Workplace Environment Assessment

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Workplace Environment Assessment

 

 

 

 

 

Workplace Environment Assessment

 

 

 

 

The safety of the work environment remains a crucial central area that the management is required to focus on to ensure that both clients and the employees are safe and healthy. Safety measures and reporting are some of the criteria used for evaluating the organization and scoring the organization’s performance in terms of quality services and safety to employees (Badri et al., 2018). The purpose of this summary goals is to provide a summary of the outcomes of the work environment assessment earlier complete, a literature review by giving a brief explanation of the theory of concept presented in the articles selected, and evidence-based strategies that can be used to create high-performance interprofessional teams.

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Work Environment Assessment

 

            Based on the outcomes from the work environment assessment that was completed on the workplace, the overall civility score was 55, indicating that the workplace was unhealthy. The two and most surprising things about the results were that the workplace does not have a positive environment as it was previously thought. There is a considerable gap between the leadership and the rest of the workers concerning the decision-making processes. The single idea that I believed before the performance of the assessment and was confirmed is the workload of the employees, which is unfairly distributed and the majority of the workers being overworked (Clark, 2015). Therefore, based on the health and the civility of the workplace, the outcomes of the workplace assessment indicate that the workplace is unhealthy and has a lower level of civility.

Reviewing the Literature

 

The model or theory presented by the selected article is the DESC model. This model is essential in structuring the civility conversation. T is based on the Team-STEPPs, which is an evidence-based teamwork system used to improve the communication and the skills of the team (Griffin & Clark, 2014). This, in turn, leads to improved safety and healthcare quality. The model works effectively with the cognitive rehearsal to address particular incivility cases.

The selected theory is related to the results of the work environment assessment. The results from the work environment assessment show that the overall civility score was 55. This reveals the unhealthy status of the workplace, hence needs further improvement. The model plays an essential role in addressing the incivility evident in this organization. This can be achieved when the staff and the management work as a team, as supported by this model. Working as a team is an essential intervention in ensuring that both parties understand one another and share the success and the challenges encountered in dealing with organizational safety (Clark, 2015). Since the model is based on the Team-STEPPS, it makes it easier for the management and the staff to improve their skills and communication, which leads to the overall enhancement of the safety and quality of care in the organization. With effective implementation of the model, there will be an improvement in the overall civility score hence an improvement in the health and safety status of the workplace.

The DESC model can improve organizational health and stronger work teams successfully. The use of the model makes it possible to address the uncivil encounter within the organization. It promotes critical conversation with the uncivil colleague hence allowing the staff and management to move forward as a team (Clark, 2015). The model or theory is vital since it makes it possible to have a perfectly prepared team for the conversation whereby each member speaks with confidence and uses respectful expressions. This critical approach ensures an end to the silence that is considered the essential characteristic of incivility.

The encounter with incivility is made more effective by using the model. Ensuring that the staff and the management perfectly understand the tools in the DESC model makes it possible to encounter incivility as a team. The model makes it possible for each member to speak confidently and use respectful expressions (Clark, 2015). This gives the members an opportunity of describing and expresses their concerns to the management and propose alternative approaches that can be adopted to improve the safety and health of the workplace.

Evidence-Based Strategies to create High-Performance Interprofessional Teams

It is essential to ensure that the issues that affect the score of the work environment are addressed ideally. To achieve this process, it is necessary to have excellent strategies that assist both staff and management in dealing with the issue of incivility in the work environment. One of the approaches is to ensure an effective communication process within the organization (Andriani et al., 2018). This intervention is essential in providing that both parties are involved in addressing conflict in the negotiation process to ensure that the shortcomings in the work environment are dealt with accordingly (Clark, 2015). Effective communication is also helping in providing that there is an effective problem-solving process since members consult each other and arrive at an effective solution.

The other strategy is to ensure that there is a culture of collaboration amongst the members. The collaboration process is essential since it allows the members to synthesize their unique strengths brought by each member to the workplace. This approach makes it possible to create a workplace a civil one (Clark, 2015). Therefore, the staff and the management will always focus on the higher purposes, i.e., providing safe, effective patient care and engaging in respectful communication.      

It is also essential to improve the successful practices revealed in the workplace environment. Based on the assessment, there was a gap between the leadership and the employees, especially in terms of decision-making. The other issue is the staff’s workload that is unfairly distributed and some of the workers being overworked. Therefore, it is essential to ensure that all the team in the organization is involved in the decision-making process (Clark, 2015). It is also necessary to ensure that the staff is provided with feedback on the successes and the areas that need improvement in terms of the safety and health of the work environment. The other approach is for the organization to ensure an increase in the number of staff since it appears the few available employees are overworked.

Summary or Conclusion

            The personal assessment of the workplace indicates incivility based on a civility score of 55. This is a clear indication that the workplace has an unhealthy working environment characterized by the more significant gap between the leadership and the employees in decision-making processes and the workload that the workers experience. Dealing with these issues requires adopting the DESC model that supports effective communication processes that support the civility conversation between the team members (Clark & Ritter, 2018). It also supports a collaborative approach that leads to the exploitation of the unique strengths brought by the members and supports a respectful expression by the members. The model is also essential in helping conflict negotiation, and problem-solving promote the safety and health of both patients and providers.

 

 

 

 

References

Andriani, S., Kesumawati, N., & Kristiawan, M. (2018). The influence of the transformational leadership and work motivation on teachers performance. International Journal of Scientific & Technology Research, 7(7), 19-29.

Badri, A., Boudreau-Trudel, B., & Souissi, A. S. (2018). Occupational health and safety in the industry 4.0 era: A cause for major concern? Safety science, 109, 403-411.

Clark, C. M. (2015). Conversations to inspire and promote a more civil workplace. American Nurse Today, 10(11), 18-23. https://doi.org/10.3928/01484834-20180522-02

Clark, C. M., & Ritter, K. (2018). Policy to foster civility and support a healthy academic work environment. Journal of Nursing Education, 57(6), 325-331.

Griffin, M., & Clark, C. M. (2014). Revisiting cognitive rehearsal as an intervention against incivility and lateral violence in nursing: 10 years later. The Journal of Continuing Education in Nursing, 45(12), 535-542. Doi:10.3928/00220124-20141122-02

 

Nursing homework help

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Nursing homework help

What is the Erikson Stage of Development for a client diagnose with staphylococcus aureus bacteremia? Give at least one example a time a client shows their development stage.  How does the stage of development impact the care given to a client?  Staphylococcus aureus bacteremia

 

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What are some cultural consideration you noticed with a client and family when dealing with Staphylococcus aureus bacteremia.

 

 

 

 

 

 

 

 

 

 

 

 

Healthcare systems elements (continued)                      ALLERGIES:
Medications: List all medications, dosages, classifications and the rational for the medications prescribed for this patient include major considerations for administration and the possible negative outcomes associated with this medication.

                                 DEFINE 1:  What the medications does to the body to the cellular level AND 2: Why the patient is taking the medication?

Medication/dose              Classification          Indication/ Rationale        SE’s/Nursing Considerations                 Client Education                    Text Reference
Triamcinolone acetonide ointment

 

          
Aspirin chewable table

 

          
Hydroxyzine oral syrup

 

          
Ibuprofen          
 

 

          
 

 

          
 

 

          
 

 

          
 

 

          
 

 

          
 

 

          
 

 

          
 

 

          
 

 

          

 

 

 

 

 

 

 

 

 

CONCEPT MAP

 

 

 

 

 

 

 

 

 

 

 

 

               

Nursing Diagnosis

Problem statement: (NANDA)

 

Related to: (What is happening in the body to cause the issue?)

 

Manifested by: (Specific symptoms)

 

               

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

REMEMBER THAT THE EXPECTED OUTCOMES MUST BE MEASURABLE.  THE INTERVENTIONS ARE WHAT YOU DO TO ASSURE THE OUTCOME AND THE CLIENT’S RESPONSE IS SPECIFICALLY HER RESPONSE.  

                                                    PLAN OF CARE:                                                                                             Use your top two priorities

NANDA NURSING DIAGNOSIS use NANDA definition Expected outcomes of care (Goals)          Interventions       Patient response        Goal evaluation
NRS DX:

Problem Statement: 

 

 

 

 

 

 

 

 

R/T: (What is the cause of the symptom)

 

 

 

 

 

 

 

 

Manifested by: (Specific symptoms)

 

 

 

 

 

 

 

 

 

 Short term goal:  Create a SMART goal that relates to hospital stay/shift/day.

 

 

 

 

 

 

 

 

 

 

 

 

Long term goal:  Create a SMART goal that is appropriate for discharge.

 

 This is specific to the patient that you are caring for. A list of planned actions that will assist the patient to achieve the desired goal. (i.e. obtain foods that the patient can eat/ likes)

 

Interventions for short-term goal:

1.

2.

3.

 

 

 

 

Interventions for longterm goal:

1.

2.

3.

 

 

 Identify what the patients response or “outcome is to the goal or care that you have provided. i.e. patient ate 45% of lunch)

 

 

 

Reassess for short-term goal:

1.

2.

3.

 

 

 

 

 

Reassess for long-term goal:

1.

2.

3.

 

 Was it met or not met there is no partially met.
NANDA NURSING DIAGNOSIS use NANDA definition Expected outcomes of care (Goals)           Interventions        Patient response        Goal evaluation
NRS DX:

Problem Statement:

 

 

 

 

 

 

 

 

R/T: (What is the cause of the symptom?)

 

 

 

 

 

 

 

 

 

 

Manifested by: (specific symptoms)

 

 

 

 

 

 Short term goal:  Create a SMART goal that relates to hospital stay.

Long term goal:  Create a SMART goal that is appropriate for discharge.

 

 This is specific to the patient that you are caring for. A list of planned actions that will assist the patient to achieve the desired goal. (i.e. obtain foods that the patient can eat/ likes)

 

 

 Identify what the patients response or “outcome is to the goal or care that you have provided. i.e. patient ate 45% of lunch) Was it met or not met there is no partially met.

 

Interview and Interdisciplinary Issue Identification

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Interview and Interdisciplinary Issue Identification

 

 

 

 

 

 

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Interview Summary

Summarize your interview in this section. Be sure to relate concise information about:

  • the health care organization that was discussed in the interview.
  • the interviewee’s role and duties.
  • the relevant issues at the organization.
  • any relevant comments on the actions taken by the organization or leadership previously and their effectiveness.
  • the organizational culture related to collaboration.
  • any relevant collaboration or interdisciplinary team experience you interviewee has had.

The goal of this section is to convey what was discussed at the interview and identify an issue to pursue throughout the rest of this assessment (and future assessments in this course), as well as have enough information to relate theories, strategies, and approaches to the situation at the organization.

Issue Identification

Identify the issue from the interview for which you consider an evidence-based interdisciplinary approach appropriate. Provide one or more specific reasons why an interdisciplinary approach would be appropriate for the issue.

Change Theories That Could Lead to an Interdisciplinary Solution

For this section, look to the literature and describe one or more change theories that would help to develop an interdisciplinary solution to the identified issue. Also, you should briefly note the relevance and credibility of the sources that you cite.

Another way to think through this section is:

  • What is the change theory?
  • How could it help create an interdisciplinary solution?
  • How relevant is the theory to the specific identified issue?
  • How credible is the source?

Leadership Strategies That Could Lead to an Interdisciplinary Solution

This section is similar to the previous one, except you will be looking to the literature to help you describe one or more leadership strategy that would help you develop an interdisciplinary solution to the identified issue. Also, you should briefly note the relevance and credibility of the sources that you cite.

Another way to think through this section is:

  • What is the leadership strategy?
  • How could it help create an interdisciplinary solution?
  • How relevant is the strategy to the specific identified issue?
  • How credible is the source?

