NR-503 Epidemiology final
Cultural Awareness
:Self-examination of one's own prejudices and biases toward other cultures. An in-depth exploration
of one's own cultural/ethnic background.
Cultural competence in nursing consists of four principles.
Care is designed for the specific client.
Care is based on the uniqueness of the person's culture and includes cultural norms and values.
Care includes self-employment strategies to facilitate client decision making to improve health
behaviors.
Care is provided with sensitivity and is based on the cultural uniqueness of clients.
The APN may also use the Kleinman Explanatory Model of Illness (1978). Below are the questions that
can be utilized.
What do you call your problem?
What do you think caused your problem?
Why do you think it started when it did?
What does your sickness do to you?
What do you fear most about your sickness?
What are the chief problems your sickness has caused you?
What kind of treatment do you think you should receive?
What is the most important result you hope to receive from the treatment?
According to Giger and Davidhizer (2000), although cultures differ, they all have the same basic
organizing factors that must be assessed in order to provide care for culturally diverse patients. These
factors include
communication (verbal and nonverbal);
personal space;
social organization;
time perception;
environmental control; and
biological variations.
The NCCC uses four major approaches to fulfill its mission, including
Web-based technical assistance, (2) knowledge development and dissemination, (3) supporting a
community of learners, and (4) collaboration and partnerships with diverse groups.
Epidemiological Triad:
host, agent, environment
Genetics
The study of individual genes and their impact on relatively rare single gene disorders
Absolute risk
is the probability of an event, such as illness, injury, or death. Gives no indication of how its
magnitude compares with others
,The odds ratio
closely approximates the relative risk if the disease is rare.
Odds ratio and the relative risk are used
to assess the strength of association between risk factor and outcome.
How is Attributible risk used
is used to make risk-based decisions for individuals.
Population-attributable risk measures
are used to form public health decisions
EGAPP:
Evaluation of Genomic Applications in Practice and Prevention
GAPPNet
Genomic Applications in Practice and Prevention Network (established in 2009) is a collaborative
initiative involving partners from across the public health sector working together to realize the
promise of genomics in health care and disease prevention.
GEDDI
Genetics Early Disease Detection Intervention project (GEDDI) (established in 2009) developed a
model strategy for using clinical, genetic, and family history information to reduce the risk of disease,
death, and disability in affected individuals, family members, and populations.
HuGENet
Human Genome Epidemiology Network (HuGENet) (established in 1998) helps translate genetic
research findings into opportunities for preventive medicines and public health by advancing the
synthesis, interpretation, and dissemination of population-based data on human genetic variation in
health and disease. HuGENet reviews are systematic, peer-reviewed synopses of the epidemiologic
aspects of human genes, including prevalence of allelic variants in different populations, population-
based information on disease risk, evidence for gene-environment interaction and quantitative data
on genetic tests and services carried out according to specific guidelines.
NHANES III
DC's Office of Public Health Genomics (established in 2002) formed a multidisciplinary working group
with members from across CDC. It developed a proposal to measure the prevalence of selected
genetic variants of public health significance in a representative sample of the U.S. population and to
examine the association between the selected genetic variants and disease outcomes available in
NHANES III data.
The World Health Organization defines a pandemic
as a global epidemic that spreads to more than one continent (WHO, 2009). One of the more recent
pandemics that you might be familiar with is the H1N1 influenza outbreak of 2009.
Outbreak
, the occurrence of disease within persons in excess of what would normally be expected in a clearly
defined community, location, or time of year. An outbreak may only last for a matter of days or
weeks, but may last for years
Quarantine
the separation and restriction of the movement of people who were or are exposed to a contagious
disease for a set period of time, to see whether they become ill
Antigenic drift
is a term describing the changes that occur within virus's ribonucleic acid that changes the virus.
Typically, these changes create seasonal changes or new strains of a virus
WHO Pandemic Phases
Phase 1—None of the current viruses circulating in animals have been reported to cause infection in
humans.
Phase 2—An animal-based influenza virus is known to have caused infection in humans and is
considered a potential pandemic threat.
Phase 3—An animal- or human-animal-based virus has caused some clusters of cases in people, but
has not caused human-to-human transmission that is significant enough to cause community-level
outbreaks.
Phase 4—Human-to-human transmission of an animal or human-animal virus is causing community
outbreaks and sustained disease. This is a significant shift in risk and any country with such an
outbreak should consult with WHO.
Phase 5—There is human-to-human spread of the virus in at least two countries. This phase means
that pandemic is imminent and that community action and implementation of planned mitigation
procedures is needed.
Phase 6—This is the pandemic phase, characterized by outbreaks in more than one WHO defined
region in addition to all Phase 5 criteria (WHO, 2009)
Phase 1
None of the current viruses circulating in animals have been reported to cause infection in humans.
Phase 2
An animal-based influenza virus is known to have caused infection in humans and is considered a
potential pandemic threat.
Phase 3
An animal- or human-animal-based virus has caused some clusters of cases in people, but has not
caused human-to-human transmission that is significant enough to cause community-level outbreaks.
Phase 4
Human-to-human transmission of an animal or human-animal virus is causing community outbreaks
and sustained disease. This is a significant shift in risk and any country with such an outbreak should
consult with WHO.
Phase 5
There is human-to-human spread of the virus in at least two countries. This phase means that
pandemic is imminent and that community action and implementation of planned mitigation
procedures is needed.
