Discussion: Pharmacokinetics and Pharmacodynamics

As an advanced practice nurse assisting physicians in the diagnosis and treatment of disorders, it is important to not only understand the impact of disorders on the body, but also the impact of drug treatments on the body. The relationships between drugs and the body can be described by pharmacokinetics and pharmacodynamics.

Pharmacokinetics describes what the body does to the drug through absorption, distribution, metabolism, and excretion, whereas pharmacodynamics describes what the drug does to the body.

Photo Credit: Getty Images/Ingram Publishing

When selecting drugs and determining dosages for patients, it is essential to consider individual patient factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes. These patient factors include genetics, gender, ethnicity, age, behavior (i.e., diet, nutrition, smoking, alcohol, illicit drug abuse), and/or pathophysiological changes due to disease.

For this Discussion, you reflect on a case from your past clinical experiences and consider how a patient’s pharmacokinetic and pharmacodynamic processes may alter his or her response to a drug.

To Prepare

• Review the Resources for this module and consider the principles of pharmacokinetics and pharmacodynamics.
• Reflect on your experiences, observations, and/or clinical practices from the last 5 years and think about how pharmacokinetic and pharmacodynamic factors altered his or her anticipated response to a drug.
• Consider factors that might have influenced the patient’s pharmacokinetic and pharmacodynamic processes, such as genetics (including pharmacogenetics), gender, ethnicity, age, behavior, and/or possible pathophysiological changes due to disease.
• Think about a personalized plan of care based on these influencing factors and patient history in your case study.

By Day 3 of Week 1

Post a description of the patient case from your experiences, observations, and/or clinical practice from the last 5 years. Then, describe factors that might have influenced pharmacokinetic and pharmacodynamic processes of the patient you identified. Finally, explain details of the personalized plan of care that you would develop based on influencing factors and patient history in your case. Be specific and provide examples.

Learning Resources

Required Readings (click to expand/reduce)

Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.
Chapter 1, “Prescriptive Authority” (pp. 1–3)
Chapter 2, “Rational Drug Selection and Prescription Writing” (pp. 4–7)
Chapter 3, “Promoting Positive Outcomes of Drug Therapy” (pp. 8–12)
Chapter 4, “Pharmacokinetics, Pharmacodynamics, and Drug Interactions” (pp. 13–33)
Chapter 5, “Adverse Drug Reactions and Medication Errors” (pp. 34–42)
Chapter 6, “Individual Variation in Drug Response” (pp. 43–45)

American Geriatrics Society 2019 Beers Criteria Update Expert Panel. (2019). American Geriatrics Society 2019 updated AGS Beers criteria for potentially inappropriate medication use in older adults. Journal of the American Geriatrics Society, 67(4), 674–694. doi:10.1111/jgs.15767
American Geriatrics Society 2019 updated AGS Beers criteria for potentially inappropriate medication use in older adults by American Geriatrics Society, in Journal of the American Geriatrics Society, Vol. 67/Issue 4. Copyright 2019 by Blackwell Publishing. Reprinted by permission of Blackwell Publishing via the Copyright Clearance Center.

This article is an update to the Beers Criteria, which includes lists of potentially inappropriate medications to be avoided in older adults as well as newly added criteria that lists select drugs that should be avoided or have their dose adjusted based on the individual’s kidney function and select drug-drug interactions documented to be associated with harms in older adults.

Drug Enforcement Administration. (n.d.-a). Code of federal regulations. Retrieved February 1, 2019, from https://www.deadiversion.usdoj.gov/21cfr/cfr/1300/1300_01.htm

This website outlines the code of federal regulations for prescription drugs.

Drug Enforcement Administration. (n.d.-b). Mid-level practitioners authorization by state. Retrieved May 13, 2019 from http://www.deadiversion.usdoj.gov/drugreg/practioners/index.html

This website outlines the schedules for controlled substances, including prescriptive authority for each schedule.

Drug Enforcement Administration. (2006). Practitioner’s manual. Retrieved from http://www.legalsideofpain.com/uploads/pract_manual090506.pdf
This manual is a resource for practitioners who prescribe, dispense, and administer controlled substances. It provides information on general requirements, security issues, recordkeeping, prescription requirements, and addiction treatment programs.

