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Case Study 1 & 2 Lyme Disease and Peripheral Vascular Disease 

The answers must be in your own words with reference to journal or book where you found the evidence to your answer. Do not copy paste or use a past students work as all files submited in this course are registered and saved in turn it in program.

Turn it in Score must be less than 50% or will not be accepted for credit, must be your own work and in your own words. You can resubmit, Final submission will be accepted if less than 50%. Copy paste from websites or textbooks will not be accepted or tolerated. Please see College Handbook with reference to Academic Misconduct Statement.

All answers to case studies must have reference cited in text for each answer and minimum of 2 Scholarly References (Journals, books) (No websites)  per case Study

1. Your community is at risk for a specific type of natural disaster (e.g., tornado, flood, hurricane, earthquake). Use Nightingale’s principles and observations to develop an emergency plan for one of these events. Outline the items you would include in the plan.

2. Using Nightingale’s concepts of ventilation, light, noise, and cleanliness, analyze the setting in which you are practicing nursing as an employee or student.

3. You are participating in a quality improvement project in your work setting. Share how you would develop ideas to present to the group based on a Nightingale approach

Explain in 3 paragraphs total

I NEED A RES

ZERO PLAGIARISM

3 REFERENCES

Cognitive Behavioral Therapy: Group Settings Versus Family Settings

Cognitive Behavior Therapy (CBT) has proven to be an effective evidenced based psychotherapy for many individuals with psychological and emotional disorders in both family and group therapy settings as it is in individual settings (Landa, Mueser, Wyka, Shreck, Jespersen, Jacobs, … Walkup, 2016; Patterson, 2014). The paramount goal of CBT is to modify the maladaptive thinking of individual in the group so that they can better adjust in their perceptual, affective, and behavioral domains, interaction, and relationships (Wheeler, (Ed.), 2014). However, unlike in individual psychotherapy, where an individual’s thinking can be challenged directly, family and group sessions presents the dilemma of involvement of others whose definition of a problem may be at variance (Yalom and Leszcz, 2005). Furthermore, the issues of privacy, confidentiality, and honest exchange can present additional obstacles (Patterson, 2014; Wheeler, (Ed.), 2014).

In the light of this, determining if family or group CBT is appropriate for any individual or groups of individuals should be based on thorough assessment of the environment or contest in which communication take place (Wheeler, (Ed.), 2014; Yalom and Leszcz, 2005). The family provide the primary socializing environment for people of all cultures. Maladaptive behaviors in individuals can therefore be seen as a product of that family dysfunction (Gomes, Cordioli, Bortoncello, Braga, Gonçalves, Heldt, 2016). Family structure, hierarchy, alliances, boundaries, and communication patterns provide the context in which interaction that provide a feedback loop (negative or positive) take place (Selles, Belschner, Negreiros, Lin, Schuberth, McKenney, … Stewart, 2018; Gomes et al, 2016; Landa et al, 2016). Family CBT may be useful in families with multigenerational dysfunctional thinking patterns, feeling of a sense of guilt for the suffering of another, severe differentiation, triangulation of members, or role conflict, such as in post-traumatic stress disorder (PTSD), Obsessive compulsive disorders (OCD), and psychosis (Selles et al, 2018; Gomes et al, 2016; Landa et al, 2016).

A combination of cognitive and behavior approach is used to redirect the thinking of family members in more realistic way about the peculiar dysfunctions of the family, such as role differentiation, obsessions, entrenched behavioral responses, structures and subsystems, and communication patterns to produce second-order changes. Methods may include cybernetics, role reversal, acting out an escalation of dysfunction or the desired state, and exploiting the family feelings and reaction. When family members accept certain symptoms as normal, this may in effect reestablish dynamic family equilibrium in interaction (Sheehan and Friedlander, 2015),

Group CBT on the other hand can be used for therapeutic and preventive intervention in varying populations. Often shared symptomatology or diagnosis are the bases for group formation. At other times, groups may be formed around sociocultural identities. Whatever is the underlying reason for the group formation, proper assessment is necessary for setting, group membership, ground rules, development of goals and objectives (Selles, Belschner, Negreiros, Lin, Schuberth, McKenney, … Stewart, 2018). Psychoeducation of group members is done to introduce member to issues of rules, norms, gals, privacy, confidentiality and the limitation thereof (Mulia, Keliat, and Wardani, 2017). Unlike in family therapy, where embers have shared concerns and relative involvement in each others life, members of the group may not see how the group may be helpful to them.

