NURS 8310 Entire Course Weekly Discussions And Assignments

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NURS 8310/ NURS 8310F/ NURS 8310M/ NURS 8310A/ NURS 8310C: Epidemiology and Population Health 

NURS 8310 Entire Course Weekly Discussions And Assignments

NURS 8310/ NURS 8310F/ NURS 8310M/ NURS 8310A/ NURS 8310C Week 1: Introduction to Epidemiology and Population Health

Imagine walking out of your home to a chaotic scene of disaster relief personnel dressed in hazmat suits. Hollywood has long played upon fears of a catastrophic epidemic with movies such as Outbreak (1995) and Contagion (2011). In films such as these, the protagonist races to identify the origin of a fast-spreading disease, determine the potential course of the outbreak, and develop a method to control the spread of harm. Although these films are designed to entertain, they show how epidemiologic methods can be used to analyze and control a health event that has the potential to debilitate a large population.

It is important to note, however, that epidemiology relates to more than just acute outbreaks of illness; it addresses many chronic population health problems that nurses and health care professionals deal with every day, such as obesity, cardiovascular disease, and cancer. This first week of the course introduces the principles of epidemiology, as well as how epidemiology is used to study and address population health problems. As a nurse engaged in advanced practice, it is essential that you understand these concepts and appreciate the importance of epidemiology.

This week, you will examine one of the great success stories of the application of epidemiology to improve population health: the eradication of smallpox. You use this historic example to explore current population health problems, and you will consider how epidemiologic principles can be applied to address them. Finally, you will begin to consider the cost effectiveness of addressing a health problem at the population level versus the individual level.

Learning Objectives

Students will:

  • Apply principles of epidemiology to population health problems
  • Evaluate cost effectiveness of population health care versus individual health care

NURS 8310 Entire Course Weekly Discussions And Assignments

Reflect on your nursing practice for a moment. If you could wipe out one illness, what would it be? How would that impact not just an individual patient, but your entire patient population? What would be the long-term benefits of eliminating that one illness?

The eradication of smallpox by 1979 provides an excellent example of this scenario. This eradication came about as a result of global collaborative efforts involving many countries and organizations, as well as the application of epidemiologic methods. In spite of high initial financial costs, it is estimated that millions of dollars continue to be saved around the world each year as a result of the eradication of this disease.

The eradication of smallpox illustrates the rich history of epidemiology and demonstrates the cost/benefits and implications of improving health at the population level. The application of epidemiologic methods and principles to other critical population health issues continues to play an essential role in improving health and health outcomes.

For this Discussion, you will identify a current population health problem, and you will examine how, and if, the problem is being addressed through the application of epidemiologic principles. You will also discuss the cost-effectiveness of dealing with the problem at the population level.

To prepare:

  • Review the Learning Resources, focusing on the smallpox epidemic of the 1960s and 1970s and how health organizations applied principles of epidemiology to eradicate this disease.
  • In light of this example, consider the cost effectiveness of addressing smallpox at the population level.
  • Using the Learning Resources, research a current population health problem (local or global). Select one on which to focus for this Discussion.
  • Think about how principles of epidemiology are being applied—or could be applied—to address the problem.
  • What lessons from the use of epidemiology in the eradication of smallpox might be applicable to this selected problem? What are the financial benefits of addressing this issue at the population level as opposed to the individual level?

By Day 3

Post a cohesive response that addresses the following:

  • Briefly summarize your selected population health problem and describe how principles of epidemiology are being applied—or could be applied—to address the problem.
  • Are there any lessons learned from the use of epidemiology in the eradication of smallpox that can be applied to your selected problem?
  • Evaluate the cost effectiveness of addressing this health problem at the population level versus the individual level.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues in one or more of the following ways:

(Make sure that you respond to at least one colleague who selected a population health problem different than the one you selected.)

  • Ask a probing question, substantiated with additional background information, evidence or research.
  • Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
  • Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
  • Validate an idea with your own experience and additional research.
  • Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
  • Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

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NURS 8310/ NURS 8310F/ NURS 8310M/ NURS 8310A/ NURS 8310C: Epidemiology and Population Health | Week 2

In 2009, the FDA and Centers for Disease Control (CDC) made policy recommendations that all girls ages 11 or 12 should consider receiving the Human Pappillomavirus (HPV) vaccine in an effort to prevent cervical cancer. What investigations led to this controversial recommendation? How did the CDC determine who should receive this vaccine and at what age?

Week 1 presented foundational concepts of epidemiology and described how epidemiology is used to improve population health. Building on that information, this week, you will be introduced to descriptive epidemiologic research studies. You will examine the purposes of descriptive epidemiology, which provides a picture of the distribution of disease in terms of person, place, and time. You will also look at sources of health data that can be useful for this type of research. By understanding the descriptive characteristics of diseases, public health nurses and health care providers can develop hypotheses related to diseases. They can then address these further by using analytic epidemiologic study techniques, which will be discussed in subsequent weeks.

