Course Syllabus

SYL_NURS_4100_783_2205_gonzales (002).rtf

NURS 4100
Section 783, Spring, 2020
Genetics in Nursing Syllabus

Basic Information

Instructor Name: Rene Rodriguez, DNP, RN

OFFICE: Virtual

OFFICE PHONE: 432-552-2560

E-MAIL: rodriguez_r@utpb.edu

OFFICE HOURS: Virtual

ROOM & TIME: By Appointment

This course is a Web Course and is conducted within Canvas http://utpb.instructure.com

NOTE: The due dates and times for the activities will adhere to the Central Time Zone.

Course Description

Course Catalog Description:

Integration of genetic/genomic information into nursing practice, including ethical, legal, psychological, cultural, and social issues are examined. The role of the nurse as advocate for individual rights regarding access to and use of genetic information, decision-making, and actions are emphasized throughout the course. Genetic-/genome-related history taking, patient/family education, support, and incorporation of genetic/genome information in evidence-based nursing care are explored

Measurable Learning Outcomes:

By the end of this course, you will be able to: (use active verbs)

1. Describe the genetic and genomic bases with implications for health and/or illness.
2. Recognize potential for genetic conditions in persons of all ages as a function of nursing assessments and process and advocate for client’s/patient’s rights concerning genetics and genomic services.
3. Incorporate genetics and genomics knowledge and technologies in nursing practice.
4. Describe the laws and ethics concerning individual rights concerning genetics and genomic processes and information.
5. Integrate and tailor genetic and genomic information and services based on the client’s culture, religion, knowledge level, literacy, values, and preferences.

Prerequisites: Admission to the nursing program or prior approval of Director

Materials

Required Materials: 

Beery, Workman, & Eggert. (2018). Genetics and Genomics in Nursing and Health Care. (2nd ed.). Philadelphia, PA. F.A. Davis Publishing. ISBN- 978-0-8036-6083-0

Ignatavicius, D. & Workman, L. (2018). Medical-surgical nursing: Patient centered collaborative care. (9th ed.). St. Louis, MO: Saunders Elsevier. ISBN: 9780323461702.

American Psychological Association. (2010). Publication Manual of the American Psychological Association. (6th ed.). Washington, D.C.: American Psychological Association. ISBN-13: 978-1-4338-0561-1

Recommended Materials: 

American Nurses Association. (2009). Essentials of genetic and genomic nursing: Competencies, curriculum guidelines, and outcome indicators. American Nurses Publishing. May be downloaded as pdf file from:

https://www.nursingworld.org/~4af0c1/globalassets/docs/ana/ethics/essentials-of-geneticgenomic-nursing-2009.pdf

Other materials:  N/A.

Important Academic Dates

UTPB Academic Calendar

Course Overview

Teaching Strategies:

Lecture, seminar, team learning, breakout groups, Socratic questioning, and discussions are teaching strategies utilized in teaching this course. Assigned reading is to be completed prior to the class. Course grade is based on participation, quizzes, genetic pedigree project assignment, mid-term exam, and a final exam.

Class Preparation:

You should read the textbook as assigned. Most of the lectures provide expansion of specific textbook topics and guidance on important areas. Face- to-face lectures will be summaries, elaborations on specific topics, and discussion.

Readings:

Readings related to course and module objectives are indicated in each module, and come from both textbooks, PowerPoints developed by the instructor and or published articles/website links.

Exams/Quizzes:

The student must achieve a cumulative grade of 75% or greater on the course to pass the course.

 *There are two exams during this course: 

1. Mid-Term Exam = 30%
2. Final Exam = 30%

 

*Quizzes will be given be at the beginning of the class. If you are late, you may not take the quiz once it has been given. No make-ups are given on quizzes.  You have two quizzes:

1. Quiz 1 = 5%
2. Quiz 2 = 5%

Assignments:

Research Projects:

Students will be assigned to one group project in this semester. This assignment is worth 20% of the total grade

