Recent orders
LEGISLATORS BELONGING TO THE MENTAL HEALTH INITIATIVE COMMITTEE
September 8, 2018
to: Legislators belonging to the mental health initiative committee
from: Diamond marie breland
subject: Buidling bridges to accessible mental health care
CC: Dr. Nandan kumar jhA
Introduction
The inaccessibility to Mental Health has become problematic in the United States. Each year, millions of Americans with mental illness struggle to find care. Nearly half of the 60 million adults and children living with mental health conditions in the United States go without any treatment. People who do seek treatment must navigate a fragmented and costly system full of obstacles. Many people cannot access mental health care when they most need it. Despite the passage of federal mental health and addictions parity law in 2008, significant barriers exist in accessing mental health treatment and support. Barriers include high rates of denials of care by insurers, high out-of-pocket costs for mental health care, difficulties accessing psychiatric medications and problems finding psychiatrists and other mental health providers in health insurance networks. In 2016, NAMI, the National Alliance on Mental Illness, conducted its third nationwide survey to explore the relationship between health coverage and access to mental health care. The survey found that people with mental illness continue to experience significant barriers to finding affordable, accessible mental health care. These barriers exist whether the person is covered by private insurance or by a public plan such as Medicaid.
Specific Challenges
Difficulty finding a new provider
Current Providers are overwhelmed
Not enough providers to meet demand
Providers are not located in areas of high need
Providers are not responding to inquires
Out of Pocket Costs are too high making it unaffordable
Lack of inpatient mental health care facilities
The stigma surrounding mental health treatment
Future Challenges
If the inaccessibility to mental health services isn’t resolved, this can lead to complicating and detrimental challenges in other sectors of society.
An increase in homelessness
According to the Substance Abuse and Mental Health Services Administration, 20 to 25% of the homeless population in the United States suffers from some form of severe mental illness. In comparison, only 6% of Americans are severely mentally ill (National Institute of Mental Health, 2009).
An increase in incarceration rates
As a result, 2 million people with mental illness are booked into jails each year. Nearly 15% of men and 30% of women booked into jails have a serious mental health condition. (National Institute of Mental Health, 2009).
An increase in avoidable emergency room visits
Between 2007 and 2011, the rate of ED visits related to M/SUDs increased by over 15 percent (National Institute of Mental Health, 2016). ED visits involving M/SUDs are considered potentially avoidable—if these conditions were adequately managed through appropriate outpatient care, then ED visits should be rare (Owens, et all. 2017).
Implementation
Policy Analysis on the problem of mental health care being inaccessible needs to happen fast as people are falling victim to their untreated mental health illnesses. Mental health illness is a contributor to other negative events that are occurring in our country. By addressing the mental health of our citizens, we are giving people the ability to continue their pursuit of happiness in this country. Inaccessibility to Mental health in a public health crisis where the cure can be found through policy analysis. We ask that you allot funding to research the best practices to address the challenges set forth in this memo. Exploration and implementation cannot be done without support from your legislation.
Separation of Spinach Pigments by Column Chromatography
Separation of Spinach Pigments by Column Chromatography
Theoretical Background
Chromatography is the science which studies the separation of molecules based on differences in their structure and/or composition [1]. Chromatography involves a sample (or sample extract) being dissolved in a mobile phase (which may be a gas, a liquid or a supercritical fluid). The mobile phase is then forced through an immobile, immiscible stationary phase. The phases are chosen such that components of the sample have differing solubilities in each phase. A component which is quite soluble in the stationary phase will take longer to travel through it than a component which is not very soluble in the stationary phase but very soluble in the mobile phase. As a result of these differences in mobilities, sample components will become separated from each other as they travel through the stationary phase [2].
Chromatographic separations can be carried out using a variety of supports, including immobilized silica on glass plates (thin layer chromatography), volatile gases (gas chromatography), paper (paper chromatography) and liquids which may incorporate hydrophilic, insoluble molecules (liquid chromatography) [1]. Column chromatography is another of the isolation and purification techniques used extensively by organic chemists to obtain pure samples of chemicals from natural sources or from reaction sequences [3].
If the compounds to be separated in a column chromatography are colored (as is the case for the pigments to be isolated in this experiment) then the progress of the separation can simply be monitored visually. However, it is more common that the compounds to be isolated from a column chromatography are colorless. In that case, several means for monitoring the separation progress have been devised. One of the simplest of these involves the collection of relatively small fractions of the eluent in labeled tubes and the analysis of the component(s) of these fractions by the technique of thin layer chromatography [4].