It is therefore the responsibility of the leader or therapist to ensure that curative/therapeutic factors, such as, building hope, encouraging and guiding group interaction, emotional expression, real time awareness of the impact of interaction and communication patterns on individual in the session are addressed in a way that real but non-patronizing way (Patterson, 2014; Wheeler, (Ed.), 2014; Yalom and Leszcz, 2005).  During psychoeducation, integrative factors including group cohesion, universality of issues and cohesiveness should be emphasized.  Conflicts which may arise in groups should be considered as unique opportunity for social learning (Mulia, Keliat, and Wardani, 2017; Patterson, 2014; Yalom and Leszcz, 2005).

In a small-scale study conducted by Landa, Mueser, Wyka, Shreck, Jespersen, Jacobs, … Walkup, they found that group CBT did not only reduce psychotic symptoms in adolescents with predisposition to psychosis, but the “family members showed significant improvements in use of CBT skills, enhanced communication with their offspring, and greater confidence in their ability to help” (2016, p. 511). Another study by Mulia, Keliat, and Wardani (2017), showed significant improvement in anxiety in drug addicted inmates, using the Hamilton Anxiety Scale (HAM-A) post treatment with CBT compared to routine nursing intervention.

The media from Week 5 highlights some of the challenges of using cognitive behavioral therapy for groups. The clients (Ms. Johnson) who had been traumatized by sexual abuse could not at the time see the usefulness of therapy despite reassurance from peers. Self-blame was a central team for members of the group and that can be confronted with CBT.

I attended  a group therapy session where, a patient  was prematurely discharged from group therapy due to inability to follow rules. He has dysfunctional overcompensation for his internalized self-blame and maladaptive response to deal with his anger and feeling of inadequacy (Webb, Hirsch, Visser, and Brewer, 2013). His daughter was sexually abused by his younger brother while he was incarcerated, and he has not forgiven himself or his brother for what happened to his only daughter. Presently, he is overprotective of his daughter and excessively tax himself financially and otherwise to meet and exceed every irrationally perceived need of his daughter. Family CBT was recommended for him and his daughter before his premature discharge from the group therapy session.

In such situation a dyad type family CBT can be more beneficial than a group CBT therapy.

References:

Gomes, J. B., Cordioli, A. V., Bortoncello, C. F., Braga, D. T., Gonçalves, F., & Heldt, E. (2016). Impact of cognitive-behavioral group therapy for obsessive-compulsive disorder on family accommodation: A randomized clinical trial. Psychiatry Research, 246, 70–76. https://doi-org.ezp.waldenulibrary.org/10.1016/j.psychres.2016.09.019

Landa, Y., Mueser, K. T., Wyka, K. E., Shreck, E., Jespersen, R., Jacobs, M. A., … Walkup, J. T. (2016). Development of a group and family-based cognitive behavioural therapy program for youth at risk for psychosis. Early Intervention in Psychiatry, 10(6), 511–521. https://doi-org.ezp.waldenulibrary.org/10.1111/eip.12204

Laureate Education (Producer). (2013c). Johnson family session 3 [Video file]. Author: Baltimore, MD.

Mulia, M., Keliat, B. A., & Wardani, I. Y. (2017). Cognitive behavioral and family psychoeducational therapies for adolescent inmates experiencing anxiety in a narcotics correctional facility. Comprehensive Child & Adolescent Nursing, 40, 152–160. https://doi-org.ezp.waldenulibrary.org/10.1080/24694193.2017.1386984

Patterson, T. (2014). A Cognitive Behavioral Systems Approach to Family Therapy. Journal of Family Psychotherapy, 25(2), 132–144. https://doi-org.ezp.waldenulibrary.org/10.1080/08975353.2014.910023

Selles, R. R., Belschner, L., Negreiros, J., Lin, S., Schuberth, D., McKenney, K., … Stewart, S. E. (2018). Group family-based cognitive behavioral therapy for pediatric obsessive compulsive disorder: Global outcomes and predictors of improvement. Psychiatry Research, 260, 116–122. https://doi-org.ezp.waldenulibrary.org/10.1016/j.psychres.2017.11.04

Sheehan, A. H., & Friedlander, M. L. (2015). Therapeutic alliance and retention in brief strategic family therapy: A mixed-methods study. Journal of Marital and Family Therapy, 41(4), 415–427. doi:10.1111/jmft.12113

Time to explore! Find a communication message about a health outbreak (this can be past or present) and include the link in your post. What is the health issue, why is this important, who was at risk, how effective was this communication message (think the type of communication, health literacy, cultural competence, etc.), could it be improved? Explain your answers, provide evidence-informed information, and explain how you could improve the message knowing what you know now. 