Drug Enforcement Administration. (n.d.-c). Registration. Retrieved February 1, 2019, from https://www.deadiversion.usdoj.gov/drugreg/index.html

This website details key aspects of drug registration.

Fowler, M. D. M., & American Nurses Association. (2015). Guide to the Code of Ethics for Nurses with Interpretive Statements: Development, Interpretation, and Application (2nd ed.). Silver Spring, Maryland: American Nurses Association.

This resource introduces the code of ethics for nurses and highlights critical aspects for ethical guideline development, interpretation, and application in practice.

Institute for Safe Medication Practices. (2017). List of error-prone abbreviations, symbols, and dose designations. Retrieved from https://www.ismp.org/recommendations/error-prone-abbreviations-list

This website provides a list of prescription-writing abbreviations that might lead to misinterpretation, as well as suggestions for preventing resulting errors.

Ladd, E., & Hoyt, A. (2016). Shedding light on nurse practitioner prescribing. The Journal for Nurse Practitioners, 12(3), 166–173. doi:10.1016/j.nurpra.2015.09.17

This article provides NPs with information regarding state-based laws for NP prescribing.

Sabatino, J. A., Pruchnicki, M. C., Sevin, A. M., Barker, E., Green, C. G., & Porter, K. (2017). Improving prescribing practices: A pharmacist‐led educational intervention for nurse practitioner students. Journal of the American Association ofNursePractitioners, 29(5), 248–254. doi:10.1002/2327-6924.12446

The authors of this article assess the impact of a pharmacist‐led educational intervention on family nurse practitioner (FNP) students’ prescribing skills, perception of preparedness to prescribe, and perception of pharmacist as collaborator.

Required Media (click to expand/reduce)

Introduction to Advanced Pharmacology
Meet Dr. Terry Buttaro, associate professor of practice at Simmons College of Nursing and Health Sciences as she discusses the importance of pharmacology for the advanced practice nurse. (8m)
Accessible player –Downloads–Download Video w/CCDownload AudioDownload Transcript

Nature Video. (2016). The evolution of oral anticoagulants [Video]. https://www.youtube.com/watch?v=Gp-ucDRiaUA
Note: This media program is approximately 5 minutes.

Speed Pharmacology. (2015). Pharmacology – Pharmocokinetics (Made Easy) [Video]. https://www.youtube.com/watch?v=NKV5iaUVBUI&t=16s
Note: This media program is approximately 14 minutes.

Speed Pharmacology. (2017).  Pharmacology – Diuretics (Made Easy) [Video]. https://www.youtube.com/watch?v=9OBvNpnS0h4&t=664s
Note: This media program is approximately 18 minutes.

Speed Pharmacology. (2017). Pharmacology – Antiarrhythmic Drugs (Made easy) [Video]. https://www.youtube.com/watch?v=9xSqezCMHnw&t=1205s
Note: This media program is approximately 23 minutes.

Speed Pharmacology. (2015). Pharmacology – Pharmocokinetics (Made Easy) [Video]. https://www.youtube.com/watch?v=NKV5iaUVBUI&t=16s
Note: This media program is approximately 14 minutes.

Speed Pharmacology. (2016). Pharmacology – Adrenergic receptors & agonists (MADE EASY) [Video]. https://www.youtube.com/watch?v=KtmV-yMDYPI&t=372s
Note: This media program is approximately 18 minutes.

Speed Pharmacology. (2017). Drugs for Hyperlipidemia (Made Easy) [Video]. https://www.youtube.com/watch?v=Of1Aewx-zRM&t=24s
Note: This media program is approximately 14 minutes.

3 resources for this discussion

I need these questions answered in 120 words each with individual references

UNIT 1

DQ1

Define endemic, epidemic, and pandemic, and provide an example of each. Describe a current epidemic. Describe one example of each of the prevention types (primary, secondary, and tertiary) that could be applied to control the epidemic.

DQ2

Discuss the role the CDC’s Morbidity and Mortality Weekly Report (MMWR) plays in conveying public health information and recommendations. Describe the type of data and information provided by the MMWR. Choose a report posted within the last 2 years from the “Publications – Weekly Report” tab. Provide a brief summary of the disease report, including the natural history and mode of transmission, and whether the report is an example of descriptive epidemiology or analytical epidemiology.

