Reflection on Achievement of Outcomes Concept Map

homework help

concept map video: https://www.youtube.com/watch?v=sZJj6DwCqSU

Week 1 Discussion topic: exercise

Good morning Professor and class,

I have chosen to do excise 1.5 from chapter one. The first question is what are six cancers associated with obesity incidence rates. The six most common cancers associated with obesity within young adults ages 15-35 are:
1.Colorectal: 12% (Cancer, 2020).
2. Thyroid: 12% (Cancer, 2020).
3. Breast: 11% (Cancer, 2020).
4. Prostate: 30% (Bleyer, Spreafico, & Barr 2020).
5.Cervix: 21% (Cancer, 2020).
6. Lymphomas: 22% (Cancer, 2020).

(American Cancer Society, 2020). The prevalence rate of obesity within New Jersey for people younger than 18 is 22.8%. The rate for children is pretty close, for African American it is 34.2%, for Hispanic children it is 26.2% and for Caucasians it is 26.1%. (Americans Health Ranking, 2020). The numbers are devastating to look at, over all NJ is 28th in in rank for unhealthiest state in terms of obesity. NJ is stepping up and they have been for a while, they have set up the Obesity prevention program of NJ in place since 2013. This program offers education and resources to families of meal ideas as well as activity plans to get people moving. It has a great deal of data as well, it is filled with statistics about obesity and information of what can happen if people don’t take action. (NJAAP, 2020). NJ obesity rates have decreased from 2017, by about 4.9%, so although I do I think some of the programs are working, however I think much more work needs to be done. The numbers of obesity, and the issues it causes consistently grow, I feel as if more proactive action needs to happen. The only state involvement includes that physical education is a requirement, healthy food financing funding’s, and there are laws preempting local policies related to nutrition, however I don’t believe it is enough, because than our incidence rates would be much lower and we would see a consistent decrease in numbers, which is not the case. (Americans Health Ranking, 2020).

References:

Americans Health Ranking. 2020. NJ Obesity Rates. Retrieved from:

https://www.americashealthrankings.org/explore/annual/measure/Obesity/state/NJ (Links to an external site.)

American Cancer Society. (2019, February 4). Obesity-related cancers rising in young
adults in the US: Millennials have about double the risk of some cancers compared to
Baby Boomers at same age. ScienceDaily.

Bleyer, A., Spreafico, F., & Barr, R. (2020). Prostate cancer in young men: An emerging
young adult and older adolescent challenge. Cancer, 126(1), 46-57.

Cancer. 2020. Cancer Statistics. Retrieved from: 

https://www.cancer.org (Links to an external site.)

NJAAP. 2020. Obesity prevention. Retrieved from:

https://njaap.org/programs/obesityprevention/

Response to a peer for week 1 :

Good morning Angelic,

Diabetes is a serious health problem affecting many people in America. Although this problem can be manage in simple ways like through diet modification, physical activity and medications, many Americans do not have the appropriate resources, education or information to better manage this serious health problem affecting our communities. Due to the increasing need to educate people on the importance of preventing and managing diabetes, it is important to identify and assess individuals at risk in other to better manage diabetic disease (Tung & Peek, 2015). Connecting with a diabetes support group is usually a good resource to hep identify different outcomes related to diabetes because these groups are often open, no registration needed and are free to welcomes people with pre-diabetes, type 1 or 2 diabetes as well as those with an interest in diabetes education. Also, there is a National Diabetes Prevention Program database created by the CDC in partnership with other individual organizations such as
American Diabetes Association (ADA), and the American Medical Association (AMA ) have provided a framework for type 2 diabetes prevention efforts in the U.S. Diabetes outcome that are creating a significant impact to the community are increased risk of serious health complications such as vision loss, heart disease, stroke, kidney failure, and amputation of toes, feet, or legs. Many people in the community who have had amputations due to diabetes either did not know they are diabetic or did not have the proper education and treatment on how to better manage this disease process ( Klonoff, 2015). Many people in the community can monitor their blood glucose level, excises and calories in-take without having to leave their homes. When individuals are keeping personal data about their health, they are motivated to make life style adjustments, adherence to their
treatment plans and goals and are excited about receive adequate education on how to manage their health and utilize the emerging power of telemedicine support that is increasingly associated with medical monitors.

References:

Klonoff D. C. (2015). Improved outcomes from diabetes monitoring: the benefits of better adherence,
therapy adjustments, patient education, and telemedicine support. Journal of diabetes science and
technology, 6(3), 486–490. 

Tung, E. L., & Peek, M. E. (2015). Linking community resources in diabetes care: a role for technology?.
Current diabetes reports, 15(7), 45.

· Week 2 discussion topic: Describe the diagnostic or screening tool selected, its purpose, and what age group it targets.  

Has it been specifically tested in this age group?  

Next, discuss the predictive ability of the test. For instance, how do you know the test is reliable and valid? What are the reliability and validity values? What are the predictive values? Is it sensitive to measure what it has been developed to measure, for instance, HIV, or depression in older adults, or Lyme disease? Would you integrate this tool into your advanced practice based on the information you have read about the test, why or why not?