Your post needs to be at least 350 words and provide at least 3 references. Respond to 2 peers. 

please read before you start writing the response on the attachment, which talk about the Texas Board of Nursing restrictions or protection for each. 

write at least 100 word, APA format. 

Leading Innovation in Nursing

2 pages, double spacing, APA format. At least 2 references. Absolutely plagiarism free.

Propose a future development that affects value-based healthcare and address the following.

· What would you create, and why? What problem does this innovation solve?

· How does this innovation impact value-based healthcare?

· How will it enhance your leadership capacity?

· As a leader, explain one barrier you may have in implementing the innovation and how you could use the 5-Stage Innovation-Decision Process to overcome that barrier.

Reading:

Chism, L. A. (2019). The Doctor of Nursing Practice: A guidebook for role development and professional issues (4 th ed.). Jones & Bartlett Publishers.

· Chapter 12: Shaping Your Brand: Marketing Yourself as a DNP Graduate

o Rogers’s Diffusion of Innovation Theory, p. 304

https://online.vitalsource.com/#/books/9781284155259/epubcfi/6/296%5B%3Bvnd.vst.idref%3Di23_Chapter12%5D!/4/2%5Bch12%5D/2%5Bvst-image-button-215147%5D/2%400:43.4

Discussion: Diversity and Health Assessments

May 2012, Alice Randall wrote an article for The New York Times on the cultural factors that encouraged black women to maintain a weight above what is considered healthy. Randall explained—from her observations and her personal experience as a black woman—that many African-American communities and cultures consider women who are overweight to be more beautiful and desirable than women at a healthier weight. As she put it, “Many black women are fat because we want to be” (Randall, 2012).

Photo Credit: Getty Images

Randall’s statements sparked a great deal of controversy and debate; however, they emphasize an underlying reality in the healthcare field: different populations, cultures, and groups have diverse beliefs and practices that impact their health. Nurses and healthcare professionals should be aware of this reality and adapt their health assessment techniques and recommendations to accommodate diversity.

In this Discussion, you will consider different socioeconomic, spiritual, lifestyle, and other cultural factors that should be taken into considerations when building a health history for patients with diverse backgrounds. Your Instructor will assign a case study to you for this Discussion.

To prepare:

·  Reflect on your experiences as a nurse and on the information provided in this week’s Learning Resources on diversity issues in health assessments.

·  By Day 1 of this week, you will be assigned a case study by your Instructor. Note: Please see the “Course Announcements” section of the classroom for your case study assignment.

·  Reflect on the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient assigned to you.

·  Consider how you would build a health history for the patient. What questions would you ask, and how would you frame them to be sensitive to the patient’s background, lifestyle, and culture? Develop FIVE targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.

·  Think about the challenges associated with communicating with patients from a variety of specific populations. What strategies can you as a nurse employ to be sensitive to different cultural factors while gathering the pertinent information?

By Day of Week 2

1-Post an Explanation of the Specific Socioeconomic, Spiritual, Lifestyle, and other cultural factors associated with the patient you were assigned.

2- Explain the Issues that you would need to be Sensitive to When interacting with the patient, and WHY.

3- Provide at least Five Targeted Questions you would ask the patient to build his or her health history and to assess his or her health risks.

“CASE STUDY #1”

MR, a 23-year-old Native American male comes in to see you because he has been having anxiety and wants something to help him. He has been smoking “pot” and says he drinks to help himself too. He tells you he is afraid that he will not get into heaven if he continues in this lifestyle. He is not taking any prescriptions medications and denies drug use. He has a positive family history of diabetes, hypertension, and alcoholism.

Note: REMEMBER AT LEAST THREE REFERENCES AND APA FORMAT.

For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!

