unit 15

obesity classes

- below 18.5 is underweight · between 18.5 and 24.9 is healthy · between 25 and 29.9 is overweight · 30-34.5 is class one obesity (low risk) · 35-39.9 is class 2 obesity (moderate risk) · 40+ is class 3 obesity (high risk)

active participation in 'If You See Something, Say Something™' campaign

-All U. S. citizens should report suspicious activity to their local law enforcement authorities - Homeland security begins with hometown security, where an alert public plays a critical role in keeping our nation safe.

- Active participation in the 'Stop.Think.Connect.' Campaign.

-Cybersecurity is a shared responsibility. Every individual can help keep the Internet safe using simple steps. -National public awareness campaign aimed at increasing the understanding of cyber threats and empowering the American public to be safer and more secure online. - October is National Cyber Security Awareness Month

o Centers for Disease Control Emergency Preparedness and Response

-Mass causalities-explosions, blasts, injuries -Radiation emergencies- nuclear blasts, dirty bombs, acute radiation syndrome -Bioterrorism-anthrax, plague, smallpox -Chemical emergencies-Ricin, chlorine, nerve agents

Social and physical environments

-The way mass media show tobacco product use as a normal activity can make young people want to try these products. -Youth are more likely to use tobacco products if they see people their age using these products. -High school athletes are more likely to use smokeless tobacco than those of the same age who are not athletes. -Young people may be more likely to use tobacco products if a parent uses these products.

Biological and genetic factors

-There is evidence that youth may be sensitive to nicotine and that teens can feel dependent on nicotine sooner than adults. -Genetic factors may make quitting smoking harder for young people. -A mother's smoking during pregnancy may increase the likelihood that her children will become regular smokers.

HIV/Aids-Worldwide Prevalence

38.4 million people living with HIV in 2020 In 2021, 75% [66-85%] of all people living with HIV were accessing treatment. As of 30 June 2021, 28.2 million people were accessing antiretroviral therapy · 40 million people live with HIV/AIDS worldwide · Tuberculosis (TB) is the most common opportunistic infection affecting individuals living with HIV/AIDS. TB forms a disastrous combination with HIV, each potentiating/speeding the other's progress. People living with HIV are 18 times more likely to become ill with TB than those without HIV. In 2017, HIV/TB co-infection accounted for ~one-third of the people living with HIV and AIDS. Worldwide, TB remains the leading causes of death among people living with HIV causing 1 in 3 HIV deaths.

· Yes, cardiovascular diseases killed 17.9 million people in 2019. Cardiovascular disease causes 32% of deaths worldwide.

Are cardiovascular diseases the number 1 cause of death throughout the world?

CBRNE

Chemical, Biological, Radiological, Nuclear, Explosive

Smoking causes more deaths combined with

Human immunodeficiency virus (HIV) Illegal drug use Alcohol use Motor vehicle injuries Firearm-related incidents

tobacco Toll national

More than 16 million Americans are living with a disease caused by smoking. For every person who dies because of smoking, at least 30 people live with a serious smoking-related illness. Cigarette smoking is responsible for more than 480,000 deaths per year in the United States, including more than 41,000 deaths resulting from secondhand smoke exposure. This is about one in five deaths annually, or 1,300 deaths every day. If smoking continues at the current rate among U.S. youth, 5.6 million of today's Americans younger than 18 years of age are expected to die prematurely from a smoking-related illness. This represents about one in every 13 Americans aged 17 years or younger who are alive today.More than 10 times as many U.S. citizens have died prematurely from cigarette smoking than have died in all the wars fought by the United States. Smoking causes about 90% (or 9 out of 10) of all lung cancer deaths. More women die from lung cancer each year than from breast cancer. Smoking causes about 80% (or 8 out of 10) of all deaths from chronic obstructive pulmonary disease (COPD). 40 million adults in the United States currently smoke cigarettes more than 480,000 deaths every year, or about 1 in 5 deaths 16 million live with a serious illness caused by smoking

Opioids

Opioids are psychoactive substances derived from the opium poppy, or their synthetic analogues. Examples are morphine and heroin. · interact with opioid receptors on nerve cells in the body and brain → reduce the intensity of pain signals and feelings of pain. · drugs such as morphine, codeine, oxycodone, hydrocodone, methadone, tramadol, fentanyl, and the illegal form of morphine called heroin. · Opioids are a class of drugs which contains either natural or synthetic chemical used to reduce pain. · Prescription opioids can be prescribed by doctors to treat moderate to severe pain. · Fentanyl is a synthetic opioid pain reliever. It is many times more powerful than other opioids and is approved for treating severe pain, typically advanced cancer pain.1 Illegally made and distributed fentanyl has been on the rise in several states. · Heroin is an illegal opioid. Heroin use has increased across the U.S. among men and women, most age groups, and all income levels.

Active participation in 'Ready'

Plan.Prepare.Stay informed.

Response to an active shooter

Run, Hide, Fight

mental health

There is a strong relationship between youth smoking and depression, anxiety, and stress.

obesity prevalence in the U.S.

There was no significant difference in the prevalence of obesity between men and women overall or by age group. · Most obese country · Americans are eating more calories than ever before · More than one-third of adults in the United States have obesity · 1 in 5 children and adolescents in the US have obesity · Obesity Disproportionately Impacts Some Racial and Ethnic Minority Groups · Economic burden is estimated annual medical cost of nearly $173 billion in 2019 · Economic impact of excess weight now exceeds $1.7 trillion (includes associated costs -loss 0f productivity)

tobacco toll Louisiana

Tobacco, 19.5% of Adult Current Smokers > Cancer deaths per 100,000: 217.9 (4th highest)> Premature deaths per 100,000: 445.9 (6th highest) · Louisiana Adults who die each year from their own smoking 7,200 · Smoking kills more people than alcohol, AIDS, car crashes, illegal drugs, murders, and suicides combined — and thousands more die from other tobacco-related causes — such as fires caused by smoking (more than 1,000 deaths/year nationwide) and smokeless tobacco use.

Violence prevention

Violence can be prevented around the world. · small-scale individual · community efforts · national policy and legislative initiatives · ways to prevent: · Support local, national, international efforts to prevent violence · Raise awareness about the problem of violence · Inform general public · Be watchful for the signs and symptoms · Publicize where help can be obtained · Monitor public places-neighborhoods, schools, workplaces and take steps to address problems that might lead to violence · Promote healthy relationships

Personal views

When young people expect positive things from smoking, such as coping with stress better or losing weight, they are more likely to smoke

· Alcohol screening

_______________ and brief interventions take advantage of "teachable moments" to identify people at risk for alcohol problems and get them treatment as needed. This combined strategy, which can be delivered in health care, university, and other settings, helps change behavior and reduces alcohol-impaired crashes and injuries.

· Injuries

__________________ caused less than 10% of all deaths.

· School-based

________________________ instructional programs are effective at teaching teens not to ride with drunk drivers. More evidence is needed to see if these programs can also reduce drunk driving and related crashes.

· Ignition interlocks

_________________________ installed in cars measure alcohol on the driver's breath. Interlocks keep the car from starting if the driver has a BAC above a certain level, usually 0.02%. They're used for people convicted of drunk driving and are highly effective at preventing repeat offenses while installed. Mandating interlocks for all offenders, including 1st-time offenders, will have the greatest impact.

