NR 503 Week 1: Healthy People 2020 Impact Paper

Chamberlain University NR 503 Week 1: Healthy People 2020 Impact Paper– Step-By-Step Guide

This guide will demonstrate how to complete the Chamberlain University NR 503 Week 1: Healthy People 2020 Impact Paper   assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for NR 503 Week 1: Healthy People 2020 Impact Paper              

Whether one passes or fails an academic assignment such as the Chamberlain University NR 503 Week 1: Healthy People 2020 Impact Paper  depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for NR 503 Week 1: Healthy People 2020 Impact Paper              

The introduction for the Chamberlain University NR 503 Week 1: Healthy People 2020 Impact Paper  is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

How to Write the Body for NR 503 Week 1: Healthy People 2020 Impact Paper              

After the introduction, move into the main part of the NR 503 Week 1: Healthy People 2020 Impact Paper assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for NR 503 Week 1: Healthy People 2020 Impact Paper              

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for NR 503 Week 1: Healthy People 2020 Impact Paper              

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Sample Answer for NR 503 Week 1: Healthy People 2020 Impact Paper

Human immunodeficiency virus (HIV) is a disease that destroys the CD4 cells (T cells) that fight off disease and infection. No cure has been developed for HIV. The disease can be managed with the proper care and medication. In the U.S., people typically get HIV through having unprotected anal or vaginal sex with a partner(s) or through using infected needles or syringes. Untreated, HIV develops into acquired immunodeficiency syndrome (AIDS). 

Overview of concern

HIV is transmitted through direct contact with infected bodily fluids, such as blood, semen, rectal and vaginal fluids, and breast milk (CDC: Fact Sheet…, 2017). The prevalence is an estimated 1.2 million people have been diagnosed with HIV, but even worse is, one out of eight people (15 percent of U.S. population) have HIV and do not even know it (Division of HIV/AIDS Prevention et al., 2018). 2016 data compiled by the CDC reports the incidence rate within that year was 39,782 new diagnosed HIV cases (CDC: Fact Sheet…, 2017). Specifically, 32,131 of the cases affected males 13 years and older, 7,529 adult and adolescent females, and 122 children under age 13 years (Division of HIV/AIDS Prevention et al., 2018)

Epidemiological analysis

The morbidity rate within the U.S. population is an estimated 38,513 new HIV infections per year (CDC: National Center for Health Statistics, 2017). The mortality rate from 1987 through 2015 totals 507,351; in 2015, a reported 6,465 people died (CDC: HIV in the United States…, 2018). Distribution of new infections differs by race, gender, and sexual orientation: Caucasians 41percent, African Americans 40 percent, and Hispanics 19 percent; the female distribution is African Americans 61 percent, Caucasians 23 percent, and Hispanics 16 percent (CDC: HIV in the United States…, 2018). Gay/bisexual men account for 67 percent of all newly acquired HIV cases and 83 percent among males. African-Americans account for 44 percent and Hispanics account for 25 percent of all HIV diagnoses (CDC: HIV in the United States…, 2018). The U.S. government spends $26 billion annually to fight HIV (HIV.gov, 2018).

HealthyPeople 2020 goals

The National HIV/AIDS strategy has three primary goals: to reduce the number of new HIV infections, improve access to care and health outcomes for HIV patients, and minimize HIV-related health inequities (HealthyPeople.gov, 2018). Guidelines for screening and diagnosis of HIV include routine screening for pregnant women and the recommendation for anyone between ages 13 and 64 to get tested at least once a year (HealthyPeople.gov, 2018).  There are three types of HIV tests: nucleic acid tests (NAT), antigen/antibody, and antibody (HealthyPeople.gov, 2018). If a test reads positive, the individual will be referred to a health care provider for follow-up testing (Division of HIV/AIDS Prevention et al., 2018). 

Activities and implementation strategies

The federal government has established 28 agencies that focus on reducing HIV acquisition and transmission, as well as treating and monitoring HIV patients (Division of HIV/AIDS Prevention et al., 2018). Agencies pass out free condoms and needles, show patients how to properly take HIV medications, and suggest that non-HIV persons engage in low-risk sex (Division of HIV/AIDS Prevention et al., 2018). One federal program that has seen a 90 percent success rate is the Pre-Exposure Prophylaxis (PrEP) Framework (CDC: Effectiveness of prevention strategies…, 2017). PrEP involves taking a pill daily to reduce the risk of transmission and improve health (CDC: effectiveness of prevention strategies…, 2017). This program also focuses on reducing homelessness among HIV patients and providing free testing and resources to care (CDC: effectiveness of prevention strategies…, 2017).