I need these questions answered in 120 words each with individual references

UNIT 1

DQ1

Define endemic, epidemic, and pandemic, and provide an example of each. Describe a current epidemic. Describe one example of each of the prevention types (primary, secondary, and tertiary) that could be applied to control the epidemic.

DQ2

Discuss the role the CDC’s Morbidity and Mortality Weekly Report (MMWR) plays in conveying public health information and recommendations. Describe the type of data and information provided by the MMWR. Choose a report posted within the last 2 years from the “Publications – Weekly Report” tab. Provide a brief summary of the disease report, including the natural history and mode of transmission, and whether the report is an example of descriptive epidemiology or analytical epidemiology.

RESOURCES

Read Chapters 1, 2, and 6 in Gordis Epidemiology.

Read “Smoking and Carcinoma of the Lung,” by Doll and Hill, from British Medical Journal (1950). URL: https://www-ncbi-nlm-nih-gov.lopes.idm.oclc.org/pmc/articles/PMC2038856/pdf/brmedj03566-0003.pdf

Read “The Training of Epidemiologists and Diversity in Epidemiology: Findings from the 2006 Congress of Epidemiology Survey,” by Carter-Pokras et al., from Annals of Epidemiology (2009). URL: http://www.sciencedirect.com.lopes.idm.oclc.org/science/article/pii/S104727970900060X

Watch “Epidemiology the Backbone of Public Health,” by Greg Martin (2017), located on the YouTube website. URL: https://www.youtube.com/watch?v=S5XRh47T420

Read “The Framingham Study: ITS 50-Year Legacy and Future Promise,” by Kannel, from Journal of Atherosclerosis and Thrombosis (2000). URL: https://www.jstage.jst.go.jp/article/jat1994/6/2/6_2_60/_pdf

Read “Epidemiological Background and Design: The Framingham Study,” located on the Framingham Heart Study website. URL: https://www.framinghamheartstudy.org/fhs-about/history/epidemiological-background/

Read “Epidemiological Approaches to Heart Disease: The Framingham Study,” by Dawber, Meadors, and Moore, from American Journal of Public Health (1951). URL:http://scholar.google.com/scholar_url?url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1525365/pdf/amjphnation00421-0020.pdf&hl=en&sa=X&scisig=AAGBfm10VqiSJ6tLAYY0TMfm15VR8M93MA&nossl=1&oi=scholarr

View “Global Disease Detectives,” by the Center for Global Health (2013), located on the Centers for Disease Control and Prevention (CDC) website. URL: https://www.cdc.gov/cdctv/dataandstatistics/disease-detectives.html

Read “Section 2: Historical Evolution of Epidemiology,” from Lesson 1 of  the Centers for Disease Control and Prevention (CDC) self-study course, Principles of Epidemiology in Public Health Practice (2012), located on the CDC website. URL:https://www.cdc.gov/csels/dsepd/ss1978/lesson1/section2.html

Explore the CDC Current Outbreak List page of the Centers for Disease Control and Prevention (CDC) website. URL: https://www.cdc.gov/outbreaks/index.html

Explore the Epidemic Intelligence Service page of the Centers for Disease Control and Prevention (CDC) website. URL: https://www.cdc.gov/eis/index.html

Explore the Morbidity and Mortality Weekly Report (MMWR), located on the Centers for Disease Control and Prevention (CDC) website. URL: https://www.cdc.gov/mmwr/index.html

UNIT 2

DQ1

Disease surveillance is a necessary public health role. Passive surveillance relies on individuals and local authorities “pushing” information to national agencies who then compile, analyze, and disseminate the information. Unfortunately, significant gaps occur in reporting.

Review your textbook, and the CDC’s National Notifiable Disease Surveillance System (NNDSS). Discuss the strengths of the current surveillance systems, the gaps you identified, and why these gaps occur. Discuss the global challenges of coordinating surveillance between multiple countries and provide an example highlighting the challenges. What could other governments and agencies, such as the World Health Organization and the Centers for Disease Control and Prevention, do to strengthen global disease surveillance systems?

DQ2

Explain the importance of validity and reliability in diagnostic testing or research. Describe how validity relates to sensitivity and specificity in diagnostic testing. Identify a health screen specific to a diagnostic test that is currently being debated regarding its use, recommended ages, or frequency, and discuss how validity and reliability play into this debate. What other factors should you consider when you assess the recommendations for a diagnostic test or screen?