RESOURCES

Read Chapters 1, 2, and 6 in Gordis Epidemiology.

Read “Smoking and Carcinoma of the Lung,” by Doll and Hill, from British Medical Journal (1950). URL: https://www-ncbi-nlm-nih-gov.lopes.idm.oclc.org/pmc/articles/PMC2038856/pdf/brmedj03566-0003.pdf

Read “The Training of Epidemiologists and Diversity in Epidemiology: Findings from the 2006 Congress of Epidemiology Survey,” by Carter-Pokras et al., from Annals of Epidemiology (2009). URL: http://www.sciencedirect.com.lopes.idm.oclc.org/science/article/pii/S104727970900060X

Watch “Epidemiology the Backbone of Public Health,” by Greg Martin (2017), located on the YouTube website. URL: https://www.youtube.com/watch?v=S5XRh47T420

Read “The Framingham Study: ITS 50-Year Legacy and Future Promise,” by Kannel, from Journal of Atherosclerosis and Thrombosis (2000). URL: https://www.jstage.jst.go.jp/article/jat1994/6/2/6_2_60/_pdf

Read “Epidemiological Background and Design: The Framingham Study,” located on the Framingham Heart Study website. URL: https://www.framinghamheartstudy.org/fhs-about/history/epidemiological-background/

Read “Epidemiological Approaches to Heart Disease: The Framingham Study,” by Dawber, Meadors, and Moore, from American Journal of Public Health (1951). URL:http://scholar.google.com/scholar_url?url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1525365/pdf/amjphnation00421-0020.pdf&hl=en&sa=X&scisig=AAGBfm10VqiSJ6tLAYY0TMfm15VR8M93MA&nossl=1&oi=scholarr

View “Global Disease Detectives,” by the Center for Global Health (2013), located on the Centers for Disease Control and Prevention (CDC) website. URL: https://www.cdc.gov/cdctv/dataandstatistics/disease-detectives.html

Read “Section 2: Historical Evolution of Epidemiology,” from Lesson 1 of  the Centers for Disease Control and Prevention (CDC) self-study course, Principles of Epidemiology in Public Health Practice (2012), located on the CDC website. URL:https://www.cdc.gov/csels/dsepd/ss1978/lesson1/section2.html

Explore the CDC Current Outbreak List page of the Centers for Disease Control and Prevention (CDC) website. URL: https://www.cdc.gov/outbreaks/index.html

Explore the Epidemic Intelligence Service page of the Centers for Disease Control and Prevention (CDC) website. URL: https://www.cdc.gov/eis/index.html

Explore the Morbidity and Mortality Weekly Report (MMWR), located on the Centers for Disease Control and Prevention (CDC) website. URL: https://www.cdc.gov/mmwr/index.html

UNIT 2

DQ1

Disease surveillance is a necessary public health role. Passive surveillance relies on individuals and local authorities “pushing” information to national agencies who then compile, analyze, and disseminate the information. Unfortunately, significant gaps occur in reporting.

Review your textbook, and the CDC’s National Notifiable Disease Surveillance System (NNDSS). Discuss the strengths of the current surveillance systems, the gaps you identified, and why these gaps occur. Discuss the global challenges of coordinating surveillance between multiple countries and provide an example highlighting the challenges. What could other governments and agencies, such as the World Health Organization and the Centers for Disease Control and Prevention, do to strengthen global disease surveillance systems?

DQ2

Explain the importance of validity and reliability in diagnostic testing or research. Describe how validity relates to sensitivity and specificity in diagnostic testing. Identify a health screen specific to a diagnostic test that is currently being debated regarding its use, recommended ages, or frequency, and discuss how validity and reliability play into this debate. What other factors should you consider when you assess the recommendations for a diagnostic test or screen?

STUDY MATERIALS

Read Chapters 3-5 and 18 in Gordis Epidemiology.