Collaboration Approaches for Interdisciplinary Teams

Again, this section will be similar to the previous once, except that the focus will be on collaboration approaches. Depending on whether or not your interviewee’s organization uses interdisciplinary teams frequently, your focus in this section may be on how to establish interdisciplinary teams and a collaborative foundation or how to improve the collaboration within an already established teams. You should also briefly note the relevance and credibility of the sources that you cite.

Another way to think through this section is:

  • What is the leadership approach?
  • How could it help establish or improve collaboration?
  • How relevant is the approach to the specific identified issue?
  • How credible is the source?

 

 

References

Nursing homework help

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Nursing homework help

Cancer is the uncontrollable growth of abnormal cells in the human body. It is defined by a malfunction in cellular mechanisms that control cell growth. Cells evade checkpoint controls and begin growing uncontrollably which resulting in an increase in abnormal cells, cancer cells. These cancer cells form a mass tissue known as a tumor. In the United States of America, cancer has been determined to be among the leading causes of mortality rates after cardiovascular conditions, where one in every four deaths is caused by cancer. The most common types of cancer include prostate cancer, lung cancer, and breast cancer. Risk factors for cancer include excess smoking, radiation exposure, genetics, and environmental pollution. Colon cancer, or colorectal cancer, affects the distal third of the large intestine, the colon, as well as the rectum, chamber in which feces is stored for elimination. Colorectal cancer is the third leading cause of death in cancer-related issues in the United States in both males and females (Beadnell et al., 2018). This essay explores the physiology and pathophysiology of colon cancer. Nursing homework help

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Polyps are tissue growths that generally look like small, flat bumps and are generally less than half an inch wide. They are generally non-cancerous growths that can develop with age on the inner wall of the colon or rectum. There are several types of polyps, such as hyperplastic. They are common and have a low risk of turning cancerous. Hyperplastic polyps found in the colon will be removed and biopsied. Pseudo polyps also referred to as inflammatory polyps, usually occur in people suffering from inflammatory bowel disease and are unlike other polyps. This type of polyp occurs due to chronic inflammation as seen in Crohn’s disease and ulcerative colitis. However, a polyp cells which can turn out to be malignant. Villous adenoma or tubulovillous adenoma polyps carry a high risk of turning cancerous. They are sessile and develop flat on the tissue lining the organs. They might blend within the organ, making polyps not easily identifiable and difficult to locate for treatment. Adenomatous or tubular adenoma polyps have a high chance of being cancerous. When a polyp is found, it must be biopsied, and then will regular screenings and polyp removal will follow.

An adenocarcinoma is a cancer formed in a gland that lines an organ.  This cancer impacts the epithelial cells, which are spread throughout the human body. Adenocarcinomas of the colon and rectum make up ninety-five percent of all colon cancers (Chang, 2020). Colon adenocarcinomas usually begin in the mucous lining the spread to different layers. Two subtypes of adenocarcinomas are mucinous adenocarcinoma and signet ring cells. Mucinous adenocarcinomas contain about sixty percent mucus which can cause cancer cells to spread faster and become more hostile than typical adenocarcinomas. Signet ring cell adenocarcinoma is responsible for less than one percent of all colon cancer. It is given this name because of how it appears under a microscope. These cells are aggressive and are more challenging to treat. The symptoms of colorectal adenocarcinoma are abdominal pain, blood in stool, constipation or diarrhea, and weight loss. The standard treatment for colorectal adenocarcinomas is chemotherapy, surgery, targeted therapy, and radiation.

Gastrointestinal carcinoid tumors are another type of cancer that affects the rectum. These cells grow in nerve cells known as neuroendocrine cells which help in regulating hormonal production. Carcinoid tumor cells grow slowly and can also develop in the lungs and other parts of the gastrointestinal tract. They cause about one percent of all colon cancers and half of cancer found in the small intestines. Symptoms are different depending on the growth location of the tumor (Falanga et al., 2019). A tumor in the appendix usually has no symptoms unless it starts to obstruct the path from the appendix to the intestines, causing appendicitis symptoms such as fever, vomiting, and nausea. Carcinoid tumors sometimes make hormones that might lead to a variety of symptoms that are dependent on produced hormones. Patients suffering from these tumors can experience flushing in the face, wheezing, quick heartbeats, and diarrhea. Tumors in the colon can cause weight loss, tiredness, stomach cramps, and pain. Gastrointestinal carcinoid tumor treatment options are similar to those of the aforementioned treatments.

Anorectal melanoma is a rare cancer that starts in the anus or rectum. This cancer can develop anywhere in the large intestines or rectum and spread aggressively. Melanomas are estimated to affect less than two percent of colon cancer. It rarely occurs; however, it is very aggressive and challenging to treat. This type of cancer can be easily missed during initial and follow-up diagnoses because it is rarely seen.

Familial adenomatous polyposis (FAP) accounts for almost one percent of all cancers in the rectum or colon. FAP is an inherited disorder distinguished from colon cancer, but some people can develop the abnormal gene that leads to this condition. People having this syndrome can create a lot of polyps in the colon as early as their teenage age. The patient’s colon has to be removed to stop the polyps from becoming cancerous. People with familial adenomatous polyposis keep increasing as they age because hundreds or thousands of polyps can grow in the colon as they age (Freidman et al., 2020). Patients with it may not have any symptoms at the early stages of the disease until it is in the advanced settings. The symptoms of familial adenomatous polyposis are abdominal cramps, unexpected weight loss, cysts of the skin, and lamps on the bones of the legs, arms, skull, and jaw. Treatment for this cancer can be the removal of the colon to curb the spread of the polyps which can cause cancer.

 

 

 

 

Pathophysiology of Colorectal Cancer

Pathophysiology is the combination of pathology and physiology. The study of the disordered physiological process associated with an injury or disease. Pathophysiology aims to explain the functional differences occurring within a person because of being sick. Colorectal Cancer or CRC can be sporadic, hereditary, or inflammatory bowel disease.

Sporadic colorectal cancer develops from the colorectum without known contribution from germline causes. Different mutations occur, which lead to CRC. Sporadic CRC is a somatic cell mutation that is a natural developmental process in the immune system. A bodily genetic disease might be caused by the local colonic environment and a person’s background genetic makeup (Ju et al., 2019). Two-thirds of all colon cancers are this type and are primarily seen in clinical practice. In sporadic CRC, we have mutations such as microsatellite instability or mutator pathway dysfunction. Microsatellite instability or MSI is a hypermutable phenotype resulting from DNA mismatch repair activity loss. MSI is found in about fifteen percent of colon cancers. Twelve percent are associated with sporadic and the other three percent with Lynch syndrome. This instability is caused by germline mutations in mismatch repair or MMR genes. MMR system proofreads as DNA is formed when it identifies an abnormality in sequence repairs to the DNA are made. MMR gene dysfunction allows DNA to increase at high speed. These mutations confer a selective advantage on the cells, leading to the cancer spreading. CpG Island Methylator Phenotype or CIMP is another mutation that happens. CpG Island Methylator Phenotype is brought by DNA methyltransferases that support hypomethylation in promoter-associated CpG enough regions with tumor suppressor genes turned off. The switching off the CIMP pathway, abnormal cells can develop, and malignant cells develop, which leads to the spread of colon cancer in the body.

Hereditary is another war cancer is spread. It is an inherited disorder with a high chance of contracting some cancers. Changes or mutations bring about hereditary cancer symptoms in specific genes passed from parents to children. In this case, similar cancers might be seen in the same family members who are close such as a father, son, and brother having the same cancer and developing it from early stages. Hereditary cancer includes Lynch Syndrome or LS. LS is an inherited disorder that increases the chance of contracting particular colon cancer. Patients with Lynch syndrome have a high probability of having stomach, brain, and skin cancer. There is an attempt to repair defective cells in the body. They form mismatch repair genes as these genes continue to accumulate errors. As the abnormal cells increase, this can lead to abnormal growth of cells and possibly cancer. Familial Adenomatous Polyposis or FAP is also caused by Adenomatous Polyposis Coli or APC gene mutation. APC gene issues instructions for developing APC protein. These mutations cause the production of abnormally short non-function APC proteins. The fast APC protein cannot prevent the cellular overgrowth that causes the formation of polyps in the large intestines which can become cancerous. People who have inherited FAP have a lot of polyps in their colons, and all those with this genetic disorder will have colorectal cancer. The patients must undergo early examination because the number of polyps in their colons might increase, and they have a high chance of getting cancer.

Inflammatory Bowel Disease or IBD is a common term given to describe disorders that involve chronic inflammation of the digestive tract. Types of IDs include ulcerative colitis, inflammation, and sores or ulcers along the superficial lining of the large intestines. Crohn’s disease is identified by inflammation of the lining in the digestive tract, including the deeper layers of the digestive tract (Szekanecz et al., 2019). Chronic inflation is caused by cytokines and chemokines. These are secreted proteins with development and activation functions that control and decide the nature of immune response and control immune cell trafficking at the cellular arrangement of immune organs. Patients suffering from IDB have a high chance of contracting colon cancer if they have contracted an IBD liver complication known as primary sclerosing cholangitis. Before sclerosing cholangitis inflammation that causes scars within the bile ducts, the spots make the ducts hard and narrow, causing severe liver damage.

Providing Care to Patients in a Holistic Manner

The provision of care in a holistic manner means providing care to patients who are majored in a mutual understanding of their physical, psychological, emotional, and spiritual dimensions. Nursers are in charge of health promotion. Nurses working with colorectal cancer or CRC patients can promote health by mobilizing patients to take screening for colon cancer. Nurses should have a bond with patients, which will help them communicate about screening and its importance. The patients who connect with the nurses can also be taught ways to prevent them from getting CRC and symptoms of the disease. A nurse should be compassionate to patients, understand their problems, and be present. CRC can be contracted because of a patient’s background. You have to ask them about their background, what they eat, and their overall lifestyle (Verkhratsky & Nedergaard, 2018). CRCs can also be inherited through genes asking patients if any conditions exist in their families to help find if that is the problem. There are rapid changes in health care, allowing nurses to identify patients likely to have CRC. Advancements have shown that CRC appears when a person is aging. It will help nurses talk to patients encouraging them to take screening to check if they have CRC. A holistic manner can work well if a nurse creates a good rapport with the patients and communicates effectively.

Cancer is spreading and becoming a significant health issue in society. Awareness has to be raised on cancer and how it affects people, the patients, and those close to them. There are many causes of cancer, such as pollution or exposition to radiation. These issues have to be looked into to help in reducing the spread of cancer. Colon cancer can be inherited genetically to avoid further spread, screening has to be done, and those having it undergo treatment with their children. To ensure that someone can grow without being worried about contracting cancer. Screening of people over forty years old should be started as some of these colon cancers start turning into cancerous tumors. It will help control the number of people affected with cancer and help them to get treatment before their condition becomes worse. Nurses should also be able to communicate with patients with colon cancers and form a good rapport with them to help each other out. Nursers should also figure out a colon cancer patient’s background, diet, and activities to help diagnose the patient. Nurses play a vital role in helping patients who have colon cancer.

 

 

References

Alahmad, M. (2020). Strengths and Weaknesses of Cognitive Theory. Budapest International Research and Critics Institute (BIRCI-Journal): Humanities and Social Sciences, 3(3), 1584-1593.

