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Sectiоn 3: Essаy Write а three-pаrt essay that addresses the fоllоwing topics. Be as thorough and specific as possible in your essay. The best responses will demonstrate mastery, rather than sufficient or incomplete knowledge, of the content. Part I (20 points). How does the threat of war and war itself structure political relationships among great powers? Be sure to illustrate your general claims by drawing on theoretical content from throughout our course. Part II (25 points). Provide multiple examples of the general claims developed in part 1 through an exploration of contemporary relations among the United States, China, and Russia. To help with this section, you might organize your discussion by responding to the following more specific question: How have wars or the threat of war shaped recent changes in the political relationships among China, Russia, and the United States? Part III (15 points). Draw on the theoretical arguments and empirical evidence developed in Parts 1 and 2 to offer two sets of policy recommendations to the President of the United States. These policy recommendations should be designed to enhance the national security of the United States, sustain alliance relationships that support its national interests, and prevent great power war.
Reаd the fоllоwing cаse scenаriо, as documented in a "SO"AP format. Then follow the directions. Patient Information Name: Ava KimAge: 2 yearsSex: FemaleRace/Ethnicity: Asian American Setting Ava Kim is a 2-year-old Asian American female who presents to her pediatrician's office accompanied by her mother with complaints of right ear pain, fever, and increased fussiness. Chief Complaint (CC) Mother states: "She's been pulling at her right ear and crying most of the night." History of Present Illness (HPI) Ava's mother reports that her daughter began developing nasal congestion and a runny nose approximately five days ago. Two days ago, Ava became increasingly fussy and developed a low-grade fever. During the past 24 hours, she has been pulling at her right ear, crying whenever she lies down, and has been difficult to console. Her mother reports that Ava awoke several times during the night crying and refused to sleep on her right side. She has had a decreased appetite but continues to drink fluids. She has had several wet diapers today. The mother has been administering acetaminophen, which temporarily reduces the fever and improves Ava's comfort. She denies vomiting, diarrhea, rash, difficulty breathing, neck stiffness, ear drainage, facial swelling, recent trauma, or foreign body insertion into the ear. No known sick contacts outside of daycare, although several children in her classroom recently had colds. Past Medical History Full-term vaginal delivery without complications Normal growth and development Two previous episodes of acute otitis media, both successfully treated with oral antibiotics Immunizations current according to CDC schedule Surgical History None Medications Acetaminophen as needed for fever No daily medications Allergies No known drug allergies Family History Mother: Seasonal allergic rhinitis Father: Healthy Maternal grandmother: Hypertension No family history of congenital hearing loss, recurrent ear infections requiring tympanostomy tubes, or immunodeficiency disorders Social History Lives with both parents and an older brother Attends daycare five days per week No tobacco exposure in the home Uses an age-appropriate car seat Drinks from a cup during the day but occasionally uses a bottle before bedtime Developmental milestones appropriate for age Review of Systems (ROS) General Mother reports fever, increased irritability, decreased appetite, and poor sleep. Denies lethargy or weight loss. Skin Denies rash, bruising, or skin lesions. HEENT Head: Denies head injury. Eyes: Denies redness, drainage, swelling, or visual concerns. Ears: Reports pulling at the right ear, increased crying when lying down, and apparent right ear pain. Denies ear drainage or bleeding. Nose: Reports nasal congestion and clear rhinorrhea for five days. Throat: Mild decrease in appetite but continues drinking fluids. Denies drooling or difficulty swallowing. Respiratory Reports mild cough associated with nasal congestion. Denies wheezing, stridor, shortness of breath, or increased work of breathing. Cardiovascular Denies cyanosis or decreased activity tolerance. Gastrointestinal Reports decreased appetite. Denies vomiting, diarrhea, or abdominal pain. Genitourinary Normal urine output with several wet diapers today. Musculoskeletal Denies neck stiffness or extremity pain. Neurological Mother reports increased fussiness but denies seizures, altered level of consciousness, or weakness. Objective Assessment Findings Vital Signs Temperature: 101.8°F (38.8°C) Heart Rate: 122 beats/min Respiratory Rate: 26 breaths/min Blood Pressure: 92/58 mmHg Oxygen Saturation: 99% on room air Weight: 13.2 kg (29 lb) Physical Examination General Alert, irritable toddler sitting on mother's lap. Cries during the examination but is consolable. Appears mildly ill but nontoxic. Skin Warm, pink, and dry. No rash or lesions. Head Normocephalic and atraumatic. Eyes Conjunctivae clear. Sclerae white. Pupils equal, round, and reactive to light. Extraocular movements intact. Ears Right Ear External ear normal without swelling or erythema. Ear canal patent without edema or drainage. Tympanic membrane is erythematous, bulging, opaque, and has loss of normal landmarks. Decreased mobility of the tympanic membrane with pneumatic otoscopy. No perforation observed. Left Ear External ear and canal normal. Tympanic membrane pearly gray, translucent, with normal landmarks and normal mobility. Nose Nasal mucosa mildly erythematous with clear rhinorrhea. Mouth/Throat Oral mucosa pink and moist. Mild posterior pharyngeal erythema without tonsillar enlargement or exudate. Neck Supple. Small, mobile, mildly tender right anterior cervical lymph node palpated. No meningismus. Respiratory Respirations even and unlabored. Lungs clear to auscultation bilaterally. Cardiovascular Regular rate and rhythm. No murmurs. Capillary refill less than 2 seconds. Abdomen Soft, nondistended, nontender. Normoactive bowel sounds. Neurological Alert and interactive. Age-appropriate behavior. No focal neurologic deficits. Diagnostics No laboratory studies or imaging have been obtained prior to today's evaluation. No tympanocentesis performed. ---------------------------------------------------------------------------------- Based on Ava Kim's history and physical examination findings: Explain whether additional diagnostic testing is indicated. Identify three (3) "red flag" findings that would warrant additional evaluation or referral and explain why. Directions: Respond in 3-4 well-developed paragraphs using in-text citations when needed. Course book(s), course lecture notes, and course content are the only resources allowed to use. A reference page is not required. *Please see the attached rubric.