Learning Objectives

Students will:

  • Evaluate a population health problem in terms of person, place, and time
  • Assess strengths and limitations of health data sources
  • Analyze methods for collecting raw descriptive epidemiologic data

NURS 8310 Entire Course Weekly Discussions And Assignments

HIV/AIDS was first recognized as an epidemic in the United States in 1981. At the beginning of the AIDS epidemic, the life expectancy for infected persons was less than 7 years. Today, because of research and new treatment options, people who begin treatment soon after diagnosis can expect to live a nearly normal life span (Cairns, 2010). The HIV/AIDS epidemic was identified through descriptive epidemiology.

Descriptive epidemiologic studies are often conducted as precursors to analytic studies. Epidemiologic concepts are used to gather data to better understand and evaluate health trends in populations. Data such as characteristics of the persons affected, place where an incident occurred, and time of occurrence are collected and analyzed to look for patterns in an effort to identify emerging health problems. In this Discussion, you will apply the epidemiologic concepts of time, place, and person to a specific population health problem.

To prepare:

  • Consider a variety of population health problems, and then select one on which to focus for this Discussion.
  • Identify a specific population affected by your selected health problem.
  • Research the patterns of the disease in your selected population using the epidemiologic characteristics of person, place, and time.
  • Explore three to five data sources presented in the Learning Resources that could aid you in describing the population and magnitude of the problem. Analyze the strengths and limitations of each data source.
  • Consider methods for obtaining raw data to determine the variables of person, place, and time for your health problem. Ask yourself: How would the methods I select influence the accuracy of case identification, definition, and diagnosis?

By Day 3

Post a cohesive response that addresses the following:

  • Evaluate your selected health problem in the population you identified by describing three to five characteristics related to person, place, and time.
  • Appraise the data sources you utilized by outlining the strengths and limitations of each.
  • Discuss two methods you could use to collect raw data to determine the descriptive epidemiology of your health problem, Determine how these methods would influence the completeness of case identification as well as the case definition/diagnostic criteria used.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues in one or more of the following ways:

  • Ask a probing question, substantiated with additional background information, evidence, or research.
  • Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
  • Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
  • Validate an idea with your own experience and additional research.
  • Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
  • Expand on your colleagues’ postings by providing additional insights or by contrasting perspectives based on readings and evidence.

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NURS 8310/ NURS 8310F/ NURS 8310M/ NURS 8310A/ NURS 8310C Week 3: Analytic Epidemiology Designs: Observational

Consider for a moment the great strides made in treating breast cancer, or as noted last week, the change in life expectancy for patients with HIV/AIDS. These strides toward improving health outcomes are a result of research; research has helped health care professionals and others better understand disease and, therefore, offer more effective treatment.

In Week 2, you explored descriptive epidemiological studies, examining the distribution of disease in terms of person, place, and time. This week you will begin looking at analytic epidemiology designs that focus on the association between an exposure to a risk factor (e.g., radiation, cigarette smoke, poor diet) and the resulting health outcomes. You will examine observational studies in particular, and you will consider how and why this approach could be appropriate for a specific health problem and population. In addition, you will select a significant population health problem of interest to you in preparation for Major Assessment 7.

Learning Objectives

Students will:

  • Analyze observational study designs used in analytic epidemiology
  • Evaluate the application of observational studies for improving population health status
  • Characterize a significant population health problem

A clinical pediatric nurse has noticed a rise in childhood cancer diagnoses among the Hispanic population served by the local clinic. The nurse is concerned about this increase in cancer incidence in the patient population and turns to the literature to explore current research on this topic. The nurse finds through the reading that there appears to be an association between parental smoking and childhood cancer and wonders if this could be the cause of the rise in cases.

This type of suspected association between a risk factor (exposure) and a particular outcome (childhood cancer) can be evaluated using an observational study design. This week, you were introduced to observational study designs used in epidemiology. For this Discussion, you will identify an epidemiologic association of interest (e.g., smoking and lung cancer, obesity and heart disease, hormone replacement/modification therapy and breast cancer) and determine an appropriate observational study design for exploring that association.

To prepare:

  • Review the different types of observational study designs presented in the Learning Resources: ecologic, cross-sectional, case-control, and cohort.
  • Carefully examine the characteristics, strengths, and limitations of each design.
  • Consider an association between a risk factor and a particular health outcome that is of interest to you. Then, select the observational study design you think would be the most appropriate for exploring this association.
  • Consider how using observational study designs can lead to improvements in population health.

