Category: Nursing

Foundational Neuroscience

The Agonist-To-Antagonist Spectrum of Action of Psychopharmacologic Agents

Agonists are neurotransmitters that stimulate receptors while antagonists obstruct the action of neurotransmitters at its receptor. Drugs act in the same manner where some medications trigger receptors just like neurotransmitters and therefore such drugs are agonists. Other medications normally obstruct the action of neurotransmitter at its receptor and therefore such medications are known as antagonists (Stahl, 2013).  In addition, other medications act on the contrary to agonists and are known as inverse agonists. Therefore, psychopharmacologic agents acting at the receptor occur within a spectrum from a complete agonist to antagonist and then to inverse agonist (Zimmer, 2016) Foundational Neuroscience. The spectrum involves agonists that open the ion channel entirely, while antagonists maintain the resting state, and finally, the inverse agonists close the ion channel (Stahl, 2013).

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Stahl (2013) explains that there are various medications that bind to neurotransmitter sites to produce signal transduction effects; these medications are direct-acting agonists. In addition, antagonists work by blocking agonists’ action. Therefore, antagonists can only function where an agonist is there; this means that medications that are antagonists do not have an inherent activity when an agonist is absent. Therefore, the antagonist will obstruct everything within the agonist spectrum (Stahl, 2013).

Actions of G Couple Proteins and Ion Gated Channels

G couple proteins normally have receptors that have trans-membrane regions that have binding sites for neurotransmitters. This facilitates the targeting of exact psychotropic medications. When medications bind to the sites, this can result in various modifications of receptor actions as a result of imitating or obstructing, the neurotransmitter function occurring at the receptor (Johnson & Lovinger, 2016). Actions of such medications can, therefore, influence molecular events. Similarly, the medications can alter the expressed genes and hence the proteins synthesized and the amplified functions. On the other hand, ion gated channels are linked to the ionotropic receptor; the ionotropic receptors are used as sites where neurotransmitters bind and therefore these can be target sites for medications (Stahl, 2013).

The Role of Epigenetics in Pharmacologic Action

Epigenetics is a system that regulates the silencing or expression of genes (Stahl, 2013). The body cells consist of comparable but differentiated pair of genes that can be silenced or expressed. Therefore, neurotransmission, genes or even medications can influence the specific genes that will be expressed or suppressed. Epigenetic control can suppress or express genes by altering the structure of chromatin using chemicals like phosphorylation, drugs, methylation or neurotransmission (Stahl, 2013). Chemical processes like methylation or phosphorylation can be disrupted using drugs and this controls if the genes are epigenetically suppressed or expressed. For instance, chromatin alterations from drug actions have led to antidepressant responses that are associated with triggering genetic changes (Stefanska & David, 2015).

How the information may Impact Medication Prescription to Clients

Some classes of drugs are prepared to control epigenetic action and thus pharmacologic action of such drugs is broader. This is because some pharmacological agents require epigenetically function on diverse genes in on to ensure their efficacy in treating some conditions (Stefanska & David, 2015). For example, while medications with the epigenetic function may be effective in treating some types of diseases like diabetes, the approach of using epigenetics in drugs has been shown not to be effective in the treatment of mental health disorders like schizoaffective disorder, depression or schizophrenia. Therefore, this information may impact the prescription of medications to clients in that some conditions may require drugs with an epigenetic action, while other conditions may not.

 

 

References

Johnson K & Lovinger D. (2016). Presynaptic G Protein-Coupled Receptors: Gatekeepers of Addiction?
Front Cell Neurosci
. 10(264).

Stahl, S. M. (
2013
).
Stahl’s essential psychopharmacology
:
Neuroscientific basis and practical applications (4th ed.)
. New York, NY, US: Cambridge University.

Stefanska B & David M. (2015). Epigenetics and pharmacology.
British Journal of Pharmacology
. 172(11), 2701–2704.

Zimmer L. (2016). Pharmacological agonists for more-targeted CNS radio-pharmaceuticals.
Oncotarget
. 7(49), 80111–80112.

 

1. Explain the agonist-to-antagonist spectrum of action of psychopharmacologic agents.

2. Compare and contrast the actions of g couple proteins and ion gated channels.

3. Explain the role of epigenetics in pharmacologic action.

4. Explain how this information may impact the way you prescribe medications to clients. Include a specific example of a situation or case with a client in which the psychiatric mental health nurse practitioner must be aware of the medication’s action.

Credible reference material within the last 5 yrs only will be accepted. Sites such as WebMD, epocrates, Mayo Clinic, Rx List, Wikipedia, drugs.com (among others) will not be counted.

 

Discussion: Does Psychotherapy Have a Biological Basis?

Biological Basis of Psychotherapy Treatments

Psychotherapy is a biological treatment because it actually addresses the brain in accordance with the brain development, maturation, as well as brain’s operations. This is because psychotherapy follows the ideologies of evolutionary adaptation and hence it is consistent with genetics (Jeon & Kim, 2016).  As a result, psychotherapy treats and heals the problematic adaptations of the brain in exactly the same manner these problematic adaptations initially evolved. This is because psychotherapy disengages maladaptive brain mappings and substitutes these mappings with new and constructive mappings. Normally, the brain maps memories and experiences by connecting and linking many neuronal connections; consequently, psychotherapy deactivates the defective mappings and replaces them with new mappings (Zaman & Mark, 2016).

According to Jeon & Kim (2016) the implicit memory structure in the brain is responsible for processing information about affect and forms huge quantities of multifaceted information excerpts and stocks rules. The learning of the rules is implicit and this results in self-perpetuating bias when it comes to future interpretations of experiences; these interpretations guides and directs behaviors without any reflection (Zaman & Mark, 2016). During psychotherapy, there is reevaluation and reflection of the implicit rules and hence change is instituted by learning new patterns that are repeated continually until the new habit and behavior is embedded within the implicit memory structure in the brain. Accordingly, effective psychotherapy results to long-term behavioral, cognition and emotional change (Mathew & Ahn, 2014). Foundational Neuroscience.

The main types of psychotherapies include; psychodynamic, behavioral, and cognitive therapy. Behavioral psychotherapy addresses the dysfunction in modest forms of memory and learning and the associated motor behavior. The brain structures involved in behavioral psychotherapy include the hippocampus, amygdala, as well as basal ganglia (Zaman & Mark, 2016).

On the other hand, cognitive psychotherapy addresses the patterns involved in information processing as well as thinking patterns during a certain mental disorder (Mathew & Ahn, 2014). This means that cognitive psychotherapy tackles the defective and genitive cognitions that contribute to the development of the patient’s psychopathological state; cognitive psychotherapy examines and alters such defective thinking patterns. Neocortex is the brain structures involved in cognitive psychotherapy, particularly the frontal cortex (Zaman & Mark, 2016).

Finally, psychodynamic psychotherapy addresses the interpersonal depiction of the established expectations regarding self and other individuals, as well as their connection to behavior, affect, and behavior, as well as the neuropsychological factors behind these interpersonal representations.   The brain regions involved during psychodynamic psychotherapy include subcortical regions and cerebral hemispheres (Zaman & Mark, 2016).

 

Influences of Culture, Religion, and Socioeconomics on Personal Perspectives of Psychotherapy Treatments

Religion and culture impact an individual’s perspective on psychotherapy in different ways. For instance, an extremely religious person may prefer to seek spiritual intervention, for example, prayers for healing instead of seeking psychotherapy. Individuals may also use religion as coping mechanisms instead of seeking psychotherapy. For example, a study conducted by Agorastos et al (2014) indicated that individuals may use religiosity and spirituality to ease grieving after the death of a loved one. Therefore, an individual’s perspective regarding   psychotherapy can be influenced by religious beliefs Foundational Neuroscience.

Culture also influences an individual’s perspective regarding psychotherapy. Some cultures view psychotherapy as not appropriate and this influences an individual’s perspective on psychotherapy (Choudhry et al, 2016). For example, in the Czech Republic, psychotherapy is perceived as not okay when compared to pharmacotherapy. The culture supports taking pills than attending therapy sessions where those attending psychotherapy are sometimes stigmatized (Kuska et al, 2016) Foundational Neuroscience.  This, therefore, indicates that culture influences how an individual views psychotherapy because in some cultures attending psychotherapy sessions is very appropriate.

Finally, socioeconomic status also influences an individual’s perspective on psychotherapy. At times a complete psychotherapy can be relatively costly and hence people from low socioeconomic status may not afford this form of treatment and may prefer other forms of treatments. Similarly, those who can afford psychotherapy sessions may view it as an effective option and faithfully attend the sessions (Cummings, 2014). Foundational Neuroscience.

References

Agorastos A, Demiralay C & Huber C. (2014). Influence of religious aspects and personal beliefs on psychological behavior: focus on anxiety disorders,
Psychol Res Behav Manag
. 1(7), 93–101.

Choudhry F, Mani V, Ming L & Khan T. (2016). Beliefs and perception about mental health issues: a meta-synthesis.
Neuropsychiatr Dis Treat
. 1(12): 2807–2818.

Cummings J. (2014). Contextual Socioeconomic Status and Mental Health Counseling Use Among U.S. Adolescents with Depression.
J Youth Adolesc
.  43(7), 1151–1162 Foundational Neuroscience.

Jeon S & Kim Y. (2016). Neurobiological Correlates on Psychotherapy in Depression.
Acta Psychopathol.
2(12). doi: 10.4172/2469-6676.100039

Kuska M, Trinka R, Tavel P, Michael C, Angus L & Moertl K. (2016). The role of cultural beliefs and expectations in the treatment process: Clients’ reflections following individual psychotherapy.
Sexual and Relationship Therapy
. 31(3), 259–270.

