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Paper Abstract: Its use for an alcoholic coming to a medical clinic. Symptoms of nusea and vomiting. Examines components of the protocol: assessment, diagnosis, treatment planning, case management, teaching the patient how to manage the condition outside the clinical setting. Evaluation instruments (CAGE questionnaire), Alcohol Clinical Index (ACI), AUDIT, NIAAA Guidelines. Nurse-patient collaboration. Paper Introduction: This research sets forth a case-study protocol for an alcoholic coming to a medical clinic with increased nausea and vomiting. The following components of the protocol will be examined: assessment, diagnosis, treatment planning, case management, and teaching the patient how to manage the condition outside the clinical setting. For each component, appropriate evaluation instruments will be identified, and appropriate reference to relevant literature will be made. Assessment Because the case study assumes the patient presents with increased nausea and vomiting, it may seem reasonable to presume that the patient has already been identified as alcoholic, hence subject to a range of symptoms of which nausea and vomiting may be typical and a candidate for acute intervention. Dayer-Beren Text of the Paper: The entire text of the paper is shown below. However, the text is somewhat scrambled. We want to give you as much information as we possibly can about our papers and essays, but we cannot give them away for free. In the text below you will find that while disordered, many of the phrases are essentially intact. From this text you will be able to get a solid sense of the writing style, the concepts addressed, and the sources used in the research paper. case management and teaching the the case study assumes the patient presents with increasednausea typical and a candidate for acuteintervention Dayer-Berenson cautions why appropriate assessment is so important Early-stage alcoholism has been as well as ulcers Hill Kugelmas If on AlcoholAbuse and Alcoholism NIAAA are reduced to two What is important is toobtain information about in the literature is the so-called CAGE questionnaire based on your drinking Have people annoyed in the morning to steady tobe its nonconfrontationalism NIAAA a The another benefit and the originator of the questionnaire says study indicates that on its own CAGE The AlcoholClinical Index ACI an assessment tool that medical history ACI's inventors Skinner et al provide more detailed during clinicalexamination including evidence of abnormal vascular around the navel This condition is a as AUDIT whichstands for Alcohol Use Disorders Identification Test Screening Procedure during which questions that do notrefer from diagnosis inthat the latter should elicit additional information that It consists of multiple-choice questionsdealing with drinking behavior vomit stomach cramps as a result of drinking a The ADS isconsidered a strong predictor with respect to a Composite International Diagnostic Interview serves thediagnostic criteria takes minutes which may make it impractical to use in to intervention treatment matching outcomeevaluation and program evaluation NIAAA e to have implications for the be too late for earliest-stage intervention treatment and of those in need of treatment for alcoholism or the lack of pressure from family friends and of repeated failed attempts to cut In this case the comorbidity under these conditions involving thepatient may overlap andconverge to some extent Outpatient in conjunction with such programs as Alcoholics Anonymous of an A A group according to AA the term but that can sobriety AA According to the Addiction Resource Guide determining fit with those factors are candidates forinpatient treatment rehab both of which are typically covered by insurance the possibility that detoxification could eliminate the habits to successfullymaintain a recovery in their community ARG haveemerged in recent years and research has stage and drug therapy is monitor symptoms of depression and anxiety thatmay accompany abstinence protocols Although AA membership is famous formonitoring a patient's progress The Brown-Peterson and other treatment programs may help physically eliminatethe factor urinalysis and ultrasound readings of pancreas stomach intestine andgall bladder more fully than a physician certified addictions nurse or other and treatment must be undertaken in is the first step This working with rather than talking at the notes thatsome nurses express anger or strongly risks Additionally it is important to Questionnaire DEQ which uses questions to measuresix useful during treatment as wellas follow-up and that it Retrievedfrom the World Wide Web February athttp www toomuch Advising patients about safe levels of alcohol Web February at http nsweb of preventive services nd Ed Washington D hq Hquest fws T db local ppip ppipc screen Wallack S October Executive summary nih gov publications exsum htm intro Hays J T Hill D B Kugelmas M April R Berkow M H Beers A abuse-relatededucation in nursing curricula Alcohol Health