GENETIC PEDIGREE GROUP PROJECT ASSIGNMENT INSTRUCTIONS

Components	Exemplar Requirements & Description	Points
Pedigree Graphic Instructions	The Pedigree must include at least three (3) generations. ·         The Proband is “YOU”. ·         Include all siblings for each bloodline ·         Interview an accurate historian from each bloodline so that the Pedigree is accurate. ·         Label each individual from each bloodline in terms of his/her relationship to the proband (you). ·         Indicate the following for each individual represented on the Pedigree Ø  DOB (Date-of-Birth) Ø  If the individual is still living, indicate the following: §  Current state of health: A & W (Alive & Well), or §  Any/all diseases/illnesses and co-morbidities §  Provide date of medical diagnosis(es), if known, for each (e.g. Hyperlipidemia; Dx: 1998; Hypothyroidism: Dx: 2004) Ø  DOD (Date-of-Death, if appropriate) §  If deceased, indicate cause of death	40
Written Component Instructions	Based on your Pedigree: Identify at least three (3) risks for health/wellness, listed in order of priority (these must be represented in the Pedigree) Indicate whether each risk for health/wellness (trait/gene) occurs in the paternal, maternal, or in both bloodlines. Ø  If the trait is genetically-linked, indicate whether it is recessive or dominant. Choose one (1) of the traits/genes and develop a Plan of Care (Nursing Diagnosis, Family-Centered Goal/Outcome, Nursing Intervention) to eliminate, or diminish, the risk to health/wellness associated with the identified trait/gene. Based on your Plan of Care: Ø  Identify the “most significant” barrier to eliminating, or diminishing, the trait/gene. §  Include rationale regarding why this would be the most significant barrier Ø  Explain how a Pedigree might be used to improve the care provided to one (1) of the following groups: §  Older adults §  Adult Women, Men, or both §  Adolescents §  Children §  Infants	45
Format Instructions	The written component of the Genetic Pedigree Project Assignment should be typed, double-spaced, 1-inch margins, using at least a 12-point font, include cover page that contain all the group members’ names and list of references using APA format. The Pedigree (graphic) should be on a separate page (landscape orientation) Ø  The Pedigree should be neatly typed, organized, using appropriate symbols (provided during lecture). §  6-point or 8-point font may be used for the Pedigree graphic. Ø  Each response for this project that is highlighted in yellow must be supported by an evidence-based source from current (2011 or later) literature Ø  At least one (1) evidence-based reference must be from a professional, peer-reviewed nursing journal. Ø  Include all cited references in the List of References in correct APA format.	15
Submission Instructions	Save the Genetic Pedigree Project Assignment as follows: Ø  Your Group’s Name_Pedigree.docx Ø  Submit the completed Genetic Pedigree Project Assignment by email attachment to: Abualhaija_n@utpb.edu Ø  The completed Genetic Pedigree Project Assignment is due on or before the due date indicated on the course calendar by 2359.
Total		100

 

GENETIC PEDIGREE PROJECT GRADING RUBRIC

The following criteria will be used to grade the Genetic Pedigree Project Assignment. The Genetic Pedigree Project Assignment counts for 20% of the course grade. The score requirement described under each point on the scale defines the minimum performance that must be demonstrated in order to achieve that score.

CATEGORY	3	2	1	0
Pedigree Graphic (40%) Representative of at least three (3) generations Required information included Correct symbol use	Three or more generations are included in the Pedigree       All required information is present   Symbols used on the Pedigree are correct   Pedigree graphic is legible and well-organized	Three generations included in the Pedigree     Some required information missing   Majority of symbols are correct   Pedigree graphic organized; some areas difficult to read	Only two generations included in the Pedigree     Much of the required information missing   Numerous errors in symbol use   Pedigree graphic disorganized; difficult to read written information	Less than two complete generations in Pedigree   Most of required information missing   Symbol use incorrect   Pedigree graphic disorganized, poor legibility
Written Component (45%) Three (3) risks for health/wellness identified & correctly prioritized (must also be represented in Pedigree Graphic) Bloodline(s) for identified health/wellness risks are accurately indicated Any genetically-linked traits/genes are correctly indicated as either dominant or recessive Plan of Care accurate & complete Significant Barrier to diminishing/eliminating risk identified & rationale provided Explanation for Pedigree use to improve care is comprehensive with evident use of critical-reasoning skills	Effective introduction, body & conclusion     Writing flows smoothly, with effective paragraph transitions    Effective plan with evidence of analysis	Clear introduction, body & conclusion albeit somewhat mechanical   Effective paragraph transitions, however sentence conventional   Specific plan followed fairly consistently	Reasonably adequate introduction, body and conclusion   Mechanical or abrupt transitions     Specific plan identified but limited	No clear introduction or conclusion     Transitions poor and inappropriate   Plan of development minimally adequate
Format (15%)  Coherent articulation of Pedigree findings Adherence to format instructions Adherence to APA guidelines Submitted by due date/time as instructed	Clear, controlled and fluent diction   Appropriate, active voice, and wide-ranging word choice   No major errors         Evidence of careful proofreading throughout     Excellent APA formatting with full congruence between citations and reference list	Clear and reasonably fluent   Appropriate, clear and correct word choice     A few minor errors and one or two major errors, which do not reduce the clarity of communication   Occasional spelling, punctuation, or typographical errors   Good APA formatting with congruence between citations and reference list	Functionally correct, unclear in some areas   Unimaginative word choice     Minor errors and a few major errors that reduce clarity of communication   Multiple spelling, punctuation, or typographical errors   Fair APA formatting with some differences between citations and reference list	Frequently awkward     Limited and sometimes inaccurate words   Frequent errors that impede communication     Significant spelling, punctuation & typo errors   Incorrect APA format and little congruence between citations and reference list
Total	100

