Exam 2 Community
WHO Health Care Ranking 2016 (#1, Last and US)
#1 France Last New Zeeland USA #37
Ethical and Legal Implications With Genetic Testing
*Many clients fear that their genetic tests/family history will affect their health insurance status or eligibility despite current laws to protect them. Genetic Information Nondiscrimination Act (GINA) (Nov. 2009) Designed to prohibit the improper use of genetic information in health insurance and employment
GINA (2009)
1. prohibits employers from discriminating against an employee based on genetic information 2. places broad restrictions on an employer's deliberate acquisition of genetic information 3. mandates confidentiality for genetic information that employers lawfully collect 4. strictly limits disclosure of such information 5. prohibits retaliation against employees who complain about genetic discrimination
Brief History of The human Genome
1988 to 2003: Human Genome Project (HGP) All humans are 99.9% identical at the DNA level Nearly 25,000 genes make up the human genome
Indications for genetic and DNA Testing
> Predicting development of genetic disorders > Screening populations (secondary prevention) > Confirming clinical diagnosis > Prenatal testing > Development of individualized medical treatment Genetic correlation for drugs and tests to prevent overdoses
What are the pro's of the EPA?
>Air regulation -- Before the EPA, there was extremely high air pollution from things like smokestacks and tailpipes. The dense, dark, and sometimes even choking smog made the air clouded and dirty. People occasionally died from the toxins in the air. However, the Clean Air Act of 1970 allowed the EPA to regulate harmful air pollutants. Now there are significantly lower levels of mercury, benzene, arsenic, and sulfur dioxide emissions in the air >Water regulation -- The Clean Water Act of 1972 provided the U.S. with guidelines for how water should be purified. Before this act, sewage went straight into the waterways. Sometimes used bits of toilet paper were found in the water people were swimming in. >Pesticides -- The Federal Environmental Pesticide Control Act allowed the EPA to regulate pesticides and make a beneficial impact on the health and environment of our communities. This way, humans and animals are not exposed to toxic chemicals in their day to day lives. >Hazardous waste -- Hazardous waste used to be disposed of with normal trash. This waste would seep into the soil and sometimes made its way into the nearby streams to contaminate whatever came into its path. The Resource Conservation and Recovery Act allows the EPA to regulate proper disposal of these materials. >Climate -- The Clean Power Plan sets a national limit on the carbon pollution from power plants in the U.S. This has led to a significant decrease in carbon emissions, which affects the climate.
What is the purpose of the EPA?
>All Americans are protected from significant risks to human health and the environment where they live, learn and work >Efforts to reduce environmental risk are based on the best, current, and available scientific information >Federal laws protect human health and the environment and are enforced fairly and effectively >Environmental protection is an fundamental consideration in U.S. policies concerning natural resources, human health, economic growth, energy, transportation, agriculture, industry, and international trade, and these factors are similarly considered in establishing environmental policy >Everyone in this society has access to accurate information to effectively participate in managing human health and environmental risks >Environmental protection contributes to making our communities and ecosystems diverse, sustainable and economically productive >U.S. plays a leadership role in working with other nations to protect the global environment
Parish nursing tertiary Prevention
>Collaborate closely with the ministerial team about sessions that deal with healthy nutrition, exercise with injury prevention guidelines, health concerns related to being overweight, and advantages of maintaining a healthy weight, and support, stress management, and improved quality-of-life sessions. >Follow up and monitor health care provider's plan of care for older adults challenged with chronic disease such as hypertension, diabetes, and depression; provide education, support, and spiritual care >Facilitate a faith-based activities program for aging in place >Discuss in older adult gatherings the need for loving, caring friends, and the support need for mental health and overall well-being
What are the con's of the EPA?
>Complying with the EPA's air pollution rules can be very expensive for companies to follow. It is considered the biggest burden the agency poses on the economy. >Companies complain that the EPA limits their economic growth and hurts international competitiveness >The EPA causes widespread layoffs and plant closures >It can sometimes even force businesses to flee to more "accommodating" countries.
