NR-503 Epidemiology final Exam Questions and Answers 2022/2023

Kleinman explanatory Model - ANSWER Eliciting the patient's (explanatory) model gives the physician knowledge of the beliefs the patient holds about his illness, the personal and social meaning he attaches to his disorder, his expectations about what will happen to him and what the doctor will do, and his own therapeutic goals Cultural competence - ANSWER Cultural competence is defined as "a dynamic, fluid, continuous process whereby an individual, system or health care agency find meaningful and useful care delivery strategies based on knowledge of the cultural heritage, beliefs, attitudes, and behavior of those to whom they render care" Cultural Awareness - ANSWER: Self-examination of one's own prejudices and biases toward other cultures. An in-depth exploration of one's own cultural/ethnic background. Cultural humility - ANSWER A lifelong commitment to self-evaluation and self-critiques, redressing the power of imbalances in the patient- physician dynamic, developing mutually. Beneficial relationships. Cultural Knowledge - ANSWER Obtaining a sound educational foundation concerning the various worldviews of differences cultures. Obtaining knowledge regarding biological variations, disease and health conditions and variation in drug metabolism. Cultural Skill: - ANSWER Ability to collect culturally relevant data regarding the client's health history and presenting problem. Ability to conduct culturally based physician assessments. Conducting these assessments in a culturally sensitive manner. Cultural Desire - ANSWER Motivation of the healthcare provider to "want" to engage in the process of cultural competence, characteristics of compassion, authenticity, humility, openness, availability, and flexibility, commi tment and passion to caring, regardless of conflict. ethnicity - ANSWER as "the aggregate of cultural practices, social influences, religious pursuits, and racial characteristics shaping the distinctive identity of community" Cultural competence in nursing consists of four principles. - ANSWER 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. - ANSWER 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 - ANSWER communication (verbal and nonverbal); personal space; social organization; time perception; environmental control; and biological variations. The National Center for Cultural Competence (NCCC) provides national leadership and contributes to the body of knowledge on cultural and linguistic competency within systems and organizations. Major emphasis is placed on translating evidence into policy and practice for programs and personnel concerned with health and mental healthcare delivery, administration, education, and advocacy. - ANSWER The NCCC uses four major approaches to fulfill its mission, including - ANSWER Web-based technical assistance, (2) knowledge development and dissemination, (3) supporting a community of learners, and (4) collaboration and partnerships with diverse groups. These approaches entail the provision of training, technical assistance, and consultation and are intended to facilitate networking, linkages, and information exchange. The NCCC has particular expertise in developing instruments and conducting organizational self-assessment processes to advance cultural and linguistic competency. - ANSWER Epidemiological Triad: - ANSWER host, agent, environment Genetics is considered an agent in the epidemiological triad - ANSWER Genetics - ANSWER The study of individual genes and their impact on relatively rare single gene disorders Genomics - ANSWER The study of all genes in the human genome as well as their interaction with other genes, the individual's environment, and the influence of cultural and psychosocial factors Genetic epidemiology - ANSWER the link of epidemiology and genetics Absolute risk - ANSWER is the probability of an event, such as illness, injury, or death Absolute risk - ANSWER gives no indication of how its magnitude compares with others. The odds ratio - ANSWER closely approximates the relative risk if the disease is rare. Odds ratio and the relative risk are used - ANSWER to assess the strength of association between risk factor and outcome. Attrubutible risk - ANSWER is used to make risk-based decisions for individuals. Population-attributable risk measures - ANSWER are used to form public health decisions EGAPP: - ANSWER Evaluation of Genomic Applications in Practice and Prevention GAPPNet - ANSWER 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 - ANSWER 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 - ANSWER 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 - ANSWER 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 - ANSWER 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 - ANSWER 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 - ANSWER 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 Isolation - ANSWER the separation of sick people with a contagious disease from those who are not ill Disaster epidemiology - ANSWER "Disaster epidemiology is defined as the use of epidemiology to assess the short- and long-term adverse health effects of disasters and to predict consequences of future disasters. It brings together various topic areas of epidemiology including acute and communicable disease, environmental health, occupational health, chronic disease, injury, mental health, and behavioral health" Antigenic drift - ANSWER 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 - ANSWER 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 - ANSWER None of the current viruses circulating in animals have been reported to cause infection in humans. Phase 2 - ANSWER An animal-based influenza virus is known to have caused infection in humans and is considered a potential pandemic threat. Phase 3 - ANSWER 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 - ANSWER 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 - ANSWER 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 - ANSWER 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 - ANSWER 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 - ANSWER - 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. Health effects of climate change - ANSWER increasing temperatures, extreme weather, desertification, and flooding on asthma, chronic obstructive lung disease, and respiratory infections History of WHO - ANSWER 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 - ANSWER 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 Find common ground Nurses may want to consider assessing the environment where patients live and work (or go to school, for pediatric patients), including air quality by noting the proximity to emissions from cars (living close to highways) or factories and their mass transit accessibility. Teaching families how to assess allergen exposure and palliative measures are also important steps nurses can take. - ANSWER Health Outcomes - ANSWER 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 - ANSWER 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 three components: structure, process, and outcome. Structure refers to healthcare resources, such as the number and type of health and social service agencies, and can also include utilization indicators. Process describes how the healthcare is delivered, and outcome refers to the change in health status related to the intervention provided - ANSWER Domain 1 - ANSWER 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 - ANSWER 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. Domain 3 - ANSWER 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 - ANSWER 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.