Good afternoon Professor and class,

Zika virus is a tetrogenic virus that is most commonly passed through the bites of infected mosquitoes. The incidence and prevalence of the zika virus, as a result, is determined by the prevalence of mosquitoes in a given geographical area. The detrimental risk of contracting the disease is highest amongst pregnant individuals and the possible fetal and maternal issues zika could cause. Typically, screening for zika begins at the patient intake assessment at a doctor’s appointment. In an article by DeCocker (2019), “CDC’s top priority for Zika is to protect pregnant women because of the risks associated with ZIKV infection during pregnancy” (p. 292). This article goes on to state that screening must be performed at every prenatal and postpartum visit to educate the patient on risk of exposure and to determine, and be able to act upon, exposures in a timely fashion (p. 293). The patient is typically asked if she has visited a zika infected area or has traveled outside the country within the last ninety days. If exposure has been detected, bloodwork is performed to determine if the patient is carrying the Zika antibody while appropriate counseling is done pre- and post- testing. DeCocker (2019) studied testing for this particular patient population and determined that while studies exist more studies are needed to identify “the limitations of prenatal and postnatal testing for detection of ZIKV-associated birth defects and long-term neurocognitive deficits are needed to improve guiding and counseling for women with a possible infectious exposure” (p. 293). The testing that does exist merely determines the presence of the antibodies in the prenatal and post-natal population. A study by Bingham, Cone, Mock, Heberlein-Larson, Stanek, Blackmoer and Likos (2016), determined the differences in Zika testing utilizing urine, serum, and saliva specimens. The study identified that limited data exists in regard to testing for zika utilizing alternative methods, such as urine and saliva. However, the authors suspect that saliva can be contributed to the passing of the disease (p. 477). The study compared “53 persons with Zika virus disease with urine, saliva, and serum specimens collected on the same date found positive results from testing in 49 (92%) urine specimens, 43 (81%) saliva specimens, and 27 (51%) serum specimens” (p. 477). Because a limited amount of studies has been done, the study concluded in stating that the most indicative way of determining Zika antibodies is through the utilization of serum analysis, but urine may also be a possible
screening tool. In my personal practice, if there were a quick-test method to determine positive antibody exposure in urine, such as a dipstick, it would be timelier and less invasive than serum testing. It also maintains a level of truth, if patients are poor historians. In my opinion, testing methods that are least invasive but also provides quick and accurate results is beneficial for all parties involved.

References:

Bingham, A. M., Cone, M., Mock, V., Heberlein-Larson, L., Stanek, D., Blackmore, C., & Likos, A.
(2016). Comparison of Test Results for Zika Virus RNA in Urine, Serum, and Saliva Specimens
from Persons with Travel-Associated Zika Virus Disease – Florida, 2016. MMWR. Morbidity And
Mortality Weekly Report, 65(18), 475–478. 

DeCocker, K. (2019). Zika Virus and Pregnancy Concerns. Nursing Clinics of North America, 54(2),
285–295.

Week 2 discussion response to a peer:

Good afternoon Ravi,

I enjoyed reading your post. OraQuick Advance is a rapid, point-of-care HIV test that is manufactured by Ora Sure Technologies Inc. It is a rapid test that looks for antibodies to HIV-1 and HIV-2 and is approved by the FDA to be used with oral fluid, fingerstick blood, and whole blood (Orasure Technologies Inc, 2016). IV-1 and HIV-2 are the viruses that cause AIDS. Early diagnosis is key to early intervention and starting antiviral therapy. The package insert does not explicitly state what age group it targets but there includes a statement that “clinical data has not been collected to demonstrate the performance of the OraQuick ADVANCE ® Rapid HIV-1/2 Antibody Test in persons under 12 years of age” (Orasure Technologies, Inc, 2016, p.8). The test is considered valid and reliable based on numerous clinical studies. Guillon et al. (2018) provides details of several trials showing >99% sensitivity and specificity claimed across the various specimens allowed including oral fluid, fingerstick blood and whole blood. In addition, per the package, in a study utilizing 4,999 people, a false positive occurred in 0.01% while a false negative occurred in 8.3%. Only 1.1% of the study subjects received no result. This reflects an expected outcome of 91.7% for test specificity meaning the results will be positive when HIV is present. There is also an expected outcome of 99.99% for test sensitivity meaning the results will be negative when HIV is present. The expectation of one false positive out of every 5,000 tests in uninfected people shows that it truly is sensitive to measure the presence of antibodies to HIV-1 and HIV-2. Martin (2018) details a study involving 252 participants that illustrates a negative predictive value (NPV) and positive predictive value (PDV) of 1.0 and sensitivity and specificity of 100%. Negative predictive value of a test is important as it reflects the probability that the disease is truly absent when the test reflects a negative result (Curley & Vitale, 2016). Positive predictive value of a test is also important because it reflects a positive test result when the disease being tested for is present (Curley & Vitale, 2016). Key to accuracy is quality control (Martin, 2018). If continuing to engage in behavior that would put a person at risk for HIV, repeat testing should be done at a later time. I would strongly consider integrating this test into practice. Early diagnosis of HIV is critical. When asked preference of testing type, 65.8% stated a test preference for oral fluid testing over fingerprick or whole
blood testing method (Martin et al., 2018). The most common reason was that oral fluids testing was less painful. Those that chose blood testing felt it was more accurate. The results discussed related to OraQuick ADVANCE for both oral fluid and blood testing provide evidence of similar accuracy and allow a choice to ensure a greater number are getting tested. With three ways to utilize the test, it allows for the possibility of a larger number of people getting tested.

1. Week 3 discussion topic: What is the fundamental difference between the method you have chosen (either the case-control or cohort method) and the randomized controlled trial?

2. What are the advantages and disadvantages of the study method you chose (case-control or cohort study)?

3. What are the characteristics of a correlational study?

4. Where does the method you chose (case-control or cohort study) fall on the research pyramid? What does where it is on the research pyramid mean?

Good afternoon Professor and class,

The fundamental difference between case-control studies and randomized controlled trial is the selection of the participants. In the case-control, simply put, you have two groups of individuals: one group with a certain outcome (cases), and one group without
that certain outcome (controls). In randomized control trials (RCTs) participants are chosen at random to either receive or not receive a treatment/intervention (Curley,2020). Another fundamental difference is the direction of the studies. Case-control studies essentially move backwards in time by choosing an outcome first (Morrow,2010).

A disadvantage of the case-control study is that it uses odds ratio (OR) and this can’t be used as a calculation of risk as with relative risk (RR) in a cohort study. The OR cannot be used to predict whether or not certain exposures or risk factors will turn in to whatever outcome (disease process) is being measured. Also as noted previously, these studies are done by identifying an outcome first and working backwards to find possible correlation with exposure. However, the advantage of this method is that it is a relatively simple calculation which can create the argument of someone being more likely or less likely to have said outcome based on a certain exposure (Curley, 2020).

