NUR 503 EPIDEMIOLOGY FINAL EXAM 2025

NUR 503 EPIDEMIOLOGY FINAL EXAM 2025 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 NUR 503 NUR 503 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. NUR 503 NUR 503 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. NUR 503 NUR 503 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). Pandemic Severity Index - -Category 1—case fatality ratio of less than 0.1% and fewer than 90,000 U.S. deaths Category 2—0.1%-0.5% case fatality ratio and 90,000-450,000 U.S. deaths Category 3- 0.5%—1% case fatality ratio and 450,000-900,000 U.S. deaths Category 4—1-2% case fatality ratio and 900,000-1.8 million U.S. deaths Category 5—greater than 2% case fatality ratio and more than 1.8 million U.S. deaths (CDC, 2014). SDG's - -- No poverty - Zero hunger - Good health and wellbeing - Quality education - Gender equality - Clean water and sanitation - Decent work and economic growth - Peace, justice and strong institutions The Sustainable Development Goals (SDGs), otherwise known as the Global Goals, are a universal call to action to end poverty, protect the planet and ensure that all people enjoy peace and prosperity. History of WHO - -1945: charter of the United Nations; article calling for establishment of health agency with wide powers 1946: UN representatives created and ratified the constitution of WHO 1948: constitution went into force and WHO began work The World Health Organization (WHO) is a specialized agency of the United Nations that is concerned with international public health. It was established on 7 April 1948, and is headquartered in Geneva, Switzerland. The WHO played a leading role in the eradication of smallpox. Its current priorities include communicable diseases, in particular HIV/AIDS, Ebola, malaria and tuberculosis; as well as the mitigation of the effects of non-communicable diseases such as sexual and reproductive health, development, and aging; nutrition, food security and healthy eating; occupational health; substance abuse; and driving the development of reporting, publications, and networking. Call to action - -It falls to nurses and midwives, the most numerous and arguably most patient-centered component of the health workforce, to assume a leadership role in addressing planetary health. Leadership begins with educating ourselves, students, staff, patients, and communities. Engagement in political and policy processes are needed-and can take many forms. Even small measures may have impact. Local level sustainability and readiness is meaningful at one's university, hospital, and or health system levels. Learn Communicate NUR 503 NUR 503 Find common ground Health Outcomes - -defined as an end result that follows some kind of healthcare provision, treatment, or intervention and may describe a patient's condition or health status outcomes may be classified into categories by describing - -who is measured, such as individuals, aggregates, communities, populations, or organizations; by identifying the "what" or the type of outcome, such as care, patient, or performance-related outcomes determining the "when" or the time it takes to achieve an outcome, such as short-term, intermediate, or long-term outcomes Domain 1 - -DOMAIN 1: Capacity Strengthening Capacity strengthening is the broad sharing of knowledge, skills, and resources for enhancement of global public health programs, infrastructure, and workforce to address current and future global public health needs. 1.1Design sustainable workforce development strategies for resource-limited settings. 1.2Identify methods for assuring health program sustainability. 1.3Assist host entity in assessing existing capacity. 1.4Develop strategies that strengthen community capabilities for overcoming barriers to health and well-being. Domain 2 - -DOMAIN 2: Collaborating and Partnering Collaborating and partnering is the ability to select, recruit, and work with a diverse range of global health stakeholders to advance research, policy, and practice goals, and to foster open dialogue and effective communication. 2.1Develop procedures for managing health partnerships. 2.2Promote inclusion of representatives of diverse constituencies in partnerships. 2.3Value commitment to building trust in partnerships. 2.4Use diplomacy and conflict-resolution strategies with partners. 2.5Communicate lessons learned to community partners and global constituencies. 2.6Exhibit interpersonal communication skills that demonstrate respect for other perspectives and cultures. NUR 503 NUR 503 Domain 3 - -DOMAIN 3: Ethical Reasoning and Professional Practice Ethical reasoning and professional practice is the ability to identify and respond with integrity to ethical issues in diverse economic, political, and cultural contexts, and promote accountability for the impact of policy decisions on public health practice at local, national, and international levels. 3.1Apply the fundamental principles of international standards for the protection of human subjects in diverse cultural settings. 