The case study I chose this week was the young patient, Katie, who presents with symptoms of attention deficit hyperactivity disorder (ADHD), predominantly inattentive presentation. Her teacher describes her symptoms as inattentive, easily distracted, forgets things she already learned, and is poor in spelling, reading, and arithmetic. ADHD is the most common neurodevelopmental disorder diagnosed in childhood and is characterized by chronic symptoms of inattention, impulsivity, and/or hyperactivity leading to functional impairment in multiple settings (Danielson, Bitsko, Ghandour, Holbrook, Kogan & Blumberg, 2018).

The first decision I made in Katie’s plan of care was prescribing Ritalin chewable tablets 10mg orally in the morning. Katie and her parents returned to the clinic four weeks later stating that the medication did improve her symptoms in the morning and overall academic performance, but by the afternoon Katie became easily distracted again. She also was tachycardic from the medication. My next decision was to discontinue the Ritalin and prescribe Adderall XR 15mg orally daily. The extended release helped maintain her attention throughout the day, but Katie still was tachycardic. At this point, my next decision was simply to reduce the dose to 10mg. Unfortunately, tachycardia is a main side effect from Adderall, but Katie’s could have been worse because she was started at a higher dose. It is important to initially start at 10mg and increase to 5-10mg once the patient is tolerating the medication well. 

The administration of the associated pharmacotherapeutics I recommended may impact the patient’s pathophysiology in different ways. For example, the drugs Ritalin and Adderall are both stimulants causing a possible increased heart rate, which is the main side effect this patient presented with. This is why it is important to start the patient on a low dose and gradually increase the dose as needed. In addition, these drugs may also impact the patient’s sleep and cause eating problems, which has commonly been reported but can be managed by making adjustments to the medication regimen or daily routines (Hennissen, Bakker, Banaschewski, Carucci, Coghill, Danckaerts, Buitelaar, 2017). However, these types of drugs are highly effective in the treatment of ADHD by improving attention and focus causing the impulsiveness and hyperactivity to decline because the child is now able to concentrate on the specific task (Rosenthal & Burchum, 2021). 

References 

Danielson, M. L., Bitsko, R. H., Ghandour, R. M., Holbrook, J. R., Kogan, M. D., & Blumberg, S. J.(2018). Prevalence of Parent-Reported ADHD Diagnosis and Associated Treatment Among U.S. Children and Adolescents, 2016. Journal of clinical child and adolescentpsychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53, 47(2), 199–212. https://doi.org/10.1080/15374416.2017.1417860

Hennissen, L., Bakker, M. J., Banaschewski, T., Carucci, S., Coghill, D., Danckaerts, M., . . .

Buitelaar, J. K. (2017). Cardiovascular Effects of Stimulant and Non-Stimulant Medication

for Children and Adolescents with ADHD: A Systematic Review and Meta-Analysis of

Trials of Methylphenidate, Amphetamines and Atomoxetine. CNS Drugs,31(3), 199-215.

doi:10.1007/s40263-017-0410-7

Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice

nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.

 TOPIC: Benchmark – Epidemiologic Profile Assignment

An epidemiologic profile is a summary of a significant public health issue, or issues, in your community, county, state, or country. An epidemiological profile helps to coordinate activities and policies from various agencies and organizations to improve health.

Review the available data, reports, and documents for your locale. Assess how the methods of epidemiology (study designs, data collection, measures of association, etc.) are used to determine who needs what services, where the services are needed, and how those services should be delivered. Define your community as your city, metropolitan area, or county and write a 2,000-2,250 word epidemiological profile (word limit excludes references and title page).The profile can be a general profile that provides a landscape picture of several significant chronic and infectious diseases in your defined community, or it can be a specific profile that targets one health issue, such as diabetes, asthma, STDs, flu, heart disease, obesity, alcohol abuse, or other drug use. Include the following:

Executive Summary

1. Describe the purpose of the epidemiologic profile and the health issue(s) it addresses. Discuss its importance to the community and how it will be utilized.
2. Summarize the key findings from your review of available data, reports, and documents for the community.

Introduction

1. Describe the defined community and population using demographic and socio-economic information and data.
2. Briefly describe the history and cultural background of the community.
3. Explain any unique contextual information that pertains to the public health of the defined community.
4. Describe any key public health projects, grants, or existing epidemiology-related working groups or committees in the community/county.

Description of Available Data

Identify at least two different data sources relevant to your profile. Discuss data from these sources and their relation to the issue or community.

