Introduction

Government and Environmental Health

Disasters, both natural and man-made, can greatly affect human health. Government agencies must work together during a disaster to protect the health and safety of the individuals involved. Fire, rescue, police, hospital staff, public health departments, military, and civil defense all have a role to play. Heat waves, drought, hail, tornadoes, hurricanes, tsunamis, and blizzards are all natural, climatological disasters. Fortunately, technology allows us to predict many of these events, so we can warn citizens and emergency personnel.

Geological disasters such as floods, landslides, avalanches, earthquakes, and volcanic eruptions can sometimes be predicted; usually, the only available response is the evacuation of the region. Man-made disasters include forest fires, industrial accidents, and transportation accidents. In 2007, several disasters caught the media’s attention, including the Minneapolis bridge collapse and the collapse of a coal mine in Utah. These tragedies required the response of a large number of trained professionals from various organizations. Another man-made disaster concern is terrorism.

Terrorism is a purposeful disaster carried out to scare or threaten a large group of people. Terrorism includes both domestic and international acts. The state of the environment and its link to human health have gotten a lot of attention in the last few years. Individuals are more aware of how air and water quality, food safety, and disaster preparation are important to maintaining their health and safety. This trend is not just occurring in the United States but throughout the world. The World Health Organization (2014) has instituted healthy cities initiatives that “address a range of key topics: air quality, climate change, and flooding, food safety, housing, noise, transport, urban planning, waste, and water. Each offers information and support to people working at the local level. Other information and support for local government includes guides to planning and pamphlets for local authorities.”

Going Green

Green architecture and green energy and transportation are becoming more popular, as people understand the benefits of these technologies. Homes of the future will likely:

• Be easier to maintain.
• Be energy efficient with solar or alternative types of heating and cooling.
• Use recycled materials and nonpolluting paint.
• Have heat-efficient windows, low-flow toilets, and a reservoir for rainwater.

More and more cities are seeing the benefits of green areas and greenways for biking, hiking, and recreation. These changes benefit the health of individuals by providing fresh air, a space for exercise, and an option for commuting without a car. Urban planners are looking more at public transportation, energy conservation, waste treatment, and urban forestry. Downtowns are being redeveloped in many areas, and community gardens and recycling centers are growing. The future holds many opportunities for us to improve environmental health. By making wise personal choices, we can improve environmental health for ourselves and those around us.

Reference

World Health Organization Regional Office for Europe (WHO). (2014). Healthy cities. Retrieved from http://
www.euro.who.int/en/health-topics/environment-and-health/urban-health/activities/healthy-cities

Demonstration of Proficiency

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

• Competency 1: Assess basic environmental health principles, theories, and issues.
  • Define the term environmental health.
  • Assess how healthy cities relate to environmental health.
  • Analyze obstacles for a city in becoming a healthy city.
  • Describe the financial issues involved in creating a healthy city.
  • Analyze how environmental health is an individual concern.
  • Analyze how environmental health is a global concern.
• Competency 3: Apply personal and professional decisions based upon an understanding of environmental risks.
  • Describe how a city could become prepared for disasters.
  • Assess benefits of developing a healthy city to one’s self, family, and community.
• Competency 4: Communicate effectively in a variety of formats.
  • Write coherently to support a central idea in appropriate format with correct grammar, usage, and mechanics.

Preparation

Please review the assessment instructions and scoring guide. No additional preparation is required.

Instructions

The purpose of this assessment is to consider aspects of what makes a healthy city and to integrate your research to provide strategies for individuals and communities to improve environmental health.

To begin, suppose you are working with your city planner to develop a healthy city initiative for your city (or a city near you). You are tasked with developing a report that will be presented to your city council.

Craft a 4–5-page written document that could be presented to your city council, addressing the following points:

• What is environmental health?
• Why is creating a healthy city important to environmental health?
• What could your city do to become a healthy city?
  • What would be the obstacles to change and why are they obstacles?
  • What financial issues would have to be considered?
  • How would these changes benefit you, your family, and your community?
• What could your city do to become better prepared for disasters, both natural and human-made?
• Why should environmental health be considered an individual concern? Why should it be considered a global concern?
• What could you or your family do—in your home, your neighborhood, and your workplace—to reduce your personal impact on the environmental health of your city?

