NR-503 Epidemiology final/ FINAL Week 8: Epidemiology/ NR 503-MIDTERM EXAM [BUNDLE] WITH A, Exams of Health sciences

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NR-503 Epidemiology final/ FINAL Week 8:

Epidemiology/ NR 503-MIDTERM EXAM

[BUNDLE] WITH ANSWERS..

Kleinman explanatory Model - correctly answered Eliciting the patient's (explanatory) model gives the physician knowledge of the beliefs the patient holds about his illness, the personal and social meaning he attaches to his disorder, his expectations about what will happen to him and what the doctor will do, and his own therapeutic goals Cultural competence - correctly answered Cultural competence is defined as "a dynamic, fluid, continuous process whereby an individual, system or health care agency find meaningful and useful care delivery strategies based on knowledge of the cultural heritage, beliefs, attitudes, and behavior of those to whom they render care" Cultural Awareness - correctly answered :Self-examination of one's own prejudices and biases toward other cultures. An in-depth exploration of one's own cultural/ethnic background. Cultural humility - correctly answered A lifelong commitment to self-evaluation and self-critiques, redressing the power of imbalances in the patient- physician dynamic, developing mutually. Beneficial relationships. Cultural Knowledge - correctly answered Obtaining a sound educational foundation concerning the various worldviews of differences cultures. Obtaining knowledge regarding biological variations, disease and health conditions and variation in drug metabolism. Cultural Skill: - correctly answered Ability to collect culturally relevant data regarding the client's health history and presenting problem. Ability to conduct culturally based physician assessments. Conducting these assessments in a culturally sensitive manner.

Cultural Desire - correctly answered Motivation of the healthcare provider to "want" to engage in the process of cultural competence, characteristics of compassion, authenticity, humility, openness, availability, and flexibility, commi tment and passion to caring, regardless of conflict. ethnicity - correctly answered as "the aggregate of cultural practices, social influences, religious pursuits, and racial characteristics shaping the distinctive identity of community" Cultural competence in nursing consists of four principles. - correctly answered Care is designed for the specific client. Care is based on the uniqueness of the person's culture and includes cultural norms and values. Care includes self-employment strategies to facilitate client decision making to improve health behaviors. Care is provided with sensitivity and is based on the cultural uniqueness of clients. The APN may also use the Kleinman Explanatory Model of Illness (1978). Below are the questions that can be utilized. - correctly answered What do you call your problem? What do you think caused your problem? Why do you think it started when it did? What does your sickness do to you? What do you fear most about your sickness? What are the chief problems your sickness has caused you? What kind of treatment do you think you should receive? What is the most important result you hope to receive from the treatment? According to Giger and Davidhizer (2000), although cultures differ, they all have the same basic organizing factors that must be assessed in order to provide care for culturally diverse patients. These factors include - correctly answered communication (verbal and nonverbal); personal space; social organization; time perception; environmental control; and biological variations.

The National Center for Cultural Competence (NCCC) provides national leadership and contributes to the body of knowledge on cultural and linguistic competency within systems and organizations. Major emphasis is placed on translating evidence into policy and practice for programs and personnel concerned with health and mental healthcare delivery, administration, education, and advocacy. - correctly answered The NCCC uses four major approaches to fulfill its mission, including - correctly answered Web-based technical assistance, (2) knowledge development and dissemination, (3) supporting a community of learners, and (4) collaboration and partnerships with diverse groups. These approaches entail the provision of training, technical assistance, and consultation and are intended to facilitate networking, linkages, and information exchange. The NCCC has particular expertise in developing instruments and conducting organizational self-assessment processes to advance cultural and linguistic competency. - correctly answered Epidemiological Triad: - correctly answered host, agent, environment Genetics is considered an agent in the epidemiological triad - correctly answered Genetics - correctly answered The study of individual genes and their impact on relatively rare single gene disorders Genomics - correctly answered The study of all genes in the human genome as well as their interaction with other genes, the individual's environment, and the influence of cultural and psychosocial factors Genetic epidemiology - correctly answered the link of epidemiology and genetics Absolute risk - correctly answered is the probability of an event, such as illness, injury, or death Absolute risk - correctly answered gives no indication of how its magnitude compares with others. The odds ratio - correctly answered closely approximates the relative risk if the disease is rare.