Column Chromatography of Spinach Pigments
Two categories of molecules are primarily for photosynthesis in plants: the chlorophylls and the carotenoids. Chlorophylls, the green pigments, absorb certain wavelenghts of light that are then converted into chemical energy. Examples of chlorophylls are chlorophyll a, chlorophyll b, pheophytin a, and pheophytin b. The structure of chlorophyll a is shown below. In chlorophyll b, the starred (*) methyl group is replaced by a –CHO group. Pheophytin a and b are identical to chlorophyll a and b, respectively, except that in these molecules, the Mg2+ ion is replaced by 2H+ ions [4].
Figure 1. Chlorophyll a
Carotenoids, the yellow pigments found in spinach, are also involved in photosynthesis. The structure of β-caretone is given below. α-Caretone differs from β-caretone in the placement of the double bond on one of the rings. Xanthophylls are oxygen-containing derivatives of the carotenes [4].
β-caretone
Carotene is the compound which gives butter and margarine their characteristic yellow color. Cows eat the caretone-containing green grass, but do not metabolize the carotene entirely, and it ends up in their milk and, thus, in the butter made from the milk. At certain times of the year, the food which cows eat does not contain carotene, and the butter made from this milk is white. Since the consumer prefers yellow butter (and margarine), the dairy companies used to add a dye called Butter Yellow to white butter. However, Butter Yellow (an azo dye) was found to be carcinogenic. Currently, butter and margarine are colored with synthetic carotene [5].
In this column chromatography experiment, you will separate the pigments from the spinach. An aliquot experiment of the extracted spinach will be applied to an silica column. Although there are many different components in the extract, they separate into two main bands on the column. The fastest-moving band (yellow) contains the carotenes and the slower-moving band (green) contains the chlorophylls.
APPARATUS
Equipment
Chromatography column Funnel
Erlenmeyer flask 50 mL * 6 Pipette 10 mL * 4
Mortar and pestle Beaker 400 mL
Beaker 100 mL Clamps, Ring
Stand Suction bulb
Chemicals
Silica Gel
Acetone, CH3COCH3
Petroleum ether
Sodium chloride, NaCl
Calcium carbonate, CaCO3
Sodium sulfate, Na2SO4
PROCEDURE
Preparation of the column
Fill the column with dry silica.
Put 1-2 mL 7:3 petroleum ether and acetone solution into the column to create a gel.
Collected excess solvent can be reused to place the column.
Preparation of spinach sample
Put the spinach into a mortar; add 3 mL acetone, 1 mL petroleum ether and spatula tip of calcium carbonate, CaCO3.
Grind the leaves until the pieces are too small to be seen and then filter the pigment extract if needed.
Put the filtrate into a separatory funnel and add 20 mL petroleum ether and 20 mL 10% NaCl solution.
Shake the separatory funnel and drain the lower layer into a beaker.
Wash the upper layer twice with 5 mL distilled water.
Then put the extract into a 50 mL erlenmeyer flask and add a spatula tip of sodium sulfate, Na2SO4, then decant the solution in another 50 mL erlenmeyer flask. Evaporate the excess solvent if needed.
Performing the column chromatography
Using a pipette, add 1-2 mL leaf extract to the top of the column.
Let the elute pass through the column slowly. As the eluent passes down the column, the sample is developed.
When the yellow band reaches the bottom of the column, collect layer in a test tube.
Add more of your solvent system to elute the remaining fraction.
Change the test tube as the eluent changes color. Separation of the sample is achieved.
If needed, evaporate the excess solvent in the sample, close the sample test tubes with parafilm and store.
TLC analysis
Perform a TLC analysis of your mixture and each fraction you’ve collected to confirm adequate separation
Calculate the Rf value for each spot
Results
Create a table containing following information about each spot: appearance, distance traveled, Rf value
Sketch your TLC plate
Attempt to identify each of the spots
Post-Lab Questions
Why are the chlorophylls less mobile than the carotenes on the TLC plate?
Very polar compounds are sometime purified by reverse phase chromatography where the stationary phase is very nonpolar while the solvent is very polar. Why might one want to use this technique with extremely polar compounds?
REFERENCES
Mckay, P., An Introduction to Chromatography, The National Health Museum http://www.accessexcellence.org/LC/SS/chromatography_background.html
Sheffield Hallam University, School of Science and Mathematics, Chromatography http://www.shu.ac.uk/schools/sci/chem/tutorials/chrom/chrom1.htm
Norman, R.O.C., Waddington, D.J., “Modern Organic Chemistry”, Mills and Boon, London, 1974.