 

 

Discussion Topics: N/A

Final Exam:

There will be a single exam at the end of the course, which account for 30% of the course total final grade

Presentations: N/A

Grading:

Course Activity	Points	Percentage of Total Grade
Genetic Pedigree Group Project Assignment	100	25
Quizzes (2)	15	15
Mid-Term Exam	30	30
Final Exam	30	30
Total	100	100

 

Grading Scale: 

Grade Range	Letter Grade
90 and above	A
80 to 89	B
70 to 79	C
60 to 69	D
Less than 60	F

*Unless otherwise stated, all materials, activities, and assessments are required and are not optional. Only final grades will be rounded using the common rounding rule. A grade with 0.5 or above will be rounded up and a grade with a 0.4 or below will be rounded down.  For example, if a student receives a final grade of 79.5, he or she will receive an 80 for the final grade. If a student receives a grade of 79.4, he or she will receive a 79 for the final grade.

Communication, Grading & Feedback: 

Communication is expected to be professional in all encounters. Foul or abusive language in the classroom, clinical setting, or university will not be tolerated. Conflicts are to be resolved in a manner that respects the dignity of every person involved.

Email is an important communication tool used by the College of Nursing. Official communication must take place through UTPB email. The College of Nursing communicates with students using UTPB student email or messaging in Canvas Learning Management System. Faculty members may not respond to emails from other servers such as hotmail.com, gmail.com, yahoo.com or other email servers.

Faculty in the College of Nursing will respond to emails within 24 hours on weekdays and 48 hours on weekends or holidays. Students should check UTPB email daily and respond to emails sent by faculty within 24 hours on weekdays and 48 hours on weekends or holidays.

Faculty members have office hours where they will be available for consultation.  Days/Times will be made available to you. Students are encouraged to contact their instructor if they wish to discuss their progress, a problem or need assistance related to their role as a student.

Time Management:

Each student should expect to spend a minimum of three hours on preparation and learning assignments for every semester credit hour.  Since this class is a 1-semester credit hour class, it is expected that each student should spend about 3 hours out of class on assignments in addition to 1 hour of in-class time for a total of about 4 hours per week to obtain an "A" in a class. It will be important to develop a Time Management Plan to be successful.

Policies

ATI Testing:

ATI testing and learning resources are embedded throughout the nursing program. Please see individual course syllabus for details outlining grading policy.

The grading system for proctored exam scoring is outlined below:

Content Mastery Threshold	1st Proctored Exam Attempt	2nd Proctored Exam Attempt
Level 3	100% of points	85% of points
Level 2	90% of points	80% of points
Level 1	60% of points, develop* focused review and must retake exam	50 % of points
Less than Level 1	0% of points, develop* focused review and must retake exam	0% of points

Clinical Absences:

Attendance for all class is mandatory. There are no excused absences. Students can have no more than one clinical absence a semester. A mandatory make-up day will be set by faculty based on availability. In the event a student misses more than one day of clinical, including simulation lab hours, or a scheduled make-up day, this may result in course failure.