STUDY MATERIALS

Read Chapters 3-5 and 18 in Gordis Epidemiology.

Read “Types of Surveillance,” located on the London School of Hygiene and Tropical Medicine website. URL:http://conflict.lshtm.ac.uk/page_75.htm

Read “WHO Report on Global Surveillance of Epidemic-Prone Infectious Diseases – Introduction,” located on the World Health Organization (WHO) website. URL: https://www.who.int/csr/resources/publications/introduction/en/

Read “CDC 24-7 Fact of the Week,” located on the Centers for Disease Control and Prevention (CDC) website. URL:https://www.cdc.gov/about/facts/index.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fabout%2Ffacts%2Fcdcfastfacts%2Fsurveillance.html

Read “Two by Two Tables,” by Sullivan, Dean, and Pezzullo, from OpenEpi: Open Source Epidemiologic Statistics for Public Health (2013), located on the OpenEpi website. URL: http://www.openepi.com/TwobyTwo/TwobyTwo.htm

Read “Goodness of Measurement: Reliability and Validity,” by Bajpai and Bajpai, from International Journal of Medical Science and Public Health (2014). URL: https://www.ejmanager.com/mnstemps/67/67-1380953319.pdf

Use the “Compendium of Acute Foodborne and Waterborne Diseases,” located on the Centers for Disease Control and Prevention (CDC) website, to assist in completing the Oswego Outbreak Case History assignment. URL: https://www.cdc.gov/eis/casestudies/xoswego.401.303.compendium.pdf

View “How to Create an Epidemic Curve,” by Martin (2016), located on the YouTube website. URL: https://www.youtube.com/watch?v=dn84ezAzV4k

View “Know How to Interpret an Epidemic Curve?” by Martin (2017), located on the YouTube website. URL: https://www.youtube.com/watch?v=7SM4PN7Yg1s

Explore the National Notifiable Diseases Surveillance System (NNDSS) page of the Centers for Disease Control and Prevention (CDC) website. URL: https://wwwn.cdc.gov/nndss/

Explore Public Health Surveillance and Data page of the Centers for Disease Control and Prevention (CDC) website. URL: https://www.cdc.gov/surveillance/

UNIT 3

DQ1

Differentiate between bias and confounding. Discuss the criteria necessary to establish a factor as a confounder and provide an example applying these criteria. What is one way to adjust for a confounding relationship in the study design or the analysis?

DQ2

Explain the two major types of bias. Identify a peer-reviewed epidemiology article that discusses potential issues with bias as a limitation and discuss what could have been done to minimize the bias (exclude articles that combine multiple studies such as meta-analysis and systemic review articles). What are the implications of making inferences based on data with bias? Include a link to the article in your reference.

STUDY MATERIALS

Read Chapters 14 and 15 in Gordis Epidemiology.

Read “Association or Causation: Evaluating Links Between ‘Environment and Disease,'” by Lucas and McMichael (2005), located on the World Health Organization website. URL: https://www-ncbi-nlm-nih-gov.lopes.idm.oclc.org/pmc/articles/PMC2626424/pdf/16283057.pdf

Read “Weak Associations in Epidemiology: Importance, Detection, and Interpretation,” by Doll, from Journal of Epidemiology (1996). URL: https://www.jstage.jst.go.jp/article/jea1991/6/4sup/6_4sup_11/_pdf

Read “Causal Inference Based on Counterfactuals,” by Hofler (2005), located on the BioMed Central website. URL: https://bmcmedresmethodol.biomedcentral.com/articles/10.1186/1471-2288-5-28

Read “Multicausality: Confounding,” by Schoenbach (2004), located on the Epidemilog.net website. URL: http://www.epidemiolog.net/evolving/Multicausality-Confounding.pdf

View “Sensitivity and Specificity – Explained in 3 Minutes,” by Martin (2014), located on the YouTube website. URL: https://www.youtube.com/watch?v=FnJ3L-63Cf8

View “The Relationship Between Incidence and Prevalence,” by Patwari (2013), located on the YouTube website. URL: https://www.youtube.com/watch?v=1jzZe3ORdd8

Use the “Creating a 2×2 Contingency Table” resource to assist with the completion of the Measuring Morbidity: Prevalence and Incidence assignment, as needed.