Column Chromatography, Lab Techniques, Colorado University, 2005 http://orgchem.colorado.edu/hndbksupport/colchrom/colchrom.html
Nichols, M.A, Introduction to Chromatography, 2003
http://chemistry.jcu.edu./nicholsweb/ch223f01/spinachextraction.pdf
Sentinel City Simulation
Sentinel City Simulation
Lucreshia Jackson
American Sentinel College of Nursing & Health Sciences
Dr. Teri Logghe
19th September 2022
Sentinel City Simulation
The overall population of Sentinel City is 663,862 people with its four neighborhoods; Caser park district, Industrial Heights, Nightingale square, and Acer Tech Center. The highest population is found in the Casper Park district with a population of 352,643 people and the lowest population of 38,855 is found in the Industrial Heights neighborhood. The other two neighborhoods have a population of 103,974 people in Nightingale square and 168,390 people in Acer Tech. Among this population, the persons over the age of 65 years are 10.5% of the total population, those under the age of 18 who are the majority make up 21.7% of the total population and the rest,7.4% is of those persons who are under the age of 5 years. The city is comprised of several racial groups. The majority of these racial groups are the whites at 80.6% and the lowest racial group is Alaska and Native Americans who constitute 2% of the total population. Other racial groups include Asians at 3.7%, Latinos and Hispanics at 31.5%, and Native Americans who constitute 10.4% of the total population (Sentinel City, 2022).
In Nightingale, most of the population is the Whites at 81.3% and the least populated are the Latino/Hispanic at 3.7%. The majority of the age groups in Nightingale are of age between 18 and 64 years at 77.82%, children under 5 years constitute 2.4% of the population while those under the age of 18 years are at 5.9% of the population, and 13.9% are people above the age of 65 years. In Acer Tech Center, the most dominant race is the whites who constitute 70.2% of the population, The Latinos/ Hispanics constitute 13.7% of the population. Children under the age of 17 years constitute 11.1% of the population while those above the age of 65 years are at 19.8% of the population. Casper Park District’s population has whites as the majority at 63% of the population while Latinos/Hispanics constitute 24% of the population. Children under the age of 5 years are at 10.9% of the population, children below the age of 18 years at 33.8% of the population, and those above the age of 65 years are at 6.5% of the population. The population in Industrial Heights has Latinos/Hispanics as the majority ethnic group at 46.8% of the population, and African Americans at 13.1% of the population. The people above the age of 65 years in this neighborhood are 0.9% of the population (Sentinel City, 2022).
The median household income of Sentinel City is $49,091. The lowest median income is in Industrial Heights with an income of $24,672. The highest median income is at Nightingale Square with an income of $269,550. The other neighborhoods have a median household income of $80,134 in Casper Park District and an income of $166,300 Acer Tech community. The population in sentinel City that lives below the level of poverty is 18.9%. The non-insured residents in each of the four neighborhoods are 22.7% in Casper Park, 1.5% in Acer Tech Center, 0.7% in Nightingale Square, and 37.5% in Industrial Heights (Sentinel City, 2022).
Poverty signs in this city can are evident in the Industrial Height neighborhood where the buildings have old bricks and cracks with so much graffiti on them. Some homeless people are seen on the streets, especially along the Inter-Faith Church. The neighborhood also has plenty of trash cans and more garbage spilled especially in the Bogeda Market and the street along School District. There are also garbage heaps that are very large around the buildings with rats running around them in Industrial Height, especially along the Acer Condominium. There is also a fire and a burning car that can be observed near the Soup Kitchen with the smoke polluting the air. Most of the buildings are either abandoned or in need of repair. The streets also have sinkholes with cracks on them. Other signs of poverty especially in this neighborhood of Industrial Heights are its lowest household income of $24,672 and also it has the highest number of non-insured residents which is 37.5% of the total population in Sentinel City (Sentinel City, 2022).
While I take the trip through the city, I could observe more police officers, especially in the two neighborhoods of Industrial Heights and Casper Park District. I could also see many people riding bikes and others running since the city is very much urban. The city is also active with children playing in their respective schools, running, and riding their bikes, people could be seen talking in various outdoor eateries, and many people visit on the sidewalks. There were also a few individuals using crutches, wheelchairs, and walkers but there were no accessibility ramps in the City. Some dogs could be seen roaming around the streets. There are also a few homeless individuals on the streets. Most of the population in the city seemed to be whites with a few Middle Eastern men and a single African American man that could be seen walking along the sidewalks.