Research World National National Association of StateAlcohol and Drug Abuse Directors National Institute Retrieved from theWorld Wide Web February athttp www publications instable htm National Institute on and Alcoholism b December Alcohol use disorders December Alcohol dependence scale Alcoholism Treatment Assessment Instruments TreatmentAssessment Instruments Retrieved from the World Wide Web Wide Web February athttp www niaaa nih www niaaa nih gov publications instable htm National Institute on instable htm O'Malley S S Jaffe A J laboratory detection of alcohol abuse The Alcohol Sobell M B Behavioral assessmentand treatment planning Alcohol Health Research World vomiting The followingcomponents of the protocol will be identified and appropriate reference torelevant literature as alcoholic hence subject to a often present with a medicalor psychological problem inflamed stomach lining consistent with deterioration and health-care costs Sobell Toneatto Sobell family history A variety of psychometric instruments can bemarshaled as behavior Fox One of out cage The questions are keyed as follows guilty about your drinking Have the effectiveness of CAGE as literature andit must begin at indicating more severe cases This assertion appears to have been increasednausea is an aspect CAGE is alcohol use andpatient issues regarding alcohol use Both CAGE questions last month Inaddition ACI gives a examination refers to dilation of collateral blood vessels havebeen formed Skinner et al Another patient's involvementwith alcohol Like ACI AUDIT can be combined if patients aredefensive about alcohol use Fox NIAAA b Diagnosis a program of intervention options TheAlcohol Dependence Scale ADS has symptoms of withdrawal For example Do you that a b c etc that is importantfor treatment planning especially with respect to some symptoms NIAAA d CIDI isdependent on computer which is similar to ADS in that it to patient behavior history ofalcohol use and attitudes toward undergoing an increase innausea and vomiting and of the National Institute on including financial geographic and cultural barriers denial that that patients should be advised to abstainaltogether from if they are drinking aboverecommended low-risk amounts and there alcohol NIAAA guidelines say that the next step is office NIAAA Various abstinence-treatment options and philosophies exist problems andsupport in maintaining abstinence fromalcohol through the teaching and practice of definesalcoholism as a progressive illness that cannot be an opportunity for members to sharewith one another on problems to attend sessions regularly and abstinence for hours the financialreach of most inpatients However many units follow-up rehabilitation isusually indicated long-term residential rehab for persons who lack of willingness to cooperate Pharmacological drug therapy candidates must be inmanaging a case Physicians are advised to GGT which indicatesexcessive drinking This would effects ofabstinence or not irrespective of self-reports of By extension the patient's status can be an index of and vomiting are notsolely a consequence at the forefrontof delivering much primary care education including developing a repertoire and DrugDependence Sullivan stresses the the symptomatic evidence of a drinking problem plus management and recreation and the disease of alcoholism Effectiveeducation attitudes Sullivan Citing results of a survey of nurses about planning is being specific about that may enable nurses to trackthe efficacy of intervention and and dependence NIAAA g says also be used to plantreatment References Addiction Resource Guide February athttp www alcoholics-anonymous org Bradley K A L Identifying alcoholism in the Alcohol UseDisorders Identification Test AUDIT in a college Science Office of DiseasePrevention and Health Promotion Retrieved from the J Morse R M Schuckit Institute onAlcohol Abuse and Alcoholism Retrieved from the E Hofmann A L Winter Nurse educators look Validation of a new alcoholism instrument American Journal frontline Journal of American College Health Naegle M research in the use ofmedications as an adjunct to alcohol No Washington D C U S Department of Health Treatment Assessment Instruments Retrievedfrom the World Wide from the World Wide Web February athttp www niaaa nih Web February athttp www niaaa nih gov publications instable htm publications instable htm National Institute on Alcohol Abuse and Alcoholism f December Brown-Peterson recovery progress inventory Drinking expectancy questionnaire Alcoholism Treatment AssessmentInstruments Retrieved from Alcoholism Treatment AssessmentInstruments Retrieved from the World Wide Archives of General Psychiatry Skinner H detection of alcohol abuse The Alcohol Clinical Index Behavior Therapy Sullivan E J Handley S M Connors This research sets forth a case-study protocol for patient how to managethe condition outside the and vomiting it may seem reasonable against failing to addressalcohol addiction as associated with gastrointestinalcomplaints including nausea vomiting the known alcoholicpatient's nausea and majorrecommendations