UNIT 4

DQ1

Based on the “Multicausality: Confounding – Assignment,” by Schoenbach, discuss two significant insights you learned about confounding. Use specific examples from the assignment to support your answer.

DQ2

Describe the characteristics and design of a cohort study. Based on a disease or health condition identified from the “2020 LHI Topics” on the Healthy People 2020 website, or an article from the GCU library, discuss a real example of a cohort study (include the link to the article in your post to the forum). Include the participants, exposures or treatment groups, timeframe, and outcomes that were measured. Why is a cohort study described as an “observational” study rather than an “experimental” study design?

STUDY MATERIALS

Read Chapters 7-9 in Gordis Epidemiology.

View “Randomized Control Trials and Confounding,” by Martin (2013), located on the YouTube website. URL: https://www.youtube.com/watch?v=7ybuE39BpQ8

Read “2020 LHI Topics,” located on the Healthy People 2020 website. URL: https://www.healthypeople.gov/2020/leading-health-indicators/2020-LHI-Topics

Complete the “Multicausality: Confounding – Assignment,” by Schoenbach (2001), located on the Epidemilog.netwebsite. URL: http://www.epidemiolog.net/evolving/ConfoundingAssgt.pdf

Refer to the “Multicausality: Confounding – Assignment Solutions,” by Schoenbach (2001), located on the Epidemilog.netwebsite, to check your answers to the assignment. URL: http://www.epidemiolog.net/evolving/ConfoundingSolns.pdf

Read “Understanding Controlled Trials: Why Are Randomized Controlled Trials Important?” by Sibbald and Roland, from British Medical Journal (1998). URL:http://search.proquest.com.lopes.idm.oclc.org/docview/1777585669/fulltextPDF/2BDCED02960C4E6APQ/1?accountid=7374

UNIT 5

DQ1

Describe the common characteristics and design of a case-control study. Discuss the three important features when it comes to selecting cases and controls, and identify a situation when one of these might be violated. Discuss the limitations of using questionnaires for determining exposure status and provide examples of alternative strategies for collecting this information in a case-control study.

DQ2 

Discuss the strengths and weaknesses of cross-sectional studies and examples of how they can be “descriptive” or “analytic” study designs. Discuss an example of a disease where survival could influence the association between a possible exposure and the disease when measured with a cross-sectional study. Do not discuss examples used in the textbook.

STUDY MATERIALS

Read Chapter 10 in Gordis Epidemiology.

View “Cohort and Case Control Studies,” by Martin (2013), located on the YouTube website. URL: https://www.youtube.com/watch?v=J3GHTYa-gZg

Read “Introduction to Study Designs – Cross-Sectional Studies,” located on the Health Knowledge website. URL: https://www.healthknowledge.org.uk/e-learning/epidemiology/practitioners/introduction-study-design-css

Read “Cross-Sectional Studies,” from ERIC Notebook (2012), located on the Gillings School of Global Public Health -University of North Carolina website. URL: https://sph.unc.edu/files/2015/07/nciph_ERIC8.pdf

Read “Section 7: Analytic Epidemiology,” from Lesson 1 of the Centers for Disease Control and Prevention (CDC) self-study course, Principles of Epidemiology in Public Health Practice: An Introduction to Applied Epidemiology and Biostatistics (2012), located on the CDC website. URL: https://www.cdc.gov/csels/dsepd/ss1978/lesson1/section7.html

UNIT 6

DQ1

Differentiate between association and causation using the causal guidelines. Discuss which of the guidelines you think is the most difficult to establish. Discuss the four types of causal relationships and use an example not listed in the textbook to describe each relationship.

DQ2

Explain the difference between relative risk, attributable risk, and population attributable risk. Provide an example (not from the textbook) of how each type of risk is used in epidemiology. How would you propose using population attributable risk to advocate for a health policy or intervention relative to your health interest?

STUDY MATERIALS

Review Chapter 14, and read Chapters 11-13 in Gordis Epidemiology.

