of measles-related deaths, as it is a rare, long-term complication of measles, affecting a small percentage of people who contract the disease.
B) Crowded populations - This is a factor, as measles is a highly contagious airborne disease that can spread rapidly in densely populated areas.
C) Waterborne transmission - This is not a factor, as measles is primarily transmitted through respiratory droplets, not water.
D) Animal reservoirs - This is not a factor, as measles is a human-specific disease with no known animal reservoirs.
E) Ineffectiveness of the vaccine - This is not a major factor, as the measles vaccine is highly effective when administered correctly.
F) Low levels of herd immunity - This is a factor, as insufficient vaccination coverage can lead to outbreaks, especially in areas with low vaccination rates or weak healthcare systems.
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The nurse is instructing a client with moderate persistent asthma on the proper method for using metered-dose inhalers (MDIs) and various types of medications. Which medication should the nurse advise the client to administer first?
Beta agonist
Steroid
Anticholinergic
Mast cell stabilizer
The nurse should advise the client to administer the beta agonist medication first as it is a quick-relief medication and can help to relieve the symptoms of mild asthma quickly.
The proper method for using MDIs should also be emphasized during the instruction to ensure the medication is administered correctly. The other types of medications listed (steroid, anticholinergic, and mast cell stabilizer) are typically used as long-term control medications for mild asthma.
When compared to FABA as needed alone, FABA/ICS as needed is clinically effective in lowering the risk of exacerbations, hospital admissions, or unanticipated doctor visits, exposure to systemic corticosteroids, and probably minimising side effects in adults and adolescents with moderate asthma.
FABA/ICS as needed is just as effective as conventional ICS and reduces both average ICS exposure and hospital admissions or unanticipated medical visits linked to asthma. It is also unlikely to be connected to a rise in unfavourable incidents.
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55 yo F c/o dizziness that started this morning and of "not hearing well." She feels nauseated and has vomited once in the past day. She had a URI two days ago. What the diagnostic?what the diagnosis?
Based on the symptoms presented, the most likely diagnosis is vertigo, which is a type of dizziness that can cause nausea and vomiting. The recent upper respiratory infection may also be contributing to the dizziness. However, it is important for the individual to see a healthcare provider for a proper diagnosis and treatment plan.
A possible diagnosis for this 55-year-old female could be labyrinthitis. Labyrinthitis is an inner ear disorder that can cause dizziness, nausea, vomiting, and hearing problems. It is often associated with a recent upper respiratory infection (URI), which the patient had two days ago. To confirm the diagnosis, it is essential to consult with a healthcare professional who can evaluate the patient's symptoms and medical history, perform a physical examination, and potentially order further tests if necessary.
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how long does it take for manifestations of tertiary (late active) syphillis to appear?
Tertiary (late active) syphilis is the third and most severe stage of the infection. Manifestations of this stage typically appear several years after the initial infection, sometimes even 10 to 30 years later.
The symptoms can include damage to various organs and tissues, such as the heart, brain, and nervous system, as well as the development of gummas, which are soft, tumor-like growths that can affect various parts of the body. It is important to diagnose and treat syphilis in its earlier stages to prevent the development of tertiary syphilis and its potentially severe complications. Regular testing and timely treatment with antibiotics, such as penicillin, can help eliminate the infection and reduce the risk of long-term health issues.
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A progressive exercise routine is the best therapy for the client with chondromalacia patellae.
True
False
True. Chondromalacia patellae is a common knee problem that affects the cartilage underneath the kneecap. It often results from overuse or injury and can cause pain, swelling, and difficulty moving the knee joint. A progressive exercise routine is the best therapy for this condition as it helps to strengthen the muscles surrounding the knee, improve joint mobility and flexibility, and reduce pain and inflammation.
The exercise routine should include a combination of stretching, strengthening, and low-impact aerobic activities such as swimming, cycling, and walking. The routine should start with low-intensity exercises and gradually increase in intensity and duration over time. It is important to work with a physical therapist or qualified exercise specialist who can develop a personalized exercise plan that takes into account the severity of the condition and the client's specific needs and goals. In addition to exercise, other therapies such as ice therapy, bracing, and medication may also be recommended to manage pain and inflammation. Overall, a progressive exercise routine is a safe and effective way to manage chondromalacia patellae and improve the client's quality of life.
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Which individual is at greatest risk for the development of hypertension?
a. 40 year-old Caucasian nurse
b. 60 year-old Asian-American shop owner
c. 45 year-old African-American attorney
d. 55 year-old Hispanic teacher
The combination of being an African-American and middle-aged puts the attorney at the greatest risk for developing hypertension.
The individual at greatest risk for the development of hypertension is c. 45 year-old African-American attorney. African-Americans have the highest rates of hypertension in the United States, followed by Asian-Americans, Hispanics, and Caucasians. Age is also a risk factor for hypertension, with the risk increasing as individuals get older.
