Preparing the Assignment
Requirements
The Concept Map must visually connect all of the specified objectives (Program Outcomes, MSN Essentials, and NONPF Competencies) to course work (such as specific discussion board topics, written assignments, exams, lessons, and reading content).
All items should be labeled, for instance, label the objectives and label the course work you select with name of the assignment/reading/discussion board topic and which week it was introduced.
Use Microsoft Word or a PowerPoint to create a Concept Map. You can use the features found on the “Insert” tab of a Word doc (in the horizontal ribbon on the top of a Word doc page). For instance, if you click on “insert” you will see shapes and SmartArt. You can use a PowerPoint slide with shapes and lines to create a concept/mind map. This is not a PowerPoint presentation , but a PowerPoint slide can be used to “draw” the Map.
Outcomes/Competencies to be connected with course learning:
MSN Program Outcome #2:
Create a caring environment for achieving quality health outcomes (Care-Focused).
MSN Essential VIII:
Clinical Prevention and Population Health for Improving Health
National Organization of Nurse Practitioner Competencies #4
Practice Scholarship and Translational Science
Recognizes that the master’s-prepared nurse applies and integrates broad, organizational, client-centered, and culturally appropriate concepts in the planning, delivery, management, and evaluation of evidence-based clinical prevention and population care and services to individuals, families, and aggregates/identified populations.
Your Concept Map will visually depict how you see the assignments of the course meeting the outcomes above.
WEEK 1
Exercise and Discussion Questions from Curley Text Book
Discussion
Purpose
This discussion board content is intended to facilitate learning for students through engaging dialogues as they achieve the desired learning outcomes/competencies associated with their course in a manner that empowers them to organize, integrate, apply and critically appraise their knowledge to their selected field of practice.
The use of discussions provides students with opportunities to contribute graduate level-appropriate knowledge and experience to the topic in a safe, caring, and fluid environment that models professional and social interaction. The ebb and flow of a discussion is based upon the composition of student and faculty interaction in the quest for relevant scholarship.
Participation in the discussion generates opportunities for students to actively engage in the written ideas of others by carefully reading, researching, reflecting, and responding to the contributions of their peers and course faculty. Discussions foster the development of members into a community of learners as they share ideas and inquiries, consider perspectives that may be different from their own, and integrate knowledge from other disciplines.
Due Date
Initial prompt due by Wednesday, 11:59 PM MT of week 1
One peer and one faculty or two peer posts due by Sunday 11:59 PM MT of week 1
A 10% late penalty will be imposed for initial discussions posted after the weekly deadline regardless of the number of days late. No postings will be accepted after 11:59pm MT on Sunday (i.e. student will receive an automatic 0). Week 8 discussion closes on Saturday at 11:59pm MT.
Total Points Possible: 60 Points
Preparing the Assignment
Choose one of the following to respond to in Week 1 Discussion Board;
Chapter 1, Exercise 1.5 or
Chapter 2, Exercise 2.1 or
Chapter 2, Exercise 2.4
Respond with a minimum of two (2) paragraphs of 4-5 sentences each.
You should address each bullet point in the exercise you select.
Your work should have in-text citations integrating at a minimum one scholarly article from this week’s readings and course textbook.
APA format should be utilized to include a reference list.
Correct grammar, spelling, and APA should be adhered to when writing, work should be scholarly without personalization or first person use.
Respond to a minimum of two (2) individuals, peer and/or faculty, with a scholarly and reflective post of a minimum of two (2) paragraphs of 4-5 sentences. A minimum of one (1) scholarly article should be utilized to support the post in addition to your textbook.
Chamberlain College of Nursing
NR 503 Population Health, Epidemiology, & Statistical Principles
Professor Kristin Curcio
March 5, 2024
Chapter 1: Exercise 2.1
An APRN is working in a community clinic providing postnatal care to a diverse population of families. The APRN knows that there is an ethnic disparity for infant mortality. 1. Where could the APRN go to find information on infant mortality disparities? 2. What is the ethnic disparity in infant mortality? 3. What social determinants of health are associated with infant mortality? 4. How might an APRN participate in local efforts to reduce infant mortality rates on a population level?
An APRN would be able to locate baby mortality gap data by searching through credible sources such as the National Partnership for Action (NPA), the Association of American Medical Colleges (AAMC), National Quality Partner (NQP), and the Office of Minority Health and Health Disparities (OMHD), which is within the Centers for Disease Control and Prevention (CDC) (Curley et al., 2024). The organizations have such data, articles, and resources that depict that every cute tricking race has a different death rate. With these references, the APRN would not be ignorant of both the contemporary state of the issue and the contributors to it.
There is a substantial discrepancy across different ethnicities in the United States regarding infant mortality. African American infants die in a figure that is approximately twice higher than the number of non-Hispanic whites among the infants. Among healthy White infants, they die more frequently in comparison to either Native Americans or Puerto Ricans, whose babies possess a much lower mortality rate (Curley et al., 2024). Several social risk factors are the main drivers of the question of why some infants die. Examples of some are, for instance, if a pregnant woman has access to adequate prenatal care, her education level and if the household is well off financially, proper housing is available, and also the environment, such as air pollution and lead exposure is no longer a thing to deal with then the MMR can be optimized just because of these (Reno & Hyder, 2018).
To participate in the community-based effort to reduce the population-based infant mortality rates, an APRN can collaborate with community-based organizations at prenatal level care, which is culturally appropriate and provides prenatal education at the policymaking level by advocating for social determinants of health and with public health departments to develop targeted interventions for populations at high risk at the population level. APRNs could be involved in researching different ways of reducing infant mortality in wealthy and poor communities and designing outcomes for women and children.
References
Curley, A. L., Niedz, B. A., & Erikson, A. (Eds.). (2024). Population-based nursing: Concepts and competencies for advanced practice. Springer Publishing Company.
Reno, R., & Hyder, A. (2018). The evidence base for social determinants of health as risk factors for infant mortality: a systematic scoping review. Journal of health care for the poor and underserved, 29(4), 1188-1208. https://muse.jhu.edu/pub/1/article/708237/summaryLinks to an external site.
WEEK 2
Epidemiological Methods
Discussion
Purpose
This discussion board content is intended to facilitate learning for students through engaging dialogues as they achieve the desired learning outcomes/competencies associated with their course in a manner that empowers them to organize, integrate, apply and critically appraise their knowledge to their selected field of practice.
The use of discussions provides students with opportunities to contribute graduate level-appropriate knowledge and experience to the topic in a safe, caring, and fluid environment that models professional and social interaction. The ebb and flow of a discussion is based upon the composition of student and faculty interaction in the quest for relevant scholarship.
Participation in the discussion generates opportunities for students to actively engage in the written ideas of others by carefully reading, researching, reflecting, and responding to the contributions of their peers and course faculty. Discussions foster the development of members into a community of learners as they share ideas and inquiries, consider perspectives that may be different from their own, and integrate knowledge from other disciplines
Course Outcomes
This assignment enables the student to meet the following course outcomes:
CO 4: Discriminate among various screening tools that may be used in the provision of care as an Advanced Practice Nurse.
Due Date
Initial prompt due by Wednesday, 11:59 PM MT of week 2
One peer and one faculty or two peer posts due by Sunday 11:59 PM MT of week 2
A 10% late penalty will be imposed for initial discussions posted after the weekly deadline regardless of the number of days late. No postings will be accepted after 11:59pm MT on Sunday (i.e. student will receive an automatic 0). Week 8 discussion closes on Saturday at 11:59pm MT.
Total Points Possible: 60 points
Preparing the Assignment
Assignment Requirements
Your course faculty will provide you with topics for the Week 2 Discussion Board. You will need to check the NR503 course Announcements for the topics for the Week 2 Discussion Board regarding screening. The week’s topics were choosen from the following website: Agency for Healthcare Research and QualityLinks to an external site.
Reply to the following prompt:
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?