Ask about typical drinking the patient's physical condition by asking aboutphysical symptoms of Mayfield et al The CAGEinstrument makes use of four you by criticizing your drinking your nerves or get rid importance of rapport withalcoholic patients is a thatit predicts that patients who answer yes to two is less sensitive toearly problem drinking also uses the results ofclinical examination questions about individual and familyhistory formation Fox The condition known as sign that liver vessels for filtering The AUDIT consists of questions designed to specifically to alcohol use may nevertheless can be morespecifically quantified than the general self-awareness of a drinking compulsion andfeeling that drinking is out No b Sometimes c Almost every time I drink DSM diagnosis Moreover the ADS yields a measure of DSM-III-R and ICD for alcohol abuse nonspecialized clinicalsettings A more salient instrument It is to treatmentplanning that we now structure of treatment planning Thefact that that a moreintensive intervention is called alcohol problems have actuallygotten it This gap may be the employers to seek treatment Geller down pregnant or trying to conceive contraindicated medical of nausea andvomiting consistent with the last bulleted item in the referral decision discussing alcohol-treatment servicesthat are available treatment programs include educationand counseling Alcoholics Anonymous AA is a self-help group known literature The Twelve Steps topersonal recovery are be arrested through totalabstinence from alcohol in any form AA whetherto make an outpatient referral What the ARG calls freestanding inpatientrehabilitation e g Rehab is alsoroutinely associated with step treatment modalities ARG cautions alcoholic's GIcomorbidity and demotivate him to continue with treatment Whether the alcoholicin this case would be a candidate for showed the complementary utilityof drug-based not recommended as a substitute forbehavioral intervention NASADAD Management NIAAA and to monitor compliance by for protecting the confidentiality ofmembers the GGT test is a Recovery ProgressInventory B-PRPI measures a patient's current functioning level in'working' of alcohol from the patient's life there remains the may be indicated Merck Teaching the patient how to Naegle also connectssuccessful patient teaching to successful substanceabuse expert local chapters of Alcoholics Anonymous State agencies foralcohol partnership withthe patient to prepare the ground would include providing information about such documented risk factorsas family patient to define the problem andencourage cooperation Effective held opinions of disapproval ofpatients who are deemed to ask the patient How to you feel factors of alcohol involvement assertion can discriminate between problem drinkers and canbe addictionresourceguide com Alcoholics Anonymous The twelve steps of alcoholics anonymous consumption Archivesof Internal Medicine Collins H L December The patients nursingspectrum com ce ce htm Fleming M F C U S Department of Health and Human Services PublicHealth Geller A Day N L Crane Improving thedelivery of alcohol treatment and prevention services a Spickard W A Alcoholism Early diagnosis Alcoholic liver disease Postgraduate Medicine Mayfield B Fletcher Eds New York Pocket Books Miller Association of State Alcohol and Drug Abuse Directors December State on Alcohol Abuse and Alcoholism Physicians'guide to helping patients niaaa nih gov publications physicn htm National Institute on Alcohol Abuse and Alcoholism a identification test Alcoholism Treatment AssessmentInstruments Retrieved from the World Wide Web February at http www niaaa nih gov gov publications instable htm National Institute on Alcohol Alcohol Abuse and Alcoholism f Chang G Rose S Schottenfeld R Meyer R E Rounsaville Clinical Index British Medical Journal Skinner H A for alcohol tobacco and other drug be examined assessment diagnosis treatment planning will be made Assessment Because range of symptomsof which nausea and vomiting may be that appears to be totally unrelated to alcohol That is nausea vomiting right-abdominal pain and irritable bowelsyndrome Assessment guidelines promulgated by the National Institute into identifying the specifics of a case the most popular and widely cited Have you ever felt you ought to cut down on you ever had a drink first thing an assessment tool is said the earliest stage of clinical contact The simplicity ofCAGE is confirmed by various studies However at least one however flexible It is incorporated into and ACI are meantto be collapsed into the general list of clinical signs to note veins under the skin of the abdomen early screening assessment instrument is known with a clinical examinationcalled the Clinical Assessment or screening is to be distinguished been identified as a diagnosticinstrument NIAAA c get physically sick e g The higherthe score the more alcohol dependence the subject reveals the intensity oftreatment NIAAA c The scoring and administration of the test is considered useful in evaluating response alcohol's role in one's life has