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UTA NURS 4462 Exam 2

UTA NURS 4462 Community Exam 2

QuestionAnswer
vulnerable populations (groups of people) poor or homeless persons, pregnant adolescents, migrant workers, severely mentally ill individuals, substance abusers, abused individuals, persons with communicable diseases, and persons with sexually transmitted diseases, including HIV and HBV.
Vulnerable populations (definition) those at greater risk for poor health status and health care access.
Problems that predispose people to vulnerability Socioeconomic problems, including poverty and social isolation, physiological and developmental aspects of age, poor health status, and highly stressful life experiences.
one of the primary contributors to vulnerability Resource limitations are strongly related to health. Lack of adequate social, educational, and economic resources make people more vulnerable and more likely to experience health disparities, and poverty is a primary cause of vulnerability.
Nursing roles working with vulnerable populations health teacher, counselor, direct care provider, case manager, advocate, health program planner, and participant in developing health policies.
Title XXI of the Social Security Act, passed in 1998, established the State Children's Health Insurance Program to provide funds to insure currently uninsured children. Legislation enacted subsequently provided for new outreach and case-finding efforts to enroll eligible children in Medicaid.
MAP-IT an acronym for Mobilizing community resources, Assessing, Planning, Implementing, and Tracking results.
Minimizing the "hassle factor" One of the principles of intervening with vulnerable populations
Vulnerable populations adversely affected by the Balanced Budget Act of 1997 The act's more stringent regulations regarding which services will be reimbursed and for how long may limit access to care for frail older adults, chronically ill individuals whose care is largely home based, and people who are HIV positive
Health People 2020 key goal r/t vulnerable populations to eliminate health disparities
barriers to access financial or nonfinancial impediments to obtaining health care. May include lack of funds to pay for health care/inadequate insurance coverage or cultural obstacles and practical problems, such as lack of transportation or inconvenient clinic hours.
block grant intended to enable local areas to have more control in deciding how to spend funds so that they can respond to local needs and conditions.
brokering health services coordinating services provided by multiple agencies. Case managers often coordinate services to provide comprehensive care for clients.
carve outs the care for a specific population has been carved out of an overall managed care plan for all other clinical populations.
case finding locates individuals and families with identified risk factors and connects them with resources.
case management interchangeable term with care management. Case management is a process that enhances continuity and appropriateness of care. Most often used with clients whose health problems are actually or potentially chronic and complex.
comprehensive services services that completely meet an individual's or family's needs.
culturally and linguistically appropriate care fits with the cultural expectations and norms of a particular group to the extent possible and that is provided in the language of that group.
cumulative risk factors related risks that increase in effect with each added risk.
cycle of vulnerability the feedback effect of factors that predispose one to vulnerability and lead to negative health outcomes, which then increase the predisposing factors and so on.
differential vulnerability hypothesis vulnerable population groups are those who not only are particularly sensitive to risk factors but also possess multiple, cumulative risk factors.
disadvantaged lacking in the basic resources or conditions believed to be necessary for an equal position in society.
empowerment helping people acquire the skills and information necessary for informed decision making and ensuring that they have the authority to make decisions that affect them.
federal poverty guideline a federal poverty measure given by the Department of Health and Human Services (HHS). It helps agencies determine eligibility for certain programs. It is based upon how many people live in poverty as HHS defines poverty yearly.
food insecurity lack of access to sufficient food for an active and healthy lifestyle because of inadequate economic resources.
health disparities refers to the wide variations in health services and health status between certain population groups.
health literacy “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions” (Ratzan and Parker, 2000).
iterative assessment process obtaining only as much assessment data as necessary at one time; then obtaining additional data as needed.
language concordance the language used by the person providing health information is the same as that of the client hearing the information.
outreach locates populations-of-interest or populations-at-risk and provides information about the nature of the concern, what can be done about it, and how services can be obtained.
priority population groups those groups targeted by national governments for special emphasis on health care goals because they have particularly poor health status.
safety net providers increase access to health and social services for vulnerable populations with limited financial ability to pay for care (Institute of Medicine, 2000; Hansen-Turton, 2005).
social determinants of health factors such as economic status, education, environmental factors, nutrition, stress, and prejudice that lead to resource constraints, poor health, and health risk (Wilensky and Satcher, 2009).
social justice providing humane care and social supports for the most disadvantaged members of society.
vulnerable population group a subgroup of the population that is more likely to develop health problems as a result of exposure to risk or to have worse outcomes from these problems than the population as a whole.
waiver an agreement between a health care payer and entities such as an organization or a state that gives the entity permission to waive certain usual payer requirements.
wrap-around services social and economic services that are provided, directly or through referrals, in addition to comprehensive health services, so social and economic services that will help ensure effectiveness of health services are "wrapped around" health services
Health problems of migrant farmworkers linked to their work and housing environments, limited access to health services and education, and lack of economic opportunities.