You should include a minimum of two (2) scholarly articles from the last five (5) years (3 is recommended).
Respond to a minimum of two (2) individuals, peer and/or faculty, with a scholarly and reflective post of a minimum of two (2) paragraphs of 4-5 sentences. A minimum of one (1) scholarly article should be utilized to support the post in addition to your textbook.
Your work should have in-text citations integrating at a minimum one scholarly article and the course textbook. APA format should be utilized to include a reference list. Correct grammar, spelling, and APA should be adhered to when writing, work should be scholarly without personalization or first – person use.
Need assistance? Click here for the Week 2 FAQ documentLinks to an external site. that discusses these terms.
Chamberlain College of Nursing
NR503 Population Health, Epidemiology, & Statistical Principles
Professor Kristin Curcio
March 12, 2024
Evaluation of a Screening Tool for Older Adults: A Critical Analysis
Introduction
The depressed state of older people is a considerable medical issue, therefore calling for the use of appropriate screening instruments to discover those affected and implement the necessary preventive measures (Brañez-Condorena et al., 2021). The Geriatric Depression Scale (GDS) is a valuable tool that benefits by evaluating depressing symptoms in senior adults over the age of 65. The diversity of assessment options, accuracy, and convenience of information extraction improve the quality of care by advanced practitioner nurses for older people.
Reliability and Validity of the GDS are the two critical psychometric properties. There are plenty of researches that prove the adequacy and effectiveness of GDS in the measurement of depressing symptoms that represent older people. Steps like that of internal consistency and test-retest reliability will consistently show a high level of coherence within the scale items. At the same time, concurrent validity studies have ascertained that the GDS successfully spots depressive symptoms, which are verified by specified standards and other assessments.
Predictive Ability
Sensitivity is the core subject that underlies the predictive capacity of the GDS. It is proven to be one of the most productive instruments in identifying depression symptoms in older people. In test results where more sensitive values are observed, these data indicate the effectiveness of the tool in identifying individuals who could be suffering from depressive symptoms without compromising low false negatives. This ability is paramount so that early detection is conducted and the issue is handled as early as possible, thereby improving the quality of life and reducing the cost of healthcare caused by untreated depression.
The GDS possess that beyond what they would exhibit in a traditional screen for depressive symptoms, the predictive capacity of the GDS is revealed to be quite good. Furthermore, depression forecasting using AI advancements has been consistently observed across new, old-aged people(“The Guide to Clinical Preventive Services,” n.d.). Health professionals can identify people at high risk for experiencing such difficulties during the timely screening and thus could design personalized treatment strategies that aim at preventing the progression of depressive symptoms and avoiding possible relapse.
Integration into Clinical Practice
The design of the GDS simplifies the use and comprehension of such a tool. Therefore, it is practicable to include the GDS in the everyday nurse’s clinical practice of advanced nurses(Curley et al., 2024). The possibility to assess depressive symptoms in advance and implement necessary interventions before it is too late is to preserve the mental health of older people. GDS is an integrative factor that boosts mental health assessment and, hence, improves the well-being among older small groups.
However, implementing the GDS into clinical practice is applicable to more than just applying that tool. Doing that also means giving feedback and requiring additional input that follows the test outcomes. In healthcare point, clinicians use this questionnaire frequently (Figueiredo-Duarte et al., 2021).. It is known as the Geriatric Depression Scale, which is internationally among the most commonly utilized screening tool. Advanced practice nurses can utilize the GDS as part of comprehensive geriatric assessments, incorporating the findings into holistic care plans for older adults. Moreover, the nursing staff frequent revising and update depression screening and treatment, making them more competent to utilize GDS for their regular work. Undoubtedly, adopting GDS on a daily scheme of evaluation by nursing staff allows them to make a tangible difference in the mental health conditions and well-being of older adults (Curley et al., 2024).
Conclusion
Finally, the Geriatric Depression Scale is a reliable, valid, and sensitive screening tool for the aging population for revealing depressive symptoms. It is the exemplary and validated performance of the predictive nature of AIBILL during various testing and validation trials that firms it as valuable to clinical dentistry. Working closely with older individuals, Advanced practice nurses contribute to the broadening of symptoms review through the integration of GDS into mental health appraisal to help improve the quality of life for seniors.
References
Brañez-Condorena, A., Soriano-Moreno, D. R., Navarro-Flores, A., Solis-Chimoy, B., Diaz-Barrera, M. E., & Taype-Rondan, A. (2021). Accuracy of the Geriatric Depression Scale (GDS)-4 and GDS-5 for the screening of depression among older adults: A systematic review and meta-analysis. PLoS One, 16(7), e0253899.
Curley, A. L., Niedz, B. A., & Erikson, A. (Eds.). (2024). Population-based nursing: Concepts and competencies for advanced practice. Springer Publishing Company.
Figueiredo-Duarte, C., Espirito-Santo, H., Sério, C., Lemos, L., Marques, M., & Daniel, F. (2021). Validity and reliability of a shorter version of the Geriatric Depression Scale in institutionalized older Portuguese adults. Aging & Mental Health, 25(3), 492-498.
The Guide to Clinical Preventive Services. https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/clinicians-providers/guidelines-recommendations/guide/cpsguide.pdfLinks to an external site.
Healthy People 2030 Impact Paper
Assignment
Purpose
The concepts of epidemiology provide the framework for the study of infectious and chronic health issues/diseases, which provides a rich source of data for the analysis of trends in disease and health.This assignment will offer the learner the opportunity to explore the population health effects of a topic which will be assigned by your course faculty.
As an example, you may be asked to identify populations at risk for oral health issues or, for instance, issues related to the frail living at home, and design a population health focused educational intervention for your target population.
In addition, you will look at what outcomes will be addressed to determine if your interventions are effective. This paper should integrate HP2030 and CDC information into your paper.
Link to HP2030Links to an external site.
Activity Learning Outcomes
Through this assignment, the student will demonstrate the ability to:
CO 3: Identify appropriate outcome measures and study designs applicable to epidemiological sub-fields such as infectious disease, chronic disease, environmental exposures, reproductive health, and genetics.
CO 6: Identify important sources of epidemiological data.
Due Date
Sunday by 11:59pm MT of Week 2
Students are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction of 10% of the total points possible for that assignment for each day the assignment is late. Assignments will be accepted, with penalty as described, up to a maximum of three days late, after which point a zero will be recorded for the assignment. Quizzes and discussions are not considered assignments and are not part of the late assignment policy.
Total Points Possible
This assignment is worth 125 points.
Preparing the Assignment
Research Topic: Your course faculty will provide you with topic/s for this assignment. Please check the NR503 Course Announcements.
Identify your target population (for instance, age or other demographic, aggregate population); this must be in your city or state.
Discuss population-based health education interventions for your target population that is aimed at reducing morbidity and mortality for the problem. Be sure to review the research literature and HP2030 for interventions.
Identify how and what data for interventions is being tracked.
In a four (4) page paper, address the following. Refer to rubric for expanded details related to grading expectations.
Identify the problem in the introduction section.
Provide an overview of the problem in your state/national.
Review of descriptive epidemiological and demographic data on mortality/morbidity and risk.
HP2030: Present the goal, overview and objectives of Healthy People 2030 for the paper topic.
Population level prevention and health promotion review. Describe population and/or primary health care focused interventions. Use of scholarly literature and HP2030 is required. There should be direct correlation to evidence for all strategies.