By Day 3

Post a cohesive response that addresses the following:

  • Identify the association between the risk factor and health outcome you selected, and suggest which observational study design you feel is most appropriate for examining that association.
  • Support your selection of the observational design, noting its strengths and limitations for addressing the health problem.
  • What might you be able to learn by using your selected study design that might lead to improvements in population health? Support your response with evidence from the literature.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least three of your colleagues in one or more of the following ways:

  • Suggest a different study design that would be appropriate for your colleague’s health problem.
  • Ask a probing question, substantiated with additional background information, evidence, or research.
  • Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
  • Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
  • Validate an idea with your own experience and additional research.
  • Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
  • Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

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NURS 8310/ NURS 8310F/ NURS 8310M/ NURS 8310A/ NURS 8310C Week 4: Analytic Epidemiology Designs: Experimental

In the fall of 2011, the FDA announced a shortage of important chemotherapy drugs; this shortage, in turn, disrupted clinical trials and led to potential challenges in assessing data from those studies. Experimental research, which includes clinical trials, plays a pivotal role in the advancement of disease prevention and treatment. Once a risk factor has been established, the next step is testing an intervention through experimental research methods. Does this drug actually prevent or ameliorate symptoms?

In Week 3, you examined observational study designs, an important form of analytic epidemiology. This week, the focus turns to experimental studies. As you explore this topic, think about why experimental research is considered the “gold standard” of epidemiology. You will also begin developing Assignment 2 (Sections 1 and 2 of Major Assessment 7) and consider which research design will best address your selected population health problem.

Learning Objectives

Students will:

  • Analyze a randomized controlled trial research study
  • Analyze ethical issues with a randomized control trial study
  • Evaluate epidemiologic study designs to answer a population health study question
  • Evaluate the strengths and limitations of health data sources to answer a population health study question
  • Determine primary data collection methods for a specific population health problem

According to the Centers for Disease Control (CDC), asthma is a leading chronic illness in children ages 5 to 17, a leading cause of school absenteeism, and the third highest cause of hospitalizations in children younger than 15 (2011). The costs associated with treating this chronic illness are high.

A number of randomized control trials have examined the effect of instituting a home management program for treating asthma in combination with pharmaceuticals. These studies found that, by implementing a structured home management program, the morbidity, severity, and frequency of asthmatic episodes were reduced (Agrawl, Singh, Mathew, & Malhi, 2005). Recent research is also exploring how and when to cut back on levels of medication as asthma episodes become controlled, further reducing the cost of this chronic illness; however, controversy remains over the long-term effects of reducing levels of medication due to the disparateness of asthma (Rogers & Reiberman, 2012).

For this Discussion, you are asked to identify an example of an experimental study design in the popular literature and consider the ethical implications of the randomized control trial design.

To prepare:

  • Search the Internet and credible websites to locate a news piece or article that features a randomized trial study design. The article should be from a widely distributed news source, accessible to and written for a lay audience. Possible sources include, but are not limited to, online magazines, online newspapers, and health news websites. Be sure to include a link to the article in your posting. You may not select an article already posted by one of your colleagues for this Discussion.
  • Critically analyze the following aspects of the research study:
    • Purpose
    • Study population
    • Length of the trial
    • Data collection methods
    • Outcome measures
    • Results and conclusions
    • Ethical issues associated with the study
  • Ask yourself: How did this research study benefit from its randomized design? What was discovered by randomization that might not otherwise have been demonstrated?

By Day 3

Post a cohesive scholarly response that addresses the following:

  • Summarize the research study addressing the aspects bulleted above. In your posting, provide a link to the article you selected.
  • Identify and discuss the ethical issues associated with this study.

By Day 5

Respond to at least one of your colleagues in one or more of the following ways:

  • Ask a probing question, substantiated with additional background information, evidence, or research.
  • Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
  • Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
  • Validate an idea with your own experience and additional research.
  • Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
  • Expand on your colleague’s posting by providing additional insights or contrasting perspectives based on readings and evidence.

Discussion 2: Epidemiologic Designs

As introduced in the first few weeks of this course, investigators use various epidemiological study designs to study health problems and the effects of health interventions. You have examined several study designs, including descriptive designs (in Week 2) and analytic study designs that are observational (in Week 3) or experimental (this week). As a DNP student, you should be able to determine which study design would be most suitable for addressing a health problem of interest to you, as this is a foundation for evidence-based practice.

For this Discussion, you will consider which epidemiologic study design (i.e., descriptive, ecologic, cross-sectional, case-control, cohort, or experimental) is most appropriate for investigating the population health problem you selected for Assignment 1. In addition, you will consider which epidemiologic data sources you would use to examine your health problem.

To prepare:

  • Reflect on the population health problem you identified in Assignment 1, which you will use for Major Assessment 7, and your early review of the literature.
  • Identify a question for your study; this will help you select an appropriate design.
  • Consider which epidemiologic study design (i.e., descriptive, ecologic, cross-sectional, case-control, cohort, or experimental) is most appropriate for addressing your selected health problem based upon the assumptions and basic tenets of each design.
  • Determine which epidemiological design(s) would not be appropriate for your study and why.
  • Also, explore the various health data resources that were presented in Chapter 5 of the course text,Epidemiology for Public Health Practice. Consider which data resources you could use for your study, assessing the strengths and limitations of those resources.

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NURS 8310/ NURS 8310F/ NURS 8310M/ NURS 8310A/ NURS 8310C Week 5: Epidemiologic Applications, Part 1

A healthy environment is fundamental to life, and attention to the effects of the environment on human health is essential if we are to achieve the goal of health for all.