· Drunk driving laws

_________________________ make it illegal nationwide to drive with a BAC at or above 0.08%. For people under 21, "zero tolerance" laws make it illegal to drive with any measurable amount of alcohol in their system. These laws, along with laws that maintain the minimum legal drinking age at 21, are in place in all 50 states and the District of Columbia, and have had a clear effect on highway safety, saving tens of thousands of lives since their implementation.

noncommunicable diseases (NCDs)

___________________________ diseases were responsible for over 74% of all deaths globally in 2019. · Are the most widespread diseases. · Include cardiovascular diseases, cancers, respiratory diseases and diabetes mellitus.

· Multi-component interventions

_____________________________ combine several programs or policies to prevent drunk driving. The key to these comprehensive efforts is community mobilization by involving coalitions or task forces in design and implementation.

· Sobriety checkpoints

_______________________________ allow police to briefly stop vehicles at special, highly visible locations to see if the driver is impaired. Police may stop all or a certain portion of drivers. Breath tests may be given if police have a reason to suspect the driver is intoxicated.

· Mass media campaigns

_____________________________________ spread messages about the physical dangers and legal consequences of drunk driving. They persuade people not to drink and drive and encourage them to keep other drivers from doing so. Campaigns are most effective when supporting other impaired driving prevention strategies.

· Communicable, maternal, neonatal and nutrition conditions

_______________________________________________________________________ collectively were responsible for just under 20% of global deaths.

Mass casualty incident (MCI)

a disaster situation that results in a large number of victims who need the response of multiple organizations.

Hospital incident command system (HICS)

a multi agency operational structure that uses a model adopted by the Fire and Rescue community. The ICS can be useful in any size or type of disaster to control response personnel, facilities, and equipment.

All-hazards approach

a process approach for all sectors to prepare for any emergency or disaster that may occur.

Disaster condition

a significant natural disaster or human-caused event that overwhelms the affected state, necessitating both federal public health and medical care assistance.

Crisis standard of care

a substantial change in usual health care operations and the level of care it is possible to deliver, which is made necessary by pervasive pandemic or catastrophic disaster. This change in the level of care delivered is justified by specific circumstances and is formally declared by a state government, in recognition that crisis operations will be in effect for a sustained period.

Recovery

activities designed to return responders and the facility to full normal operational status and to restore fully the capability to respond to future emergencies and disasters; activities traditionally associated with providing federal supplemental disaster relief assistance under a presidential major disaster declaration.

Preparedness

activities that build capability and capacity to address potential needs identified by the threat and vulnerability study.

Response

activities to address the immediate and short-term effects of an emergency or disaster. The response includes immediate actions to save lives, protect property, and meet the basic human needs.

Active shooter

an individual actively engaged in killing or attempting to kill people in a confined and populated area; in most cases, active shooters use firearms and there is no pattern or method to their selection of victims.

Emergency Management assistance compact (EMAC)

an organization authorized by the US Congress through which a state impacted by a disaster can request and receive assistance from other member states quickly and efficiently.

Terrorist attack

as defined by the FBI, a violent act or an act that is dangerous to human life, in violation of the criminal laws of the United States or any state, and intended to intimidate or coerce a government, the civilian population, or any segment thereof in furtherance of political or social objectives.

Lead agency

as defined by the FBI, the federal department or organization assigned a primary responsibility to manage and coordinate a specific function-either crisis management or consequence management. Lead agencies are designated on the basis of their having the most authority, resources, capabilities, are expertise relative to accomplishment of this specific function.

Major disaster

as defined under the Stafford act, any natural catastrophe (including any hurricane, tidal wave, tornado, storm, high water, wind driven water, tsunami, earthquake, volcanic eruption, landslide, mudslide, snowstorm, or drought) or, regardless of cause, any fire, flood, or explosion in any part of the United states that is in the determination of the president causes damage of sufficient severity and magnitude to warrant major disaster assistance to supplement the efforts and available resources of states, local government, and disaster relief organizations in alleviating the damage, loss, hardship, are suffering caused thereby.

Emergency

as the fine by federal legislation in the Stafford act, any occasion or instance for which, indent determination of the president, federal assistance is needed to supplement state and local efforts and capabilities to save lives and protect property, public health, and safety; includes emergencies other than natural disasters.

Disease Burden

impact of a health problem as measured by financial cost, mortality, morbidity, or other indicators

Comorbidity

means that a person has more than one illness at the same time.

Biologic agents

microorganisms are toxins from living organisms with infectious or noninfectious properties that produce lethal or serious effects in plants and animals.

preparedness, response and recovery resources available for terrorism

o United Nations Global Counter-Terrorism Strategy o World Health Organization (WHO) o Federal Emergency Management Agency (FEMA) o U. S. Department of Homeland Security-National Terrorism Advisory System § Transportation Security, including aviation and maritime security § Nuclear security § Chemical security § Cybersecurity § Border security § Economic Security § Critical infrastructure and perimeter protection § Domestic and international intelligence activities § Research on next-generation security technologies o American Red Cross o Disaster Help o Institute of Health [IOM] non-governmental, non-profit organization provided Activity and Reports on Terrorism o Louisiana Department of Health and Hospitals

· Collective violence

o the instrumental use of violence by people who identify themselves as members of a group -whether this group is transitory or has a more permanent identity - against another group or set of individuals, in order to achieve political, economic or social objectives. -Forms of collective violence have been · Wars, terrorism and other violent political conflicts that occur within or between states. · State-perpetrated violence such as genocide, repression, disappearances, torture and other abuses of human rights. · Organized violent crime such as banditry and gang warfare o During the 20th century, it's estimated that 191 million people lost their lives directly or indirectly as a result of conflict, and more than half of them were civilians

Pandemic

outbreak of disease that affects populations worldwide; for example, COVID-19 pandemic that causes serious illness and death worldwide.

Triage

process of prioritizing which patients are to be treated first; first action in any disaster response.

Mortality

refers to death.

Morbidity

refers to illness or disease. It is the state of having a specific illness or medical condition.

Three broad categories of violence

self-directed, interpersonal, collective

Chemical agents

solids, liquids, organisms with chemical properties that produce lethal or serious effects in plants and animals.

· Opioid Epidemic

started as a result of pharmaceutical companies in the 1990s reassuring the medical community and health care providers that patients would not get addicted to opioids.

Scene assessment

the act of reviewing the location of an event to look for information that might help to determine treatment options.

Mitigation

those activities designed to alleviate the effects of a major disaster or emergency are long-term activities to minimize the potentially adverse effects of future disasters in affected areas.

Influenza prevention

· "Safe and effective vaccines have been available and used for more than 60 years" · Recent studies show the flu vaccine reduces the risk of flu illness by between 40% and 60% among the overall population during seasons when most circulating flu viruses are well-matched to those used to make flu vaccines. · The CDC recommends a yearly flu vaccine for everyone 6 months of age and older. It is especially important for people at higher risk of serious influenza complications to get vaccinated. · The vaccine costs $25, but it would cost you at least $1500 if you caught the disease and had to be treated in a hospital. · . It is recommended that people get the influenza vaccine as soon as the vaccine becomes available in their community. · good hand washing and covering one's mouth and nose when they cough or sneeze. These two are just basic good health practices because they are also beneficial in preventing the spread of other communicable diseases as well. · Stay away from sick people · Stay home if sick with flu · Ongoing education of the public

United Nation's Universal Declaration of Human Rights

· 'Everyone has the right to a standard of living adequate for the health and well being of himself and his family, including food, clothing, housing and medical care...'