Healthy People 2030 Impact Paper
Vanessa Ochoa
Chamberlain
College of Nursing
NR503 Population
Health, Epidemiology, & Statistical Principles
Professor Kristin
Curcio
March 17, 2024
Healthy People 2030 Impact Paper
Dementia
denotes a degenerative disease that affects millions globally, with older
adults having a high prevalence. It is a non-specific, progressive, and complex
condition where individuals exhibit an overall decline in cognitive skills and memory,
thereby decreasing the patient’s ability to perform activities of daily living
(Cao et al., 2020). Cao et al. (2022) further defined dementia as a severe
neurodegenerative disorder that is categorized into several subtypes with
varying pathogenic causes. The leading subtypes of dementia include vascular
dementia, Alzheimer’s disease, Huntington’s disease, the Wernicke-Korsakoff
syndrome, dementia with Lewy bodies, chronic traumatic encephalopathy, and
frontotemporal dementia (Cao et al., 2020). Scholarly evidence revealed that
dementia is a significant nursing issue due to its increasing prevalence and
negative implications on diagnosed individuals’ overall health and well-being
(Hudomiet et al., 2022). A 2021 study by Hudomiet et al. (2022) found that 6.2
million people in the United States aged 65 and older are living with dementia,
thus revealing the importance and severity of the healthcare issue. Nurses and
healthcare assistants are the leading first-line care providers for persons
diagnosed with dementia. These healthcare practitioners are instrumental in ascertaining
that individuals diagnosed with dementia have enhanced patient safety, a high
quality of life, and improved health outcomes despite the diagnosis of the
progressive disease. This paper identifies dementia as a significant healthcare
issue affecting older adults in Illinois. It discusses the disease, including
its risk factors, complications, and morbidity and mortality rates. The paper
also conducts an epidemiological analysis of dementia while applying related
Healthy People 2030 goals and objectives and analyzing population-level
planning linked to dementia care in Illinois.
Discussion
Dementia
denotes a progressive, life-limiting syndrome affecting millions of individuals
in the United States and globally. The care of patients with dementia in
clinical settings is often complex due to the multi-factorial nature of the
disease (Seifert et al., 2022). For instance, the neuropsychiatric symptoms
presented by dementia patients are a primary concern when caring for diagnosed
individuals, leading to most being institutionalized (Seifert et al., 2022).
Evidence-based research found that this neurodegenerative disease is
characterized by symptoms such as disturbances in cognitive function and
language, difficulties in memory, impairments in activities of daily living,
and behavioral changes (Lindeza et al., 2020). Individuals diagnosed with
dementia also exhibit neurological disorders characterized by cognitive
impairment and cognitive loss. Therefore, this reveals the importance of
integrating best-practice and specialized healthcare to ensure that the unique
care needs of this patient population are met (Lindeza et al., 2021).
Dementia
has an increasing prevalence and incidence at the national and state levels.
For instance, Hudomiet et al. (2022) argued that 6.2 million people in the
United States aged 65 and older live with dementia. The national incidence and
prevalence of dementia are expected to rise over the next decade (Hudomiet et
al., 2022). In Illinois, 230,000 individuals over 65 years are living with
dementia, per the 2020 statistics by the Illinois Department of Public Health
(Illinois Department of Aging, 2024). In retrospect, older adults have the
highest risk and incidence of dementia in Illinois. The Illinois Department of
Public Health further argued that this figure is projected to rise by 13% in
2025, thereby increasing the care burden linked to dementia care (Illinois
Department of Aging, 2024).
Livingston
et al. (2020) assessed that various risk factors are linked with dementia.
Evidence-based research revealed that modifiable risk factors are tied to 35%
of dementia diagnoses. These modifiable risk factors encompass hearing loss,
physical inactivity, high blood pressure, low literacy, obesity, depression,
social isolation, and smoking (Livingston et al., 2020). In addition, there are
gender and racial disparities in dementia incidence in the United States and,
by extension, Illinois. The Illinois Department on Aging (2023) argued that
women, compared to men and racial minorities, have the highest prevalence of
dementia.
Epidemiological Analysis
Dementia
is a prevalent, chronic, and neurodegenerative disease that affects millions of
individuals in the United States and a significant population in Illinois.
While there are several subtypes of dementia, Emmady et al. (2022) revealed
that Alzheimer’s disease is the most widespread, accounting for 70% to 80% of
all dementia cases. Other prevalent dementia subtypes with lower incidences
than Alzheimer’s disease include frontotemporal dementia (25%), vascular
dementia (15%), and Parkinson’s disease (10%) (Emmady et al., 2022). However,
the development of these dementia subtypes is dependent on the risk factors
presented by individuals. For instance, the leading risk factors for vascular
dementia in individuals include age, diabetes mellitus, smoking, hypertension,
and hypercholesteremia (Emmady et al., 2022). Emmady et al. (2022) argued that
the incidence of vascular dementia increases with advancing age and doubles
every 5.3 years. Livingston et al. (2020) added that traumatic brain injury and
excessive alcohol consumption are also associated with an increased risk of
dementia. In contrast, non-modifiable risk factors for dementia include age and
genetics. Evidence-based research found that most individuals diagnosed with
dementia are of advanced age (Livingston et al., 2020). Healthy People 2030
(n.d.) supported this revealing age as the leading risk factor for all dementia
subtypes. Livingston et al. (2020) further hypothesized that genetics is a
potential risk factor for dementia, particularly in etiologies such as
Alzheimer’s, revealing the need to assess a patient’s family history.
Racial
and gender disparities are also evident in dementia diagnoses. For instance,
the 2022 survey by the Alzheimer’s Association revealed that older African
Americans were twice as likely to develop dementia compared to Caucasians. The
survey further added that older Hispanics are one and a half times more likely
to develop dementia than older Caucasians. In addition, women have a higher
prevalence of dementia compared to men. National statistics found that of the
6.5 individuals diagnosed with dementia, four million are women while 2.5
million are men, revealing the high prevalence of dementia in women (Illinois
Department of Aging, 2023).
Application of Healthy People 2030
The
overall goal of Healthy People 2030 (n.d.) linked to the identified healthcare
issue is improving the health and quality of life of individuals diagnosed with
dementia. The associated objectives related to this goal include decreasing the
hospitalization of dementia patients and increasing the proportion of dementia
patients with caregivers (Healthy People 2030, n.d.). Although there is no cure
for dementia, early diagnosis and intervention coupled with supportive care can
help improve the quality of life of diagnosed individuals, providing the
rationale of the supporting objectives (Healthy People 2030, n.d.). While there
is no standardized screening method for dementia, healthcare providers in
Illinois and across the United States employ various screening tools such as the
Eight Item Informant Interview to Differentiate Aging and Dementia and the
Mini-Mental State Examination (MMSE) (Galvin et al., 2020). The screening tools
help in the early identification, diagnosis, and treatment of dementia, thus
patient outcomes and quality of life.
Population Level Planning
While
there is no cure for dementia, healthcare providers in Illinois and the United
States currently integrate various pharmacological and non-pharmacological
interventions to delay progressive cognitive decline while reducing the
suffering caused by cognitive decline and associated symptoms (Emmady et al.,
2022). Emmady et al. (2022) revealed that FDA-approved medications for dementia
include memantine and cholinesterase inhibitors. These pharmacological
interventions aim to improve patients’ cognitive function, which delays
cognitive decline. Non-pharmacological interventions such as integrating
cognitive stimulating activities in daily living and physical activity are also
used by providers to manage dementia.
Educational
programs for healthcare providers and caregivers are also integrated to enhance
dementia care. Mellinger et al. (2023) argued that the limited health literacy
in dementia-specific care by healthcare providers and caregivers is linked with
low care quality, negative attitudes towards dementia, poor management
strategies, poor communication skills, and lack of confidence by the providers.
The researchers argued that these factors have contributed to the poor health
outcomes and quality of care delivered to individuals diagnosed with this
neurodegenerative disease. Therefore, healthcare organizations have prioritized
training providers caring for dementia patients to enhance care quality and
improve patient outcomes. The outcomes tracked for these evidence-based
interventions include patients’ quality of life, health outcomes, and
hospitalization rates.
References
Cao,
Q., Tan, C. C., Xu, W., Hu, H., Cao, X. P., Dong, Q., Tan, L., & Yu, J. T.