Beadnell, T., Scheid, A., Vivian, C., & Welch, D. (2018). Roles of the mitochondrial genetics in cancer metastasis: not to be ignored any longer. Cancer And Metastasis Reviews, 37(4), 615-632. https://doi.org/10.1007/s10555-018-9772-7

Chang, J. (2020). Pathophysiology of Inflammatory Bowel Diseases. New England Journal Of Medicine, 383(27), 2652-2664. https://doi.org/10.1056/nejmra2002697

Falanga, A., Schieppati, F., & Russo, L. (2019). Pathophysiology 1. Mechanisms of Thrombosis in Cancer Patients. Thrombosis And Hemostasis In Cancer, 11-36. https://doi.org/10.1007/978-3-030-20315-3_2

Freidman, N., Chen, I., Wu, Q., Briot, C., Holst, J., & Font, J. et al. (2020). Amino Acid Transporters and Exchangers from the SLC1A Family: Structure, Mechanism, and Roles in Physiology and Cancer. Neurochemical Research, 45(6), 1268-1286. https://doi.org/10.1007/s11064-019-02934-x

Ju, H., Zhao, Q., Wang, F., Lan, P., Wang, Z., & Zuo, Z. et al. (2019). A circRNA signature predicts postoperative recurrence in stage II/III colon cancer. EMBO Molecular Medicine, 11(10). https://doi.org/10.15252/emmm.201810168

Kaplan, D. E. (2018). Piagetian Theory in Online Teacher Education. Creative Education, 9(6), 831-837.

Moheghi, M., Ghorbanzadeh, M., & Abedi, J. (2020). The Investigation and Criticism Moral Development Ideas of Kohlberg, Piaget, and Gilligan. International Journal of Multicultural and Multireligious Understanding, 7(2), 362-374.

Szekanecz, Z., Raterman, H., Pethő, Z., & Lems, W. (2019). Common mechanisms and holistic care in atherosclerosis and osteoporosis. Arthritis Research &Amp; Therapy, 21(1). https://doi.org/10.1186/s13075-018-1805-7

Verkhratsky, A., & Nedergaard, M. (2018). Physiology of Astroglia. Physiological Reviews, 98(1), 239-389. https://doi.org/10.1152/physrev.00042.2016

BHA-FPX4002: History of the United States Health Care System

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BHA-FPX4002: History of the United States Health Care System

 

 

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Historical Trend Analysis

 

 

Historical Trend Analysis

Write your introduction here. Provide a brief explanation of the purpose of this historical trend analysis and how it might be used in your work as a health administrator (1 paragraph). Where appropriate, reference significant health care milestones, regulations, and measures for access, quality, and cost.

Trends and Regulations

Provide a brief description of the key measures of health care services, which are access, quality, and cost (1–2 paragraphs).

Health Care Access

            Explain why access to health care is important and what it means. What U.S. legislation, regulatory agencies, and quality initiatives for the 1800s, 1900s and 2000s have influenced access to health care services in the United States. What does your milestone trend analysis reveal for access to care? (1–2 paragraphs)

Health Care Quality

Explain what quality health care is and why it is important. What U.S. legislation, regulatory agencies, and quality initiatives for the 1800s, 1900s and 2000s have influenced care quality in health care services in the United States. What does your trend analysis reveal for care quality? (1–2 paragraphs)

Health Care Cost

            Explain what health care cost is and why it is important. What U.S. legislation, regulatory agencies, and quality initiatives for the 1800s, 1900s and 2000s have affected health care costs for medical services. What does your trend analysis reveal for medical service costs? (1–2 paragraphs)

Trend Analysis

Analyze the trends and regulations in health care access, quality, and cost to draw conclusions about the evolution of health care regulations and practice throughout the recent eras (1–2 paragraphs). Describe professional experiences or examples to illustrate the trends. Include citations and references to specific regulations, events, or agencies.

Conclusion

Summarize clear and concise conclusions of your trend analysis (1 paragraph). What are the trends revealed for health care access, quality, and cost? Draw a conclusion about how the changes have improved, been neutral, or inhibited progress of the U.S. health care system.

 

References

Kroth, P. J., & Young, K. M. (2018). Sultz & Young’s health care USA: Understanding its organization and delivery (9th ed.). Jones & Bartlett.

 

 

Appendix

 

Trend Analysis Table: Evolution of Access, Quality, and Cost in Health Care

 
Milestones Health Care Access Health Care Quality Health Care Costs
1800s

Regulatory Legislation, Agencies, or Quality Initiatives

 Year, Milestone

·         Note

·         Note

 Year, Milestone

·         Note

·         Note

 Year, Milestone

·         Note

·         Note
Year, Milestone

·         Note

·         Note

 Year, Milestone

·         Note

·         Note

 Year, Milestone

·         Note

·         Note
1900s

Regulatory Legislation, Agencies, or Quality Initiatives

 Year, Milestone

·         Note

·         Note

 Year, Milestone

·         Note

·         Note

 Year, Milestone

·         Note

·         Note
Year, Milestone

·         Note

·         Note

 Year, Milestone

·         Note

·         Note

 Year, Milestone

·         Note

·         Note
2000s

Regulatory Legislation, Agencies, or Quality Initiatives

 Year, Milestone

·         Note

·         Note

 Year, Milestone

·         Note

·         Note

 Year, Milestone

·         Note

·         Note
Year, Milestone

·         Note

·         Note

 Year, Milestone

·         Note

·         Note

 Year, Milestone

·         Note

·         Note

 

Nursing homework help

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Nursing homework help

 

NR534A-NEED RESPONSES

Louann Robinson 

 

  • Health Insurance Portability and Accountability (HIPAA) Rules regulate the use and disclosure of personal health information (PHI). The national standards were created to protect our PHI from data theft. The Health Information Technology for Economic and Clinical Health Act (HITECH Act), adopted in 2009, was established to improve health care quality, safety, and efficiency through the promotion of health IT and promote interoperability (CMS, 2021;OCR, 2021).

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  • Data sets help with healthcare analytics to evaluate collected data in a meaningful way. The University of Washington (2022) explains that clinical data collected can include “administrative and demographic information, diagnosis, treatment, prescription drugs, laboratory tests, physiologic monitoring data, hospitalization, patient insurance” (para. 4).
  • This information placed in the correct algorithm can look for trends that can guide nurse schedules and the correlation to medication errors and patient safety and outcomes, which relates to the Excel spreadsheet I created (see Appendix). In addition, this information could be used to negotiate nurse contracts between the union and the hospital in the future

References
Centers for Medicare and Medicaid Services. (2021, December 1). Privacy and Security Information | CMS. CMS. Retrieved May 1, 2022, from https://www.cms.gov/Regulations-and-Guidance/Administrative-Simplification/HIPAA-ACA/PrivacyandSecurityInformation

Office for Civil Rights (OCR). (2021, June 28). HITECH Act Enforcement Interim Final Rule. HHS.Gov. https://www.hhs.gov/hipaa/for-professionals/special-topics/hitech-act-enforcement-interim-final-rule/index.html#:%7E:text=The%20Health%20Information%20Technology%20for,use%20of%20health%20information%20technology.

University of Washington. (2022, April 19). Library Guides: Data Resources in the Health Sciences: Clinical Data. Retrieved May 1, 2022, from https://guides.lib.uw.edu/hsl/data/findclin

Carolyn Gaeckle 

One focus that I have had lately is that of patients being treated with a second-generation anti-psychotic. Many patients who take these medications experience weight gain, dyslipidemia, and elevated A1C levels, increasing their risk for obesity, cardiac disease, and diabetes (Lieberman, 2004). I think it would be of benefit to monitor patients who are prescribed an anti-psychotic for weight gain, as well monitoring their lipid profiles and A1C. The spreadsheet I have created in Excel can collect these various data points and in the end, can be used to determine things such as average increase in weight, total cholesterol, or A1C. This could be a helpful tool in monitoring patients for things such as metabolic syndrome, dyslipidemia, and diabetes, in which an educated decision could be made (or with the help of a CDSS) to prescribe the patient a statin to help regulate cholesterol or metformin to help lower A1C. Metformin has also been shown to be helpful in reducing weight gain associated with the use of anti-psychotics (de Silva et al., 2016).

de Silva, V.A., Suraweera, C., Ratnatunga, S.S. et al. (2016) Metformin in prevention and treatment of antipsychotic induced weight gain: a systematic review and meta-analysis. BMC Psychiatry 16, 341. https://doi.org/10.1186/s12888-016-1049-5

Lieberman J. A., 3rd (2004). Metabolic changes associated with antipsychotic use. Primary care companion to the Journal of clinical psychiatry, 6(Suppl 2), 8–13.

 

 

Euridice Nobre 

Week 9 Discussion

Clinical data is the information collected to enable the evolution of new knowledge

to guide the development of best practices and represents the resource most central to healthcare progress (Institute of Medicine, 2010).

I chose to create a spreadsheet in Excel because it is a great way to store, calculate, analyze data, and generate reports. In addition, Excel is relatively cheap and provides flexible data structures (variables can be added and removed as needed) (Bruland & Dugas, 2017). The spreadsheet attached is an example of how fall data related to psychotropic drugs may be stored and monitored to implement fall prevention protocol throughout my organization. Du et al. (2016) found that the use of psychotropic medications, in general, is significantly correlated with higher risks of falls, especially synthetic antidepressants, e.g., SSRIs. The spreadsheet can be used to organize, collected data to implement changes to decrease falls in hospitalized patients by systematically reviewing, tapering, reducing, or discontinuing psychotropic medications periodically.

 

References

Bruland, P., & Dugas, M. (2017). S2O – A software tool for integrating research data from general purpose statistic software into electronic data capture systems. BMC Medical Informatics and Decision Making, 17(1), 3-3. https://doi.org/10.1186/s12911-016-0402-4

Du, Y., Wolf, I., & Knopf, H. (2016). Psychotropic drug use and alcohol consumption among older adults in Germany: Results of the German health interview and examination survey for adults 2008-2011. BMJ Open, 6(10), e012182-e012182. https://doi.org/10.1136/bmjopen-2016-012182

Institute of Medicine (US) Roundtable on Value & Science-Driven Health Care. (2010). Clinical Data as the Basic Staple of Health Learning: Creating and Protecting a Public Good: Workshop Summary. Washington (DC): National Academies Press (US). Summary. Available from: https://www.ncbi.nlm.nih.gov/books/NBK54290/

 

Alicia Michonski 

The National Association of School Nurses (2022), Every Student Counts Initiative was established to create a national school health data set. The primary goal of the data initiative is to create robust health data that will influence local, state, and national student health policy. Additionally, the data initiative is to be leveraged to advocate for the needs of the students, increase evidence-based school nursing practice, and improve student health outcomes (NASN, 2022). Clinical data from my school can be collected and added to the national database to assist with these goals.

One identified data point within this initiative is chronic absenteeism. To develop clinically meaningful use, EHR content must be transformed into readily analyzed data. Keys to successful meaningful use include facilitating data collection at the point of care and generating adequate data sets (Abernathy et al, 2017). For this week’s assignment, I have created a spreadsheet that will help track the number of students who are chronically absent from school. The spreadsheet breaks the data down into reasons why the student has missed class and the duration. This also aligns with my health IT eval project as missed class time is one of my key measures.

Microsoft Excel was used to create the spreadsheet as it is one of the most commonly used software for data visualization and analysis, and it is compatible with the health center’s computer systems. Additionally, Excel has many capabilities to store, organize, and track data within a shared system. Lastly, Excel was most suitable as the health center staff are already familiar with Microsoft Excel and its shared functions. Please see the attached document for the spreadsheet.

References
Abernethy, A. P., Gippetti, J., Parulkar, R., & Revol, C. (2017). Use of electronic health record data for quality reporting. Journal of Oncology Practice, 13(8).

NASN. (2022). National School Health Data Set: Every Student Counts. National Association of School Nurses. Retrieved on May 2, 2022, from https://www.nasn.org/research/everystudentcounts

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Nursing homework help

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Nursing homework help

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Answer:

  1. 1 1-What are Genes?