· World Health Organization [WHO] Constitution:

· 'the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being...'

Tobacco Free

· 2014 · UL and other public universities in Louisiana went smoke-free. · CVS -made the bold decision to eliminate tobacco products from all of our CVS Pharmacy stores nationwide, remain the only national pharmacy to do so · 2019 · Federal minimum age of sale of tobacco products from 18 to 21 years

Influenza Prevalence in Louisiana

· 2019-2020 · 755,000 cases · 8,000 hospitalized · 4,500 deaths

Influenza Prevalence in the U.S.

· 2021-2022 season · ~ 9 million flu illnesses, · ~4 million flu-related medical visits, · ~100,000 flu-related hospitalizations, · ~5,000 flu deaths

Alcohol Prevalence · National

· 95,000 die from alcohol-attributable causes (261 deaths/day) · These deaths shorten the lives of those who die by an average of almost 29 years · The Centers for Disease Control and Prevention reports that 32 people in the United States die in motor vehicle crashes that involve an alcohol-impaired driver daily. One death every 45 minutes

revocation or suspension

· Administrative license_____________________________ laws allow police to take away the license of a driver who tests at or above the legal BAC limit or who refuses testing. States decide how long to suspend the license; a minimum of 90 days is effective.

Alcohol

· Alcohol is a psychoactive substance with dependence-producing properties. · Ethyl alcohol, or ethanol, intoxicating ingredient found in beer, wine, and liquor · Central nervous system depressant · Affects every organ in the body · Intensity of the effect of alcohol on the body is directly related to the amount consumed · Excessive alcohol use, including underage drinking and binge drinking, can lead to increased risk of health problems such as injuries, violence, liver diseases, and cancer · Globally, alcohol is a leading risk factor for disease burden · Alcohol affects each person different. · There are many factors that affect Blood Alcohol concentration (BAC) including age, gender, person's size, physical condition, body fat percentage, how much sleep they have had, amount and time of food consumed, and any drugs or medications that are taken, fatigue, stress factors can affect the blood alcohol level. Also important is how much and what concentration of alcohol is consumed. · an intoxicated individual endangers himself and those around him including family, friends, colleagues, and even strangers in the form of vehicle accidents, violence, suicides, and other fatal injuries · Binge drinking is the most common and deadly pattern of excessive alcohol use in the U.S. · CDC defines binge drinking as a pattern of drinking that brings a person's blood alcohol concentration (BAC) to 0.08 g/dl or above. This typically happens when men consume 5 or more drinks or women consume 4 or more drinks in about 2 hours. ). · People who binge drink are not necessarily alcohol dependent

Alcohol Prevalence · Louisiana comparison to Nati0nal (2019)

· Alcohol-Impaired* Driving Fatalities per 100,000 Population · National 3.1 Louisiana 4.7 · Under 21 Alcohol-Impaired* Driving Fatalities per 100,000 Population · National 1.1 Louisiana 1.7 · (*a blood alcohol content of 0.08 or above)

Mass Casualty Incident (MCI)

· Also called Mass casualty Event (MCE) · A disaster situation that results in a large number of victims who need the response of multiple organizations.

how to prevent MDROs

· Antibiotic stewardship involves ensuring that patients get the right antibiotic, at the right dose, at the right time and for the right duration · Good hand washing is critical to good infection control practices. In health care facilities, inadequate hand washing contributes to the spread of infections, including those infections that are caused by antibiotic resistant organisms. Adequate hand washing is also critical for the prevention of the spread and the development of these resistant organisms. · MDROs can kill, hamper the control of infectious diseases, and increase the cost of health care. · Take antibiotics as prescribed for the full duration · Vaccinate children against preventable diseases · Follow a healthy lifestyle & reduce the need for antibiotics · Throw away old medications & never self medicate · Combat drug resistance: no action today, no cure tomorrow

preventing opioid overdose as educators

· As educators/patient advocates, nurses are in a unique position to help with: · non-opioid pain management including other medication modalities · regional anesthetic interventions, surgery · psychological therapies · rehabilitative/physical therapy · complementary and alternative medicine (CAM).

Multidrug-Resistant Organisms (MDROs):

· Bacteria and other microorganisms that have developed resistance to antibiotic drugs · also known as "superbugs" · When bacteria are resistance to antibiotics, they become more difficult and more expensive to treat. Infections caused by drug resistant bacteria risk becoming uncontrollable and untreatable. Persons who contract drug resistant infections have a much greater risk of death due to infection with these bacteria. · MDROs that are currently of great concern include: · MRSA- Methicillin/oxacillin-Resistant Staphylococcus Aureus · VRE- Vancomycin-Resistant Enterococci · ESBLs- Extended Spectrum Betalactamases · C-diff- Clostridium Difficile · Acinetobacter baumannii · MDR-TB-Multi-drug resistant tuberculosis · CRE - Carbapenem-Resistant Enterobacteriaceae · Drug-resistant Candida · Drug-resistant Neisseria gonorrhoeae · Increase length of stay, costs and mortality

ways to protect against terrorism

· Be aware of local policy and procedure · Support local government/policy · Support public health response · Monitor health

COVID-19 CDC

· CDC Recommendations (as of Fall 2023): · If you test positive for COVID-19: · Everyone, regardless of vaccination status: · Stay home for 5 days · If you have no symptoms or your symptoms are resolving, you can leave your house · Continue to wear a mask around others for 5 additional days. · If you have fever, continue to stay home until your fever resolves. · As new knowledge about the prevention, detection, and treatment of this novel disease is discovered, frequent updates are communicated regarding home isolation and testing recommendations.

COVID-19 UL Lafayette

· COVID- 19 Response: · Students who feel ill should stay home and call Student Health Services at (337) 482-1293 to review status and treatment. · Students are required to report illness or a known COVID-19 exposure via the UL Lafayette Student Quarantine and Isolation form. · View pdfs of the CDC's latest quarantine and isolation guidelines and what to do if you have been in close contact with someone who has COVID-19.

Smoking consequences

· Cancer, lung diseases, cardiovascular diseases · Cigarette smoking and tobacco use harms nearly every organ in the body and is a known risk factors for many diseases, including (but not limited to): · Cancer of the lung, lip, mouth, larynx, pharynx, esophagus or oral cavity, acute myeloid leukemia, bladder cancer, cancer of the cervix, kidney cancer, pancreatic cancer, stomach cancer · Respiratory disease · Cardiovascular disease · Stroke · Diabetes · Decay of exposed tooth roots · White patches or red sores in the mouth that can turn into cancer · Smoking also increases risk for tuberculosis, certain eye diseases, and problems of the immune system, including rheumatoid arthritis. · Smoking is a known cause of erectile dysfunction in males. · Infertility · Preterm delivery · Stillbirth · Low birth weight · Sudden Infant Death Syndrome (SIDS) · Postmenopausal women who smoke have lower bone density than women who never smoked · Smoking is considered to be a gradual killer because there is a lag of years from the time someone picks up the smoking habit until the time of an identifiable smoking related illness · Not only are smokers affected by smoking related illnesses, people who are consistently exposed to secondhand smoke (including children) are also at risk for developing smoking related diseases. · Smoking is also associated with high-risk sexual behavior, use of alcohol and drugs.