Mathew L & Ahn W. (2014). Effects of biological explanations for mental disorders on clinicians’ empathy.
Proc Natl Acad Sci U S A
. 111(50), 17786–17790.

Zaman R & Mark A. (2016). Psychological Treatments and Brain Biology .
Psychiatria Danubina
. 21(1), 31–35 Foundational Neuroscience

NURS 6650 Week 2 practicum journal entry

Introduction

Clients with mental health illness use group therapy as one of the psychotherapy techniques to deal with different ideas. This paper will talk about different therapy that the family can benefit such as structural family therapy, cognitive behavioral therapy, problem solving that will involve the family and the client, and solutions that are needed. “All of this leads to the obvious fact that expectations from patient to patient were different, as was perception of relevance, depending on the task” (Roman, 2018). The therapist will use experimental therapy to focus on family relationship which will help the family to develop an insight in their relationship. This will also help the family to communicate openly and sincere with each other during therapy. In the context of a group therapy setting, patients that participate develop a bond that allows them to share ideas, experiences, and set-backs. “They teach each other self-advocacy skills, link them to other members in the community and provide a canvas that each patient can use to comfortably discuss their situation that a clinician alone may not be able to provide” (Roman, 2018).  In solving family problem, it is important to educate the family about mental health illness and supporting the client with the illness which will bring hope to the families and the client. “In any group therapy setting, the clinician is exposed to a variety of patient personalities with diverse backgrounds” (Roman, 2018). In this paper, I will about two of the clients that attended the group therapy PW and MJ. NURS 6650 Week 2 practicum journal entry

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Pertinent and Medical History

PW is a 26 years Caucasian female who has illicit drug abuse and was recently diagnosed with chronic liver disease because of her drinking too since she was 15 years old. Because of her drinking and taking illicit drugs her children were taken away from her to her grandmother who is now in custody of her children. She has been taken to the emergency room several times where she was referred to a rehabilitation center that helped her in counseling and was given medication to get rid of the marijuana addiction in her system. She grew in a family that her mother was using illicit drugs and she was abused by her step father which contributed to her mental illness. She has diagnosis of Cannabis use, Generalized Anxiety Disorder (GAD), Panic disorder, Adjustment disorder with mixed anxiety and depressed mood, and bipolar disorder.  She is taking Buspirone and Wellbutrin. “It is accompanied by symptoms such as restlessness, fatigue, muscle tension, irritability, sleep disturbance, and difficulty concentrating; trembling, sweating, headache, or gastrointestinal symptoms may also be present” (Gilmour, 2016).

On the other hand, MJ is a 30-year-old Caucasian female who has diagnosis of Post Stress Traumatic Disorder (PSTD), Major Depression Disorder (MDD), and Generalized Anxiety Disorder (GAD). She was recently diagnosed with blood clot and was started on anticoagulant due to her birth control patch that has not changed for months. Her depression affects her sleep and eating habits. She was abused by her step-father and her mother does not care about her that much. She is on Guanfacine, Prozosin, Ambien, Zoloft, and Buspar. She lives with her boyfriend who sometimes does not help her in dealing with her mental illness. NURS 6650 Week 2 practicum journal entry.

Diagnostic and Statistical Manual of Mental Health Disorder (DSM-5)

PW has diagnosis of alcohol abuse disorder which according to DSM-5 client with symptoms of alcohol craving, not able to control self, and physically depending on others falls on alcohol category. MJ suffers from Generalized Anxiety Disorder (GAD), Post Stress Traumatic Disorder (PSTD), and Major Depression Disorder (MDD) which were outlined through DSM-5. “Generalized Anxiety Disorder (GAD) is characterized by excessive, often irrational, worry about events and situations such as work, school, health, relationships, finances or routine activities and the anxiety persists for at least six months, is difficult to control, and interferes with occupational, social or other areas of functioning” (Gilmour, 2016). “According to DSM-5, client experiencing symptoms such as depressed mood, having difficult time sleeping, losing weight, not eating well, and having fatigue for several weeks qualifies that client as having diagnosis of depression. Also, clients who have these significant symptoms without been caused by alcohol use or substance abuse or any other psychological disorder are categorized is been having depression disorder. “Diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) include the following: Excessive anxiety and worry for at least six months, difficulty controlling the worrying. Anxiety and worry associated with at least three of the following: Restlessness or feeling keyed up or on edge, being easily fatigued, difficulty in concentrating or mind going blank, irritability, muscle tension, and sleep disturbance” (Munir, & Hughes, 2018). The best intervention for the clients is cognitive behavioral therapy which will help them to overcome their problems by changing how they think will help them to avoid having any harmful behavior, stay off stress emotions, and help them in practicing and recognizing the healthy ways of thinking. NURS 6650 Week 2 practicum journal entry.

Legal and Ethical Implications

It is important for the therapist to inform the client that she will be tested for substance abuse. Making sure that they get consent from the client who and what information will be shared. Informing the clients what medications will be prescribed and the side effects. It is very important for the therapist to keep that information received from the client confidential and shared whatever that client wants the therapist to share. “In working with certain population, each clinician may be working with an immigrant client(s) from specific cultural background, socioeconomic status or mental health care system, for places where it exists, that have a unique perspective of what a visit to a mental health clinician really means and informed consent defines the roles of the clinician and the client(s) during the therapeutic interaction” (Lewis, Paik, & Tseng, 2017). It is very important for the mental health professional has to refer to the facility’s ethical policy when caring for the needs of the client that are outside the professional scope of practice. NURS 6650 Week 2 practicum journal entry.

Conclusion

“To address the individuality of the patient, it might be necessary to provide extra “homework” to individuals within the group and this homework may be informational in nature, such as doing additional research on the diagnosis, interventions, and the implementing the interventions” (Roman, 2018). The outcome of the group therapy will benefit the clients in a clinical setting and the implementing the client to attend the group therapy will provide benefits to those clients with mental illness and addictions. CBT has been helpful to the clients when the therapist use it to deal with different difficulties and mental illness. CBT have been used in a crucial situation and have been effective and resulted to positive outcomes. “The core value of confidentiality is one of the factors of therapy that promote the comfortability to be vulnerable that clients need and facilitate healing. Transparency could be utilized in discussing the times when confidentiality will need to be broken in order to promote safety” (Lewis, Paik, & Tseng, 2017). NURS 6650 Week 2 practicum journal entry.

 

References

Cho, J. M., & Lee, K. (2018). Effects of motivation interviewing using a group art therapy program on negative symptoms of schizophrenia. Archives Of Psychiatric Nursing, 32(6), 878–884.
https://doi-org.ezp.waldenulibrary.org/10.1016/j.apnu.2018.07.002

 

Gilmour, H. (2016). Threshold and subthreshold Generalized Anxiety Disorder (GAD) and suicide ideation. Health Reports, 27(11), 13–21. Retrieved from
https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=27849314&site=ehost-live&scope=site

 

Lewis, F., Paik, S., & Tseng, C.-F. (2017). Deconstructing the Legal Process for the Immigrant Population in the United States: Ethical Implications for Mental Health Professionals. Contemporary Family Therapy: An International Journal, 39(3), 141–149. https://doi-org.ezp.waldenulibrary.org/10.1007/s10591-017-9418-x NURS 6650 Week 2 practicum journal entry

 

Munir, S., & Hughes, J. (2018). Anxiety, Generalized Anxiety Disorder (GAD). Retrieved from https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=28722900&site=ehost-live&scope=site

 

Roman, A. M. (2018). It Takes a Village: Lessons in Group Aural Rehabilitation Therapy. Audiology Today, 30(2), 12–14. Retrieved from
https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=128026647&site=ehost-live&scope=site
 NURS 6650 Week 2 practicum journal entry

Voluntary and involuntary commitment essay Assignment

Review the Learning Resources concerning voluntary and Involuntary Commitment

PMHNPs may find themselves working in a wide variety of settings—each having their own unique challenges and inherent legal issues. For instance, what do you do in your state of practice when you are providing a therapy/treatment session and a client reports active suicidal ideation? What do you do if you are covering inpatient psychiatric consults and are called to see a patient in the ICU who overdosed on prescription medication requiring intubation? What do you do if you are a PMHNP on an inpatient unit and a client who admitted themselves on a voluntary basis suddenly states that they have decided to sign themselves out of the hospital so that they can go home to kill themselves? These are just some of the legal questions that PMHNPs must know the answers to specific to their state of licensure/practice. Voluntary and involuntary commitment essay.

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In this Assignment, you investigate Texas state’s laws concerning voluntary and involuntary commitment. You also analyze a case to determine if the client is eligible for involuntary commitment.