—Naomi Higenbottam, RN, The Luminary Project: Nurses Lighting the Way to Environmental Health

A wide range of environmental agents affect human health, from noise pollution to air and water quality to possible food contamination in a restaurant, home, or grocery store. Nurses engaged in advanced practice need to be aware of those agents in the environment that can have an impact on the health and well being of individuals and populations.

Equally important are the genetic factors that also influence health and wellness. Advances in the identification of disease-linked genes has improved both individual and population health. Recognizing patterns of inherited diseases and understanding how genes interact with the environment to cause disease are requisite skills for DNP-prepared nurses.

This week, you will explore environmental and genetic factors that influence population health and may result in health disparities in populations. Finally, you will explore how these factors may influence the population health problem you selected for Major Assessment 7.

Learning Objectives

Students will:

  • Evaluate environmental agents and genetic factors associated with population health effects
  • Propose ways in which environmental or genetic factors may result in health disparities in populations

In Le Roy, New York, in 2011, a mysterious medical condition emerged: Several teenage girls suddenly began to exhibit symptoms similar to those of Tourette’s Syndrome, including involuntary twitches, movements, and sounds. Soon after, the number of individuals experiencing comparable symptoms increased. As media attention toward the situation grew, questions and concerns intensified about the origin of this condition. Did an environmental exposure trigger this? Was it the result of an infectious disease? If so, why were some people in the region affected and not others? In other words, could genetic factors play a role in this?

This week, you have been exploring a number of environmental and genetic factors that influence population health. Understanding how environmental and genetic factors influence populations will support your work as an advanced practice nurse. Therefore, for this Discussion, you will investigate the relationship between an environmental agent or genetic factor and a population health problem. You will also give attention to health disparities that may arise within a population because of environment or genetics.

To prepare:

  • Review the Learning Resources, and select one environmental agent or one genetic factor and an associated population health problem. For example, you might consider lead paint and its effect on children, air pollution and its effect on individuals with asthma, genetic associations of various cancers, etc.
  • Conduct additional research using the Walden Library and credible websites, reviewing the literature on your selected health problem and the relevant environmental agent or genetic factor.
  • Explore health data resources and determine morbidity, mortality, incidence, prevalence, exposures, and costs to society as they relate to your chosen environmental agent or genetic factor.
  • How might your chosen environmental or genetic factor result in health disparities in populations?

By Day 3

Post a cohesive scholarly response that addresses the following:

  • Identify the environmental agent or genetic factor that you selected and the population health problem with which it is associated.
  • Evaluate the significance of the health risk resulting from your selected environmental agent or genetic factor, discussing such aspects as morbidity, mortality, incidence, prevalence, exposures, and costs to society. Support your response with references and data.
  • How might the environmental or genetic factor you identified result in health disparities in populations?

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues in one or more of the following ways:

Note: Make sure you respond to at least one person that selected a different factor than you (e.g., if you picked a genetic factor, then respond to someone selected an environmental factor).

  • Ask a probing question, substantiated with additional background information, evidence, or research.
  • Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
  • Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
  • Validate an idea with your own experience and additional research.
  • Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
  • Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

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NURS 8310/ NURS 8310F/ NURS 8310M/ NURS 8310A/ NURS 8310C Week 6: Epidemiological Applications, Part 2 and Data Interpretation

Can a person’s experience with racial discrimination impact aging and his or her physical health? The answer may be yes, according to a preliminary epidemiologic research study sponsored by the National Institute on Aging (NIA) and the National Institute of Health (Szanton et al., 2011; NIH, 2011). The NIA looks at factors such as race and socioeconomic status in relation to health disparities and outcomes. The Szanton et al. study identified a sample population of African Americans living in the Baltimore area who reported experiencing racial discrimination in their lifetime. This sample population showed higher levels of red blood cell oxidative stress, a potential risk factor in cardiovascular and other age-related diseases. Although this study presents only preliminary findings, it is interesting to consider the role that stress and other psychosocial factors play in the overall health of individuals and populations.

This week, you will examine psychosocial factors that influence health and disease. By understanding the role of these factors in health, along with environmental and genetic factors, you will have additional tools to improve health outcomes for individuals and populations.

Finally, in order to develop evidence-based interventions, DNP-prepared nurses need to be able to critically appraise the research literature, including the conclusions drawn from the data analysis. To practice this skill, you will appraise two articles and consider potential sources of confounding and bias.

Learning Objectives

Students will:

  • Evaluate the influence of psychosocial factors in health and disease
  • Critically appraise epidemiologic literature
  • Analyze the potential influence of confounding variables in a research study
  • Analyze potential sources of bias in epidemiologic research

Although the United States spends more money per capita on health care delivery, statistics indicate it is not a particularly healthy country. Over 50% of all preventable deaths in the United States are a result of unhealthy lifestyle behaviors (AACN, 2006). As epidemiologists explore essential questions such as how stressful life events and behavioral choices may influence an individual’s health, society wrestles with the distinction of what is actually within the control of an individual, and therefore relates to a personal responsibility for promoting well being, versus how larger-scale efforts can modulate psychosocial risk factors that result in population health problems.

