Tag: Clinical-Nursing

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

Complimentary or Alternative (CAM) Therapy Essay

Question 1

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Herb Name

Rationale

Benefits

Consequences

Drug interaction

Vasambu (Acorus calamus)

Relieves gastric issues such as peptic ulcers by regulating digestive acids for easy digestion. It also eases counter-acidity and heartburn issues.

 

Eases Indigestion, acid reflux and constipation

Complimentary or Alternative (CAM) Therapy Essay

Nausea and vomiting

Interacts with Monoamine Oxidase Inhibitors (MAOIs) used in the management of depression, interacts with sedatives and can potentially lead to too much sleepiness, interacts with H2-blockers and proton-pump inhibitors causing hyperacidity which reduces the effectiveness of antacids (Tachjian, Maria & Jahangir, 2010)

Yohimbine(
Pausinystalia johimbe
)

Increases blood pressure, levels of epinephrine, the heart rate and central sympathetic outflow.

Anxiety, depression, erectile dysfunction (impotence), dry mouth and exhaustion.

 

Paralysis, difficulty breathing, sleeps difficulties, irritability, frequent urination, low blood pressure and death in high doses.

Interacts with MAOIs, clonidine, Tricyclic antidepressants, antihypertensives, stimulants, naloxone, and phenothiazine’s.

Gynura (
Gynura procumbens
)

Reduces blood pressure and improves microcirculation by inhibiting  angiotensin-converting enzyme

Lowers cholesterol, reduces hypertension, treats sinusitis, relives constipation

Weight gain, hepatic toxicity
,
jaundice and hepatomegaly, and hypotension when used in high doses(Tachjian, Maria & Jahangir, 2010).

Can reduce the effectiveness of  antihypertensives

Black cohosh(
Actaea racemosa)

Increases or decreases the effects of estrogen in some parts of the body as a selective estrogen receptor modulator

Improves sleep patterns and mood and reduces hot flashes for menopausal women. Used in the treatment of premenstrual syndrome, acne, osteoporosis, and dysmenorrhea.

Camping, stomach upsets, weight gain, rash and vaginal spotting/bleeding, hepato-toxicity, dark urine, and jaundice.

Interacts with Atorvastatin and may cause damage to the liver and reduces the effectiveness of cisplatin.

Licorice (Glycyrrhiza glabra)

Reduces swelling, thin mucus secretions reduces cough and increase  the production of chemicals that promote ulcer healing

Eczema, dyspepsia, irritable bowel syndrome and stomach ulcers.

High blood pressure, low potassium, headaches, retention of sodium and water, decreased libido in men

Increases the breakdown of warfarin hence reducing its effectiveness, reduces levels of potassium in the body which increases digoxin side effects, reduces the effectiveness of estrogen pills and furosemide (Tachjian, Maria & Jahangir, 2010).

Aconite (
Aconitum
)

Stimulates and causes paralysis of nerves that transmit pain signals causing pain relief.

Joint pains, nerve pains, gout, inflammation, and wounds.

Vomiting, nausea, palpitations, respiratory  complications and paralysis, hypotension and death

Reduces the efficiency and effectiveness of antihypertensives.

Echinacea
(
Echinacea purpurea)

Stimulation of macrophages and other immune system cells resulting in their activation and cytokine release.

Common cold, anxiety, gingivitis, herpes simplex virus, tonsillitis influenza and infection of the middle ear.

Diarrhea, dry mouth, sleeping difficulties, muscle and joint aches, dermatitis, dyspnea tongue numbness, and dizziness.

Increases the risk of liver toxicity when used together with statins and niacin, increases the absorption of midazolam in the body, and increases the QT interval when used together with amiodarone(Tachjian, Maria & Jahangir, 2010).

Danshen(
Salvia miltiorrhiza
)

Prevents clotting of blood and platelets through blood thinning. It also promotes vasodilation which improves circulation (Tachjian, Maria & Jahangir, 2010).

Angina, coronary artery disease, venous thromboembolism, heart disease, liver cirrhosis, hyperlipidemia, stroke, and high blood pressure

Increases the risk of bleeding among people with bleeding disorders, reduces blood pressure

Increases digoxin side effects, slow the clotting of blood when used with anticoagulants increasing the risk of bleeding, prolongs the action duration of warfarin (Tachjian, Maria & Jahangir, 2010).

