Promoting Positive Outcomes

Promoting Positive Outcomes Through Targeted Communication Within Cultural Groups

Promoting Positive Outcomes

Identify disparities in health among populations for a Healthy People 2020 health issue. For this assignment:

Describe the chosen Healthy People 2020 topic area and specific health issue.
Contrast causes of disparities related to this health issue within populations.
Propose a public health communication strategy to reduce disparity and promote health.
Outline a plan for the communication.
Describe an evaluation plan for the communication.
Create targeted communication for each population.
Reflect on learning through this project.
– formatted per current APA

– 5 – 7 pages in length, excluding the title, abstract and references page.

Incorporate a minimum of 3 current (published within last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work.

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Foundational Neuroscience

Foundational Neuroscience

NOTE: 300 words with 5 resources (2 below+3 others). Kindly read the instruction below.

As a psychiatric and mental health nurse practitioner, it is essential for you to have a strong background in foundational neuroscience. In order to diagnose and treat patients, you must not only understand the pathophysiology of psychiatric disorders but also how medications for these disorders impact the central nervous system. These concepts of foundational neuroscience can be challenging to understand. Therefore, this Discussion is designed to encourage you to think through these concepts, develop a rationale for your thinking, and deepen your understanding by interacting with your colleagues.

For this Discussion, reflect on the concepts of foundational neuroscience as they might apply to your role as the psychiatric mental health nurse practitioner in prescribing medications for patients.

ASSIGNMENT

Post a response to each of the following:

  1. Explain      the agonist-to-antagonist spectrum of action of psychopharmacologic      agents, including how partial and inverse agonist functionality may impact      the efficacy of psychopharmacologic treatments.
  2. Compare      and contrast the actions of g couple proteins and ion gated channels.
  3. Explain      how the role of epigenetics may contribute to pharmacologic action.
  4. Explain      how this information may impact the way you prescribe medications to      patients. Include a specific example of a situation or case with a patient      in which the psychiatric mental health nurse practitioner must be aware of      the medication’s action.

Resources

1). Camprodon, J. A., & Roffman, J. L. (2016). Psychiatric neuroscience: Incorporating pathophysiology into clinical case formulation. In T. A. Stern, M. Favo, T. E.Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 1–19). Elsevier.

2). The University of British Columbia (n.d.). Neuroanatomy videos. http://neuroanatomy.ca/videos.html

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Verbal And Nonverbal Communication In Public Speaking

Verbal And Nonverbal Communication In Public Speaking

Verbal And Nonverbal Communication In Public Speaking

Part I

Integrated communication refers to the energy public speakers bring to their presentation through the excitement of their voice, the sincerity of their face, their body language and gestures, and the intensity of their connection with listeners. When used together, these dimensions of integrated communication can create a powerful public speech. When communication is not integrated, a public speaker’s verbal communication often does not match his or her nonverbal signals. For example, imagine a news anchor who smiles while talking about an accident caused by a drunk driver or a speaker persuading an audience to travel to Hawaii with a monotone voice and lackluster appearance.

Part II

Respond to the following questions, and if it’s relevant, include your own personal experience:

  • Think about how you feel when your communication partner’s verbal statements clearly don’t match his/her nonverbal communication? What message does the audience receive when this happens with a speaker?
  • Give an example of when you experienced this, and explain what could have been done to improve the speaker’s communication integration. If you have never experienced this, think about the examples provided here and explain the steps public speakers in general should take to ensure their verbal communication matches their nonverbal signals.

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Nursing Evolution

Nursing Evolution

Nursing Evolution

Nursing Evolution

-How has nursing evolved since you graduated from your original nursing program? Is nursing today what you expected when you enter nursing education?

– Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources.

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spiritual beliefs influenced the mother’s reaction

 religious or spiritual beliefs influenced the mother’s reaction

spiritual beliefs influenced the mother’s reaction

DQ1:

1.  A family is gathered around in the ICU waiting room to monitor the status of a 22-year-old male, David, who sustained traumatic injuries in a motorcycle accident. He is in critical unstable condition with many wounds and severe abrasions. David’s mom keeps crying and saying, “What did I do to deserve this, God?” The family is Roman Catholic.

  • a.   What information should you ask the family regarding their culture, beliefs, and coping mechanisms?
  • b. The family wants to be at the bedside with David and requests to be present if he has a code blue or becomes asystolic.
  • c. What is your best response to their request?

2.  A 45-year-old divorced Filipino man with end-stage Alzheimer’s disease was found dead from hanging. While preparing the body for the morgue, the mother tells the nurse that he has disgraced the family and he will go to hell.

  • a.   What religious or spiritual beliefs influenced the mother’s reaction?
  • b. How should the nurse respond to the mother?