Discuss the methods used in the data collection process (data source and organization providing the data; how often the data are collected; data limitations including response rates, missing data, selection of participants, etc.). Potential data sources and databases might include the following depending on what is available for your community or county:

1. Behavioral Risk Factor Surveillance System (BRFSS) data
2. Youth risk behavioral survey
3. Surveillance, epidemiology, and end results (SEER)      program data
4. CDC Wonder (multiple data sources)
5. County health rankings data (multiple data sources)
6. Alcohol-related disease impact data
7. Demographic health survey data (international)
8. Global school-based student health survey (international)
9. Local evaluation reports from the department/ministry of health or other nonprofit organizations

Interpretation of Results Regarding Key Health Issue

1. Size and magnitude of the measures
2. Trends and comparisons
3. Economic costs

Discussion of Problems and Strategies

1. Discuss disparities, limitations, and gaps in the information available regarding the health issue(s).
2. Describe potential public health strategies to address these gaps.
3. Use graphs and tables where appropriate.

Conclusion

You are required to cite to at least five sources to complete this assignment. Sources should be published within the last 5 years and appropriate for the assignment criteria and public health content.

General Requirements

Prepare this assignment according to the guidelines found in the APA Style Guide.

You are required to submit this assignment to LopesWrite. 

Benchmark Information

This benchmark assignment assesses the following programmatic competency:

MPH

2.1 Apply epidemiological methods to the breadth of settings and situations in public health practice.

MSN Public Health Nursing

6.2 Apply epidemiological methods to the breadth of settings and situations in public health practice.

STUDY MATERIALS

Read Chapters 17, 19, and 20 in Gordis Epidemiology.

CDC. (2014). Integrated Guidance for Developing Epidemiologic Profiles. Retrieved from https://www.cdc.gov/hiv/pdf/guidelines_developing_epidemiologic_profiles.pdf

Read “Health Inequalities Among British Civil Servants: The Whitehall II Study,” by Marmot and Smith, from The Lancet (1991). URL:https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=hch&AN=9107080526&site=ehost-live&scope=site

Read “The Role of Epidemiology in Disaster Response Policy Development,” by Thorpe et al., from Science Direct (2015). URL:http://www.sciencedirect.com.lopes.idm.oclc.org/science/article/pii/S1047279714003184?_rdoc=1&_fmt=high&_origin=gateway&_docanchor=&md5=b8429449ccfc9c30159a5f9aeaa92ffb

Read “Prescription Drug Abuse: From Epidemiology to Public Policy,” by McHugh, Nielsen, and Weiss, from Journal of Substance Abuse Treatment (2015). URL:http://www.sciencedirect.com.lopes.idm.oclc.org/science/article/pii/S0740547214001871?_rdoc=1&_fmt=high&_origin=gateway&_docanchor=&md5=b8429449ccfc9c30159a5f9aeaa92ffb&ccp=y

Read “The Role Epidemiology in Evidence-Based Policy Making: A Case Study of Tobacco Use in Youth,” by Aldrich et al., from Annals of Epidemiology (2015). URL:http://www.sciencedirect.com.lopes.idm.oclc.org/science/article/pii/S1047279714001495?_rdoc=1&_fmt=high&_origin=gateway&_docanchor=&md5=b8429449ccfc9c30159a5f9aeaa92ffb

Read “Epidemiology, Policy, and Racial/Ethnic Minority Health Disparities,” by Carter-Pokras et al., from Annals of Epidemiology (2012). URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3724931/

Read “Epidemiology and Public Policies,” by Barata, from Revista Brasileira de Epidemiologia (2013). URL: http://www.scielo.br/scielo.php?pid=S1415-790X2013000100003&script=sci_arttext&tlng=en

Read “Ethical Issues in Epidemiologic Research and Public Health Practice,” by Coughlin, from Emerging Themes Epidemiology (2006). URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1594564/

Explore the “Viral Hepatitis Epidemiologic Profiles” map, located on the Association of State and Territorial Health Officials (ASTHO) website, to assist with topic assignment.URL: https://www.astho.org/Viral-Hepatitis-Epi-Profiles/Map/

Use the “BRFSS Web Enabled Analysis Tool,” located on the Centers for Disease Control and Prevention (CDC) website, to complete the topic assignment. URL: https://nccd.cdc.gov/weat/#/

Review the “Belmont Report,” by the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research (1979), located on the U.S. Department of Health and Human Services – Office for Human Research Protections website. URL: https://www.hhs.gov/ohrp/regulations-and-policy/belmont-report/index.html

Explore the resources on “Health Data Tools and Statistics,” located on the PHPartners website. URL: https://phpartners.org/health_stats.html

Explore “Surveillance, Epidemiology and the End Results Program,” from the National Cancer Institute.URL: https://seer.cancer.gov/

Explore the STEPwise Approach to Surveillance (STEPS) page of the World Health Organization (WHO) website. URL: http://www.who.int/chp/steps/en/