“Reform of Healthcare Market and Regulation and Antitrust Policy in Health Care”  Please respond to the following:

• From the  United States Department of Health and Human Resources , synthesize the primary ways in which consumer and provider incentives work together to achieve cost reduction under the Affordable Care Act (ACA). Provide at least one (1) example of such synthesis to support your response.
• Defend or critique the key provisions of antitrust legislation in the United States. Analyze the major ways in which quality issues in health care affect antirust healthcare policy. Provide at least one (1) example of antitrust laws in action to support your response.

In collaboration with your approved course mentor, you will identify a specific evidence-based practice proposal topic for the capstone project. Consider the clinical environment in which you are currently working or have recently worked. The capstone project topic can be a clinical practice problem, an organizational issue, a quality improvement suggestion, a leadership initiative, or an educational need appropriate to your area of interest as well as your practice immersion (practicum) setting. Examples of the integration of community health, leadership, and an EBP can be found on the “Educational and Community-Based Programs” page of the Healthy People 2020 website.

Write a 750-1000 words description of your proposed capstone project topic. Make sure to include the following:

1. The problem, issue, suggestion, initiative, or educational need that will be the focus of the project . {Problem:Childhood Obesity]
2. The setting or context in which the problem, issue, suggestion, initiative, or educational need can be observed.
3. A description providing a high level of detail regarding the problem, issue, suggestion, initiative, or educational need.
4. Impact of the problem, issue, suggestion, initiative, or educational need on the work environment, the quality of care provided by staff, and patient outcomes.
5. Significance of the problem, issue, suggestion, initiative, or educational need and its implications to nursing.
6. A proposed solution to the identified project topic

You are required to retrieve and assess a minimum of 8 peer-reviewed articles. Plan your time accordingly to complete this assignment.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

 Provide peer response to the following discussion which requires  one reference from a peer-reviewed NURSING journal less than 5 y/o. Response has to be in APA format.

Discussion One:

According to de Chesnay and Anderson (2015), a vulnerable population is, generally speaking, a group of individuals who have an increased risk of developing physical, social, or psychological health problems (de Chesnay & Anderson, 2015, p. 3). This could be the case either due to genetic predispositions, life events, or any other circumstances that can influence a patient’s socioeconomic, physical, or psychological status.

De Chesnay and Anderson (2015) state that there are some major factors by which the vulnerable populations can be identified: ethnicity, immigration status, age, gender, and socioeconomic status, but there are many other factors that should be taken into consideration (de Chesnay & Anderson, 2015, p. 4). Based on these factors, high-risk population groups can be identified and assessed.

One of the vulnerable population groups are the elderly. As Oster and Oster (2015) mention cellular changes occur as part of the aging process, and therefore, the body fluids and bone mass decrease (Oster & Oster, 2015, p. 445). This puts the elderly at increased risk for injuries and prolongs or hinders the 

healing process after injuries or surgical interventions.

Other changes that contribute to an increased risk for physical, psychological, or social health problems are age-related confusion and depression. Oftentimes elderly people live alone after the loss of a spouse. They might not leave the house at all due to their depression and therefore, show signs of from malnutrition, a lack of hygiene, or medication non-compliance. Many times the psychological changes go hand in hand with the physiological ones.

No plagiarism please.

Will need minimum of 150 words for each response, APA Style, double spaced, times new roman, font 12, and and Include: (1 reference for each response within years 2015-2018) with intext citations. 

An adolescent’s concerns about privacy can prevent them from seeking primary health care, especially for specific sensitive health care services such as STI screening and family planning issues. Those with privacy concerns are also less likely to talk openly with a health care clinician about important health issues, such as substance use, mental health, and risky sex. Recognizing that confidentiality is critical to high-quality care for adolescent women, professional health care organizations have adopted policy statements and practice guidelines that support the provision of confidential services. 

Discuss these guidelines and the laws in your state that address adolescent confidential health care.

Peer Response 1

This is a great discussion topic, because I have often thought about adolescent care and confidentiality, but have never gotten the chance to thoroughly investigate the topic. I have worked with adult populations and therefore it has never been a big issue in my professional career. We all know that adolescent brains are not fully developed and they require teaching, support and valid resources when they encounter problems in their lives. This is why laws were enacted to allow adolescents to see a provider confidentially and seek medical help from a professional without the repercussions from their parents who may disapprove of their actions or situation.

            In my state of Idaho, mental health services are confidential for adolescents after the age of 14 and cannot be shared with the parents without written consent of the adolescent unless they need to disclose information in order to bill insurance, carry out a treatment plan or prevent harm to the child or others or if they are ordered to by a court of law (Children’s Mental Health Services, 2018). Therefore, the clinician does have quite a bit of wiggle room in the statue because a majority of mental health issues can result in harm to the child or others. Either way, it’s good to understand that the age of 14 is the deciding factor. After 18 though, it is all confidential and no parents have rights to the individual’s medical records.

As for medical information. Every state allows adolescents to be seen, screened and treated for sexually transmitted infections and diseases without release of information to the parents. This law was passed as research was conducted that indicated that adolescents were MUCH less likely to seek medical help for STD’s if they knew their parents would find out. Therefore, in an attempt to decrease the prevalence of STD’s, no parental consent or notification is necessary (Bornstein, 2000). Even though confidentiality is attempted in this population with sensitive sexual or reproductive issues, obstacles to patient privacy remain. Overall, from what I can find, the provider in Idaho has the discretion to notify parents of any medical information of an adolescent.