Criteria for school nurses
>Develop school health policies and procedure >Evaluate own nursing practice >Keep up with nursing practice >Interact with the trans-disciplinary healthcare team >Ensure confidentiality when providing health care >Consult with others to provide complete care >Apply research findings in practice >Ensure the safety of children, including when care is delegated to other school personnel >Have good communication skills >Manage a school health program effectively >Teach others about wellness
School Nurse Roles
>Direct Caregiver: Expected to give immediate nursing care to the ill or injured child or school staff member. >Health Educator: Teach children both individually and in the classroom. >Case Manager: Helping to coordinate the health care for children with complex health problems. >Consultant: The best person to provide health information to school administrators, teachers, and parent-teacher groups - Provide information about posed changes in the school environment and their impact on the health of the children. >Counselor: The school nurse may be the person whom children trust to tell important secrets about their health. The school nurse must have a reputation as being a trustworthy person to whom the children can go if they are in trouble or if they need to confide about a personal matter. >Community outreach: Nurses can be involved in community health fair or festivals in the schools, using that opportunity to teach others. >Research: The school nurse is responsible for making sure that the school nursing care given is based on solid, evidence-based practice
Forensic Nursing Working Environments
>Emergency departments >Community based urgent care clinics >Medical examiner or coroner's office >Law enforcement investigative units >Criminal justice agencies >Governmental safety prevention programs >Serves as: >>Conent experts >>Clinical advisors >>Clincial managers as part of a community response to injury prevention
Nursing profession and global health
>Poorly defined in lesser developed nations >Care often depends on physicians >Leaders in natural disaster response >Role changes in China and Taiwan (Sending nurses out of the country to get an education in hopes that they will return - not likely, uncommon) >Political pressures >High physician to population ratio in some countries >Physicians become expensive >Nurse clinics seen as competitive >Physicians wield more political power
Parish nursing secondary prevention
>Provide health assessment and counseling during home visits for health promotion such as visits after a hospitalization >when making home visits, identify safety concerns and make suggestions such as eliminating throw rugs, decreasing clutter, decreasing use of extension cords, and moving heat sources from flammable products such as oxygen. >using an attitudinal/behavioral risk survey, identify factors influencing health behaviors >Be available for health counseling for older adults before and after activities
Social determinants of health
>Socioeconomic status >Living conditions >Geographic location >Social class >Education >Environmental factors >Nutrition >Stress >Prejudice
Bilateral organizations
A single government agency that provides aid to less developed countries All bilateral organizations are influenced by political and historical agendas that determine which countries receive aid US Agency for International Development (USAID)
Public policies affecting vulnerable populations
>The social security act of (1935) >Medicare and Medicaid amendments of the social security act (1965) >Community mental health care act (1965) rescinded in use 1980s >Head start (1965) >SNAP (1965) - supplemental nutrition assistance program (food stamps) >WIC (1972) >Health insurance portability and accountability act of (1996) (HIPPA) >TANF (1996) - Temporary Assistance for needy families >Title of XXI of the social security act state child health insurance program (CHIP) (1998) >Stewart B, McKinney Homeless Assistance Act (1998) > Patient protection and affordable care act of 2010 (ACA)
Implications for Practice - Genetic Testing
>Understand genomics as it affects the health of the community - use information differently >Obtain adequate history and assessment >Genetic, Environmental, Genomic influences & Risk Factors >Do a 3 generation family pedigree >Analyze the history, physical assessment, and patient knowledge >Incorporate genomics into plans of care >Refer, educate and support
Nursing Approaches to Care in the Community
>Wrap-around services >Comprehensive services >Advocacy >Social justice >Linguistically appropriate healthcare >Case management
Parish nursing primary prevention
>hold classes for older adults on healthy eating including food selection, preparation, and increasing socialization opportunities at mealtimes for widows/widowers >promote and encourage age-appropriate activities include daily physical exercise with increased focus on improved balance related to muscle strength, proprioception, and coordination >encourage a variety of activities of individual and group interest and discourage extended inactivity >encourage healthy snacks and meals for older adult gatherings and activities check page 977 for more examples