Interpersonal violence

· Child maltreatment abuse and neglect that occurs to children under 18 years of age o all types of physical and/or emotional ill-treatment, sexual abuse, neglect, negligence and commercial or other exploitation, which results in actual or potential harm to the child's health, survival, development or dignity in the context of a relationship of responsibility, trust or power. · Intimate partner violence o refers to behavior in an intimate relationship that causes physical, sexual or psychological harm, including physical aggression, sexual coercion, psychological abuse and controlling behaviors · Sexual violence o is any sexual act, attempt to obtain a sexual act, unwanted sexual comments or advances, or acts to traffic, or otherwise directed against a person's sexuality using coercion, by any person regardless of their relationship to the victim, in any setting. It includes rape, defined as the physically forced or otherwise coerced penetration of the vulva or anus with a penis, other body part or object. · Elder maltreatment o any abuse and neglect of persons age 60 and older by a caregiver or another person in a relationship involving an expectation of trust o Also vulnerable to economic abuse—where others make improper use of their resources o In a survey in the United States § 36 % of nursing-home staff reported having witnessed at least one incident of physical abuse of an elderly patient in the previous year § 10% admitted having committed at least one act of physical abuse themselves § 40% said that they had psychologically abused patients · Youth Violence o adolescents and young adults between the ages of 10 and 29 years o main victims and perpetrators of youth violence are adolescents and young adults

World AIDS Day

· December 1st · Red ribbon

Biologic

· Disease-causing organisms (bacteria, viruses, toxins) · Available; small quantities can have a large effect; they spread through large areas; they can remain in the air or on surfaces; and they're difficult to prepare against. · They have delayed effects; production hazardous to terrorists; and difficult to develop · the treatment is dependent on the agent used; most cause flu like symptoms; plague and smallpox are the most contagious; timing of specific treatment is critical; in some cases there are vaccines.

· BAC of .05% to .08%

· EVERYONE HAS REACHED THIS BAC POINT AFTER JUST THEIR 1ST OR 2ND DRINK · Functioning ability definitely impaired. · Walking, speech, and hand movements clumsy. Blurred, split, or tunnel vision may occur. Judgment and equipment operating ability impaired. Chance of accident is greatly increased by up to 300% or more.

Global to Local

· GloCal health · Global=worldwide · Local= your patient and where you live

Influenza pandemic

· Global outbreak that occurs when a new influenza virus "emerges" in the human population, causing serious illness and death as it spreads worldwide · Biologic cause of Mass Casualty · Health care providers · position of being first responders · Surveillance · The flu requires constant surveillance and aggressive preventive measures to contain and control the potential devastating effects. · good surveillance and monitoring of the flu and resultant flu vaccinations which are targeted at the strains of influenza that are most likely to cause the most illness.

Obesity Prevalence Worldwide

· Globally, the prevalence of obesity is that worldwide obesity has nearly tripled since 1975 · The risk of death rises with increasing weight. Individuals who are obese have a 50 to 100% increased risk of premature death from all causes, compared to individuals with a healthy weight. · Over 5 million people died prematurely in 2019 as a result of obesity. · 2019 - over 5 million died prematurely · 2019 - 38.2 million children under five were overweight or obese; one in five children and adolescents are overweight. · 2020 - more than 2 billion adults were overweight. Of these, over 650 million were obese. · 2021- 2.8 million people die each year as a result of being overweight or obese · 2020- more than 2 billion adults were overweight. Of these, over 650 million were obese. · 2020—39 million children under five are overweight or obese · Healthcare costs exceeding $700 billion each year · No country is on track to meet the WHO's 2025 targets on obesity; rates continue to rise globally · By 2030, it is predicted that 1 in 5 women and 1 in 7 men will be living with obesity (BMI ≥30kg/m2), equating to over 1 billion people globally · Countries are moving away from, rather than towards the targets, as levels of obesity continue to rise.

HIV/AIDS Transmission

· HIV is transmitted through the exchange of specific bodily fluids [blood, semen, vaginal secretions, breast milk and other body fluids containing blood] from infected individuals · For transmission to occur, these fluids must come in contact with mucous membrane [found inside the rectum, the vagina, the opening of the penis, and the mouth] or be directly injected into the blood-stream [from a needle or syringe]. · An infected HIV individual can transmit HIV by unprotected sexual intercourse (anal or vaginal), transfusion of contaminated blood, sharing of contaminated needles, and between a mother and her infant during pregnancy, childbirth and breastfeeding. · HIV cannot be spread through the air and it does not live long outside of the body. Transmission cannot occur from pets or insects including ticks and mosquitoes; saliva, tears, sweat, or urine; causal contact such as hand shaking; closed mouth or "social" kissing; or from a door knob, drinking fountain, drinking glasses, dishes, food, or cigarettes.

run

· Have an escape route and plan in mind · Evacuate regardless of whether others agree to follow · Leave belongings behind · Help others escape, if possible · Prevent individuals from entering an area where the active shooter may be · Keep your hands visible · Follow the instructions of any police officers · Do not attempt to move wounded people · Call 911 when you are safe

WHO definition of health

· Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. This definition has not been amended since 1948.

hide

· Hiding place should be out of active shooter's view · Provide protection if shots are fired in your direction · Try not to trap yourself · Lock the door · Blockade the door with heavy furniture · Silence cell phone · Turn off other sources of noise (TV or radio) · Hide behind large items · Remain calm and quiet · Dial 911

Illicit Drugs

· Illicit = unlawful or illegal · The United Nations Office on Drugs and Crime defines drug trafficking as "a global illicit trade involving the cultivation, manufacture, distribution, and sale of substances which are subject to drug prohibition laws. · The main drugs involved include the opiates (mostly heroin), cannabis (marijuana and hashish), cocaine, and amphetamine-type stimulants such as amphetamines, methamphetamine, and ecstasy. · Hallucinogens · Inhalants

· Radiologic

· Immediate effects: burns & poisonings · Long-term effects: cancer & drinking water contamination · Ionizing radiation is able to strip electrons from atoms, causing chemical changes in molecules; expression may be delayed; radiation depends on time, distance, Shielding, and quantity of radioactive material. · Available; psychological effect likely to be substantial; often used in conjunction with explosive devices (dirty bombs) · delayed effects of radiation materials; difficult to shield against · dirty bomb causes immediate effects (radiation burns, acute poisoning) and long term effects (cancer, contamination of drinking water); decontamination must occur before patient care can be safely provided by the health care worker.

effects of terrorism

· Increases morbidity and mortality · Physical illnesses · Disabilities · Mental health trauma ----Distress responses · Sense of vulnerability · Insomnia · Irritability, distraction -------Health Risk Behaviors · Smoking · Alcohol · Over dedication -------Psychiatric Illness · PTSD · Depression · Complex grief · socio economic destruction

Influenza

· Influenza or the "flu" is an acute viral illness caused by the influenza virus · The flu attacks the respiratory system and in some cases the flu can cause very severe illness which can result in death. · The flu is typically a seasonal illness occurring primarily in the autumn and winter months · There are four main influenza viruses - types A, B, C and D. · Influenza types A & B cause the majority of the illnesses and therefore these are the ones that are typically targeted against with vaccinations. Typical signs and symptoms of the flu include fever, cough, headache, muscle and joint pain and severe malaise (feeling of unwell). Symptoms persist for about 1 week in healthy persons without medical attention. · Contagious- via droplets · An epidemic can take an economic toll · Lost workforce productivity · Strain health services · While any age group, any ethnic group and any gender can contract the flu, those at highest risk for severe illness are those with chronic health conditions (heart disease, lung disease, kidney disease, liver problems, diabetes and those with weakened immune systems), those over 65 and children younger than 5, especially those below the age of 2 years. Pregnant women, American Indians and Alaskan Natives are also at high risk. Those populations who are considered high-risk typically have an increased incidence of severe illness with complications which can result in death.

terrorists attack examples

· Kidnappings and Hostage-Takings · Arsons and Firebombing · Hijackings and Skyjackings

fight

· Last resort · When life is in imminent danger · Attempt to disrupt or incapacitate the active shooter · Act aggressively · Throw items · Improvise weapons · Yell · Commit to your actions

CDC tips to help prevent opioid-related overdoses:

· Learn more about opioids so you can help people who are most at risk for opioid use disorder and overdose in your community. · Provide tools and information for healthcare professionals working on overdose prevention and treatment. · Help those struggling with opioid use disorder find the right care and treatment. · Increase awareness and share best practices with providers and patients in your community. · As a patient, a healthcare provider, or a member of a community you can ensure that the best information is being shared and understood to prevent overdose deaths.