A unit of heredity which is transferred from a parent to offspring and is held to determine some characteristic of the offspring (proteins coded directly by genes). A distinct sequence of nucleotides forming part of a chromosome, the order of which determines the order of monomers in a polypeptide or nucleic acid molecule which a cell or virus may synthesize.

 

      2 2-Describe what a chromosome is and how are present normally in human beings?

Chromosomes are thread-like structures located inside the nucleus of animal and plant cells. Each chromosome is made of protein and a single molecule od deoxyribonucleic acid (DNA). Passed from parents to offspring, DNA contains the specific instructions that make each type of living creature unique.

 

3 3-Concepts for: Euploid cells, Diploid Cells, Aneuploid Cells? What is a Polyploidy?

Euploid cells: Is a chromosomal variation that involves the entire set of chromosomes in a cell or an organism. Euploidy is more tolerated in plants than in animals. There may be in a single set (monoploidy), two sets (diploidy), or multiple sets (polyploidy).

 

Diploids cells: Diploid is a term that refers to the presence of two complete sets of chromosomes in an organism’s cells, with each parent contributing a chromosome to each pair. Humans are diploid, and most of the body ‘cells contain 23 chromosomes pairs.

 

Aneuploids Cells: Aneuploid cells have an abnormal number of chromosomes. Because each chromosome contains hundreds of genes, the addition or loss of even a single chromosome disrupts the existing equilibrium in cells. And in most cases, is not compatible with life.

 

 

  

 

       4-What is a Trisomy and an example of it?

The presence of an extra chromosome in some or all the body’s cells. This results in a total of three copies of that chromosome instead of the normal two copies. For examples, Down syndrome (trisomy 21) is caused by having three copies of chromosome 21 instead of the usual two copies.

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  1. 5 5-What means Homozygous and heterozygous in Mendelian Heritance?

Through careful study of patterns of inheritance, Mendel recognized that a single trait could exist in different versions, or alleles, even within an individual plant or animal.

An organism with two of the same alleles for a particular gene is homozygous at that locus; an organism with two different alleles for a particular gene is heterozygous at that locus. An organism phenotype is an observable trait.

 

  1. 6 6-Which are special features of X Linked genetic diseases?

X-linked inheritance means that the gene causing the trait, or the disorder is located on the X-chromosome. A male carrying such a mutation will be affected because he carries only one X chromosome. A female carrying a mutation in one gene, with a normal gene on the other X chromosome, is generally unaffected.

Examples of X-linked recessive conditions include Red-green color blindness. Red, green color blindness simply means that a person cannot distinguish shades of red and green (usually blue-green). Their visual acuity is normal.

 

 

7     7-What is a risk factor?

A risk factor or determinant is a variable associated with an increased risk of disease or infection. Due to a lack of harmonization across disciplines, determinant, in its more widely accepted scientific meaning, is often used as a synonym. Something that increase the chance of developing disease.

 

8     -8 Also, what is a congenital disease?

A congenital disorder is a condition that is present from birth. Congenital disorders can be inherited or caused by environmental factors. Congenital anomalies can be defined as structural or functional anomalies that occur during intrauterine life.

 

9     -9 Epigenetic and Mental Health.

Current mental health epigenetic research supports that adverse psychosocial experience are associated with mental disorders. Epigenetic has been linked to several disorders such as anxiety, stress, depression, schizophrenia, and addiction

Psychiatric disease is believed to result from a combination of genetic vulnerability and environmental influence. At the crux are epigenetic modifications, which mediate the influence of environment on the genome.

 

 

 

 

10  10-DNA Methylation: why is important?

DNA methylation is a biological process by which methyl groups are added to the DNA molecule. Methylation can change the activity of a DNA segment without changing the sequence. When located in a gene promoter, DNA methylation typically acts to repress gene transcription.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Orencia Gonzalez

What are Genes?

Genes are items of DNA (deoxyribonucleic acid) inside each cell that inform the cell what to do and when to expand and divide. Each gene is composed of a particular DNA series which contains the code (the directions) to make a certain healthy protein, each of which has a details task or function in the body.

Describe what a chromosome is and how are present normally in human beings?

Chromosomes are thread-like frameworks located inside the nucleus of pet and also plant cells. Each chromosome is made from healthy protein as well as a single particle of deoxyribonucleic acid (DNA). Passed from moms and dads to children, DNA consists of the specific guidelines that make each type of living creature one-of-a-kind. The distinct structure of chromosomes maintains DNA firmly twisted around spool-like healthy proteins, called histones (Park, et al., 2017). Without such product packaging, DNA particles would be as well lengthy to fit within cells. For a microorganism to grow and also work correctly, cells have to regularly separate to create brand-new cells to replace old, damaged cells. Throughout cellular division, it is necessary that DNA remains undamaged and uniformly distributed amongst cells. Chromosomes are a key part of the process that makes sure DNA is accurately duplicated as well as dispersed in the huge bulk of cellular division (Park, et al., 2017). Still, blunders do occur on unusual celebrations.

Concepts for: Euploid cells, Diploid Cells, Aneuploid Cells? What is a Polyploidy?

Euploldy is the presence of chromosome number which is the numerous of the basic chromosome set. An organism with the fundamental chromosome number 7, might have euploids with chromosome number 7, 14, 21, 28, 35, 42. Euploids are even more of different types– monoploids, diploids and also polyploids. Diploid cells have two collections of chromosomes (Park, et al., 2017). It is developed by the blend of two haploid cells. Most mammals are diploid, that is, they have two homologous duplicates of each chromosome in cells. They are generated by mitosis. Somatic cells in human beings are diploid cells. The aneuploidy refers to a condition in which you add or delete one or some chromosomes regular variety of chromosomes. Consequently, the number of chromosomes in aneuploidy might be better or less than the number of chromosomes in the wild type, a strain that is prevalent amongst people under natural conditions (Park, et al., 2017). Different kinds of aneuploidy can be recognized as nullisomy, monosomy, and also trisomy.

What is a Trisomy and an example of it?

A trisomy is a kind of polysomy in which there are three circumstances of a particular chromosome, instead of the regular two. A trisomy is a sort of aneuploidy (an unusual variety of chromosomes). Trisomies can occur with any kind of chromosome, yet frequently lead to miscarriage, instead of live birth. For instance, Trisomy 16 is one of the most usual trisomy in human pregnancies, happening in greater than 1% of pregnancies; just those pregnancies in which some typical cells occur in addition to the trisomic cells, or mosaic trisomy 16, survive (Iannello, & Belfiore, 2021).

What means Homozygous and heterozygous in Mendelian Heritance?

Homozygous (and its less usual kind homozygotic) indicates associating with a cell that has two the same alleles for a certain genetics at equivalent positions on homologous chromosomes. Heterozygous (and its less typical kind heterozygotic) indicates relating to a cell that has 2 various alleles for a certain genetics at corresponding positions on homologous chromosomes.

Which are special features of X Linked genetic diseases?

X-linked problems arise from mutated genetics on the X chromosome. Males, who have just one X chromosome (i.e., they are hemizygous), will totally express an X-linked problem. On the other hand, females, who have two X chromosomes, will certainly be carriers of the defect in the majority of cases, and so they are typically asymptomatic (Iannello, & Belfiore, 2021). Although women have two X chromosomes to the male’s one, products from this chromosome are quantitatively similar in both sexes since one of both X chromosomes in women is inactivated. X-linked problem with decreased variable VIII (hemophilia A), irregular element VIII with platelet dysfunction (von Willebrand’s illness), or aspect IX (hemophilia B– Christmas illness); characterized as mild, moderate, or extreme based upon quantity of variable existing.

What is a risk factor?

Risk variable is a variable associated with an increased risk of disease or infection. Danger variables are correlational and also not necessarily causal, since connection does not verify causation. For instance, being young can not be said to cause measles, yet young people have a greater price of measles due to the fact that they are much less most likely to have created immunity throughout a previous epidemic (Iannello, & Belfiore, 2021).

Also, what is a congenital disease?

Congenital heart disease is one or more problems with the heart’s structure that exist given that birth. Hereditary ways that you’re born with the condition. Congenital heart disease in grownups and also children can alter the way blood flows with the heart (Tonelli, 2016). There are many different kinds of congenital heart flaws.

Epigenetics and Mental Health.

Most of us can remember a miserable or stressful incident in our childhood years, but that’s very various from experiencing persistent trauma as well as stress and anxiety. Injury and also PTSD are classified as either basic or complicated. Basic trauma is normally related to a certain, considerable event, such as all-natural disaster or an auto crash (Tonelli, 2016). Complex trauma is persistent and prevalent, and also it’s this type of ongoing tension that influences individuals both physically as well as emotionally for the remainder of their lives. When youngsters mature in an atmosphere where they are subjected on a regular basis to what they regard as a risk, their nerves is perennially in a state of fight-flight-or-freeze. Epigenetics, in its simplest meaning, describes the stable modifications in genetics expression without adjustment of the DNA sequence. In the context of depression, these modifications are usually triggered by severe stress, and they can result in a boosted vulnerability in the mind’s limbic areas (Tonelli, 2016).

DNA Methylation: why is important?

DNA methylation is essential for silencing retroviral aspects, controling tissue-specific genetics expression, genomic imprinting, and also X chromosome inactivation. Notably, DNA methylation in various genomic regions may put in different impacts on genetics tasks based on the hidden hereditary series.

Reference

Park, M. J., An, G. J., Jeong, J. S., Kim, H. S., Hong, H. S., & Choe, M. (2017). Educational need assessment of advanced practice nurses on the pathophysiology. Journal of Korean Biological Nursing Science, 9(1), 85-102.

Iannello, S., & Belfiore, F. (2021). A review of pathophysiological, clinical and therapeutical aspects. Panminerva medica, 43(3), 177-209.

Tonelli, M. R. (2016). Integrating evidence into clinical practice: an alternative to evidence‐based approaches. Journal of evaluation in clinical practice, 12(3), 248-256.

 

 

 

 

 

 

 

 

 

Taymir Torres

Genes

Genes are the basic functional unit of heredity that act as guidelines to make proteins and are made up of DNA (Dueñas et.al, 2019).

Chromosome

A is a thread-like structure made of protein and a single molecule of DNA and is located in the nucleus of plant and animal cells. It is also passed to offspring from their parents and makes any living organism unique (Dueñas et.al, 2019).

Euploid cells, Diploid Cells, Aneuploid Cells and Polyploidy

Euploid cells are cells that possess a chromosomal variation where there is an additional set of chromosomes in a cell. The number of chromosomes in euploid cells is an exact multiple of chromosome number in normal cells. Diploid cells are cells with two sets of chromosomes. Aneuploid cells are cells with a variable number of chromosomes in a cell. This variation occurs when one or a few chromosomes are either deleted or added from the normal chromosome number (Dueñas et.al, 2019).

Trisomy

Trisomy is a genetic disorder where individuals have three sets of chromosomes instead of the normal two. The most common types of trisomy are triple X syndrome, Down syndrome, and Klinefelter syndrome (Dueñas et.al, 2019).

Homozygous and heterozygous in Mendelian Heritance

Mendelian inheritance is a biological inheritance that follows particular patterns to indicate how traits can be passed to offspring (Mittelsten, 2022). In Mendelian inheritance, a trait is inherited when through a certain pattern with a controlled single locus. Through mutation, a single gene has the power to cause a disease that can be inherited.

Homozygous refers to inheritance where an offspring inherits the same version of the gene from each parent resulting in two matching genes. Heterozygous refers to inheritance where an offspring ends up with two versions of a gene, one from each parent (Mittelsten, 2022).