In this Discussion, you will consider the connection between psychosocial risk factors and health outcomes. As you review the research literature, consider how you have come across this issue in your professional practice. As a nurse leader, what opportunities do you have to apply the information presented this week to promote improvements in population health status?

To prepare:

  • Review the Learning Resources, focusing on the influence of psychosocial factors on health and disease.
  • Locate at least two examples from the research literature of how these factors influence health. If necessary, conduct additional research using the Walden Library and credible websites.
  • Examine strategies currently being employed to address these factors, including health promotion and disease prevention efforts.
  • Ask yourself: How are these strategies designed to improve population health status?

By Day 3

Post a cohesive scholarly response that addresses the following:

  • Provide a brief summary of each example, including the influence of psychosocial factors on health and disease as discussed in the research literature. Cite your sources.
  • What strategies are currently being used to address these factors? Support your response with examples from the literature.
  • Knowing that there are psychosocial factors that influence acute and chronic diseases, what is the role of the nurse in probing for that information or in larger initiatives?

Read a selection of your colleagues’ responses.

By Day 5

Respond to at least one of your colleagues in one or more of the following ways:

  • Ask a probing question, substantiated with additional background information, evidence, or research.
  • Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
  • Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
  • Validate an idea with your own experience and additional research.
  • Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
  • Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Discussion 2: Appraising the Literature

For the DNP-prepared nurse, it is important to hone skills related to reviewing and evaluating research literature to implement evidence-based practices. As you examine epidemiological research, in particular, it is essential to ask, “What are the strengths and weakness of the research method(s)? Are the data analysis and interpretation sound? Is there any evidence of bias?” This Discussion provides you and your colleagues valuable practice in critically analyzing research literature.

To prepare:

  • With this week’s Learning Resources in mind, reflect on the importance of analyzing epidemiological research studies.
  • Critically appraise the Oppenheimer (2010) and Elliott, Smith, Penny, Smith and Chambers (1999) articles presented in the Learning Resources using Appendix A in Epidemiology for Public Health Practice as a guide.
  • Determine the strengths and weaknesses of the research methods and data analysis of each study.
  • Ask yourself, “Is any bias evident in either study? What did the researchers do to control for potential bias?”
  • Finally, consider the importance of data interpretation in epidemiologic literature and the issues that may arise if potential confounding factors are not considered.

By Day 5

Post a cohesive scholarly response that addresses the following:

  • Appraise the Oppenheimer (2010) and Elliott et al. (1999) articles, summarizing the strengths and weaknesses of each study.
  • Analyze potential sources of bias in each study, and suggest strategies for minimizing bias.
  • Suggest possible confounding variables that may have influenced the results of each study.

Read a selection of your colleagues’ responses.

By Day 7

Respond to at least one of your colleagues in one or more of the following ways:

  • Ask a probing question, substantiated with additional background information, evidence, or research.
  • Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
  • Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
  • Validate an idea with your own experience and additional research.
  • Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
  • Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

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NURS 8310/ NURS 8310F/ NURS 8310M/ NURS 8310A/ NURS 8310C Week 7: Application of Measures of Effect

Working near farm fields may be hazardous to your health. A recent epidemiologic study revealed a link between three agricultural pesticides and the development of Parkinson’s disease (Wang et al., 2011; UCLA, 2011). This link was initially suspected because of higher rates of Parkinson’s in farmers and others living in rural areas. Researchers analyzed risk estimates—for those working near the fields, not in them—and determined an 80% increased risk for Parkinson’s. As demonstrated with this example, researchers can begin to define the effects of exposure by comparing rates of disease from those exposed to certain conditions and those not exposed. This, in turn, can lead to development of interventions for the affected population.

In Weeks 5 and 6, you explored how the environment, genetics, and psychosocial factors influence population health. This week, you will continue to examine the association between risk factors and the etiology of disease by investigating measures of effect. You will examine tools used to ascertain these measures (incidence, prevalence, relative risk, and odds ratios), and you will consider how nurses use measures of effect to make informed health care practice decisions. You will also begin Assignment 3.

Learning Objectives

Students will:

  • Analyze how measures of effect strengthen and support nursing practice
  • Determine a causal model that applies to a specific population health problem

One important application of epidemiology is to identify factors that could increase the likelihood of a certain health problem occurring within a specific population. Epidemiologists use measures of effect to examine the association or linkage in the relationship between risk factors and emergence of disease or ill health. For instance, they may use measures of effect to better understand the relationships between poverty and lead poisoning in children, smoking and heart disease, or low birth weight and future motor skills.

What is the significance of measures of effect for nursing practice? In this Discussion, you will consider this pivotal question.