Alcohol - Reduction/Prevention Efforts

· License revocation · Minimum Legal Drinking Age - age 21 · .08 BAC Law - legal blood alcohol concentration limit for drivers >21 y/o · Zero Tolerance Law · Intensive Sobriety Checkpoint Program · Ignition Interlocks · ULL SLIDDE School Leaders Involved in Drinking & Drug Education According to WHO, there are strategies that have evidence of effectiveness, some of which include the following: · Regulating the marketing of alcohol, especially to younger ages · Restricting and regulating availability of alcohol · Enacting appropriate drinking & driving policies · Availability of affordable treatment for those with alcohol problems

obesity prevalence in Louisiana

· Louisiana ranks #1 in the U.S. for adult obesity (2022) · Nearly one out of four adults in is considered obese · 24% of youth ages 10 to 17 have obesity (3rd in U.S.) · Super-sized rice servings, going for seconds, all-you-can-eat buffets, high carbohydrate and fried food intake, sedentary lifestyle-> extra calories · Louisiana was the most-overweight state in the country 2012; in 2022, Louisiana once again, had the highest obesity rate in the nation. Childhood (youth ages 10 to 17) obesity ranks 3rd out of the 5o states and D.C. Obesity and overweight have reached epidemic proportions Obesity & overweight are associated with increased risk for costly chronic diseases, such as diabetes, cardiovascular disease, osteoarthritis and some cancers Obese adults have a 36% higher average annual medical expenditure than adults at normal weight The cost of child obesity-associated illness increased from 35 to 127 million in the past 2 decades · Louisiana can use several strategies to reduce the prevalence of obesity: · develop supportive environments and communities, make healthier food choices (have affordable and accessible healthy foods), and incorporate regular physical activity. · Other strategies include healthy problem-solving techniques and or coping strategies.

· Other influences that affect youth tobacco use

· Lower socioeconomic status, including lower income or education · Not knowing how to say "no" to tobacco product use o Lack of support or involvement from parents o Accessibility, availability, and price of tobacco products o Doing poorly in school o Low self-image or self-esteem o Seeing tobacco product advertising in stores, on television, the Internet, in movies, or in magazines and newspapers

Louisiana 2017 Legislature for opioids

· Mandates prescribers to register in Prescription Monitoring Program (PMP). Patient's prescription history is checked for possible abuse. · First-time opioid prescription for acute pain limited to seven-day supply. · Louisiana Board of Elementary and Secondary Education added requirement for schools on substance abuse prevention education, identification and referral

· Explosive

· Most common method for terrorists · Capable of violent decomposition; pressure, temperature changes, and propellants cause injury or death. · Available materials to construct explosive device; large devices can be placed in abandoned vehicles; smaller device can be placed on the body of a person willing to commit suicide by igniting the device · volatile ingredients could cause premature explosion of this device, That's creating danger for terrorists; government agencies have improved training and processes for identifying incendiary devices · symptomatic; often requires treatment for burns.

· BAC of .01% to .05%

· NOTE THAT FOR MANY PEOPLE, ONLY "ONE" DRINK WILL TAKE THEM TO THIS LEVEL OF DECREASED COORDINATION. · Some loss of judgement and · coordination. · Thinking is dulled, changes in mood and behavior. A BAC of 0.02% at many U.S. companies will require that an employee be relieved of duty for 24 hours and at 0.04 they will be fired. In an organization with a "zero-tolerance" policy as regards alcohol use, you will be fired if you test at 0.001% BAC

· BAC of .08% and over

· NOTE THAT SOME PEOPLE REACH THIS BAC POINT BY THEIR 2ND DRINK AND ALL HAVE BY THEIR 3RD OR 4TH. · Functioning and judgement very seriously affected. · Responses greatly slowed. Behavior greatly affected. Very high risk of accident. In most U.S. States, with a BAC of .08% or higher, you will be arrested if driving a car.

Naloxone

· Naloxone is a very effective drug for reversing opioid overdoses. · Police officers, emergency medical services providers, and non-emergency professional responders carry the drug for that purpose. · The Surgeon General of the United States is also urging others who may encounter people at risk for opioid overdose to have naloxone available and to learn how to use it to save lives · 46 states now have available over the counter the sale of Naloxone · can be life-saving if administered in time. · sold under the brand name Narcan or Evzio · Controversial in many states of over the counter availability · Louisiana has a standing order that naloxone is available without a prescription at local pharmacies. · free for Medicaid patients; coverage for other insurance varies · Now being carried by firefighters, ambulance drivers, several locations on UL campus Main campus Narcan Locations

Alcohol health risks/Long-Term Health Risks-Over time, excessive alcohol

· Neurological problems, dementia, stroke, neuropathy, memory and learning problems · Cardiovascular problems, including myocardial infarction, cardiomyopathy, atrial fibrillation, hypertension · Cancer of the mouth, throat, esophagus, liver, colon, and breast · Liver diseases, including— o Alcoholic hepatitis. o Cirrhosis, which is among the 15 leading causes of all deaths in the United States o Among persons with Hepatitis C virus, worsening of liver function and interference with medications used to treat this condition. · Other gastrointestinal problems, including pancreatitis and gastritis · Diabetes · Psychiatric problems, including depression, anxiety, and suicide · Social problems, including unemployment, lost productivity, family problems, criminal convictions · Alcohol dependence

Global health

· Nurses are engaged in the global health community through collaborative networks, research projects, and shared publications. Programs incorporate global content, and Students learn to participate in international health research projects and communication through the Internet and have direct learning experiences in countries abroad. · These trends challenge students to prepare for a wide spectrum of nursing practice that depends on competencies such as clinical decision making, communication, collaboration, and leadership. · Students need to learn how to manage illness and prevent health care for diverse clients dispersed throughout the community as well as to provide critical care to hospital patients who are sicker and go home sooner.

Violence

· Nurses have always worked in situations emanating from disasters, abuse, and violence in families and communities, and in military conflicts. · Domestic violence, especially against women and children, has increased as has violence in the workplace and schools. Greater violence has precipitated an increased emphasis in nursing education and in the state regulations for reporting and responding to violent incidents. Criminal acts and substance abuse have become more common in hospitals, and other health care agencies, and schools of nursing, threatening the safety of patients and staff. · As a consequence criminal background checks are required for all students and employees by education programs as well as by agencies providing clinical experiences to students. · The World Health Organization defines violence as 'The intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group or community, that either results in or has a high likelihood of resulting in injury, death, psychological harm, mal-development or deprivation.'

preventing opioid overdose as nurses

· Nurses often lead the way in an attitudinal transformation toward pain management by recognizing needs for: · Prevention, early recognition, intervention of pain issues · person-centered, interdisciplinary approach to pain management · RNs practice in a variety of direct-care, care-coordination, leadership, and executive roles, they are often in a key position to help patients and their families understand the risks and benefits of pain treatment options.