Odds ratio and the relative risk are used - correctly answered to assess the strength of association between risk factor and outcome. Attrubutible risk - correctly answered is used to make risk-based decisions for individuals. Population-attributable risk measures - correctly answered are used to form public health decisions EGAPP: - correctly answered Evaluation of Genomic Applications in Practice and Prevention GAPPNet - correctly answered Genomic Applications in Practice and Prevention Network (established in

2009. is a collaborative initiative involving partners from across the public health sector working together to realize the promise of genomics in health care and disease prevention. GEDDI - correctly answered Genetics Early Disease Detection Intervention project (GEDDI) (established in 2009) developed a model strategy for using clinical, genetic, and family history information to reduce the risk of disease, death, and disability in affected individuals, family members, and populations. HuGENet - correctly answered Human Genome Epidemiology Network (HuGENet) (established in 1998) helps translate genetic research findings into opportunities for preventive medicines and public health by advancing the synthesis, interpretation, and dissemination of population-based data on human genetic variation in health and disease. HuGENet reviews are systematic, peer-reviewed synopses of the epidemiologic aspects of human genes, including prevalence of allelic variants in different populations, population-based information on disease risk, evidence for gene-environment interaction and quantitative data on genetic tests and services carried out according to specific guidelines. NHANES III - correctly answered DC's Office of Public Health Genomics (established in 2002) formed a multidisciplinary working group with members from across CDC. It developed a proposal to measure the prevalence of selected genetic variants of public health significance in a representative sample of the U.S. population and to examine the association between the selected genetic variants and disease outcomes available in NHANES III data. The World Health Organization defines a pandemic - correctly answered as a global epidemic that spreads to more than one continent (WHO, 2009). One of the more recent pandemics that you might be familiar with is the H1N1 influenza outbreak of 2009.

Outbreak - correctly answered the occurrence of disease within persons in excess of what would normally be expected in a clearly defined community, location, or time of year. An outbreak may only last for a matter of days or weeks, but may last for years Quarantine - correctly answered the separation and restriction of the movement of people who were or are exposed to a contagious disease for a set period of time, to see whether they become ill Isolation - correctly answered the separation of sick people with a contagious disease from those who are not ill Disaster epidemiology - correctly answered "Disaster epidemiology is defined as the use of epidemiology to assess the short- and long-term adverse health effects of disasters and to predict consequences of future disasters. It brings together various topic areas of epidemiology including acute and communicable disease, environmental health, occupational health, chronic disease, injury, mental health, and behavioral health" Antigenic drift - correctly answered is a term describing the changes that occur within virus's ribonucleic acid that changes the virus. Typically, these changes create seasonal changes or new strains of a virus WHO Pandemic Phases - correctly answered Phase 1—None of the current viruses circulating in animals have been reported to cause infection in humans. Phase 2—An animal-based influenza virus is known to have caused infection in humans and is considered a potential pandemic threat. Phase 3—An animal- or human-animal-based virus has caused some clusters of cases in people, but has not caused human-to-human transmission that is significant enough to cause community-level outbreaks. Phase 4—Human-to-human transmission of an animal or human-animal virus is causing community outbreaks and sustained disease. This is a significant shift in risk and any country with such an outbreak should consult with WHO. Phase 5—There is human-to-human spread of the virus in at least two countries. This phase means that pandemic is imminent and that community action and implementation of planned mitigation procedures is needed. Phase 6—This is the pandemic phase, characterized by outbreaks in more than one WHO defined region in addition to all Phase 5 criteria (WHO, 2009)

Phase 1 - correctly answered None of the current viruses circulating in animals have been reported to cause infection in humans. Phase 2 - correctly answered An animal-based influenza virus is known to have caused infection in humans and is considered a potential pandemic threat. Phase 3 - correctly answered An animal- or human-animal-based virus has caused some clusters of cases in people, but has not caused human-to-human transmission that is significant enough to cause community-level outbreaks. Phase 4 - correctly answered Human-to-human transmission of an animal or human-animal virus is causing community outbreaks and sustained disease. This is a significant shift in risk and any country with such an outbreak should consult with WHO. Phase 5 - correctly answered There is human-to-human spread of the virus in at least two countries. This phase means that pandemic is imminent and that community action and implementation of planned mitigation procedures is needed. Phase 6 - correctly answered This is the pandemic phase, characterized by outbreaks in more than one WHO defined region in addition to all Phase 5 criteria (WHO, 2009). Pandemic Severity Index - correctly answered Category 1—case fatality ratio of less than 0.1% and fewer than 90,000 U.S. deaths Category 2—0.1%-0.5% case fatality ratio and 90,000-450,000 U.S. deaths Category 3- 0.5%—1% case fatality ratio and 450,000-900,000 U.S. deaths Category 4—1-2% case fatality ratio and 900,000-1.8 million U.S. deaths Category 5—greater than 2% case fatality ratio and more than 1.8 million U.S. deaths (CDC, 2014). SDG's - correctly answered - No poverty

