This week your Discussion will focus on interprofessional practice. This Discussion is an opportunity for you to examine your perspective and experiences with interprofessional collaborative practice and to apply your knowledge to managing patient care.To prepare:Identify a professional nursing organization and review their position on interprofessional practiceReview the following case study:Case Study:Ms. Tuckerno has been diagnosed with multiple sclerosis (MS). The patient receives care at an internal medicine clinic. Her internist is not in the office today and she is being treated by the nurse practitioner. The patient is on two medications for her MS, three different blood pressure medications, one medication for thyroid disease, one diabetic pill daily, insulin injections twice a day, she uses medical cannabis, and uses eye drops for glaucoma. Upon assessing the patient, the nurse practitioner (NP) decides her treatment plan should be adjusted. The NP discontinues some of the patient’s meds and discontinues medical cannabis. She orders the patient to follow up in two weeks.The patient returns and is seen by her internist. The internist speaks with the patient and reviews her medical chart. The internist states to the patient, “I am dissatisfied with the care you received from the nurse practitioner.” The internist places the patient back on originally prescribed medications and medical cannabis.Post  2 pages on : An explanation of your understanding of interprofessional practice.Also, explain the position on interprofessional practice for a professional nursing organization that you are a member of or of which you plan to become a member.Then, explain what you think is the best collaborative approach to manage Ms. Tuckerno’s care.ReferencesRequired ReadingsAltman, S. H., Butler, A. S., Shern, L. (Eds.). (2015). Assessing Progress on the IOM Report The Future of Nursing. Washington, DC: The National Academies Press. Retrieved from http://www.nationalacademies.org/hmd/Reports/2015/Assessing-Progress-on-the-IOM-Report-The-Future-of-Nursing.aspx doi: 10.17226/21838Bankston, K., & Glazer, G., (2013) Legislative: Interprofessional collaboration: What’s taking so long? OJIN: The Online Journal of Issues in Nursing, 19(1).Buppert, C. (2015). Appendix 11-D: Sample Professional Services Agreement. In Nurse Practitioner’s Business Practice and Legal Guide (5th ed.) (417-422). Burlington, MA: Jones & Bartlett.Buppert, C. (2015). Legal Scope of Nurse Practitioner Practice. In Nurse Practitioner’s Business Practice and Legal Guide (5th ed.) (37-78). Burlington, MA: Jones & Bartlett.Hain, D., & Fleck, L. (2014). Barriers to nurse practitioner practice that impact healthcare redesign. OJIN: The Online Journal of Issues in Nursing, 19(2).Note: Retrieved from the Walden Library databases.Hamric, A. B., Hanson, C. M., Tracy, M. F., & O’Grady, E. T. (2014). Collaboration. In Advanced Practice Nursing: An Integrative Approach (5th ed.) (299-327). St. Louis, MO: Elsevier Saunders.

Main Discussion Post: Factors that influence the development of psychopathologyNeedless to say, this is a broad, multifactorial, and very complex subject! Numerous factors are involved in the development of psychopathology, and a thesis could be written, so I will expound on a few of them. Biological, social, psychological, cultural, ethnic, socioeconomic, genetic, developmental, cognitive, age, gender, gender identity, experiential, familial, endophenotype (characteristics not seen), and environmental are some factors involved that increase the risk of psychopathology.It is well known that there is a genetic component to psychiatric illness and physiologic differences in parts of the brain and with neurotransmission that affect personality, temperament, cognition, sensory input interpretation, and behavior. Psych disorders can be associated with specific genes and probably a combination of effects from multiple genes. Cognition influences psych disorders and psych disorders influence cognition. Abnormal anatomy and circuitry have been observed. There is a pattern of reduced neocortical thickness common across all psychiatric disorders and is a feature of general psychopathology. A thinner neocortex has been associated with numerous negative outcomes throughout life, such as brain age vs. chronological age associated with lower intelligence in midlife. A thinner cortex has also been associated with the internalization, externalization, and thought disorder aspects of psychiatric illness and the progression of symptoms with Alzheimer’s disease (Romer et al., 2021).The role of age and development in stages of life, especially during childhood and adolescence, impact psychopathology. Minor changes in life circumstances impact mental health and behavior due to a lack of communication and coping skills. Symptoms are often unrecognized or overlooked as part of childhood that will be outgrown. Prenatal and perinatal influences, injuries, and illnesses, parenting styles, genetic predispositions, epigenetics, and environmental factors shape what and how the predispositions are ultimately expressed. Mood and anxiety disorders in childhood lead to persistent psychiatric issues in adulthood. Traumatic experiences, gender, and social expectations and the stress that accompanies the expectations, access to services, sibling influences, polypharmacy, overmedication, and inappropriate use of antipsychotics for anxiety, religious, cultural, and