Tobacco Toll (Global)

· One billion smokers · Kills more than 8 million people/year · ~ 1 person dies every 4 seconds · Every day, 80,000 to 100,000 young people become addicted to tobacco · Each year, secondhand smoke kills more than 1.2 million, including children · More than eight million people each year die from smoking related illness, of which more than 7 million are users and ex users and about 1.2 million are nonsmokers exposed to second-hand smoke. Every 4 seconds, approximately one person dies due to tobacco; this accounts for one in 10 adult deaths. · WHO notes that there is no safe level of exposure to second-hand tobacco smoke; with infants, it can cause sudden death; with pregnant women, it causes their babies to have low birth weight. Eight million people die per year from tobacco use with 7 million dying from direct use and 1.2 million dying from second hand smoke.

opioid stats

· Overdoses killed 50,943 individuals in the U.S. in 2021, with 81.9% of those deaths involving at least one opioid (most of which are illegally manufactured Fentanyl) · Continues to increase year to year About 284 million people worldwide (aged 15-64 years) used drugs at least once during 2020. Among them, there were about 61 million people who used opioids for non-medical reasons and about 31 million who used opiates. (mostly heroin) Opioids accounted for 77% of the drug related deaths in 2020. There were an estimated 38.6 million people who suffered from opioid use disorders in 2020. The majority of people dependent on opioids used illicitly cultivated and manufactured heroin, but an increasing proportion used prescription opioids. Roughly 494,000 people died because of drug use in 2019. Of those deaths, 64% were caused by opioids, mostly heroin and morphine, Overdose deaths contribute to between roughly a third and a half of all drug-related deaths, which are attributable in most cases to opioids. Lifetime prevalence of witnessed overdose among drug users is about 70%. There are effective treatments for opioid dependence yet less than 10% of people who need such treatment are receiving it. Due to their pharmacological effects, opioids in high doses can cause respiratory depression and death. The inexpensive medication naloxone can completely reverse the effects of opioid overdose and prevent deaths due to opioid overdose.

influenza pandemic protection

· Planning aimed at saving the largest number of people with control methods · Social Distancing · the attempt to keep people as far apart as possible to limit the possibilities of spreading germs. · Isolation · Quarantine · Restrictions · Limitations include: · Suspension of large public gatherings · School closures · Social distancing · Practice good health hygiene · Follow the general principles of sound public health · Cover mouth when coughing · Appropriately dispose of used tissues · Wash hands frequently and correctly · Stockpiling food and medicine · Develop contingency plans for school and business closures, unavailability of public transportation, and disruption in social activities

Nuclear

· Requires decontamination · Radioactive fallout · depends on yield of nuclear weapon, but consist of blast range effects, thermal radiation, nuclear radiation, and radioactive fallout. · Requires decontamination; contamination can remain for many years; psychological Infected likely to be substantial · Large, heavy, and dangerous weapons; hazardous to terrorist; make weapons of this type expensive and difficult to make · symptomatic treatment of thermal burns, shrapnel injuries and radioactive fallout; depends on distance from source and time of exposure

Self-directed violence

· Self-abuse o Major self-mutilation - including self-blinding and the amputation of fingers, hands, arms, limbs, feet or genitalia. o Stereotypical self-mutilation - such as banging one's head, biting oneself, hitting one's arm, gouging one's eyes or throat, or pulling one's hair. o Superficial-to-moderate self-mutilation - such as cutting, scratching or burning one's skin, sticking needles into one's skin, or pulling one's hair compulsively. · Suicide o human act of self-inflicting one's own life cessation o More than ½ of all deaths due to violence are from suicide

Terrorism

· Since the terrorist attacks on September 11, 2001, in New York City, Washington DC, and Pennsylvania, more nurses and all other health care personnel and first responders are more prepared to respond to attacks of terrorism and disaster. · Many nursing programs have added courses or even entire programs of study for specialized preparation as first responders, emergency nursing, and flight nursing. · The ANA and American Red Cross provide educational opportunities for nurses interested in disaster preparedness. · Terrorism is man-made; it has been used throughout human history in every part of the world. · Terrorism-No agreed upon definition -There is no single, universally accepted, definition of terrorism. · Premeditated unlawful life-threatening violence · Uses weapons for mass destructions against the civilian population · Used to: · Achieve political or social ends · Intimidate opponents, or · Publicize grievances · Attack is planned to obtain the greatest publicity

laws related to smoking in Louisiana

· Smoking is prohibited in all government and private workplaces, schools, childcare facilities, restaurants, retail stores and recreational/cultural facilities. · Smoking restrictions are required in casinos/gaming establishments (tribal establishments are exempt). Smoking restrictions are not required in bars. · There are municipalities in Louisiana with local 100% smoke-free laws, including bars. · The use of e-cigarettes is prohibited on any school property · It shall be unlawful for the operator or any passenger in a motor vehicle to smoke cigarettes, pipes, or cigars in a motor vehicle, passenger van, or pick-up truck, when a child who is required to be restrained in a rear-facing child safety seat, a forward-facing child safety seat, a booster seat, or a motor vehicle's safety belt is also present in such vehicle, regardless of whether windows of the motor vehicle are down. For purposes of this Section, the term "smoke" shall mean inhaling, exhaling, burning, or carrying any lighted cigarette, cigar, pipe, weed, plant, or other combustible substance in any manner or in any form

Chemical

· Spread easily through air · Cause immediate effects · Agents injure or kill through a variety of means; vesicant, nerve, blood, respiratory · Require decontamination · it's less toxic than biologic agents; they need to be used in large quantities; they are subject to dispersion by wind; terrorists need to protect themselves; they require train hazmat teams. · The treatment is dependent on the agent used; in some cases there are agent specific medications; they require decontamination; require the use of personal protective equipment by personnel.

Laws related to smoking (federal)

· The Family Smoking Prevention and Tobacco Control Act (known as the Tobacco Control Act) has given the Food and Drug Administration (FDA) broad authority to regulate the manufacturing, marketing, and distribution of tobacco products. · On Dec. 20, 2019, President Trump signed legislation to amend the Federal Food, Drug, and Cosmetic Act, raising the federal minimum age of sale of tobacco products from 18 to 21 years. This legislation (known as "Tobacco 21" or "T21") became effective immediately. It is now illegal for a retailer to sell any tobacco product, including cigarettes, cigars and e-cigarettes, to anyone under 21. · In 2014, the Affordable Care Act required that Medicaid programs cover all quit medications.

violence prevention organizations

· The Violence Prevention Alliance (VPA) is a network of WHO Member States, international agencies and civil society organizations working to prevent violence. · Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Violence Prevention · The Louisiana Coalition against Domestic Violence (LCADV) is a statewide network of domestic violence programs, supportive organizations, and individuals that share the goal of ending violence against women and children in Louisiana. LCADV empowers its members through advocacy, education, resource development, allocation of funds, and technical assistance.

Alcohol Prevalence globally

· The harmful use of alcohol is a global issue that impacts society and results in 3 million deaths per year Alcohol is a causal factor in more than 200 disease and injury conditions · Globally, in 2017, 107 million people are estimated to have an alcohol use disorder with 70% (75 million) male compared to 32 million females. The alcohol-attributable global deaths among men was 7.7 % compared to 2.6 % among women.