 

X Linked genetic diseases

In X-linked inheritance, a father is unable to pass X-linked traits to their male offspring leading to X-linked recessive disorders (Matsunari et al., 2018). The X gene in males can mutate leading to X-linked recessive inheritance. However, x-linked recessive inheritance does not affect female since one carrying a mutation in one gene while the other gene in normal remains unaffected by recessive disorders.

Risk factor

A risk factor is anything that increases the chance of conducting a disease. In gene inheritance, risk factors are inherited from parents to offspring through genetic difference that increases the risk of getting diseases.

Congenital disease

A congenital disease is a medical condition inherited from parents that occur before or at birth (Duena et al., 2019). Some examples of congenital diseases are congenital heart disease, cleft lip and cleft palate, haemophilia, cystic fibrois and Down syndrome. A congenital disease is popularly referred to as a birth defect and can be acquired in fetal stage of development or from genetic inheritance from parents. A congenital disease can also be caused by environmental (external) factors.

Epigenetics and Mental Health

Epigenetics and mental health are related as exposure to environmental stressors can lead to the development of mental health or vice versa (Mews et al., 2019). For instance, while traumatic life events can trigger mental health problems, exposure to a salutary environment has a positive impact on mental health.

Methylation

Methylation is a chemical reaction, which affects nucleic acids and proteins, where a small molecule is added to other molecules (Joyce et al., 2018). While methylation may contribute to health problems, it is crucial to the overall wellbeing of an individual since it regulates tissue-specific gene expressions, silences retroviral elements, and plays a crucial role in gene imprinting. Methylation helps the body detoxify and regulate hormones.it helps the body make neurotransmitters that contribute to brain health and mental wellbeing of a person by balancing their mood.

 

References

Dueñas, A., Expósito, A., Aranega, A., & Franco, D. (2019). The role of non-coding RNA in congenital heart diseases. Journal of Cardiovascular Development and Disease, 6(2), 15.

Joyce, B. T., Zheng, Y., Zhang, Z., Liu, L., Kocherginsky, M., Murphy, R., … & Hou, L. (2018). miRNA-Processing gene methylation and cancer risk. Cancer Epidemiology and Prevention Biomarkers, 27(5), 550-557.

Matsunari, H., Watanabe, M., Nakano, K., Enosawa, S., Umeyama, K., Uchikura, A., … & Nagashima, H. (2018). Modeling lethal X-linked genetic disorders in pigs with ensured fertility. Proceedings of the National Academy of Sciences, 115(4), 708-713.

Mews, P., Calipari, E. S., Day, J., Lobo, M. K., Bredy, T., & Abel, T. (2021). From circuits to chromatin: the emerging role of epigenetics in mental health. Journal of Neuroscience, 41(5), 873-882.

Mittelsten Scheid, O. (2022). Mendelian and non-Mendelian genetics in model plants. The Plant Cell, koac070. https://doi.org/10.1093/plcell/koac070

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Clara Pena Espinosa

What are Genes?

A gene is the basic physical as well as functional device of heredity. Genetics are composed of DNA. Some genes act as directions to make molecules called proteins.

Describe what a chromosome is and how are present normally in human beings?

A chromosome is a lengthy DNA particle with component or every one of the hereditary material of an organism. Most eukaryotic chromosomes consist of product packaging healthy proteins called histones which, assisted by chaperone healthy proteins, bind to and condense the DNA molecule to keep its integrity (Tkacs, et al., 2020). These chromosomes display a complicated three-dimensional framework, which plays a substantial role in transcriptional regulation.

Concepts for: Euploid cells, Diploid Cells, Aneuploid Cells? What is a Polyploidy?

A regular diploid cell has a total amount of 46 chromosomes, arranged in 23 sets. This is called a 2n cell. Diploid cells increase by mitotic cell division. Throughout reproduction, gametes such as sperms and also egg cells are generated by meiosis cellular division. Euploidy refers to the variation in the full set of chromosomes in a cell or microorganism. Euploidy is common in plants and also happens in high frequency than animals. Considering that chromosomal number in a cell affects the sex equilibrium of pets, euploidy in animal cells results in sterility (Tkacs, et al., 2020). Thus, euploidy is typically pertaining to plants greater than animals. Aneuploidy describes a variation in the total chromosome number in a cell or organism by addition or deletion of chromosomes. Unlike euploidy, it does not include a distinction of several full sets of chromosomes. As a matter of fact, aneuploidy does not alter the variety of chromosome sets, it just alters the regular total variety of chromosomes in a cell or microorganism.

What is a Trisomy and an example of it?

The term “trisomy” is made use of to describe the existence of an additional chromosome or three instead of the typical set. For instance, trisomy 21 or Down syndrome occurs when an infant is born with three # 21 chromosomes. In trisomy 18, there are 3 duplicates of chromosome # 18 in every cell of the body, as opposed to the normal pair (Collard, & Gelman, 2021). One of the most usual is Requirement Trisomy 21, in which the daddy’s sperm or the mom’s egg cell includes the extra chromosome. In Mosaic Down syndrome, the added chromosome automatically looks like the embryo creates.

What means Homozygous and heterozygous in Mendelian Heritance?

Homozygous has 2 same duplicates of the same allele coding for a specific attribute. Includes just one type of allele, either dominant or recessive. Self-fertilization leads to the repeating of the very same traits over generations. Only one kind of gamete is created. It can be either homozygous leading or homozygous recessive. Heterozygous has 2 different duplicates of alleles coding for a specific characteristic. Has various alleles for an attribute (Collard, & Gelman, 2021). Both leading and recessive. Self-fertilization leads to different mix of traits over the future generation. Two sorts of gametes are produced. Heterozygous alleles can reveal full dominance, codominance or insufficient supremacy.

Which are special features of X Linked genetic diseases?

X-linked recessive inheritance is a setting of inheritance in which a mutation in a genetics on the X chromosome triggers the phenotype to be always revealed in males (who are always homozygous for the gene anomaly due to the fact that they have one X and one Y chromosome) as well as in women that are homozygous for the gene anomaly. Ladies with one duplicate of the mutated genetics are service providers. X-linked inheritance means that the gene causing the quality or the condition is located on the X chromosome (Collard, & Gelman, 2021). Females have two X chromosomes while males have one X and also one Y chromosome. Carrier females that have only one copy of the anomaly do not typically express the phenotype, although distinctions in X-chromosome inactivation (called skewed X-inactivation) can cause varying levels of clinical expression in provider females, since some cells will share one X allele and also some will reveal the various other.

What is a risk factor?

Any kind of behavioral, hereditary, environmental, or other factor to consider which increases the probability of creating a condition or disorder, or becoming associated with hazardous circumstances.

Also, what is a congenital disease?

A congenital disorder is a condition that is present from birth. Congenital disorders can be acquired or caused by ecological aspects. Their impact on a child’s wellness as well as advancement isn’t always extreme, as well as often it can be fairly moderate. Nevertheless, a kid with a congenital disorder may experience a handicap or health problems throughout life. It’s natural to be concerned about congenital disorders if you’re pregnant or planning a maternity, specifically if your family has a background of a particular disorder (Laleman, et al., 2015). It’s feasible to examine for some, yet not all conditions while pregnant, and there are additionally points you can do to minimize the opportunities of your baby being born with a congenital disorder.

Epigenetics and Mental Health.

Epigenetics is a brand-new and also revolutionary concept in the field of psychology and psychological wellness. Epigenetics research is revealing that our genes can in fact switch on or turn off in action to what happens in our life and also how our atmosphere influences us. This understanding has actually lastly put to bed the olden debate relating to nature vs. support– in other words, whether who we are is established by our genetic make-up or by our life experiences (Laleman, et al., 2015). Epigenetics makes it clear that they work in tandem to influence both physical and also mental health and wellness.

DNA Methylation: why is important?

DNA methylation is the process of transferring 4 atoms into different materials in your body. Or, to break it down also further, methylation is the procedure your body uses to include methyl teams to the DNA particle, thus altering the task of a DNA sector without altering the sequence. DNA methylation manages gene expression by recruiting healthy proteins associated with genetics repression or by inhibiting the binding of transcription element( s) to DNA (Laleman, et al., 2015). The precise policy of DNA methylation is vital for normal cognitive function.

Reference

Tkacs, N., Herrmann, L., & Johnson, R. (Eds.). (2020). Advanced Physiology and Pathophysiology: Essentials for Clinical Practice. Springer Publishing Company.

Collard, C. D., & Gelman, S. (2021). Pathophysiology, clinical manifestations, and prevention of Diseases. The Journal of the American Society of Anesthesiologists, 94(6), 1133-1138.

Laleman, W., Van Landeghem, L., Wilmer, A., Fevery, J., & Nevens, F. (2015). Portal hypertension: from pathophysiology to clinical practice. Liver International, 25(6), 1079-1090.

 

 

 

 

 

 

 

 

 

 

 

 

NRNP – 6665: Child and Adolescent Assessment Paper

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NRNP – 6665: Child and Adolescent Assessment Paper

NRNP – 6665: Child and Adolescent Assessment

All diagnoses, from infancy to adulthood, begin with an examination. While an organic basis for most medical disorders can be determined through the use of diagnostic testing, the field of psychiatry is different in that patients cannot be sent to the lab for blood tests to determine the degree of depression. Similarly, patients cannot be sent to the radiology department for a “scan” to determine the severity of their bipolar disorder. Instead, the field of psychiatry must use psychiatric assessments, such as the comprehensive integrated physical exam, diagnostic interviews, and questionnaires to make diagnoses. These tools must be specialized to address the needs of children and adolescents. NRNP – 6665: Child and Adolescent Assessment Paper

 

Diagnostic assessment of the child and adolescent is a specialized area of expertise. The PMHNP will often see children who have already been seen by a primary care provider. Many PCPs are comfortable handling attention-deficit/hyperactivity disorder (ADHD) and other straightforward childhood disorders. That means that the PMHNP will often treat the more complicated patients. This week, you explore psychiatric assessment techniques and tools for children and adolescents. You also examine the role of the parent/guardian in the assessment process for this patient population.

Learning Objectives

Students will:

  • Evaluate comprehensive integrated psychiatric assessment techniques for children and adolescents
  • Recommend assessment questions for child and adolescent patients
  • Explain the importance of thorough psychiatric assessment for children and adolescents
  • Identify rating scales that are appropriate for child/adolescent psychiatric assessment
  • Identify psychiatric treatments appropriate for children and adolescents
  • Explain the role of the parent/guardian in child/adolescent psychiatric assessment

Learning Resources

Required Readings (click to expand/reduce)

 

Required Media (click to expand/reduce)

 

Recommended Reading (click to expand/reduce)

 

Optional Discussion Forum: PMHNP Study Support Lounge

The PMHNP Study Support Lounge is offered throughout the course as a place of academic refuge where you can ask questions, offer insights, and interact with your peers. Your Instructor may also weigh in to provide global feedback to the group based on trends, common problems, and common strengths in student posts. NRNP – 6665: Child and Adolescent Assessment Paper

Photo Credit: [Jacob Ammentorp Lund]/[iStock / Getty Images Plus]/Getty Images

You are encouraged to provide constructive, helpful feedback to your peers. Advanced practice nurses always benefit from the feedback of others. Your Study Support Lounge posts may be procedural (“How do I attach a Kaltura video to a Discussion post?”), conceptual (“How does this relate to the other therapy approaches we have studied?”), or analytical (“What do these diagnostic results actually mean in the context of this specific patient case?”). Although not mandatory, this is an opportunity to interact and study together as you navigate the assignments, so you are highly encouraged to take part in this activity. Full participation in activities like this is a statistically significant predictor of success.

To Participate in this Optional Discussion:

PMHNP Study Support Lounge

 

Acknowledgment

Practicum Manual Acknowledgment

The Practicum Manual describes the structure and timing of the classroom-based and practicum experiences and the policies students must follow to be successful in the nurse practitioner (NP) specialties.