Scenario for Week 7 Case:

You are a PMHNP working in a large intercity hospital. You receive a call from the answering service informing you that a “stat” consult has been ordered by one of the hospitalists in the ICU. Upon arriving in the ICU, you learn that your consult is a 14 year old male who overdosed on approximately 50 Benadryl (diphenhydramine hydrochloride) tablets in an apparent suicide attempt. At the scene, a suicide note was found indicating that he wanted to die because his girlfriend’s parents felt that their daughter was too young to be “dating.” The client stated in the suicide note that he could not “live without her” and decided to take his own life. Although he has been medically stabilized and admitted to the ICU, he has been refusing to talk with the doctors or nurses. The hospital staff was finally able to get in touch with the clients parents (using contact information retrieved from the 14 year old’s cell phone). Unbeknown to the hospital staff, the parents are divorced, and both showed up at the hospital at approximately the same time, each offering their own perspectives on what ought to be done. The client’s father is demanding that the client be hospitalized because of the suicide, but his mother points out that he does not have “physical custody” of the child. The client’s mother demands that the client be discharged to home with her stating that her son’s actions were nothing more than a “stunt” and “an attempt at manipulating the situation that he didn’t like.” The client’s mother then becomes “nasty” and informs you that she works as a member of the clerical staff for the state board of nursing, and if you fail to discharge her child “right now” she will make you “sorry.” How would you proceed?

The Assignment (write 2 pages):

Based on the scenario, would you recommend that the client be voluntarily committed? Why or why not?

Based on the laws in your state, would the client be eligible for involuntary commitment? Explain why or why not.

Did understanding the state laws confirm or challenge your initial recommendation regarding involuntarily committing the client? Explain.

If the client were not eligible for involuntary commitment, explain what actions you may be able to take to support the parents for or against voluntary commitment.

If the client were not eligible for involuntary commitment, explain what initial actions you may be able to take to begin treating the client. Voluntary and involuntary commitment essay.

 

Voluntary or Involuntary Commitment? The Case of a Suicidal Teenager in the State of Texas

Mental health instability can often lead one to become violent or a risk to themselves and others. This is usually a mental health emergency and the law in every state in the United States recognizes this. The person in question may want to harm others or may want to attempt suicide. To save lives, this kind of person is often committed to inpatient treatment against their will. This is involuntary detention. Of course, when a mentally ill person checks themselves in a mental health facility, that becomes voluntary commitment. This paper is about the action a psychiatric-mental health nurse practitioner (PMHNP) can take regarding these two possibilities in the case of a suicidal Texas teenager. Voluntary and involuntary commitment essay.

As a PMHNP, I would be of the opinion that the 14 year-old suicidal teenager in this case study is not eligible for voluntary admission to a mental health facility. Therefore, I would not recommend that he be voluntarily committed. This is because of two reasons. First, the teenager has already demonstrated that they are a danger to themselves since they attempted to kill themselves through a drug overdose. This is one of the reasons the Texas Mental Health Code gives for detaining a mentally ill patient involuntarily (State Bar of Texas, 2008; Barrows Firm, 2016). Secondly, the teenager comes from a dysfunctional family with divorced parents who cannot even agree on the way forward concerning his care. The father, who reasonably wants the teenager to be committed and treated, has no physical custody of the minor. The mother who has physical custody, on the other hand, wants the minor released to go home in his suicidal state. But this is against what the law and best practice dictates.

Based on the law in Texas, this teenager is perfectly eligible for involuntary commitment. The law in Texas states that a mentally ill person who shows that they are a danger to others by, for instance, being violent is eligible for involuntary commitment by direction of the courts. Also, if they are suicidal or have already attempted suicide (as is the case with the teenager in this case study), they are candidates for involuntary admission. This is so that the life of the patient and that of others around them can be saved (State Bar of Texas, 2008; Barrows Firm, 2016; Disability Rights Texas, 2018). As such, the understanding of the law in Texas regarding voluntary and involuntary admission confirms my initial stand that this teenager does not qualify for voluntary admission but is a perfect candidate for involuntary admission. Voluntary and involuntary commitment essay.

If the patient were not eligible for involuntary commitment, I would involve a counsellor to talk to the mother and explain to her the importance of giving consent for her son to be admitted for treatment and observation until he is free of suicidal thoughts. As a professional, the threats from the mother would not deter me from doing the right thing. Doing this would be in line with the Texas Board of Nursing PMHNP Standards of Practice. Therefore, if the client were not eligible for involuntary commitment, one of the first things I would have done would have been to have a physician colleague examine him and give his opinion and recommendations. This is because voluntary commitment status can change at any time to involuntary commitment status and vice versa, depending on the patient’s progress. In the event that the status changes to a need for involuntary commitment, a physician’s opinion is one of the requirements by the courts for granting permission for involuntary commitment (State Bar of Texas, 2008; Barrows Firm, 2016). Voluntary and involuntary commitment essay.

References

Barrows Firm (2016).
Involuntary mental health commitments In Texas
. Retrieved 10 January 2020 from
https://barrowsfirm.com/involuntary-mental-health-commitments-texas/

Disability Rights Texas (2018).
Your legal rights under emergency commitment
. Retrieved 10 January 2020 from

Your Legal Rights Under Emergency Commitment

State Bar of Texas (2008).
Committed to healing: Involuntary commitment procedures
. Retrieved 10 January 2020 from
www.texasbar.com 
 Voluntary and involuntary commitment essay

NURS 6650 Week 1 Practicum Journal Entry

Week 1: Journal Entry

 
The purpose of the week one journal entry is to review both a nursing theory and a counseling theory that will guide my practice as a student PMHNP. Also, this journal will cover three goals and objectives that I have for this practicum experience as well as a timeline for my practicum activities.

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Nursing Theory

The nursing theory that I have chosen to guide my practice is the Theory of Interpersonal Relations by Hildegard Peplau. In psychotherapy, the relationship developed between the PMHNP and the patients is the base of treatment. The PMHNP must earn the clients trust for therapy to be effective. Peplau’s theory contains four phases of the professional and client relationship- orientation, identification, exploitation, and resolution (Fatemeh et al., 2017). During the orientation phase, the client defines their problem, and the mental health professional will complete their initial assessment. Gaining a patients trust is important because they need to be comfortable enough to be completely truthful so they can be treated properly. For example if a client has a history of sexual abuse in childhood and does not disclose it with the PMHNP then the form of treatment they need they may not receive. I have worked with several patients that have had difficulty disclosing childhood trauma until they felt comfortable enough with me. NURS 6650 Week 1 Practicum Journal Entry.

Second is the identification phase where a plan of care will be created, during this time the patient will feel as if they belong and that they have real potential to fix the problem. The third is the exploitation phase where the nursing plan will be implemented; actions will be taken in meeting the goals (Bittencourt et al., 2018). The last stage in Peplau’s theory is the resolution phase where the termination of the professional relationship is completed because the client’s needs have been met though their collaboration. I believe that it is critical to develop a strong bond with each client I work with; this theory can be used with every client. NURS 6650 Week 1 Practicum Journal Entry.
 

Behavioral Theory

 
The behavioral theory assumes that behavior is learned from the environment and individuals around us (McLeod, 2010). Thus, being said if a behavior is learned by a person it can be unlearned. I like the behavioral theory to use with individuals because it gives the opportunity to focus on current problematic behaviors that the client may be facing (McLeod, 2010). This theory only looks at observable behaviors, unlike the psychoanalytic theory that focuses on emotions. The reason I chose this theory is that my goal is to work with children that have mental health conditions that result in behavioral issues such as a child with autism or ADHD. Today behavior analysis is often used as a therapeutic technique to help children with autism, and developmental delays acquire new skills (Siti Ithriyah, 2018).  ABA is used to help children diagnosed with ASD to decrease negative behaviors that can affect learning and to increase the positive and helpful behaviors.

Goals for Psychotherapy with Groups & Families

           
The first goal that I have for this course is to fully understand the laws and state regulations regarding group and family therapy in the state of Florida. There are many legal and ethical considerations when conducting group or family therapy, and it is crucial for the PMHNP to be aware of these regulations, so I will be able to protect myself as well as the clients I work with.

The second goal I have in this course is to have the ability to document on a group therapy session properly. Though I am a registered psychiatric nurse, I have never documented on a family or group therapy session so learning the documentation process and notes is very important for me to learn while in this course.

Lastly, the third goal I have in this course is to build confidence in running a group therapy session. I have done many assessments and therapy with individuals but when there are multiple people present with different opinions the therapy session can be tricky. NURS 6650 Week 1 Practicum Journal Entry.

Objectives for Psychotherapy with Groups & Families

           
My first learning objective for this course is to have the capability to provide accurate psychiatric diagnoses for the clients I assess during practicum upon completion of the course. Second objective is to have the ability to recall important legal and ethical implications specific to the state of Florida when providing psychotherapy with groups and families. The last learning objective is to complete at least 5 full initial assessments with new clients during my practicum experience and to develop a plan of care with those clients.

 

My Course Timeline

 
I will be completing a total of 10 weeks of clinicals with a total of at least 144 clinical hours. Each week I will be working with my preceptor for a minimum of two days per week at least 8 hours day. The first two weeks I plan to get acquainted with my preceptor Dr. Vega and the practicum site NURS 6650 Week 1 Practicum Journal Entry. During my first two weeks I plan to shadow Dr. Vega and get set up with the computer system that she uses. By week 3, I want to be comfortable with her computer system and the have the capability to chart properly on the therapy sessions that have been completed.

By weeks 4-5, I want to be more comfortable with the documentation process and complete notes on my own. Also, during weeks 3-6 I want to be treating patients by joint care with my preceptor until I become comfortable to become mostly independent. In weeks 7-10 I plan to be practicing mostly independently, after each session I will receive feedback from my preceptor, so I will be aware of specific areas that I can improve on.  I would like the opportunity to complete assessments on new patients to have the opportunity to formulate a proper psychiatric diagnosis and plan of care. By the last week of clinical I want to feel confident it my ability to provide psychotherapy to groups and families. NURS 6650 Week 1 Practicum Journal Entry.

