Three top healthcare issues with room for improvement in Rockford, Illinois, are opioid abuse, high blood pressure, and obesity (NYU Langone Health, 2021). Obesity is a significant contributor to multiple chronic diseases and metabolic disorders (Jakobsen et al., 2018). Chronic diseases accounted for most US healthcare costs and decreased productivity (Chapel et al., 2017). Global Burden of Disease researchers (Institute for Health Metrics and Evaluation, 2021) acknowledge that these diseases increase societal costs, morbidity, and mortality by limiting healthy days lived.

     Several national initiatives are underway that have a local impact on this burden of disease. The Substance Abuse and Mental Health Services Administration (SAMHSA) endorses using Medication-Assisted Therapy (MAT) to mitigate opioid abuse and the societal effects of chronic substance abuse (SAMHSA, 2020). The American Heart Association provides a comprehensive public health education program on steps to control high blood pressure to reduce heart disease and strokes (American Heart Association, 2021). The Centers for Disease Control and Prevention (2021) offers multiple interventions to reduce obesity in the Healthy People 2030 goals outlined by the Division of Nutrition, Physical Activity, and Obesity.

     Concerned voters could influence local policymakers to transfer these national initiatives to Rockford with an informed advocate, such as the DNP scholar. The advocate starts by building a grassroots coalition of the voting public to endorse specific improvements to existing health policy. Next, prepare a health policy brief, then research and contact the policymakers to open discussion. The brief should specify the problem and current policy while providing a rationale for change that includes the impact of the health problem on the constituency. Harnessing the power of multiple voters increases the likelihood that those in power will actively consider a policy change. Social media, like Twitter, can be used to build this coalition. My suggested tweet is #HealthyPeople 2030, #Healthy Rockford! Improve our community step by step! Healthy People 2030 | Data & Statistics | DNPAO | CDC (Links to an external site.)

     Dr. Riley presented her case to Congressman Aiken just as recommended. The DNP scholar was prepared and researched the issue and her audience’s stance on healthcare access. Dr. Riley met with stakeholders to inform discussion with the congressman on the impacts and relevance of improving access to transportation in her community. Dr. Riley introduced herself as a concerned health professional and advocate, presented the pros and cons of the proposed clinic bill, and stated appreciation for partial gains while remaining open to future improvements. She was thankful and expressed her willingness to offer professional support on future projects.  Dr. Riley’s approach left Congressman Aiken with a positive memory of Dr. Riley, specifically, and the profession of nursing and nurse practitioners as collaborative partners in health policy. She could have provided a business card, including email in parting. A follow-up email thanking the congressman would support this memorable encounter.

References

American Heart Association. (2021). Five steps to control your blood pressure. Five Simple Steps to Control Your Blood Pressure | American Heart Association (Links to an external site.)

Centers for Disease Control and Health Prevention. (2021). Healthy People 2030: Indicators and objectives align with DNPAO’s work. Healthy People 2030 | Data & Statistics | DNPAO | CDC (Links to an external site.)

Chapel, J.M., Ritchey, M.D., Zhang, D., & Wang, G. (2017). Prevalence and medical costs of chronic diseases among adult Medicaid beneficiaries. American Journal of Preventative Medicine, 53(6, S2), S143-S154. https://doi.org/10.1016/j.amepre.2017.07.019 (Links to an external site.)

Institute for Health Metrics and Evaluation. (2021). GBD Compare. GBD Compare | IHME Viz Hub (healthdata.org) (Links to an external site.)

Jakobsen, G.S., Smastuen, M.C., Sandbu, R., Nordstrand, N., Hofso, D, Lindberg, M., Hertel, J.K., & Hjelmesaeth, J. (2018). Association of bariatric surgery vs. medical obesity treatment with long-term medical complications and obesity-related comorbidities. JAMA 319(3), 291-301. https://doi.org/10.1001/jama.2017.21055 (Links to an external site.)

NYU Langone Health. (2021). City Health Dashboard: Rockford, Illinois. Rockford, IL – City Highlights | City Health Dashboard (Links to an external site.)