  • Field Experience: MSN Nurse Practitioner Practicum Manual

Click here and follow the instructions to confirm you have downloaded and read the entire MSN Nurse Practitioner Practicum Manual and will abide by the requirements described in order to successfully complete this program.

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Discussion: Comprehensive Integrated Psychiatric Assessment

Photo Credit: Seventyfour / Adobe Stock

Many assessment principles are the same for children and adults; however, unlike with adults/older adults, where consent for participation in the assessment comes from the actual client, with children it is the parents or guardians who must make the decision for treatment. Issues of confidentiality, privacy, and consent must be addressed. When working with children, it is not only important to be able to connect with the pediatric patient, but also to be able to collaborate effectively with the caregivers, other family members, teachers, and school counselors/psychologists, all of whom will be able to provide important context and details to aid in your assessment and treatment plans.

Some children/adolescents may be more difficult to assess than adults, as they can be less psychologically minded. That is, they have less insights into themselves and their motivations than adults (although this is not universally true). The PMHNP must also take into consideration the child’s culture and environmental context. Additionally, with children/adolescents, there are lower rates of neurocognitive disorders superimposed on other clinical conditions, such as depression or anxiety, which create additional diagnostic challenges. NRNP – 6665: Child and Adolescent Assessment Paper

In this Discussion, you review and critique the techniques and methods of a mental health professional as the practitioner completes a comprehensive, integrated psychiatric assessment of an adolescent. You also identify rating scales and treatment options that are specifically appropriate for children/adolescents.

To Prepare

  • Review the Learning Resources and consider the insights they provide on comprehensive, integrated psychiatric assessment. Watch the Mental Status Examination B-6 and Simulation Scenario-Adolescent Risk Assessment videos.
  • Watch the YMH Boston Vignette 5 video and take notes; you will use this video as the basis for your Discussion post.

By Day 3 of Week 1

Based on the YMH Boston Vignette 5 video, post answers to the following questions:

  • What did the practitioner do well? In what areas can the practitioner improve?
  • At this point in the clinical interview, do you have any compelling concerns? If so, what are they?
  • What would be your next question, and why?

Then, address the following. Your answers to these prompts do not have to be tailored to the patient in the YMH Boston video.

  • Explain why a thorough psychiatric assessment of a child/adolescent is important.
  • Describe two different symptom rating scales that would be appropriate to use during the psychiatric assessment of a child/adolescent.
  • Describe two psychiatric treatment options for children and adolescents that may not be used when treating adults.
  • Explain the role parents/guardians play in assessment.

Support your response with at least three peer-reviewed, evidence-based sources and explain why each of your supporting sources is considered scholarly. Attach the PDFs of your sources.

Read a selection of your colleagues’ responses.

By Day 6 of Week 1

Respond to at least two of your colleagues on 2 different days by offering additional insights or alternative perspectives on their analysis of the video, other rating scales that may be used with children, or other treatment options for children not yet mentioned. Be specific and provide a rationale with evidence.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit! NRNP – 6665: Child and Adolescent Assessment Paper

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 1 Discussion Rubric

 

Post by Day 3 of Week 1 and Respond by Day 6 of Week 1

NRNP – 6665: Child and Adolescent Assessment

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First Name Last Name

Patricia France

English 150

5/21/21

In with the New

There is no doubt that America is having a mental health crisis. It is estimated that 46 million Americans today are suffering from some sort of mental health issue, ranging from anxiety to sever depression to paranoid schizophrenia. What is even more surprising is that despite the incredible amount of people who are suffering, less than 43 percent are actively seeking any sort of treatment for their mental health (Zhong). Whether it is the lack of available mental health treatment, the stigma that our culture has fabricated around mental health, or the fear of having expensive drugs with harmful side-effects pushed upon patients, it is more than apparent that our mental health as a nation is on the decline, and possibly beginning a spiral down. Luckily, our understanding of our mental health has come a long way from when we used to drill holes in people’s heads because we thought evil spirits were living there. We have broadened our understanding of our mental health and with that, an increased awareness of mental health, as well as new, innovative treatments have been developed to help those in need.

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Hippocrates, also known as the “Father of Medicine”, is thought to be the first physician to suggest a link between health and environment, diet, and lifestyle instead of the work of supernatural forces upon the human body. While many physicians are still struggling to convince people of this it would also be a long time until this approach to medicine would allow physicians around the world to make significant progress. We must remember that it is called “practicing medicine” and for good reason. I do not believe that there is a single doctor today that can tell you they completely understand the inner working of the human body, let alone the complexities of the human mind. Like the evolution of the treatment of our physical health, physicians would slowly and painstakingly peel back each layer of the human mind while meticulously putting the puzzle pieces together that make up the human psyche over the next two and a half millennia. Hippocrates had a total of eight mental health diagnoses which were, “Mania, Melancholy, Phrenitis, Insanity, Disobedience, Paranoia, Panic, Epilepsy and Hysteria” (Taylor). While some of these words are still used in modern medicine, the fact that physicians limited mental health diagnoses to only eight shows that we have already come a long way in broadening our understanding since Hippocrates’ time.

One of the biggest problems is the stigma that we have allowed our culture to create surrounding mental health. It has permeated our television shows, movies, and minds. One of America’s most popular shows, “The Sopranos” opens with the lead character Tony, in the office of his new therapist. He immediately denies having a panic attack and then goes on to question the effectiveness of psychotherapy. Later in the pilot, Tony wonders where “Guys like Clark Gable went, you know the strong, silent types?”. Growing up all my life as a boy, I was expected to keep my emotions on the inside and believed that showing any sign of an emotion like sadness or having any doubt in myself would be perceived as a weakness. Talking with my friends it was like this for all of us, and even with my closest of friends we found it difficult to talk about anything that we thought was wrong with us. Now though, we know not only are these emotions normal for us to have but healthy for us to express them in a positive and non-destructive manner. These ideas were presented on a show that was so popular at the time, people would have viewing parties with their friends to watch the newest episodes. Tony’s battle with his psyche is the central conflict for the remainder of the series, and it paints a terrific picture of how psychotherapy and our mental health is viewed in America today.

            Another major issue with America’s mental health is that we have been conditioned to seek happiness and relief inside of little orange bottles with white lids. Unfortunately, drugs are used as the first line of defense far too frequently in the treatment of our mental health. Some may argue that it is because so many people are suffering in America today, and that doctors simply cannot handle the staggering number of cases that they get. They take the easy way out and write a prescription for their patients in hopes of helping them and moving onto the next patient. It makes sense, if you could give someone a pill and cure what ails them, and move on to someone else, helping more and more people quickly and effectively, then why would doctors not want to do that? Prescriptions for antidepressants were so commonplace, I remember I had a close friend who was prescribed fluoxetine when we were in middle school because their therapist thought it would be the most effective treatment. Fluoxetine goes by a much more popular name, that most people are familiar with, Prozac. This is the root of the problem. The pharmaceutical industry has tenaciously pushed dangerous drugs on the American people while lining their own pockets.  Dr. Irving Kirsch is a retired psychologist who studied the effects of antidepressants, His book The Emperor’s New Drugs: Exploding the Antidepressant Myth investigates one of the most common mental health treatments in America and found the antidepressants he had studied were no more effective than the placebo effect on the patients involved. These drugs have very harmful side effects, such as weight gain, decreased libido, and, potentially, risk of suicide. So, if the drugs are not effective and they have the potential to be harmful, why has the U.S. seen such prolific use of drugs in the treatment of mental health? It may have something to do with the fact that of the 394 doctors who received over $100,000 from pharmaceutical companies in 2006, 116 of them were psychologists and that the pharmaceutical industry spent nearly a billion dollars on lobbying from 1998 to 2006 or that the pharmaceutical industries sales were around 289 billion in 2010 (Taylor). Anyone who has been unfortunate to have to go to the hospital has seen firsthand the capitalistic greed that has seeped into our healthcare industry. Where most other countries have some form of basic universal health care for their citizens, the U.S. healthcare industry is still mostly comprised of private companies that expect you to have insurance or to pay for treatments out of pocket. The costs and time investments of these treatments can discourage patients and makes drugs seem like a quick and easy fix. Physicians are encouraged to dole out drugs to get onto the next patient and make their hospital’s money or even worse get some form of kick back from the big pharmaceutical companies.

There needs to be another paradigm shift in the way that doctors are treating their mental patients. Electroconvulsive therapy, or electroshock therapy, used to be an incredibly commonplace treatment for a whole host of illnesses ranging from depression to extreme psychosis, just like doctors are handing drugs out left and right today. Doctors today know from their past mistakes that there are very extreme cases where electroconvulsive therapy can be useful when administered in an incredibly controlled environment, but they are far and few between (Taylor).  Why not take this same approach with the harmful drugs that have become so commonplace today? We have seen that they have negative side effects, just like electroconvulsive therapy when it is being used incorrectly, and sometimes they are not any more effective than the placebo effect. Instead of immediately reaching for a bottle Prozac, Wellbutrin, or Xanax, doctors should take a deeper assessment of their patients. If someone lost their job, their spouse left them, and their dog died all in the same week, I would imagine that they would feel terrible. Three devastating life changing events like that would almost be guaranteed too. But if that person then went to seek some professional help and were handed a prescription for antidepressants that could permanently alter their brain chemistry, would that benefit someone in that situation? Maybe continued psychotherapy during that person’s transition in life would be more beneficial without the risks that come from antidepressants or anti-anxiety medication. The important thing is not to immediately reach for the prescriptions and to see if something else might be able to help the patients instead. With that thought in mind, today doctors around the world are working together to try and figure out what they can do to improve our mental health in many different and innovative ways.

            One of the more recent changes in the approach to mental health is the understanding of the important link between physical and mental health. Today you can go online and find a group to hike with, jog with or even do yoga with all with the expressed intent of improving your mental health. The benefits of all these activities on our mental health have begun to be investigated by doctors. According to the Anxiety and Depression Association of America (ADAA), studies show that physical activity can reduce stress levels and fatigue while improving concentration and cognitive function. The ADAA also states that people who exercise regularly are 25 percent less likely to develop any kind of anxiety disorder or depression. Another interesting study from the Joslin Diabetes Center showed that our gut biome may be directly linked to our mental health. Poor, high-fat diets that are often associated with obesity and type II diabetes were shown to increase depressive behaviors in mice. Once the mice were given antibiotics to flush out the harmful gut flora in them, after their mood improved and returned to normal the mice maintained their normal behavior when they were put on a poor diet and antibiotics simultaneously to negate any production of harmful (Haridy). Michelle Obama, probably the most famous first lady since Jackie Kennedy, made it her mission while she was first lady to improve the health of our country. She saw that obesity and laziness had spread across the U.S. like an epidemic and sought to eradicate it where possible. She pushed to have the sugar companies put the daily value of sugar on the labels of food and beverages, something that large sugar companies had lobbied against for decades. She pushed against childhood obesity in her “Let’s Play” initiative, where she encouraged healthy eating and the importance of exercise. She did all of this because she saw how unhealthy we are as a nation. With nearly one third of Americans being obese perhaps the first thing to try is improving where you can physically and seeing what that does for you mentally (Sinha).