Herrera et al. (2020) did a case study to assess the association between interatrial block (IAB) with cognitive impairment. A total of 265 subjects with 143 cases and 122 controls showed a higher prevalence of IAB (51% vs 31%), higher prevalence of advanced IAB (19.6% vs 8.2%) with cognitive impairment (Herrera et al., 2020). The case-control study managed to show an independent association between IAB and cognitive impairment. Currently, one of the main treatments of heart failure is the use of ACE inhibitors. Authors of a randomized control trial showed that ACEI, specifically enalapril might be the most effective for patients diagnosed with Heart Failure, however there has also been a 10-20% intolerance observed with patients starting to have a troubling cough after starting the medication (Uribe, 2018).

As per Curley (2020), in correlational studies, “rates are calculated for characteristics that describe populations and are used to compare frequencies between different groups at the same time or the same group at different times.” They essentially do just what the name implies; find a correlation or relationship such as between high red meat consumption and incidence of cancer. Correlational studies don’t link direct exposure but they do open the door for further investigation and more specific targeted studies (Curley, 2020).

Case-control studies are almost on the bottom of the evidence-based research pyramid. The lower on the pyramid a study is, the greater number of studies there are with lower amounts of evidence. Moving up the pyramid represents a lower number of studies with a higher degree of evidence (narrower) (St. John & McNeal, 2017).

References:

Curley, A. L. (2020). Population-based nursing: Concepts and competences for
advanced practice (3rd ed.). Springer Publishing Company. 

Herrera, C., Bruna, V., Abiznda, P., Diez-Villanueva, P., Formiga, F., Torres,
R.,…Martinez-Selles,, M. (2020). Relation of interatrial block to cognitive impairment in
patients>70 years of age (from the CAMBIAD case-control study). American Journal of
Cardiology, 136, 94-99.

Morrow, B. (2010). An overview of case-control study designs and their advantages and
disadvantages. International Journal of Therapy & Rehabilitation, 17(11), 570-574. 

St. John, K., & McNeal, K. S. (2017). The strength of evidence pyramid: One approach
for charaterizing the strength of evidence of geoscience education research (GER)
community claims. Journal of Geoscience Education, 65(4), 363-
372. 

https://files.eric.ed.gov/fulltext/EJ1161347   (Links to an external site.)

Herrera, C., Bruna, V., Abiznda, P., Diez-Villanueva, P., Formiga, F., Torres,
R.,…Martinez-Selles,, M. (2020). Relation of interatrial block to cognitive impairment in
patients>70 years of age (from the CAMBIAD case-control study). American Journal of
Cardiology, 136, 94-99.

Uribe, L. M. (2018). Heart failure: Treatment with ACE inhibitors. CINAHL Nursing
Guide, , .

Week 7 discussion topic: 1. Locate a lay press article from a national newspaper, for example, from The New York Times, The Washington Post, or other national publication. The article should be no more than three (3) years old.

Locate an article on one of the following topics:

A. Sex trafficking

B. Environmental global health issue: For example, but not limited to: Safe water, sanitation, disasters, or oral health.

2. Read over your chosen article and respond to the following:

· Provide a summary of your article. Include the name of the newspaper and author, as well as date of publication.

· Include data that supports the significance of the topic. For example, related deaths, health care costs, demographic information.

· During NR503, we have discussed the determinants of health, at-risk groups, social justice theory, outcomes, inter-professional collaboration, advocacy, and other concepts related to epidemiology and population health. How do the concepts addressed in NR503 relate to your article’s topic? Provide definitions and examples in your writing.

· Integrate information from the World Health Organization and the SDG’s.

Good evening Professor and class,

In the article reviewed that was published by USA Today in April of 2021, a middle-aged woman, who runs a bar in Texas, has been accused of selling the time and sexual acts of their waitresses to their clients (Aspegren, 2021). This has been going on for approximately ten years in which customers could pay $70 to receive 15 minutes with a waitress (Aspegren, 2021). The owner’s two sons and a nephew acted as “enforcers” who would ensure the waitresses remained compliant with these acts and would not call the authorities (Aspegren, 2021). The victims included adults, one minor, and a victim who was flown into Texas from Puerto Rico specifically to perform these sex acts (Aspegren, 2021). The woman, her two sons and nephew are all under arrest and face jail time and fines (Aspegren, 2021).

Sex trafficking is a global problem, with 4.8 million people being victims of forced sexual exploitation in 2016, 99% of which were female
(International Labour Organization & Walk Free Foundation, 2017). In 2018, the United States reported an increase in human trafficking cases, the top three origin countries are the US, Mexico and the Philippines, finding that the most vulnerable populations were most commonly trafficked, including children in welfare and juvenile justice systems, foster care, runaways, homeless, and unaccompanied foreign children (U.S. Department of State, 2020). Traffickers have used the ease of access and reach of the internet to start recruiting victims online using a “hunting” and “fishing” techniques where the traffickers either actively approach the victim in an online space (hunting) or wait for the victims to respond to ads that (fishing) (United Nations Office on Drugs and Crime, 2021). The internet has become a very effective way for traffickers to recruit at-risk persons because it can be anonymous, easy to use and access, and it is far-reaching.

The populations most at-risk for being trafficked include populations who face health disparities, which is “confounding variables that result in subpar health communication” (Chamberlain University, n.d.). According to the World Health Organization (WHO), 73% of countries have national plans of action regarding violence against women and 79% of countries globally have a national guideline or protocol that address health care system responses to violence against women (World Health Organization, 2020). Within these
countries, it’s reported that only 66% of them have training programs for healthcare providers that educates them on the appropriate responses and treatments for violence against women (World Health Organization, 2020). As Nurse Practitioners (NP), screening patients for trafficking should be a priority, especially in these at-risk groups, which is a subgroup or population that share high risk factors like health conditions or health factors (Curley, 2020).