References

CDC: National Center for Health Statistics. (2017, May 3). AIDS and HIV. Retrieved from https://www.cdc.gov/nchs/fastats/aids-hiv.htm

Centers for Disease Control and Prevention (CDC). (2017, March 7). Effectiveness of prevention strategies to reduce the risk of acquiring or transmitting HIV. Retrieved from https://www.cdc.gov/hiv/risk/estimates/preventionstrategies.html

Centers for Disease Control and Prevention (CDC). (2018, June 26). HIV in the United States: At a Glance. Retrieved from https://www.cdc.gov/hiv/statistics/overview/ataglance.html

Centers for Disease Control and Prevention. (2017, February). CDC fact sheet HIV incidence: Estimated annual infections in the U.S., 2008-2014, overall and by transmission route. Retrieved from https://www.cdc.gov/nchhstp/newsroom/docs/factsheets/hiv-incidence-fact-sheet_508.pdf

Sample Answer 2 for NR 503 Week 1: Healthy People 2020 Impact Paper

Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, HIV Incidence and Case Surveillance Branch, Data Management Team of the Quantitative Sciences and Data Management Branch, Linley, L., … Morgan, M. (2018). Estimated HIV incidence and prevalence in the United States 2010–2015. HIV Surveillance Report, 23(1), 1-77. Retrieved from https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-supplemental-report-vol-23-1.pdf

HealthyPeople.gov. (2018, July 13). HIV. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/hiv

HIV.gov. (2018, January 15). Federal funding for HIV?AIDS. Retrieved from https://www.hiv.gov/federal-response/funding/budget

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Sample Answer 3 for NR 503 Week 1: Healthy People 2020 Impact Paper

Population health addresses and focuses on health outcomes of specific groups based on the geographic distribution in communities, disability, age, or ethnicity, among other factors. The concept of epidemiology is critical in population health as it facilitates the scientific and systematic study of the distribution and occurrence of determinants of diseases among different groups to develop effective strategies for intervention. The Healthy People (HP) 2020 outlines specific objectives regarding specific health issues and provides guidelines and screening tools to help detect the diseases among different populations early onstage for effective treatment. Conducting a comprehensive epidemiological analysis facilitates the identification of prevalence, risk factors, susceptible people or impacts, and effective planning of effective interventions at the state or national level.

Overview, Background, and Significance of the Problem

Dementia is a collective term for the syndrome characterized by significant impairment and decline in cognitive, social, and behavioral functions by affecting an individual’s thinking, remembering, or decision-making capabilities, interfering with daily living activities (ADL). The most common type of dementia is Alzheimer’s disease (AD) which is a condition that causes memory loss and challenges in thinking or solving problems hence interfering with daily activities and routines, and others include cerebrovascular and Lewy body disease (Hwang et al., 2019). Although dementia is more prevalent among the older population, this health condition is not a normal part of aging. Racial and ethnic disparities heighten the risk of dementia; hence minority populations including Hispanics, non-Hispanic whites, African-Americans, Indian, and Alaska natives are more susceptible.

The primary risk factor for dementia is age, and the aging population is growing more racially and ethnically diverse. The prevalence of AD in California among people aged 65 years and above was approximately 660,000, which is 11% of the total rate in the United States of 5.8 million, and 177,345 of this population was from Los Angeles (L.A.) (Ross et al. 2021). The number of Americans living with AD may rise to 16 million by 2030. AD has severe implications on families since, in 2020, approximately 1.6 million caregivers, 60% of whom are female in California, will bear the burden by providing 1, 849 million hours of unpaid care at a value of $24 billion, which impacts their social, emotional and physical well-being (Ross et al. 2021). Alzheimer’s disease and related dementias (ADRD) also affect the healthcare system, with the disease cost amounting to around $4.2 billion in California. The number of deaths associated with dementia in 2017 was approximately 266,957 from AD in the U.S., and 25,017 were in California, precisely 3,994 in L.A (Ross et al. 2021). The mortality rate of AD in California was 47 per 100,000 in 2018, with 16,627 deaths, compared to 37.3 per 100,000 in the United States (Alzheimer’s Association Report, 2020). In 2018, Californians aged 65 to 84 in 2018 identified as Black or African American reported the highest death rates.

Epidemiological Analysis

Descriptive epidemiology entails the organization and analysis of data defining and describing the frequency of disease variation by covering the aspects of time, person, and place and correlating the three components to determine risk factors accurately. By 2050, the number of patients with AD may rise exponentially from 5.8 million to 13.8 million, and 68% of this global increase will be in low and middle-income countries (LMICs) (Zhang et al., 2021). The percentage of people with AD increases rapidly with age since populations within 65-74 years, 75-84 years and above at the percentage rate of 3%, 27%, and 32% AD. An estimated 60% of the population residing in have dementia, and the number may rise to 152 million globally in mid-century in LMICs (Zhang et al., 2021). The lifetime risk for AD is approximately 20% and 10% for women and men at age 45.