 

References

 
Annette M. Matthews, M. D. . author. (2005). Cognitive Behavioral Theories of Counseling: Traditional and Nontraditional Approaches.
Psychiatric Services
, (9), 1164–a. https://doi-org.ezp.waldenulibrary.org/10.1176/appi.ps.56.9.1164-a

Bittencourt, M. N., Dias Marques, M. I., & Mendes Diniz de Andrade Barroso, T. M. (2018). Contributions of nursing theories in the practice of the mental health promotion.
Revista de Enfermagem Referência
,
4
(18), 125–132.
https://doi-org.ezp.waldenulibrary.org/10.12707/RIV18015

Cottone, R. R. (2017). Counseling Theories for Alcohol and Drug Education.
Journal of Alcohol & Drug Education
, (3), 86. Retrieved from
https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=edsgea&AN=edsgcl.532655330&site=eds-live&scope=site

fatemeh cheraghi, mahnaz khatiban, reza borzou, parasto hosayni, & salam vatandost. (2017). Application of Peplau’s theory of Interpersonal Relations in Nursing Practice: A systematic
, Vol 3, Iss 2, Pp 1-11 (2017)
, (2), 1. Retrieved from https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=edsdoj&AN=edsdoj.4b6d676559514bdcadcc0c35c154b1d2&site=eds-live&scope=site

McLeod, S. A. (2010). Behavioral therapy. Retrieved from https://www.simplypsychology.org/behavioral-therapy.html NURS 6650 Week 1 Practicum Journal Entry

Norton, A. L., & Tan, T. X. (2018). The relationship between licensed mental health counselors’ political ideology and counseling theory preference.
American Journal of Orthopsychiatry
. https://doi-org.ezp.waldenulibrary.org/10.1037/ort0000339

Siti Ithriyah. (2018). Effectiveness ABA Therapy for Children with Special Needs of Autism: A Study of Psycholinguistics View. 
Ethical Lingua: Journal of Language Teaching and Literature, Vol 5, Iss 2, Pp 149-158 (2018)
, (2), 149. https://doi-org.ezp.waldenulibrary.org/10.30605/ethicallingua.v5i2.887 NURS 6650 Week 1 Practicum Journal Entry

Genitalia Assessment SOAP note case study – Special Examinations—Breast, Genital, Prostate, and Rectal

In this assignment, you will analyze a SOAP note case study that describes abnormal findings in patients seen in a clinical setting. You will consider what history should be collected from the patients, as well as which physical exams and diagnostic tests should be conducted. You will also formulate a differential diagnosis with several possible conditions.

GENITALIA ASSESSMENT

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Subjective:

CC: “I have bumps on my bottom that I want to have checked out.”

HPI: AB, a 21-year-old WF college student reports to your clinic with external bumps on her genital area. She states the bumps are painless and feel rough. She states she is sexually active and has had more than one partner over the past year. Her initial sexual contact occurred at age 18. She reports no abnormal vaginal discharge. She is unsure how long the bumps have been there but noticed them about a week ago. Her last Pap smear exam was 3 years ago, and no dysplasia was found; the exam results were normal. She reports one sexually transmitted infection (chlamydia) about 2 years ago. She completed the treatment for chlamydia as prescribed.

PMH: Asthma Genitalia Assessment SOAP note case study – Special Examinations—Breast, Genital, Prostate, and Rectal

Medications: Symbicort 160/4.5mcg

Allergies: NKDA

FH: No hx of breast or cervical cancer, Father hx HTN, Mother hx HTN, GERD

Social: Denies tobacco use; occasional etoh, married, 3 children (1 girl, 2 boys)

Objective:

VS: Temp 98.6; BP 120/86; RR 16; P 92; HT 5’10”; WT 169lbs

Heart: RRR, no murmurs

Lungs: CTA, chest wall symmetrical

Genital: Normal female hair pattern distribution; no masses or swelling. Urethral meatus intact without erythema or discharge. Perineum intact with a healed episiotomy scar present. Vaginal mucosa pink and moist with rugae present, pos for firm, round, small, painless ulcer noted on external labia

Abd: soft, normoactive bowel sounds, neg rebound, neg murphy’s, neg McBurney

Diagnostics: HSV specimen obtained Genitalia Assessment SOAP note case study – Special Examinations—Breast, Genital, Prostate, and Rectal

Assessment:

To prepare:

With regard to the SOAP note case study provided:

consider the insights they provide about the case study.

Consider what history would be necessary to collect from the patient in the case study.

Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?

Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.

To complete:

Analyze the SOAP note case study. Using evidence based resources, answer the following questions and support your answers using current evidence from the literature.

Analyze the subjective portion of the note. List additional information that should be included in the documentation.

Analyze the objective portion of the note. List additional information that should be included in the documentation.

Is the assessment supported by the subjective and objective information? Why or Why not?

Would diagnostics be appropriate for this case and how would the results be used to make a diagnosis?

Would you reject/accept the current diagnosis? Why or why not? Identify three possible conditions that may be considered as a differential diagnosis for this patient. Explain your reasoning using at least 3 different references from current evidence based literature. Genitalia Assessment SOAP note case study – Special Examinations—Breast, Genital, Prostate, and Rectal

 

Additional Information to Include in Subjective Data

Onset-The client reported that she noticed bumps I week ago which means that she was not certain for how long they have been present.
I will request the patient to explain the bumps more in terms of its size, pattern, shape, and color. In the past, have you noticed bumps or this is the first time? If you noticed them previously, did you make any efforts to treat them? Recently, have you had any fevers or illnesses? Have you undergone any recent procedures or surgeries that need anesthesia or happened to start a new medication? At the time that you discovered the bumps what were you doing? When you had chlamydia 2 years ago, did you experience similar symptoms? Recently in your house, has anyone had scabies or lice?

Location-patient initially reported external bumps on her genitalia.

Apart from the genitalia, have you noticed bumps elsewhere on your body? If there are any that are internal, can you tell?

Associated Symptoms
– the patient reported that the bumps feel rough and are painless

Currently, before noticing the bumps, did you experience any form of burning or itching? Do the bumps tend to crust over, weep or ulcerate? In the entire period since you noticed them, do the bumps have the same appearance or it happened to change? Do the bumps spread?

Duration- the patient noticed the bumps one week ago but remained uncertain on their exact onset.
Can you tell whether the bumps are always present throughout or if they come and go?

Aggravating factors-
Are you informed of potential factors that tend to aggravate the occurrence of the bumps? Are they irritated by warm water, clothing and tight undergarments? Personally, do you often use douches and fragrant soaps? Recently, have you changed body soaps and detergents that you use?

Relieving factors- Are you aware of anything that tends to reduce/decrease their number, makes them disappear, change its texture or shape?

Alternative treatments-
before seeking medical help, have you tried any topical medications or home remedies? If so, was there any appreciable change or improvement?

Scaling pain- the patient clearly reported that the bumps were painless

Can you please rate the degree to which the bumps bother and affect your life with 10 as the maximum effect?

Past Medical History: Chlamydia and Asthma

Do you have any past medical history of other STIs or Genital Herpes apart from chlamydia?

Underlying skin conditions such as psoriasis and eczema?

Have you either suffered from chicken pox or had its immunization?

Have you previously been admitted to the hospital? If so, how many times and what were the indications?

At what age were you diagnosed with Asthma and are you currently having any complications with it?

What medications were you prescribed previously for chlamydia and who prescribed them?

Past Surgical History

Have you had any major surgical operations or C-section?

Medications: the patient uses Symbicort 160/4.5mcg

Are you taking any birth control meds, medications for acne or other drugs? If yes, when did you start and do you have any issues with it so far?

Since you are asthmatic, do you have a rescue inhaler?

OTC Medications, Supplements, and Herbs

Are you currently taking any work-out supplements, vitamins or OTC medications? If so which ones?

Denies History of?

Do you have a history of Psoriasis, Syphilis, Diabetes, thyroid disease, and a recent candida or step infection and HIV?

Allergies

Do you have any food, drug, and environmental allergies?

Personal Socio-Economic History- The client is a college student, married with children (2 boys and 1 girl). The patient denied the use of tobacco, occasional ETOH.

Do you live in a single home with the children and your spouse? If she lives in a dorm, it is worth knowing how many people they share the bathrooms with. Do you use/abuse any prescription drugs and illicit drugs? What kind of work do you do? What is your husband’s occupation? What are your hobbies? Have you had any recent increase in stressors? What is the client’s cultural history, religion and support system? Genitalia Assessment SOAP note case study – Special Examinations—Breast, Genital, Prostate, and Rectal

Sexual Reproductive History- she is single and sexually active since 18 years of age. She also reports that she had more than 1 partner in the past year. She did a pap smear 3 years ago, which appeared to be normal with no dysplasia. She was diagnosed with Chlamydia 2 years ago and took a complete drug regimen.

It will be necessary to confirm if the client has had any problems since she completed treatment for chlamydia. It will also be necessary to confirm the number of sexual partners that she has had so far and discuss the use of protection. Information on her sexual orientation and how well she prescribes her gender will also be important. Have you ever gotten pregnant? Have you ever had any abortions and miscarriages? Do you know the sexual status of your partners? Do you engage in anal sex? Genitalia Assessment SOAP note case study – Special Examinations—Breast, Genital, Prostate, and Rectal. Do you undertake self-breast exams, if yes, how frequently?

Family History: No previous history of cervical cancer or cervical cancer. Father has a history of Hypertension and mother has a history of GERD and Hypertension.