Environmental risks for migrant farmworkers Exposure to both naturally occurring plant substances and applied chemicals such as pesticides places farmworkers at risk of immediate health problems (contact dermatitis, allergies, conjunctivitis) and long-term health effects (lung diseases and cancer)
Barriers to health promotion and disease prevention for migrant workers their beliefs regarding disease causality, their irregular and episodic contact with the health system, and their lower educational level
common folk illnesses that a nurse may encounter when working with clients from Mexico mal de ojo (evil eye), susto (fright), empacho (indigestion), and, for infants, caida de moller (fallen fontanel)
most common herbs used by the folk healers chamomile (manzanilla), peppermint (yerba buena), aloe vera, nopales (cactus), and epazote
factors that limit adequate provision of health care services to migrant farmworkers lack of knowledge abt services, inability to afford care, lack of availability, lack of transportation, inconvenient hrs, difficulty in tracking client, discrimination, lack of documentation, lack of English language skills, and cultural aspects
case mappings done when rises in gastroenteritis or parasite infestations are noted in migrant population housing for migrant workers—may be crowed (e.g., 50 men/house or 3 families/trailer), lack individual sanitation, bathing, or laundry facilities; provide poor cooking/refrigeration facilities; and lack window screens, fans, or heaters.
Factors that increase risk of potential pesticide exposure in some migrant workers hot-cold beliefs (may not shower immediately due to concerns of exposure to cooler water when hot from working); housing that lacks showers and/or adequate laundry machines (prevent from washing pesticides off themselves and their clothing in timely)
Hot-cold balance Mexican community cultural belief; Some migrant workers may not shower when they return from the fields as a result of cultural beliefs about being exposed to cooler water while feeling hot from working
Cuarentena Mexican community cultural belief about postpartum behaviors.
migrant farmworker an individual whose principal employment within the past 24 months is in agriculture on a seasonal basis and who establishes for the purpose of such employment a temporary abode.
Migrant Health Act United States legislation that funds more than 100 migrant health projects that have 364 actual clinic sites and serve more than 500,000 farmworkers and their families in 40 states and Puerto Rico.
migrant health centers provide comprehensive primary and preventive health care to migrant and seasonal farmworkers and their families. They offer services on a sliding fee scale to patients regardless of immigration status.
migrant lifestyle the process of a family or individual moving from a home-based site to obtain temporary work and live in temporary housing.
Common occupational health risks in migrant farmworkers lumbar strain from stooping to harvest produce to systemic poisonings from pesticide exposure.
pesticide exposure risk to farmworkers working in fields that have been treated with pesticides. Residue from pesticides enters farmworkers' homes and their food. Risks include mild psychological and behavioral deficits, and acute severe poisoning that can result in death
seasonal farmworker works cyclically in agriculture but does not migrate.
Factors influencing social and community violence changing social conditions, economic conditions, population density, community facilities, and institutions within a community, such as organized religion, education, the mass communication media, and work.
most effective primary prevention intervention to reduce the incidence of child abuse Provision of parenting and conflict-management classes for survivors of child abuse
five principles of providing care to families who are experiencing violence intolerance for violence, respect and care for all family members, safety as a first priority, absolute honesty, and empowerment
Community-level factors that influence violence and human abuse Density, poverty, diversity, and a lack of sense of cohesiveness
Response to abuse process moves from commitment to the relationship to leaving to start of a new life
Indicators of potential or actual elder abuse fear of a relative or caregiver; unexplained genital infections; unmet basic needs; withdrawal and passivity
categories of child neglect physical, emotional, educational, and medical
assault a violent physical or verbal attack.
elder abuse a form of violence against older adults. May include neglect and failure to provide adequate food, clothing, shelter, and physical and safety needs; can also include roughness in care and actual violent behavior toward the elderly.
emotional abuse extreme debasement of a person's feelings so that he or she feels inept, undesirable, and worthless.
emotional neglect the omission of the basic nurturing, acceptance, and caring essential for healthy personal development.
forensic pertaining to the law.
intimate partner violence physical or emotional mistreatment of one's partner.
passive neglect unintentional failure to provide basic physical, emotional, and safety needs of children or the lack of fulfilling caretaking responsibilities of the elderly.
physical abuse one or more episodes of extreme discipline or displaced aggression or frustration, often resulting in serious physical damage to the internal organs, bones, central nervous system, or sense organs.
physical neglect failure to provide adequate food, proper clothing, shelter, hygiene, or necessary medical care.
posttraumatic stress disorder reaction of people who have suffered from severe and/or long-term trauma. Can include hypervigilance and flashbacks of abusive experiences.
sexual abuse abuse ranging from fondling to rape; robs children of the feeling of being in control of themselves and emphasizes their vulnerability.
sexual assault nurse examiner (SANE) a registered nurse specially trained to provide care to sexual assault patients. The SANE conducts medical forensic examinations and can serve as an expert witness.
spouse abuse physical or emotional mistreatment of one's partner.
violence non-accidental acts, interpersonal or intrapersonal, that result in physical or psychological injury to one or more of the people involved.
Unintended consequence of deinstitutionalization of chronically ill individuals from publicly funded psychiatric hospitals increased the number of homeless persons as adequate community-based services were not funded as originally intended
Most vulnerable of the impoverished older adult population the homeless older adult as they have long lived in poverty, have fewer supportive relationships, and are likely to have become homeless as a result of catastrophic events
Effect of poverty on pregnant women Poor pregnant women are more likely than other women to receive late or no prenatal care and to deliver low-birth-weight babies, premature babies, or babies with birth defects
Classes of factors effecting societal responses to poverty and homelessness social, cultural, and environmental factors
risks of poverty for young children (0-5) increases the likelihood of chronic diseases, injuries, traumatic death, developmental delays, poor nutrition, inadequate immunization levels, iron-deficiency anemia, and elevated blood lead levels.