Substance Abuse and Mental Health Services Administration. (2020). Naltrexone. Naltrexone | SAMHSA

I NEED A COMMENT FOR THIS DICUSSION BOARD WITH AT LEAST 2 PARAGRAPHS AND USE 3 SOURCES NO LATER THAN 5 YEARS

Respond to two colleagues in one of the following ways:

If your colleagues’ posts influenced your understanding of these   concepts, be sure to share how and why. Include additional insights you   gained.

If you think your colleagues might have misunderstood these   concepts, offer your alternative perspective and be sure to provide an   explanation for them. Include resources to support your perspective.

                                                  Main Post

Agonist-to-Antagonist Spectrum

The agonist-to-antagonist spectrum of action refers to  the action  that is taken by a neurotransmitter to produces a  conformational change  (Stahl, 2013).  The spectrum starts with the  agonist action, which,  with the help of a second-messenger, can turn on  the full potential of  change (Stahl, 2013). Full agonists can be natural  transmitters used to  produce change.  An antagonist blocks the  conformational change of the  potential of the transmitter for binding  with the intended agonist  (Stahl, 2013).  The role of the antagonist is  to keep the receptors in a  baseline state in order to reverse what the  agonist has done (Stahl,  2013). This is the opposite end of the spectrum  and seeks to block  agonists.  In the middle, some partial agonists  mimic its agonist  partner to a lesser degree, and inverse agonists stop  all activity from  occurring on the receptor (Stahl, 2013).  The  conformational change is  needed for a receptor to open to the action of  drugs, particularly,  psychopharmaceutical medications in this case.

G couple proteins and Ion gated channels

G couple proteins are used at the binding site of a  neurotransmitter  to act as a conduit for enzymes (Stahl, 2013). Whereas,  ion gated  channels exist as targets to regulate chemical  neurotransmitters  (Stahl, 2013).  Ion gated channels consist of channels  and receptors  that can only be opened by the neurotransmitters.   Conversely, G couple  proteins attach to neurotransmitters and conform to  enzymes to serve  as a channel for a second messenger (Stahl, 2013).   Most psychotropic  medications aim for the ion gated channels, which open  through chemical  neurotransmission and initiate the signal transduction  cascade (Stahl,  2013).  The cascade results in faster uptake of  psychotropic  medications into the system.

The Role of Epigenetics

According to DeSocio (2016), epigenetics is the study  of how genomes  that undergo changes with certain molecular compounds and   environmental changes can leave the essential DNA unchanged.  It is a   modification of gene expression that is independent of the DNA  (DeSocio,  2016).  DNA is the code that determines much of who we are.   Changes in  that code can be seen as a result of heredity, the  environment, or  neurotransmission (Stahl, 2013).  These alterations  affect individuals  at a physical, emotional, and psychological level.   Stress and adversity  play a significant role in epigenetics by changing  the genomes, which  in turn leads to changes in a person’s DNA (Park et  al., 2019).  These  alterations influence psychological issues related  to many individuals.   It is essential to know how to combat these  changes when determining a  plan of care for clients.

Implications of Findings to Prescribing

As nurse practitioners, it is essential to have an  extensive  understanding of how the above processes affect the way we  prescribe  medications to clients.  It is also essential to take into   consideration how the environment impacts maintaining optimal health  and  healing (DeSocio, 2016).  Knowing the mechanisms of action for   medications that we are prescribing is vital to providing competent   care.  For example, a patient with a generalized anxiety disorder (GAD)   is prescribed Venlafaxine.  The PMHNP needs to understand that the   Venlafaxine works by boosting the serotonin, norepinephrine, and   dopamine neurotransmitters (Stahl, 2014).  This action blocks serotonin   reuptake, norepinephrine reuptake, and the dopamine reuptake (Stahl,   2014).  Each of these actions then increases these neurotransmissions  in  the brain providing therapeutic results. 

                                          References

DeSocio, J.E. (2016). Epigenetics: An emerging framework for advanced practice psychiatric nursing. Perspectives in Psychiatric Care, 52(3), 201-207. https://doi.org/10.1111/ppc.12118

Park, C.,  Rosenblat, J.D., Brietzke, E.,  Pan, Z., Lee, Y., Cao, B.,  Zuckerman, H., Kalantarova, A., McIntyre,  R.S. (2019). Stress,  epigenetics, and depression: A systematic review. Neuroscience and Biobehavioral Reviews, 102, 139-152. https://doi.org/10.1016/j.neubiorev.2019.04.010

Stahl, S.M. (2014). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.