Service Learning:

As a key component of the education process, the College of Nursing recognizes the need for students to participate in service learning. Service learning is attributed to experiential learning, community betterment and self-reflection. As a contribution to the University and the community, all students will be required to complete a minimum of four hours of service learning each semester. The service learning opportunity must be approved by the course faculty and should include 2-3 student-designed objectives. The service learning opportunity may be separated into two separate experiences, but both should have a public health focus, which can include a broad array of experiences

Discussion Board

Discussion Board is primarily for discussing course related topics and issues.
Best practices are:

• Read all message postings in online discussion.
• Respond to the question directly
• Reply to minimum of two other student posts.
• Use a person's name in the body of your message when you reply to their message.
• Avoid postings that are limited to 'I agree' or 'great idea', etc.
• Ensure responses to questions are meaningful, reflective.
• Support statements with concepts from course readings, refer to personal experience, examples.
• Follow Rules of Behavior (below).
  
  

Rules of Behavior 

Discussion areas are public to every student in this class (including your instructor) who will see what you write. Please pay attention to the language you use and adhere to the following guidelines:

• Do not post anything too personal.
• Do not use language that is inappropriate for a classroom setting or prejudicial in gender, race, or ethnicity.
• Do not use all caps in the message box unless you are emphasizing (it is considered shouting).
• Be courteous and respectful to other people on the list
• Do not overuse acronyms like you would use in text messaging. Some of the list participants may not be familiar with acronyms.
• Use line breaks and paragraphs in long responses.
• Write your full name at the end of the posting.
• Be careful with sarcasm and subtle humor; one person's joke is another person's insult.

Professional Behavior of Caring and Respect in Classroom, Clinical Settings, University, and Community.

Faculty and students are expected to conduct themselves professionally—in demeanor, use of language, and appearance—in the presence of faculty, staff, other students, patients, and visitors in the classroom, laboratory and health care settings and the community.

Classroom Environment 

Faculty and students are expected to uphold a classroom atmosphere conducive to learning. The faculty is committed to providing the curriculum in a manner that will prepare graduates to be successful in the health care workplace. It is expected that students will be ready to work and listen at the beginning of class and after breaks.  Professional behavior means that students do not have to be called to order more than once.

Classroom Conduct 

Professional demeanor and courtesy to peers, faculty, and guests and/or guest lecturers in the classroom setting are essential to the teaching-learning experience.  Classroom conduct is expected to demonstrate mutual respect of faculty, students and peers.  Elected course representatives will participate in the management of peer classroom conduct

Make-Up/Late Submission Policy

All course activities must be submitted before or on set due dates and times. If the student is unable to abide by the due dates and times, it is her/his responsibility to contact the instructor immediately. Please upload all your work onto Canvas. If work is submitted late, 10% will be deducted from the assignment’s grade each day it is late. Late assignments will not be accepted after the third day of the due date.

Academic Dishonesty/Plagiarism/Cheating 

The academic community regards academic dishonesty as an extremely serious matter, with serious consequences. Any effort to gain an advantage not given to all students is dishonest whether or not the effort is successful.  Any suspicion of academic dishonesty will be reported and investigated. A student who engages in scholastic dishonesty that includes, but is not limited to cheating, plagiarism, and collusion will receive an “F” for the course.

All persons involved in academic dishonesty will be disciplined in accordance with University regulations and procedures. For complete information on UTPB student conduct and discipline procedures consult the University’s Handbook: Scholastic Dishonesty.

Academic dishonesty includes, but is not limited to cheating, plagiarism, collusion, falsifying academic records, misrepresenting facts, the submission for credit of any work or materials that are attributable in whole or in part to another person, taking an examination for another person, any act designed to give unfair advantage to a student such as, but not limited to, submission of essentially the same written assignment for two courses without the prior permission of the instructor, or the attempt to commit such acts.

Plagiarism includes, but is not limited to the appropriation of, buying, receiving as a gift, or obtaining by any means material that is attributable in whole or in part to another source, including words, ideas, illustrations, structure, computer code, other expression and media, and presenting that material as one's own academic work being offered for credit.

Attendance and Class Participation

All the course activities have set dates to be completed and submitted. After the due dates, the activities will not be available for the students. Your attendance is expected at every class and clinical session (This course does not require clinical practicum); attendance will be recorded at every class. This type of course requires participation in all areas for accurate evaluation of performance. Intelligent participation requires that you come prepared for the class. Your attendance is expected at every class and/or lab and clinical. Contact instructor immediately in case of emergency medical situation..