It will be important to know the age of the client’s parents and if they are deceased or alive. Additional history on both paternal and maternal grandparents and siblings should also be obtained.

Review of Systems

General: 
Have you had any recent weight gain or loss, symptoms of fever and fatigue?

HEENT:
Have you had a recent sore throat, noticed any sores in your oral cavity and throat or white coating on your tongue?

Breasts: 
Do your breasts have any drainage, lumps, tenderness or lumps? Genitalia Assessment SOAP note case study – Special Examinations—Breast, Genital, Prostate, and Rectal.

Respiratory:
Any chest tightness, cough, wheezing or pleurisy?

Cardiovascular/ Peripheral Vascular:         
Any palpitations, chest pain, edema, murmur and arrhythmias?

Gastrointestinal:
Have you experienced symptoms of vomiting, nausea, heartburn, vomiting. Do you experience fresh blood in stool, gray or black stools?

Genitourinary:
What is your last LMP? Do you have any issues with your menstrual cycle? Do you experience urinary symptoms of hesitancy, pain, burning and increased frequency? Do you have any tenderness on the vulval region, dyspareunia, foul odor or vaginal bleeding?

Skin:  
Do you have any histories of eczema, skin cancer, and psoriasis or removal of lesions? Have you experienced any recent or past increased sensitivity to lotions, soaps, and detergents?

Additional Information to Include in Objective Data

Physical Exam:

Vital signs:
Temp 98.6, PR 92, RR 16, BP 120/86, Ht 5’10”, Wt. 169 lbs., BMI = 24.2.

General
: I will describe the patient’s stature, walking gait, grooming, eye contact and affect

HEENT
: I will assess for edema, any drainage, cold sores, tonsils, lesions, oral thrush and look for systemic signs of infection of HSV or other viral infections. Genitalia Assessment SOAP note case study – Special Examinations—Breast, Genital, Prostate, and Rectal.

Neck:
I will assess for nodal tenderness, enlarged nodes at the cervical and clavicular regions, jugular venous distension and bruits.

Chest
: I will assess for labored or non-labored breathing, No breast lumps, nipple discharge, tenderness or nodules. No enlargement of the axillary nodes.

Lungs:
Symmetrical chest wall, CTA. Check for nasal flaring, retractions and wheezing.

Heart & Peripheral Vascular-Rapid Respiratory rate, no murmur, no edema.

Abdomen: Soft, non-tender, normal and active bowel sounds,        no rebound tenderness, negative murphy’s and McBurney’s sign

Genital/Rectal
: Normal distribution of hair, normal hair pattern, no swellings or masses, the urethral meatus has no discharge or erythema and is intact; the perineum is also intact with a healed scar for an episiotomy. The vaginal mucosa is moist, has rugae and is pink in color. The POS is firm, small and round. On the external labia, a painless ulcer is noted.

It is notable that the client has not had a pap smear for 3 years and had a history of chlamydia. Therefore, I will immediately do a pap smear and inspect the cervix for its presentation and motion tenderness in the process. I will check for possible vaginal bleeding, and note any foul discharge or odor. I will palpate to check for enlargement and tenderness of the inguinal lymph nodes. I will check for discharge in the scene and Bartholin glands. I will also note if the ulcer is indurated, whether or not it is the only one and its color. Genitalia Assessment SOAP note case study – Special Examinations—Breast, Genital, Prostate, and Rectal.

Skin: I will examine the skin for dryness, warmth, and pinkness. I will also check other regions for redness, discoloration, scaling, and patches.

Diagnostics

An HSV specimen was obtained for viral culture. To obtain results that are more specific, it will take 1-7 days.

A PH litmus and wet mount KOH should also be considered depending on the PE. Aspects such as clue cells, high PH and a gray discharge should be looked for.

Nontreponemal, PCR, EIA and VDRL tests should be considered for syphilis serology (Gayet-Ageron, et al., 2015).

A small scraping should also be obtained to look for spirochetes

A tzanck smear from the vesicles base should also be done. This test is definite for HSV. The findings that are most likely to be present are multinucleated giant cells but is only if the specimen will be from a herpes lesion that is intact. Genitalia Assessment SOAP note case study – Special Examinations—Breast, Genital, Prostate, and Rectal.

Assessment: Possible Differential Diagnosis

Acute Contact Dermatitis

Syphilis

Herpes Progenitalis(Simplex II)

Syphilis
– This most likely but confirmation with serology is needed. Since the patient has previous STIs history with multiple sexual partners, she is at risk of syphilis. Besides, the place where the lesion is located on the external labia permits easy contact with a direct syphilitic sore (Gayet-Ageron, et al., 2015). Based on the fact that currently, the ulcer is painless, with no itching, burning or pain prior to its eruption, syphilis is a likely diagnosis but previous diagnoses should be ruled out.

Both the objective and subjective data supports a Syphilis diagnosis. However, intensive diagnostics and questioning of the patient should be considered to obtain information that is more precise. For instance, it is important to know about the lesion’s borders, if its base is clear and firmness.

Acute Contact Dermatitis
– this is not likely since the patient has no history of allergens. It should also be noted that the client’s history of her work environment and most recent activities could lead to this diagnosis. If it were contact related, large erythema region could also be expected (Seller& Symons, 2012) Genitalia Assessment SOAP note case study – Special Examinations—Breast, Genital, Prostate, and Rectal.

Herpes Progenitalis (Simplex II)
– The assumption that only a single ulcer exists minimizes the possibility of Herpes Progenitalis, besides, the ulcer that was described was firm. In case of a previous infection, it is usually intensive while the recurrent tend to be localized with patches.  Lesions can even burn and are always painful (Wagenlehner, et al., 2016).

 

References

Dains, J. E., Baumann, L. C., & Scheibel, P., (2016). 
Advanced health assessment and clinical diagnosis in primary care
(5
th
ed.). St. Louis, MO: Elsevier Mosby.

Gayet-Ageron, A., Sednaoui, P., Lautenschlager, S., Ferry, T., Toutous-Trellu, L., Cavassini, M., & Schrenzel, J. (2015). Use of Treponema pallidum PCR in the testing of ulcers for diagnosis of primary syphilis.
Emerging infectious diseases
, 
21
(1), 127.

Seller, R. H., Symons, A.B. (2012). 
Differential Diagnosis of Common Complaints
(6
th
ed). Philadelphia, PA.: Elsevier-Saunders Genitalia Assessment SOAP note case study – Special Examinations—Breast, Genital, Prostate, and Rectal.

Seidel, H.M., Ball, J. S., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015).
Seidels’s guide to physical examination
(8
th
ed.).  St. Louis, MO: Elsevier Mosby

Wagenlehner, F. M., Brockmeyer, N. H., Discher, T., Friese, K., & Wichelhaus, T. A. (2016). The presentation, diagnosis, and treatment of sexually transmitted infections. 
Deutsches Ärzteblatt International
, 
113
(1-2), 11 Genitalia Assessment SOAP note case study – Special Examinations—Breast, Genital, Prostate, and Rectal.

PUB 540 Principles of epidemiology

An epidemiologic profile is a summary of a significant public health issue, or issues, in your community, county, state, or country. An epidemiological profile helps to coordinate activities and policies from various agencies and organizations to improve health.

Review the available data, reports, and documents for your locale. Assess how the methods of epidemiology (study designs, data collection, measures of association, etc.) are used to determine who needs what services, where the services are needed, and how those services should be delivered. Define your community as your city, metropolitan area, or county and write a 2,000-2,250 word epidemiological profile (word limit excludes references and title page) PUB 540 Principles of epidemiology. The profile can be a general profile that provides a landscape picture of several significant chronic and infectious diseases in your defined community, or it can be a specific profile that targets one health issue, such as diabetes, asthma, STDs, flu, heart disease, obesity, alcohol abuse, or other drug use. Include the following:

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Executive Summary

Describe the purpose of the epidemiologic profile and the health issue(s) it addresses. Discuss its importance to the community and how it will be utilized.

Summarize the key findings from your review of available data, reports, and documents for the community.

Introduction

Describe the defined community and population using demographic and socio-economic information and data.

Briefly describe the history and cultural background of the community.

Explain any unique contextual information that pertains to the public health of the defined community.

Describe any key public health projects, grants, or existing epidemiology-related working groups or committees in the community/county PUB 540 Principles of epidemiology.

Description of Available Data

Identify at least two different data sources relevant to your profile. Discuss data from these sources and their relation to the issue or community.

Discuss the methods used in the data collection process (data source and organization providing the data; how often the data are collected; data limitations including response rates, missing data, selection of participants, etc.). Potential data sources and databases might include the following depending on what is available for your community or county:

Behavioral Risk Factor Surveillance System (BRFSS) data

Youth risk behavioral survey

Surveillance, epidemiology, and end results (SEER) program data

CDC Wonder (multiple data sources)

County health rankings data (multiple data sources)

Alcohol-related disease impact data

Demographic health survey data (international)

Global school-based student health survey (international)

Local evaluation reports from the department/ministry of health or other nonprofit organizations

Interpretation of Results Regarding Key Health Issue

Size and magnitude of the measures

Trends and comparisons

Economic costs

Discussion of Problems and Strategies

Discuss disparities, limitations, and gaps in the information available regarding the health issue(s).

Describe potential public health strategies to address these gaps.

Use graphs and tables where appropriate.

Conclusion

You are required to cite to at least five sources to complete this assignment. Sources should be published within the last 5 years and appropriate for the assignment criteria and public health content.