Examples of vulnerable groups
>poor and homeless individuals >pregnant teens >migrant workers and immigrants >persons with mental health problems >persons who abuse substances >persons with communicable diseases >people who have HIV of STDs >people who have hep B >persons who have been incarcerated >persons of color >elderly
Prospective payment system
A Prospective Payment System (PPS) is a method of reimbursement in which Medicare payment is made based on a predetermined, fixed amount. The payment amount for a particular service is derived based on the classification system of that service (for example, diagnosis-related groups for inpatient hospital services). CMS uses separate PPSs for reimbursement to acute inpatient hospitals, home health agencies, hospice, hospital outpatient, inpatient psychiatric facilities, inpatient rehabilitation facilities, long-term care hospitals, and skilled nursing facilities. Determining insurance reimbursement to hospitals and health care providers, based on predetermined prices for specific codes Capitated systems/propective systems >Medicare/medicaid >HMOs >PPOs
Risk Assessment and Interpretation for genetic testing
A family history is a great place to begin before considering genetic testing Comprehensive history and physical History: medical, surgical, family, social, medications, allergies Social history: Environmental concerns Family pedigree 3 generations (Family health history) >First degree (Parents, siblings, children) >Second degree (Half-siblings, grandparents, aunts, uncles, and grandchildren) >Third degree (cousins) Any abnormal genetic disorders?
Malaria
Affects more than 50% of the world's population
Health for all in the 21 century (HFA21)
All world citizens should enjoy a level of health that permits them to lead a productive life. Health people 2020
Example of Implication for Practice - Genetic Testing
BRCA1 & 2 are tumor suppressor genes Positive for BRCA1: Increased risk for breast, cervical, uterine, pancreatic, colon, testicular, and prostate cancer Positive for BRCA2: Increased risk for breast, pancreatic, stomach, gallbladder, bile duct, and melanoma Surgery for women with these gene mutations could reduce the risk of breast and ovarian cancer by 85% or more
Brownfield sites
Brownfield sites are properties that are cleaned up then expanded, redeveloped, and/or reused after. Starting in the mid-1900s the EPA provided the local governments with small amounts of money to start hundreds of Brownfield sites. Grant money continues to be the main support behind funding for the EPA's Brownfield program.
Web of Causation Model
Can be applied to many concepts such as cardiovascular disease and diabetes. The combonation of variables that leads to more powerful outcomes. the model of web of causation emphasizes on agents in explaining causes of diseases, while providing multifactoral causes that traverse various pathways, mirroring reality. In this model, the disease or a health condition is not only seen to be having different causes, but each one of these individual causes is viewed as a consequence that came from the multiple causes, of which each is an effect resulting to multiple causes. Has proven useful in identifying possible factors for preventive interventions in community health
The Superfund is responsible for
Cleaning up contaminated land Responding to emergencies >>Oil spills >>Natural disasters Superfund conducts a site assessment to evaluate the potential or confirmed risk of hazard that could be a threat to the community, health, or the environment. A Hazard Ranking System (HRS) guides the process. During which the EPA, state, and other government agencies collect data on the hazard in order to pinpoint and rank hazardous waste sites based on the HRS. The HRS is the only way the EPA can get a site placed on the National Priorities List (NPL). Additionally, only sites that are on the NPL will get Superfund assistance. Waste plants will always be considered a Superfund site at present unless something changes. This is because Brownfields can be designated to be recycled into housing with use of the aquifers (water source) on that site, we know what chemicals or toxins were there and can neutralize them.
What is the safety net?
Collection of services provided by the state or other institutions such as friendly societies, including welfare, unemployment benefits, universal healthcare, homeless shelters, and sometimes subsidized services such as public transport, which prevent individuals from falling into poverty beyond a certain level.
Global Disease burden & major health problems
Communicable diseases Diarrheal disease Maternal and Women's health Nutrition and world health Natural and man-made disasters
Wrap-around services
Comprehensive health services are available and social and economic services are "wrapped around" these services
The Social Security Act of (1935)
Created the largest federal support program in history for elderly and poor Americans. This act was intended to ensure a minimal level of support for people at risk for problems resulting from inadequate financial resources.