HIV/AIDS

· The human immunodeficiency virus (HIV) is a retrovirus (virus with genetic information in the RNA instead of the DNA) that infects cells of the immune system, destroying or impairing their function. As the infection progresses, the immune system becomes weaker, and the person becomes more susceptible to infections. · The most advanced stage of HIV infection is acquired immunodeficiency syndrome (AIDS). · The HIV/AIDS pandemic outbreak began in 20th century

Alcohol Prevalence

· The prevalence of excessive drinking is higher among: · Men compared with women. · Adults ages 18-44 compared with adults ages 45 and older. · Hawaiian/Pacific Islander, followed by Hispanic, multiracial, American Indian/Alaska Native and white adults, compared with Black and Asian adults. · Adults ages 25 and older who graduated high school compared with those who did not. · Adults ages 25 and older with an annual household income of $75,000 or higher compared with adults with all lower income levels.

Obesity Health consequences

· The risk for noncommunicable diseases increases, with increases in BMI · Obesity can be linked to more than 60 chronic diseases. · The majority of health consequences associated with obesity are: · Cardiovascular diseases (mainly heart disease & stroke) · Diabetes · Musculoskeletal disorders (especially osteoarthritis) · Cancers (endometrial, breast, colon) · Childhood obesity is associated with a higher change of obesity, premature death, and disability in adulthood. In childhood, it is also associated with breathing difficulties (sleep apnea, asthma), increase risk of fractures, hypertension, early markers of cardiovascular disease, insulin resistance, gastrointestinal problems (gallstones, gastro-esophageal reflux - GERD), and psychological effects (discrimination and low self-esteem)

COVID-19 Vaccines

· There are COVID-19 vaccines, which include primary series and boosters, recommended in the United States. · Vaccine recommendations are based on age, the first vaccine received, and time since last dose. · People who are moderately or severely immunocompromised have specific recommendations for COVID-19 vaccines, including boosters

how MDROs are spread

· There are many issues that contribute to the development of antimicrobial resistance. One contributing factor is when physicians or nurse practitioners prescribe antibiotics unnecessarily or when they prescribe inappropriate antibiotics. When individuals who are prescribed an antibiotic regimen and do not follow their prescribed treatment regimen the risk of that organism developing antibiotic resistance is increased. In healthcare facilities, inadequate hand washing contributes to the spread of antibiotic resistant organisms from patient to patient.

Smoking-Tobacco Control

· There are multiple strategies aimed at smoking cessation. These include: · Mass media campaigns aim at education the public regarding the hazards of smoking · Taxation on tobacco products trying to make it prohibitively expensive with tax revenues being earmarked for smoking related health issues. · Banning of ads on tobacco products · Banning smoking in public places making it inconvenient for smokers and to protect the "air" of non-smokers. · Protect children and youths from tobacco · Prevent them from starting · Offer tobacco users help to quit · Protect nonsmokers from exposure to second-hand tobacco smoke · Warn people about the dangers of tobacco · Regulate tobacco products · Ban tobacco advertising, promotion & sponsorship · In 2008, WHO introduced a package of tobacco control measures to further counter the tobacco epidemic and to help countries to implement the WHO Framework Convention. Known by their acronym MPOWER, the measures are identified as "best buys" and "good buys" in tobacco control. Each measure corresponds to at least one provision of the WHO Framework Convention on Tobacco Control. · The six MPOWER measures are: Monitor tobacco use and prevention policies Protect people from tobacco use Offer help to quit tobacco use Warn about the dangers of tobacco Enforce bans on tobacco advertising, promotion and sponsorship Raise state taxes on tobacco

HIV/Aid Prevalence Louisiana

· There are persons living with HIV/AIDS in every parish in Louisiana; we have staggering statistics! · HIV · 4th in nation · 2019 · Baton Rouge 4th · New Orleans 6th · Aids · 3rd in nation · Baton Rouge 1st · New Orleans 3rd

HIV/AIDS Reduce your risk of infection

· There is a link between sexually transmitted diseases (STDs) and HIV. Research has confirmed that there is significant biological evidence supporting that the presence of other STDs increases the chances of both transmitting and acquiring HIV. · Some key ways to prevent HIV transmission: · abstain from sex, or practice safe sexual behaviors such as using condoms the correct way every time · get tested and treated for sexually transmitted infections, including HIV · avoid injecting drugs, or if you do, always use new and disposable needles and syringes · ensure that any blood or blood products that you might need are tested for HIV · Reduce number of sexual partners · Male circumcision · and education and awareness

Smoking [Tobacco]

· Tobacco products are products made entirely or partly of leaf tobacco as raw material, which are intended to be smoked, sucked, chewed or snuffed · All contain the highly addictive psychoactive ingredient, nicotine · Using tobacco (cigarettes, chewing tobacco, cigars, pipes) is the world's leading cause of preventable death. The tobacco epidemic is global and has become one of the biggest health threats the world has ever faced. · Smoking contributes to disease and death. Smoking is the leading cause of preventable death. · World Health Organization notes that tobacco smoke contains more than 4000 chemicals with at least 250 that are known to be harmful and more than 50 are known to cause cancer. · Tobacco smoke hurts anyone who breathes it, including family and friends and children. According to the World Health Organization, tobacco kills nearly half of its users. · The tobacco user will usually die ~ 10 years earlier than the nonuser; in addition to the emotional loss, they deprive their families of income, raise the cost of health care and hinder economic development. · The most common form of tobacco used worldwide is cigarette smoking.

Alcohol health risks/ immediate

· Unintentional injuries · Intentional injuries · Violence · Risky sexual behaviors · Miscarriage and stillbirth among pregnant women, and a combination of physical and mental birth defects among children that last throughout life. · Alcohol poisoning, a medical emergency

first responders

· Unlike the other hazards these situations placed the health care providers in a position of being ______________________. Traditionally first responders to emergencies have been the law enforcement firefighters and emergency medical technicians who respond with ambulances.

95-95-95

· Updated UNAIDS targets for 2030 aim for · 95% of people living with HIV know their status, of whom 95% are on treatment; 95% are virally suppressed. · In 2021, with about 38 million people living with HIV, 85% knew their status, 75% were accessing treatment and 68% were virally suppressed.