Therefore, the combination of being an African-American and middle-aged puts the attorney at the greatest risk for developing hypertension.
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Mr. Browne has a new prescription for Ultram. What is the generic name for Ultram?
â Diclofenac
â Meloxicam
â Nabumetone
â Tramadol
The generic name for Ultram is Tramadol. Ultram is a brand name for Tramadol, which is an opioid pain medication used to treat moderate to severe pain.
Tramadol works by changing how the body senses and responds to pain. It is often used to treat chronic pain conditions such as fibromyalgia, arthritis, and nerve pain. It is important to note that Tramadol can be habit-forming and should only be used as directed by a healthcare provider. Additionally, it can have potentially dangerous interactions with certain medications, so it is important to inform your healthcare provider of all medications you are taking before starting Tramadol. Overall, Tramadol is a commonly prescribed medication for the management of pain, but it is important to use it safely and under the guidance of a healthcare professional.
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what schedule drugs have high potential for abuse, are considered dangerous, and are available only by prescription?
There are several drugs that fall under this category, known as Schedule drugs. These drugs are classified based on their potential for abuse and dependence, as well as their accepted medical uses. The most commonly known Schedule drugs are Schedule II drugs, which have a high potential for abuse and dependence, and are considered dangerous even when used as prescribed.
These drugs include opioids such as oxycodone and fentanyl, as well as stimulants like Adderall and Ritalin. Other Schedule drugs include Schedule III drugs such as codeine and ketamine, Schedule IV drugs such as benzodiazepines like Valium and Xanax, and Schedule V drugs such as cough syrups containing codeine. It is important to note that all Schedule drugs are only available by prescription and should only be used as directed by a healthcare professional.
Examples of Schedule II drugs include opioids such as oxycodone, morphine, and fentanyl, as well as stimulants like Adderall and Ritalin.
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A student in a health class is making flash cards to study during the first aid unit. The student writes ""Signs of Shock"" on the front of a card. Which phrase should the student include on the back of that card?
Answer: Pale, cold, clammy skin Shallow, rapid breathing, Difficulty breathing, Anxiety, Rapid heartbeat, Heartbeat irregularities or palpitations, Thirst or a dry mouth, Low urine output or dark urine Nausea, Vomiting, Dizziness, Light-headedness, Confusion, and disorientation, Unconsciousness.
Explanation: your probably not going to fit all of that in a flash card but these are the common signs of shock
Which characteristic distinguishes post-traumatic stress disorders from other anxiety disorders?
A. Lack of interest in family and others
B. Reliving the trauma in dreams and flashbacks
C. Avoidance of situations that resemble the stress
D. Blunted affect when discussing the traumatic situation
The characteristic that distinguishes post-traumatic stress disorder from other anxiety disorders is B. Reliving the trauma in dreams and flashbacks.
While anxiety disorders can also involve avoidance of situations that trigger anxiety, as well as blunted affect, it is the presence of vivid and intrusive memories and flashbacks of the traumatic event that sets post-traumatic stress disorders apart. Additionally, individuals with post-traumatic stress disorder may experience a persistent state of hyperarousal, which can include exaggerated startle responses, difficulty sleeping, and a sense of being constantly on guard. They may also have a heightened sensitivity to potential threats in their environment, even if those threats are not related to the original traumatic event.
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The presence of distinctive ______ in sputum, spinal fluid, and biopsies gives a very straightforward diagnosis of coccidioidomycoosis
The presence of distinctive fungal elements in sputum, spinal fluid, and biopsies gives a very straightforward diagnosis of coccidioidomycosis.
The presence of distinctive "spherules" in sputum, spinal fluid, and biopsies gives a very straightforward diagnosis of coccidioidomycosis. Here is a step-by-step explanation:
1. Collect samples: Obtain sputum, spinal fluid, or biopsy samples from the patient.
2. Examine the samples: Analyze the samples under a microscope.
3. Identify the presence of spherules: Look for distinctive, thick-walled structures called spherules, which are characteristic of the Coccidioides fungus that causes coccidioidomycosis.
4. Make a diagnosis: If spherules are present in any of the samples, this gives a straightforward diagnosis of coccidioidomycosis.
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Many of the toothpastes geared for children taste very good. What is the concern regarding the ingestion of too much toothpaste in young children?
Toothpaste that are geared toward children often come in fruity flavors, making them more enticing for young children to use.
However, the concern with these toothpaste is the potential ingestion of too much fluoride, which can be harmful to young children. Fluoride is a mineral that is commonly found in toothpaste and is essential in protecting teeth against decay. However, if too much fluoride is ingested, it can cause fluorosis, which is a condition that causes discoloration and staining of the teeth. Young children are especially vulnerable to fluorosis as they may not have the ability to spit out the excess toothpaste after brushing their teeth. Furthermore, young children may also have a tendency to swallow the toothpaste, which can lead to the ingestion of harmful amounts of fluoride. While the amount of fluoride in toothpaste is generally safe for adults, it can be toxic in young children.
