Studied by 40 peopleEpidemic
a disease occurence that clearly exceeds the normal or expected frequency in a community or region
Pandemic
an epidemic that is worldwide in distribution
Endemic
the continual presence of a disease or infectious agent in a particular area or population
Host
susceptible human or animal who harbors and nourishes a disease-causing agent
agent
a factor that causes or contributes to a health problem or condition
environment
all the external factors surrounding the host that might influence vulnerability or resistence
Epidemiological Triangle
Host, Environment, Agent
Theories of Causality in Health and Illness
relationship between a cause and its effect -chain of causation; web of causation (multiple causation); causation in noninfectious disease
metainflammation
systemic, chronic inflammation at molecular level
anthropogens
inducers associated with lifestyles and modern built environments
Web of Causation and Implication
combination of multiple factors leading to disease and poor outcomes Intervention[breaking the web] could profoundly impact the development of that disease
immunity
a host's ability to resist a particular infectious disease-causing agent
passive immunity
short-term; acquired naturally or artificially
active immunity
long-term, sometimes lifelong; acquired naturally or artifically
cross immunity
immunity to one agent providing immunity to another related agent
Herd immunity
Immunity level present in a population group
Natural History of a Disease or Health Condition: Stages
[PHASE 1: Pre-pathogenesis] Susceptibility Stage; Subclinical State (Incubation period & Induction period); [PHASE 2: Pathogenesis] clinical disease stage; resolution stage
Susceptibility Stage
Host and environment factors influence population's vulnerability
Subclinical disease stage
invasion by causative agent; people are asymptomatic includes: incubation period and induction period
clinical disease stage
disease or condition evident in population
Resolution stage
disease or condition concludes in renewed health, disability or death
Incidence: how to calculate
number of new cases in a specified time divided Population total x 1000 = _______ per 1000
Prevalence: how to calculate
number of existing cases in the population at a specified time divided Population total x 1000= _______ per 1000
Mortality rate: how to calculate
mortality measures given information about causes of death. With the many variations of these measurements: crude death rate, cause-specific death rate, case-fatality ratio Number of deaths/population
case fatality rate: how to calculate
proportion of persons with a particular condition/case who die from that condition. This measures the severest of the condition [Number of cause-specific death among the incident cases] divided Total number of incident cases x 100 (or could use 1000) = expressed as a percentage (%)
Cause specific death rate: how to calculate
number of deaths in the population attributed to a certain diagnosis or disease at a specified time Divided by population total x 1000 = ______ per 1000
What are the two conditions that must be met to state that a causal relationship exists?
Causal agent is shown to increase probability of disease occurrence in many studies, populations
A reduction in causal agent is shown to reduce frequency of disease
What are common sources used by epidemiologists to obtain and track data?
Vital statistics, census data, reportable diseases, disease registries, surveillance systems, environmental monitoring, national center for health statistics (health surveys), federal public health agency reports, information observational studies, scientific studies
new challenges in disease control that have emerged in the 21st century?
rapid population aging, increased disability, antimicrobbial resistence etc
which agency is first notified of a communicable disease occurring in the community?
State and local health department
Describe the approach used by a C/PHN when investigating a communicable disease that has been reported
uses a systematic approach -review the information -clarify whether the disease is suspect or lab confirmed -review the case definition -review the disease information -use disease-specific questionnaire when available
Describe the three methods of disease transmission interruption
Treatment- taking countermeasures or interventions to slow or stop the transmission of the disease Isolation- the separation for the period of communicability, of known infected persons in such places and under such conditions as to prevent or limit the transmission of the infectious agent Quarantine- restrict activities of asymptomatic persons who have been exposed to the communicable disease during or immediately prior to the period of communicability
Describe the challenges that C/PHNs face with implementing programs to immunize children
oppose government mandates sheer number of vaccines veer from the recommended spacing schedule religious objections philosophical or medical objections
identify vector organisms that commonly transmit infectious disease in the modern day world (global community, not just U.S)
Vector transmission: occurs when the infectious agent is carried by a vector (nonhuman carrier such as an animal or insect) West Nile virus (mosquito) Lyme disease (tick) Rocky Mountain spotted fever (tick) malaria (mosquito)
Describe how to interpret a Mantoux Tuberculin skin test. What indicates a positive result?
Two factors may/influence positive result: Measurement in millimeters of the induration persons risk of TB infection or the risk of progression to TB disease if infected
Measurement of 15 or more mm is considered positive in people with no known risk factors for TB Measurement of 10 or more mm is considered positive in people born in countries where TB disease is common, people who abuse drugs, mycobacteriology lab workers, people who live or work in high risk congregate settings, with certain medical conditions that palace them at high risk of TB, high risk children, infants and adults, people with low body weight (<90%) Measurement of 5 or more mm is considered positive in people living with HIV, a recent contact of a persons with TB, positive chest X-RAY findings suggesting previous or current tb, other immunosuppressed people, people with organ transplants
when a positive result is suspected, patient will have to get chest x-ray to get confirmation
What is latent tuberculosis and the recommendations for treatment?
What characterisitics about the disease of anthrax make it an effective biologic agent of terrorism?