ethnic factors that influence thoughts and behaviors, substance use, and abuse and environmental factors all influence and increase the risk of psychopathology (Butcher & Kendall, 2018).Sociocultural influences, especially related to immigrants and refugees, are contributing factors. Adapting to a different culture, parental and family separation, lower socioeconomic status and poverty, unemployment, and lack of education lead to minority stress related to discrimination and/or perceived discrimination and disparities in treatment and access to care. The DSM-5 has begun to address this in the Outline for Cultural Formulation, but it is still lacking (Cheung & Mak, 2018). Diagnosticians can get it wrong, which skews incidence and prevalence.A study done by Class et al. has discussed the p factor, a general factor of psychopathology. It manifests individual differences in one or more expressed traits, but especially negative emotionality, which is tied to risk for all psychopathology, not including psychosis or personality disorders. `It was a 12-year study which observed a link between child temperament and stress, family transitions, and parenting styles and predicted future psychopathology  (2019).Research has also connected poverty and socioeconomic status to changes and variations in brain structure and function on self-regulation. Gaps in socioemotional domains and cognition are linked to poverty. Neurobiology connected to self-regulation, poverty, and its effects on neurodevelopment increase the risk for psychopathology (Palacios-Barrios & Hanson, 2019).Environment and non-genetic cumulative exposures beginning at conception have brought about an “exposome paradigm” akin to genomics research to help understand the role of environmental factors such as psychological trauma, exposures to noise and air pollution, and weather, among other things that can predispose, precipitate, and perpetuate both risk and protective factors that influence psychiatric outcomes. It has been found that biological pathways can induce epigenetic changes that can modify behavioral phenotypes and increase susceptibility to stress and even alter presynaptic dopaminergic functioning (Erzin, & Gülöksüz, 2021).ReferencesButcher, J. N., & Kendall, P. C. (2018). Introduction to childhood and adolescentpsychopathology. In J.N. Butcher & P. C. Kendall (Eds.), APA handbook ofpsychopathology: Child and adolescent psychopathology., Vol. 2. (pp. 3-14). AmericanPsychological Association. https://go.openathens.net/redirector/waldenu.edu?url=https://doi.org/10.1037/0000065-001Cheung, F. M., & Mak, W. W. S. (2018). Sociocultural factors in psychopathology. In J. N.Butcher & J. M. Hooley (Eds.) APA handbook of psychopathology: Psychopathology:Understanding, assessing, and treating adult mental disorders., Vol. 1 (pp.127-147).American Psychological Association.https://goathens.net/redirection/waldenu.edu?url=https://doi.org/10.1037/0000064-006Class, Q. A., Rathouz, P. J., Zald, D. H., Van Hulle, C. A., Applegate, B., & Lahey, B. B. (2019).Socioemotional dispositions of children and adolescents predict general and specificsecond-order factors of psychopathology in early adulthood: A 12-year prospective study.Journal of Abnormal Psychology, 128(6), 574–584.https://doi.org/10.1037/abn0000433Erzin, G., & Gülöksüz, S. (2021). The exposome paradigm to understand the environmentalorigins of mental disorders. Alpha Psychiatry, 22(4), 171–176. https://doi.org/10.5152/alphapsychiatry.2021.21307Palacios-Barrios, E. E., & Hanson, J. L. (2019). Poverty and self-regulation: Connectingpsychosocial processes, neurobiology, and the risk for psychopathology. ComprehensivePsychiatry, 90, 52–64.https://doi.org/10.1016/j.comppsych.2018.12.012Romer, A. L., Elliott, M. L., Knodt, A. R., Sison, M. L., Ireland, D., Houts, R., Ramrakha, S.,Poulton, R., Keenan, R., Melzer, T. R., Moffitt, T. E., Caspi, A., & Hariri, A. R. (2021).Pervasively thinner neocortex as a transdiagnostic feature of generalpsychopathology. American Journal of Psychiatry, 178(2), 174–182.https://doi.org/10.1176/appi.ajp.2020.19090934

Week 2 DiscussionCOLLAPSEThe interview with the patient is considered the core of the assessment process. One of the main learning goals in the psychiatric curriculum is to perform a psychiatric interview and document the recorded findings (Dreimüller et al., 2019). There are components of the interview process and tools used in helping when it comes to assessing and diagnosing patients.  These components are very critical for a psychiatric interview process. The three components are developing the functional relationship between the healthcare professional and understanding the points without any specific information.  These components include consciousness, Affect and mood, thought, and perception.  Some components need to be considered at the psychiatric interview to achieve effective communication and the proper therapeutic outcomes (Dreimüller et al., 2019).Different assessment tools are used to diagnose psychic patients, check status, and reevaluate patient response to treatment. The assessment tool assigned to group B is the PTSD checklist (PCL), a post-traumatic stress disorder. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) for the PTSD criteria require exposure to a traumatic event involving actual or threatened death or serious injury (Schinke et al., 2007).According to Schinke et al. (2007), this event must produce a response of intense fear, helplessness, or horror (criteria A), and the experience of as many as 17 symptoms that are categorized as falling in three symptoms clusters (DMS-IV Criteria B, C, and D), re experiencing, avoidance or numbing, and arousal. According to Schinke et al. (2007), the diagnosis of PTSD requires that an individual experience at least one of five re experiencing symptoms, three of seven avoidance or numbing symptoms, and two of five arousal symptoms.The most frequently used instrument for the exploration of the structure of PTSD symptomatology has been the Civilian Version of the PTSD Checklist (PCL-C) (Schinke et al., 2007) The PCL-C consists of 17 questions that assess the 17 DSM-IV symptoms corresponding to Criteria B–D. The checklist provides a total score for reexperiencing, avoidance/numbing, and arousal subscales. The PCL-C does not address DSM-IV Criteria A, E, or F (Schinke et al., 2007).When it comes to Affect and mood, the Affect can be expressed differently because it shows how the patient represents themselves based on their emotions at hand.In addition, if the expression is not in line with the emotions at hand, the patient might be experiencing mental problems.The thought and perception is the last part which would help in patient understanding level of thinking and how they see the questions at hand.The second question addressed the psychiatric interview, which focused on understanding the patient’s mental health status. This is very important in selecting medical procedures and determining the treatment process. The psychiatric interview components are consciousness, affect and mood, and thought. The perception would play a significant role when it comes to an understanding of the patient’s mental capacity to go through treatment. According to David C. Martin (2020), the components would help bring closure whether the patient has mental issues that are depression, dementia, and others.Question 3 is about understanding the Brief Psychiatric Rating Scale, a tool used by clinicians and researchers to determine the signs and symptoms of Psych in a patient.These are the tool used to measure the symptoms, which are depression, psychoses, and anxiety. The Multiple results would be showing the signs of the presence of mental problems (Psychiatric Times Website, 2020). The scale ranging from 17 and 1 shows no symptoms, and 7 indicates moderate to severe psychiatric problems.The number four question, BPRS, can be used whenever a patient is shown more than one symptom of a psychiatric condition, such as anxiety, guilt, hallucinations, depression, and related behaviors. This scale would be helpful for indication of the severity of the situation that has been a study. This would indicate more or severe psychiatric disorders.The BPRS helpful to the psychiatric nurse; the scale would be beneficial in determining the severity of the condition, which would help determine the appropriate approach to identify the patient’s conditions because the scale would help in rating about 18 symptoms connected to a psychiatric illness.Reference:Dreimüller, N., Schenkel, S., Stoll, M., Koch, C., Lieb, K., & Juenger, J. (2019, May 2). Development of a checklist for Evaluating Psychiatric Reports. BMC medical education. Retrieved December 9, 2021, from https://www.ncbi.nlm.nih.gov/pubmed/31046745.Psychiatric Times. (2021, March 19). BPRS Brief Psychiatric Rating Scale. Psychiatric Times. Retrieved December 9, 2021, from https://www.psychiatrictimes.com/view/bprs-brief-psychiatric-rating-scale.Martin, D. C. (1990, January 1). The mental status examinations . Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Retrieved December 9, 2021, from https://www.ncbi.nlm.nih.gov/books/NBK320/.Schinka, J. A., Brown, L. M., Borenstein, A. R., & Mortimer, J. A. (2007, June 27). Confirmatory factor analysis of the PTSD Checklist in the Elderly. Wiley Online Library. Retrieved December 8, 2021, from https://onlinelibrary.wiley.com/doi/10.1002/jts.20202.

Week 6 Research Proposal Project: Data Analysis PlanFor this section of your research proposal assignment, you will carefully design a plan for analyzing your quantitative data. Explain in detail how you will go about analyzing your data.

Present the findings from your practicum experience in a 10-15-minute presentation for a group of nurses.  Imagine that you presenting this to your coworkers or at a nursing conference.  Make it interesting and visually appealing.Create a seven- to ten-slide, professional quality presentation with approximately six bullet points per slide.  Slides should contain relevant pictures, tables, and charts when indicated.  In your presentation, address the following information:Title pageIntroduction to the at-risk group. Include descriptive and demographic data.Description of the community (city or county).Summary of the needs assessment (step 1).Summary of the health disparity and recommendation (step 2)Summary of the community strengths, assets, and programs available for this group (step 3).Description of the agency and summary of the interview (step 3).How your plan supports social justice advocacy to improve the health of at-risk populations (new information).ReferencesNarrate your presentation.  Once you have created your slides, write a script to narrate the presentation in the notes section of your presentation. Your narration text should support and explain the information on the slides. You are also welcome to use a voice over narration.