Cultural Awareness
:Self-examination of one's own prejudices and biases toward other cultures. An in-depth exploration
of one's own cultural/ethnic background.
Cultural competence in nursing consists of four principles.
Care is designed for the specific client.
Care is based on the uniqueness of the person's culture and includes cultural norms and values.
Care includes self-employment strategies to facilitate client decision making to improve health
behaviors.
Care is provided with sensitivity and is based on the cultural uniqueness of clients.
The APN may also use the Kleinman Explanatory Model of Illness (1978). Below are the questions that
can be utilized.
What do you call your problem?
What do you think caused your problem?
Why do you think it started when it did?
What does your sickness do to you?
What do you fear most about your sickness?
What are the chief problems your sickness has caused you?
What kind of treatment do you think you should receive?
What is the most important result you hope to receive from the treatment?
According to Giger and Davidhizer (2000), although cultures differ, they all have the same basic
organizing factors that must be assessed in order to provide care for culturally diverse patients. These
factors include
communication (verbal and nonverbal);
personal space;
social organization;
time perception;
environmental control; and
biological variations.
The NCCC uses four major approaches to fulfill its mission, including
Web-based technical assistance, (2) knowledge development and dissemination, (3) supporting a
community of learners, and (4) collaboration and partnerships with diverse groups.
Epidemiological Triad:
host, agent, environment
Genetics
The study of individual genes and their impact on relatively rare single gene disorders
Absolute risk
is the probability of an event, such as illness, injury, or death. Gives no indication of how its
magnitude compares with others
,The odds ratio
closely approximates the relative risk if the disease is rare.
Odds ratio and the relative risk are used
to assess the strength of association between risk factor and outcome.
How is Attributible risk used
is used to make risk-based decisions for individuals.
Population-attributable risk measures
are used to form public health decisions
EGAPP:
Evaluation of Genomic Applications in Practice and Prevention
GAPPNet
Genomic Applications in Practice and Prevention Network (established in 2009) is a collaborative
initiative involving partners from across the public health sector working together to realize the
promise of genomics in health care and disease prevention.
GEDDI
Genetics Early Disease Detection Intervention project (GEDDI) (established in 2009) developed a
model strategy for using clinical, genetic, and family history information to reduce the risk of disease,
death, and disability in affected individuals, family members, and populations.
HuGENet
Human Genome Epidemiology Network (HuGENet) (established in 1998) helps translate genetic
research findings into opportunities for preventive medicines and public health by advancing the
synthesis, interpretation, and dissemination of population-based data on human genetic variation in
health and disease. HuGENet reviews are systematic, peer-reviewed synopses of the epidemiologic
aspects of human genes, including prevalence of allelic variants in different populations, population-
based information on disease risk, evidence for gene-environment interaction and quantitative data
on genetic tests and services carried out according to specific guidelines.
NHANES III
DC's Office of Public Health Genomics (established in 2002) formed a multidisciplinary working group
with members from across CDC. It developed a proposal to measure the prevalence of selected
genetic variants of public health significance in a representative sample of the U.S. population and to
examine the association between the selected genetic variants and disease outcomes available in
NHANES III data.
The World Health Organization defines a pandemic
as a global epidemic that spreads to more than one continent (WHO, 2009). One of the more recent
pandemics that you might be familiar with is the H1N1 influenza outbreak of 2009.
Outbreak
, the occurrence of disease within persons in excess of what would normally be expected in a clearly
defined community, location, or time of year. An outbreak may only last for a matter of days or
weeks, but may last for years
Quarantine
the separation and restriction of the movement of people who were or are exposed to a contagious
disease for a set period of time, to see whether they become ill
Antigenic drift
is a term describing the changes that occur within virus's ribonucleic acid that changes the virus.
Typically, these changes create seasonal changes or new strains of a virus
WHO Pandemic Phases
Phase 1—None of the current viruses circulating in animals have been reported to cause infection in
humans.
Phase 2—An animal-based influenza virus is known to have caused infection in humans and is
considered a potential pandemic threat.
Phase 3—An animal- or human-animal-based virus has caused some clusters of cases in people, but
has not caused human-to-human transmission that is significant enough to cause community-level
outbreaks.
Phase 4—Human-to-human transmission of an animal or human-animal virus is causing community
outbreaks and sustained disease. This is a significant shift in risk and any country with such an
outbreak should consult with WHO.
Phase 5—There is human-to-human spread of the virus in at least two countries. This phase means
that pandemic is imminent and that community action and implementation of planned mitigation
procedures is needed.
Phase 6—This is the pandemic phase, characterized by outbreaks in more than one WHO defined
region in addition to all Phase 5 criteria (WHO, 2009)
Phase 1
None of the current viruses circulating in animals have been reported to cause infection in humans.
Phase 2
An animal-based influenza virus is known to have caused infection in humans and is considered a
potential pandemic threat.
Phase 3
An animal- or human-animal-based virus has caused some clusters of cases in people, but has not
caused human-to-human transmission that is significant enough to cause community-level outbreaks.
Phase 4
Human-to-human transmission of an animal or human-animal virus is causing community outbreaks
and sustained disease. This is a significant shift in risk and any country with such an outbreak should
consult with WHO.
Phase 5
There is human-to-human spread of the virus in at least two countries. This phase means that
pandemic is imminent and that community action and implementation of planned mitigation
procedures is needed.