Vulnerability
Defined as susceptibility to actual or potential stressors that may lead to adverse effects
Define the Environmental Protection Agency (EPA) and discuss its history
Definition: The United States Environmental Protection Agency (EPA or sometimes U.S. EPA) is an agency of the federal government of the United States which was created for the purpose of protecting human health and the environment by writing and enforcing regulations based on laws passed by Congress. History: The EPA was proposed by President Nixon It was proposed during a time of elevated concern about environmental pollution. It was established on December 2, 1970 to consolidate in one agency a variety of federal research, monitoring, standard-setting and enforcement activities to ensure environmental protection. Since its inception, EPA has been working for a cleaner, healthier environment for the American people.
Public health nurses should be able to
Demonstrate basic knowledge of the role genomics plays in the development of disease Identify limits of his or her genomic expertise Make appropriate referrals to those with more genomic expertise
Medicare
Federal Title XVII of the SS Act of 1965; for those age 65 and older disabled persons under 65, and persons with end-stage renal disease Part A: Inpatient, Home care Part B: Outpatient care, physician office, PT, covers most medically necessary doctors' services, preventive care, durable medical equipment, hospital outpatient services, laboratory tests, x-rays, mental health care, and some home health and ambulance services. You pay a monthly premium for this coverage. Part C: (Medicare Advantage) Combination of Part A and Part B. These Medicare private health plans, such as HMOs and PPOs, are known as Medicare Advantage Plans. Part D: Supplemental drug coverage
Retrospective payment system
Fee-for-service OR Retrospective payment means that the amount paid is determined by (or based on) what the provider charged or said it cost to provide the service AFTER tests or services had been rendered to beneficiaries. Here providers have no incentive to hold down their charges or costs, and the payer has few mechanisms for controlling expenditure Provide payment to health-care providers based on their actual charges and AFTER services - Traditional type of insurances (Aetna). Uses specific codes.
Disenfranchisement
Feeling of separation from mainstream society No emotional connection with any group in particular or with the larger society "Invisible" to society - weak social groups
What is the goal of the EPA?
Goals: The EPA identifies 5 strategic goals to guide the agency's work. These are apart of the EPA's strategic plan and include the following 1: Addressing Climate Change and Improving Air Quality 2: Protect America's Waters 3: Cleaning Up Communities and Advancing Sustainable Development 4: Ensuring the Safety of Chemicals and Preventing Pollution 5: Protecting Human Health and the Environment by Enforcing Laws and Assuring Compliance (EPA, 2017).
Improved nutrition is related to
Improved immune systems, decreased illness, better maternal, and child health, longer lifespans, and improved learning outcomes for children.
Patient Protection and Affordable Care Act (ACA) (2010)
Has provisions for reducing the growth of future Medicare expenditures. Obamacare Obamacare works by mandating that everyone get health insurance or pay a tax. The Patient Protection and Affordable Care Act provides subsidies for middle-income families. ... It pays for this by taxing some health care providers and high-income families. Subsidy: a sum of money granted by the government or a public body to assist an industry or business so that the price of a commodity or service may remain low or competitive.
Head Start (1965)
Head Start is a program of the United States Department of Health and Human Services that provides comprehensive early childhood education, health, nutrition, and parent involvement services to low-income children and their families. The program's services and resources are designed to foster stable family relationships, enhance children's physical and emotional well-being, and establish an environment to develop strong cognitive skills.
Health disparities and vulnerability
Health disparities refer to a wide variation in health services and health status among certain population groups. healthy people 2020 - 38 topics addressed DEFINITION by Healthy People 2020 A particular type of health difference that is closely linked with an economic, social, or environmental disadvantage. Health disparities adversely affect groups of people who have systematically experienced greater social or economic obstacles to health based on their racial or ethnic group, religion, socioeconomic status, gender, age or mental health: Cognitive, sensory, or physical disability, sexual orientation or gender identity, geographic location, or other characteristics historically linked to discrimination or exclusion.