beenfound not just onset thereof provides a clue that itmay Alcohol Abuse and Alcoholism as littleas treatment is needed concern about the stigma of alcohol under these conditions evidence of alcohol dependence history is no evidence of alcoholdependence NIAAA a patient referral foradditional diagnosis and treatment inpatient outpatient and self-help These options ARG Health-care counseling couldbe pursued the Twelve Steps is the solepurpose cured in theordinary sense of related to drinking patterns and attempts toachieve stable at a time with support Patients who do not hospitals have rehab and or detoxunits This is a potential problem in the instant case becauseof the impulse control and sober as well as behavioral treatments for alcohol use identified in the screening andassessment ask for periodic updates fromtreatment specialists to be consistent with both inpatient andoutpatient treatment the results of behaviorinterventions Psychometric instruments have also been developed theeffectiveness of a given program While AA of alcohol use Thus such tests as a blood count to patients and their families and serve apedagogic role of resources for treating patients Such resources include a need for nurse-patient collaboration Assessment planning informationabout the role of alcohol in the current medical problem of an alcoholic patient involves rapport and people skills who dislike treatingcertain kinds of patients including alcoholics Collins drinking patterns and related health education alike Of special note is theDrinking Expectancy that the DEQ is indicated as Addiction resource guide Acomprenensive directory of addiction treatment facilities online Donovan D M Larson E B How much is hospitalizedpatient Nursing Spectrum Retrieved from the World Wide sample InternationalJournal of Addiction Fox C E Clinician's handbook World Wide Web February athttp hstat nlm nih gov M A Steinwachs D Suchinsky R T World Wide Web February at http www niaaa atalcohol education for the profession Alcohol Health Research World of Psychiatry Merck manual of medical information A Spring The need for alcohol treatment and implications for statealcohol treatment systems Washington D C and Human Services Public Health Service National Institutes of Health Web February athttp www niaaa nih gov gov publications instable htm National Institute on Alcohol Abuse National Institute on Alcohol Abuse and Alcoholism c and Alcoholism d December Composite international diagnostic interview Alcoholism Alcoholism Treatment AssessmentInstruments Retrieved from the World the World Wide Web February athttp Web February athttp www niaaa nih gov publications A Holt S Sheu W J Israel Y Clinicalversus British Medical Journal Sobell L C Toneatto T H Spring Role ofnurses in primary care managing alcohol-abusing patients an alcoholic comingto a medical clinic with increased nausea and clinical setting For each component appropriateevaluation instruments will to presume that the patient hasalready been identified the underlying cause of another clinic-admittingdiagnosis Alcoholic patients she explains indigestion esophageal reflux indicating accumulated acid in stomach and or vomiting are increasing intervention may become morecritical to avoid further patterns and ask aboutpersonal and substance abuse including but not limited to GIproblems as well questions with key words in the questionsspelling Have you ever felt bad or of a hangover eye-opener NIAAA a The key to point driven home repeatedly in the questions are in early-stage alcoholism with yes answers to more Hays Spickard of which onset of plus medical history evidence of of alcohol use over the past months and over the caput Medusa be relevant to a GI toxins out of thebody are blocked and that compensating or identify the extent of the elicit case-relevantinformation This procedure is deemed useful especially drinking-related questions of thescreening phase and thereby point to of one's control increased physical alcoholtolerance and NIAAA c ADS answers are scored such of the severity of dependence harmful use and dependence as well as onset of may be the Chemical DependencyAssessment Profile CDAP turn Planning The specificity of ADS with regard the alcoholic of the case study is for According to the National Longitudinal Alcohol EpidemiologicalSurvey result of various factors barriers to accessing alcohol services et al NIAAA guidelines say condition or medicationPatients should be advised to cut down drinking above suggests that thebest plan is to abstain from scheduling a referral appointment with the patientstill in the group bonding work on denial of drinking for its stepprogram of permanent abstinence from alcohol Sobriety freedom anchored in spiritual terms but AA Closed AA meetings whichare limited to alcoholics provide depends on two factors willingness andability Betty Ford Clinic would be out of thatin hospitals that have only detox ARG In addition to hospital rehab there is long-term rehab would depend on anaccurate assessment and behavior-based treatments O'Malley et al However provides specific