Read “Causation in Epidemiology: Association and Causation,” located on the Health Knowledge website. URL: https://www.healthknowledge.org.uk/e-learning/epidemiology/practitioners/causation-epidemiology-association-causation

Read “Section 5: Measures of Association,” from Lesson 3 of the Centers for Disease Control and Prevention (CDC) self-study course, Principles of Epidemiology in Public Health Practice: An Introduction to Applied Epidemiology and Biostatistics (2012), located on the CDC website. URL: https://www.cdc.gov/csels/dsepd/ss1978/lesson3/section5.html

Use the “BRFSS Web Enabled Analysis Tool,” located on the Centers for Disease Control and Prevention (CDC) website, to complete the topic assignment. URL: https://nccd.cdc.gov/weat/#/

Review “Multicausality: Confounding,” by Schoenbach (2004), located on the Epidemilog.net website. URL: http://www.epidemiolog.net/evolving/Multicausality-Confounding.pdf

View “How to Calculate Relative Risk,” by Shaneyfelt (2012), located on the YouTube website. URL: https://www.youtube.com/watch?v=xk2uK14eHNs

View “How to Calculate an Odds Ratio,” by Shaneyfelt (2012), located on the YouTube website. URL: https://www.youtube.com/watch?v=ITi0SxmQTO8

UNIT 7

DQ1

Epidemiological methods are used in a variety of public health areas (including infectious disease, chronic disease, and social health) and settings (including the community, schools, and the workplace). Epidemiological methods are used to assess, describe, analyze, and make comparisons of populations to inform evidence-based practices, policies, and interventions. Propose a study based on the methods you have learned thus far designed to investigate an association within one of the public health areas listed (infectious disease, chronic disease, or social health) and the methods you would apply. Discuss and define the risk factor or exposure that is being assessed, the method of comparison that is used, and the setting or situation (community, school, workplace, etc.) your study would look to address. Consider the concepts of causal inference, measures of association, and study design.

DQ2

Race is often used as a descriptor of disease burden and helps us to determine where health disparities exist in order to address them, which is important. It is helpful to differentiate between race as a descriptor and race as a risk factor. Think about institutional racism and its influence on health. Consider the factors related to race and ethnicity that might be influencing disease status more than the genetics of race when answering this discussion question.

Consider the following statement: “Race is not a risk factor and should not be used in public health data collection.” Discuss the ethical and public health implications of this statement. When might collecting data on race perpetuate institutional racism leading to health disparities and when is it necessary to improve public health? Provide support and examples for your answer. Consider ethical issues related to respect for persons, beneficence, and justice as described in “The Belmont Report.”

STUDY MATERIALS

Read Chapters 17, 19, and 20 in Gordis Epidemiology.

Read “Health Inequalities Among British Civil Servants: The Whitehall II Study,” by Marmot and Smith, from The Lancet (1991). URL:https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=hch&AN=9107080526&site=ehost-live&scope=site

Read “The Role of Epidemiology in Disaster Response Policy Development,” by Thorpe et al., from Science Direct (2015). URL:http://www.sciencedirect.com.lopes.idm.oclc.org/science/article/pii/S1047279714003184?_rdoc=1&_fmt=high&_origin=gateway&_docanchor=&md5=b8429449ccfc9c30159a5f9aeaa92ffb

Read “Prescription Drug Abuse: From Epidemiology to Public Policy,” by McHugh, Nielsen, and Weiss, from Journal of Substance Abuse Treatment (2015). URL:http://www.sciencedirect.com.lopes.idm.oclc.org/science/article/pii/S0740547214001871?_rdoc=1&_fmt=high&_origin=gateway&_docanchor=&md5=b8429449ccfc9c30159a5f9aeaa92ffb&ccp=y

Read “The Role Epidemiology in Evidence-Based Policy Making: A Case Study of Tobacco Use in Youth,” by Aldrich et al., from Annals of Epidemiology (2015). URL:http://www.sciencedirect.com.lopes.idm.oclc.org/science/article/pii/S1047279714001495?_rdoc=1&_fmt=high&_origin=gateway&_docanchor=&md5=b8429449ccfc9c30159a5f9aeaa92ffb

Read “Epidemiology, Policy, and Racial/Ethnic Minority Health Disparities,” by Carter-Pokras et al., from Annals of Epidemiology (2012). URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3724931/

Read “Epidemiology and Public Policies,” by Barata, from Revista Brasileira de Epidemiologia (2013). URL: http://www.scielo.br/scielo.php?pid=S1415-790X2013000100003&script=sci_arttext&tlng=en