Global health
Health problems addressed multi-nationally More than just managing illness care Addresses health and wellness at the individual, group, family, community, and systems level
Social Justice
Includes the concepts of egalitarianism and equality - values equality and recognizes the worth of all members of society. Humane care and social support for all people.
Factors contributing to vulnerability
Limitations in physical, environmental, personal (human capital), biopsychosocial, cause vulnerability Vulnerability has many aspects. It often comes from a feeling of lack of power, limited control, victimization, disadvantaged status, disenfranchisement, and health risks. vulnerability can be reversed by obtaining resources that increase resilience.
Seven World Health Organization (WHO) factors
Income and social status: Higher income and social status are associated with better health Education: Low education is linked to poor health, more stress, and lower self-confidence. Physical Environment: safe water and clean air; healthy workplaces, safer homes, communities, and roads, and good employment and working conditions, especially when the person has more control, all contribute to good health. Social support networks: Family, friends, and community, as well as culture, customs, traditions, and beliefs, affect health. Genetics: as well as personal behavior and coping skills, affect health Health services: access and use of services affect health. Gender: Men and women suffer from different types of diseases at different ages.
AIDS
Increasing incidence in adolescents, young adults, and heterosexuals
what was the event that jettisoned the start of the environmental movement and the development of the EPA?
It was a documentary called Silent Spring which came out in 1962 about the effect of chemicals including DDT and other pesticides. This documentary helped inform the general population about what was going into their food sources and the environmental effects of these pesticides. Rachel Carson an environmentalist wrote the book "Silent Spring" in 1962.
Nursing role in genetic testing
It's important that nurses help individuals and communities understand the purpose, limitations, potential benefits, and potential risks of a genetic test before they do it Helping patients and families navigate through the disclosure process and uncovering their personal and family health history and understanding specific genetic tests is an important role for the public health nurses Nurses play an important role in answering questions and assisting in challenges
Tuberculosis (TB)
Largest cause of death from a single infectious agent worldwide 3 million people each year
Millennium Development Goals (MDGs)
MDGs set by the United Nations (UN) (2005) Describes developed nations responsibilities to lesser developed nations were developed to relieve poor health conditions around the world and to establish positive steps to improve living conditions by the year 2015
Linguistically appropriate health care
Means communicating health-related information in the recipient's primary language when possible and always in a language the recipient can understand. Using terminology the recipient can understand.
Medicare and Medicaid Social Security Act Amendments of 1965
Medicare and Medicaid provided for the health care needs of older adults, the poor, and disabled people who might be vulnerable to impoverishment resulting from high medical bills or poor health status from inadequate access to health care.
Major global health organizations
Multilateral organizations Bilateral organizations Non-Governmental organizations (NGOs) or Private Voluntary Organizations (PVOs)
Case Management
Nurse navigators - help make arrangments, referrals, and act as advocates
Multilateral organizations
Recieve funding from multiple government and nongovernment sources Work with several countries WHO, UN, World Bank, World Trade Organization
The Code of Ethics - International Council of Nurses
People have a right to seek and recieve genomic health care that is nondiscriminatory, confidential, and private, and enables patients to make informed decisions.
Cycle of vulnerability
Poor health creates stress as individuals and families try to manage health problems with inadequate resources. Sometimes when one problem is solved, another one quickly arises. Vulnerable populations suffer from MANY stressors.
Nutrition and World Health
Poor nutrition by itself or that associated with infectious disease accounts for a large portion of the world's disease burden. Many children around the world are underweight and have multiple micronutrient deficiencies (Protein, iodine, Vit A, Ca++, Folic Acid, Fe+)
Advocacy
Refers to actions taken on behalf of another e.g. working for the passage and implementation of policies that lead to improved public health services for vulnerable populations.