Effects of poverty on health care outcomes higher rates of chronic illness, higher rates of infant morbidity and mortality, shorter life expectance, and more complex health problems
Effects of homelessness on health care outcomes Higher incidence of acute and chronic disease; Higher risk of physical trauma; Crisis-oriented health care, usually in emergency departments; Lack of awareness of care options
Factors leading to the growing number of poor persons in the United States decreased earnings, unemployment, diminishing availability of low-cost housing, increased number of households headed by women, inadequate education, lack of marketable job skills, welfare reform, and reduced Social Security payments to children
Factors contributing to homelessness increase in number of persons living in poverty, diminishing availability of low-cost housing, increased unemployment, substance abuse, lack of treatment facilities for mentally ill, domestic violence, & family situations causing children to run away
complex health problems of homeless persons inability to get adequate rest, exercise, and nutrition; exposure; infectious diseases; acute and chronic illnesses; infestations; trauma; and mental health problems
Living wage vs. minimum wage when a person makes minimum wage yet does not make enough to live.
consumer price index the basic indicator of inflation—a measurement of inflation by comparison of prices overall and of categories of consumed goods and services purchased by urban wage earners and their families over a certain period of time.
crisis poverty a situation of hardship and struggle; may be transient or episodic. Can result from lack of employment, lack of education, domestic violence, or similar issues. These issues lead to persistent poverty.
cultural attitudes the beliefs and perspectives that a society values.
deinstitutionalization effort to move long-term psychiatric patients out of the hospital and back into their own community.
Elizabethan poor laws laws during the reign of Queen Elizabeth I of England that address poverty and assistance measures.
emergency housing shelters for persons who are already homeless. Especially important for prevention of health problems for persons who are recently homeless.
Federal Income Poverty Guidelines or Poverty Threshold Guidelines Drafted by the Social Security Administration in 1964; defines poverty in terms of income, family size, the age of the head of household, and the number of children under 18 years of age. Change annually to be consistent with the consumer price index.
Interagency Council on the Homeless a council composed of the heads of 16 federal agencies that have programs or activities for the homeless; created by the Stewart B. McKinney Act to coordinate and direct federal homeless activities.
media discourses communication of thoughts and attitudes through literature, film, art, television, and newspapers.
near poor people who earn slightly more than the government-defined poverty level, are unable to meet living expenses, and are not eligible for government assistance programs.
neighborhood poverty refers to spatially defined areas of high poverty, characterized by dilapidated housing and high levels of unemployment.
persistent poverty refers to individuals and families who remain poor for long periods of time.
poverty refers to having insufficient financial resources to meet basic living expenses , people who are more likely to live in dangerous environments and people who work in high risk jobs, and eat less nutritious foods
Stewart B. McKinney Homeless Assistance Act of 1987 PL 100-77 passed in 1987 officially involved the federal government in meeting the needs of homeless persons. It was intended to respond to the range of emergency needs facing homeless Americans, such as food, shelter, and health care.
supportive housing subsidized housing for vulnerable population groups.
Temporary Assistance to Needy Families (formerly called Aid to Families with Dependent Children) federal & state program to provide financial assistance to needy children deprived of parental support d/t death, disability, absence, or, in some states, unemployment. Mandates that women heads-of-household find employment to retain benefits.
Women, Infants, and Children special supplemental food program administered by the Department of Agriculture through the state health departments. Provides nutritious foods that add to the diets of pregnant and nursing women, infants, and children less than 5 years of age.
Risks for teen pregnancies more likely to deliver prematurely and have a low-birth-weight baby.
Factors that can influence whether a young woman becomes pregnant a history of sexual victimization, family dysfunction, substance use, and failure to use birth control. Several factors may overlap
Significant marker for a normal-weight baby weight gain during pregnancy; it is recommended that women gain between 25 and 35 pounds during pregnancy. If less weight is gained, the risk of a low–birth-weight baby is greater.
Interventions for adolescent fathers information about pregnancy and delivery, declaration of paternity, care of infants and children, and psychosocial support in this role
Services available to adolescent parents financial assistance for medical care, nutritional programs, and school-based support groups
Emotional, social, and cognitive development in children born to adolescents at risk for academic and behavioral problems as they become older. Teens who receive education on normal development and childcare are more likely to avert these problems with their children.
Schooling during teen pregnancy Expected to attend school. Homebound instruction is reserved for those with medical complications. Teen mothers who return to school and complete their education after the birth of their child are less likely to have a repeat pregnancy.
Barriers to teen parents returning to school after birth Problems finding childcare and the need to have an income can create an obstacle to school return.