These victims fall under both of these definitions and by working closely with advocacy centers and other healthcare professionals, a screening tool can be used to identify these victims and report the occurrence to the appropriate law enforcement agencies (Moore et al., 2017). This will then lead to appropriate services and follow up care such as mental health care, ongoing medical care
for STIs and safety planning (Moore et al., 2017). Awareness and education are the most important first-step for healthcare providers to make to help eradicate sex trafficking, which is becoming a more prominent issue within the US.
References:

Aspegren, E. (2021, April 1,). Family charged for coordinating sex trafficking
operation at Houston bar for more than a decade, US attorneys say. Usa
Todayhttps://www.usatoday.com/story/news/nation/2021/04/01/houstonfamily-
sex-trafficking-operation-bar-puerto-allegre/4845328001 

Chamberlain University. (n.d.). NR503-60510: Population health epidemiology
and statistical principles. https://chamberlain.instructure.com/courses/76835/pages/week-5-
lesson-culture-and-socioeconomic-status?module_item_id=11213712. https://chamberlain.instructure.com/courses/76835/pages/week-5-lessonculture-
and-socioeconomic-status?module_item_id=11213712

Curley, A. (2020). Population-based nursing : Concepts and competencies for
advanced practice (3rd ed.). Springer Publishing Company.
International Labour Organization, & Walk Free Foundation. (2017). Global
estimates of modern slavery forced labour and forced marriage

Moore, J. L., Kaplan, D. M., & Barron, C. E. (2017). Sex trafficking of
minors. Pediatric Clinics of North America, 64(2), 413-421. https://doiorg.
chamberlainuniversity.idm.oclc.org/10.1016/j.pcl.2016.11.013 

U.S. Department of State. (2020). 2019 trafficking in persons report: United
states. (). https://www.state.gov/reports/2019-trafficking-in-persons-report-
2/united-states

United Nations Office on Drugs and Crime. (2021). Global report on trafficking
in persons 2020. United Nations
Publication, https://www.unodc.org/documents/data-and analysis/
tip/2021/GLOTiP_2020_15jan_web

12

Epidemiological Analysis: Chronic Health Problem

Author’s Name

Institutional Affiliation

Course Name and Number

Instructor

Due Date

Epidemiological Analysis: Chronic Health Problem

Identification of the Health Problem

The health problem under review in this paper is Rheumatoid Arthritis (RA). According to the CDC (2020), RA refers to an inflammatory and autoimmune disease whereby a person’s immune system mistakenly attacks the healthy cells in his/her body leading to inflammation in the affected boy parts. This disease often attacks the joints in the knees, wrists, and hands. RA causes inflammation in the linings of a joint and damages the joint tissue. Consequently, the tissue damage may lead to chronic pain, deformity, and unsteadiness. This is a serious disease that adversely impacts a person’s productivity and overall quality of life. To understand the significance of RA, this paper presents comprehensive research of the disease and offers context in the form of state and national data. The state of focus, in this case, is Illinois. By investigating the surveillance/ reporting methods of RA, the epidemiology of RA, and the screening/diagnosis guidelines, a plan of action is developed based on evidence-based interventions.

Background and Significance of the Health Problem

Each year in the US, approximately 71 out of 100, 000 people are diagnosed with RA. This translates to around

1.5 million

people with RA in the country (Hunter et al., 2019). In Illinois, the prevalence of the disease aligns with the national data. Out of a population of around

12.67 million

, approximately

100,000

people in Illinois have been diagnosed with RA. The trends of both national and state data reveal that women have a higher likelihood of getting RA compared to men. For US adults, the lifetime risk of getting RA is

1.7% for men and 3.6% for women

(Hunter et al., 2019). It is asserted that the hormones in both genders tend to play a huge role in the prevention or triggering of the disease. Although RA can target people of all ages, it is mostly prevalent in adults. The table below gives a brief overview of RA-related state and federal data.

Table 1: RA-Related State and Federal Data

1.7% for men and 3.6% for women

Item	State	Federal
Population	12.67 million	329.5 million
No. of people with RA (Approx.)	100,000	1.5 million
Prevalence Based on Gender (Approx.)		1.7% for men and 3.6% for women
Associated Healthcare Costs (Approx.)	$1.7 billion	$20 billion

The state and national data reveal similar trends in the risk factors and prevalence rates of people with RA. As aforementioned, women have a higher likelihood of getting RA than men. Also, the prevalence of the disease rises with an increase in age. People over the age of 65 are six times more likely to have RA than those in the 18-44 age bracket. When it comes to race, Asian adults show a lower prevalence of getting the disease compared to multiracial, black, white, and American Indian adults. Another risk factor is education with statistics showing the less education one has, the higher the chances of getting RA. Similarly, the less income one has, the higher the chances of having the disease. Finally, people who are physically inactive are more at risk of getting the disease than those who are physically active. Other lifestyle factors like obesity and smoking, in addition to jobs that require repetitive squatting and bending, may increase one’s chances of having RA.

RA is a big problem in both Illinois and the country as a whole. For starters, RA increases the probability of a person contracting other diseases such as stroke and heart disease. It can also impact a person’s eyes, blood, lungs, and vascular system. Consequently, RA has adverse consequences for the state and federal healthcare costs. It is estimated that anyone with RA is likely to spend $5,720 in relevant healthcare costs (Raimundo et al., 2019). This figure can rise up to $20,000 in extreme cases (Raimundo et al., 2019). Additionally, the costs related to the quality of life for a person with RA also increase. This is because a person with RA has a higher chance of needing help with personal care and having activity limitations. These limitations may impact his/her productivity and ability to get regular income (Lundkvist, Kastäng, & Kobelt, 2018).

Current Surveillance and Reporting Methods

At both the state and national levels, public health departments utilize passive disease surveillance to promote good health and prevent disease in the context of RA. This system is essential in ensuring that it is possible to monitor the trends related to RA and facilitate the planning of relevant public health programs. Passive surveillance implies that healthcare providers are tasked with the initiating of reporting to the national and state officials, reportable instances of RA are submitted to the officials on a case-by-case basis. It is vital to note that there is no mandatory reporting of RA since this is not an infectious or communicable disease that can swiftly threaten the general population.