Hawthorn(
Crataegua monogyna
)

Increases blood supply to the heart through vasodilation and positive inotropic effects.

Cerebral insufficiency, CHF, angina, and bradyarrhythmia

Nausea, sweating, palpitations, agitation, headaches, fatigue and insomnia.

Increases the dilation of the coronary artery with theophylline, sodium nitrate, epinephrine, and adenosine, and increases sleep induced by barbiturates(Tachjian, Maria & Jahangir, 2010)

Saw Palmetto (
Serenoa repens
)

Prevents the conversion of testosterone to dihydrotestosterone which is a more potent form of testosterone

Benign prostatic hyperplasia(BPH), androgenic hyperplasia, prostate cancer and  underactive bladder(Tachjian, Maria & Jahangir, 2010)

Toxicity of the liver and pancreas

Interacts with anticoagulants and can increase the risk of bleeding.

Question 2

Vitamin Name

Rationale

Benefits

Consequences

Complications and drug interaction

Vitamin A

Undergoes conversion in the retina, attaches to opsin in rhodopsin which triggers impulses to the brain that permit light perception (Ezzo, 2007).

General healthy growth and development, healthy eyes, skin, and teeth

Toxicity, nausea, irritability, anorexia, hair loss, blurred vision, and anemia

Reduces the efficacy of doxycycline, warfarin, and neomycin

Vitamin B1

Thiamin is converted from the provitamin form to the active form and used for energy metabolism.

Helps to maintain a healthy metabolism and normal appetite, digestion, and nerve function

Urticaria, angioedema, anaphylaxis, cyanosis and warmth sensation

Interacts with anti-seizure medications, chloramphenicol, and levodopa. And can result in significant renal impairment (Ezzo, 2007).

Vitamin C

Undergoes reversible oxidation in the body in an oxidation-reduction reaction to facilitate metabolism of lipids, carbohydrates, iron, respiration in cells and resistance to infections.

Strengthens vascular blood vessels, increases elasticity of the skin, improves the absorption of iron and serves as an anti-oxidant (Ezzo, 2007).

Vomiting, nausea, heartburn, trouble breathing and abdominal pains

Limits the duration and intensity of action of coumarins.

Complimentary or Alternative (CAM) Therapy Essay

Vitamin D

Vitamin D undergoes hydroxylation resulting in a primary active metabolite which binds to vitamin d receptors used in different regulatory roles (Ezzo, 2007).

Strengthens bones

Headaches, a metallic taste, loss of appetite, dry mouth, and fatigue

Interacts with antacids which contain aluminum and increases its rate of absorption. Can lead to irregular heartbeats when it interacts with digoxin.

Vitamin E

Reacts with lipid radicals that are unstable to form stable lipids and vitamin E radicals which are then converted back to stable vit E.

Improves  the circulation of blood and safeguards the body from free radicals

Hemorrhagic stroke, bleeding, easy bruising, stomach cramps, and blurred vision.

Increases the rate of absorption of cyclosporines. Increases the risk of bleeding and bruising when taken along with warfarin.

Vitamin K

Converts coagulation factors II, VII, IX, and X  to their active forms to promote blood coagulation(Ezzo, 2007).

Improves the blood coagulation process

Palpitations, shortness of breath, sweating, pain and swelling at the site of injection

Increases the risk of bleeding when taken with aspirin. Interacts with NSAIDs and Warfarin.

Zinc

Influences resistance to  epithelial apoptosis as an antioxidant

Helps in building muscles and to maintain oxygen-rich blood

fever, coughing, stomach pain, fatigue

Reduces the efficacy and absorption of quinolones and tetracyclines (Ezzo, 2007).  .

Calcium

 

Promotes strong and healthy bones and teeth

Complimentary or Alternative (CAM) Therapy Essay

 

Iron

Combines with chains of globin and porphyrin for hemoglobin formation which is essential for carrying oxygen (Ezzo, 2007).

Promotes the body’s immunity, growth and development, and fertility.

Abdominal upsets abdominal pains, constipation, diarrhea, nausea, and vomiting.