Read “Types of Surveillance,” located on the London School of Hygiene and Tropical Medicine website. URL:http://conflict.lshtm.ac.uk/page_75.htm

Read “WHO Report on Global Surveillance of Epidemic-Prone Infectious Diseases – Introduction,” located on the World Health Organization (WHO) website. URL: https://www.who.int/csr/resources/publications/introduction/en/

Read “CDC 24-7 Fact of the Week,” located on the Centers for Disease Control and Prevention (CDC) website. URL:https://www.cdc.gov/about/facts/index.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fabout%2Ffacts%2Fcdcfastfacts%2Fsurveillance.html

Read “Two by Two Tables,” by Sullivan, Dean, and Pezzullo, from OpenEpi: Open Source Epidemiologic Statistics for Public Health (2013), located on the OpenEpi website. URL: http://www.openepi.com/TwobyTwo/TwobyTwo.htm

Read “Goodness of Measurement: Reliability and Validity,” by Bajpai and Bajpai, from International Journal of Medical Science and Public Health (2014). URL: https://www.ejmanager.com/mnstemps/67/67-1380953319.pdf

Use the “Compendium of Acute Foodborne and Waterborne Diseases,” located on the Centers for Disease Control and Prevention (CDC) website, to assist in completing the Oswego Outbreak Case History assignment. URL: https://www.cdc.gov/eis/casestudies/xoswego.401.303.compendium.pdf

View “How to Create an Epidemic Curve,” by Martin (2016), located on the YouTube website. URL: https://www.youtube.com/watch?v=dn84ezAzV4k

View “Know How to Interpret an Epidemic Curve?” by Martin (2017), located on the YouTube website. URL: https://www.youtube.com/watch?v=7SM4PN7Yg1s

Explore the National Notifiable Diseases Surveillance System (NNDSS) page of the Centers for Disease Control and Prevention (CDC) website. URL: https://wwwn.cdc.gov/nndss/

Explore Public Health Surveillance and Data page of the Centers for Disease Control and Prevention (CDC) website. URL: https://www.cdc.gov/surveillance/

UNIT 3

DQ1

Differentiate between bias and confounding. Discuss the criteria necessary to establish a factor as a confounder and provide an example applying these criteria. What is one way to adjust for a confounding relationship in the study design or the analysis?

DQ2

Explain the two major types of bias. Identify a peer-reviewed epidemiology article that discusses potential issues with bias as a limitation and discuss what could have been done to minimize the bias (exclude articles that combine multiple studies such as meta-analysis and systemic review articles). What are the implications of making inferences based on data with bias? Include a link to the article in your reference.

STUDY MATERIALS

Read Chapters 14 and 15 in Gordis Epidemiology.

Read “Association or Causation: Evaluating Links Between ‘Environment and Disease,'” by Lucas and McMichael (2005), located on the World Health Organization website. URL: https://www-ncbi-nlm-nih-gov.lopes.idm.oclc.org/pmc/articles/PMC2626424/pdf/16283057.pdf

Read “Weak Associations in Epidemiology: Importance, Detection, and Interpretation,” by Doll, from Journal of Epidemiology (1996). URL: https://www.jstage.jst.go.jp/article/jea1991/6/4sup/6_4sup_11/_pdf

Read “Causal Inference Based on Counterfactuals,” by Hofler (2005), located on the BioMed Central website. URL: https://bmcmedresmethodol.biomedcentral.com/articles/10.1186/1471-2288-5-28

Read “Multicausality: Confounding,” by Schoenbach (2004), located on the Epidemilog.net website. URL: http://www.epidemiolog.net/evolving/Multicausality-Confounding.pdf

View “Sensitivity and Specificity – Explained in 3 Minutes,” by Martin (2014), located on the YouTube website. URL: https://www.youtube.com/watch?v=FnJ3L-63Cf8

View “The Relationship Between Incidence and Prevalence,” by Patwari (2013), located on the YouTube website. URL: https://www.youtube.com/watch?v=1jzZe3ORdd8

Use the “Creating a 2×2 Contingency Table” resource to assist with the completion of the Measuring Morbidity: Prevalence and Incidence assignment, as needed.

UNIT 4

DQ1

Based on the “Multicausality: Confounding – Assignment,” by Schoenbach, discuss two significant insights you learned about confounding. Use specific examples from the assignment to support your answer.