recommendations for follow-through testing forelevations in serum gamma-glutamyltransferase simple method of tracking the somatic a step' Alcoholics Anonymous oriented recovery program NIAAA f need toaddress symptoms of comorbidity intrinsically Nausea manage the condition Heinemann and Hofmann explain that nurses are assessment procedures Sullivan offers specific suggestions for effective patient and drug abuse and the National Council on Alcohol for meaningful teaching Providingfeedback on history of alcohol abuse alternatives to alcohol use such asstress education may also mandate a nurse's adjustment of be responsible for their condition What isessential about your drinking NIAAA Psychometric instruments are available affective change sexualenhancement cognitive change tension reduction used to follow progress in therapy It can A A Fact File Retrieved from the World Wide Web your colleagues hate tonurse RN Dayer-Berenson Barry K L MacDonald R The Service Office of Public Health and S C Hersh A S Holder H Manning W Mayas national plan foralcohol health services research Bethesda Md National andintervention Journal of General Internal Medicine Heinemann M D McLeod G Hall P The CAGE questionnaire J B March Clinic nurses Confronting campus alcoholuse on the issue brief no Current alcohol with alcohol problems NIH Publication Alcohol Abuse and Alcoholism a December CAGE questionnaire Alcoholism December Chemical dependency assessment profile Alcoholism Treatment AssessmentInstruments Retrieved Retrieved from the World Wide February athttp www niaaa nih gov publications instable htm National Institute on Alcohol Abuse Abuse and Alcoholism f December December Drinker inventory of consequences B Six-month follow-up of naltrexoneand psychotherapy for alcohol dependence Holt S Sheu W J and Israel Y Clinicalversus laboratory problems Current status with an emphasis on clinical applications case management and teaching the the case study assumes the patient presents with increasednausea typical and a candidate for acuteintervention Dayer-Berenson cautions why appropriate assessment is so important Early-stage alcoholism has been as well as ulcers Hill Kugelmas If on AlcoholAbuse and Alcoholism NIAAA are reduced to two What is important is toobtain information about in the literature is the so-called CAGE questionnaire based on your drinking Have people annoyed in the morning to steady tobe its nonconfrontationalism NIAAA a The another benefit and the originator of the questionnaire says study indicates that on its own CAGE The AlcoholClinical Index ACI an assessment tool that medical history ACI's inventors Skinner et al provide more detailed during clinicalexamination including evidence of abnormal vascular around the navel This condition is a as AUDIT whichstands for Alcohol Use Disorders Identification Test Screening Procedure during which questions that do notrefer from diagnosis inthat the latter should elicit additional information that It consists of multiple-choice questionsdealing with drinking behavior vomit stomach cramps as a result of drinking a The ADS isconsidered a strong predictor with respect to a Composite International Diagnostic Interview serves thediagnostic criteria takes minutes which may make it impractical to use in to intervention treatment matching outcomeevaluation and program evaluation NIAAA e to have implications for the be too late for earliest-stage intervention treatment and of those in need of treatment for alcoholism or the lack of pressure from family friends and of repeated failed attempts to cut In this case the comorbidity under these conditions involving thepatient may overlap andconverge to some extent Outpatient in conjunction with such programs as Alcoholics Anonymous of an A A group according to AA the term but that can sobriety AA According to the Addiction Resource Guide determining fit with those factors are candidates forinpatient treatment rehab both of which are typically covered by insurance the possibility that detoxification could eliminate the habits to successfullymaintain a recovery in their community ARG haveemerged in recent years and research has stage and drug therapy is monitor symptoms of depression and anxiety thatmay accompany abstinence protocols Although AA membership is famous formonitoring a patient's progress The Brown-Peterson and other treatment programs may help physically eliminatethe factor urinalysis and ultrasound readings of pancreas stomach intestine andgall bladder more fully than a physician certified addictions nurse or other and treatment must be undertaken in is the first step This working with rather than talking at the notes thatsome nurses express anger or strongly risks Additionally it is important to Questionnaire DEQ which uses questions to measuresix useful during treatment as wellas follow-up and that it Retrievedfrom the World Wide Web February athttp www toomuch Advising patients about safe levels of alcohol Web February at http nsweb of preventive services nd Ed Washington D hq Hquest fws T db local ppip ppipc screen Wallack S October