• Zero hunger
• Good health and wellbeing

• Quality education
• Gender equality
• Clean water and sanitation
• Decent work and economic growth
• Peace, justice and strong institutions The Sustainable Development Goals (SDGs), otherwise known as the Global Goals, are a universal call to action to end poverty, protect the planet and ensure that all people enjoy peace and prosperity. Health effects of climate change - correctly answered increasing temperatures, extreme weather, desertification, and flooding on asthma, chronic obstructive lung disease, and respiratory infections History of WHO - correctly answered 1945: charter of the United Nations; article calling for establishment of health agency with wide powers 1946: UN representatives created and ratified the constitution of WHO 1948: constitution went into force and WHO began work
  The World Health Organization (WHO) is a specialized agency of the United Nations that is concerned with international public health. It was established on 7 April 1948, and is headquartered in Geneva, Switzerland. The WHO played a leading role in the eradication of smallpox. Its current priorities include communicable diseases, in particular HIV/AIDS, Ebola, malaria and tuberculosis; as well as the mitigation of the effects of non-communicable diseases such as sexual and reproductive health, development, and aging; nutrition, food security and healthy eating; occupational health; substance abuse; and driving the development of reporting, publications, and networking. Call to action - correctly answered It falls to nurses and midwives, the most numerous and arguably most patient-centered component of the health workforce, to assume a leadership role in addressing planetary health. Leadership begins with educating ourselves, students, staff, patients, and communities. Engagement in political and policy processes are needed-and can take many forms. Even small measures may have impact. Local level sustainability and readiness is meaningful at one's university, hospital, and or health system levels. Learn Communicate Find common ground

Nurses may want to consider assessing the environment where patients live and work (or go to school, for pediatric patients), including air quality by noting the proximity to emissions from cars (living close to highways) or factories and their mass transit accessibility. Teaching families how to assess allergen exposure and palliative measures are also important steps nurses can take. - correctly answered Health Outcomes - correctly answered defined as an end result that follows some kind of healthcare provision, treatment, or intervention and may describe a patient's condition or health status outcomes may be classified into categories by describing - correctly answered who is measured, such as individuals, aggregates, communities, populations, or organizations; by identifying the "what" or the type of outcome, such as care, patient, or performance-related outcomes determining the "when" or the time it takes to achieve an outcome, such as short-term, intermediate, or long-term outcomes three components: structure, process, and outcome. Structure refers to healthcare resources, such as the number and type of health and social service agencies, and can also include utilization indicators. Process describes how the healthcare is delivered, and outcome refers to the change in health status related to the intervention provided - correctly answered Domain 1 - correctly answered DOMAIN 1: Capacity Strengthening Capacity strengthening is the broad sharing of knowledge, skills, and resources for enhancement of global public health programs, infrastructure, and workforce to address current and future global public health needs. 1.1Design sustainable workforce development strategies for resource-limited settings. 1.2Identify methods for assuring health program sustainability. 1.3Assist host entity in assessing existing capacity. 1.4Develop strategies that strengthen community capabilities for overcoming barriers to health and well-being.

Domain 2 - correctly answered DOMAIN 2: Collaborating and Partnering Collaborating and partnering is the ability to select, recruit, and work with a diverse range of global health stakeholders to advance research, policy, and practice goals, and to foster open dialogue and effective communication. 2.1Develop procedures for managing health partnerships. 2.2Promote inclusion of representatives of diverse constituencies in partnerships. 2.3Value commitment to building trust in partnerships. 2.4Use diplomacy and conflict-resolution strategies with partners. 2.5Communicate lessons learned to community partners and global constituencies. 2.6Exhibit interpersonal communication skills that demonstrate respect for other perspectives and cultures. Domain 3 - correctly answered DOMAIN 3: Ethical Reasoning and Professional Practice Ethical reasoning and professional practice is the ability to identify and respond with integrity to ethical issues in diverse economic, political, and cultural contexts, and promote accountability for the impact of policy decisions on public health practice at local, national, and international levels. 3.1Apply the fundamental principles of international standards for the protection of human subjects in diverse cultural settings. 3.2Analyze ethical and professional issues that arise in responding to public health emergencies.