Peer Response 2

When it comes to healthcare, Patient’s confidentiality is paramount, a sensitive issue, and is part of the law in many states.  When caring for adolescent patients, care is not any different.  If a minor is seeking care and fears his or her information would be disclosed to their parents, it might prevent them from seeking preventative care such as contraceptives, pregnancy testing, sexually transmitted infection testing, or even psychological help if needed.  Unless, the provider suspects neglect or abuse, confidentially should always be provided to adolescents.  Judgement by the provider regarding the best medical interest and safety of the patient should prevail (AAFP, 2013). 

In the state of Florida, the Florida Legislature (2017) there are some cases a minor could consent for their own care without a parent’s consent.  For example, if the minor is not married and pregnant or a mother, she could consent for herself and for her child; if the minor is seventeen years-old he could consent for blood donation; also, contraceptives and services of a nonsurgical nature; confidential medical services and counselling related to substance abuse and mental health outpatient counselling and treatment to minors, that does not need medications and other somatic treatments or less than two outpatient visits.

Healthcare providers must be familiar with their federal and state laws related to adolescent consent and confidentiality.  Respecting adolescent patient’s rights and privacy is essential, but as a provider encouraging the adolescent seeking care to talk to their parents regarding their health could promote better communication between child and parents.  In some facilities, the provider may make a verbal contract with the parents and teenager regarding confidentiality.  This would assure the patient that any information obtain during the visit will remain in strict confidence unless the provider thinks it could pose a danger to the patient or if the patient themselves want to share the information with their parents. 

Ultimately as a healthcare provider, it is important to protect patient’s privacy and confidentiality but, at the same time, we must be aware that in all states, a person needing emergency medical treatment they may be treated without consent if securing a consent would delay treatment and places the patient’s life or health at risk (Olson and Middleman, 2018).  Patient care should not be delayed under any circumstances that will pose harm to the patient or cause death.   

 NEED 9/3/18 Please use attached file to complete assignment Please no plag

Prepare: View the Globalization at a Crossroads (Links to an external site.)Links to an external site. series episode and read the article A Model of Global Citizenship: Antecedents and Outcomes by Stephen Reysen and Iva Katzarska-Miller (2013). Go to the Ashford University Library, and locate one additional source on global citizenship that will help support your viewpoint.

Reflect: Please take some time to reflect on how the concept of global citizenship has shaped your identity, and think about how being a global citizen has made you a better person in your community.

Write: Use the Week 1 Example Assignment Guide when addressing the following prompts:

• Describe and explain a clear distinction between “globalism” and “globalization” after viewing the video and reading the article.
• Describe how being a global citizen in the world of advanced technology can be beneficial to your success in meeting your personal, academic, and professional goals.
• Explain why there has been disagreement between theorists about the definition of global citizenship and develop your own definition of global citizenship after reading the article by Reysen and Katzarska-Miller.
• Choose two of the six outcomes of global citizenship from the article (i.e., intergroup empathy, valuing diversity, social justice, environmental sustainability, intergroup helping, and the level of responsibility to act for the betterment of this world).
  • Explain why those two outcomes are the most important in becoming a global citizen compared to the others.
• Describe at least two personal examples or events in your life that illustrate the development of global citizenship based on the two outcomes you chose.
• Identify two specific general education courses.
  • Explain how each course influenced you to become a global citizen.

The Importance of Becoming a Global Citizen

• Must be 750 to 1,000 words in length (not including title and references pages) and formatted according to APA style, as outlined in the Ashford Writing Center’s APA Style (Links to an external site.)Links to an external site.
• Must include a separate title page with the following:
  • Title of paper
  • Student’s name
  • Course name and number
  • Instructor’s name
  • Date submitted
• For further assistance with the formatting and the title page, refer to APA Formatting for Word 2013 (Links to an external site.)Links to an external site..
• Must utilize academic voice. See the Academic Voice (Links to an external site.)Links to an external site. resource for additional guidance.
• Must include an introduction and conclusion paragraph. Your introduction paragraph needs to end with a clear thesis statement that indicates the purpose of your paper.
  • For assistance on writing Introductions & Conclusions (Links to an external site.)Links to an external site. as well as Writing a Thesis Statement (Links to an external site.)Links to an external site., refer to the Ashford Writing Center resources.
• Must use at least one credible source in addition to the two required sources (video and article).
  • The Scholarly, Peer Reviewed, and Other Credible Sources (Links to an external site.)Links to an external site. table offers additional guidance on appropriate source types. If you have questions about whether a specific source is appropriate for this assignment, contact your instructor. Your instructor has the final say about the appropriateness of a specific source for an assignment. The Integrating Research (Links to an external site.)Links to an external site. tutorial will offer further assistance with including supporting information and reasoning.
• Must document in APA style any information used from sources, as outlined in the Ashford Writing Center’s In-Text Citation Guide (Links to an external site.)Links to an external site..
• Must have no more than 15% quoted material in the body of your essay based on the Turnitin report. References list will be excluded from the Turnitin originality score.
• Must include a separate references page that is formatted according to APA style. See the Formatting Your References List (Links to an external site.)Links to an external site. resource in the Ashford Writing Center for specifications.

Before you submit your written assignment, you are encouraged to review the review the Grammarly (Links to an external site.)Links to an external site. page tutorial, set up a Grammarly account (if you have not already done so), and use Grammarly to review a rough draft of your assignment. Then carefully review all issues identified by Grammarly and revise your work as needed.