Communicable disease
Prevention - Immunizations Prevention through immunization and improving environmental conditions Eradication of smallpox throughout the world -- The systematic and planned small-pox program formed the basis for a series of worldwide efforts that are now being implemented to control and eradicate other infectious and communicable diseases
School nurse: Levels of Prevention
Primary Prevention: Health program activities Teaching healthy lifestyles Immunizing children for school entry Secondary Prevention: Screening for health problems Caring for ill or injured children and staff Tertiary Prevention: Caring for children with chronic health problems Health referrals and continuity of care
Temporary Assistance to Needy Families (TANF) (1996)
Program is designed to help needy families achieve self-sufficiency. States receive block grants to design and operate programs that accomplish one of the purposes of the TANF program. The four purposes of the TANF program are to: Provide assistance to needy families so that children can be cared for in their own homes Reduce the dependency of needy parents by promoting job preparation, work, and marriage Prevent and reduce the incidence of out-of-wedlock pregnancies Encourage the formation and maintenance of two-parent families
Health Maintenance organizations (HMOs)
Prospective payment system A health maintenance organization (HMO) is an organization that provides health coverage for a monthly or annual fee. A Health Maintenance Organization (HMO) is a group of medical insurance providers that limit coverage to medical aid provided from doctors that are under the contract of HMO. These contracts allow for premiums to be lower since the health providers have the advantage of having patients directed to them; but these contracts also add additional restrictions to HMO's members. An HMO is an organized public or private entity that provides basic and supplemental health services to its subscribers. The organization secures its network of health providers by entering into contracts with primary care physicians, clinical facilities, and specialists. The medical entities that enter into contracts with the HMO are paid an agreed fee to offer a range of services to the HMO's subscribers. The agreed payment allows an HMO to offer lower premiums than other types of health insurance plans, while retaining a high quality of care from its network. In addition to the low premiums, there are typically no deductibles with an HMO. Instead, the organization charges an amount, known as a copayment, for each clinical visit, test, or prescriptions. Copayments in HMOs are typically low and amount to $5, $10, or $20 per care, thereby, minimizing out-of-pocket expenses and making HMO plans affordable for families and employers.
Preferred Provider Organizations (PPOs)
Prospective payment system A preferred provider organization is a subscription-based medical care arrangement. A membership allows a substantial discount below the regularly charged rates of the designated professionals partnered with the organization. is a managed care organization of medical doctors, hospitals, and other health care providers who have agreed with an insurer or a third-party administrator to provide health care at reduced rates to the insurer's or administrator's clients.
Kwashiorkor
Protein deficiency starvation Symptoms - apathy, muscular wasting, edema, and pigmentation loss in the skin and hair. BIG BELLY - Older children
Non-governmental Organizations (NGOs) or Private Voluntary Organizations (PVOs)
Provide almost 20% of all external aid to less developed countries most effective voices for the concerns of ordinary people in the international arena Doctors without Borders, OxFam, Religious organizations, Red Cross/Cresent
"Genetic Red Flags"
QUICK TIPS FOR RISK ASSESSMENT: >Earlier than expected age of disease onset >Multiple family members with similar or related disorders, with or without a pattern >Atypical presentation of a disorder >Condition in the less-often-affected gender (i.e. males with breast cancer) >Disease in the absence of known risk factors >Ethnic predisposition to certain genetic disorders >Close biological relationship between parents (consanguinity)
Diarrheal Causes
Related to unsafe water, sanitation, and hygiene One of the leading causes of illness and death in children less than 5 years of age throughout the world Each year there are 1.6 million diarrheal deaths related to unsafe water, sanitation, and hygiene Leading cause of malnutrition in children under 5 years old Many countries have developed diarrhea control programs that improve childhood nutrition
Aetna
Retrospective payment system Aetna Inc. is an American managed health care company, which sells traditional and consumer directed health care insurance plans and related services, such as medical, pharmaceutical, dental, behavioral health, long-term care, and disability plans. Aetna is a member of the Fortune 500.
SANE nurse
Sexual assault nurse examiners (SANEs) are registered nurses who have completed specialized education and clinical preparation in the medical forensic care of the patient who has experienced sexual assault or abuse.
Resilience
Some members ability to avoid succumbing to health risks that impinge on vulnerable populations.
How is the Paris Agreement like the EPA?