3.3Explain the mechanisms used to hold international organizations accountable for public health practice standards. 3.4Promote integrity in professional practice. Domain 4 - correctly answered DOMAIN 4: Health Equity and Social Justice Health equity and social justice is the framework for the analysis of strategies to address health disparities across socially, demographically, or geographically defined populations. 4.1Apply social justice and human rights principles in public health policies and programs. 4.2Implement strategies to engage marginalized and vulnerable populations in making decisions that affect their health and well-being. 4.3Critique policies with respect to impact on health equity and social justice. 4.4Analyze distribution of resources to meet the health needs of marginalized and vulnerable groups. Domain 5 - correctly answered DOMAIN 5: Program Management Program management is the ability to design, implement, and evaluate global health programs to maximize contributions to effective policy, enhanced practice, and improved and sustainable health outcomes. 5.1Conduct formative research. 5.2Apply scientific evidence throughout program planning, implementation, and evaluation. 5.3Design program work plans based on logic models.

5.4Develop proposals to secure donor and stakeholder support. 5.5Plan evidence-based interventions to meet internationally established health targets. 5.6Develop monitoring and evaluation frameworks to assess programs. 5.7Utilize project management techniques throughout program planning, implementation, and evaluation. 5.8Develop context-specific implementation strategies for scaling up best-practice interventions. Domain 6 - correctly answered DOMAIN 6: Sociocultural and Political Awareness Sociocultural and political awareness is the conceptual basis with which to work effectively within diverse cultural settings and across local, regional, national, and international political landscapes. 6.1Describe the roles and relationships of the entities influencing global health. 6.2Analyze the impact of transnational movements on population health. 6.3Analyze context-specific policy-making processes that impact health. 6.4Design health advocacy strategies. 6.5Describe multiagency policy making in response to complex health emergencies. 6.6Describe the interrelationship of foreign policy and health diplomacy.

Domain 7 - correctly answered DOMAIN 7: Strategic Analysis Strategic analysis is the ability to use systems thinking to analyze a diverse range of complex and interrelated factors shaping health trends to formulate programs at the local, national, and international levels. 7.1Conduct a situation analysis across a range of cultural, economic, and health contexts. 7.2Identify the relationships among patterns of morbidity, mortality, and disability with demographic and other factors in shaping the circumstances of the population of a specified community, country, or region. 7.3Implement a community health needs assessment. 7.4Conduct comparative analyses of health systems. 7.5Explain economic analyses drawn from socioeconomic and health data. 7.6Design context-specific health interventions based on situation analysis. The WHO conceptual framework for social determinants of health identifies five multifactorial components of population health that impact health outcomes - correctly answered biology and genetics, individual behavior, social environment, physical environment, and health services. USAID - correctly answered Activating a Disaster Assistance Response Team (DART) staffed by the CDC, in Monrovia, Liberia, and Guinea, to coordinate planning, operations, logistics, administrative issues, and interagency work •Saving more than 3 million lives with immunization programs •Reaching over 850,000 people with HIV-prevention education after establishing programs in 32 countries since 1987; training over 40,000 people to support HIV/AIDS programs in their own countries

•Providing family planning to more than 50 million couples worldwide •Training 21,000 Honduran farm families to prevent soil erosion •Providing oral rehydration therapy in Bangladesh; saving tens of millions of lives worldwide with this program •Providing loans and operating costs to Bolivian Banco Solidario (BancoSol), which is the first self- sustaining commercial bank in Latin America to focus on microbusiness (small business loans averaging $200 each) USAID works with WHO to promote and protect health as an essential element for human welfare, economic, and social development (WHO, n.d.-a). The WHO was created in 1946, as part of the UN, to find solutions for post-World War II Europe - correctly answered WHO global outbreak - correctly answered global Outbreak Alert and Response Network (GOARN), which initiates an international disease outbreak alert, technical support, vaccines, drugs, specialists, and equipment, to prevent spread, such as the plague in India, in 1995, which had an economic cost of over $1.7 billion •Chemical Incident Alert and Response System (ChemiNet): initiates alerts of industrial accidents, chemical, water, sanitation, radionuclear or environmental health emergencies •Global network of national health systems •Global Polio Eradication Initiative Network (GPEIN) •Global Influenza Surveillance Network (GISN) •FluNet