Pregnant adolescents who decide to have a child are at increased risk for poverty, school failure, and limited life options
Factors that pose the greatest nutritional challenge for pregnant adolescents lifestyle, growth, and development
Healthy People 2020 goals for adolescent pregnancies reduce pregnancies, decrease number engaging in sexual intercourse < 15 yrs, increase number who have never had sexual intercourse, increase use of contraceptive methods, and increase number receiving formal instruction on reproductive issues < 18 years
Risk factors for becoming pregnant adolescent immaturity, low levels of contraceptive use, early age of initiation of sexual activity, sexual victimization, and peer pressure
Factors associated with decreased sexual risk behaviors in teens raised in two-parent family; parental higher education, family communication, and good family health practices
Self-care activities that will be important for teen at school need to use the bathroom frequently, the need to carry and drink more fluids or snacks to relieve nausea, the need to avoid climbing stairs and carrying heavy bookbags, and problems fitting comfortably behind stationary desks
US vs. other developed countries r/t adolescent pregnancies US leads the developed world in rates of teenage pregnancy, teen births, and teen abortions, caused by the limited use of contraception and a general ambivalence about providing comprehensive sexuality education at home and at school
coercive sex sexual relations that occur with force, intimidation, or authority.
repeat pregnancy a closely spaced second pregnancy. For teen mothers, it often leads to poorer education and economic outcomes.
statutory rape sexual intercourse with a female who is below the age of consent. Varies by state.
Leading cause of disability in the US Mental disorders
leading cause of productivity loss because of disability in the United States depression
Two major movements that influenced advances in the treatment of mental illness consumer advocacy and better understanding of the neurobiology of mental illness
Consumer advocacy movements for people with mental illness came about to fulfill unmet needs and to attempt to decrease the stigma associated with mental illness; includes the National Alliance for the Mentally Ill (NAMI)
First consumer group to advocate for better services for mental illness the National Alliance for the Mentally Ill (NAMI)
Community Support Program (CSP) by the National Institute of Mental Health (NIMH) provided grant monies to states to develop comprehensive services for persons discharged from psychiatric institutions and invited consumers to participate
Humanitarian Reform movement revolution in mental health care that led to hospital expansion, medical treatment, and the community mental health movements
Mental Hygiene movement attention shifted to ideas about prevention, early intervention, and the influence of social and environmental factors on mental illness
1946 National Mental Health Act Education and research for mental health treatment approaches began (NIMH).
1955Mental Health Study Act Resulted in Joint Commission on Mental Illness and Health, which recommended transformation of state hospital systems and establishment of community mental health clinics.
1963 Community Mental Health Centers Act Marked beginning of community mental health centers’ concept and led to deinstitutionalization of large psychiatric hospitals.
1975 Developmental Disabilities Act Addressed the rights and treatment of people with developmental disabilities and provided foundation for similar action for individuals with mental disorders.
1977 President’s Commission on Mental Health Reinforced importance of community-based services, protection of human rights, and national health insurance for mentally ill persons.
1978 Omnibus Reconciliation Act Rescinded much of the 1977 commission’s provisions and shifted funds for all health programs from federal to state resources.
1986 Protection and Advocacy for Mentally Ill Individuals Act Legislated advocacy programs for mentally ill persons.
1996 Mental Health Parity Act Attempted to address discrepancy between mental health and medical–surgical benefits in employer-sponsored health plans.
2008 Mental Health and Addiction Equity Act Prohibits discrepancy in coverage between mental health and physical health benefits in employer-sponsored and private insurance plans and added substance abuse as a covered mental health condition.
2010 Patient Protection and Affordable Health Care Act Prohibits discrimination in coverage for preexisting conditions. Prohibits discontinuation of coverage because of illness.
Populations at risk for mental health problems Low-income and minority groups are often at increased risk because they lack access to services and because programs may lack cultural sensitivity.
Health People 2020 goal r/t mental health Improve mental health and ensure access to appropriate, quality mental health services, includes reducing suicide rate and proportion of persons with major depressive disorder and increasing persons who receive treatment
diathesis-stress model integrates the effects of biology and environment, or nature and nurture, on the development of mental illness (when an individual predisposed to a disorder is challenged by an environmental stressor, the mental disorder may result)
populations at greatest risk for suicide persons between the ages of 15 and 25 years, prior suicide attempt, stressful life events, access to lethal methods, and men between the ages of 65 and 74 years
role of the nurse in community mental health serving as clinician (helping to maintain/regain coping abilitities), educator (teaching symptom self-management and medication management), and coordinator (case finding, referral, and follow up).
Healthy People 2020 objectives that specifically address adolescents and mental health (1) reducing the rate of suicide attempts by adolescents, (2) reducing the relapse rates for persons with eating disorders, and (3) ensuring that children in the juvenile justice system receive access to mental health assessment and treatment.
Healthy People 2020 targeted national health objectives for mental health and mental disorders increase the proportion of persons with mental disorders and/or co-occurring substance abuse that receive treatment for each or both disorders, reduce the suicide rate, and reduce the proportion of persons who experience major depressive episodes
Healthy People 2020 Objectives that address tertiary prevention and are target to persons with serious mental illness to reduce the proportion of homeless adults who have serious mental illness, to increase their employment, and to decrease the number of adults with mental disorders who are incarcerated.
Cultural groups with the lowest rates of utilization of mental health services African Americans, Asian Americans, Pacific Islander Americans (lowest of all), and Native Americans
community-oriented nursing strategies that can be used to improve the care of clients with persistent mental illness agency networking, interagency collaboration, and building of relationships
Five basic services mandated for community mental health centers inpatient services, outpatient services, partial hospitalization, 24-hour emergency services, and consultation and education services for community agencies and professionals. Also encouraged diagnostic and rehabilitative precare and aftercare services
Percentage of persons with a mental disorder that obtain help for their illness in any part of the health care system 25%
Environmental factors that place children at risk for mental health issues crowded living conditions, violence, separation from parents, and lack of consistent caregivers.