DQ2

Describe the characteristics and design of a cohort study. Based on a disease or health condition identified from the “2020 LHI Topics” on the Healthy People 2020 website, or an article from the GCU library, discuss a real example of a cohort study (include the link to the article in your post to the forum). Include the participants, exposures or treatment groups, timeframe, and outcomes that were measured. Why is a cohort study described as an “observational” study rather than an “experimental” study design?

STUDY MATERIALS

Read Chapters 7-9 in Gordis Epidemiology.

View “Randomized Control Trials and Confounding,” by Martin (2013), located on the YouTube website. URL: https://www.youtube.com/watch?v=7ybuE39BpQ8

Read “2020 LHI Topics,” located on the Healthy People 2020 website. URL: https://www.healthypeople.gov/2020/leading-health-indicators/2020-LHI-Topics

Complete the “Multicausality: Confounding – Assignment,” by Schoenbach (2001), located on the Epidemilog.netwebsite. URL: http://www.epidemiolog.net/evolving/ConfoundingAssgt.pdf

Refer to the “Multicausality: Confounding – Assignment Solutions,” by Schoenbach (2001), located on the Epidemilog.netwebsite, to check your answers to the assignment. URL: http://www.epidemiolog.net/evolving/ConfoundingSolns.pdf

Read “Understanding Controlled Trials: Why Are Randomized Controlled Trials Important?” by Sibbald and Roland, from British Medical Journal (1998). URL:http://search.proquest.com.lopes.idm.oclc.org/docview/1777585669/fulltextPDF/2BDCED02960C4E6APQ/1?accountid=7374

UNIT 5

DQ1

Describe the common characteristics and design of a case-control study. Discuss the three important features when it comes to selecting cases and controls, and identify a situation when one of these might be violated. Discuss the limitations of using questionnaires for determining exposure status and provide examples of alternative strategies for collecting this information in a case-control study.

DQ2 

Discuss the strengths and weaknesses of cross-sectional studies and examples of how they can be “descriptive” or “analytic” study designs. Discuss an example of a disease where survival could influence the association between a possible exposure and the disease when measured with a cross-sectional study. Do not discuss examples used in the textbook.

STUDY MATERIALS

Read Chapter 10 in Gordis Epidemiology.

View “Cohort and Case Control Studies,” by Martin (2013), located on the YouTube website. URL: https://www.youtube.com/watch?v=J3GHTYa-gZg

Read “Introduction to Study Designs – Cross-Sectional Studies,” located on the Health Knowledge website. URL: https://www.healthknowledge.org.uk/e-learning/epidemiology/practitioners/introduction-study-design-css

Read “Cross-Sectional Studies,” from ERIC Notebook (2012), located on the Gillings School of Global Public Health -University of North Carolina website. URL: https://sph.unc.edu/files/2015/07/nciph_ERIC8.pdf

Read “Section 7: Analytic Epidemiology,” from Lesson 1 of the Centers for Disease Control and Prevention (CDC) self-study course, Principles of Epidemiology in Public Health Practice: An Introduction to Applied Epidemiology and Biostatistics (2012), located on the CDC website. URL: https://www.cdc.gov/csels/dsepd/ss1978/lesson1/section7.html

UNIT 6

DQ1

Differentiate between association and causation using the causal guidelines. Discuss which of the guidelines you think is the most difficult to establish. Discuss the four types of causal relationships and use an example not listed in the textbook to describe each relationship.

DQ2

Explain the difference between relative risk, attributable risk, and population attributable risk. Provide an example (not from the textbook) of how each type of risk is used in epidemiology. How would you propose using population attributable risk to advocate for a health policy or intervention relative to your health interest?

STUDY MATERIALS

Review Chapter 14, and read Chapters 11-13 in Gordis Epidemiology.