General Requirements

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the 
LopesWrite Technical Support articles
 for assistance.

Benchmark Information

This benchmark assignment assesses the following programmatic competency:

MPH

2.1 Apply epidemiological methods to the breadth of settings and situations in public health practice.

MSN Public Health Nursing

6.2 Apply epidemiological methods to the breadth of settings and situations in public health practice.

 

Historical Review of Epidemiology

 

Key individuals and historical events have helped shape the field of epidemiology. Research the following individuals and their roles in shaping contemporary epidemiology:

John Graunt

James Lind

Edward Jenner

Ignaz Semmelweis

John Snow

Choose three of the individuals from your research. In a 1,000-1,250 word paper, describe the epidemiological advancements that were influenced by these individuals. Include the following:

Describe the disease and the event. Using descriptive epidemiology, discuss how common the disease was at the time, who was infected, when it occurred (time of year or season), and the mode of transmission. If the individual is not associated with a specific disease, discuss a significant disease happening during that period.

Discuss how the individuals influenced or advanced epidemiological methods and the process they used to describe and control disease. Discuss how their contributions helped to inform the definition of epidemiology. Consider whether they used qualitative, quantitative, or both types of data collection methods, and the approach they used to test their hypotheses.

Discuss how similar epidemiological methods have been used to understand one current public health issue (not one for each individual). Discuss the key research studies used to understand the risk factors associated with the problem or disease. Two potential examples include lung cancer (Doll and Hill, 1950) or cardiovascular disease and the Framingham Heart Study (Drawber, Meadors, & Moore, 1950; Kannel, 2000).

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for succes.

You are required to submit this assignment to LopesWrite. Refer to the 
LopesWrite Technical Support articles
 for assistance.

 

Topic 2: Disease Surveillance and Measurement

 

Objectives:

Evaluate the effectiveness of disease surveillance in public health.

Apply measurement tools to assess the impact of disease, its burden, and associated risk factors.

Discuss the importance of validity and reliability.

Evaluate the steps for investigating the occurrence of disease.

Oswego Outbreak Case Study

 

Read the “Oswego Outbreak Investigation,” located in the Topic Materials.

Part 1

Complete the following:

Using the line listing in the Excel “Oswego Line Listing Workbook,” calculate the attack rate ratios for each food item using the table in the Excel “Oswego Attack Rate Table.” Create a separate 2×2 table for the food item you think is responsible for the outbreak and interpret the attack rate ratio for this food item. Refer to the “Creating a 2×2 Contingency Table” resource for guidance.

Using the line listing in Excel “Oswego Line Listing Workbook,” construct an epidemic curve by the time of onset of illness. What does this curve tell you regarding the average incubation period, source, and transmission?

Using the incubation range and clinical symptoms, identify potential infectious agents that could be responsible for the outbreak (refer to the Topic Material, “Compendium of Acute Foodborne and Waterborne Diseases”). Discuss your rationale.

Part 2

In a 500-750 word paper, evaluate the situation and present your findings. Including the following:

Does this case meet the definition of an “outbreak?” Why or why not?

Identify the steps required to investigate an outbreak. How did these steps help in investigating the Oswego event? Include the relevant information needed for each step to be successful.

Discuss the possible routes of transmission for the expected agent.

Based on this information, what control measures would you recommend? State whether they are primary, secondary, or tertiary prevention strategies.

General Requirements

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the 
LopesWrite Technical Support articles
 for assistance.

Topic 2 DQ 1

 

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?

Topic 2 DQ 2

 

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?

Topic 3: Causal Inference, Confounding, and Bias

 

Objectives:

Determine sources of bias within a study design.

Describe confounding relationships.

Evaluate the types of causal relationships associated with causation.

Assess measures of morbidity.

Measuring Morbidity: Prevalence and Incidence

 

Read the scenario below and complete the assignment as instructed.

Scenario

In Community X (population 20,000), an epidemiologist conducted a prevalence survey in January of 2012 and reported an HIV prevalence of 2.2%. Over the next 12 months, the department of health reported an additional 50 new HIV cases between February 2012 and January 2013. The total population stayed constant at 20,000.

Part 1

How many people had HIV in January 2012? Present or describe the formula you used to arrive at your answer.

Calculate the incidence rate assuming no HIV-related deaths over the 12-month period. Present or describe the formula you used to arrive at your answer. Be sure to clearly indicate the numerator and denominator used in your calculation and include an appropriate label for the rate.

In a summary of 200-250 words, interpret the results and discuss the relationship between incidence and prevalence. Discuss whether or not the epidemiologist should be concerned about these new HIV infections, assuming a previous incidence rate of 0.5 per 1,000 person-years prior to this updated risk assessment.

Part 2

A rapid test used for diagnosing HIV has a sensitivity of 99.1% and a specificity of 90%. Based on the population prevalence of 2.2% in 2012, create a 2×2 table showing the number of true positives, false positives, false negatives, and true negatives. Calculate the positive predicative value and negative predictive value for this test. Refer to the “Creating a 2×2 Contingency Table” resource for guidance.

In 200-250 words, discuss whether or not the epidemiologist should recommend this test as part of a universal HIV screening program. Provide rationale for your recommendation applying the positive and negative predictive values. Present or describe the formula you used to arrive at your answer.

General Requirements

APA style is not required, but solid academic writing is expected.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are not required to submit this assignment to LopesWrite.

Topic 3 DQ 1

 

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?

Topic 3 DQ 2

 

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.

Topic 4: Study Designs I

Objectives:

Compare and contrast randomized trials and cohort studies.

Differentiate between experimental and observational categories of study designs.

Multicausality: Confounding Assignment

 

These estimates include the influence of other extraneous variables, such as confounders. Confounding is often considered a type of bias, but it is a real relationship that requires an adjustment in the study design or analysis. Understanding how to identify confounding is important as most associations have multiple causal factors. Recognizing if a study adjusted for the appropriate confounding variables is important to determine the validity of the association. To assist your proficiency with the concept of confounding, and how it ultimately affects public health, this practice assignment has been provided.

Complete Problems 1 to 4 from the “Multicausality: Confounding – Assignment” by Schoenbach, located in your Topic Materials. Check your answers against the solutions presented in the “Multicausality: Confounding – Assignment Solutions” Topic Material. PUB 540 Principles of epidemiology.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

You are not required to submit this assignment to LopesWrite.

Topic 4 DQ 2

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?

Topic 5 DQ 1

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. PUB 540 Principles of epidemiology.

Topic 5 DQ 2

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.

Topic 6: Measures of Association and Application

Objectives:

 

Differentiate between association and causal relationships.

Determine the relative risk and odds ratio as measures of association.

Evaluate the utility of the population attributable risk.

Evaluate the types of causal relationships and associated guidelines for establishing causality.

Calculating Odds Ratio

Data can be qualitative or quantitative. Qualitative data is helpful to generate a hypothesis and gather information if little is known about an expected association. Focus groups, key informant interviews, and case studies are types of qualitative data collection methods used to identify common themes from which to build a hypothesis. Quantitative data collection and analysis is used to test a hypothesis and make comparisons to determine the direction and strength of a potential association. The Behavioral Risk Factor Surveillance System (BRFSS) is cross-sectional panel survey used to collect quantitative data on adult behaviors and risk factors. It is one of the largest U.S. health data collection efforts. The data can be used to analyze associations on a state or country level. Follow the steps to obtain a 2×2 contingency table (also known as a “cross tabulation”) crossing binge drinking with depression PUB 540 Principles of epidemiology.

Retrieve the “BRFSS Web-Enabled Analysis Tool” resource provided in the Topic Materials.

Select “Cross Tabulation.”

Select “2015” for the year.

Select “Arizona” for the state.

Select “Alcohol Consumption: Binge drinkers (males having five or more drinks on one occasion, females having four or more drinks on one occasion)” for Step 2 Select Row.

Select “Chronic Health Conditions: Ever diagnosed with a depressive disorder, including depression, major depression, dysthymia, or minor depression” for Step 3 Select Column.

Skip Steps 4 and 5.

Select “Sample Size” for Step 6 Select Statistics and run the report for the cross tabulation.

Part 1

Using the data from the cross tabulation results, calculate the odds ratio for depression among those exposed to binge drinking. Interpret the odds ratio and discuss if the odds ratio is a good estimate of the relative risk in this situation. Why or why not? Show your 2×2 table and all calculations. Present or describe the formula you used to arrive at your answer. PUB 540 Principles of epidemiology.

Part 2

Use the Topic Material, “BRFSS Web-Enabled Analysis Tool,” located on the CDC website, and run a report for two variables of interest to you. Create a 2×2 table and calculate the odds ratio for this association. Interpret the odds ratio and discuss the public health importance of the association. Show your
2×2 table
. Present or describe the formula you used to arrive at your answer.

Refer to the “Creating a 2×2 Contingency Table” resource for guidance in creating 2×2 contingency tables.

General Requirements

APA style is not required, but solid academic writing is expected.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the 
LopesWrite Technical Support articles
 for assistance.

Topic 6 DQ 1

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. PUB 540 Principles of epidemiology.

Topic 6 DQ 2

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?

Topic 7: Applying Epidemiology to Policy

Objectives:

Apply epidemiological methods to the breadth of settings and situations in public health practice.

Discuss the means by which social inequities, and racism undermine health and create challenges to achieving health equity at organizational, community and societal levels.