DQ2:

 

Please answer the following Discussion Question. Please be certain to answer the three questions on this week DQ and to provide a well-developed and complete answer to receive credit. Your main discussion answer needs to be at least 3 paragraphs in length with 3 references to justify your answer. Use APA format.

Also, please ensure to have read the assigned chapters for the current week.

  1. Do you believe nurses should belong to professional organizations?
  2. Describe your ideal health care system of the future.

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Assignment 1: Evaluation And Management

Assignment 1: Evaluation And Management

Assignment 1: Evaluation And Management

PLEASE FOLLOW INSTRUCTION BELOW, ZERO PLAGIARISM, FIVE REFERENCE NOT MORE THAN FIVE YEARS, 7TH APA FORMAT, RUBRIC & E/M PATIENT CASE SENERIO ATTACHED

Insurance coding and billing is complex, but it boils down to how to accurately apply a code, or CPT (current procedural terminology), to the service that you provided. The payer then reimburses the service at a certain rate. As a provider, you will have to understand what codes to use and what documentation is necessary to support coding.

For this Assignment, you will review evaluation and management (E/M) documentation for a patient and perform a crosswalk of codes from DSM-5-TR to ICD-10.

To Prepare

  • Review this week’s Learning Resources on coding, billing, reimbursement.
  • Review the E/M patient case scenario provided.

The Assignment

  • Assign DSM-5-TR and ICD-10 codes to services based upon the patient case scenario.

Then, in 1–2 pages address the following. You may add your narrative answers to these questions to the bottom of the case scenario document and submit altogether as one document.

  • Explain what pertinent information, generally, is required in documentation to support DSM-5-TR and ICD-10 coding.
  • Explain what pertinent documentation is missing from the case scenario, and what other information would be helpful to narrow your coding and billing options.
  • Finally, explain how to improve documentation to support coding and billing for maximum reimbursement.

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Prevention Of Communicable Diseases

Prevention Of Communicable Diseases

As a health care professional for an international health care network, you plan to visit 7 foreign countries this year as part of a communicable disease prevention program. Before you travel, you need to provide information to your assistants about the health care services in the countries you will be visiting, as well as on the World Health Organization (WHO), the agency that is concerned with international public health.

Research using the Library and other resources to address the following in 400 words :

Provide examples that show how the WHO is involved with global health care assistance.

Explain the role that the WHO plays in the prevention of communicable diseases.

Select 7 foreign countries, and briefly describe the communicable disease situation in the selected countries. Include your statistics in a table format.

What are the possible sources of financing for programs like the one in which you are involved?

Be sure to support your information by citing at least 2 scholarly references using APA format.

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Foreign Countries

Foreign Countries

Select 1–3 foreign countries, and provide the following information about the access, quality, and cost of health care in 3 pages :

  • Compare a foreign country’s quality of care to the United States’ quality of care.
  • Compare a foreign country’s cost of health care to the United States’ cost of health care.
  • Compare 1 of the foreign countries’ access to medical care to the United States’ access to medical care.
  • Give examples of how the World Health Organization (WHO) helps to provide health care in times of need.

Be sure to support your information by citing at least 2 scholarly references using APA format.

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Public Health

Public Health

Public Health

Public Health

Part 1

From the readings and your own research, discuss the evolution of epidemiology in public health. Choose 1 of the following key pioneers in the field, and discuss his influence and contribution to epidemiology in public health:

  • Hippocrates
  • John Graunt
  • Edward Jenner
  • Lemuel Shattuck
  • Edwin Chadwick
  • John Snow
  • Louis Pasteur
  • Robert Koch

Respond to other students who chose a pioneer different from the one you chose, and discuss how the contributions of both relate to each other. Show either how one paved the way or how one built on the work of those before him.

Part 2

Choose a disease or health condition Determine a local jurisdiction on which you would like to concentrate (city, township, county, or state). Examine the epidemiology of the chosen disease, reviewing its history and trend, comparing the national trend to the chosen local jurisdiction. Describe the local jurisdiction (population and demographics). This will be the introduction

2–3 pages in length and APA-formatted with in-text citations and references

A component of your final project is to complete a needs assessment of your target population pertaining to the disease or health issue for which you are proposing the need for an intervention or prevention program. A component of the needs assessment is to describe the disease or health issue to demonstrate the need.  Using the epidemiologic triad of people, time, and place, provide a descriptive analysis of the health issue and the impacted population.

For data on your chosen disease or health issue, review the following data sources:

Describe the disease in terms of the following:

  • People: Demographics of those impacted (age, race/ethnicity, gender)
  • Time: The time period of the data you are reviewing (5–10 years, 1 year, etc.)
  • Place: Built environment and other environmental factors

Represent the data in graphs, charts, and tables as relevant, accompanied by a brief explanation.