(2020). The prevalence of dementia: A systematic review and
meta-analysis. Journal of Alzheimer’s Disease, 73(3),
1157-1166. https://doi.org/10.3233/JAD-191092
Emmady,
P. D., Schoo, C., & Tadi, P. (2022, November). Major
neurocognitive disorder (dementia). StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK557444/#article-20337.s4
Galvin,
J. E., Tolea, M. I., & Chrisphonte, S. (2020). What older adults do with
the results of dementia screening programs. PLoS One, 15(7),
e0235534. https://doi.org/10.1371%2Fjournal.pone.0235534
Gkioka,
M., Schneider, J., Kruse, A., Tsolaki, M., Moraitou, D., & Teichmann, B.
(2020). Evaluation and effectiveness of dementia staff training programs in
general hospital settings: A narrative synthesis with Holton’s three-level
model applied. Journal of Alzheimer’s Disease, 78(3),
1089-1108. https://doi.org/10.3233%2FJAD-200741
Healthy
People 2030. (n.d.). Dementias. US Department of Health and Human
Services. https://health.gov/healthypeople/objectives-and-data/browse-objectives/dementias
Hudomiet,
P., Hurd, M. D., & Rohwedder, S. (2022). Trends in inequalities in the
prevalence of dementia in the United States. Proceedings of the
National Academy of Sciences, 119(46), e2212205119. https://doi.org/10.1073/pnas.2212205119
Illinois
Department on Aging. (2023). State of Illinois Alzheimer’s disease
plan: 2023 –2026 report and recommendations. Illinois Department on Aging.
https://ilaging.illinois.gov/content/dam/soi/en/web/aging/programs/documents/2023-2026-idph-alzheimers-state-plan.pdf
Illinois
Department on Aging. (2024). Caring for a loved one with Alzheimer’s
or Dementia. Illinois Department of Aging. https://ilaging.illinois.gov/programs/alzheimersanddementia.html
Lindeza,
P., Rodrigues, M., Costa, J., Guerreiro, M., & Rosa, M. M. (2020). Impact
of dementia on informal care: A systematic review of family caregivers’
perceptions. BMJ Supportive & Palliative Care. http://dx.doi.org/10.1136/bmjspcare-2020-002242
Livingston,
G., Huntley, J., Sommerlad, A., Ames, D., Ballard, C., Banerjee, S., Brayne,
C., Burns, A., Cohen-Mansfield, J., Cooper, C., & Mukadam, N. (2020).
Dementia prevention, intervention, and care: 2020 report of the Lancet
Commission. The Lancet, 396(10248), 413-446. https://doi.org/10.1016%2FS0140-6736(20)30367-6
Mellinger,
T. J., Forester, B. P., Vogeli, C., Donelan, K., Gulla, J., Vetter, M.,
Vienneau, M., & Ritchie, C. S. (2023). Impact of dementia care training on
nurse care managers’ interactions with family caregivers. BMC
Geriatrics, 23(1), 1-9. https://doi.org/10.1186/s12877-022-03717-w
Seifert,
I., Wiegelmann, H., Lenart-Bugla, M., Łuc, M., Pawłowski, M., Rouwette, E.,
Rymaszewska, J., Szcześniak, D., Vernooij-Dassen, M., Perry, M., & SHARED
consortium. (2022). Mapping the complexity of dementia: Factors influencing
cognitive function at the onset of dementia. BMC Geriatrics, 22(1),
507. https://doi.org/10.1186/s12877-022-02955-2
WEEK 3
Epidemiological Methods and Measurements
Discussion
Purpose
This discussion board content is intended to facilitate learning for students through engaging dialogues as they achieve the desired learning outcomes/competencies associated with their course in a manner that empowers them to organize, integrate, apply and critically appraise their knowledge to their selected field of practice.
The use of discussions provides students with opportunities to contribute graduate level-appropriate knowledge and experience to the topic in a safe, caring, and fluid environment that models professional and social interaction. The ebb and flow of a discussion is based upon the composition of student and faculty interaction in the quest for relevant scholarship.
Participation in the discussion generates opportunities for students to actively engage in the written ideas of others by carefully reading, researching, reflecting, and responding to the contributions of their peers and course faculty. Discussions foster the development of members into a community of learners as they share ideas and inquiries, consider perspectives that may be different from their own, and integrate knowledge from other disciplines.
Due Date
Initial prompt due by Wednesday, 11:59 PM MT of week 3
One peer and one faculty or two peer posts due by Sunday 11:59 PM MT of week 3
A 10% late penalty will be imposed for initial discussions posted after the weekly deadline regardless of the number of days late. No postings will be accepted after 11:59pm MT on Sunday (i.e. student will receive an automatic 0). Week 8 discussion closes on Saturday at 11:59pm MT.
Total Points Possible: 60 Points
Preparing the Assignment
This week we are comparing and contrasting epidemiological methods of research; case-control and cohort study methods. Select either the case-control or cohort study method and compare its features, the methodology, to a randomized controlled trial using the following questions. Please format, organize, your responses using each question below:
What is the fundamental difference between the method you have chosen (either the case-control or cohort method) and the randomized controlled trial?
What are the advantages and disadvantages of the study method you chose (case-control or cohort study)?
What are the characteristics of a correlational study?
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?
Post your response to the DB. Your analysis should have in-text citations and utilize a scholarly voice with APA formatting.
Respond to a total of two posts: Either two (2) peer posts or a peer and faculty post (all faculty posts require a response), with a minimum of one paragraph of 4-5 sentences, on two (2) different days of the week. Your reply post should be specific to this week’s topic of epidemiological research methods and should integrate in-text citation(s).
Your reply post/s should integrate course content (such as course terminology) related to the study method as well as an integration of in-text citations along with a scholarly voice and APA formatting. The textbook may be utilized as a resource.
Comparing Case-Control Study Method with Randomized Controlled Trial
Vanessa Ochoa
Chamberlain College of Nursing
Professor Kristin Curcio
NR 503 Population Health, Epidemiology, & statistical principles
March 20, 2024
Comparing Case-Control Study Method with Randomized Controlled Trial
Population-based research methods are fundamental in revealing the distribution and underlying causes of health and disease. Via identifying trends and risk factors, these approaches can be utilized to design and implement public health interventions, healthcare policies, and clinical practice, resulting in better population health outcomes and reduced disease burden. Therefore, compares the case-control study method and the randomized controlled trial (RCT) in epidemiological studies.
The core differences between the case-control study and the randomized controlled trial (RCT) lies in their design and appointment of the participants. The case-control study technique involves picking participants based on their outcome status (cases with the disease/condition) and then retrospectively examining the exposure history of cases relative to controls without the disease. On the contrary, the randomized controlled trial (RCT) randomly assigns participants to intervention and control groups, and finally, follow-ups are carried out to evaluate outcomes (Ding & Li, 2018). This difference manifests itself in the way they are designed and allocate participants. Unlike cases-control studies, that begin with identified cases and controls, RCT groups participants randomly so that bias is reduced and causal inference is allowed. This distinction allows for case-control studies to be retrospective and observational, while RCTs to be prospective and interventional. It also provides different levels of evidence to support or disprove causal relationships in epidemiological research.
Case-control studies have an advantage in studying the rare diseases because investigators can study simultaneously many exposures that lead to a single outcome in an effective and economical way. Nonetheless, this method is characterized by memory bias and selection bias, which weaken the reliability of the results (Ding & Li, 2018). Definitive causality can be difficult to establish because of retrospective nature of case-control studies, and there might be exposure misclassification. Despite these constraints, case-control studies still play a major role in developing hypotheses and exploring the relationships between exposures and outcomes in the epidemiological science.
Characteristics of correlational studies analogous to case-control designs include investigating the link between the variables not affecting them. In this case study, the researchers quantify a level of association between variables, most commonly using the correlation coefficients. Unlike the case-control studies, the correlational research has no backward selection of cases and controls which could be controlled. Rather it studies the naturally evolved relationships inside a society (Astley et al., 2018). Similar to case-control designs, the correlational studies cannot prove causation because they are basically observational. The correlations although are helpful in bringing associations into light, no causality can be determined until direct manipulations and controlling variables are made, which calls for caution when interpreting the outcomes.