Passive surveillance is effective for the monitoring and reporting of RA since it casts a wide net on the general population and can be easily implemented. The challenge is that it normally leads to incomplete and underreporting of data. More so, considering that RA does not fall under the group of diseases that require mandatory reporting, many cases of RA go unreported. Hence, there is a high probability that the prevalence of the disease is higher than currently reported (Raimundo et al., 2019).

Currently, the CDC uses an arthritis case definition to monitor and report cases of RA in Illinois and the rest of the country. Case definitions are important in allowing public health officials to classify and count RA cases consistently across various geographical territories. The collection of RA data is further facilitated by the National Health Interview Survey and the Behavioral Risk Factor Surveillance System (Li et al., 2018). The former offers vital information regarding the percentage and number of individuals who have been diagnosed with RA, the trend of the percentages/numbers in the context of rising or falling, and the impact of RA on the quality of life of its victims.

Descriptive Epidemiology Analysis of Health Problem

According to Silman and Pearson (2017), “the descriptive epidemiology of RA is suggestive of a genetic defect.” Silman and Pearson (2017) assert that RA occurrence is considerably constant with a prevalence ranging from 1.5 to 1.0 percent frequency in the general American population. The five Ws of epidemiology offer a more comprehensive insight into RA:

a) Who: Women are three times more likely to be affected by RA compared to men. Also, the older a person gets, the higher the likelihood of the individual being diagnosed with the disease. RA has also been shown to be more common in poor households and individuals with limited education. Regarding race, Asian adults show a lower prevalence of getting the disease compared to multiracial, black, white, and American Indian adults.

b) What: RA is not an infectious disease. However, it has adverse impacts on the people who get diagnosed with it. It also has negative consequences to the community as a whole. RA increases the probability of a person contracting other diseases such as stroke and heart disease. RA also results in higher state and federal healthcare costs. It is also vital to acknowledge the costs related to the quality of life for a person with RA. This is because a person with RA has a higher chance of needing help with personal care and having activity limitations. These limitations may impact his/her productivity and ability to get regular income.

c) When: RA has been prevalent in Illinois and the rest of the country for as long as written records have been available. Symptoms of the disease can be identified throughout history based on historical texts that predate modern medicine. Therefore, RA is not a new disease but rather one that has been plaguing many people throughout history. This is because the risk factors of the disease are mainly hereditary, age-based, and lifestyle-based.

d) Where: The exact origins of RA are currently unknown. However, researchers have attributed RA to various causes. For instance, Boissier et al (2020) assert that the genetic predisposition of RA can be traced to MHC class II genes. Boissier et al (2020) add that non-genetic factors can account for the rest of the reasons. However, Svartz (2015) suggests that a bacterial infection is the origin of RA. This argument notes that the infection led to the changes seen in the macrophages with the subsequent enzyme release and secondary abnormal immune processes.

e) Why: As aforementioned, RA is attributed to genetic and lifestyle factors. Therefore, early screening can help identify a person’s genetic predisposition to the disease and help chart a treatment and management intervention before the symptoms of the disease become unmanageable. Identifying risk factors can help people to avoid the negative behaviors that can lead them into developing RA.

Screening & Diagnosis Guidelines

The screening and diagnosis of RA do not rely on one test but rather a combination of medical history, lab tests, physical exams, and imaging tests (Sharma et al., 2020). First, the medical history will reveal the past and current symptoms of the patients, which are related to RA, for instance, stiffness, swelling, and pain. The family medical history of the patients may also help point out possible genetic connections to the disease. Second, the physical examination will help the rheumatologist to test the patient’s joints for things like range of motion, tenderness, and swelling. Third, the lab tests will also be necessary to disprove or confirm RA. The lab tests are vital for the differential diagnosis so that the rheumatologist is sure of whether the patient has RA or simply has symptoms that are synonymous with RA. Examples of such tests include the C-reactive protein (CRP) and the erythrocyte sedimentation rate (ESR) blood tests. These tests detect and measure the body’s inflammation levels (Sharma et al., 2020). Other tests are the anti-CCP and the rheumatoid factor, which are antibody tests that search for RA-associated proteins. Finally, imaging tests such as ultrasounds and X-rays may be vital in diagnosing or ruling out RA in an individual. Due to the comprehensive nature of this diagnostic and screening process, the validity and reliability of the entire process used to check for RA are significantly high.

Plan of Action

After graduation, the nurse will address the issue of RA in Illinois and the country as a whole by advocating for and implementing three evidence-based interventions. First, there is the primary intervention. This will take the form of an education and sensitization drive where the members of the public will be regularly educated on RA, risk factors, and the lifestyle habits to avoid or embrace in order to avoid contracting the disease in the first place (van Boheemen et al., 2021). This is a preventive-based solution, which is essential in reducing the number of people who develop RA in the country. This preventive solution will ensure that people avoid poor lifestyle habits such as sedentary living, poor diets, smoking, and excessive alcohol consumption. These are habits that put one at a high risk of getting RA.

Second, there is the secondary intervention. This will take the form of mass screening. According to Adami and Saag (2019), mass screening programs are essential for the detection of inapparent diseases; these are diseases characterized by a silent/latent period where early diagnosis and subsequent treatment tend to lead to enhanced positive healthcare outcomes. In Illinois and the rest of the country, mass screening programs will ensure that there is the detection of RA as early as possible within members of the public. The earlier the detection of RA can be done, the sooner the treatment and therapy can commence. It is easier to handle the disease early before its symptoms become worse. More so, it will reduce the healthcare costs related to the treatment of RA and will enhance the productivity and quality of life of the affected individual in the long run.

Finally, there is the tertiary intervention. This will be characterized by the enhanced treatment of RA. Bullock et al. (2018) note that one common misconception about RA is that the disease cannot be treated. Although RA has no cure, Bullock et al. (2018) assert that early treatment with certain medications tends to be efficient in pushing the symptoms of RA into remission. These medications are commonly referred to as disease-modifying anti-rheumatic drugs. The objective of this intervention will be to enhance the quality of life of the affected individuals in order to ensure that they are dependent on others and are more productive in society.

