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lReflection Paper #2 Write a short paper reflecting on the following questions related to the case study below. You may need to bring in additional resources to effectively address the case study:
1. What is are the ethical issues/dilemma presented in the story? If more than one, which one would take priority? What are the facts that support the decision making process related to the chosen ethical dilemma, including objective and subjective facts, who are the moral agents, what values impact decision making for each moral agent, what are some external forces (social, legal, community, religion, scientific evidence based treatments etc).
2. What ethical principles and theories apply to this situation? Define and then give specific examples of how the principles/theory apply to the case and how these may aid in ethical decision making by the moral agents.
3. As a healthcare provider, how might you address the ethical issue? What are some of the possible solutions to the ethical issue?
4. What is your personal reflection related to the ethical issues?
Remember to use APA format including double spacing, citing your sources of information with intext citations and include a reference list ). Please do not submit in .pages format
Below is a case study for this discussion.
Children represent a small number of individuals with gender dysphoria and in only 10-20% of the children, gender dysphoria will continue to manifest in adolescence [5]. However, psychological therapy and support are highly recommended; while such services are now far more widely available, they are still insufficient to provide for complete wellbeing of these patients. Inadequate management of children with persistent gender dysphoria can lead to isolation, feeling of self-hatred, and suicidal ideas and attempts. Also, “passing through the wrong puberty” can have serious consequences for these individuals. Viable treatment options vary from fully reversible treatment, such as puberty-suppressing gonadotropin-releasing hormone analogues (GnRH) to partly reversible treatment, gonadal steroid treatment, as well as irreversible treatment, such as surgical removal of genitalia and reconstruction of new ones according to the desired gender. Surgery includes bilateral mastectomy with chest reconstruction, hysterectomy with oophorectomy followed by either metoidioplasty or phalloplasty for trans-male individuals, and bilateral orchiectomy with penectomy followed by vulvoplasty and vaginoplasty in trans-female individuals [6].
Pubertal suppression is implemented using GnRH analogues at Tanner 2 or 3 stage of puberty. Hypothalamus produces GnRH at low levels in prepubertal children. Levels become cyclical during puberty, leading to the production of luteinizing hormone (LH) and follicle stimulating hormone (FSH) by the anterior pituitary. LH and FSH stimulate ovaries and testicles to produce sex hormones, estrogen and testosterone, which are responsible for stimulating the growth of genitalia. Also, they lead to the development of breasts, voice deepening, menstrual cycle, and so forth, which transgender youth can find particularly tough to handle [7].
There are only a few reports related to the use of GnRH analogues in transgender youth. De Vries et al. were the first to introduce the concept and research on the use of puberty blockers for treatment of transgender youth. The main idea behind the suppression of endogenous puberty was to decrease distress by preventing the development of “noncongruent” secondary sexual characteristics. This would give young individuals more time to get accustomed to their situation and to better explore their gender. In the examined group, all of 70 eligible candidates showed improved mental health and general functioning. Authors concluded that the treatment was fully reversible, which was one of its main advantages [8]. Despite the positive outcomes in puberty suppression, many experts still have concerns and resist the implementation of this treatment in their regular practice. Viner et al. proposed that GnRH therapy can be physically damaging for teenagers and can lead to unfavorable psychological consequences [9]. Olson-Kennedy et al. also recognized these dilemmas, stating that available data on puberty suppression was limited and many questions remained unanswered [10]. One of the main reasons against this treatment is that going through puberty may help the individual to become congruent with their biological sex, meaning that their GD would not persist into adolescence. Results from Steensma et al. showed that majority of children developed homosexual orientation after completion of the GnRH treatment [11]. As for potential consequences, Hembree recently reported no long-term consequences in follow-up studies of GnRH treatment [12].
Finally, the decision about implementing GnRH treatment is very difficult and cannot be made without ethical dilemmas. Both opponents and advocates of pubertal suppression are guided by the same ethical principles, beneficence, nonmaleficence, and autonomy, but have different views on where these principles lead. A unique and clear overview is necessary, and, to this day, it has not yet been elaborated. Considering that GnRH treatment is relatively new and controversial, additional qualitative research and empirical studies are necessary for appropriate bioethical definitions.
Bizic, M., Jeftovic, M, & Pusica, S. (2018). Gender dysphoria: Bioethical aspects of medical treatment. BioMed Research International 2018

Which of iRobot’s competitors presents that greatest competitive threat? Why? Support your answer.

State three experiments described in the chapter that you believe violated all three ethical principles on which, per the Belmont Report, responsible research must be founded. Explain how these experiments violated the three principles.

CHAPTER 8, CHAPTER 9
Research in Healthcare Organizations,
Clinical Interactions

You can turn these in however you want. Photos of handwritten notes, typed notes, Pdfs of crazy flow charts. Whatever. Just show me that you’ve done the reading carefully and on time. Quotes, key passages, questions, outlines, are all acceptable ways to take notes. This link is the video to show you what we need for the reading notes (https://voicethread.com/myvoice/thread/7007713/37272001/38441781). Please write down your reflection, reaction, not only summary.

Has to be based on work load management and how its benefecial for corportaye america.

Each annotation will have these elements.
The correct APA-style reference
A summary of the source written in your own words (never copy the abstract)
One brief, interesting quotation, introduced with a verb phrase, author and date citation, and page number
An overall assessment of the article and an explanation of how it will be used in your report or proposal

1. According to Nieto and Bode, the “Affirming Diversity” book provides a “forum for reflection and discussion so teachers take responsibility for their own actions” (p. 5). The mindfulness of these actions will support teachers in their creative and intellectual prowess to “challenging the actions of schools and society that affect their students’ education and in helping bring about positive change” (p. 5). With this in mind…”How can teachers (i.e. you), regardless of their own identities and experiences, prepare to effectively teach students of all backgrounds?” (Keep in mind any laws or legislation currently in place.)

Discuss the manner in which US Indian policy changed after the Civil War. How had the US government misinterpreted both the Battle of Little Bighorn and the later Ghost Dance Movement and what effects did these events have upon US Indian policy?

The third reaction paper is due at 10:00pm on Friday September 24, 2021. The assigned chapters for this week are: Chapter Three Racial and Ethnic Inequality, Chapter Four: Gender Inequality, so your news story should highlight an issue covered in one of these chapters. Remember, the main focus of your paper should be the social problem the news story highlighted from the text. So, what your text has to say about the issue and the extent of it should be discussed. How does your news story either support or not support what is stated in the text about the social problem should also be discuss.

This week, you will submit the second project, VM Scanner Background Report, based on the Nessus Report. As you are writing your report, you may want to refer back to the CEO’s video in Week 1 to make sure your analysis and recommendations align with the CEO’s priorities and concerns.
You should link your analysis to the kinds of organizational functions and data associated with a transportation company (e.g., protecting order data, customer lists, sales leads, Payment Card Industry (PCI) compliance for processing credit, proprietary software, etc.) and provide your recommendation if Mercury USA should purchase the Nessus tool. This report should be four to six pages in length and include a title/cover page. Include in-text citations and a reference page with three quality sources in a citation style of your choice.

You will create a well-developed outline including all paper headings and subheadings. Review
the Integrative Learning Project Assignment Instructions. Use it as a guide for what
headings need to be included in this outline. At a minimum, the APA level 1, 2 and 3 headings
should be in the outline and it must show which Key Chapter Concepts will be in your Integrated
Learning Project as well as the titles of the appendices. Please review the Integrated Learning
Project General Instructions. Current APA format must be used.