Reduces the efficacy and absorption of quinolones and tetracyclines.

Question 3

Acupuncture is a form of complementary therapy whose origin was based on traditional Chinese medicine with principles that are closely linked to Taoism and Confucianism. Among most of the commonly existing complementary medicines, acupuncture is widely used in Asian countries and the West as it has demonstrated to be highly efficacious in the management of various conditions. It is a technique that involves the stimulating particular points on the body through the insertion of thin needles on the skin. The stimulation from acupuncture is believed to influence inflammatory markers and induce changes in the hormone levels (Jishun & Mittelman, 2014). It has demonstrated to have numerous benefits in treating  low back pains, rheumatoid arthritis, migraine, osteoarthritis, migraine, and  post-operative vomiting and nausea,

Among patients suffering from migraine headaches, acupuncture reduces the intensity and frequency of headaches to the extent that patients may not require the use of prophylactic treatment. Among patients who have just undergone surgery, acupuncture is not only an effective antiemetic but also reduces pain and the need for opioids post-surgery. These effects have been linked to the P6 acupoint on the wrist and the release of endorphins respectively (Chou & Chu, 2018). Ultimately, this also helps to reduce the side-effects of opioids post-surgery which negatively impacts the process of patient recovery from surgery.

Scientific research reveals that even when used alone or when combined with other forms of treatment, acupuncture has significant benefits in clinical rheumatoid arthritis. In a study that was conducted by Chou & Chu (2018), it was established that acupuncture has no significant side effects on individuals suffering from RA. Instead, it promotes functioning capacity and the quality of life. Its mechanisms were attributed to an antioxidative and anti-inflammatory outcomes and regulating the functioning of the immune system.

Question 4

           
A commonly prescribed supplement by medical professionals in practice is calcium. Calcium supplements are highly recommended to prevent the deterioration of bone density and bone strength in people who may be at high risk of inadequate dietary calcium intake or osteoporosis irrespective of age. Osteoporosis has however been identified to be a common occurrence among post-menopausal women (Reid, Bristow & Bolland, 2015). Some of the factors which increase the risk of post-menopausal women to osteoporosis include lack of physical exercise, excessive weight, and low estrogen levels. Calcium performs the following roles in the body: regulating impulse transmission, regulating the secretion of hormones, maintaining basic life activities, the skeleton and vascular activities (Reid, Bristow & Bolland, 2015).

The mode of action of calcium supplements is highly dependent on adequate amounts of total calcium levels in the body. Calcium primarily exists in the skeleton as hydroxyapatite, calcium carbonate, and amorphous calcium phosphate. Calcium which exists in the bones constantly exchanges with plasma calcium and this helps to maintain a balance of calcium levels (Reid, Bristow & Bolland, 2015). A slight disturbance in this balance to fulfill the body’s needs often results in depletion of calcium in bones. Potential concerns with patients taking calcium supplements are: constipation, rebound acidity and hypercalcemia. Overdosing/hypercalcemia can result in confusion, nausea, and vomiting among other neurological issues and manage through rigorous rehydration (Reid, Bristow & Bolland, 2015). Complimentary or Alternative (CAM) Therapy Essay

 

References

Chou, P. C., & Chu, H. Y. (2018). Clinical Efficacy of Acupuncture on rheumatoid arthritis and associated mechanisms: a systemic review. 
Evidence-Based Complementary and Alternative Medicine
, 
2018
.

Ezzo, D. C. (2007). Drug interactions with vitamins and minerals. 
US Pharm
, 
1
, 42-55.

Jishun, J., & Mittelman, M. (2014). Acupuncture: past, present, and future.

Reid, I. R., Bristow, S. M., & Bolland, M. J. (2015). Calcium supplements: benefits and risks. 
Journal of internal medicine
, 
278
(4), 354-368.

Tachjian, A., Maria, V., & Jahangir, A. (2010). Use of herbal products and potential interactions in patients with cardiovascular diseases. 
Journal of the American College of Cardiology
, 
55
(6), 515-525. Complimentary or Alternative (CAM) Therapy Essay

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Complimentary or Alternative (CAM) Therapy Essay Assignment:

Write a 1200-1500 word APA formatted essay with three sources of support, addressing all of the following topics:

Compile a list of at least 10 herbal medications you have seen patients taking in your practice. Discuss the rationale for taking each medication, possible benefits and consequences of taking it, and drugs that it may interact with. This question can be completed as a grid or an essay.