Outcomes of the interventions will be measured by conducting a survey to check if there is a drop in the number of people who get diagnosed with RA after every one-year period. It is expected that the preventive measures will ensure people live healthier lifestyles leading to fewer new cases of RA. Also, it is expected that the healthcare costs related to the treatment of RA will be significantly reduced. The integration of health policy advocacy will be vital to ensure that regulations and policies are put in place to support the active implementation and funding of the three interventions mentioned.

Conclusion

RA is a big problem in both Illinois and the country as a whole. RA increases the probability of a person contracting other diseases such as stroke and heart disease. Consequently, RA has adverse consequences for the state and federal healthcare costs. It is estimated that anyone with RA is likely to spend $5,720 in relevant healthcare costs (Raimundo et al., 2019). Additionally, the costs related to the quality of life for a person with RA also increase. This is because a person with RA has a higher chance of needing help with personal care and having activity limitations. These limitations may impact his/her productivity and ability to get regular income (Lundkvist, Kastäng, & Kobelt, 2018). To this end, three evidence-based interventions have been identified to deal with the RA problem.

First, there is the primary intervention. This will take the form of an education and sensitization drive where the members of the public will be regularly educated on RA, risk factors, and the lifestyle habits to avoid or embrace in order to avoid contracting the disease in the first place (van Boheemen et al., 2021). Second, there is the secondary intervention. This will take the form of mass screening. According to Adami and Saag (2019), mass screening programs are essential for the detection of inapparent diseases. Finally, there is the tertiary intervention. This will be characterized by the enhanced treatment of RA. Although RA has no cure, Bullock et al. (2018) assert that early treatment with certain medications tends to be efficient in pushing the symptoms of RA into remission.

References

Adami, G., & Saag, K. G. (2019). Osteoporosis pathophysiology, epidemiology, and screening in rheumatoid arthritis. Current Rheumatology Reports, 21(7), 1-10.

Boissier, M. C., Biton, J., Semerano, L., Decker, P., & Bessis, N. (2020). Origins of rheumatoid arthritis. Joint Bone Spine, 87(4), 301-306.

Bullock, J., Rizvi, S. A., Saleh, A. M., Ahmed, S. S., Do, D. P., Ansari, R. A., & Ahmed, J. (2018). Rheumatoid arthritis: A brief overview of the treatment. Medical Principles and Practice, 27(6), 501-507.

CDC. (2020, July). Rheumatoid arthritis (RA). Centers for Disease Control and Prevention. https://www.cdc.gov/arthritis/basics/rheumatoid-arthritis.html

Hunter, T. M., Boytsov, N. N., Zhang, X., Schroeder, K., Michaud, K., & Araujo, A. B. (2019). Prevalence of rheumatoid arthritis in the United States adult population in healthcare claims databases, 2004–2014. Rheumatology International, 37(9), 1551-1557.

Li, C., Balluz, L. S., Ford, E. S., Okoro, C. A., Zhao, G., & Pierannunzi, C. (2018). A comparison of prevalence estimates for selected health indicators and chronic diseases or conditions from the Behavioral Risk Factor Surveillance System, the National Health Interview Survey, and the National Health and Nutrition Examination Survey, 2007–2008. Preventive Medicine, 54(6), 381-387.

Lundkvist, J., Kastäng, F., & Kobelt, G. (2018). The burden of rheumatoid arthritis and access to treatment: Health burden and costs. The European Journal of Health Economics, 8(2), 49-60.

Raimundo, K., Solomon, J. J., Olson, A. L., Kong, A. M., Cole, A. L., Fischer, A., & Swigris, J. J. (2019). Rheumatoid arthritis–interstitial lung disease in the United States: prevalence, incidence, and healthcare costs and mortality. The Journal of Rheumatology, 46(4), 360-369.

Sharma, S., Ghosh, S., Singh, L. K., Sarkar, A., Malhotra, R., Garg, O. P., … & Biswas, S. (2020). Identification of autoantibodies against transthyretin for the screening and diagnosis of rheumatoid arthritis. PLoS One, 9(4), e93905.

Silman, A. J., & Pearson, J. E. (2017). Epidemiology and genetics of rheumatoid arthritis. Arthritis Research & Therapy, 4(3), 1-8.

Svartz, N. (2015). The origin of rheumatoid arthritis. Rheumatology, 6, 322-328.

van Boheemen, L., Ter Wee, M. M., Seppen, B., & van Schaardenburg, D. (2021). How to enhance recruitment of individuals at risk of rheumatoid arthritis into trials aimed at prevention: Understanding the barriers and facilitators. RMD Open, 7(1), e001592.

Running head: INFECTIOUS DISEASES ASSIGNMENT 1

INFECTIOUS DISEASES ASSIGNMENT 3

Infectious Disease:

Childhood Ear Infections

Name

Institutional Affiliation

Childhood Ear Infections

Introduction

Ear infections, also known as otitis media (OM), are common in younger children. In children, ear infections are a major health issue that may result in delayed language development and hearing impairment if left untreated. Ear infections are often caused by bacteria. They occur when the middle ear is inflamed, and fluid builds up behind the ear. Children are more prone to getting ear infections than adults. 5 out of 6 children under the age of three will get infections (Mukara & Lilford, 2017). Acute otitis media is the most common ear infection, and it causes earache, and a child might also develop a fever.

Most children will develop ear infections before they have learned how to talk, and a parent might find it difficult because the child cannot speak. There are some signs that parents can look out for in case they think their child has an ear infection. They include a child pulling or tugging the ears, trouble responding to quiet sounds and hearing, a fever, clumsiness or trouble with balance, as well as fussiness and crying.

In most cases, an ear infection will be caused by bacteria and will develop after a child has a cold, a sore throat, or other upper respiratory infection. If an infection is caused by bacteria, these bacteria can spread to the middle ear, and if the infection is viral, such as a cold, bacteria may move to the middle ear as a secondary infection as it is drawn to the microbe-friendly environment. Due to this infection, fluid builds up behind the eardrum.