            While there is a currently a tremendous amount of people suffering from mental illnesses, the way that technology has been adapted to treat people has been truly innovative. Before the world stopped thanks to the Covid-19 pandemic, taking the time out of your day to go down to your therapist’s office for an hour-long session could be hard for people working multiple jobs, or have families to tend to. They might have to work during all their local therapists’ hours and cannot make it in when they are open, or perhaps the thought of going and sharing deep and intimate thoughts with a stranger in a foreign environment generates a lot of anxiety, especially in extreme cases like those suffering from agoraphobia. Luckily, there are things like Zoom for patients who would rather meet with their therapists from the comfort of their own home. Also, smartphone applications like BetterHelp have been developed and designed to allow people to seek out professional mental health for a whole host of illnesses such as depression, anxiety, eating disorders, and even borderline personality disorder. They have patients fill out a profile to match them with a mental health professional that they feel would be appropriate to treat you based on a lot of factors such as how you want to meet such as over the phone or video calls, when you can meet, and what you are looking to have treated. With over a million downloads currently, apps like BetterHelp shows it is obvious that being able to seek out professional help in a remote setting is starting to catch on. The pandemic prompted doctors to study the effectiveness of remote telepsychiatry as people were no longer able to meet with their physician face-to-face anymore, and countries like China reported a significant rise in remote telepsychiatry being used to treat people during the pandemic. Some may thing that the lack of face-to-face interaction maybe too much of a disadvantage to make telepsychiatry an effective tool in treatment, but all the evidence points to the contrary. The Indian Journal of Psychiatry has an article titled ““Telepsychiatry” in the time of Covid-19: Overcoming the challenges” and it states that when it comes to matter of the effectiveness of telepsychiatry, that “the quality of doctor–patient interactions is the same as an in-person interview, while it also is seemingly cost-effective.”. Telepsychiatry is on the rise and could very well be the next big innovation in the treatment of mental health.

            The Center of Disease Control and Prevention says that today in the United States nearly 1 out of 10 children from the ages of 2-17 suffers from attention-deficit/hyperactivity disorder (ADHD). What is worse is that over 60 percent of these children also suffer from some other form of mental illness as well such as depression, anxiety, Autism spectrum disorder, Tourette syndrome or behavioral problems. While the average number of children with ADHD that are getting treatment is higher than the national average, all these children deserve effective treatment and should have it available to them. Unfortunately, the treatment that the lucky ones do receive come with drugs as only 15% of the children receiving treatment were not on some form of medication for their ADHD. These medications include things like Adderall which is known to cause loss of appetite, nausea, vomiting, headache, and trouble sleeping just to name a few off the laundry list of side effects. The Food and Drug Administration approved the first ever video game that could be prescribed for treating ADHD in 2019, hopefully taking a step towards ending the drugs being pushed onto our children. EndeavorRx is a racing game designed to help relieve the symptoms brought on by ADHD, and half of the parents of the children involved in the study of the game said they saw “a clinically meaningful change in their children’s day-to-day impairments,” and that was just after a month of treatment with EndeavorRx. Another benefit of EndeavorRx is, that contrary to the mainstream media’s belief, children that were treated with EndeavorRx had “No serious adverse reactions with EndeavorRx in any study to date.”. Every child deserves every opportunity to grow up healthy both physically and mentally. Why not treat common ailments like ADHD with things that kids already enjoy like video games instead of drugs with detrimental side effects?  Maybe in the future instead of handing your child a bottle full of Ritalin, doctors will prescribe them a Nintendo or PC game instead.

Americans are suffering from mental illnesses at a staggering rate. We need to change the way that we approach our mental health and start doing something positive for it. Too many people are embarrassed to seek help, and the few that are trying to do something, are given a bottle of pills, and told that those will make everything better. We should take a step back and look at the other factors like diet, lack of exercise or alternative treatments like EndeavorRx as viable options instead of always reaching for the medicine cabinet. People can seek out help when and where they need it with the option of telepsychiatry and apps on their smart phones. While America might be suffering from poor mental health now, our future might be one where we better understand the human psyche and how to keep the mind healthy thanks to the innovations being made today.

Works Cited

“: Online Counseling & Therapy – Apps on Google Play.” Google, Google, play.google.com/store/apps/details?id=com..

“Data and Statistics About ADHD.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 16 Nov. 2020, www.cdc.gov/ncbddd/adhd/data.html.

“EndeavorRx.” Children’s Technology Review, vol. 28, no. 3, Sept. 2020, p. 9. EBSCOhost, search.ebscohost.com/login.aspx?direct=true&db=f6h&AN=145892778&site=eds-live.

Haridy, Rich. “Exciting Insight into Role Gut Bacteria Play in Obesity-Related Depression and Anxiety.” New Atlas, 18 June 2018, newatlas.com/gut-bacteria-obesity-depression-anxiety/55072/.

Kirsch, Irving. The Emperor’s New Drugs: Exploding the Antidepressant Myth. Basic Books, 2011.

Perera SR, Gambheera H, Williams SS. “Telepsychiatry” in the time of COVID-19: Overcoming the challenges. Indian J Psychiatry 2020; 62: S391-4.

Sinha, Ashish C., editor. OXFORD TEXTBOOK OF ANAESTHESIA FOR THE OBESE PATIENT. OXFORD UNIV PRESS, 2021.

Taylor, Michael A. Hippocrates Cried: The Decline of American Psychiatry. Oxford Univ. Press, 2013.

Zhong Li, et al. “Telepsychiatry Adoption across Hospitals in the United States: A Cross-Sectional Study.” BMC Psychiatry, vol. 21, no. 1, Apr. 2021, pp. 1–12. EBSCOhost, doi:10.1186/s12888-021-03180-8.

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Mayelin Ruiz

 

Atrophy

Atrophy is the decrease in the size of a tissue, cell, organ, or any body part. The term suggests that the part of the body that was atrophied was a normal size according to the individual’s age and circumstance before the decrement occurred.

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Physiologic atrophy

Physiologic atrophy is a type of atrophy where a body part decreases in size due to insufficient use of muscle. This type of atrophy is caused by physical inactiveness and therefore can be reversed through better and proper nutrition and sufficient exercise (Galluzi et al., 2018). (c)

Hypertrophy

Hypertrophy refers to the increase and growth of muscle cells through exercise. Physical exercise tones and improves muscles leading to an increase in size. People who often work out or exercise by lifting heavy weights contribute to their muscle increment.

Hyperplasia

Hyperplasia is the enlargement of body tissues or organs due to an increased amount of organic tissue. This increment in the amount of organic tissue is a result of cell proliferation.

Pathologic hyperplasia

Pathologic hyperplasia is the increment in cell production in a normal organ or tissue due to precancerous or abnormal changes such as an abnormal stressor. This condition can lead to several disorders due to high or abnormal levels of cell production.

Dysplasia

Dysplasia is a term that describes the presence of abnormal cells in a body organ or tissue. Although dysplasia is not a type of cancer it can become cancer if it is severe. 

Metaplasia

Metaplasia is the process of replacing one type of mature tissue with another tissue that is not indigenous to the part of the tissue. Metaplasia is caused by environmental factors such as inflammation and microorganisms.

Mechanisms of cell injury

There are four main mechanisms of cell injury. These mechanisms are acute-phase responses, ischemic (anoxic), heat shock, and oxidative responses.

Reversible Vs irreversible

Reversible cell injury is a type of cell injury caused by a short period of hypoxia or ischemia. Cells subjected to this kind of injury can revert to normal activities and conditions (Bielaszewska et at., 2017). On the other hand, irreversible cell injury is a type of cell injury that leads to the death of a cell or causes tissue damage. This type of cell injury includes hydrolysis of phospholipids and interruption of membrane integrity among others.

Necrosis Vs apoptosis

Necrosis is a kind of cell death that is caused by uncontrolled external factors. This kind of cell death is passive, untimely, and accidental as a result of external perturbations. It is characterized by the uncontrolled release of inflammatory cellular contents (Alisha et al., 2019). Meanwhile, apoptosis is described as a kind of cell death by predefined cell suicide by destroys itself by actively dismantling, therefore, leaving the body functioning smoothly by avoiding inflammation.

Nucleus

The nucleus is a crucial part of a cell that controls and regulates all the activities of the cell. It also carries genes and other hereditary information.

Nucleolus

The nucleolus is a part of a cell that facilitates the biogenesis of ribosomes. It achieves this function by processing, synthesizing, and arranging ribosomal RNA into preribosomal particles.

Mitochondrion

Mitochondrion generates energy to power the cell by breaking down sugar and fat through cellular respiration.

Ribosomes

Ribosomes are cell organelles that synthesize proteins.

Cytoplasm

The cytoplasm is a fluid in a cell that provides a medium for chemical reactions such as cell growth and cell organelle replication.

Cell membrane

The cell membrane protects the organelles inside of a cell from the outside environment. It also regulates materials being transported inside and outside of the cell.

Hyperkalemia and Hypocalemia

Hyperkalemia is a high level of potassium in the blood. There are various causes of hyperkalemia in the body. Two of these causes are kidney disease, which occurs if the kidney is not functioning properly, and a diet that has high potassium, especially in patients with advanced kidney disease. Hyperkalemia is characterized by shortness of breath, muscle weakness, heart palpations, chest pains, and nausea among other symptoms such as tingling and unusual feeling.

On the other hand, hypokalemia is an extremely low level of potassium in the body. There are several symptoms of hypokalemia such as muscle cramps, abnormal heart rhythms, fatigue, weakness, and constipation (Barrera et al., 2018). Hypokalemia is caused by kidney failure, folic acid deficiency, and some asthma medications.

Hypercalcemia and Hypocalcemia

Hypercalcemia is a condition where there are high levels of calcium in the body. Hypercalcemia is caused by cancer and overactivity in parathyroid glands. Hypercalcemia symptoms include bone pain, stomach pain, and increased urination and thirst.

Meanwhile, hypocalcemia is a condition where there is an extremely low level of calcium in the blood (Banerjee et al., 2020). It is caused by inadequate vitamin D, renal disease, and hypoparathyroidism. Symptoms of hypocalcemia include muscle spasms, depression, memory loss, confusion, hallucinations, and weak nails.

Hypercalcemia and Hyponatremia

Hypercalcemia is a high concentration of sodium in the blood, especially in individuals who do not drink sufficient water. Symptoms of hypernatremia include fatigue, thirst, and restlessness. Hypernatremia is caused by impaired thirst mechanisms and insufficient water in the body. Hyponatremia is a low concentration of sodium in the blood. It is caused by excess water in the body heart failure and inappropriate antidiuretic hormone production in the body.

Acidosis and Acidosis

Acidosis is a build-up of acid in the blood caused by the overproduction of acids in the body. In its severe form acidosis leads to labored breathing and poor lung function. Alkalosis is excess base in body fluids such as blood. Alkalosis can be due to decreased carbon dioxide levels in the blood.

(a) Mr. Epperson’s myocytes were initially injured by ischemia.

(b) Ischemia injures cells faster than hypoxia alone.

(c) Reversible myocyte swelling was caused by a lack of ATP to fuel ion pumps.

(d) Irreversible myocyte injury occurred when mitochondrial and plasma membranes were disrupted.

(e) Dissolving the blood clot rescued some myocytes by providing oxygen for generating ATP.

(f) Dissolving the blood clot damaged some myocytes by reperfusion injury.

 

 

References

Alishahi, M., Ghaedrahmati, F., Kolagar, T. A., Winlow, W., Nikkar, N., Farzaneh, M., & Khoshnam, S. E. (2019). Long non-coding RNAs and cell death following ischemic stroke. Metabolic Brain Disease, 34(5), 1243-1251.

Banerjee, R., Joshi, N., & Nagotu, S. (2020). Cell organelles and yeast longevity: an intertwined regulation. Current Genetics, 66(1), 15-41.

Barrera, K., Stanek, A., Okochi, K., Niewiadomska, Z., Mueller, C., Ou, P., … & Huan, C. (2018). Acinar cell injury induced by inadequate unfolded protein response in acute pancreatitis. World Journal of Gastrointestinal Pathophysiology, 9(2), 37.