I could also notice that the city is more of an urban area with fewer trees even in areas along the park. There is also much less space for outdoor recreation. Many people in this city however utilize public transportation means as many people around the bust stops could be seen waiting for the bus. Many people could be seen using bicycles for transport and also others who lived around the city traveling by foot. Others could use personal cars as I observed parked cars on the streets. There are also many places where people could meet and socialize such as tennis courts in the Nightingale Square neighborhood, outdoor restaurants, or hanging out around stores such as Joe’s market.
The city also has few centers. For example the Senior Center in Nightingale. There are also churches for example the Catholic Church in Industrial Heights. This church has a soup kitchen that serves 12% veterans,7% disabled adults, 64% homeless people, 6% elderly, 7% disabled, 25 healthy children, 3% homeless children, and 6% healthy adults. It serves between 39,000 and 51,000 meals per month (Sentinel City, 2022). There is also the Interfaith Church. There is also a Muslim faith since I could observe men dressed in robes and women in their veils as I took a trip around the city. The churches were in good shape indicating that these institutions were being used frequently. There are also medical centers with nursing homes. There are playing grounds for children. There were also more dining and shopping centers around the city such as Joe’s Grocery, Fresh Market, and The Bodega.
The community services available in the City include parks and recreational facilities that offer educational programs such as swimming classes, adult fitness, gardening and food programs, city sports, and summer camps for the kids. The system of healthcare also offers services to the elderly such as service animals, senior transportation, abuse prevention advocates for the elders, community centers, medical care advocates, service animals, and government entitlement assistance. There are other senior living options offered such as swing beds, living units for the seniors, nursing home units, and long-term care. The city hall offers services to victims of assault, legal aid, shelter, emergency and therapy funds, and group treatment. The housing project offers the house to low-income persons or families as their rentals are 2 or 1-bedroom units and studios.
From my analysis of this City, I noticed that the area with the highest median household income was a nice area with more insured residents in that area. For example, Nightingale square with the highest median income had the least insured individuals compared to Industrial Heights with the lowest median income and the highest number of uninsured individuals. The poorest part of the city was Industrial Heights with characteristics such as garbage all over the streets, abandoned and old buildings, and buildings that are rats infested. The area which was the richest is Nightingale square because its streets and buildings were well kept and clean. I also noticed that income is the biggest issue that affects tye population of this city. For instance, those people living in Industrial Heights and are insured live in conditions that are unhealthy with no or little access to healthcare and therefore are more vulnerable to diseases in this area compared to other areas in Sentinel City.
One of my target populations of interest in the City is the younger adults between the ages of 14-25 years who make up around 30% of the population. After my first stop at the Better Health clinic in this city, I observed that almost 75% of the people diagnosed with gonorrhea were individuals between these age brackets. Therefore, the major concerns of health to this target population are their vulnerability to sexually transmitted infections. HPV was among 45% of this population and 60% had chlamydia. According to the World Health Organization, most STI infections are at higher rates for people between 20-24 years followed by 15-19 years old (Mcharo et al., 2022). This number is so shocking and makes me question the main cause of these particular cases. Therefore, the city lacks sex education services for the youths, and also the poverty levels could be the reason. Another health concern is the lack of space for outdoor recreation activities. There are also few basketball or tennis courts and no hiking or bike trails for the kids. This leads to the kids being inactive. According to (Marker et al., 2018) fitness and exercise activities improve the quality of life.
The simulation, therefore, has provided an emerging experience on how to pay attention to the good stuff in our community. Going through all the data presented in this report, therefore, provides me with the skills of developing the correlation between health and the income of my community as well. With this experience, I know that in some way I can be able to contribute to huge changes in my community to improve the well-being of the people in my community as I can be able to identify the areas that need to be fixed.References
Marker, A. M., Steele, R. G., & Noser, A. E. (2018). Physical activity and health-related quality of life in children and adolescents: A systematic review and meta-analysis. Health Psychology, 37(10), 893.
Mcharo, R. D., Kisinda, A., Njovu, L., Mcharo, M., Mbwilo, F., Mihale, G., … & Msuya, S. E. (2022). Prevalence of and risk factors associated with HIV, Herpes Simplex Virus-type 2, Chlamydia trachomatis, and Neisseria gonorrhoeae infections among 18–24-year-old students attending Higher Learning Institutions in Mbeya-Tanzania. PloS one, 17(5), e0266596.
Sentinel, C. (2022). Getting on the bus: evaluation of Sentinel City® 3.0 virtual simulation in community/population health clinical placement. International Journal of Nursing Education Scholarship, 17(1).