The pyramid of research shows the hierarchy of evidence, with systematic reviews/meta-analyses being at the apex and expert opinions being at the bottom. Case-control studies fill a significant niche rating higher than correlational studies because of their structured design and capacity to study association. Nevertheless, they cannot reach such a level as RCTs as RCTs test causality through controlled interventions (Vandenbroucke & Pearce, 2019). This means that the choice between the case-control study and the RCT would depend on the robustness of the evidence for informing healthcare decisions. The understanding of the hierarchy determines the order of evidence-based practices, and stresses the necessity for rigorous methodologies to guarantee the quality of healthcare.
Case-control study provides fundamentally different design and participant allocation from the RCTs. They come with an advantage of studying rare diseases and exposures but the biasedness is a disadvantage. Nevertheless, correlational studies lack experimental manipulation and can`t prove causation while RCTs have a greater ability to establish causal relationships. The place of case-control studies upon the research pyramid reveals the significance of this method in evidence generation and the need for caution in interpretation.
References
Astley, S. M., Harkness, E. F., Sergeant, J. C., Warwick, J., Stavrinos, P., Warren, R., … & Evans, D. G. (2018). A comparison of five methods of measuring mammographic density: a case-control study. Breast cancer research, 20, 1-13.
Ding, P., & Li, F. (2018). Causal inference. Statistical Science, 33(2), 214-237.
Vandenbroucke, J. P., & Pearce, N. (2019). Test-negative designs: differences and commonalities with other case–control studies with “other patient” controls. Epidemiology, 30(6), 838-844.
Curley, A. L., Niedz, B. A., & Erikson, A. (Eds.). (2024). Population-based nursing: Concepts and competencies for advanced practice. Springer Publishing Company
WEEK 5
Infectious Disease Paper
Assignment
Purpose
Infectious disease occurs worldwide and must be addressed just as chronic disease is approached. This assignment will present the learner an opportunity to explore a communicable disease, to apply the epidemiological triad, and to discern the demographic and at-risk background data for a specific infectious disease agent.
Activity Learning Outcomes
Through this assessment, the student will meet the following Course Outcomes.
Identify appropriate outcome measures and study designs applicable to epidemiological sub-fields such as infectious disease, chronic disease, environmental exposures, reproductive health, and genetics. (CO3)
Identify important sources of epidemiological data. (CO6)
Due Date
Assignment is due by Sunday, 11:59 p.m. MT of Week 5
Students are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction of 10% of the total points possible for that assignment for each day the assignment is late. Assignments will be accepted, with penalty as described, up to a maximum of three days late, after which point a zero will be recorded for the assignment. Quizzes and discussions are not considered assignments and are not part of the late assignment policy.
Total Points Possible
This assignment is worth 125 points.
Preparing the Assignment
Requirement
Choose a topic from the list provided to you by your course faculty. Apply the concepts of population health and epidemiology to the topic.
Synthesize Course content from Weeks 1-5 according to the following sections:
Introduction: Analysis of the communicable disease (causes, symptoms, mode of transmission, complications, treatment) to include demographic break down that includes age, gender, race, or other at-risk indicators (da ta per demographics should include mortality, morbidity, incidence, and prevalence).
Determinants of Health: Define, identify and synthesize the determinants of health as related to the development of the infection. Utilize HP2020.
Epidemiological Triad: Identify and describe all elements of the epidemiological triad: Host factors, agent factors (presence or absence), and environmental factors. Utilize the demographic break down to further describe the triad.
Role of the NP: Succinctly define the role of the nurse practitioner according to a national nurse practitioner organization ( National Board of Nursing or AANP, for example) and synthesize the role to the management of infectious diseases (surveillance, primary/secondary/tertiary interventions, reporting, data collecting, data analysis, and follow-up). This includes the integration of a model of practice which supports the implementation of an evidence-based practice. Refer to your course textbook for models of practice examples.
Understanding Syphilis: A
Population Health and Epidemiological Perspective
Vanessa Ochoa
Chamberlain College Of
Nursing
NR 503 Population Health,
Epidemiology, & Statistical Principles
March 29, 2024
Introduction
Syphilis,
caused by Treponema pallidum, is a global health issue. Symptoms change as the illness
advances. Chancres are painless ulcers caused by primary syphilis. This pain
generally starts in the mouth, anus, or genitalia. A secondary infection causes
a rash, fever, enlarged lymph nodes, and other systemic signs. Latent infection
may result from failed treatment. Tertiary syphilis is the most dangerous and
can cause cardiovascular and neurological issues. These adverse effects
demonstrate why syphilis must be diagnosed and treated early to avoid long-term
health consequences.
Demographic Breakdown
STDs
like syphilis are complex public health issues. It affects various groups
differently. Young men aged 20–29 is particularly afflicted by syphilis. This
trend indicates that age-specific public health interventions and education are
needed to address risk factors. Syphilis incidence varies significantly by race
and ethnicity (Mutagoma et al., 2019). Syphilis may be more common
among blacks and Hispanics. Cultural norms on sexual health, STD prevention,
education, healthcare, and socioeconomic status may explain these differences.
Regional
variety drives syphilis epidemiology. Public health restrictions, sexual health
treatment availability, and community knowledge may increase case numbers.
Socioeconomic status impacts syphilis rates. Low-income persons may have
problems accessing STI testing and treatment. Misdiagnosis and inaction may
spread illness. Syphilis is more widespread in various communities (Mutagoma
et al., 2019). Hence, a multimodal approach is essential. Public health
programs should incorporate socioeconomic variables that influence STD risk.
Health, sexual health education, and condom usage must be addressed in
low-income populations. The cultural values of impacted communities must be
considered in health promotion.
Determinants of Health
Social Determinants: Socioeconomic
factors affect syphilis, a deadly STD, including birth, living conditions,
education, job, leisure, and age. Not everyone can afford STD testing and
treatment. Cost should not delay syphilis treatment since it increases the
danger of transmission and disastrous effects. Poor urban and rural areas with
inadequate healthcare services and accessibility are worse. Trouble diagnosing
and treating STIs swiftly and providing prevention advice is difficult. Thus,
these inhabitants may not know how to prevent syphilis (Johnson
et al., 2022). Syphilis can result from STD stigma. STI patients experience
shame and stigma that hinders testing, treatment, and education. Many
religions, cultures, and societies stigmatize STI sufferers. Medical therapy
may be avoided due to fear of prejudice or social isolation. These
socioeconomic variables must be addressed to end syphilis. Health and poverty
reduction should be addressed in low-resource areas. Education may reduce
stigma and misinformation, encouraging treatment and knowledge.
Behavioral Determinants: Certain
behaviors can raise the risk of syphilis, a Treponema pallidum-caused STD.
Intercourse without protection is a critical behavioral element. Direct
bacterial transmission with unprotected sexual contact increases infection
risk. Several sexual partners considerably increase syphilis transmission.
Contact with an infected person increases the chance of contracting and
transmitting the virus. Syphilis spreads swiftly, making several sexual
partners without protection a public health danger. Drug and alcohol abuse
promotes syphilis. Drugs impair judgment, causing sexual risk-taking. Alcohol
and drugs make people more prone to disregard the health dangers of sexual
partners or unsafe sexual activity (Johnson et al., 2022).
Syphilis and other STDs may rise if individuals are careless. Education and
prevention are needed to lessen these behavioral elements’ public health
implications. Comprehensive sexual education programs that promote condom usage
can lower syphilis.
Structural Determinants: Social
structure affects syphilis transmission. These cultural elements mirror
America’s healthcare and social disparities. Lack of healthcare resources makes
STI treatment difficult in developing nations. One concern is medical personnel’s
STD diagnosis and treatment ineptitude. Low syphilis testing kits aggravate the
issue in a doctor-poor nation. Because treating patients is complex, the virus
spreads quickly. Managing STD prevention program ineffectiveness is another
systemic challenge (Johnson et al., 2022). This is needed to
fight syphilis and other infectious diseases. Education on STIs and their harm
helps public education.