To prepare:

  • With the Learning Resources in mind, consider how measures of effect strengthen and support nursing practice.
  • What would be the risk of not using measures of effect in nursing practice?
  • Conduct additional research in the Walden Library and other credible resources, and locate two examples in the scholarly literature that support your insights.

By Day 3

Post a cohesive scholarly response that addresses the following:

  • Analyze how measures of effect strengthen and support nursing practice. Provide at least two specific examples from the literature to substantiate your insights.
  • Assess dangers of not using measures of effect in nursing practice.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues in one or more of the following ways:

  • Ask a probing question, substantiated with additional background information, evidence, or research.
  • Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
  • Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
  • Validate an idea with your own experience and additional research.
  • Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
  • Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

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NURS 8310 Entire Course Weekly Discussions And Assignments

NURS 8310/ NURS 8310F/ NURS 8310M/ NURS 8310A/ NURS 8310C Week 8: Screening for Diseases

What might happen to cancer rates if existing screening tests were no longer used? Consider, as an example, colorectal cancer. The American Cancer Society (ACS) identifies colorectal cancer as the third most common cancer in men and women, as well as the second leading cause of cancer-related death (2011). Colorectal cancer screening tests can detect abnormal cell growth before cancer even forms, allowing for early detection, more successful treatment, and—in some cases—the prevention of cancer altogether. The ACS recommends this screening for all men and women over the age of 50 and earlier for individuals with additional risk factors. Much to the credit of screening procedures, “the death rate from colorectal cancer has been dropping for more than 20 years” (ACS, 2011).

Scientists are continually seeking to develop new screening tests that can detect diseases earlier. Screening is an essential tool for the secondary prevention of disease. It is used when the earlier detection of disease is associated with an improved outcome, as is the case with colorectal cancer. This week, you will examine the process of screening for disease, the effectiveness of different screening tests, and the controversies that surround screening programs.

Learning Objectives

Students will:

  • Analyze how epidemiologic data are used to argue for or against a screening program
  • Analyze how epidemiologic data can be used to formulate policy for improving population health
  • Evaluate the social impact of addressing a population health problem
  • Develop an evaluation plan for a health intervention

Although many individuals and organizations may endorse the goal of screening programs, the details and implementation are often controversial. For some types of screening, it can be quite challenging to weigh the human and economic costs and benefits and determine a clear recommendation. For instance, in an article in theNew England Journal of Medicine, Dr. Michael Barry (2009) indicates that “serial PSA [prostate-specific–antigen] screening has at best a modest effect on prostate-cancer mortality during the first decade of follow-up. This benefit comes at the cost of substantial over-diagnosis and overtreatment. It is important to remember that the key question is not whether PSA screening is effective but whether it does more good than harm.”

This week’s Learning Resources include articles about screening programs for four different diseases that contain potentially controversial recommendations. For this Discussion, you will select a disease and examine the epidemiological evidence to assess a recommendation for screening guidelines. In addition, you will consider possibilities for furthering policy to promote population health related to this disease.

To prepare:

  • Review the four articles concerned with screening and public policy listed in this week’s Learning Resources. All four articles contain potentially controversial recommendations for screening and prevention.
  • Select one article on which to focus for this Discussion.
  • Analyze how the epidemiologic data could be used to formulate policy for improving population health.

By Day 3

Post a cohesive scholarly response that addresses the following:

  • Summarize the recommendations of your selected article. Discuss ethical considerations and whether or not you believe the recommendations are justified.
  • Describe the epidemiological evidence in support of your position.
  • Identify whether the screening program you review is population-based or high-risk based and how that influences your assessment.
  • How can the reported data be used to move policy forward for improving population health around this issue?

By Day 6

Respond to the postings of at least two colleagues who commented on an article you did not select. Review his or her summary and make an argument to support a different position. Again, cite epidemiological evidence that supports your opposing view.

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NURS 8310 Entire Course Weekly Discussions And Assignments

NURS 8310/ NURS 8310F/ NURS 8310M/ NURS 8310A/ NURS 8310C Week 9: Emergence and Reemergence of Infectious Disease

As you have examined in this course, the scope of epidemiology has broadened over the years to include the global investigation of chronic, environmental, and genetic diseases and other health-related conditions. Yet, the practice of epidemiology has its roots in the study of infectious disease, global epidemics, and pandemics. Perhaps you recall the widely reported concerns about the H1N1 virus, SARS, or the reemergence of measles, tuberculosis, or whooping cough. The emergence and reemergence of infectious disease has long held the attention of epidemiologists, as well as the general public.

This week, you will explore the investigative process epidemiologists use to examine infectious diseases. You will also submit Assignment 4.

Learning Objectives

Students will:

  • Analyze the investigative process for disease outbreaks
  • Evaluate the application of health care interventions on emerging or reemerging infectious diseases
  • Formulate an evaluation plan for a population health intervention

NURS 8310 Entire Course Weekly Discussions And Assignments

Some of the most notable epidemics include the bubonic plague in the 14th century, smallpox in the 18th century, and influenza in the 20th century. Reportedly, the bubonic plague caused over 137 million deaths, whereas the death toll associated with influenza was 25 million (Ernst, 2001). These are dramatic examples of the kinds of acute outbreaks that led to the practice of epidemiology.