Benchmark – Epidemiologic Profile Assignment

An epidemiologic profile is a summary of a significant public health issue, or issues, in your community, county, state, or country. An epidemiological profile helps to coordinate activities and policies from various agencies and organizations to improve health.

Review the available data, reports, and documents for your locale. Assess how the methods of epidemiology (study designs, data collection, measures of association, etc.) are used to determine who needs what services, where the services are needed, and how those services should be delivered. Define your community as your city, metropolitan area, or county and write a 2,000-2,250 word epidemiological profile (word limit excludes references and title page).The profile can be a general profile that provides a landscape picture of several significant chronic and infectious diseases in your defined community, or it can be a specific profile that targets one health issue, such as diabetes, asthma, STDs, flu, heart disease, obesity, alcohol abuse, or other drug use. Include the following:

Executive Summary

Describe the purpose of the epidemiologic profile and the health issue(s) it addresses. Discuss its importance to the community and how it will be utilized. PUB 540 Principles of epidemiology.

Summarize the key findings from your review of available data, reports, and documents for the community.

Introduction

Describe the defined community and population using demographic and socio-economic information and data.

Briefly describe the history and cultural background of the community.

Explain any unique contextual information that pertains to the public health of the defined community.

Describe any key public health projects, grants, or existing epidemiology-related working groups or committees in the community/county.

Description of Available Data

Identify at least two different data sources relevant to your profile. Discuss data from these sources and their relation to the issue or community.

Discuss the methods used in the data collection process (data source and organization providing the data; how often the data are collected; data limitations including response rates, missing data, selection of participants, etc.). Potential data sources and databases might include the following depending on what is available for your community or county:

Behavioral Risk Factor Surveillance System (BRFSS) data

Youth risk behavioral survey

Surveillance, epidemiology, and end results (SEER) program data

CDC Wonder (multiple data sources)

County health rankings data (multiple data sources)

Alcohol-related disease impact data

Demographic health survey data (international) PUB 540 Principles of epidemiology

Global school-based student health survey (international)

Local evaluation reports from the department/ministry of health or other nonprofit organizations

Interpretation of Results Regarding Key Health Issue

Size and magnitude of the measures

Trends and comparisons

Economic costs

Discussion of Problems and Strategies

Discuss disparities, limitations, and gaps in the information available regarding the health issue(s).

Describe potential public health strategies to address these gaps.

Use graphs and tables where appropriate.

Conclusion

You are required to cite to at least five sources to complete this assignment. Sources should be published within the last 5 years and appropriate for the assignment criteria and public health content.

General Requirements

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the 
LopesWrite Technical Support articles
 for assistance.

Benchmark Information

This benchmark assignment assesses the following programmatic competency:

MPH

2.1 Apply epidemiological methods to the breadth of settings and situations in public health practice.

MSN Public Health Nursing

6.2 Apply epidemiological methods to the breadth of settings and situations in public health practice.

 

Topic 7 DQ 1

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. PUB 540 Principles of epidemiology.

Topic 7 DQ 2

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.”

Topic 8: Environment and Genetics

Objectives:

Discuss how genetic and environmental factors interact in causing disease.

Explain the biological and genetic factors that affects a population’s health.

Topic 8 DQ 1

 

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?

Topic 8 DQ 2

 

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? PUB 540 Principles of epidemiology.

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:

Group results by 1. States and 2. Race (leave the rest of the group options as “None”)

Measures – click “Count” (default) and “Age Adjusted Rates”

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

Select year and demographics

Year – 2014

Sex – All genders

Age groups – All ages

Ethnicity – All ethnicities

Race – All races

Select cancers of interest – select “Pancreas”

Other options – keep default settings PUB 540 Principles of epidemiology

Historical Review of Epidemiology

Key individuals and historical events have helped shape the field of epidemiology. Research the following individuals and their roles in shaping contemporary epidemiology:

John Graunt

James Lind

Edward Jenner

Ignaz Semmelweis

John Snow

Choose three of the individuals from your research. In a 1,000-1,250 word paper, describe the epidemiological advancements that were influenced by these individuals. Include the following:

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Describe the disease and the event. Using descriptive epidemiology, discuss how common the disease was at the time, who was infected, when it occurred (time of year or season), and the mode of transmission. If the individual is not associated with a specific disease, discuss a significant disease happening during that period.

Discuss how the individuals influenced or advanced epidemiological methods and the process they used to describe and control disease. Discuss how their contributions helped to inform the definition of epidemiology. Consider whether they used qualitative, quantitative, or both types of data collection methods, and the approach they used to test their hypotheses. Historical Review of Epidemiology.

Discuss how similar epidemiological methods have been used to understand one current public health issue (not one for each individual). Discuss the key research studies used to understand the risk factors associated with the problem or disease. Two potential examples include lung cancer (Doll and Hill, 1950) or cardiovascular disease and the Framingham Heart Study (Drawber, Meadors, & Moore, 1950; Kannel, 2000).

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for succes.

You are required to submit this assignment to LopesWrite. Refer to the 
LopesWrite Technical Support articles
for assistance. Historical Review of Epidemiology.

PUB 540 Principles of epidemiology Topic 1 DQ 1

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.

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Topic 1 DQ 1

According to MacIntyre and Bui (2017) a true epidemic has a rise in case rates over days or weeks, whereas an endemic disease may rise or fall over years or decades. The words epidemic and pandemic are often misused. A pandemic is simply a global epidemic, and an epidemic is an outbreak of disease that attacks many people at about the same time and spreads through a defined population (MacIntyre and Bui, 2017). It is defined by rate of growth of the epidemic curve. Epidemics have a sudden and immediate impact on the health system and require surge capacity. The rapid increase in cases observed during an epidemic or pandemic is what causes immediate impacts on health systems, stressing these systems beyond normal operating capacity. A pandemic of a highly infectious microbe will evolve rapidly and affect many people within a short period of time (MacIntyre and Bui, 2017). PUB 540 Principles of epidemiology Topic 1 DQ 1.

According to Troncoso (2015), an influenza pandemic once it begins, would be expected to reach its peak within 2 months. Malaria, TB and AMR organisms, are usually endemic diseases. Endemic diseases may occur in very high numbers, but their rate is constant or changes slowly, over months or years, sometimes decades (Troncoso, 2015). An unprecedented epidemic of Ebola virus has been causing thousands of deaths in West Africa since 2014 (Guinea, Liberia, Nigeria and Sierra Leone). The Ebola virus was first identified in 1976 in Yambuku, Zaire (now Democratic Republic of Congo) and Nzara, South Sudan. The Ebola virus is a zoonotic pathogen, and its circulation among humans is rare, which explains the fact that the outbreaks are intermittent and unpredictable. The most likely reservoir seems to be a fruit bat, although the link has not been confirmed (Chowell and Nishivra, 2014).

The virus has caused more than 30 outbreaks since it was identified in 1976, with less than 1600 deaths before 2014. In most cases, the virus started in rural areas and the epidemics were controlled with routine public health measures, such as the identification of cases, contact tracing, and isolation and quarantine of the patient to break the chain of transmission. PUB 540 Principles of epidemiology Topic 1 DQ 1. These public health measures have a proven efficacy record for the control of epidemics (Chowell and Nishivra, 2014).

According to Chowell and Nishivra (2014) proven treatments or vaccines against Ebola are still not available. Hence, thus the current working toolbox available to control the spread of Ebola still hinges on supportive medical care to increase the survival of those infected and basic non-pharmaceutical public health measures to prevent transmission, namely: 1) infection control measures including standard precautions in health care settings; 2) rapid contact tracing and isolation of infectious individuals; and 3) social distancing interventions in the community which may include the dissemination of awareness campaigns to inform the population on how to avoid contracting the disease, quarantining individuals potentially exposed to infectious individuals and restricting the movement of communities exhibiting local transmission to prevent onward transmission PUB 540 Principles of epidemiology Topic 1 DQ 1. These actions must be conducted in close collaboration with local community leaders to effectively reach the population at large (Chowell and Nishivra, 2014).

MacIntyre, C. R., & Bui, C. M. (2017). Pandemics, public health emergencies and antimicrobial resistance – putting the threat in an epidemiologic and risk analysis context.

Troncoso, A. (2015). Ebola outbreak in West Africa: a neglected tropical disease. Asian Pacific Journal of Tropical Biomedicine, 5: 4, pgs. 255-259.

Chowell, G., & Nishivra, H. (2014). Transmission dynamics and control of Ebola virus disease (EVD): a review. BMC Medicine, 12: 196. PUB 540 Principles of epidemiology Topic 1 DQ 1.

 

Topic 1 DQ 1

Endemic is a disease that exists permanently in a region or population. An example of this is Mexico. The water in Mexico is known for having parasites that locals have built up an immunity to that people not from that region often get very sick over. Epidemic outbreaks are a disease that attacks many peoples at about the same time and may spread through one or several communities. An example of this would be the bird flu or mad cow disease. The areas that are affected and many different government agencies act with notifications and action plans to bring it under control. Pandemic would be something that spreads worldwide. Our ability to travel has brought this to the forefront of the governments and disease control PUB 540 Principles of epidemiology Topic 1 DQ 1. The ability to work with other countries and knowing who is going where allows the population to be safe from a disease making itself present so quickly because of the people transporting the issues with them. Bed bugs would be an example of this.

 

Prevention
:

Primary Prevention – When you are trying to prevent yourself from getting a disease. An example of this is sunscreen to prevent skin cancer

 

Secondary Prevention – This would be having a doctor give you an once over and check your skins condition to see if you have skin cancer and if you do be able to treat it as early as possible.

