NR503 Epidemiology Midterm.docx

How does social justice and health inequities influence population health care provision? Why is this critical information for the provision of evidence-based care? - correct answer More and more studies are being conducted to look at the relationship of sustained exposure to toxic stress to a variety of poor health outcomes and high-risk behaviors. These behaviors include such things as cutting, hypervigilance, promiscuity, eating disorders, poor school performance, depression, violence, suicidal ideation/attempts, and justice system involvement. These are just a few of the many behaviors found to be associated with sustained exposure to toxic stress. Studies such as these illustrate the importance of understanding the social determinants of poor health and the potential for doing good and preventing harm to aggregates and populations by targeting exposures to such things as child abuse and neglect for prevention, early recognition, and intervention., Vital Statistics - correct answer Vital statistics provide important outcome measures that APRNs can monitor and compare over time and analyze by demographic variables to detect such things as health disparities. In the United States, the National Center for Health Statistics (NCHS) collects the official records of births, deaths, marriages, divorces, fetal deaths, and induced terminations of pregnancies from state and local health departments (Aschengrau & Seage, 2013). Personnel from local health departments review the data from death certificates, including demographic data, looking at the immediate cause of death and any contributing factors of death, and recording multiple causes of death. Local data are sent to a state office for collation and then sent to the NCHS, which provides this information to the public on its website ( Morbidity - correct answer Refers to ill health in an individual and the levels of ill health in a population or group. Mortality - correct answer Mortality rates, also known as death rates, can be useful when evaluating and comparing populations. As stated earlier, there are many factors that can affect the natural history of disease, and measuring mortality allows investigators to compare death rates among and within populations Cases - correct answer Refers to individuals who acquire a certain disease or condition. Social Justice - correct answer the defense of human dignity by ensuring that essential human needs are met and that essential human rights are protected for all people Epidemiology - correct answer the study of disease distribution within populations and the risk factors that affect increases or decreases in distribution. Incidence - correct answer Incidence rates describe the occurrence of new events in a population over a period of time relative to the size of the population at risk,Incidence provides information about the rate at which new cases occur and is a measure of risk. Incidence rates provide us with a direct measure of how often new cases occur within a particular population and provide some basis on which to assess risk. Prevalence - correct answer Prevalence rates describe the number of all cases of a specific disease or attribute in a population at a given point in time relative to the size of the population at risk. Period prevalence measures the number of cases of disease during a specific period of time and is a measure of burden Outcomes - correct answer The possible results of an experiment Inter-professional collaboration - correct answer Multiple health care workers from a variety of professions working together to deliver evidence-informed, patient centered health care Healthy People 2020 - correct answer Healthy People 2020 is a national document with agreed-upon national objectives that guides and assists APNs to focus on and identify levels of population healthcare for persons across the life span. There is clearly a strong and compelling linkage between epidemiological concepts, the three levels of prevention, and the goals of Healthy People 2020. The study and application of epidemiological principles enables the APN to make comprehensive, evidence-based clinical decisions for patients and populations. Determinants of health - correct answer the range of personal, social, economic, and environmental factors that influence health status Risk analysis - correct answer the process of identifying and analyzing potential issues that could negatively impact key business initiatives or critical projects in order to help organizations avoid or mitigate those risks. What is the Campaign for Action? - correct answer envisions a world where all Americans have access to high quality patient-centered care in a health care system where nurses contribute as essential partners in achieving success. Primary Prevention - correct answer Primary prevention refers to the process of altering susceptibility or reducing exposure to susceptible individuals and includes general health promotion and specific measures designed to prevent disease prior to a person getting disease. Interventions designed for primary prevention are carried out during the stage of susceptibility and can include such things as providing immunizations to change a person's susceptibility. Actions taken to prevent tobacco usage are another example of primary prevention. Secondary Prevention - correct answer The early detection and prompt treatment of a disease at the earliest possible stage are referred to as secondary prevention. The goals of secondary prevention are to either identify and cure a disease at a very early stage or slow its progression to prevent complications and limit disability. Secondary prevention measures are carried out during the preclinical or presymptomatic stage of disease. Screening programs are designed to detect specific diseases in their early stages while they are curable and to prevent or reduce morbidity and mortality related to a later diagnosis of disease. Examples of secondary prevention include the Pap smear, mentioned earlier, as well as annual testing of cholesterol levels, mammography, and rapid HIV testing of asymptomatic individuals. Tertiary Prevention - correct answer Tertiary prevention strategies are implemented during the middle or late stages of clinical disease and refer to measures taken to alleviate disability and restore effective functioning. Attempts are made to slow the progression or to cure the disease. In cases in which permanent changes have taken place, interventions are planned and designed to help people lead a productive and satisfying life by maximizing the use of remaining capabilities (rehabilitation). Cardiac rehabilitation programs that provide physical and occupational therapies to postoperative cardiac patients are an example of tertiary prevention. Is screening a tertiary intervention? If yes, why, if not, what is it? - correct answer No, screening is a secondary intervention. Screening helps APNs detect a disease once it is present and assist and facilitate the patient or population to get care for the disease that has been detected. How does a provider determine the usefulness, appropriateness, of a screening test? Where would a NP look to find a screening test? What determines if a screening test should be used? - correct answer The APN must be knowledgeable and apply standards of care and accepted national clinical guidelines to advise the individual or population to undergo preventive screening that is age appropriate and developmentally appropriate. In order to not only understand spread of disease, but to identify and conduct early prevention and intervention, the APN must be able to find out who has a disease and who does not. Screening and diagnostic tests are important, but are not always 100% accurate in confirming a diagnosis. How do we distinguish which tests are good to use? Even if a test identifies a disease, we must ask the following. Is it valid, Is it reliable, is it cost effective, does it assist us in improving outcomes for the patient (i.e., improved quality of life, more life years lived, etc.). Screening is not only testing for infectious disease. Screening guidelines such as routine blood pressure monitoring in patients over a certain age or who carry risk factors like smoking, obesity, or family history, or even quarterly hemoglobin A1c or yearly urine micro-albumin measures in patients with diabetes, all come from epidemiological research on those screening interventions. Can you explain what "descriptive epidemiology" means? What is the purpose? How is it used? - correct answer Descriptive epidemiology is the first step in any epidemiology investigation or in analyzing any health problem from a research perspective. It is sometimes called the natural history of a disease and begins with defining the differences, similarities, and correlations of key areas of any health problem. This information is gathered in an active surveillance on a case by case basis where each specific persons information is entered into a database. In passive surveillance, this information is pulled from a database. Although you often hear of descriptive epidemiology for outbreaks, this information is gathered on any (acute or chronic) disease over time to track who is at risk. The three key areas of information gathered include person, place, and time. It is needed so that we an change the natural history of disease. How do we improve survival time or quality of life? How do we cure? How do we prevent? All of this rests in epidemiological research. How are causation and descriptive epidemiology related, how do they work together to aid evidence-based care? - correct answer Descriptive epidemiology is the first step in any epidemiology investigation or in analyzing any health problem from a research perspective. It is sometimes called the natural history of a disease and begins with defining the differences, similarities, and correlations of key areas of any health problem. This information is gathered in an active surveillance on a case-by-case basis where each