Read “Causation in Epidemiology: Association and Causation,” located on the Health Knowledge website. URL: https://www.healthknowledge.org.uk/e-learning/epidemiology/practitioners/causation-epidemiology-association-causation

Read “Section 5: Measures of Association,” from Lesson 3 of the Centers for Disease Control and Prevention (CDC) self-study course, Principles of Epidemiology in Public Health Practice: An Introduction to Applied Epidemiology and Biostatistics (2012), located on the CDC website. URL: https://www.cdc.gov/csels/dsepd/ss1978/lesson3/section5.html

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 “Multicausality: Confounding,” by Schoenbach (2004), located on the Epidemilog.net website. URL: http://www.epidemiolog.net/evolving/Multicausality-Confounding.pdf

View “How to Calculate Relative Risk,” by Shaneyfelt (2012), located on the YouTube website. URL: https://www.youtube.com/watch?v=xk2uK14eHNs

View “How to Calculate an Odds Ratio,” by Shaneyfelt (2012), located on the YouTube website. URL: https://www.youtube.com/watch?v=ITi0SxmQTO8

UNIT 7

DQ1

Epidemiological methods are used in a variety of public health areas (including infectious disease, chronic disease, and social health) and settings (including the community, schools, and the workplace). Epidemiological methods are used to assess, describe, analyze, and make comparisons of populations to inform evidence-based practices, policies, and interventions. Propose a study based on the methods you have learned thus far designed to investigate an association within one of the public health areas listed (infectious disease, chronic disease, or social health) and the methods you would apply. Discuss and define the risk factor or exposure that is being assessed, the method of comparison that is used, and the setting or situation (community, school, workplace, etc.) your study would look to address. Consider the concepts of causal inference, measures of association, and study design.

DQ2

Race is often used as a descriptor of disease burden and helps us to determine where health disparities exist in order to address them, which is important. It is helpful to differentiate between race as a descriptor and race as a risk factor. Think about institutional racism and its influence on health. Consider the factors related to race and ethnicity that might be influencing disease status more than the genetics of race when answering this discussion question.

Consider the following statement: “Race is not a risk factor and should not be used in public health data collection.” Discuss the ethical and public health implications of this statement. When might collecting data on race perpetuate institutional racism leading to health disparities and when is it necessary to improve public health? Provide support and examples for your answer. Consider ethical issues related to respect for persons, beneficence, and justice as described in “The Belmont Report.”

STUDY MATERIALS

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

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/

UNIT 8

DQ1

One method to investigate gene-environment interactions is to study monozygotic twins. Identify an example of a twin study not listed in the textbook used to examine the gene-environment interaction of a specific disease or condition. Briefly summarize the gene-environment interaction investigated, the methods, and the results. What are other possible methods for studying gene-environment interactions as they relate to improving population health?

DQ2

Using the CDC Wonder website, set the query criteria for pancreatic cancer for the United States as illustrated below. Compare the rates by race for Wisconsin and Colorado. Discuss possible biological, genetic, and environmental reasons for differences. What are potential social determinants that contribute to the disparity presented between the two states?

Use this query upon entering the CDC Wonder website:

Select “Cancer Statistics” under the Wonder Systems tab

Select “Cancer Incidence 1999 – 2013” and click “Data Request”

Organize table layout:

1. Group      results by 1. States and 2. Race (leave the rest of the group options as      “None”)
2. Measures      – click “Count” (default) and “Age Adjusted Rates”

Select location – select “States” and “The United States”

Select year and demographics

1. Year      – 2014
2. Sex      – All genders
3. Age      groups – All ages
4. Ethnicity      – All ethnicities
5. Race      – All races

Select cancers of interest – select “Pancreas”

Other options – keep default settings

STUDY MATERIALS

Read Chapter 16 in Gordis Epidemiology.

Read “Gene-Environment Interaction,” located on the National Institute of Environmental Health Sciences website. URL: https://www.niehs.nih.gov/health/topics/science/gene-env/index.cfm

Read “Defeating the ZIP Code Health Paradigm: Data, Technology, and Collaboration Are Key,” by Graham, Ostrowski, and Sabina, from the Health Affairs Blog (2015), located on the Health Affairs website. URL: http://healthaffairs.org/blog/2015/08/06/defeating-the-zip-code-health-paradigm-data-technology-and-collaboration-are-key/

Explore the CDC Wonder page of the Centers for Disease Control and Prevention (CDC) website.URL: https://wonder.cdc.gov/

Review the Mapping Life Expectancy page of the Robert Wood Johnson Foundation website. URL: http://www.rwjf.org/en/library/articles-and-news/2015/09/city-maps.html

 

The purpose of this assignment is for you to put it all together now that you have explored conceptual frameworks, models, and theories that guide advanced practice nursing.