Many epidemiologists and health care professionals are concerned about the next potential pandemic or epidemic. With the increased mobility of society, the spread of infectious diseases continues to pose a serious threat. For this Discussion, you will investigate pandemics and epidemics using epidemiological tools, and you will consider strategies for mitigating disease outbreaks.

To prepare:

  • Using the Learning Resources, consider examples of emerging or reemerging infectious diseases that are occurring locally, nationally, or abroad. Then, select one example on which to focus.
  • Explore the epidemiological investigative process used to identify the emerging or reemerging infectious disease or outbreak.
  • Examine your selected infectious disease using the epidemiologic triangle and vector theory.
  • Consider how health care interventions may reduce the emergence or reemergence of infectious diseases.

By Day 3

Post a cohesive response that addresses the following:

  • Identify the emerging or reemerging infectious disease you selected.
  • Discuss the investigative process used to identify the outbreak, and describe its effect using descriptive epidemiology (person, place, and time).
  • Apply the epidemiologic triangle and vector theory to your selected outbreak.
  • Evaluate how prior health care interventions, or lack thereof, created the conditions that allowed this infectious disease to emerge.
  • Discuss how the disease outbreak might have been avoided or mitigated. Include agencies, organizations, and resources that could have supported these efforts. If appropriate, consider ongoing efforts to control the outbreak.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues in one or more of the following ways:

  • Ask a probing question, substantiated with additional background information, evidence, or research.
  • Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
  • Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
  • Validate an idea with your own experience and additional research.
  • Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
  • Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

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NURS 8310 Entire Course Weekly Discussions And Assignments

NURS 8310/ NURS 8310F/ NURS 8310M/ NURS 8310A/ NURS 8310C Week 10: Chronic Disease Management: Mortality and Morbidity

The management of chronic disease poses a significant health care challenge in the United States and elsewhere. By the year 2030, chronic disease will cost the world over 47 trillion dollars annually (Bloom, et al, 2011; Jaslow, 2011). As noted in Week 6, many of the factors that contribute to chronic illness—such as poor diet, lack of activity, drug and alcohol use, and smoking—are lifestyle choices. Consider, for instance, diabetes: the significant increase in prevalence from 1980 to 2007 is explainable almost entirely by lifestyle choices. Most adults report having the condition long term, and the direct and indirect costs associated with it are substantial (Nash, Reifsnyder, Fabius, and Pracilio, 2011).

As a nurse leader, what opportunities do you see for reducing morbidity and mortality—and, ultimately, for diminishing the tremendous personal and societal costs—related to chronic disease?

You have explored many of the facets of epidemiology throughout this course; this week, you will examine the study of chronic disease. You will investigate models and frameworks for managing chronic disease, as well as how the challenges of managing chronic disease inhibit the delivery of quality health care.

Learning Objectives

Students will:

  • Analyze a chronic disease model and its relationship to a chronic disease
  • Evaluate current challenges in delivering effective quality health care as it relates to chronic disease management

NURS 8310 Entire Course Weekly Discussions And Assignments

According to the Population Health course text, “Roughly 40 million Americans are still uninsured and 112 million Americans (almost half of the U.S. population, 45%) suffer from at least one chronic condition in the United States, an estimated 125 million persons have at least one chronic condition, and half of these persons have multiple chronic conditions” (Fabius, and Pracilio, Nash, Clark, 2015, p. 4 ).

This week’s Learning Resources examine numerous health problems that result in a need for ongoing care. As you have explored this week, many costs are associated with chronic disease—both in terms of lives lost and socioeconomic burden. What can be done to help reduce chronic disease at the population level?

For this Discussion, you will take an in-depth look at chronic disease, and you will evaluate ways to address this issue through the application of chronic disease models and frameworks. In addition, you will consider the impact of the challenges of managing chronic disease on quality of care delivery.

To prepare:

  • Review the application of chronic disease models as a method for managing chronic diseases at the population level.
  • Consider characteristics of chronic disease models and how to apply them as presented in the Learning Resources.
  • Consult Figure 13–7 (p. 267) in Population Health: Creating a Culture of Wellness, and consider examples of determinants and outcomes of population health with chronic diseases in a specific subpopulation. Then, select one chronic disease on which to focus for this Discussion.
  • Ask yourself, “What are the challenges of managing this chronic disease? How do these challenges limit the ability to deliver effective quality care?” Conduct additional research using the Walden Library and credible websites as necessary.