Describe the morbidity, mortality, incidence, and prevalence rates of the data. Describe differences in terms of age, race/ethnicity, and gender. Which age group, race, or gender seems to be most impacted by the morbidity and mortality data? What were the morbidity and mortality trends for the time period observed (5 or 10 years depending on the data)?

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RISK FACTORS FOR SUICIDE

RISK FACTORS FOR SUICIDE

Pathways Mental Health

Psychiatric Patient Evaluation

Instructions

  Use the following case template to complete Week 2 Assignment 1. On page 5, assign DSM-5 and ICD-10 codes to the services documented. You will add your narrative answers to the assignment questions to the bottom of this template and submit altogether as one document.

Identifying Information

  Identification was verified by stating of their name and date of birth. Time spent for evaluation: 0900am-0957am

Chief Complaint

  “My other provider retired. I don’t think I’m doing so well.”

HPI

  25 yo Russian female evaluated for psychiatric evaluation referred from her retiring practitioner for PTSD, ADHD, Stimulant Use Disorder, in remission. She is currently prescribed fluoxetine 20mg po daily for PTSD, atomoxetine 80mg po daily for ADHD. Today, client denied symptoms of depression, denied anergia, anhedonia, amotivation, no anxiety, denied frequent worry, reports feeling restlessness, no reported panic symptoms, no reported obsessive/compulsive behaviors. Client denies active SI/HI ideations, plans or intent. There is no evidence of psychosis or delusional thinking. Client denied past episodes of hypomania, hyperactivity, erratic/excessive spending, involvement in dangerous activities, self-inflated ego, grandiosity, or promiscuity. Client reports increased irritability and easily frustrated, loses things easily, makes mistakes, hard time focusing and concentrating, affecting her job. Has low frustration tolerance, sleeping 5–6 hrs/24hrs reports nightmares of previous rape, isolates, fearful to go outside, has missed several days of work, appetite decreased. She has somatic concerns with GI upset and headaches. Client denied any current binging/purging behaviors, denied withholding food from self or engaging in anorexic behaviors. No self-mutilation behaviors.

Diagnostic Screening Results

  Screen of symptoms in the past 2 weeks:  PHQ 9 = 0 with symptoms rated as no difficulty in functioning  Interpretation of Total Score  Total Score Depression Severity 1-4 Minimal depression 5-9 Mild depression 10-14 Moderate depression 15-19 Moderately severe depression 20-27 Severe depression  GAD 7 = 2 with symptoms rated as no difficulty in functioning  Interpreting the Total Score:  Total Score Interpretation ≥10 Possible diagnosis of GAD; confirm by further evaluation 5 Mild Anxiety 10 Moderate anxiety 15 Severe anxiety  MDQ screen negative PCL-5 Screen 32

Past Psychiatric and Substance Use Treatment

  Entered mental health system when she was age 19 after raped by a stranger during a house burglary. Previous Psychiatric Hospitalizations:  denied Previous Detox/Residential treatments: one for abuse of stimulants and cocaine in 2015 Previous psychotropic medication trials: sertraline (became suicidal), trazodone (worsened nightmares), bupropion (became suicidal), Adderall (began abusing) Previous mental health diagnosis per client/medical record: GAD, Unspecified Trauma, PTSD, Stimulant use disorder, ADHD confirmed by school records

Substance Use History

  Have you used/abused any of the following (include frequency/amt/last use): Substance Y/N Frequency/Last Use Tobacco products Y ½ ETOH Y last drink 2 weeks ago, reports drinks 1-2 times monthly one drink socially  Cannabis N Cocaine Y last use 2015 Prescription stimulants Y last use 2015 Methamphetamine N Inhalants N Sedative/sleeping pills N Hallucinogens N Street Opioids N Prescription opioids N Other: specify (spice, K2, bath salts, etc.) Y reports one-time ecstasy use in 2015 Any history of substance related:  Blackouts: +  Tremors:   – DUI: –  D/T’s: – Seizures: –  Longest sobriety reported since 2015—stayed sober maintaining sponsor, sober friends, and meetings

Psychosocial History

  Client was raised by adoptive parents since age 6; from Russian orphanage. She has unknown siblings. She is single; has no children. Employed at local tanning bed salon Education: High School Diploma Denied current legal issues.