Bielaszewska, M., Rüter, C., Bauwens, A., Greune, L., Jarosch, K. A., Steil, D., … & Karch, H. (2017). Host cell interactions of outer membrane vesicle-associated virulence factors of enterohemorrhagic Escherichia coli O157: Intracellular delivery, trafficking, and mechanisms of cell injury. PLoS Pathogens, 13(2), e1006159.

Galluzzi, L., Vitale, I., Aaronson, S. A., Abrams, J. M., Adam, D., Agostinis, P., … & Turk, B. (2018). Molecular mechanisms of cell death: recommendations of the nomenclature committee on cell death 2018. Cell Death & Differentiation, 25(3), 486-541.

 

 

 

 

Clara Pena Espinosa

5 hours ago, at 2:59 PM

 

NEW

Top of Form

1-    Which are the concepts of?

Atrophy: the partial or full wasting away of a part of the body.

Physiologic atrophy: Physiological atrophy is a function of the growth modifications of an organism (atrophy of the thymus throughout puberty, atrophy of the sex glands, skin, and also bones in old people, and so forth). General pathological atrophy (emaciation, cachexia) shows up in cases of insufficient nourishment, persistent infection or intoxication, or problems of the endocrine glands or of the main nerves.

Hypertrophy: the augmentation of a body organ or cells from the increase in size of its cells

Hyperplasia: abnormal increase in quantity of a tissue or body organ triggered by the development and also growth of brand-new regular cells.

Pathologic hyperplasia: indication of unusual or precancerous adjustments. A typical reason for pathological hyperplasia is the unwanted of hormones. Estrogen stimulation in the endometrium can cause abnormal spreading, and androgens can provide a prostatic hyperplasia. This hyperplasia is thankfully in control as well as there is no anomaly in the cell division law genes. Also, if the hormone is eliminated, the hyperplasia will regress.

Dysplasia: is any of various sorts of irregular growth or advancement of cells (tiny scale) or organs (macroscopic scale), and also the irregular histology or physiological framework resulting from such development. Dysplasias on a mostly tiny scale include epithelial dysplasia and also coarse dysplasia of bone.

Metaplasia: is the conversion from one kind of regular adult cell to another kind of normal adult cell.

2-    What are the main four mechanism of Cell Injury?

– deficiency of ATP.

– lowered degrees of oxygen as well as boosted degrees of oxygen-derived complimentary radicals.

– increased concentration of intracellular calcium and also loss of calcium steady-state.

– problems in membrane layer leaks in the structure.

3-    Cell injury: reversible vs irreversible, differences between each…

The primary difference in between relatively easy to fix and permanent cell injury is that the relatively easy to fix cell injury can go back to the normal problems by modifying the homeostasis of the cell whereas the irreparable cell injury can not go back to the sensible problems as the cell has actually passed the climax. Relatively easy to fix and also permanent cell injury are 2 sorts of cell injury that can lead to cell death. Moreover, relatively easy to fix cell injury results in mobile swelling as well as fat build-up while irreversible cell injury causes death or apoptosis.

4-    Cell Death: concepts of necrosis and apoptosis.

In apoptosis, the afflicted cell proactively joins the cell death process, whereas in death the cell death takes place in action to unfavorable problems in the cell’s environment.

5-    Function of this cell organelles:

Nucleus: DNA Storage Space

Nucleolus: helps in healthy protein synthesis and also manufacturing of the ribosome in the cells.

Mitochondria: Power production

Ribosomes: Protein synthesis

Cytoplasm: The cytoplasm holds all the essential parts of a cell including cytosol, cell organelles, inclusions, etc. Cytoplasm is straight pertaining to cell expanding and also development. The cytoplasm is the centre of several metabolic activities in the cell. From glycolysis to cellular division processes all take place in cytoplasm (McCance, & Huethe, 2014). The cytoplasm secrets enzymes, responsible for various biochemical reactions. The cytoplasm relocates all the metabolic waste materials of the cell in the direction of their location and eliminates them from the cell. It likewise removes foreign particles from cell.

Cell Membrane Layer: Define the within and outside of a cell.

6-   Hyperkalemia and Hypokalemia, causes and symptoms.

Hypokalemia as well as hyperkalemia are common electrolyte problems brought on by changes in potassium intake, transformed excretion, or transcellular shifts. Diuretic usage and also intestinal losses prevail root causes of hypokalemia, whereas kidney illness, hyperglycemia, and medicine use prevail causes of hyperkalemia. Digestion conditions like Crohn’s illness or colitis can enhance your risk of hypokalemia due to the fact that they can create chronic looseness of the bowels (McCance, & Huethe, 2014). You may likewise be at threat if you have a bad stomach bug that causes severe throwing up or looseness of the bowels. As well as you can lose potassium if you’re peing frequently or sweating greatly. Common neurologic symptoms of hyperkalemia can consist of: Reduced reflexes, Prickling, Numbness (unusual).

7-   Hypercalcemia and Hypocalcemia, causes and symptoms.

Hypercalcemia, or greater than typical degree of calcium in your blood, is a fairly usual searching for. Hypercalcemia can be caused by more than 25 separate diseases, numerous medicines and also dehydration. Primary hyperparathyroidism and numerous sort of cancers cells make up the greatest percentage of all individuals with hypercalcemia. In key hyperparathyroidism, one or more of the four parathyroid glands, situated behind the thyroid gland in your neck, generate too much parathyroid hormonal agent. Usually, the parathyroid glands deal with the kidneys, skeletal system and intestines to thoroughly manage the degree of blood calcium. However occasionally a parathyroid gland ends up being overactive, causing excess parathyroid hormone being released and an elevated blood calcium degree (McCance, & Huethe, 2014). Although having signs and symptoms of hypercalcemia is unusual, signs and symptoms can consist of: Even more regular urination and thirst, Tiredness, bone discomfort, headaches, Queasiness, vomiting, constipation, decline in cravings, Forgetfulness, Lethargy, depression, amnesia or irritation, Muscle pains, weak point, cramping and/or twitches.

Hypocalcemia describes reduced levels of calcium located on a blood test. It can trigger symptoms like tingling, muscle aches, and also heart rhythm issues that can vary from moderate to serious. Hypocalcemia may create symptoms such as the following: Sensations of pins and needles or prickling, Muscle mass aches, spasms, or weakness, Dry skin or other skin issues, Breakable nails, Difficulty swallowing, Lack of breath and also wheezing, Seizures, Heart rhythm troubles, Cardiomyopathy, Exhaustion, and Psychological disturbances such as anxiety and also complication. Many people recognize that calcium belongs of your bones (McCance, & Huethe, 2014). But calcium is likewise found in your blood as well as inside your body’s cells. Actually, calcium is associated with numerous vital organic processes. As an example, it plays roles in blood clotting and in assisting particular enzymes to function. It is likewise essential for appropriate signaling in your nerves as well as muscle mass, including your heart muscle. As a result of this, your body works to firmly control the amount of calcium existing in your blood. If it’s expensive, it tries to bring it down; if it’s as well reduced, it attempts to bring it up.

8-   Hypernatremia and Hyponatremia. causes and symptoms.

Hypernatremia refers to sodium degrees in the blood being too high. Sodium plays a crucial duty in features such as contraction, nerve impulse generation, and liquid balance. The main causes Resource of hypernatremia are inadequate liquid consumption or too much loss of fluids, causing not enough liquid in the blood. Several wellness factors can cause hypernatremia or enhance its possibility. These consist of: dehydration, Vomiting, kidney disease, unchecked diabetic issues, diabetes insipidus, severe looseness of the bowels, mental deterioration, high temperature, ecstasy (McCance, & Huethe, 2014). Having too much sodium in the blood may cause no signs and symptoms, as well as a person may be not aware of it. Nonetheless, it can cause symptoms and problems such as: extreme thirst, tiredness, confusion, adjustments in mood, muscle twitching, convulsions, seizures, coma.

Hyponatremia is a problem where sodium degrees in the blood are less than normal. Oftentimes, excessive water in the body weakens the salt, creating the condition. Chronic, extreme vomiting or diarrhea and other reasons for dehydration. This triggers your body to lose electrolytes, such as salt, as well as additionally enhances ADH degrees. Drinking excessive water. Consuming alcohol too much amounts of water can create low salt by overwhelming the kidneys’ capability to eliminate water (McCance, & Huethe, 2014). Since you lose sodium through sweat, alcohol consumption excessive water during endurance activities, such as marathons and also triathlons, can additionally weaken the salt web content of your blood. Hormonal changes. Adrenal gland insufficiency (Addison’s condition) affects your adrenal glands’ ability to produce hormones that aid maintain your body’s equilibrium of salt, potassium and water. Reduced levels of thyroid hormonal agent additionally can cause a reduced blood-sodium degree. The leisure drug Ecstasy. This amphetamine enhances the threat of serious as well as also deadly instances of hyponatremia. Hyponatremia creates neurologic signs varying from complication to seizures to coma. The extent of the symptoms depends on just how reduced the salt degrees remain in the blood stream and how swiftly they drop (McCance, & Huethe, 2014). In a lot of cases, blood sodium levels drop gradually, generating only moderate signs as the body has time to make changes. Symptoms are extra severe when blood salt levels fall promptly.

9-   What is acidosis and what is alkalosis?

Acidosis vs alkalosis might occur as a result of different underlying troubles, yet they have numerous similarities and can often be detected as well as treated similarly. Acidosis describes the problem of having an unwanted of acid in the blood. There are two sorts of acidosis: metabolic and breathing. Alkalosis is an excess in the concentration of alkaline materials or alkali in the blood and body fluids. A pH of 7 is a neutral focus of antacids. This problem is characterized by a high plasma pH (above 7.45), high bicarbonate focus, as well as low PCO2. The symptoms of acidosis are the following: feeling weary, having sore muscular tissues, troubles with breathing, as well as sensation woozy, confusion, modifications in heart rate or high blood pressure, lack of ability to urinate or sweat, as well as discomfort in the chest area (McCance, & Huethe, 2014). If you experience these signs and symptoms while additionally really feeling sick with a high temperature it is necessary to look for healthcare quickly. Symptoms of acidosis might consist of Confusion (can proceed to stupor or coma), Hand shake. Impaired thinking. Muscle twitching. Queasiness, vomiting. Tingling or tingling in the face, hands, or feet.

Altered Cellular and Tissue Biology: Environmental Agents

10- Mr. Epperson was lifting a heavy piece of furniture when he experienced crushing pain in his chest, began sweating heavily, and was nauseated. His wife drove him to the hospital, where he was diagnosed with a myocardial infarction (heart attack) and given intravenous drugs to dissolve a clot that was obstructing a major coronary artery. After his hospitalization, Mr. Epperson’s doctor told him that some of his heart muscle had died. Match the questions with the correct answers regarding the cell injury in Mr. Epperson’s heart.

  1. Mr. Epperson’s myocytes were initially injured by ___ ischemia ____.
  2. Ischemia injures cells faster than ___ hypoxia ____ alone.
  3. Reversible myocyte swelling was caused by lack of ____ ATP ___ to fuel ion pumps.
  4. Irreversible myocyte injury occurred when mitochondrial and plasma ___ membranes ____ were disrupted.
  5. Dissolving the blood clot rescued some myocytes by providing ___ oxygen ____ for generating ATP.
  6. Dissolving the blood clot damaged some myocytes by ___ reperfusion ____ injury.
  7. hypoxia
  8. sodium
  9. oxygen
  10. ATP
  11. ischemia
  12. necrosis
  13. reperfusion
  14. membranes
  15. apoptosis

Reference

McCance, Kathryn L. & Huethe, Sue E. (2014). Pathophysiology: The Biology Basis for Disease in Adults and Children. 7th Edition. Evolve Elsevier. ISBN-13: 978-0323088541

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