Stahl, S.M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications. (4th ed.). New York, NY: Cambridge University Press.

Theories are derived from conceptual models and are comprised of concepts and propositions. The only concepts that are common to all nursing theories, in some shape or form, are patient, nurse, health, and environment. These are sometimes referred to as the basic metaparadigms of the nursing domain. Identify two additional concepts that are relevant to your personal practice of nursing and explain how they relate to your practice and why they are important to your practice.

Ethical & Legal Aspects in Nursing WK 14

Please answer the following Discussion Question. Please be certain to answer the four questions on this week DQ and to provide a well-developed and complete answer to receive credit. 

Case Study, Chapter 23, Professional Identity and Image

Nursing care is frequently perceived by the public as simple and unskilled. Many male nurses live in fear of how their caring actions might be interpreted. Many nurses hold that stereotypes about the profession are true, just as the general public does. Public identity and image has been a struggle for nurses for a long time. The greater public clearly does not understand what professional nursing is all about, and the nursing profession has done a poor job of correcting long-standing, historically inaccurate stereotypes.

1. What are the common nursing stereotypes?

2. What was the role of the Center for Nursing Advocacy? Discuss the role of Truth about Nursing in addressing inaccurate or negative portrayals of nursing in the media and the process they use to raise public and professional awareness of the issues surrounding nursing public image?

3. What are some of the ways of changing nursing’s image in the public eye?

4. One of the most important strategies needed to change nursing’s image is to change the image of nursing in the mind of the image makers. What are some of the key ways for nurses to interact with the media?

INSTRUCTIONS:

APA FORMAT

IN TEXT CITATIONS WITH 3 REFERENCES NO LESS THAN 5 YEARS

HS210-4: Explain HIPAA guidelines as it relates to patient privacy and confidentiality.
Professional Competency Outcome:
PC 2.3: Demonstrate integrity through the application of relevant codes of conduct and social responsibility within one’s profession.
Instructions
Part I
For the first part of this Assignment, you will write an essay about HIPAA and the Patient Bill of Rights Act. Your essay should address the information and questions presented below. This essay must be a minimum of 200 words. Please include a title page and reference page.
The creation of privacy and security laws has been a huge step toward more efficient healthcare and faster reimbursements. Visit the United States Health and Human Services website and research HIPAA Regulations & Standards as they apply to the medical records. Also, please see the information in your text.Question: Explain how HIPAA Privacy and Security Rules benefit and support the integrity of the healthcare industry, patient, and physician.
The Patient Bill of Rights act was created with 3 goals in mind; to assist patients in being more comfortable with health care delivery systems, to develop partnerships with patients and health care providers, and to stress important roles that patients play in staying healthy. Please see the information in your text for additional information.Question: Name 3 areas within the Patient Bill of Rights Act that you feel are important for health care providers/patients to abide by, and provide an explanation as to why you feel each area you selected is important.
Part II
Please read each scenario and select the appropriate policy within the Patient Bill of Rights Act that applies to each scenario. For each scenario, describe in a paragraph why that specific policy in the Patient Bill of Rights Act is critical for demonstrating integrity within the medical assisting profession.
Scenarios:
Donna Jackson’s physician, Dr. Jones is retiring and is recommending that Donna continue services with Dr. Smith who also works in the same office. Donna is not comfortable with Dr. Smith and would like the option to select her own physician.Keith Davidson is in need of emergency services because of a life threatening condition. Keith is currently uninsured and would like to make payment arrangements at a later time.Jingle Smith has just been diagnosed with a chronic condition. She is interested in knowing all of her treatment options to combat this diagnosis. Jingle would also like for husband to be a part of the treatment process.During Lisa Smith’s visit with her primary care physician, he made derogatory and discriminating comments regarding her weight. Lisa is very uncomfortable with these remarks and wishes to file a complaint with administration.Bianca White has just discovered that someone in her primary care physician office released her medical information without her consent. Bianca is not happy about this and wishes to file a complaint with the Office of General Inspector.
Policies within the Patient Bill of Rights Act
Confidentiality of Health Information Policy Participation in Treatment Decisions Policy Access to Emergency Services Policy Choice of Providers and Plans Policy Respect and Nondiscrimination Policy