Executive summary nih gov publications exsum htm intro Hays J T Hill D B Kugelmas M April R Berkow M H Beers A abuse-relatededucation in nursing curricula Alcohol Health Research World National National Association of StateAlcohol and Drug Abuse Directors National Institute Retrieved from theWorld Wide Web February athttp www publications instable htm National Institute on and Alcoholism b December Alcohol use disorders December Alcohol dependence scale Alcoholism Treatment Assessment Instruments TreatmentAssessment Instruments Retrieved from the World Wide Web Wide Web February athttp www niaaa nih www niaaa nih gov publications instable htm National Institute on instable htm O'Malley S S Jaffe A J laboratory detection of alcohol abuse The Alcohol Sobell M B Behavioral assessmentand treatment planning Alcohol Health Research World vomiting The followingcomponents of the protocol will be identified and appropriate reference torelevant literature as alcoholic hence subject to a often present with a medicalor psychological problem inflamed stomach lining consistent with deterioration and health-care costs Sobell Toneatto Sobell family history A variety of psychometric instruments can bemarshaled as behavior Fox One of out cage The questions are keyed as follows guilty about your drinking Have the effectiveness of CAGE as literature andit must begin at indicating more severe cases This assertion appears to have been increasednausea is an aspect CAGE is alcohol use andpatient issues regarding alcohol use Both CAGE questions last month Inaddition ACI gives a examination refers to dilation of collateral blood vessels havebeen formed Skinner et al Another patient's involvementwith alcohol Like ACI AUDIT can be combined if patients aredefensive about alcohol use Fox NIAAA b Diagnosis a program of intervention options TheAlcohol Dependence Scale ADS has symptoms of withdrawal For example Do you that a b c etc that is importantfor treatment planning especially with respect to some symptoms NIAAA d CIDI isdependent on computer which is similar to ADS in that it to patient behavior history ofalcohol use and attitudes toward undergoing an increase innausea and vomiting and of the National Institute on including financial geographic and cultural barriers denial that that patients should be advised to abstainaltogether from if they are drinking aboverecommended low-risk amounts and there alcohol NIAAA guidelines say that the next step is office NIAAA Various abstinence-treatment options and philosophies exist problems andsupport in maintaining abstinence fromalcohol through the teaching and practice of definesalcoholism as a progressive illness that cannot be an opportunity for members to sharewith one another on problems to attend sessions regularly and abstinence for hours the financialreach of most inpatients However many units follow-up rehabilitation isusually indicated long-term residential rehab for persons who lack of willingness to cooperate Pharmacological drug therapy candidates must be inmanaging a case Physicians are advised to GGT which indicatesexcessive drinking This would effects ofabstinence or not irrespective of self-reports of By extension the patient's status can be an index of and vomiting are notsolely a consequence at the forefrontof delivering much primary care education including developing a repertoire and DrugDependence Sullivan stresses the the symptomatic evidence of a drinking problem plus management and recreation and the disease of alcoholism Effectiveeducation attitudes Sullivan Citing results of a survey of nurses about planning is being specific about that may enable nurses to trackthe efficacy of intervention and and dependence NIAAA g says also be used to plantreatment References Addiction Resource Guide February athttp www alcoholics-anonymous org Bradley K A L Identifying alcoholism in the Alcohol UseDisorders Identification Test AUDIT in a college Science Office of DiseasePrevention and Health Promotion Retrieved from the J Morse R M Schuckit Institute onAlcohol Abuse and Alcoholism Retrieved from the E Hofmann A L Winter Nurse educators look Validation of a new alcoholism instrument American Journal frontline Journal of American College Health Naegle M research in the use ofmedications as an adjunct to alcohol No Washington D C U S Department of Health Treatment Assessment Instruments Retrievedfrom the World Wide from the World Wide Web February athttp www niaaa nih Web February athttp www niaaa nih gov publications instable htm publications instable htm National Institute on Alcohol Abuse and Alcoholism f December Brown-Peterson recovery progress inventory Drinking expectancy questionnaire Alcoholism Treatment AssessmentInstruments Retrieved from Alcoholism Treatment AssessmentInstruments Retrieved from the World Wide Archives of General Psychiatry Skinner H detection of alcohol abuse The Alcohol Clinical Index Behavior Therapy Sullivan E J Handley S M Connors If this paper is not what you are looking for, you can search again: Search for: or Click here to request an essay written just for you.