•H5N1 Avian flu tracking •XDR-TB drug-resistant tuberculosis tracking •Containment of 21st-century threats of bioterrorism (anthrax, etc.), SARS, and toxic chemical waste dumping, such as the 2006 illegal dumping of 500 tons of chemical waste in Abidjan, Cote d'Ivoire •WHO Foreign Policy and Global Health (FPGH) Initiative •Coordination of responses to natural disasters, with concomitant infectious diseases, malnutrition, mental illness, and displacement of large numbers of people Millenium Development Goals (MDGs) - correctly answered The UN's creation of eight goals for economic development and social progress in 2000. Members agreed to reach the goals by 2015. Eradicate extreme poverty and hunger. 2.Achieve universal primary education. 3.Promote gender equality and empower women. 4.Reduce child mortality. 5.Improve maternal health. 6.Combat HIV/AIDS, malaria, and other diseases. 7.Ensure environmental sustainability. 8.Develop a global partnership for development

iceberg concept - correctly answered in counting incidence and prevalence of disease it is not sufficient to count only clinically apparent cases, but those who are asymptomatic or exposed without infection is the Clinical disease - correctly answered disease characterized by signs and symptoms Preclinical disease - correctly answered disease that is not yet clinically apparent, but is destined to progress to clinical disease Subclinical disease - correctly answered disease that is not clinical apparent, not destined to become clinically apparent Pandemic - correctly answered excessive occurrence of disease present globally Endemic - correctly answered habitual presence of disease within geographic area common-vehicle exposure - correctly answered group of people are exposed to a substance/organism that causes common illness Epidemic - correctly answered occurrence of disease in community/geographic area in excess of normal expectancy Herd immunity - correctly answered resistance of group of people to disease because large portion of population is immune Incidence - correctly answered number of new cases of a disease, during a set period of time, in a specific population who is at risk for the disease Epidemiology - correctly answered the science of public healht Population Health - correctly answered Focuses on risk, data, demographics and outcomes

Aggregate - correctly answered A defined population Community - correctly answered Composed of multiple aggregates Data - correctly answered Compiled information Prevalence - correctly answered Measures the existence of the disease Incidence - correctly answered Measures the appearance Surveillance - correctly answered Collection, Analysis, dissemination of data High Risk - correctly answered Increased chance of poor health outcome Morbidity - correctly answered Presence of illness in a population Accomadation - correctly answered

FINAL Week 8: Epidemiology

epidemiology - correctly answered _______________ is the study of the distribution and determinants of health-related states or events (including disease), and the application of this study to the control of diseases and other health problems epi - correctly answered upon demos - correctly answered people

logos - correctly answered thought Descriptive epidemiology - correctly answered § Or patterns of health events in populations in order to characterize health outcomes in terms of what, who, where, when, how and why: What is the outcome? Who is affected? Where are they? When do events occur? This focus isà descriptive epidemiology person, place, time - correctly answered Descriptive epidemiology looks at ______, _______, and

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person - correctly answered Descriptive epidemiology: o Gender, age, race, education, occupation, socioeconomic status, marital status place - correctly answered Descriptive epidemiology: o Chemical, physical, biological environment or population densities or behavioral/lifestyle time - correctly answered Descriptive epidemiology: o Long term trends, point epidemic, cyclical patterns, event-related clusters analytic epidemiology - correctly answered § Reference to the goal of understanding the etiology (or origins and causal factors) of disease; the broad consideration of many levels of potential determinants if called the ecological approach § Search for · Cause and effects · Why and how · Epidemiologists use analytic epidemiology to quantify the association between exposures and outcomes and to test hypotheses about casual relationships o Observational studies, cohort, case control, cross sectional analytic - correctly answered __________ epidemiology looks at descriptive comparisons descriptive - correctly answered __________ epidemiology sheds light on determinants