Other parts near the ear, such as the Eustachian tube, may be infected. This is the tube that connects the middle ear to the upper part of the throat. Its functions include draining fluid, supplying fresh air to the middle ear, and keeping pressure steady between the ear and nose.

Children are more prone to ear infections than adults. There are several reasons for these; the Eustachian tubes in children are smaller and more in level, which makes it difficult to drain fluid out of the ear. When children develop colds, the Eustachian tubes might be swollen and blocked with mucus, and as a result, fluid might not drain. Secondly, the immune system of children is not as effective as that of adults because it is still developing, which makes it difficult for children to fight infections.

A pneumatic otoscope will be used by a doctor to diagnose ear infections. The doctor will blow a puff of air into the ear canal. If the child does not have an infection, the eardrum will move back and forth. But with an infection, the eardrum will not move because it will have fluid behind it. The common treatment for childhood ear infections is antibiotics such as amoxicillin. This drug should be administered for 7 to 10 days as directed by a doctor. Pain killers may also be recommended, such as acetaminophen, eardrops, and ibuprofen to help with the pain and fever.

The prevalence of ear infections in children is highest in Australian Aboriginals. Nevertheless ear infections in children can be prevented. The best way of doing this and reducing the risk factors associated with them is by vaccinating a child against the flu. Parents should ensure that their children receive the influence of the flu vaccine every year.

Determinants of Health

There are a few determinants of health that contribute to the development of childhood ear infections. They include seasonal factors, allergies or asthma, poor hygiene, overcrowding, frequent upper respiratory tract infections, exposure to passive smoking, inadequate housing conditions, frequent daycare attendance, as well as socioeconomic status. It is noted that children who also breastfeed are less likely to experience ear infections (Karunanayake et al., 2016).

The biological determinant of age contributes to the development of ear infections in children. Children who are between the ages of six months to two years are more likely to get ear infections because their immune system is still developing and also the size and shape of their Eustachian tube. Also, children who are cared for in group settings such as daycares are susceptible to getting colds which may lead to ear infections as compared to children who stay at home.

Another determinant is bottle-fed babies and breastfed babies. Children who feed on a bottle and especially when lying down, are prone to getting more ear infections compared to breastfed babies. Also, the prolonged use of a pacifier can lead to ear infections.

During the fall and winter, children are more prone to suffer from ear infections. Children who have seasonal allergies such as hay fever and asthma may be at a greater risk of infection, especially when pollen counts are high.

Epidemiological Triad

The epidemiological triad, which consists of the host, agent as well as environment, is a model which is used to have a better understanding of how infections are spread. In the case of ear infections, they are caused by bacteria and viruses. Most times, an ear infection will develop after a cold or other respiratory infection. Particularly in children who are under the age of three years. The agents that cause the infection are Streptococcus pneumonia as well as non-type able Haemophilus influenza (Chiu & Lin, 2012). Allergies, asthma, and other upper respiratory diseases increase the risk of ear infections, especially when there is an increase in the pollen count.

The host of this infection is mostly children, and it is not transmissible from one child to the other. However, the colds that cause the infections are, and parents should try and decrease the spread of these germs. Some environmental factors come to play in the infection of the disease. They include living in a home with people who smoke, having allergies to environmental changes, having a lower socioeconomic status as well as having a parental history of otitis media.

Role of the NP

           The role of the nurse practitioner includes providing a wide range of health care services. These services include performing comprehensive physical exams, diagnosing and treatment of acute, complex, and chronic health issues, health promotion, and disease prevention by offering immunizations, health education as well as counseling and management of chronic health problems.

           In this case, the nurse practitioner will have a crucial role in ensuring that the rates of childhood ear infections reduce by advocating for influence and flu vaccinations. NRs can also track the effectiveness of treatments by analyzing data and finding trends that will help health care providers in understanding the risk factors associated with ear infections in children.

           They can also educate parents who visit the clinics on various ways of preventing ear infections in their young ones other than vaccinations. They include cleanliness, especially frequent washing of the hands, avoiding taking children to daycare at a young age if possible as well as avoiding the prolonged use of a pacifier. This, along with vaccinations, can ensure that the rate of ear infections in children drops significantly.

References

Chiu, N. C., & Lin, h. Y. (2012). Epidemiological and microbiological characteristics of culture-proven acute otitis media in Taiwanese children. Journal of the Formosan Medical Association.

Karunanayake, C. P., Albritton, W., & Rennie, D. C. (2016). Ear infection and its associated risk factors in First Nations and rural school-aged Canadian children. PubMed Central (PMC). 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4764758/#:~:text=Other%20risk%20factors%20for%20ear,smoking%20%5B11%2C%2012%5D%3B%20and

Mukara, K. B., & Lilford, R. L. (2017). Prevalence of middle ear infections and associated risk factors in children under 5 years in Gasabo district of Kigali city, Rwanda. PubMed Central (PMC). 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5733628/

2

Healthy People 2020 Impact Paper; Falls in Older Adults

Student’s name

Instructor

Course

Date

Healthy People 2020 Impact Paper; Falls in Older Adults

About one-third of all falls by older people each year result in serious injury or death, according to the Healthy People 2020 campaign (Healthy People 2020, n.d.). Preventing and reducing the risk of accidents by determining what causes slips and falls and what can be done to prevent them in the present and the future. Falls and fall prevention among the elderly in Illinois will be the focus of this study. An investigation of morbidity and death rates in the vulnerable population will also be examined. This document will provide an overview of the Healthy People 2020 ambitions, key themes, goals, and strategies for preventing falls in this vulnerable group. Conclusions and recommendations on community-driven intervention programs for the population targeted with the goal of decreasing mortality, morbidity, and fall rates will be included in this paper.