Directions

In this Assignment, you will create a presentation using any form of presentation software (e.g., PowerPoint®, Prezi™, Powtoons™, Slidedog™, and so on). Your presentation should bring together the conceptual framework, model and theory that best fits your concept of advanced practice nursing related to your role after graduation.

Please remember that your presentation should contain slides that have bullet points. The bullets should number no more than four to six per slide. The bullet point is not written as a complete sentence. It contains key words. You, as the presenter will explain in depth what each bullet point means in the audio portion of the presentation. Slides may contain graphics, but should be uncluttered. Background and font colors should be of sufficient contrast to make reading them easy on the eyes. Attention to colors should be paid so that a person who is colorblind can easily read the presentation.

Assignment Details

The presentation should consist of a series of slides that include:

Title Slide: A title slide that identifies the title of the presentation and name of the student.

Introduction Slide: An introduction slide that includes brief information about you and your program track. The slide should also explain to the audience the purpose of the presentation.

Conceptual Slides: The third and fourth slide will focus on a conceptual framework that aligns to your professional nursing practice. The fourth slide should include why you chose the conceptual framework and how you will apply it in practice.

Model Slides: The fifth and sixth slides will address your chosen model. The bullet points should consist of the specific characteristics of the model. You will need at least one citation that identifies where the model came from. Your audio will expound upon the model and what the characteristics mean. The fifth slide should include why you chose the model and how you will apply it in practice.

Theory Slides: The next three slides will focus on your chosen theory. The first slide should present your theory and why you chose it. The next slide would present the key concepts of the theory and how it has been used to date in past research no older than five years ago. The third slide will discuss how you will use this theory in practice as an advance practice nurse upon graduation.

Graphical Slide: The next-to-last slide will be a graphical representation of how the conceptual framework, model, theory fit together.

Conclusion Slide: The last slide will be a conclusion that brings together everything you have presented. It is not a summary that just reiterates what you presented. It is a judgment about what you presented and brings the audience home, ending the presentation on a positive note about the future.

You will need supporting citations for your slides as appropriate and your very last slide will be a reference slide.

The total slide count should not exceed 15 slides. This does not include the reference slide(s) or the title slide.

Organization, documentation, references formatting guidelines must follow APA 6th edition: To view the Grading Rubric for this Assignment, please visit the Grading Rubrics section of the Course Resources.

Assignment Requirements

Before finalizing your work, you should:

• Minimum requirement of at least five sources of support
• be sure to read the Assignment description carefully (as displayed above);
• consult the Grading Rubric (under the Course Resources) to make sure you have included everything necessary; and
• utilize spelling and grammar check to minimize errors.

Your writing Assignment should:

• follow the conventions of Standard English (correct grammar, punctuation, etc.);
• be well ordered, logical, and unified, as well as original and insightful;
• display superior content, organization, style, and mechanics; and
• use APA 7th Edition

Write a critical appraisal that demonstrates comprehension of two quantitative research studies. Use the “Research Critique Guidelines – Part II” document to organize your essay. Successful completion of this assignment requires that you provide a rationale, include examples, and reference content from the study in your responses.

Use the practice problem and two quantitative, peer-reviewed research articles you identified in the Topic 1 assignment to complete this assignment.

In a 1,000–1,250 word essay, summarize two quantitative studies, explain the ways in which the findings might be used in nursing practice, and address ethical considerations associated with the conduct of the study.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion

 

Choose a common diagnosis resulting in neurological deficit in the older adult (i.e. Parkinson’s disease, transient ischemic attacks (TIA), or cerebrovascular accidents (CVA)) and identify the risk factors, symptom presentation, and nursing care for patients with these deficits. Also, search the Internet and locate Web sites that provide information about maintaining independence and limiting further injury in older adults with neurological deficits.

• Paper should be in APA format
• Length: 2-3 pages in length EXCLUDING the title and reference pages