It is important to supervise young children while they brush their teeth and to ensure that they use only a small amount of toothpaste, about the size of a grain of rice. Parents should also teach their children to spit out the toothpaste after brushing and to rinse their mouth thoroughly with water. In cases where young children accidentally ingest large amounts of toothpaste, they should be taken to a doctor or a dentist immediately. Overall, while toothpaste is an essential tool in maintaining good oral hygiene, it is important to use it in moderation to prevent any potential harm.
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The change in a sound's relative loudness on the left and right sides is referred to as:
The change in a sound's relative loudness on the left and right sides is referred to as the interaural level difference. This refers to the difference in loudness between the two ears, which is caused by the sound waves arriving at each ear at slightly different times and with slightly different intensities.
The brain uses this information to determine the location of the sound source in space.
The change in a sound's relative loudness on the left and right sides is referred to as "panning." Panning involves adjusting the loudness of a sound in a stereo or surround sound field to create a sense of spatial placement or directionality. The explanation for panning is that it helps create a more immersive audio experience by adjusting the relative loudness between the left and right audio channels.
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T/F:
people with anorexia nervosa are usually high academic and athletic achievers
False people with anorexia nervosa are usually high academic and athletic achievers
While there may be cases where people with anorexia nervosa have high academic and athletic achievements, this is not true for everyone. Anorexia nervosa is a serious mental illness that affects people of all backgrounds and can have devastating effects on their physical and emotional health. It is important to not stereotype or make assumptions about individuals with this condition.
Anorexia nervosa is an eating disorder characterized by an intense fear of gaining weight and a distorted body image. It can affect individuals from various backgrounds and with different levels of achievement. It is important to remember that each person's experience with anorexia nervosa is unique and not solely defined by their achievements.
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a group of students is learning a dance sequence by watching a video of the dance performance and practicing it in an add-on format. the teacher observes that some students are consistently beginning the movement sequence on the left foot instead of the right and then traveling in the wrong direction. which of the following may be the cause of this problem?
One possible cause of this problem could be that the video they are watching is flipped horizontally, making it appear as though the left foot is actually the right foot.
Another possibility is that some students may have a weaker sense of left and right, making it difficult for them to distinguish between the two. It could also be that the instructions given in the video or by the teacher are not clear enough for all students to understand correctly.
To address this problem, the teacher can:
1. Explain the concept of mirroring and provide examples to help students understand how to reverse the movements they see on the screen.
2. Break down the dance sequence into smaller sections, ensuring that students learn the correct footwork and direction for each part before moving on.
3. Encourage the students to focus on the correct starting foot and direction while practicing the dance sequence.
4. Provide feedback and corrections during practice to help students adjust and improve their execution of the dance sequence.
By implementing these steps, the teacher can help the students overcome the challenges of learning a dance sequence from a video and ensure that they are performing the movements accurately.
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what phase of crisis occurs when defense mechanisms fail and involves trial-and-error attempts to solve the problem?
The phase of crisis that occurs when defense mechanisms fail and involves trial-and-error attempts to solve the problem is called the "active crisis phase."
During this phase, individuals may feel overwhelmed and uncertain as they try different strategies to cope with the crisis. It is important to seek support and guidance during this phase in order to effectively navigate through the crisis and find a resolution.
The phase of crisis you are referring to is the "Trial-and-Error Problem Solving" phase. In this phase, defense mechanisms fail and individuals engage in trial-and-error attempts to find a solution to the problem they are facing.
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Which sport requires the most skill with kicking?
A) Karate
B) Kickball
C) Hockey
D) Swimming
Answer:
i think its quite obvious but still its kickball
Explanation:
advantages of home visits include the ____ for clients (esp for those with mobility issues or those unable/unwilling to travel), client _____ and ____ of the setting, the ability to _____ services, and a ____ and ____ environment for the discussion of concerns and needs.
Advantages of home visits include the convenience for clients (especially for those with mobility issues or those unable/unwilling to travel), client comfort and familiarity of the setting, the ability to tailor services, and a private and comfortable environment for the discussion of concerns and needs.
Home visits have several advantages for clients. For those with mobility issues or who are unable or unwilling to travel, home visits provide a convenient option. Clients also benefit from the comfort and familiarity of their own environment, which can help them feel more at ease and open during discussions with their service provider. Additionally, home visits allow for services to be tailored to the specific needs of the client, as the service provider can see firsthand the client's living situation and assess their individual needs. Lastly, the private and comfortable environment of the home allows for a more relaxed and open discussion of concerns and needs.
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