Additional Requirements

Your document should follow a logical structure and be evidence based. Use the APA Paper Template as a resource for formatting and citations.

• Written Communication: Written communication should be free of errors that detract from the overall message.
• Length: The report should be 4–5 pages in content length. Include a separate title page and a separate references page.
• Font and Font Size: Times New Roman, 12-point, double-spaced. Use Microsoft Word.
• APA Formatting: Resources and in-text citations should be formatted according to the current APA style and formatting.
• Number of Resources: You are required to cite a minimum of two scholarly resources. You may conduct independent research for resources and references to support your report. Provide a reference list and in-text citations for all your resources, in APA format. You may cite texts and authors from the Resources.

  

Chapter 12 – Personal Loss

Question: 

1- Compare the Adaptive grieving model (Martin & Doka, 2000) and the Dual Process model (Stroebe & Schut, 2001). 

2- What are the similarities and differences? Which seems to fit best to your style of counseling? Why is that so? 

Guidelines: APA format, Original papers (No plagiarism).

The answer should be based on the knowledge obtained from reading the book power point attached).

Textbook: 

Crisis Intervention Strategies

Author: Richard K. James; Burl E. Gilliland

ISBN: 978-1-111-18677-7

  Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days who were assigned a different patient case study, and provide recommendations for alternative drug treatments to address the patient’s pathophysiology. Be specific and provide examples. 

                                             Main Post

Knowing how to diagnose and treat complex patient illnesses is important to understand as an advanced practice provider.  The case study provided this week is about a 66 year old women with a history of MI, HTN, Hyperlipidemia, and diabetes mellitus who presents with sudden onset of diaphoresis, nausea, vomiting, dyspnea, followed by a bandlike upper chest pain that she rates 8/10 and radiates down her left arm.  With the health history and her current symptoms, I am immediately worried about another cardiac event for this patient.  This patient has many risk factors for cardiac events. Not only does she have previous heart history, she has HTN, Hyperlipidemia and Diabetes, all of which increase her risk for cardiac events significantly. Brewer et al. (2015) state that the number of men and women who are affected by and die from CAD outnumber all other conditions including all forms of cancer in the US.  Women present differently when having cardiac events.  Brewer et al. (2015), points out that there is significant evidence that adverse outcomes in women with IHD may be fueled by underestimation of cardiovascular disease risk, leading to underdiagnosis and undertreatment.

Due to the acute presentation of this patient, treating her quickly to prevent further heart damage is imperative. An EKG needs to be done within 10 minutes of the patients’ arrival to review for ST elevation and blood sent to lab to evaluate cardiac enzymes.  Oxygen would be my first medication intervention.  The patient complains of dyspnea and chest pain with radiation on a scale of 8/10.  Anytime there is pain we assume there is damage being done to the heart.  Oxygen will help with the dyspnea and provide extra oxygen to the tissues in the heart and hopefully prevent damage.  ASA 4 chewable 81mg tablets would also need to be administered to this patient.  Aspirin suppresses platelet aggregation, producing an immediate antithrombotic effect.  It has been identified as causing a substantial reduction in mortality.

Morphine to treat the pain is the treatment of choice in acute STEMI situations.  In addition to treating the pain, it improves hemodynamics by promoting venodilation and reducing cardiac preload.  It can also reduce modest arterial dilation and in so reduce afterload as well.  This reduction in preload and afterload help by lowering cardiac oxygen demand, helping to preserve the ischemic myocardium.  Beta blockers are also important in treating acute STEMI. The reduce cardiac pain, infarct size, and short-term mortality.  They also reduce recurrent ischemia and reinfarction.  They reduce myocardial wall tension and may decrease the risk for myocardial rupture. Continued use of oral beta-blockers increases long term survival rates.  They work by blocking preventing beta receptor activation.  Ultimately this reduces heart rate and contractibility, reducing oxygen demands and blood pressure. They increase coronary blood flow and myocardial oxygen supply.  This patient is already taking Metoprolol 50mg BID at home so this step has already been taken.

The patient’s cardiac enzymes are positive which verifies an acute cardiac event.  The rest of her labs and vital signs are normal. My next drug of choice would be nitroglycerin, which according to Rosenthal et al. (2018), acts directly on vascular smooth muscle to promote vasodilation.  This works by increasing the blood flow to the ischemic areas of the heart.  Educating the patient that this medication cause headache, orthostatic hypotension, and reflex tachycardia are important, along with the benefits of this medication for her current condition.  Nitroglycerin should be avoided in patients with hypotension, bradycardia, and suspected right ventricular infection.