Americans with Disabilities Act (ADA) passed in 1990; provides protection against discrimination to Americans with disabilities; requires government and businesses to provide equal opportunities for jobs, education, access to transportation and public buildings and other accommodations
assertive community treatment individualized services provided by a multidisciplinary team that follows the client's progress during reintegration into the community.
community mental health centers comprehensive centers that implement community mental health model of care.
community mental health model the primary system of care for people with serious and persistent mental illness. Components and implementation vary from state to state but services are generally received through comprehensive community mental health centers.
Community Support Program a program funded by the Institute of Mental Health to provide grant monies to states for the development of comprehensive services for persons discharged from psychiatric institutions.
consumer advocacy a group dedicated to the protection of the rights of consumers, particularly those of people with mental illness.
deinstitutionalization effort to move long-term psychiatric patients out of the hospital and back into their own community.
institutionalization placement of psychiatric patients into large, long-term care, state-operated psychiatric hospitals.
intensive case management models approaches that enhance the frequency of contact between consumer and clinician to help prevent relapse.
managed care refers to integrating payment for services with delivery of services and emphasizing cost-effective service delivery along a continuum of care.
mental health problems difficulties related to a person's ability to manage daily life events without experiencing undue social isolation, emotional distress, or behavioral incapacity.
National Alliance for the Mentally Ill an organization that advocates for better services for people with mental illness.
National Institute of Mental Health the federal agency charged with developing and supporting education and research programs for mental health.
reinstitutionalization shifting people from one institution to another by placing persons with mental illness in nursing homes, assisted living facilities, and jails. This action prompted additional legislation and advocacy efforts.
relapse management activities of a case manager designed to foster coping and competency and manage symptoms to prevent a relapse of illness.
systems theory a useful framework for the community mental health practice because it emphasizes the relationship of the elements of a unit to the whole.
wellness recovery action plans teach patients recovery and self-management skills and strategies and promote higher levels of wellness, stability, and quality of life.
Leading cause of death among children and young adults infectious diseases, such as respiratory infections, diarrheal diseases, and malaria/measles (among children); TB/HIV (among adults)
Most common infectious diseases in 15-24 year-olds HIV and HPV
Primary prevention of infectious diseases federally supplied vaccines, “no shot” no school immunization laws, nurses delivering immunizations in community settings, checking immunization records, monitor records
Secondary prevention of infectious diseases prevent the spread of infection and/or disease when it occurs; rapid identification of contacts (new cases treated or possibly exposed, but not diseased and treated with prophylaxis)
Tertiary prevention of infectious diseases works to reduce complications and disabilities through treatment and rehabilitation
A "notifiable" disease one for which regular, frequent, and timely information regarding individual cases is considered necessary for the prevention and control of the disease. Includes Hepatitis A (acute)
Smallpox vs. chickenpox fever: smallpox 2-4 days bef rash vs. chickenpox at onset of rash; rash: smallpox centrifugal with same-stage lesions most abundant on face vs. chickpox centripetal with various stage lesions most abundant on trunk or areas covered by clothing
WHO’s Five Keys to Safer Food keep clean, separate raw and cooked, cook thoroughly, keep food at safe temperatures, and use safe water and raw materials
Secondary prevention interventions related to infectious disease prevent the spread of disease (e.g., quarantine).
Rise of hospital acquired infections cause invasive procedures, broad-spectrum antibiotics, and immunosuppressive drug treatment, along with original underlying illness, leave hospitalized clients particularly vulnerable to infection
Factors that cause emerging infections microbial adaptation, host behavior (day-care centers, illegal drugs, changing sexual behavior, transportation, air conditioning, immigration, global travel), and environmental changes (weather, deforestation, urbanization, and industrialization)
Effective intervention measures for prevention and control of infectious diseases An integrated approach aimed at breaking the chain linking the agent, host, and environment simultaneously is an ideal goal to strive for but may not be feasible for all diseases.
Most cost-effective public health strategy for communicable diseases avoiding infection through primary prevention activities
Proved the feasibility of eradication of selected communicable diseases the successful global eradication of smallpox
WHO resolutions for eradications in 1987 WHO adopted resolutions for eradication of paralytic poliomyelitis and dracunculiasis (guinea worm infection) from the world by the year 2000
Challenges to eradication political instability and sporadic violence, cultural beliefs about immunization, religious fears, and distrust of immunization
Factors that contribute to emerging or reemerging infectious diseases population moves into uninhabited areas, changes in environment, societal events, health care (transplants, immunosuppressants, antibiotics), human behavior, lacking public health programs, microbial adaptation
emerging infectious diseases diseases in which the incidence has increased in the past 2 decades or has the potential to increase in the near future (e.g., SARS and the influenza A virus (H1N1) pandemic)
endemic a disease/event that is found to be present (occurring) in a population in which there is a persistent (usual) presence with low to moderate disease/event cases.
epidemic occurrence of a disease within an area that is clearly in excess of expected levels (endemic) for a given time period.
epidemiologic triangle interaction among the host, agent, and environment.
eradication the irreversible termination of all transmission of infection by extermination of the infectious agents worldwide.
pandemic refers to the epidemic spread of the problem over several countries or continents (such as the SARS outbreak).
surveillance describes and monitors health events through ongoing and systematic collection, analysis, and interpretation of health data for the purpose of planning, implementing, and evaluating public health interventions (adapted from MMWR, 1988).