Tracking 

Learning management systems have tracking features.  Statistics are collected that quantifies how often and when students are active in the course and provides information if the student has accessed different pages of the course.

Absenteeism

Regular and active participation is crucial and expected to fully pass this course.  If for some reason, you are absent from the class, please fill out the absence form, and you have the option of either emailing the form or hand delivering a hard copy to the instructor’s office.

Course Incomplete/Withdrawal/Grade Appeal

All students are required to complete the course within the semester they are signed up.  Incomplete grades for the course are rarely given, will only be granted if the student provides a valid, documented excuse for not being able to complete the course on time, and has contacted the instructor prior to the scheduled last class to request an extension. The student signs a contract that includes the incomplete course activities and the new due dates.

Find information and dates regarding drops and withdrawals consult the University Handbook: Drops and Withdrawals and Appeal Process.

Accommodation for Students with Disabilities 

Students with Disabilities: The University of Texas of the Permian Basin in compliance with the Americans with Disabilities Act and Section 504 of the Rehabilitation Act provides “reasonable accommodations” to students with disabilities. Any student with a disability who is requesting an accommodation for this course must provide the instructor with official documentation in the form of a letter from the ADA Officer for Students.  Only those students who have officially documented a need for an accommodation will have their request honored. **Adapted from UTSA ADA syllabus statement.**

ADA Officer for Students: Mr. Paul Leverington

Address: Mesa Building 4243/4901 E. University, Odessa, Texas 79762

Voice Telephone: 432-552-4696

Email: ada@utpb.edu

For the accessibility and privacy statements of external tools used within courses, go to Accessibility and Privacy Statements.

Computer Skills, Technical & Software Requirements

Describe any special prerequisite skills (word processing, spreadsheet, presentation software, YouTube account, etc.  Example:  This course is designed as a web-based class, which necessitates specific computer expertise on the part of the student, specific computer equipment or programs, and a commitment on the part of the student beyond that of most other courses.) Student will need to create word processing documents, save files, submit files.

Students can use cloud version of Word, PowerPoint and other Microsoft products through use of their UTPB Outlook 365 and UTPB email address.  For more information refer to UTPB Office 365 Page.

Computer Technical Requirements

See Technical Requirements.

Online Student Authentication

UTPB requires that each student who registers for an online course is the same student who participates in, completes, and receives credit for the course. UTPB’s Distance Education Policy requires faculty members to employ at least two methods of verification to ensure student identities.  To access online courses students must login to the UTPB learning management system using their unique personal identifying username and secure password.  UTPB’s Distance Education Policy requires at least one additional student identification method within the course that has been determined and approved by the faculty or academic program.  This course satisfies the second method of student authentication by:

• Proctored exams using an approved photo ID*.
• Presentation of approved photo ID* through a web cam and video recorded proctoring during assessment (Respondus Monitor, Examity)
• Field or clinical experiences using an approved photo ID*.
• Synchronous or asynchronous video activities using an approved photo ID*.
• Other technologies or procedures [ONLINE FACULTY MUST SPECIFY]

*Approved up to date photo identifications are: passports, government issued identification, driver’s licenses, military ID from DoD.  Dual credit and early college high school students use school district identifications.

Using LockDown Browser & Respondus Monitor for Online Exams

This course requires the use of LockDown Browser and Monitor for online exams. Watch this short video to get a basic understanding of LockDown Browser and Monitor.

Download and install LockDown Browser. 

To take an online test, open LockDown Browser which opens Canvas and navigate to the exam. (You cannot access the exam with a standard web browser.)
When taking an online exam, follow these guidelines:

• Setup web cam for exams using Monitor.
• Ensure you're in a location where you won't be interrupted.
• Turn off all mobile devices, phones, etc.
• Clear your desk of all external materials — books, papers, other computers, or devices.
• Remain at your desk or workstation for the duration of the test.
• LockDown Browser will prevent you from accessing other websites or applications; you will be unable to exit the test until all questions are completed and submitted.

Preparation for Emergencies

Computer Crash

Not having a working computer or a crashed computer during the semester will NOT be considered as an acceptable reason for not completing course activities at a scheduled time. NOTE: Identify a second computer before the semester begins, that you can use when/if your personal computer crashes.