3.2Analyze ethical and professional issues that arise in responding to public health emergencies. 3.3Explain the mechanisms used to hold international organizations accountable for public health practice standards. 3.4Promote integrity in professional practice. Domain 4 - -DOMAIN 4: Health Equity and Social Justice Health equity and social justice is the framework for the analysis of strategies to address health disparities across socially, demographically, or geographically defined populations. 4.1Apply social justice and human rights principles in public health policies and programs. 4.2Implement strategies to engage marginalized and vulnerable populations in making decisions that affect their health and well-being. 4.3Critique policies with respect to impact on health equity and social justice. 4.4Analyze distribution of resources to meet the health needs of marginalized and vulnerable groups. Domain 5 - -DOMAIN 5: Program Management Program management is the ability to design, implement, and evaluate global health programs to maximize contributions to effective policy, enhanced practice, and improved and sustainable health outcomes. 5.1Conduct formative research. 5.2Apply scientific evidence throughout program planning, implementation, and evaluation. NUR 503 NUR 503 5.3Design program work plans based on logic models. 5.4Develop proposals to secure donor and stakeholder support. 5.5Plan evidence-based interventions to meet internationally established health targets. 5.6Develop monitoring and evaluation frameworks to assess programs. 5.7Utilize project management techniques throughout program planning, implementation, and evaluation. 5.8Develop context-specific implementation strategies for scaling up best-practice interventions. Domain 6 - -DOMAIN 6: Sociocultural and Political Awareness Sociocultural and political awareness is the conceptual basis with which to work effectively within diverse cultural settings and across local, regional, national, and international political landscapes. 6.1Describe the roles and relationships of the entities influencing global health. 6.2Analyze the impact of transnational movements on population health. 6.3Analyze context-specific policy-making processes that impact health. 6.4Design health advocacy strategies. 6.5Describe multiagency policy making in response to complex health emergencies. 6.6Describe the interrelationship of foreign policy and health diplomacy. Domain 7 - -DOMAIN 7: Strategic Analysis Strategic analysis is the ability to use systems thinking to analyze a diverse range of complex and interrelated factors shaping health trends to formulate programs at the local, national, and international levels. 7.1Conduct a situation analysis across a range of cultural, economic, and health contexts. 7.2Identify the relationships among patterns of morbidity, mortality, and disability with demographic and other factors in shaping the circumstances of the population of a specified community, country, or region. 7.3Implement a community health needs assessment. NUR 503 NUR 503 7.4Conduct comparative analyses of health systems. 7.5Explain economic analyses drawn from socioeconomic and health data. 7.6Design context-specific health interventions based on situation analysis. The WHO conceptual framework for social determinants of health identifies five multifactorial components of population health that impact health outcomes - -biology and genetics, individual behavior, social environment, physical environment, and health services. USAID - -Activating a Disaster Assistance Response Team (DART) staffed by the CDC, in Monrovia, Liberia, and Guinea, to coordinate planning, operations, logistics, administrative issues, and interagency work •Saving more than 3 million lives with immunization programs •Reaching over 850,000 people with HIV-prevention education after establishing programs in 32 countries since 1987; training over 40,000 people to support HIV/AIDS programs in their own countries •Providing family planning to more than 50 million couples worldwide •Training 21,000 Honduran farm families to prevent soil erosion •Providing oral rehydration therapy in Bangladesh; saving tens of millions of lives worldwide with this program •Providing loans and operating costs to Bolivian Banco Solidario (BancoSol), which is the first self-sustaining commercial bank in Latin America to focus on microbusiness (small business loans averaging $200 each) WHO global outbreak - -global Outbreak Alert and Response Network (GOARN), which initiates an international disease outbreak alert, technical support, vaccines, drugs, specialists, and equipment, to prevent spread, such as the plague in India, in 1995, which had an economic cost of over $1.7 billion •Chemical Incident Alert and Response System (ChemiNet): initiates alerts of industrial accidents, chemical, water, sanitation, radionuclear or environmental health emergencies •Global network of national health systems •Global Polio Eradication Initiative Network (GPEIN