The Paris Agreement is similar to the EPA because both strive to improve the quality of the environment, with the overall goal of improving the health of all people. They are different because the EPA is in the United States, and it has federal rules and regulations that companies are required to follow. The Paris Agreement is a worldwide and counties have the choice with whether or not they want to participate.
Identify specific things/sites the EPA tracks. What are examples of some of the levels of gases, toxins, etc, that are monitored in a specific area?
The EPA tracks many different things/sites that help to keep our environment clean and safe. Some examples of this include acid rain, pesticides, oil spills, drinking water, mold, chemicals such as polychlorinated biphenyls (PCBs), asbestos, radon and lead-based paint. The sites that the EPA tracks include agriculture, automotive, construction, electric utilities, oil and gas, and transportation.
How is the EPA funded? How does a community receive funding from the EPA?
The EPA's budget is determined by the federal government and includes a series of steps: >EPA develops a proposed budget for the year. >The President sends federal budgets to Congress for voting. >Congress considers the President's budget requests and passes appropriations bills. >Appropriations bills enact federal agency budgets into law upon the President's signature. >The appropriation bill that includes funding for EPA becomes the blueprint for EPA's budget activities during the year. After the EPA budget is determined, the community receives funding through applying for grant programs from the EPA.
Women, Infant, Children (WIC) (1972)
The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides Federal grants to States for supplemental foods, health care referrals, and nutrition education for low-income pregnant, breastfeeding, and non-breastfeeding postpartum women, and to infants and children up to age five who are found to be at nutritional risk.
Briefly describe the Paris Agreement.
The Paris Agreement is part of the United Nations Framework Convention on Climate Change. Countries who agree to participate in the Paris Agreement are stating that they will actively take steps to reduce climate change. Specifically, the goal of the Paris Agreement is to limit temperature increase to 1.5 degrees Celsius. One of the methods for decreasing temperature increase is that all countries who are part of the Paris Agreement must report their emissions, as well as what they are doing to decrease their emissions.
Mutations or risks within a family
The best way to identify whether there is a mutation in the family, where a hereditary disease is suspected, is to test the person who displays the most evidence of being a mutation carrier
Planning and Implementing Nursing Care in The community with vulnerable populations
The following key nursing actions should be used: >Trusting environment >Respect, compassion, and concern >Non-judgemental >Coordinate >Advocate >Prevention and strength >"Walk beside" and "Walk ahead" >Know what resources are available >Develop your own support network
Genomics - mapping of the genome
The mapping of the genome was a strategic inflection point in history of health care that created a massive shift in how all health professionals provide care and how the public approached health.
What is the mission of the EPA?
The mission of EPA is to protect human health and the environment (EPA, 2017).
Genomics
The study of individual genes within the context of the organism, as well as the environment, culture, and psychosocial factors (Epigenetics) Has Influenced the abilities of genetic testing
Genetics
The study of the function and effect of single genes that are inherited by children from their parents
Medicaid
Title XIX of the SS Act of 1965. Provides financial assistance to states/counties for medical services for poor older adults, the blind, disabled, and families with dependent children. >Program is jointly sponsored by matching funds from both federal and state governments. >States may offer monthly optional services to meet needs of indigent >Things covered include: Family planning, preventive care and early treatment for those under 21 years, physician services, skilled nursing care at home or in nursing homes for >21 years of age, and inpatient/outpatient hospital care, labs, and radiology.
Marasmus
Total caloric deprivation (No food) Wasting away of the body tissues and - Skin and bones - younger children
Primary Health Care Within MDGs
Updated goals incorporate MDGs >Organized health education >Aggressive environmental sanitation (food and water) >Maternal and child health programs >Preventive programs for local endemic diseases >Accessible, affordable treatments (Immunizations/family planning) >Available chemotherapeutic agents >Nutrition programs >Promotion of traditional medicine worldwide
Overview and historical perspective of the WHO and global health
WHO health assembly in Alma Ata, Kazakhstan (Russia) (1978) proclamation that all citizens should enjoy a level of health to permit living socially and economically productive lives
Health Insurance Portability and Accountability Act (1996)
Was intended to help people keep their health insurance when moving from one place to another. Ensuring the privacy and security of personal health information means that electric and paper health records, case management, referrals, physical space layouts (such as a computer screen visibility and clinic registration sheets) must be managed to protect the client's privacy and safeguard the privacy of personal health information.