Read “Ethical Issues in Epidemiologic Research and Public Health Practice,” by Coughlin, from Emerging Themes Epidemiology (2006). URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1594564/

Explore the “Viral Hepatitis Epidemiologic Profiles” map, located on the Association of State and Territorial Health Officials (ASTHO) website, to assist with topic assignment.URL: https://www.astho.org/Viral-Hepatitis-Epi-Profiles/Map/

Use the “BRFSS Web Enabled Analysis Tool,” located on the Centers for Disease Control and Prevention (CDC) website, to complete the topic assignment. URL: https://nccd.cdc.gov/weat/#/

Review the “Belmont Report,” by the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research (1979), located on the U.S. Department of Health and Human Services – Office for Human Research Protections website. URL: https://www.hhs.gov/ohrp/regulations-and-policy/belmont-report/index.html

Explore the resources on “Health Data Tools and Statistics,” located on the PHPartners website. URL: https://phpartners.org/health_stats.html

Explore “Surveillance, Epidemiology and the End Results Program,” from the National Cancer Institute.URL: https://seer.cancer.gov/

Explore the STEPwise Approach to Surveillance (STEPS) page of the World Health Organization (WHO) website. URL: http://www.who.int/chp/steps/en/

UNIT 8

DQ1

One method to investigate gene-environment interactions is to study monozygotic twins. Identify an example of a twin study not listed in the textbook used to examine the gene-environment interaction of a specific disease or condition. Briefly summarize the gene-environment interaction investigated, the methods, and the results. What are other possible methods for studying gene-environment interactions as they relate to improving population health?

DQ2

Using the CDC Wonder website, set the query criteria for pancreatic cancer for the United States as illustrated below. Compare the rates by race for Wisconsin and Colorado. Discuss possible biological, genetic, and environmental reasons for differences. What are potential social determinants that contribute to the disparity presented between the two states?

Use this query upon entering the CDC Wonder website:

Select “Cancer Statistics” under the Wonder Systems tab

Select “Cancer Incidence 1999 – 2013” and click “Data Request”

Organize table layout:

1. Group      results by 1. States and 2. Race (leave the rest of the group options as      “None”)
2. Measures      – click “Count” (default) and “Age Adjusted Rates”

Select location – select “States” and “The United States”

Select year and demographics

1. Year      – 2014
2. Sex      – All genders
3. Age      groups – All ages
4. Ethnicity      – All ethnicities
5. Race      – All races

Select cancers of interest – select “Pancreas”

Other options – keep default settings

STUDY MATERIALS

Read Chapter 16 in Gordis Epidemiology.

Read “Gene-Environment Interaction,” located on the National Institute of Environmental Health Sciences website. URL: https://www.niehs.nih.gov/health/topics/science/gene-env/index.cfm

Read “Defeating the ZIP Code Health Paradigm: Data, Technology, and Collaboration Are Key,” by Graham, Ostrowski, and Sabina, from the Health Affairs Blog (2015), located on the Health Affairs website. URL: http://healthaffairs.org/blog/2015/08/06/defeating-the-zip-code-health-paradigm-data-technology-and-collaboration-are-key/

Explore the CDC Wonder page of the Centers for Disease Control and Prevention (CDC) website.URL: https://wonder.cdc.gov/

Review the Mapping Life Expectancy page of the Robert Wood Johnson Foundation website. URL: http://www.rwjf.org/en/library/articles-and-news/2015/09/city-maps.html

Less than 10 % similarity

References APA

Please answer the following Discussion Question. Please be certain to answer the three questions on this week DQ and to provide a well-developed and complete answer to receive credit. Also, please ensure to have read the assigned chapters for the current week. 

Case Study, Chapter 16, Whistle-Blowing in Nursing

A student nurse asks a faculty member to explain whistle-blowing. The student nurse wants to know the work conditions that would have to be met before whistle-blowing occurs, as well as situations in which whistle-blowing is clearly indicated. The faculty member reviews key concepts with all members of the class.

1. Being a whistle-blower takes great courage and self-conviction because it requires the whistle-blower to avoid groupthink. Analyze how groupthink affects the process of whistle-blowing.

2. Discuss the pros and cons of whistle-blowing.

3. What are the key guidelines for blowing the whistle