Falls may have life-threatening consequences for the people who are at risk. The most common cause of injury and death in people 65 and older is a fall. In 2012, 756 people aged 65 and over in Illinois died as a result of accidental falls (Grossman et al., 2018). Over eighty-four percent of 2012’s accidental fall-related fatalities were among those 65 and older (2013). As many as 53% of the elderly people who fall in Illinois will end up in a nursing home (Grossman et al., 2018). Falls are already costing hospitals $30 billion annually, but according to some estimates, that number may rise to $54.9 billion by 2020. (Kiel, Schmader & Lin, 2018). The occurrence of falls among the elderly has been extensively studied, and the results of this research provide evidence-based recommendations for reducing the risk of falls and instilling a sense of safety among the elderly.

Geriatric Falls in Illinois

Geriatrics in Illinois are no different from those in any other state. Geriatrics are believed to be declining at a rate of one person every thirty minutes. There is a chance that the elderly person would suffer many injuries or possibly die as a result of this accident. A person’s risk of falling increases by 50% when they reach the age of 65, according to the CDC’s research in Illinois. Falls may lead to a variety of health problems, including muscle weakness in the lower body, vitamin D insufficiency, trouble walking and maintaining balance, the need for additional drugs, and foot discomfort. However, there is a simple solution to avoid these mishaps. When it comes to keeping the elderly safe from falling, nothing beats education. For certain elderly groups, one-on-one care may be required.

Data on Mortality and Morbidity

When it comes to geriatric deaths, there is no better killer than falls. Geriatric patients who fall are more likely to develop difficulties in the near future or perhaps die as a direct result. Osteoporosis rates grow in senior individuals who have fallen, which is linked with a higher risk of morbidity. About 36% of patients treated to emergency rooms in Illinois are hospitalized due to falls (Lesser et al., 2018). This particular population’s revisits are for the purpose of preventing more falls or possibly death. The most common cause for geriatric emergency department visits and admissions is a fall (Lesser et al., 2018). Elderly people are twice as likely to go to the ER if they have previously suffered a fall.

Healthy People 2020

A fall is treated in an emergency room every 13 seconds, according to the Healthy People 2020 report. About a third of the elderly people who fall are above the age of 65. Evidence-based practice initiatives are offered to the senior population in order to avoid falls, as stated by Healthy People 2020. These include services for the elderly, as well as other community resources.

Proper caregivers allocated to persons at risk of falling are an important strategy for the senior population to reduce the frequency of falls. Adults in hospitals who are in danger of falling should have a one-to-one caregiver allocated to them. Patients who are in danger of falling in their own homes should have a caregiver on call to assist them while they are out and about or going to the restroom. When an elderly person is alone at home, there should be measures in place to limit the risk of a fall. Wearing non-skid socks, avoiding having rugs or carpets in the home, and installing railings in bathrooms and other high-traffic areas like stairwells and bathtubs are just a few of the preventative strategies available. Healthy People 2020’s mission is to educate the elderly about self-care and fall prevention by providing them with information on the approaches outlined above.

Health Promotion Review

Elderly people (65 and older) grow healthier and live longer in the United States. To deal with this problem, Frontiers in Public Health suggests a multi-pronged preventative strategy (Grossman et al., 2018). Those with a higher risk of falling should have their fall risk assessed. In addition to the usual fall prevention teaching, it is critical to repeat these exams and include in them how drugs might mix and contribute to falls, home safety, exercise or strength-building programs, and the usage of vitamin D. (Kiel, Schmader & Lin, 2018).

Understanding the strategies outlined by Healthy People 2020 will be critical to achieving the initiative’s aim of avoiding falls among the elderly population. The most important strategy is to educate this group on avoiding falls, either via nurse education or tight caregiver assignments. Following a fall prevention plan may be used to reduce the number of falls in the geriatric population (Goldberg et al., 2020). Geriatrics will be able to follow a specific procedure to lessen the number of falls they have over the course of a year.

All of the recommendations in Healthy People 2020 apply to the older population, including the recommended interventions. Elderly people, particularly those with a history of falling, need to be closely supervised by caretakers (Goldberg et al., 2020). By adhering to provider guidelines, you may help minimize the number of emergency department visits.

Conclusion

In summation, fall-related geriatric fatalities and health issues are very common in the elderly population. Elderly adults are admitted to emergency rooms most often due to falls. Most elderly in Illinois who end up in the ER do so because of a fall, accounting for 33% of all visits. Proper fall-prevention education for older adults is recommended by the Healthy People 2020 initiative. Preventing falls may be as easy as putting on non-skid socks while walking about the home, or it can be as complex as assigning a caretaker to each patient. Elderly falls are a particular concern for Healthy People 2020. That is because better patient outcomes and higher levels of care quality may be achieved via effective fall prevention.

References

Goldberg, E. M., Marks, S. J., Ilegbusi, A., Resnik, L., Strauss, D. H., & Merchant, R. C. (2020). GAPcare: the geriatric acute and post‐acute fall prevention intervention in the emergency department: preliminary data. Journal of the American Geriatrics Society, 68(1), 198-206.

Grossman, D. C., Curry, S. J., Owens, D. K., Barry, M. J., Caughey, A. B., Davidson, K. W., … & US Preventive Services Task Force. (2018). Interventions to prevent falls in community-dwelling older adults: US Preventive Services Task Force recommendation statement. Jama, 319(16), 1696-1704.

Healthy People 2020. (n.d.). Falls Prevention in Community-Dwelling Older Adults: Interventions. Evidence-based resource summary. Retrieved January 11, 2022, from https://www.healthypeople.gov/2020/tools-resources/evidence-based-resource/falls-prevention-in-community-dwelling-older-adults-interventions

Kiel, D. P., Schmader, K., & Lin, F. (2018). Falls in older persons: Risk factors and patient evaluation. UpToDate. Waltham: UpToDate Inc.

Lesser, A., Israni, J., Kent, T., & Ko, K. J. (2018). Association between physical therapy in the emergency department and emergency department revisits for older adult fallers: a nationally representative analysis. Journal of the American Geriatrics Society, 66(11), 2205-2212.