Complete Loss of Contact

If you lose contact with course connectivity completely (i.e. you cannot contact me via Canvas or email), you need to call instructor, and leave message regarding connectivity loss and contact information.

Lost/Corrupt/Missing Files 

You must keep/save a copy of every project/assignment on an external drive, UTPB Outlook 365 OneDrive, or personal computer. In the event of any kind of failure (e.g. virus infection, student’s own computer crashes, loss of files in cyberspace, etc.) or any contradictions/problems, you may be required to resubmit the files. 

End-of-Course Evaluation & Instructor Evaluation

Every student is encouraged to complete an end of course evaluation survey provided by UTPB. During the last two weeks of class, there will be an announcement in Canvas, an email, and a button in your course navigation that will take you to any available surveys.

The survey is anonymous and your responses are confidential. Your feedback is critical to us and to your instructor as we strive to improve our offerings, and our support of you, the students.

Student Support Services

SERVICE	CONTACT
ADA Accommodation/Support	Testing Services & Academic Accommodations Department (432) 552-4696
Advising	(432) 552-2661 UTPB Academic Advising Center
Bookstore	UTPB Campus Bookstore (432) 552-0220
Email, Office 365, my.utpb.edu	Information Technology
Financial Aid and Scholarship	UTPB Financial Aid (432) 552-2620
Library	The J. Conrad Dunagan Library Online at (432) 552-2370
Registrar	UTPB Registrar (432) 552-2635
Student Services	Student Services (432) 552-2600
Technical Support	Canvas 1-866-437-0867
Tutoring & Learning Resources	If you are taking courses through UTPB the following links provide services: Smarthinking Online Tutoring (provides tutoring services), SmarterMeasure (measures learner readiness for online course).

Disclaimer & Rights

Information contained in this syllabus was to the best knowledge of the instructor considered correct and complete when distributed for use in the beginning of the semester. However, the instructor reserves the right, acting within the policies and procedures of UTPB to make changes in the course content or instructional techniques without notice or obligation. The students will be informed about the changes, if any.

Copyright Statement

Many of the materials that are posted within UTPB courses are protected by copyright law. These materials are only for the use of students enrolled in the course and only for the purpose of the course. They may not be further retained or disseminated.

Schedule

Week	Topic & Class Contents	Readings	Assignments
1	·         Introduction to Course & Orientation: §  Review: syllabus, course requirements/expectations ·         Unit I: Basic Concepts from Molecular Genetics ·         Unit V: Genomics and Disease Management	Ch.1 DNA Structure and Function Ch.18 Health Professionals and Genomic Care Ch20 Genetic and Genomic Variation	Visit the following web sites: www.genome.gov   www.cdc.gov/genomics     Discussion Questions due
2	Unit I: Basic Concepts from Molecular Genetics Unit II: Gene Expression	Ch. 2 Protein Synthesis Ch. 3 Genetic Influences on Cell Ch. 4 Patterns of Inheritance	Ignatavicius   Ch. 5 Principles of Genetics and Genomics   Discussion Questions due
3	Unit II: Gene Expression	Ch. 5 Epigenetic Influence on Gene Expression Ch. 6 Autosomal Inheritance and Disorders Ch. 7 Sex Chromosome and Mitochondrial Disorders	Discussion Questions due
4	·         Unit V: Genomics and disease Management ·         Unit II: Gene Expression	Ch. 16 Genetic and Genomic Testing Ch. 17 Assessing Genomic Variation in Drug Responses Ch. 8 Family History and Pedigree Construction	Discussion Questions due
5	·         Unit II: Gene Expression ·         Unit III: Genomics Health Problems Across the Life Span	Ch. 9 Congenital Anomalies, Basic Dysmorphology, and Genetic Assessment Ch. 10 Enzyme and Collagen Disorders Ch. 12 Common Adult Onset Genetic Disorders	Pedigree Due Discussion Questions due
6	·         Unit IV: Genomics Influences on Selected Complex Health Problems	Ch. 13 Cardiovascular Disorders Ch. 14 The Genetics of Cancer	Discussion Questions due
7	·         Unit IV: Genomics Influences on Selected Complex Health Problems ·         Unit VI: Global Genomic Issues	Ch. 15 Genetic Contributions to Psychiatric and Behavioral Disorders Ch 19 Financial, Ethical, Legal and Social Considerations	Discussion Questions due