Most common bloodborne infection in the US hepatitis C virus (HCV)
most serious communicable diseases in the US STDs. Not only is there an increased incidence of drug-resistant gonococcal infection, but other STDs, such as HPV (genital warts), HIV, and HSV (genital herpes), are associated with cancer.
Risk factors for STDs being less than 25 years of age, being a member of a minority group, living in an urban setting, being poor, and using crack cocaine.
Populations at greatest risk for contracting HIV, STDs, hepatitis, or TB Needle drug users, Multiple sexual partners, Immunocomprimised, Contaminated food/water
most serious complications caused by STDs death, pelvic inflammatory disease, infertility, ectopic pregnancy, neonatal morbidity and mortality, and neoplasia.
Treatment of communicable diseases effective medications, stress reduction, and proper nutrition.
Populations most at risk of reactivation of latent infections of tuberculosis (TB) immunocompromised persons, substance abusers, underweight and undernourished individuals, and those with diabetes, silicosis, or gastrectomy
reason HIV infection may go undetected during primary infection stage Results of an antibody test during this phase are usually negative
most frequently reported vaccine-preventable disease Hepatitis A (HAV)
Common ways of transmitting Hepatitis A most often transmitted through the fecal-oral route; outbreaks are common in daycare centers where staff must change diapers, among household and sexual contacts of infected individuals, and among travelers to countries were hepatitis A is endemic
Safer sexual behavior masturbation, dry kissing, touching, fantasy, and vaginal or oral sex with a condom.
HIV history began in sub-Saharan Africa > Emerged in rest of the world as result of multiple factors: new roads, increased commerce, prostitution, changing sexual behavior and use of illegal drugs
directly observed therapy (DOT) a system of providing medications for clients with tuberculosis infection in which the client is monitored to maximize adherence to the medication regimen and treatment.
highly active antiretroviral therapy (HAART) taking a combination of three or more antiretroviral drugs.
HIV antibody test a laboratory procedure that detects antibody to HIV. Enzyme-linked immunosorbent assay (ELISA) is the test commonly used in screening blood for the antibody to HIV; the Western blot is used as the confirmatory test.
partner notification identifying and locating contacts of persons who have been diagnosed with a transmissible disease in order to notify them of exposure and encourage them to seek medical treatment.
prevalence the number or percentage of persons in a given population with a disease or condition at a given point in time. Also the proportion of existing cases of a health outcome in a population at a particular time.
Disaster trends The number of reported natural and human-made disasters continues to rise worldwide. Although the number of lives lost declined over the past 20 years, the number of people affected increased. In one decade, the number affected tripled to 2 billion
Healthy People 2020 objectives r/t disasters Because disaster affects the health of people in many ways, disaster incidents have an effect on almost every Healthy People 2020 objective (e.g., environmental health, food safety, immunization and infectious disease, and mental health)
public health nursing role in the disaster management cycle helping clients maintain a safe environment and advocating for environmental safety measures; risk communication and client education; community assessment to include rapid needs assessment; public health triage; and surveillance and field epidemiology.
Disaster triage at the individual level process of separating casualties and allocating treatment on the basis of the individuals’ potentials for survival. Highest priority is always given to those who have life-threatening injuries but who have a high probability of survival once stabilized
Disaster public health triage population-based approach for use in an incident undefined by a geographical location; involves the sorting or identification of populations for priority interventions (e.g., in epidemics, the focus becomes the prevention of secondary infection
Factors affecting the reaction of the community in a disaster the type, cause, and location of the disaster; its magnitude and extent of damage; its duration; and the amount of warning that was provided.
Factors affecting the reaction of individuals to a disaster age, cultural background, health status, social support structure, and general adaptability to crisis.
four stages of stress during disaster honeymoon, heroic, disillusionment, and reconstruction.
Heroic phase of stress during a disaster overwhelming need for people to do whatever they can to help others survive the disaster.
Honeymoon phase of stress during a disaster survivors may be rejoicing in that their lives and the lives of loved ones have been spared.
Disillusionment phase of stress during a disaster occurs after time elapses and people begin to notice that additional help and reinforcement may not be immediately forthcoming. A sense of despair results and exhaustion starts to takes its toll on volunteers, rescuers, and medical personnel.
Reconstruction phase of stress during a disaster last and longest phase. Homes, schools, churches, and other community elements need to be rebuilt and reestablished. The goal is to return to a new state of normalcy.
Surveillance reports indicate the continuing status of the affected population and the effectiveness of ongoing relief efforts.
first priority when responding to a disaster to immediately plan for, coordinate, and carry out effective triage.
The emergency support functions of the National Response Framework (NRF) and the National Incident Management System (NIMS) provide Written approach, protocol, and common language for responders from federal agencies and other voluntary organizations
four stages of disaster-related work prevention (planning/drill participation), preparedness (course work/registration), response (clinical expertise), and recovery (monitoring).
American Red Cross a national organization that seeks to reduce human suffering through various health, safety, and disaster relief programs in affiliation with the International Committee of the Red Cross.
BioSense a data sharing program to facilitate surveillance of unusual patterns or clusters of diseases in the United States. It shares data with local and state health departments and is a part of the BioWatch system.