 

Tertiary Prevention – Is needed once something like skin cancer has happen and is now part of your life. The person learns to best adapt to the situation and learns the rules of living with such a situation.

 

World Health Organization. (2019). Dengue and severe dengue. Retrieved from https://www.who.int/news-room/fact-sheets/detail/dengue-and-severe-dengue PUB 540 Principles of epidemiology Topic 1 DQ 1

PUB 540 Principles of epidemiology Topic 1 DQ 2

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.

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Topic One, discussion question 2:

This assignment was to review the Morbidity and Mortality Weekly Report (MMWR). The MMWR is created and distributed by the Centers for Disease Control and Prevention (CDC). It is said to be the “voice of the CDC,” and the main chancel for scientific publication that is accurate, objective, and reliable for public health information and the recommendations of the CDC (CDC, 2018). PUB 540 Principles of epidemiology Topic 1 DQ 2

The MMR has different types of data and information published such as (CDC, 2018):

Recommendations and Reports

Which are articles that supply policy statements for prevention and treatment

Surveillance Summaries

Analyzes data from to find trends and or patterns

Supplements

As indicated this data is historical events or information, proceedings from conferences, etc. that can was formed from the MMWR Recommendations and Reports or Surveillance Summary.

The second part of this assignment was to pick a publication from the weekly report to review. I have selected the January 3, 2020 article, Characteristics of patients experiencing rehospitalization or death after hospital discharge in a nationwide outbreak of e-cigarette, or vaping, product use – associated lung injury – United States, 2019.

The center of diseases controls and prevention as well as the food and drug administration, public health departments at the state and local levels have been investigating the growth and negative effects of e-cigarettes and vaping as it is associated with lung injuries (Mikosz, et al. 2019).  PUB 540 Principles of epidemiology Topic 1 DQ 2

One of the main areas with this article is the understanding that at least 25 percent of those re-hospitalized and deaths occur within two days after discharge. Due to this there needs to be a review of the current discharge process and review ways to improve the process, such as a follow-up within 48 hours after hospital discharge, especially those with a chronic condition e.g., diabetes, leads to higher morbidity and mortality (Mikosz, et al. 2019).

The CDC has confirmed as of December 10, 2019 that 52 individuals have died from lung injuries associated with these products (Mikosz, et al. 2019). The CDC has developed a special task force to look at data collected from state health departments as well as hospitalization reports to find areas of opportunity to understand more about the products (Mikosz, et al. 2019). PUB 540 Principles of epidemiology Topic 1 DQ 2

This report is an example of Descriptive epidemiology as it provides a way of organizing and analyzing data on e-cigarettes and vaping in order to understand the lung injuries occurring and how it impacts different individuals based on their unique characteristics (Descriptive Epidemiology n.d.).

References:

Boston University School of Public Health (n.d.) Descriptive epidemiology. Retrieved from http://sphweb.bumc.bu.edu/otlt/MPHModules/EP/EP713_DescriptiveEpi/EP713_DescriptiveEpi_print.html.

Center of Disease Control and Prevention (CDC). (2018). Morbidity and mortality weekly report. Retrieved from 
https://www.cdc.gov/mmwr/author_guide_rrss.html

Mikosz, C., Danielson, M., Anderson, K., et al. (2019). Characteristics of patients experiencing rehospitalization or death after hospital discharge in a nationwide outbreak of e-cigarette, or vaping, product use–associated lung injury — United States, 2019. 
MMWR and Morbidity and Mortality Weekly Report. U.S. Department of Health and Human Services. (68)
1183-1188. DOI: 
http://dx.doi.org/10.15585/mmwr.mm685152e1external icon

 

Re: Topic 1 DQ 2

The Morbidity and Mortality Weekly Report (MMWR) is a weekly published report by the Center for Disease Control and Prevention (CDC). It is the main vehicle for publishing public health information and recommendations that have been received by the CDC from state health departments. It contains in-depth articles that relay policy statements for prevention and treatment on all areas in CDC’s scope of responsibility. MMWR delivers useful information to readers in the public health community, private clinicians, researchers, educators, students, and news media. Reports are based on science (especially epidemiology) or on public health policy or practice. Recommendations contained within reports must be acceptable to the CDC (CDC, 2019) PUB 540 Principles of epidemiology Topic 1 DQ 2

On December 20
th
, 2019, the CDC published an article on Driving Under the Influence of Marijuana and Illicit Drugs Among Persons Aged ≥16 Years. In the United States, driving while impaired is illegal. Nonetheless, an estimated 10,511 alcohol-impaired driving deaths occurred in 2018. The contribution of marijuana and other illicit drugs to these and other impaired driving deaths remains unknown. Data from the Substance Abuse and Mental Health Services Administration’s National Survey on Drug Use and Health (NSDUH) indicated that in the United States during 2014, 12.4% of all persons aged 16–25 years reported driving under the influence of alcohol, and 3.2% reported driving under the influence of marijuana. The impairing effects of alcohol are well established, but less is known about the effects of illicit substances or other psychoactive drugs (e.g., marijuana, cocaine, methamphetamines, and opioids, including heroin). This report provides the most recent national estimates of self-reported driving under the influence of marijuana and illicit drugs among persons aged ≥16 years, using 2018 public-use data from NSDUH (Azofeifa et al., 2019).

Since descriptive epidemiology is described as the identification of disease patterns among cases and in populations by time, place and person (CDC, 2012), the above MMWR article would be an example of descriptive epidemiology. PUB 540 Principles of epidemiology Topic 1 DQ 2

 

References:

Center for Disease Control and Prevention. (2019). Morbidity and Mortality Weekly Report (
MMWR
) Weekly. Retrieved from

https://www.cdc.gov/mmwr/author_guide.html

 

Azofeifa, A., Rexach-Guzman, B., Hagemeyer, A., Rudd, R., and Sauber-Schatz, E. (2019). Driving Under the Influence of Marijuana and Illicit Drugs Among Persons Aged ≥16 Years — the United States, 2018. Retrieved from

https://www.cdc.gov/mmwr/volumes/68/wr/mm6850a1.htm?s_cid=mm6850a1_w#

 

Center for Disease Control and Prevention. (2012). Introduction to Epidemiology. Retrieved from

https://www.cdc.gov/csels/dsepd/ss1978/lesson1/section7.html 
  PUB 540 Principles of epidemiology Topic 1 DQ 2

Benchmark – Epidemiologic Profile Assignment

An epidemiologic profile is a summary of a significant public health issue, or issues, in your community, county, state, or country. An epidemiological profile helps to coordinate activities and policies from various agencies and organizations to improve health.

Review the available data, reports, and documents for your locale. Assess how the methods of epidemiology (study designs, data collection, measures of association, etc.) are used to determine who needs what services, where the services are needed, and how those services should be delivered. Define your community as your city, metropolitan area, or county and write a 2,000-2,250 word epidemiological profile (word limit excludes references and title page).The profile can be a general profile that provides a landscape picture of several significant chronic and infectious diseases in your defined community, or it can be a specific profile that targets one health issue, such as diabetes, asthma, STDs, flu, heart disease, obesity, alcohol abuse, or other drug use. Include the following: Benchmark – Epidemiologic Profile Assignment.

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Executive Summary

Describe the purpose of the epidemiologic profile and the health issue(s) it addresses. Discuss its importance to the community and how it will be utilized.

Summarize the key findings from your review of available data, reports, and documents for the community.

Introduction

Describe the defined community and population using demographic and socio-economic information and data.

Briefly describe the history and cultural background of the community.

Explain any unique contextual information that pertains to the public health of the defined community.

Describe any key public health projects, grants, or existing epidemiology-related working groups or committees in the community/county. Benchmark – Epidemiologic Profile Assignment

Description of Available Data

Identify at least two different data sources relevant to your profile. Discuss data from these sources and their relation to the issue or community.

Discuss the methods used in the data collection process (data source and organization providing the data; how often the data are collected; data limitations including response rates, missing data, selection of participants, etc.). Potential data sources and databases might include the following depending on what is available for your community or county: Benchmark – Epidemiologic Profile Assignment

Behavioral Risk Factor Surveillance System (BRFSS) data

Youth risk behavioral survey

Surveillance, epidemiology, and end results (SEER) program data

CDC Wonder (multiple data sources)

County health rankings data (multiple data sources)

Alcohol-related disease impact data

Demographic health survey data (international)

Global school-based student health survey (international)

Local evaluation reports from the department/ministry of health or other nonprofit organizations

Interpretation of Results Regarding Key Health Issue

Size and magnitude of the measures

Trends and comparisons

Economic costs

Discussion of Problems and Strategies

Discuss disparities, limitations, and gaps in the information available regarding the health issue(s).

Describe potential public health strategies to address these gaps.

Use graphs and tables where appropriate. Benchmark – Epidemiologic Profile Assignment

Conclusion

You are required to cite to at least five sources to complete this assignment. Sources should be published within the last 5 years and appropriate for the assignment criteria and public health content.

General Requirements

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. Benchmark – Epidemiologic Profile Assignment

You are required to submit this assignment to LopesWrite. Refer to the 
LopesWrite Technical Support articles
 for assistance.

Benchmark Information

This benchmark assignment assesses the following programmatic competency:

MPH

2.1 Apply epidemiological methods to the breadth of settings and situations in public health practice.

MSN Public Health Nursing

6.2 Apply epidemiological methods to the breadth of settings and situations in public health practice. Benchmark – Epidemiologic Profile Assignment