hippocrates - correctly answered § On airs, waters, and places, suggests environmental and host factors such as behaviors might influence the development of disease john snow - correctly answered § Father of Epidemiology, cholera epidemic Florence Nightingale - correctly answered § Statistician, social reformer and founder of modern nursing § Improved outcomes for soldiers Lillian Wald - correctly answered § New York, TB agent, host, environment - correctly answered What are the three components of the epidemiological triangle? agent - correctly answered · Agent originally referred to an infectious agent: a virus, bacterium, parasite, or other microbe. Generally, the agent must be present for disease to occur; however, presence of that agent alone is not always sufficient to cause disease. · A variety of factors influence whether exposure to an organism will result in disease, including the organism's pathogenicity (ability to cause disease) and dose. · Over time, the concept of agent has been broadened to include chemical and physical causes of disease or injury. Environment - correctly answered · Environment refers to extrinsic factors that affect the agent and the opportunity for exposure. · Environmental factors include: o Physical factors: geology and climate, o Plant and animal life: agents, reservoirs or habitats o Human population distribution: crowding, social supports o Socioeconomic factors: resources, education, access to care Working conditions: noise, stress, satisfaction

host - correctly answered · A variety of factors intrinsic to the host, · sometimes called risk factors, can influence an individual's exposure, susceptibility, or response to a causative agent · Susceptibility and response to an agent are influenced by factors such as genetic composition, age or sex, and immunologic status, presence of disease or medications, and psychological makeup. · Opportunities for exposure are often influenced by lifestyle factors such as sexual practices, diet, exercise, hygiene, and other personal choices web of causality - correctly answered § When the epidemiologic triangle is not enough to describe complex relationships.... § Considers · Complex interrelationships · Interacting factors § Need to look for the "Spider" (larger factors and contexts) ecological model - correctly answered § Recognizes determinants of health at many levels: · Biological · Mental · Behavioral · Social · Environmental · Inter-related · More on page 278 epidemiological process - correctly answered § Determine the nature, extent, and possible significance of the problem § Utilize the data to formulate a possible theory § Gather info from sources to narrow the possibilities § Make a plan § Put the plan in action

§ Evaluate the plan § Report and follow up Proportion - correctly answered · Type of ratio (denominator includes the numerator) % rate - correctly answered · Measure of frequency (number of events/ population size and dimension of time · How rapidly something is happening · Change over time risk - correctly answered · Probability that an event will occur in a certain amount of time crude rate - correctly answered Measures of Morality: · Usually an annual rate that represents the proportion of a population who die from any cause during the period, using the midyear population as the denominator age specific rate - correctly answered Measures of Morality: · Number of deaths among persons of given age group per midyear population of that age group cause specific rate - correctly answered Measures of Mortality: · Number of deaths from a specific cause per midyear population infant mortality rate - correctly answered Measures of Mortality: · Number of infant deaths before one year of age in a year per number of live births in the same year neonatal mortality rate - correctly answered Measures of Mortality: · Number of infants deaths under 28 days of age in a year per number of live births in the same year mortality rates - correctly answered § Are informative only for fatal diseases and do not provide direct information about either the level of existing disease in the population or the risk of contracting any particular disease

prevalence - correctly answered Measure of Morbidity: · The number of existing cases of a particular disease, injury, or other health condition at a specific point in time incidence - correctly answered Measure of Morbidity: · The number of individuals who develop the disease over a defined period of time or the number of new cases of a particular condition identified over a period of time attack rate - correctly answered Measure of Morbidity: § Often used in infectious disease investigations number of new cases among population during the period/ population at risk at the beginning of the period surveillance - correctly answered _______________ involves the systematic collection, analysis and interpretation of data related to the occurrence of disease and the health status of a given population timeliness, representation, sensitivity, specificity - correctly answered Public health surveillance includes? timeliness - correctly answered Public Health Surveillance: · Allow for implement of effective control measures Public Health Surveillance - correctly answered § Provides and interprets data to facilitate the prevention and control of disease representation - correctly answered Public Health Surveillance· Gives an accurate picture of the trend of the disease sensitivity - correctly answered Public Health Surveillance: · Allows for identification of individual persons with disease to facilitate treatment, quarantine, or other control measures

specificity - correctly answered Public Health Surveillance: · Exclude persons not having disease primary prevention - correctly answered · Education: how to prevent communicable diseases · Vaccinate for HPV, Hep A, Hep B · Assessment: Sexual Health History secondary prevention - correctly answered · STI partner notification · Screening · Education (prevent reinfection, managing symptoms, prevent infection of others) · Administer tuberculin skin test tertiary prevention - correctly answered · Direct observe therapy (DOT) for TB · Support groups · Referral to assure adequate services · Educating families/ individuals about managing symptomatic illness/ preventing transmission HIV, STD, Hepatitis, Tuberculosis - correctly answered Types of Communicable and infectious diseases? Gonorrhea - correctly answered § Rates are starting to rise again in US § Developing a resistance to antibiotic drugs - Currently down to one remaining treatment option: injected ceftriaxone combined with oral azithromycin. § Highest incidence: · African Americans, people living in Southern US, and women 20-24 years of age Syphilis - correctly answered § All Stages · In 2018, 115,045 new diagnoses of syphilis reported. § Primary and Secondary Syphilis · In recent years, rates have been increasing among MSM as well as heterosexual men and women.

