Compare vulnerable populations. Describe an example of one of these groups in the United States or from another country. Explain why the population is designated as “vulnerable.” Include the number of individuals belonging to this group and the specific challenges or issues involved. Discuss why these populations are unable to advocate for themselves, the ethical issues that must be considered when working with these groups, and how nursing advocacy would be beneficial.  

  Case study

Jenna and Chris Smith are the proud parents of Ana, a 5–day–old baby girl born without complications at Community Hospital. Since delivery, the parents have bonded well with Ana and express their desire to raise her as naturally as possible. For the Smiths, this means breastfeeding exclusively for the first six months, making their own baby food using pureed organic foods, and not allowing Ana to be vaccinated.

The Smiths are college educated and explain they have researched vaccines and decided the potential harms caused by them far outweigh any benefits. They point to the rise in autism rates as proof of the unforeseen risk of vaccines. Their new pediatrician, Dr. Angela Kerr, listens intently to the Smiths’ description of their research, including online mommy–blogs that detail how vaccines may have caused autism in many children. The Smiths conclude by resolutely stating they’ve decided not to vaccinate Ana, despite the recommendations of the medical community.

Dr. Kerr begins by stating that while vaccines have certainly sparked controversy in recent years, she strongly recommends that Ana become fully vaccinated. Dr. Kerr explains that vaccines have saved the lives of millions of children worldwide and have been largely responsible for decreases in child mortality over the past century. For example, the decreased incidence of infection with the potentially fatal Haemophilus influenzae type b, has resulted from routine immunization against that bacterium. Similarly, epidemics such as the recent outbreak of measles are usually associated with individuals who have not been vaccinated against that pathogen.

Dr. Kerr goes on to endorse the general safety of vaccines by informing Ana’s parents that safety profiles of vaccines are updated regularly through data sources such as the federal government’s Vaccine Adverse Event Reporting System (VAERS). The VAERS, a nationwide vaccine safety surveillance program sponsored by the Food and Drug Administration and the Centers for Disease Control and Prevention, is accessible to the public at https://vaers.hhs.gov/index. This system allows transparency for vaccine safety by encouraging the public and healthcare providers to report adverse reactions to vaccines and enables the federal government to monitor their safety. No vaccine has been proven casual for autism spectrum disorder (ASD), or any developmental disorder. On the contrary, many studies have shown that vaccines containing thimerasol, an ingredient once thought to cause autism, do not increase the risk of ASD.

Finally, Dr. Kerr reminds the Smiths that some children in the general population have weakened immune systems because of genetic diseases or cancer treatment, for example. It may not be medically feasible to vaccinate such children. Other children are too young to receive certain immunizations. Instead, these children are protected because almost all other children (and adults) have been vaccinated and this decreases their exposure to vaccine–preventable illnesses (VPIs). This epidemiological concept is known as “herd immunity.” As more parents refuse immunization for their healthy children, however, the rate of VPIs will increase. This puts vulnerable children at significant risk of morbidity and mortality. Routine childhood immunization contributes significantly to the health of the general public, both by providing a direct benefit to those who are vaccinated and by protecting others via herd immunity. Dr. Kerr concludes by stating that after considering the risks versus the benefits of immunization, most states require vaccinations before children can attend school. Parents may decide not to vaccinate under specific circumstances, however, which vary by state.

Jenna and Chris Smith confirm their understanding of what Dr. Kerr has explained, but restate that they do not want Ana vaccinated at this time. Dr. Kerr is perplexed as to what to do.

Instructions

Note: The requirements outlined below correspond to the grading criteria in the scoring guide. At a minimum, be sure to address each point. In addition, you are encouraged to review the performance-level descriptions for each criterion to see how your work will be assessed.

For this assessment, develop a solution to a specific ethical dilemma faced by a health care professional. In your assessment:

