Walden NURS6700 All Weeks Discussions Latest 2019 November
NURS6700/NURS8310 Epidemiology & Population Health
Week 1 Discussion
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Epidemiology and Population Health
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.
NURS6700/NURS8310 Epidemiology & Population Health
Week 2 Discussion
Descriptive Epidemiology
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.
NURS6700/NURS8310 Epidemiology & Population Health
Week 3 Discussion
Observational Study Designs
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.
NURS6700/NURS8310 Epidemiology & Population Health
Week 4 Discussion
DQ1 Epidemiology in the News: Randomized Trials
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.
Click on the Reply button below to reveal the textbox for entering your message. Then click on the Submit button to post your message.
DQ2 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.
By Day 5
Post a cohesive scholarly response that addresses the following:
Briefly summarize the population health problem you selected for Major Assessment 7, and state the study question you want to answer.
Explain which epidemiologic study design is most appropriate for your study, as well as the assumptions and tenets that support its application.
Analyze the strengths and the limitations of the potential data sources you might use for your study.
Read a selection of your colleagues’ responses.
By Day 7
Respond to at least one of your colleagues providing feedback on the appropriateness of the study question for the health problem, the selected epidemiologic study design, and whether another design might also fit the population and population health problem. In addition, provide any further insights on the strengths and limitations of the selected data sources, and suggestions of other data sources that might be appropriate.
Click on the Reply button below to reveal the textbox for entering your message. Then click on the Submit button to post your message.
NURS6700/NURS8310 Epidemiology & Population Health
Week 5 Discussion
Environmental and Genetic Factors That Influence Health
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.
Click on the Reply button below to reveal the textbox for entering your message. Then click on the Submit button to post your message.
NURS6700/NURS8310 Epidemiology & Population Health
Week 6 Discussion
DQ1 Psychosocial Factors in Health
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.
Click on the Reply button below to reveal the textbox for entering your message. Then click on the Submit button to post your message.
DQ2 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.
Click on the Reply button below to reveal the textbox for entering your message. Then click on the Submit button to post your message.
NURS6700/NURS8310 Epidemiology & Population Health
Week 7 Discussion
Measures of Effect
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.
Click on the Reply button below to reveal the textbox for entering your message. Then click on the Submit button to post your message.
NURS6700/NURS8310 Epidemiology & Population Health
Week 8 Discussion
Screening for Disease
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 the New 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 se