Illicit Drugs-Global

· Used by 284 million people with ages 15-64 using annually; 38.6 million as problem users · Cannabis was the most commonly used drug in 2020 with 209 million people using it at least once in 2020 · 13.8 million young people aged 15-16 years old used cannabis in the past year. · Nearly 500,000 people died as a result of drug use ->overdoses involving any opioid, including prescription and illicit opioids, from 1999-2019 · 209 million use cannabis · 61 million use opioids · 34 million use amphetamines · 21 million use cocaine · 20 million use ecstasy · Louisiana: · 4.3% of Louisiana residents 12-17 years of age reported illicit drug dependence or abuse in past year. Was 2% in 2017. · 7.2% of Louisiana residents 18 years and older reported illicit drug dependence or abuse in past year

Violence prevalence globally

· Violence can be directed to people in all stages of life-infancy to elderly · More than 1.6 million worldwide die each year from violence · Suicide accounts for 54% of violent deaths globally, homicide for 35%, war and other armed conflict 11% · Violence is a leading cause of death among people aged 15-29 · Most violence occurs among poor populations in the U.S. and abroad; 91% of deaths due to violence are in low- and middle income countries · For each person killed, many more are injured and suffer from physical, sexual, reproductive and mental health problems o 1 of 2 children suffer some form of violence each year o 1 of 3 women experience either physical and/or sexual intimate partner violence or non-partner sexual violence at some point in their lives o 1 of 6 people 60 years and older experienced some form of abuse in community settings · 800,000 people die by suicide each year — one every 40 seconds -leading cause of death in young people · 415,000 people died from homicide in 2019. This was around three times the number killed in armed conflict and terrorism combined.

influenza prevalence (global)

· Worldwide, during the flu season (autumn and winter months) the flu causes 1 billion cases with severe illness in 3-5 million persons and results in approximately 290,000-650,000 deaths annually. · Epidemics can result in high levels of worker/school absenteeism and productivity losses. Clinics and hospitals can be overwhelmed during peak illness Hospitals and health care providers are inundated with large numbers of sick people while simultaneously dealing with loss of work force due to increased incidence of flu illness among health care workers. · In 191850 million died worldwide and 675,000 died in the United states · in 1957 one to two million died worldwide and 70,000 died in the United states · in 1968 seven hundred thousand died worldwide and 34,000 died in the United states.

Obesity

· a preventable disease that may impair health. · A person's weight status can be determined by a screening tool known as the Body Mass Index (BMI). BMI is a measure of body fat based on a person's weight in kilograms divided by the square of his height in meters (kg/m2) that applies to adult men and women. BMI can be a useful screening tool for predicting certain health risks. Adult BMI categories range from underweight through obese. · a common, serious, and costly disease. · the excessive accumulation of fat or adipose tissue in the body that may impair health and has body mass index (BMI) of 30 kg/m2 or higher. -· The primary cause of obesity and overweight is an energy imbalance between calories consumed and calories expended; most cases of obesity are simply related to modifiable behaviors such as a sedentary lifestyle and increased caloric intake. · Globally, there has been an increase intake of energy-dense foods that are high in fat, salt and sugar but low in vitamins, minerals and other micronutrients, a decrease in physical activity due to increasingly sedentary lifestyles, work environments, changing modes of transportation, and increasing urbanization. Other factors that contribute to obesity are genetics (Bardet-Biedl and Prader-Willi syndromes), certain diseases (Cushing Syndrome, Hypothyroidism), and certain medications (steroids, antidepressants). · The World Health Organization (WHO) defines obesity as "a condition in which percentage body fat (PBF) is increased to an extent in which health and well-being are impaired, and, due to the alarming prevalence increase, declared it as a "global epidemic".

Communicable Diseases

· also uses the terms infectious and contagious · Spread from one person to another or from an animal to a person · Spread via airborne viruses or bacteria, or also through blood or other bodily fluid

· Terrorism Target population-

· community · institution · society · state · country · in addition, vulnerable population with biological terrorism/bioterrorism-children, elderly, disadvantaged individuals

childhood obesity

· defined as a BMI at or above the 95th percentile for children of the same age and sex.

tough decisions nurses have had to make

· deliver medications when the usual pumps were not functioning · provide ventilation and suctioning without electricity · decide what medications would be given when the medication supply was depleted

· Cyber Terrorism

· designed to cause physical violence or extreme financial harm · premeditated, politically motivated attack against information, computer systems, computer programs, and data which results in violence against non-combatant targets by sub-national groups or clandestine agents [U.S. Federal Bureau of Investigation-(FBI)]cyber terrorist targets include the banking industry, military installations, power plants, air traffic control centers, and water systems [Commission of Critical Infrastructure Protection]

people at risk for MDROs

· elderly and very ill. Persons who are in hospitals and long-term care facilities such as nursing homes are also at greater risk. · There is no specific ethnicity or gender that is at any greater risk for contracting an MDRO · The risk factors for developing MDROs include the ill and elderly, those in hospitals and long-term care facilities, persons with AIDS or immunodeficiency disorders, persons with multiple chronic disorders (such as diabetes and chronic kidney disease) and those with previous exposure to a MDRO.

Centers for disease control and prevention (CDC):

· has the logo "24/7 Saving Lives. Protecting People™' and serves to protect America from health, safety and security threats, both foreign and in the U.S. · National level

The World Health organization (WHO):

· has the primary role to direct international health within the United Nations' system and to lead partners in global health responses. · International level

Health disparities

· health differences between different groups of people. These health differences may include: How many people get certain diseases. How severe the diseases are. How many people have complications because of the diseases. How many people die from a disease. Whether people can get health care How many people get screened for a disease. · These groups of people may be based on: Race Ethnicity Disability Age Sex or gender Sexual orientation Geography Income Level of education

three broad categories of disease burden

· non-communicable diseases (NCDs); · communicable, maternal, neonatal and nutritional diseases · injuries.

Nature of violent acts

· physical · sexual · psychological/emotional · involving deprivation or neglect · economic/financial abuse

The Louisiana Department of Health (LDH):

· protects and promotes health and ensures access to medical, preventive and rehabilitative services for all citizens of the State of Louisiana. · State level

COVID-19

· respiratory disease caused by SARS-CoV-2, a new coronavirus discovered in 2019 · This virus is thought to spread mainly from person to person through respiratory droplets produced when an infected person coughs, sneezes, or talks. · Some people who are infected may not have symptoms · For people who have symptoms, illness can range from mild to severe. COVID-19 most often causes respiratory symptoms that can feel much like a cold, a flu, or pneumonia. · COVID-19 may attack more than your lungs and respiratory system. Other parts of your body may also be affected by the disease. · Adults 65 years and older and people of any age with underlying medical conditions are at higher risk for severe illness. · Most people with COVID-19 have mild symptoms, but some people become severely ill. · Some people including those with minor or no symptoms may suffer from post-COVID conditions — or "long COVID". · Older adults and people who have certain underlying medical conditions are at increased risk of severe illness from COVID-19. · Hundreds of thousands of people have died from COVID-19 in the United States. · COVID-19 has impacted over 33 million people, causing over 1,000,000 deaths worldwide. · Nurses are on the frontline of care in defense and have raised concerns about sufficient protection. Nurses and other providers need to become even more diligent in preventing the spread of organisms.

Modifiable behavioral risk factors

· such as tobacco use, physical inactivity, unhealthy diet and the harmful use of alcohol, all increase the risk of NCDs. Premature deaths and disability of productive age adults are linked to unhealthy behaviors, or risk factors.

violence prevalence in Louisiana

· the murder capital of the United States and New Orleans · had the highest murder rate per capita of all major U.S. cities · has the highest murder rate in the U.S. of 16.1 murders per 100,000 residents. Murders were more than twice as common in Louisiana as they were nationwide. Murders are disproportionately concentrated in urban areas, especially New Orleans. New Orleans has a murder rate of about 51 per 100,000 residents, one of the highest of any U.S. city, followed by Baton Rouge with a murder rate of 46.5. · In addition, since 1997, consistently ranked within the top 5 states among female victims killed by male offenders o 5th highest rate of female homicide in the nation. [91% of these women knew their assailant and 70% of those victims were wives, ex-wives or girlfriends of their assailant.] women murdered by men remains 85% higher than the national average, at 2.18 homicides per 100,000 females. · Suicide death rates in U. S. =47,511 (in the year 2019); In the South: 18,716 (in the year 2019) · More than double the 6.6 per 100,000 national murder rate.