Epidemiological Triad
Syphilis
transmission may be explained by the epidemiological triad model, which
emphasizes host, agent, and context interaction. Our method clarifies disease
transmission and community persistence. Variables like personality impact
syphilis susceptibility: condom usage, sexual frequency, and the number of partners
an individual has. A weakened immune system may accelerate sickness. People
should see a doctor when unwell since early diagnosis and therapy help combat
disease. Agent variables create Treponema pallidum illness. Bacteria spread by
infectivity. Virulence affects clinical behavior and early treatment.
Antibiotic resistance can make standard treatment ineffective, spreading disease
(Johnson
et al., 2022). Environment spreads syphilis. Illiteracy and poverty may
increase the risk of sexually transmitted infections due to insufficient
treatment and information.
Role of the Nurse Practitioner
Surveillance: Nurse
practitioners are essential for syphilis prevention and treatment. They follow
occurrences, identify trends, and prevent pandemics. Their monitoring
emphasizes sickness development over evaluation. This equips the healthcare
system to adapt quickly. Nurse practitioners must record and assess events
(McGilton et al., 2021). Public health officials need more data, so any data
helps. This data can guide resource allocation. Program evaluation and targeted
interventions benefit.
Prevention: As sexual health
advocates, nurses help battle STDs like syphilis. They promote condom use and
other sexual safety to prevent virus transmission. A nurse who lets patients discuss
sexuality without judgment can educate the public. They propose early detection
and treatment with prophylactic STD testing (McGilton et al., 2021). Nurse
practitioners (NPs) assist clients in reducing sickness risk by changing their
behavior. They host safe sexual health conversations in a supportive setting.
Treatment: Nurse practitioners
treat syphilis. They oversee treatment and supply approved medications.
Therapists must be vigilant, aware of adverse effects, and track patient
improvement. Since rehabilitation is more than meets the eye, nurse
practitioners provide crucial psychological support (McGilton et al., 2021).
They understand holistic therapy encompasses mental and emotional health.
Partner Notification and Treatment: Nurse
practitioners must sensitively warn syphilis patients’ spouses of exposure
risks. A more significant public health approach to eliminate STDs like
syphilis includes this conversation. Nurses are sensitive but convey the
issue’s urgency while protecting patient privacy. Nurse practitioners consult
with couples before gently urging testing and rehabilitation (McGilton et al.,
2021). Patient and community health now and in the future depends on this. NPs
assist in early identification and treatment to inhibit illness propagation and
lower prevalence.
Conclusion
Syphilis
in public health requires a multidisciplinary epidemiology and community health
strategy. Socioeconomic position, healthcare access, and education must be
examined to combat syphilis. One must comprehend the epidemiological
triangle—agent, host, and environment to assess transmission and its impacts on
distinct populations. Nurse practitioners battle syphilis using local knowledge
and clinical skills. NPs’ health education, data analysis, and patient care
skills may minimize illness. Policymakers, healthcare providers, and public
health experts must work together to eliminate health inequities. They can
create and deliver medications to lower syphilis prevalence and improve health
equity by working together.
References
Johnson, K. A., Snyder, R. E., Tang, E. C., de Guzman,
N. S., Plotzker, R. E., Murphy, R., & Jacobson, K. (2022). Geospatial
Social Determinants of Health Correlate with Disparities in Syphilis and
Congenital Syphilis Cases in California. Pathogens, 11(5), 547. https://doi.org/10.3390/pathogens11050547
McGilton, K. S., Krassikova, A., Boscart, V., Sidani,
S., Iaboni, A., Vellani, S., & Escrig-Pinol, A. (2021). Nurse Practitioners
Rising to the Challenge During the Coronavirus Disease 2019 Pandemic in
Long-Term Care Homes. The Gerontologist, 61(4), 615–623. https://doi.org/10.1093/geront/gnab030
Mutagoma, M., Remera, E., Sebuhoro, D., Kanters, S.,
Riedel, D. J., & Nsanzimana, S. (2019). The Prevalence of Syphilis
Infection and Its Associated Factors in the General Population of Rwanda: A
National Household-Based Survey. Journal of Sexually Transmitted Diseases,
2016, 1–8. https://doi.org/10.1155/2016/4980417
WEEK 6
Epidemiological Analysis: Chronic Health Problem
Assignment
Purpose
The purpose of this assignment is:
Integrate knowledge and skills learned throughout NR503 course
Direct application of course objectives utilizing epidemiological analysis of a chronic health problem, along with state and national level data.
Activity Learning Outcomes
This assignment enables the student to meet the following course outcomes:
See weekly outcomes from Weeks 1-6.
Due Date
This assignment must be submitted by Sunday, 11:59 p.m. MT at the end of Week 6.
Total Points Possible
This assignment is worth 200 points.
Preparing the Assignment
Requirements
This paper should clearly and comprehensively discuss a chronic health disease. Select a topic from the list provided by your course faculty.
The paper should be organized into the following sections:
Introduction (Identification of the problem) with a clear presentation of the problem as well as the significance and a scholarly overview of the paper’s content. No heading is used for the Introduction per APA current edition.
Background and Significance of the disease, to include: Definition, description, signs and symptoms. Incidence and prevalence of statistics by state with a comparison to national statistics pertaining to the disease. If after a search of the library and scholarly data bases, you are unable to find statistics for your home state, or other states, consider this a gap in the data and state as much in the body of the paper. For instance, you may state something like, “After an exhausting search of the scholarly data bases, this writer is unable to locate incidence and/or prevalence data for the state of…” This indicates a gap in surveillance that will be included in the “Plan” section of this paper.
Surveillance and Reporting: Current surveillance methods and mandated reporting processes as related to the chronic health condition chosen should be specific.
Epidemiological Analysis: Conduct a descriptive epidemiology analysis of the health condition. Be sure to include all of the 5 W’s: What, Who, Where, When, Why. Use details associated with all of the W’s, such as the “Who” which should include an analysis of the determinants of health. Include costs (both financial and social) associated with the disease or problem.
Screening and Guidelines: Review how the disease is diagnosed and current national standards (guidelines). Pick one screening test (review Week 2 Discussion Board) and review its sensitivity, specificity, predictive value, and cost.
Plan: Integrating evidence, provide a plan of how a nurse practitioner will address this chronic health condition after graduation. Provide three specific interventions that are based on the evidence and include how you will measure outcomes (how will you know that the interventions have utility, are useful?) Note: Consider primary, secondary, and tertiary interventions as well as the integration of health policy advocacy efforts. All interventions should be based on evidence connected to a resource such as a scholarly piece of research.
Summary/Conclusion: Conclude in a clear manner with a brief overview of the keys points from each section of the paper utilizing integration of resources.
The paper should be formatted and organized into the following sections which focus on the chosen chronic health condition.
Adhere to all paper preparation guidelines (see below).
Preparing the Paper
Page length: 7-10 pages, excluding title page and references.
APA format current edition
Include scholarly in-text references throughout and a reference list.
Include at least one table that the student creates to present information. Please refer to the “Requirements” or rubric for further details. APA formatting required.
Length: Papers not adhering to the page length may be subject to either (but not both) of the following at the discretion of the course faculty: 1. Your paper may be returned to you for editing to meet the length guidelines, or, 2. Your faculty may deduct up to five (5) points from the final grade.
Adhere to the Chamberlain College of Nursing academic policy on integrity as it pertains to the submission of original work for assignments.