Compile a list of at least 10 vitamins and minerals, including the rationale for taking each medication and benefits and consequences of taking it. Also list any potential complications and drug interactions. This question can be completed as a grid or an essay.

Choose one type of complementary or alternative (CAM) therapy and discuss its benefits in preventing and treating disease. Discuss how the use of this CAM therapy can reduce the need for medications. Research this therapy on ProQuest or another scholarly database.  What does the research demonstrate regarding its efficacy?

Choose one nutritional supplement you see commonly prescribed or recommended by medical professionals in your practice.  Discuss the reasons why this supplement is recommended and its method of action. What concerns should you have regarding a patient taking this supplement? Could the patient overdose and if so what are the consequences and treatment? Complimentary or Alternative (CAM) Therapy Essay

Oswego Outbreak Investigation

NOTE: The following resource was prepared for class use by replicating portions of the Centers for Disease Control and Prevention’s (CDC), “Oswego – An Outbreak of Gastrointestinal Illness Following a Church Supper: Student Guide” (CDC, n.d.), except for the “Questions” section, with the understanding that the CDC document is in the public domain and available for educational use.

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Background:

On April 19, 1940, the local health officer in the village of Lycoming, Oswego County, New York, reported the occurrence of an outbreak of acute gastrointestinal illness to the District Health Officer in Syracuse. Dr. A. M. Rubin, epidemiologist-in-training, was assigned to conduct an investigation. When Dr. Rubin arrived in the field, he learned from the health officer that all persons known to be ill had attended a church supper held on the previous evening, April 18. Family members who did not attend the church supper did not become ill. Accordingly, Dr. Rubin focused the investigation on the supper. He completed interviews with 75 of the 80 persons known to have attended, collecting information about the occurrence and time of onset of symptoms, and foods consumed. Of the 75 persons interviewed, 46 persons reported gastrointestinal illness Oswego Outbreak Investigation.

Clinical Description:

The onset of illness in all cases was acute, characterized chiefly by nausea, vomiting, diarrhea, and abdominal pain. None of the ill persons reported having an elevated temperature; all recovered within 24 to 30 hours. Approximately 20% of the ill persons visited physicians. Oswego Outbreak Investigation. No fecal specimens were obtained for bacteriologic examination.

Description of the Supper:

The supper was held in the basement of the village church. Foods were contributed by numerous members of the congregation. The supper began at 6:00 p.m. and continued until 11:00 p.m. Food was spread out on a table and consumed over a period of several hours Oswego Outbreak Investigation. Data regarding onset of illness and food eaten or water drunk by each of the 75 persons interviewed [are provided in the Excel “Oswego Line Listing Workbook” (CDC, n.d.)]. The approximate time of eating supper was collected for only about half the persons who had gastrointestinal illness.

Conclusion:

The following is quoted verbatim from the report prepared by Dr. Rubin:

The ice cream was prepared by the Petrie sisters as follows:

On the afternoon of April 17 raw milk from the Petrie farm at Lycoming was brought to boil over a water bath, sugar and eggs were then added and a little flour to add body to the mix. The chocolate and vanilla ice cream were prepared separately. Hershey’s chocolate was necessarily added to the chocolate mix. At 6 p.m. the two mixes were taken in covered containers to the church basement and allowed to stand overnight. They were presumably not touched by anyone during this period. Oswego Outbreak Investigation

On the morning of April 18, Mr. Coe added five ounces of vanilla and two cans of condensed milk to the vanilla mix, and three ounces of vanilla and one can of condensed milk to the chocolate mix. Then the vanilla ice cream was transferred to a freezing can and placed in an electrical freezer for 20 minutes, after which the vanilla ice cream was removed from the freezer can and packed into another can which had been previously washed with boiling water. Then the chocolate mix was put into the freezer can which had been rinsed out with tap water and allowed to freeze for 20 minutes. At the conclusion of this both cans were covered and placed in large wooden receptacles which were packed with ice Oswego Outbreak Investigation. As noted, the chocolate ice cream remained in the one freezer can.