By Day 3

Post a cohesive scholarly response that addresses the following:

  • Identify your selected chronic disease.
  • Describe the application of a chronic disease model to address this disease at the population level. Include your rationale for selecting this particular model.
  • Discuss one or more current challenges related to the management of the chronic disease, and explain how these challenges limit the ability to deliver effective quality care.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues in one or more of the following ways:

  • Ask a probing question, substantiated with additional background information, evidence, or research.
  • Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
  • Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
  • Validate an idea with your own experience and additional research.
  • Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
  • Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

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NURS 8310 Entire Course Weekly Discussions And Assignments

NURS 8310/ NURS 8310F/ NURS 8310M/ NURS 8310A/ NURS 8310C Week 11: Practical Application of Epidemiological Interventions in Settings and Populations

Most people can recall where they were and what they were doing on the morning of September 11, 2001, when terrorists flew two airplanes into the Twin Towers. One week after that attack, anthrax was sent through the U.S. Postal Service to news media offices and politicians. In addition to these human-made emergencies, notable natural disasters have also occurred: the tsunami in Japan, a large earthquake in Haiti, tornadoes throughout the central United States, wildfires in California and Texas, flooding in the Northeast, etc. Out of all these disasters, many heroic stories unfolded as cities quickly responded to the needs of the citizens. For example, the New York Visiting Nurses Association had over 1,400 patients in the lower Manhattan area affected by the September 11th terrorist attacks. Within 3 days, they had tracked down each of their patients either in shelters or in the homes of family members.

In this final week of the course, you will consider emergency preparedness and disaster management strategies, and you will evaluate how these strategies are used to cope with disasters. In doing so, you will look through the lens of the epidemiologist and consider interventions for settings and populations. Additionally, you will be asked to synthesize your learning as you explore a case study on ethics and population health. You will also consider the effect of health care reform on a selected population health issue.

Learning Objectives

Students will:

  • Analyze epidemiological considerations resulting from natural or human-made disasters
  • Apply an epidemiological methods in a community-based or clinical setting to effectively address a population’s needs
  • Analyze the impact of culture, ethics, regulatory, and legal issues on population health
  • Evaluate the effects of health care reform as it relates to a selected population health initiative

On September 11, 2001, terrorist attacks created a grave disaster that included the destruction of the World Trade Center in New York. The day after 9/11, epidemiologists were asked to assess the environment around Ground Zero for potential hazards that might put those engaged in rescue and recovery at risk of harm. Beside the dust, what toxins might be in the air? Was the air quality safe or should rescue workers wear canister respirators or particle masks? What other protections might be necessary in the days following the disaster?

In this Discussion, you will look at the impact of a disaster through the lens of an epidemiologist, addressing such questions as, “What epidemiological considerations arise in the wake of a disaster? And, what makes disaster planning or emergency preparedness effective in terms of mitigating or preventing negative aftereffects?”

To prepare:

  • Identify a disaster that led to a population health issue. Consider this disaster through the lens of an epidemiologist, using the information presented in the Learning Resources to examine the epidemiological considerations resulting from the disaster. Conduct additional research as necessary using the Walden Library and credible websites.
  • Ask yourself, “What factors made the community’s and/or nation’s response effective or ineffective? What aspects of disaster planning or emergency preparedness did the community have in place that helped it cope with the disaster and resulting population health issue?”

By Day 3

Post a cohesive scholarly response that addresses the following:

  • Identify the disaster and resulting population health issue.
  • Describe the epidemiological considerations resulting from this disaster. Support your response with specific examples and evidence from the literature.
  • Discuss the factors that made the community’s and/or nation’s response effective or ineffective.

Read a selection of your colleagues’ responses.

By Day 5

Respond to at least two of your colleagues in one or more of the following ways:

  • Ask a probing question, substantiated with additional background information, evidence or research.
  • Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
  • Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
  • Validate an idea with your own experience and additional research.
  • Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
  • Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

NURS 8310 Entire Course Weekly Discussions And Assignments

Discussion 2: Factors That Impact Population Health

In this Discussion, you bring together the concepts that have been presented throughout this course by analyzing a current population health topic from an epidemiological approach. Consider the cultural, ethical, regulatory, and legal factors that may influence your selected topic.

To prepare:

  • Review the case study, presented on page 411 of your course text, Population Health: Creating a Culture of Wellness. Consider the cultural, ethical, and legal factors presented in the case study and how they influence the Michigan Primary Care Transformation Project.
  • With these thoughts in mind, select a current public health initiative that has been discussed in the popular press or available at the CDC website or your state’s health department website.
  • Consider this initiative through the lens of an epidemiologist, and identify what you think are the three most important issues related to culture, ethics, regulatory, or legal aspects of the public health initiative.
  • Consider how current health care legislation might impact your selected public health initiative. Conduct additional research as necessary.

By Day 4

Post a cohesive response that addresses the following:

  • Provide a summary of your selected public health initiative, and include a reference to the article (and URL to the article, if possible).
  • Analyze the cultural, ethical, regulatory, and legal factors that influence your specified population health topic.
  • Evaluate how current health care legislation may positively or negatively impact your selected public health initiative.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues in one or more of the following ways:

  • Ask a probing question, substantiated with additional background information, evidence, or research.
  • Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
  • Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
  • Validate an idea with your own experience and additional research.
  • Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
  • Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

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