Suicide / HOmicide Risk Assessment

  RISK FACTORS FOR SUICIDE: Suicidal Ideas or plans – no Suicide gestures in past – no Psychiatric diagnosis – yes Physical Illness (chronic, medical) – no Childhood trauma – yes Cognition not intact – no Support system – yes Unemployment – no Stressful life events – yes Physical abuse – yes Sexual abuse – yes Family history of suicide – unknown Family history of mental illness – unknown Hopelessness – no Gender – female Marital status – single White race Access to means Substance abuse – in remission PROTECTIVE FACTORS FOR SUICIDE: Absence of psychosis – yes Access to adequate health care – yes Advice & help seeking – yes Resourcefulness/Survival skills – yes Children – no Sense of responsibility – yes Pregnancy – no; last menses one week ago, has Norplant Spirituality – yes Life satisfaction – “fair amount” Positive coping skills – yes Positive social support – yes Positive therapeutic relationship – yes Future oriented – yes Suicide Inquiry: Denies active suicidal ideations, intentions, or plans. Denies recent self-harm behavior. Talks futuristically. Denied history of suicidal/homicidal ideation/gestures; denied history of self-mutilation behaviors Global Suicide Risk Assessment: The client is found to be at low risk of suicide or violence, however, risk of lethality increased under context of drugs/alcohol. No required SAFETY PLAN related to low risk

Mental Status Examination

  She is a 25 yo Russian female who looks her stated age. She is cooperative with examiner. She is neatly groomed and clean, dressed appropriately. There is mild psychomotor restlessness. Her speech is clear, coherent, normal in volume and tone, has strong cultural accent. Her thought process is ruminative. There is no evidence of looseness of association or flight of ideas. Her mood is anxious, mildly irritable, and her affect appropriate to her mood. She was smiling at times in an appropriate manner. She denies any auditory or visual hallucinations. There is no evidence of any delusional thinking. She denies any current suicidal or homicidal ideation. Cognitively, She is alert and oriented to all spheres. Her recent and remote memory is intact. Her concentration is fair. Her insight is good.

Clinical Impression

  Client is a 25 yo Russian female who presents with history of treatment for PTSD, ADHD, Stimulant use Disorder, in remission. Moods are anxious and irritable. She has ongoing reported symptoms of re-experiencing, avoidance, and hyperarousal of her past trauma experiences; ongoing subsyndromal symptoms related to her past ADHD diagnosis and exacerbated by her PTSD diagnosis. She denied vegetative symptoms of depression, no evident mania/hypomania, no psychosis, denied anxiety symptoms. Denied current cravings for drugs/alcohol, exhibits no withdrawal symptoms, has somatic concerns of GI upset and headaches. At the time of disposition, the client adamantly denies SI/HI ideations, plans or intent and has the ability to determine right from wrong, and can anticipate the potential consequences of behaviors and actions. She is a low risk for self-harm based on her current clinical presentation and her risk and protective factors.

Diagnostic Impression

  [Student to provide DSM-5 and ICD-10 coding] Double click inside this text box to add/edit text. Delete placeholder text when you add your answers.

Treatment Plan

  Medication: Increase fluoxetine 40mg po daily for PTSD #30 1 RF Continue with atomoxetine 80mg po daily for ADHD. #30 1 RF Instructed to call and report any adverse reactions. Future Plan: monitor for decrease re-experiencing, hyperarousal, and avoidance symptoms; monitor for improved concentration, less mistakes, less forgetful Education: Risks and benefits of medications are discussed including non-treatment. Potential side effects of medications discussed. Verbal informed consent obtained. Not to drive or operate dangerous machinery if feeling sedated. Not to stop medication abruptly without discussing with providers. Discussed risks of mixing medications with OTC drugs, herbal, alcohol/illegal drugs. Instructed to avoid this practice. Praised and Encouraged ongoing abstinence. Maintain support system, sponsors, and meetings. Discussed how drugs/ETOH affects mental health, physical health, sleep architecture. Patient was educated about therapy and services of the MHC including emergent care. Referral was sent via email to therapy team for PET treatment. Patient has emergency numbers: Emergency Services 911, the national Crisis Line 800-273-TALK, the MHC Crisis Clinic. Patient was instructed to go to nearest ER or call 911 if they become actively suicidal and/or homicidal. Time allowed for questions and answers provided. Provided supportive listening. Patient appeared to understand discussion and appears to have capacity for decision making via verbal conversation. RTC in 30 days Follow up with PCP for GI upset and headaches, reviewed PCP history and physical dated one week ago and include lab results Patient is amenable with this plan and agrees to follow treatment regimen as discussed.
 

Narrative Answers

 

[In 1-2 pages, address the following:

· Explain what pertinent information, generally, is required in documentation to support DSM-5 and ICD-10 coding.

· Explain what pertinent documentation is missing from the case scenario, and what other information would be helpful to narrow your coding and billing options.

· Finally, explain how to improve documentation to support coding and billing for maximum reimbursement.]

Add your answers here. Delete instructions and placeholder text when you add your answers.

References

[Add APA-formatted citations for any sources you referenced]

Delete instructions and placeholder text when you add your citations.

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