Anthrax: acute bacterial disease that affects mainly the skin cutaneous or respiratory tract (inhalation) case fatality: 5-20% for cutaneous; 85% for inhalation Anthrax: can make an effective biologic agent of terrorism because it can be released quietly and without anyone knowing; spores are harder to kill and can be easily spread when the microscopic spore are put in powders, sprays, food and water
Define the term ‘social determinants of health’ and give examples of a social determinant of health
Social determinants of Health are factors that influence an individual's ability to maintain good health include social, economic and physical factors such as: access to social and Economic opportunities, safe housing, quality education, clean water, air and food, safe workplaces, equitable social interactions, adequate community resources
What does it mean when there is a 'health disparity'
When the barriers for population results in increased quanitity of disease, increased burden of disease, lower age and increased rate of mortality due to disease, decrease in access to health care, decrease quality of health care It is avoidable, unfair and unjust
Stages of change as described by Kurt Lewin's theory
Unfreezing (when desire for change develops) Changing/moving (when new ideas are accepted and tried out) Refreezing (when the change is integrated and stabilized in practice)
Describe characteristics of 'planned change'
purposeful and intentional > change by design, not default > improvement as the aim for planned community health change > accomplishment through and influencing agent
Cognitive: domain of learning with example
mind and thinking processes - remember, understand, apply, analyze, evaluate, create example: a client discusses how sodium intake will affect blood pressure
Affective: domain of learning with example
emotion, feeling and affect example: client expresses acceptance of having colostomy and maintains self-esteem
psychomotor: domain of learning with example
visible demonstration of skills requiring some type or neuromuscular coordination example: community nurse teaches a client how to self-administer insulin
Factors affecting readiness to make a change according to the health belief model
factors affecting readiness to make a change: perceived susceptibility, perceived seriousness, perceived benefits of action, barriers to taking action, cues to action, self-efficacy
Brief explanation of the six stages of the Transtheoretical Change model
Precontemplation- when a person is considerign making a change/ unaware of the issue "break the spell" Contemplation- able to see that you could make a change but not heavily invested Preparation: decided to change but not ready to to take action Action- takes initiative and make the plan that you prepared for in action Maintenance: when finding success in the action stage- you reverse your old habits [change your environment and lifestyle] Relapse: "Fall of the wago" you return to one of the earlier five stages of behavior and may feel complicated feelings-disappointment, frustration and failure
Priniciples for effecting positive change
Client readiness, client perceptions, educational environment, client participation, subject relevance, client satisfaction, client application
learning styles described by ATI
Visual learning: learn through seeings and methods such as note-taking, video-viewing and presentations Auditory learning: learn through listening and methods such as verbal lectures, discussion and reading aloud Tactile-kinesthetic learning: learn through doing and methods such as trial-and-error, hands on approaches, and return demonstration
Describe health literacy with respect to the C/PHN's development of health education
Nurses should consider literacy needs when developing interventions. An individual's ability to understand basic health information and make decisions, or health literacy, can affect the ability or desire to take action
Category A biologic agents- identify the agents in this category
Anthrax (bacterial), Plague(bacterial), Botulism(bacterial), Small Pox (viral), Hemorrhagic Fever (viral), Tularemia (viral) Bioterrorism agents- posing a risk to national security because they are easily transmitted and have high mortality rates
Traumatic brain injury from warfront exposure: what are long-term physiological efffects?
Acute stress disorder, depression, PTSD
Examples of natural vs man-made disasters
Natural Disasters: Tornadoes, typhoon, floods, earthquakes Man-made disasters: war, pollution, nuclear explosions, fires [wild, house], hazardous material exposure, explosion, and transportation accidents
Epidemiological triad [host, agent, environment] and describe the factors involved in disasters
Host factors: age, general health, mobility, psychological factors and even socioeconomic factors Agent: natural or technologic element that caused the disaster environmental factors: those that could potentially contribute to or mitigate a disease
What is the role of FEMA in disasters?
Federal and State Relief- support citizens and responders to work together - prepare, protect, respond, recover and mitigate
Identify how the Incident Command System staff is organizaed
Functional areas: Operations, Planning, Logistics, Finance/administration
Describe the roles of Incident commander, Safety officer, PIO, Operations Chief, Logistics Chief, Planning Chief, Finance and Admin Chief
Incident commander: person responsible for all aspects of an emergency response including quickly developing incident objective, managing all incident operations, application of resources as well as reponsibility for all persons involved Safety officer- monitors incident operations and advises the incident commander on all matters regarding operational safety Public information officer: wgi serves as the conduit for information to internal and external stakeholders, including the media or other organizations seeking informtion directly from the incident or event Operations chief: develop and manage the operations section to accomplish the incident objectives set by the incident commander Planning Chief: responsible for providing planning services for the incident- planning section cllectrs situation and resource status information, evaluates it and processes the information for use in developing action plans Logistics Chief: provides all incident support needs with the exception of logistics support to air operations- facilites, transportation, supplies Finance/admin chief: responsible for managing all financial aspects of the incident
Phases of disaster management
Primary prevention: prevention or mitigation- Improving community and individual reaction and responses so that the effects of a disaster are minimized responses so that the effects of a disaster are minimized, preparedness- gathering essentials, education, personal preparedness, communication, home maintenance Secondary prevention: response- Local Level, national incident management system Tertiary prevention: Recovery- repair, rebuild or relocate damaged homes and businesses and restore health and social and economic vitality to the community
Note
Flashcard