BioWatch an early warning system for biothreats that uses an environmental sensor system to test the air for biological agents in several major metropolitan areas.
CBRNE threats chemical, biological, radiological, nuclear, and explosive threats to public safety.
Cities Readiness Initiative a program to aid cities in increasing their capacity to deliver medicines and medical supplies during a large-scale public health emergency, such as a bioterrorism attack or a nuclear accident.
Community Emergency Response Team (CERT) program sponsored by the FEMA to train community citizens in the basics of disaster preparedness and response. Members can assist their neighbors and co-workers following an event when professional responders are not immediately available to help.
community resilience builds on the premise that healthy individuals, families, and communities with access to health care and knowledge become some of our nation's strongest assets in disaster incidents.
Disaster Medical Assistance Team (DMAT) a team consisting of approximately 30 volunteers including physicians, nurses, and other allied health personnel who train as a group to perform specific emergency functions during a disaster.
Emergency Support Functions (ESFs) fifteen support functions that provide a mechanism to bundle federal resources/capabilities to support the nation (e.g., transportation, communications, and energy). A coordinator and primary and support agencies work together to coordinate and deliver
general population shelters accommodate a variety of functional needs for individuals such as assistance with activities of daily living.
Homeland Security Act of 2002 the U.S. Department of Homeland Security was created through the Homeland Security Act of 2002, consolidating 20 previously disparate agencies under one unified organization.
Homeland Security Exercise and Evaluation Program (HSEEP) developed to help states and local jurisdictions improve overall preparedness with all natural and human-made disasters. The program helps homeland security leaders create exercise programs for their community.
Homeland Security Presidential Directive 5 (HSPD-5) directed the Secretary of Homeland Security to develop and administer the National Incident Management System (NIMS), a unified, all-discipline, and all-hazards approach to domestic incident management.
Homeland Security Presidential Directive 8 (HSPD-8) established national policies to strengthen the preparedness of the US to prevent, protect against, respond to, and recover from threatened or actual terrorist attacks and major disasters, and it included a goal for national preparedness.
Homeland Security Presidential Directive 21 (HSPD-21), Public Health and Medical Preparedness established a national strategy that enables a level of public health and medical preparedness sufficient to address a range of possible disasters.
four critical components of public health and medical preparedness (1) biosurveillance, (2) countermeasure distribution, (3) mass casualty care, and (4) community resilience.
human-made disaster acts of individuals that cause devastation and destruction, such as war, terrorist bombings, or riots.
human-made incident accidents/disasters caused by individuals that can cause devastation and destruction.
Medical Reserve Corp (MRC) provides opportunities for nurses to support emergency preparedness and response in their local jurisdictions.
mutual aid agreement a signed document by at least two organizations that outlines the ways in which collaboration and coordination will occur between them at the time of a disaster.
National Disaster Medical System (NDMS) provides nurses the opportunity to work on specialized teams, such as the National Nurse Response Team (NNRT) and the Disaster Medical Assistance Team (DMAT).
National Health Security Strategy (NHSS) focuses specifically on the national goals for protecting people's health in the case of disaster in any setting.
National Incident Management System (NIMS) provides all responders with protocol and common language for how they can work together. Responders practice and evaluate skills and ability to work with one another through disaster drills and exercises.
National Preparedness Guidelines (NPG) established national guidelines to strengthen the preparedness of the United States to protect against, respond to, and recover from threatened or actual terrorist attacks and major disasters.
National Response Framework (NRF) guide for conducting nationwide all-hazards response “built upon scalable, flexible, and adaptable coordinating structures to align key roles and responsibilities across the Nation…”
Pandemic and All-Hazards Preparedness Act (PAHPA) enacted in 2006 to improve the nation's ability to detect, prepare for, and respond to a variety of public health emergencies.
Points of Dispensing (POD) provides medical services and supplies to the entire population within 48 hours of a disaster.
Project BioShield a program to develop and produce new drugs and vaccines as countermeasures against potential bioweapons and deadly pathogens.
Public Health Nursing Intervention Wheel a population-based practice model that encompasses 3 levels of practice (community, systems, and individual/family) and 17 public health interventions. Each contributes to improving population health, providing a practice foundation.
Public Health Security and Bioterrorism Preparedness and Response Act of 2002 addressed the need to enhance public health and health care readiness and community health care infrastructures.
public health surge overwhelming need for medical assistance during an emergency.
public health triage involves the sorting or identification of populations for priority interventions. In epidemics, for example, the public health triage focus becomes the prevention of secondary infection.
rapid needs assessment magnitude of the incident, specific health needs of the affected population, priorities and objectives for action, existing and potential public health problems, capacity of the local response, and external resource needs for priority actions.
special needs shelters designed for those individuals who have pre-existing conditions resulting in medical impairments and who have been able to maintain activities of daily living in a home environment prior to the disaster or emergency situation.
Strategic National Stockpile (SNS) a CDC-managed program that provides the national repository of antibiotics, chemical antidotes, antitoxins, other pharmaceuticals, and medical supplies and equipment to be used in the event of a terrorist attack or major natural disaster.
vicarious traumatization for nurses during a disaster/incident, this occurs in response to listening to survivors' stories of the traumatic event. Therefore, mental health workers need to assist nurses as well as the public.
constructs of global health diplomacy addressing and finding solutions to physical, environmental, fiscal, economic, political, safety, educational, and trade issues.