All handlers of the ice cream were examined. No external lesions or upper respiratory infections were noted. Nose and throat cultures were taken from two individuals who prepared the ice cream.

Bacteriological examinations were made by the Division of Laboratories and Research, Albany, on both ice creams. Their report is as follows: “Large numbers of
Staphylococcus aureus
and
albus
were found in the specimen of vanilla ice cream. Only a few staphylococci were demonstrated in the chocolate ice cream.”

Report of the nose and throat cultures of the Petries who prepared the ice cream read as follows: “
Staphylococcus aureus
and hemolytic streptococci were isolated from nose culture and
Staphylococcus albus
from throat culture of Grace Petrie.
Staphylococcus albus
was isolated from the nose culture of Marian Petrie. The hemolytic streptococci were not of the type usually associated with infections in man Oswego Outbreak Investigation.”

Discussion as to Source: The source of bacterial contamination of the vanilla ice cream is not clear. Whatever the method of the introduction of the staphylococci, it appears reasonable to assume it must have occurred between the evening of April 17 and the morning of April 18. No reason for contamination peculiar to the vanilla ice cream is known.

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In dispensing the ice creams, the same scooper was used. It is therefore not unlikely to assume that some contamination to the chocolate ice cream occurred in this way. This would appear to be the most plausible explanation for the illness in the three individuals who did not eat the vanilla ice cream.

Control Measures: On May 19, all remaining ice cream was condemned. All other food at the church supper had been consumed. Oswego Outbreak Investigation.

Conclusions: An attack of gastroenteritis occurred following a church supper at Lycoming. The cause of the outbreak was contaminated vanilla ice cream. The method of contamination of ice cream is not clearly understood. Whether the positive
Staphylococcus
nose and throat cultures occurring in the Petrie family had anything to do with the contamination is a matter of conjecture.

Note: Patient #52 was a child who while watching the freezing procedure was given a dish of vanilla ice cream at 11:00 a.m. on April 18.

Addendum:

Certain laboratory techniques not available at the time of this investigation might prove very useful in the analysis of a similar epidemic today. These are phage typing, which can be done at CDC, and identification of staphylococcal enterotoxin in food by immunodiffusion or by enzyme-linked immunosorbent assay (ELISA), which is available through the Food and Drug Administration (FDA). Oswego Outbreak Investigation.

One would expect the phage types of staphylococci isolated from Grace Petrie’s nose and the vanilla ice cream and vomitus or stool samples from ill persons associated with the church supper to be identical had she been the source of contamination. Distinctly different phage types would mitigate against her as the source (although differences might be observed as a chance phenomenon of sampling error) and suggest the need for further investigation, such as cultures of others who might have been in contact with the ice cream in preparation or consideration of the possibility that contamination occurred from using a cow with mastitis and that the only milk boiled was that used to prepare chocolate ice cream Oswego Outbreak Investigation. If the contaminated food had been heated sufficiently to destroy staphylococcal organisms but not toxin, analysis for toxin (with the addition of urea) would still permit detection of the cause of the epidemic. A Gram stain might also detect the presence of nonviable staphylococci in contaminated food.

Reference

Centers for Disease Control and Prevention. (n.d.). Oswego – An outbreak of gastrointestinal illness following a church supper: Student guide (Case No. 401-303). Retrieved from https://www.cdc.gov/eis/casestudies/xoswego.401-303.student.pdf Oswego Outbreak Investigation

Topic 4 DQ 2

 
pub 540 Topic 4 DQ 2

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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? pub 540 Topic 4 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:

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. Epidemiologic Profile Assignment

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. 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:

Behavioral Risk Factor Surveillance System (BRFSS) data

Youth risk behavioral survey Epidemiologic Profile Assignment

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) Epidemiologic Profile Assignment

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. 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. Epidemiologic Profile Assignment

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 NursingEpidemiologic Profile Assignment

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

Topic 5: Study Designs II

Objectives:

Compare and contrast case control and cross-sectional studies.

Evaluate the strengths and weaknesses of study designs used in epidemiological assessments.

Select methods to evaluate public health programs. pub 540 Topic 5: Study Designs II

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.

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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.” pub 540 Topic 7 DQ 2