§ Congenital Syphilis · 2018- 1,306 cases reported · 2017 - 73 cases reported · In 2018, rates were 6.4 times and 3.3 times higher among infants born to black and Hispanic mothers. chlamydia - correctly answered § Many people who have this STI may not know if they have the disease often does not have symptoms. § Most commonly reported STD in the U.S. § Women under 25 are the most commonly infected HIV - correctly answered o § Prevalence in Nebraska: · As of December 31st, 2015 there were 2,336 persons living with HIV/AIDS in Nebraska. The CDC estimates that 20% of HIV-infected persons nationally are undiagnosed. For Nebraska, that would mean that there are an additional 467 undiagnosed HIV-infected persons § HIV initiatives · Link or re-engage HIV diagnosed people to care by utilizing HIV surveillance data to intervene directly in disease control · Goals of Data to Care Strategy o Increase the number of HIV-diagnosed individuals who are engaged in HIV care o Increase the number of HIV-diagnoses persons with an undetectable viral load (HAART) hepatitis A - correctly answered § Transmission: Person to person through fecal-oral route § Over half of U.S. States reported outbreaks of HAV since 2016. · Over 26,000 cases · Over 60% of cases hospitalized · At least 270 deaths § Assess for risks and vaccinate § Who's at risk for acquiring HAV? § People who

· Use drugs · Are homeless or experiencing unstable housing · Are currently or recently incarcerated · Have chronic liver disease · Men who have sex with men hepatitis B - correctly answered § Acute and Chronic § Transmission: (Blood & Body Fluids) · Sex with an infected partner · Injection drug use that involves sharing needles, syringes, or drug-preparation equipment · Birth to an infected mother · Contact with blood or open sores of an infected person · Needle sticks or sharp instrument exposures · Sharing items such as razors or toothbrushes with an infected person · Pregnant women should be tested for HBV - if positive, newborns require: o Hep B immune globulin Hepatitis C - correctly answered § From 2011 - 2015, 5,223 cases of HCV were reported to NE DHHS. Using CDC's national estimates, approximately 1.3 to 1.9% of the State's population or 24,650 to 36, 028 are infected with HCV § Most common chronic bloodborne infection in the US tuberculosis - correctly answered § Number of reported cases of TB in U.S. in 2018: 9,025. Rate of 2.8 cases/100,000 persons. § 17 Cases of TB reported in Nebraska in 2019 - 9 cases were pulmonary, 8 extra-pulmonary (25 Cases reported in 2018). § Disproportionally affects Hispanics, African Americans, & Asians § Latent Tuberculosis Infection (LBI) · Latent TB infection is not reported to CDC. · Estimated that there are up to 13 million people living with Latent TB infection in U.S.

· 5-10% of infected people who do not receive treatment for LTBI will develop TB some time during their lives Describe health advocacy actions for population health versus individual level health advocacy actions - correctly answered "you will have to put your typed answer in this box for the answer" How does the ANA code of Ethics relate to health policy? - correctly answered Correct Answer is: Establishes the commitments of the nurse The World Health organization began in 1948. What Day now celebrates this date? - correctly answered Correct Answer is: World Health Day. In the article by Kurth (2017) what effect will urbanization have on health inequity? - correctly answered Choices will be Grater access to health care, Increased in food deserts, poorer health outcomes, more health care providers (** It is not Grater access to health care**) In the article by Xue & Intrator (2016), how hare vulnerable populations described? - correctly answered Correct Answer is: Groups that are most susceptible to adverse outcomes. Which of the following would be appropriate to integrate in order to provide culturally competent care?

• correctly answered Correct Answer is: Health care strategies that are based on cultural heritage and beliefs You work in a practice providing care to a migrant farm worker, In order to provide culturally congruent health care you: - correctly answered it is not Implement assessment that are focused on age based needs Why is the field of Genomic critical to population health? Select all that apply. - correctly answered Correct Answer is: It can guide interventions, and Genomics is useful for policy development.