Maternal and Women's health
When investments in women - as mothers, as individuals, as family members, and as citizens lag, the economic cost of maternal death and illness is enormous A women's ability to survive pregnancy and childbirth is indicative of the society in which she lives Maternal health has widespread effects on children and families Most deaths to women around the world are related to pregnancy and childbirth Safe motherhood initiative are still needed
Natural and man-made disasters
When poor countries face natural disasters the cost of rebuilding becomes even more of an issue when they are already in debt Natural disasters Earthquakes, tsunamis, floods, hurricanes, cyclones, droughts Typically the poor are the worst hit due to their lack of resources to cope and rebuild Man-made disasters Bioterrorism attack Chemical emergency Radiation poisoning Genocide
Title XXI of the Social Security Act State Child Health Insurance Program (CHIP) (1998)
Which provides funds to insure currently uninsured children. CHIP is jointly funded by the federal and state governments and administered by the states. Using broad federal guidelines, each state designs its own program, determines who is eligible for benefits, sets the payment levels, and decides on the administrative and operating procedures.
Maternal mortality rates (2014)
Worst status in South Africa and Sub-Saharan Africa
Supplemental Nutrition Assistance Program (SNAP) (1965)
formerly known as the Food Stamp Program, provides food-purchasing assistance for low- and no-income people living in the United States. It is a federal aid program, administered by the U.S. Department of Agriculture, under the Food and Nutrition Service, though benefits are distributed by each U.S. state's Division of Social Services or Children and Family Services. The amount of SNAP benefits received by a household depends on the household's size, income, and expenses
Comprehensive services
health services that focus on more than one health problem or concern
Stewart B. McKinney Homeless Assistance Act (1998)
is a United States federal law that provides federal money for homeless shelter programs. ensures homeless children transportation to and from school free of charge, allowing children to attend their school of origin (last school enrolled or the school they attended when they first became homeless) regardless of what district the family resides in. It further requires schools to register homeless children even if they lack normally required documents, such as immunization records or proof of residence. is a conditional funding act which means that the federal government gives grants to states and, in return, the grantee states are bound by the terms of the act. If a state chooses not to accept federal funds for these purposes, it does not have to implement the act.
Faith community nurse or parish nursing
is a recognized nursing specialty practice in the community setting, yet is frequently overlooked when creative strategies are needed for improving the health of individuals and the larger community. Work in close relationship with individuals, families and faith communities to coordinate programs and services that significantly affect health, healing, and wholeness. Address health concerns of individuals, families, and groups of all ages. Defined by the ANA as a specialized practice of professional nursing that focuses on the intentional care of the spirit as well as on the promotion of holistic health and prevention or minimization of illness within the contest of a faith community.
A vulnerable population group
is a subgroup of the population that is more likely to develop health problems as a result of exposure to risk and to have worse outcomes from these health problems than the rest of the population. Vulnerable populations are those at greatest risk for poor health status and health care access.
Outcomes of vulnerability
outcomes can be negative, such as lower health status than the rest of the population or positive with effective intervention Poor morbidity and mortality outcomes Health disparities >High prevalence of chronic illnesses (e.g. hypertension) >High prevalence of communicable diseases (e.g. TB, HepB, STDs, and upper respiratory infections such as influenza) >High mortality rates from crime and violence
human capital
refers to all the strengths, knowledge, and skills that enable a person to live a productive, happy life.
the catalyst to pulling all the agencies together to form the EPA in 1970
was the burning of the Cuyahoga River in Ohio in 1969. The river was so polluted with oil and chemicals it burned for days, polluted the air, caused increased respiratory health problems, and was unable to be used for transporting goods so businesses suffered. People began to question how could a river burn like that? One that was highly polluted.