I work in a small critical access hospital so at this point I would be contacting a tertiary care center for cardiology recommendations and transfer of cares for this patient.  Sometimes the cardiologist will recommend reperfusion therapy with fibrinolytics prior to transfer for PCI therapy.  Fibrinolytic drugs resolve clots by converting plasminogen into plasmin, a proteolytic enzyme that digests the fibrin meshwork that holds a clot together.  The common drugs used for this is alteplase, reteplase, and tenecteplase.  These drugs are most effective when presentation is early.  When given in a timely manner they can open the occluded artery in 80% of patients.  The major complications of this therapy are bleeding, which occurs in 1-5% of patients.  Intercranial hemorrhage is the greatest concern.  Patients undergo an intense screening process to make sure they are appropriate candidates for therapy and reduce the risk of these complications.  Patients who receive this therapy are also treated with anticoagulants such as heparin and antiplatelets such as aspirin or Plavix.  These are proven to decrease mortality in acute cardiac events.

The patient at this time is ready to be transferred to a cardiac unit for further evaluation and treatment by a cardiologist.  Making sure the patient is educated and understands each treatment and why it is important along with the risks is an important part of treating acute cardiac events.  It is a scary time for the patient and knowing what is going on can help to ease anxiety and fears.

   

                                                References

Anderson, J. L., & Morrow, D. A. (2017). Acute Myocardial Infarction. The New England Journal of Medicine. doi: 10.1056/NEJMral606915

Brewer, L. C., Svatikova, A., & Mulvagh, S. L. (2015). The Challenges of Prevention, Diagnosis and Treatment of Ischemic Heart Disease in Women. Cardiovascular Drugs and Therapy, 29(4), 355–368. doi: 10.1007/s10557-015-6607-4

Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advanced practice providers. St. Louis, MO: Elsevier.

 
1 postsRe: Topic 5 DQ 2

This catastrophic earthquake took place on January 12, 2010, in the country of Haiti. With a magnitude of 7.0. on the Richter scale, this earthquake took many lives. An international relief operation was initiated soon after the earthquake happened. The United States sent thousands of military troops to Haiti to provide resources, help with finding lost loved ones and friends and help sustain peace.

According to Green (2018), “Primary prevention in disaster management involves planning prior to the disaster.” Thinking of the situation that is taking place and planning how to overcome the obstacles to help treat and save people. For instance, access to surgical, medical and emergency equipment, plans set in place to handle burns, trauma or other issues that might occur. Access needs to also be available to medications like antibiotics and IV fluid. Additionally, Green (2018) adds that “Secondary prevention may occur when the onset of the disaster has occurred or within hours of its impact; this is when the response occurs during a disaster.” This could be priority immunizations, including mass vaccination campaigns for tetanus immunization as part of wound care. This happens in the second phase to insure that once people are not in danger, they do not get an infection from a secondary situation. Secondary situations to educate on would be wound care and proper dressing change Finally, Green (2018 ) describes the last stage as “Tertiary prevention occurs after the offending event has ceased and the focus is on recovery.” This stage is when the recovery process begins. The duration of the recovery phase varies and can focus on the mental health of persons involved in the tragedy. Spiritual guidance and prayer are highly recommended at this stage to help people cope with the disaster.

There are many organizations that manage a crisis to this magnitude. One organization that I would work with is FEMA. FEMA is trained to respond to crisis situations and has a protocol already in place to follow to ensure the safest and most effective rescue and treatment for the public. I would also work with the American Red Cross. This organization is also highly trained to deal with disaster situations and getting proper supplies to people in need. I would also work with community churches and faith-based organizations to help people spiritually and mentally.

References

Community and Public Health: The Future of Health Care. (2018). Retrieved from Grand Canyon University (Ed.): https://lc.

Search the Library and find one new health care article that uses quantitative research. 

Complete an article analysis and ethics evaluation of the research using the “Article Analysis and Evaluation of Research Ethics” template. 

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

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Attachments HLT-362V-RS5-ArticleAnalysisEthicalEval-Template.docx