Epidemiological
Analysis: Chronic Health Problem-Asthma
Vanessa
Ochoa
Chamberlain
College of Nursing
NR
503 Population Health, Epidemiology, & Statistical Principles
Professor
Kristin Curcio
April
14, 2024
Epidemiological
Analysis: Chronic Health Problem-Asthma
Asthma is a
chronic respiratory condition characterized by airway inflammation and
constriction, resulting in symptomatic scenarios of wheezing, coughing, chest
tightness, and shortness of breath. It involves people of all age groups and
can affect people in every country. Without proper management, a person’s
quality of life can be affected. This paper will explain asthma’s history and
relevance, epidemiological analysis, assessment and guidelines, surveillance
and reporting policies, and a plan to help nurse practitioners deal with this
concern. This will lead to a better understanding of the chronic problem.
Background
of The Asthma
Background
Asthma is a
chronic respiratory disorder manifesting with inflammation and narrowing of
airways. It causes causing symptoms such as wheezing, coughing, chest
tightness, and breathlessness. The essential inflammation in asthma leads to
the airway walls bulging and causing their sensitivity to narrow due to various
stimulants (O’Sullivan
et al., 2020). Environmental stimuli that affect the airways include pollen,
dust, respiratory infections, physical activity, cold air, and pollutants like
tobacco smoke and air pollution. The inflammatory response in asthma is
associated with the liberation of inflammatory mediators like histamine,
leukotrienes and cytokines. They cause airway hyperresponsiveness to the point
of excess mucus production and bronchospasm. Consequently, airway blockage
occurs and asthma, which has symptoms that range from the mildest to the most
severe and may change in intensity and frequency over time, appear.
Asthma is a
multifaceted disorder characterized by substantial phenotypic variations in key
clinical manifestations and primary pathophysiological mechanisms. There is
allergic and non-allergic asthma. Certain allergens bring on allergic asthma,
and non-allergic asthma develops as a result of factors such as respiratory
infections. Additionally, asthma can occur with other respiratory conditions
like hay fever and COPD, which makes diagnosis and therapy more difficult.
Significance
Asthma is a
significant challenge for public health globally, involving millions of persons
of different ages and ethnicities. The asthma burden in the United States of America
is estimated to be more than 27 million, which is 1 in every 12 people (Asthma
Facts, n.d.). Asthma is one of the most frequent cases of chronic childhood
illness, with a large number of millions of children and adolescents being
affected and asthma also being the major reason for school-day absenteeism and
pediatric hospitalization. The patient with poorly controlled asthma may have a
health condition that would profoundly affect their lung function, and this, in
turn, may affect their entire life. Repeated asthma exacerbations may result in
reduced lung function, lowered physical activity, restrained daily activities
and disturbed nighttime sleep patterns. Children who have asthma can find
academic problems because they need to stay home, and they also cannot
concentrate during the time their asthma cannot be controlled.
In addition,
asthma places a heavy financial load on health services and the population in
general. The direct costs of medical care for asthma treatment, including
drugs, inpatient and emergency department visits and outpatient care, are often
significant. Moreover, casualties, such as people’s absenteeism at the
workplace or school and the diminished quality of life, contribute to the total
financial burden. In the most severe cases, asthma attacks might be
life-threatening and even require treatment like emergency medical care, which
includes things like intensive care and hospitalization. One of the long-term
problems encountered with asthmatic deaths is that it seems to affect some
demographic groups more than others, the cause of which is mainly the poor
healthcare system.
Surveillance
and Asthma Reporting
Asthma monitoring
is crucial for measuring the disease’s burden, tracking trend progress,
assessing the success of interventions, and guiding public health policy
decisions and actions. Surveillance is a continuous data collection process
that includes data analysis, interpretation, dissemination, and monitoring of
asthma statistics among a certain population.
State and National Surveillance
CDC, the premier
agency responsible for asthma surveillance in the USA, collaborates with state
and territorial health departments to develop a comprehensive asthma monitoring
system. The CDC is the chief organization for the National Asthma Control
Program (NACP), concentrating on asthma control monitoring, education, and
intervention levels. Through the NACP, the CDC conducts joint efforts with
state health departments to assemble, analyze and publish information about
asthma frequency, severity and mortality.
Data Collection
Several data
sources contribute to asthma surveillance efforts. The CDC conducts the National
Health Interview Survey each year. It includes questions like asthma incidence,
symptoms, and therapies among people of all ages in the United States. Within
the range of NHIS activities is an Asthma Call-back Survey, which involves
additional interviews of NHIS clients with asthma for detailed data on asthma
control, management, and healthcare. The CDC is a technical advisor for state
health departments that manage the Behavioral Risk Factor. Behavioral Risk
Factor Surveillance System (BRFSS). It acquires data about the self-reported
prevalence of asthma, healthcare utilization and the risks that are related to
smoking and environmental exposure (CDC, 2023). Also, the National Health and
Nutrition Examination Survey (NHANES) comprises general physical examinations
and laboratory tests, informing the public about asthma prevalence among
participants. Furthermore, healthcare providers contribute to asthma
surveillance by recording diagnoses, flare-ups, medications, and treatment
outcomes on electronic healthcare records, which subsequently can be anonymized
and aggregated for analysis.
Reporting Mechanisms for Providers
Healthcare
providers are vital in asthma surveillance mechanisms and must notify public
health officials with timely reports and appropriate statistics. The reporting
is done for various conditions and aspects vital in managing the disease. For instance,
healthcare providers must report new asthma cases to state health departments.
These establish a base for disease identification and public health
surveillance. Reporting asthma exacerbations must also be done. Serious asthma
attacks, especially those requiring hospitalization or emergency department
visits, must be considered a surveillance measure of disease severity and
health care delivery.
Epidemiological
Analysis
What
Asthma is a
chronic inflammatory lung disease with recurrent episodes of a wheezing
sensation, shortness of breath, chest tightness, and a coughing sensation. These
symptoms are related to airflow obstruction and variable breath limitation,
which often improve after self-management or treatment. Asthma can be mild and
intermittent, occasionally, or severe and persistent, interrupting the patient
periodically. The pathophysiology of asthma involves inflammation of the
airways that leads to bronchial hyperresponse, mucus secretion, and smooth
muscle constriction.
Who
Asthma can impact
people at any age, from infants to the elderly. In most cases, the disease
appears in childhood. Although asthma affects all people regardless of racial
or ethnic background, inequalities emerge in both prevalence, morbidity and
mortality. Research findings have consistently indicated the elevated rates of
asthma in racial and ethnic minority populations and those living in
disadvantaged socioeconomic backgrounds. Such minority groups are less
privileged in the acquisition of the required health care to prevent diseases. Low-income
group is also a vital and significant consideration in the prevalence of the infection.
Where
Relating to
geography, asthma is more likely to occur in urban areas than in rural areas,
which show a lower prevalence. The urban environment can be characterized by
high air pollution levels, allergens as well as environmental tobacco smoke, a
factor that may result in increased asthma attacks and an upsurge in disease
prevalence. Furthermore, socioeconomic factors like poverty, inadequate
housing, restricted access to health care, and health misdistribution in
quality may also affect the rate of asthma and its outcomes in the urban
population. The urban environments have deprived certain neighborhoods or
communities more than others. These groups have higher asthma prevalence and worse
outcomes due to environmental injustices, sociopolitical determinants of
health, and social disparities in accessing healthcare services.
When
Asthma could
develop at any time, but since childhood is the most likely age of development,
the so-called early-onset asthma is common then compared to adult-onset asthma.
Asthma during childhood may give rise to symptoms like recurrent wheezing,
coughing and difficulty breathing in response to respiratory infections,
allergens and physical activity. People can encounter adult-onset asthma
(non-allergic asthma) without a previous asthma history. It is commonly
associated with work exposures, respiratory infections, hormonal changes, obesity,
and exposure to allergens or irritants.
Why
The development of
asthma is affected by intricate interactions of genetic dispositions,
environmental exposures, immune responses, and viral infections. Genetic risk
is currently recognized in asthma development, as family history is a
significant risk factor for asthma. Asthma is a complication that develops with
airway inflammation following exposure to environmental factors like allergens,
pollutants, smoke, or infections. One of the predisposing factors in asthmatic
individuals is allergic sensitization to particular allergens. It can produce
an immune-mediated airway inflammation in response to allergen exposure.