The major organizations involved in world health (1) multilateral, (2) bilateral and non-governmental or private voluntary, and (3) philanthropic.
Critical global health problems communicable diseases such as tuberculosis, measles, mumps, rubella, and polio; maternal and child health; diarrheal diseases; nutritional deficits; malaria; and AIDS
The colonias (colonies) settlements of workers along borders in California, Arizona, New Mexico, and Texas. Environmental conditions result in increased infectious diseases, health hazards, and injuries associated with poverty, poor sanitation, and overcrowded conditions.
The North American Free Trade Agreement passed in 1994, allowed increased importation of goods and eased the movement of people throughout the United States, Canada, and Mexico.
The Lalonde Report stated that the best approach would be to spend money on population-focused interventions to promote healthy lifestyle changes or improve social and physical environments, rather than pouring more money into the existing health care system.
Health problems of less-developed nations more exotic-sounding health problems like Buruli ulcer, leishmaniasis, schistosomiasis, pediculosis, typhus, yellow fever, and malaria as well as the ongoing problems of measles, mumps, rubella, and polio
Current health concerns for developed nations problems like hepatitis, the appearance of new viral strains such as hantavirus, and large social yet health-related issues such as terrorism, warfare, violence, and substance abuse.
the U.S. Agency for International Development (USAID) the largest bilateral organization (a single government agency that provides aid to lesser-developed countries) which operates totally outside of the United States
major components identified for implementation of primary health care organized education; sanitation; involvement of community health workers; maternal & child health programs; preventive programs; accessible & affordable; chemotherapeutic agents; nutrition programs; and promotion and acceptance of traditional medicine
bilateral organization a single government agency that provides aid to lesser-developed countries; the U.S. Agency for International Development (USAID) is an example.
determinants factors that influence the risk for or distribution of health outcomes.
developed country a country with a stable economy and a wide range of industrial and technological development—for example, the United States, Canada, Japan, the United Kingdom, Sweden, France, and Australia.
disability-adjusted life-years the disability-adjusted life-year (DALY) is an indicator of the time lived with a disability and the time lost because of premature mortality.
environmental sanitation a concept that entails maintaining an equilibrium between people and their interactions with their surrounding environment.
genocide acts committed with intent to destroy, in whole or in part, a national, ethnic, racial or religious group
global burden of disease the global burden of disease (GBD) is a way to describe the world's health. The GBD combines losses from premature death and losses that result from disability. The GBD represents units of disability-adjusted life-years (DALYs).
health commodification the intense marketing of health and pharmaceutical products, especially in lesser developed countries; the buying and selling of health and health care products.
Health for All by the Year 2000 (HFA2000) HFA2000 are goals set by the World Health Organization in order to attain, by all citizens of the world by the year 2000, a level of health that will permit them to lead a socially and economically productive life.
Health for All in the 21st Century (HFA21) HFA21 are goals set by the World Health Organization to attain, by all citizens of the world by the year 2010, a level of health that will permit them to lead a socially and economically productive life.
lesser-developed country a country that is not yet stable with respect to its economy and technological development. Examples include Bangladesh, Zaire, Haiti, Guatemala, most of the countries in sub-Saharan Africa, and the island nation of Indonesia.
Millennium Development Goals goals developed and agreed upon by world leaders at the Millennium Summit in 2000. The MDGs were developed to relieve poor health conditions around the world and to establish positive steps to improve living conditions.
multilateral organizations organizations that receive funding from multiple governmental and nongovernmental sources. Examples include the United Nations (UN), the World Health Organization (WHO), the Pan American Health Organization (PAHO), and the World Bank.
nongovernmental organization (NGO) or private voluntary organization (PVO) Examples of NGO include OXFAM, Project Hope, and the International Red Cross. May include various professional and trade organizations, Catholic Relief Services (CRS), church-sponsored health care missionaries, and many private groups.
Pan American Health Organization (PAHO) an international public health agency with 100 years of experience in working to improve health and living standards of the countries of the Americas. PAHO serves as the specialized organization for health of the Inter-American System.
philanthropic organizations these organizations receive funding from private endowment funds. Examples include W. K. Kellogg Foundation, Milbank Memorial Fund, Pathfinder Fund, Hewlett Foundation, Ford Foundation, Rockefeller Foundation, Carnegie Foundation, and Gates Foundation.
primary health care provision of integrated, accessible health care services by health care professionals; aim is to address the majority of personal health care needs, develop a sustained partnership with patients, and practice in the context of family and community.
religious organizations organizations that reflect several religious denominations and interests. They support many health care programs around the world. Examples include church-run hospitals in rural and urban areas, refugee centers, orphanages, and leprosy treatment centers.
United Nations Children's Fund (UNICEF) an organization formed shortly after World War II (WWII) to assist children in the war-ravaged countries of Europe, UNICEF is a subsidiary agency to the U.N. Economic and Social Council.
World Bank an international organization fighting poverty in more than 100 developing countries by providing loans and advice.
World Health Organization (WHO) the United Nations' specialized agency for health. WHO's objective is the attainment by all people of the highest possible level of health. Health is a state of complete physical, mental, and social well-being and not merely the absence of disease.
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