1. Access the Ethical Case Studies media piece to review the case studies you will be using for this assessment.
   • Select the case most closely related to your area of interest and use it to complete the assessment.
     • Note: The case study may not supply all of the information you need. In such cases, you should consider a variety of possibilities and infer potential conclusions. However, please be sure to identify any assumptions or speculations you make.
   • Include the selected case study in your reference list, using proper APA style and format. Refer to the Evidence and APA section of the Writing Center for guidance.
2. Summarize the facts in a case study and use the three components of an ethical decision-making model to analyze an ethical problem or issue and the factors that contributed to it.
   • Identify which case study you selected and briefly summarize the facts surrounding it. Identify the problem or issue that presents an ethical dilemma or challenge and describe that dilemma or challenge.
   • Identify who is involved or affected by the ethical problem or issue.
   • Access the Ethical Decision-Making Model media piece and use the three components of the ethical decision-making model (moral awareness, moral judgment, and ethical behavior) to analyze the ethical issues.
     • Apply the three components outlined in the Ethical Decision-Making Model media.
   • Analyze the factors that contributed to the ethical problem or issue identified in the case study.
     • Describe the factors that contributed to the problem or issue and explain how they contributed.
3. Apply academic peer-reviewed journal articles relevant to an ethical problem or issue as evidence to support an analysis of the case.
   • In addition to the readings provided, use the Capella library to locate at least one academic peer-reviewed journal article relevant to the problem or issue that you can use to support your analysis of the situation. The NHS-FPX4000: Developing a Health Care Perspective Library Guide will help you locate appropriate references.
     • Cite and apply key principles from the journal article as evidence to support your critical thinking and analysis of the ethical problem or issue.
     • Review the Think Critically About Source Quality resource.
       • Assess the credibility of the information source.
       • Assess the relevance of the information source.
4. Discuss the effectiveness of the communication approaches present in a case study.
   • Describe how the health care professional in the case study communicated with others.
   • Assess instances where the professional communicated effectively or ineffectively.
   • Explain which communication approaches should be used and which ones should be avoided.
   • Describe the consequences of using effective and non-effective communication approaches.
5. Discuss the effectiveness of the approach used by a professional to deal with problems or issues involving ethical practice in a case study.
   • Describe the actions taken in response to the ethical dilemma or issue presented in the case study.
   • Summarize how well the professional managed professional responsibilities and priorities to resolve the problem or issue in the case.
   • Discuss the key lessons this case provides for health care professionals.
6. Apply ethical principles to a possible solution to an ethical problem or issue described in a case study.
   • Describe the proposed solution.
   • Discuss how the approach makes this professional more effective or less effective in building relationships across disciplines within his or her organization.
   • Discuss how likely it is the proposed solution will foster professional collaboration.
7. Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.
   • Apply the principles of effective composition.
   • Determine the proper application of the rules of grammar and mechanics.
8. Write using APA style for in-text citations, quotes, and references.
   • Determine the proper application of APA formatting requirements and scholarly writing standards.
   • Integrate information from outside sources into academic writing by appropriately quoting, paraphrasing, and summarizing, following APA style.

During each term of the Doctoral Study students will develop a term plan with term goals that must be achieved in order earn a Satisfactory grade for the term.

Using the Doctoral Study Guide on the DHA Doctoral Study website complete the following on the discussion board.

By Day 4

Create an initial discussion board post that includes the following:

1. When are term plans required to be submitted for final approval each term?
2. What must a student submit and achieve to earn a Satisfactory grade each term?
3. Explain the relationship and purpose amongst the “Initial Term Plan”, “Mid-Term Review” and “Final Term Plan”.
4. What does the acronym SMART stand for and when is it used in term planning?
5. Based on the information from the DHA Program Prospectus Support site create a SMART term plan goal.

Support your Discussion with citations and specific references to all resources used in its preparation. You are asked to provide a reference list for all resources, including those in the resources for this course.

Question

Question 1

Endemic means that a disease:

a. Occurs clearly in excess of normal expectancy

b. Is habitually present in human populations

c. Affects a large number of countries simultaneously

d. Exhibits a seasonal pattern

e. Is prevalent among animals

Question 2

The first table shows the total number of persons who eat each of two specified food items that were possibly ifeffective with group A streptococci. The second table shows the number of sick persons (with acute sore throat) who eat each of the various specified combinations of the food items. 

Total number of persons who ate each   specified combination of food items

Ate   Tuna

Did   not Ate Tuna

Ate   egg salad

75

100

Did   not egg salad

200

50

Total   number of persons who ate each specified combination of food items & who   later became sick (with acute sore throats)

Ate   Tuna

Did   not Ate Tuna

Ate   egg salad

60

75

Did   not egg salad

70

15

What is the sore throat attack rate in persons who ate both egg salad & tuna

a. 60/75

b. 70/200

c. 60/133

d. 60/275

e. None of the above

Question 3

According to the results shown in the preceding tables, which of the following food items (or combination of food items) is most likely to be infective?

a. Tuna only

b. Egg salad only

c. Neither tuna nor egg salad

d. Both tuna & egg salad

e. Cannot be calculated from the data

Question 4

In the study of an outbreak of an infectious disease, plotting an epidemic curve is useful because:

a. It helps to determine what type of an outbreak (e.g. single-source, person-to-person) has occurred

b. It shows whether herd immunity has occurred

c. It helps to determine the median incubation period

d. A & c

e. A,b, & c

Question 5

Which of the following is characteristic of a single-exposure, common-vehicle outbreak?

a. Frequent secondary cases

b. Increasing severity with increasing age

c. Explosive

d. Cases include both people who have been exposed & those who were not exposed

e. All of the above