Screening,
Rules, And Regulations for Asthma
Screening for Asthma
Screening for
asthma seeks to identify those who have the risk of asthma or patients who have
asthma but have not yet been diagnosed and may need more assessment and care.
The screening for asthma is not regular in the general population. However, screening
could be necessary in high-risk groups. Some of the high-risk groups include
individuals with familial history of asthma or allergies, those with
respiratory symptoms suggestive of asthma, or those with exposure to known
asthma triggers.
Common screening methods for asthma
Screening for
asthma involves various approaches. Screening for asthma is done by conducting
a detailed physical examination. It may reveal any factors indicative of
asthma, such as wheezing, prolonged expiratory phase, reduced or absent breath
sounds, and signs of respiratory distress. Furthermore, the application of
screening questionnaires, including the ACT (Asthma Control Test) and the API
(Asthma Predictive Index), are to be considered as a diagnostic tool to assess
asthma symptoms, control and risks. These questionnaires give a unilateral
assessment of asthma symptoms and severity. These tools identify persons who
show signs of needing careful assessment and management. Moreover, diagnostic
strategies comprise PFTs to detect asthma by evaluating lung function.
Spirometry and PEF measurements will be the most practical tools to determine
obstruction of airways and variability of breathing for potential asthma cases.
Factors like Forced vital capacity (FVC), forced expiratory volume in one
second (FEV1), and peak expiratory flow rate (PEFR) are important measurements
taken by such tests, which indicate shrinking in people with asthma.
Guidelines
on Diagnosis and Management
National Asthma
Education and Prevention Program (NAEPP), which was set up by the NHLBI
(National Heart, Lung, and Blood Institute), established the guidelines for
adequately evaluating and treating asthma throughout the USA. NAEPP guidelines
emphasize the qualitative assessment for a comprehensive, personalized approach
to asthma based on patient education and routine monitoring until the control
is achieved and maintained. In addition, asthma management is guided by GINA-
the global initiative for asthma. GINA is an international organization that
topically addresses the three pillars of asthma diagnosis, treatment, and
prevention. GINA provides evidence-based guidelines for asthma screening,
grading, management and control and emphasizes a stepwise approach toward
pharmacotherapy depending on the severity and control of the disease. Furthermore,
the European Respiratory Society (ERS) and the American Thoracic Society (ATS)
are key in diagnosing and managing asthma. ERS and ATS work together to create
joint guidelines for asthma diagnosis, treatment, and management across Europe
and the U.S. The guidelines consider the most recent data and expert opinions
to issue recommendations on asthma diagnosis, medication use,
non-pharmacological interventions, and patient education.
Spirometry as a Screening Test
Spirometry is a
common test used to diagnose asthma and is recommended by guidelines as the
gold standard for evaluating lung function and diagnosing asthma. Spirometry
assesses the flow and volume of air during forced exhalation and helps detect
airflow obstruction, airway hypersensitivity, and variability, which are
distinguishing traits of asthma in general.
Spirometry Parameters Used in The
Diagnosis of Asthma Include
Forced expiratory volume in one
second (FEV1) is the air expelled from the lungs in the first second after a
deep breath.
Forced vital capacity (FVC) is the
number of air breaths completed by forcible exhalation from full inspiration to
full expiration.
FEV1/FVC ratio: The relative amount
of FEV1 to FVC is lowered in people with airflow obstruction airway disease,
for instance, asthma.
Plan
Implementing Community-Based Asthma
Education Programs
This will be
achieved by giving asthma education workshops through alliances with community
groups, schools, and healthcare facilities. Eversart et al. (2020) reported on
a study that found community asthma education programs improve the
participants’ understanding of asthma significantly, increase their
self-management skills, and improve medication adherence among people living in
urban environments. It is important to give measurements on improving patient
airways understanding, self-management skills and form compliance by using pre
and post-program surveys. Tracking hospital admissions and emergency department
visits before and after the program’s implementation will also indicate
efficiency.
Promoting Environmental Interventions
to Reduce Asthma Triggers
The interventions
include promoting measures and programs that encourage minimizing asthma
triggers indoors and outdoors, like cigarette smoke, indoor allergens, and air
pollution. According to Holden et al. (2023), environmental interventions,
including home visits, pest control, and indoor air quality improvement,
greatly impacted asthma-related problems and the use of healthcare
interventions. The outcomes of the intervention and its effectiveness will be analyzed
by monitoring the changes in indoor air quality indicators. This will be done
by evaluating the levels of particulate matter or allergens before and after
introducing the intervention. The outcome will be determined by examining the
rates of asthma exacerbation and hospital admissions, particularly due to
environmental triggers, to evaluate the interventions’ effectiveness.
Enhancing Access to Asthma Care
through Telehealth Services
The intervention will
be done by increasing the reach of telehealth and integrating it into asthma
management. Teleconsultation, telemonitoring, and digital asthma action plans
can all be used to ensure care availability, particularly in underserved urban
communities. Research by Wittwer et al., 2023 indicated that telehealth
interventions for asthma helped improve asthma control, medication adherence,
and the quality of life for these patients.
The outcome monitoring is done by assessing the usage of telemedicine for
asthma management purposes, including the sum of remote consultations and
patient satisfaction evaluations. It will also be carried out by assessing the
variability in asthma control levels among those patients receiving telehealth
interventions and those receiving conventional care by tracking healthcare
utilization rates.
Implementation strategy
As a healthcare provider,
I will take various measures to effectively implement the plan for managing
asthma problems. I will cooperate with local healthcare providers, community organizations,
and policymakers to develop asthmatic education plans, environmental
interventions, and telehealth services. I will also implement a multisector
approach combining the efforts of healthcare workers, public health experts,
educators, and leaders of the community necessary to properly implement
preventive measures and their long-term effects. Furthermore, I will continuously
reevaluate the efficiency of the interventions through data collection, analysis,
and stakeholders’ feedback, modifying strategies depending on the new emerging
needs and challenges.
In conclusion, asthma
is a widespread chronic respiratory problem that imposes many health and
healthcare costs on individuals and healthcare systems. Effective asthma
management needs a comprehensive solution that includes patient education,
individual treatment plans, interdisciplinary partnerships, and routine
monitoring. Nurse practitioners must be equipped with the knowledge and skills
grounded in evidence. This will enable them to address the complexity of asthma
in individuals to produce better health outcomes through a comprehensive
approach to asthma care. Employing evidence-based procedures and advocating for
policy changes are essential to facilitate asthma management. Nurse practitioners
can play a pivotal role in reducing the burden of asthma and significantly
raising the quality of life of those suffering from it.
References
Asthma
Facts. (n.d.). Asthma & Allergy Foundation of America. https://aafa.org/asthma/asthma-facts/#:~:text=More%20than%2027%20million%20people%20in%20the%20U.S.%20have%20asthma
Centers for Disease
Control and Prevention. (2023, May 22). Asthma. Centers for Disease Control and
Prevention. https://www.cdc.gov/asthma/default.htm
Everhart, R. S., Mazzeo,
S. E., Corona, R., Holder, R. L., Thacker II, L. R., & Schechter, M. S.
(2020). A community-based asthma program: study design and methods of RVA
Breathes. Contemporary clinical trials, 97, 106121.
Holden, K. A., Lee, A.
R., Hawcutt, D. B., & Sinha, I. P. (2023). The impact of poor housing and
indoor air quality on respiratory health in children. Breathe, 19(2).
O’Sullivan, M. J.,
Phung, T. K. N., & Park, J. A. (2020). Bronchoconstriction: A potential
missing link in airway remodelling. Open Biology, 10(12),
200254.
Wittwer, L. H., Walters,
E., & Jordan, K. (2023). Improving Pediatric Asthma Care Through Asthma
Apps: A Narrative Review. The Journal for Nurse Practitioners, 19(5),
104500.