Moreover, the incidence of dementia is higher among racial and ethnic minority groups; hence older Black and Hispanics are more at risk for ADRD. Data for Medicare beneficiaries report a diagnosis of ADRD among 13.8% and 12.2% African American and Latino population (Alzheimer’s Association Report, 2020). A behavioral risk factor survey findings show that 11% of Americans aged 45 years and above report cognitive but 54% do not consult healthcare providers (Alzheimer’s Association Report, 2020). Age is a common risk factor for ADRD; hence, the older population comprising adults aged 65 years and above is more susceptible. Women are also at risk for ADRD since out of the 5.2 million people with this health condition, 3.3 million are female (Healthy People 2020, n.d.). The global prevalence of AD is higher in women, 1.17 times more than in men (Zhang et al., 2021). Similarly, people with a family history of ADRD are at a greater risk since 19 new genes heighten the likelihood of contracting late-onset AD.

Application of HP 2020

HP 2020 initiative outlines specific national goals and objectives to reduce health threats and promote healthy lives. One of the goals is to achieve longer, high-quality lives free of diseases, illnesses, injuries, disabilities, or premature deaths (Healthy People 2020, n.d.). Another specific goal of this initiative is to alleviate avoidable disparities, attain equity and establish social and physical environments that influence the health of all populations. The goal is to minimize morbidity and related costs and to improve the quality of life for people with ADRD by promoting healthy behaviors, increasing practical diagnostic tools, and offering social or behavioral resources to support caregivers. The first objective is to increase the number of individuals diagnosed with dementia or their caregivers’ knowledge of diagnosis from 38.3% to 68.2% (Healthy People 2020, n.d.). The significant threats and burden of ADRD to the public health system have prompted its inclusion as a new topic in the HP 2020 initiative.

The recommended guidelines for the AD diagnostic process emphasize dividing the steps to detect, differentiate, diagnose and treat, and healthcare providers utilize various tools and approaches. The mini-mental state examination (MMSE) test is the most commonly used cognitive screening tool that entails 11 questions that healthcare providers may take 10 to 30 minutes to administer (Hwang et al., 2019). The MMSE has a cut-off value of 23/24 out of a possible 30, which indicates good reliability and validity in identifying dementia. The maximum point for the MMSE score is 30, and any points below 24 indicate concerns about dementia, whether mild, moderate, or severe. Age, education, and ethnicity affect interpretation. Early diagnosis of ADRD helps patients seek early treatment and interventions concerning lifestyle changes.

Population Level Planning and Interventions

The Department of public health in California designed and released the Assessment of cognitive complaints toolkit for AD (ACCT-AD) to assist healthcare providers in the primary care setting with an effective instrument to detect and diagnose AD or other mental issues. Utilization of systems such as the behavioral risk factor surveillance system (BRFSS), Medicare current beneficiary survey, or National health and aging trends study (NHATS) will help monitor data mortality rates, ADRD diagnoses, or utilization of services and assess the extent of progress (CDC, 2018). The Healthy Brain Initiative is a program developed in partnership with the Alzheimer’s Association and the Centers for disease control and prevention to enhance cognitive health. The program aims to strengthen knowledge about care planning, improve access to evidence-based interventions and services for people with dementia and emphasize the importance of caregivers. This strategy seeks to enhance the competence of the current workforce through extensive training to empower public health professionals with relevant knowledge on the most appropriate and reliable evidence of dementia for proper detection and treatment and meeting health needs. The outcomes of this program include increased workforce capacity, demand and utilization of dementia-related services, and improved early detection, diagnosis, and professional care (CDC, 2018). Other outcomes are an informed public and people with dementia or their caregivers, and supportive communities. Seeking public feedback using online surveys is an effective strategy to get responses to the effectiveness of the programs, such as an increased awareness of brain health and seeking input on recommendations for improvement.

Conclusion

Identifying prevalence or incidence rates, risk factors, or the burden of a chronic illness facilitates the development of strategies for strategic intervention. Infectious and chronic health diseases such as cancer, diabetes, arthritis, lung cancer, dementia, and osteoporosis are the leading cause of mortality and disability and contribute to a significant burden in healthcare due to costs associated with treatment and management. Dementia is among the leading causes of disability and mortality among older adults, and prevalence has increased exponentially, especially in relation to associated public health costs. Thus, relevant stakeholders at the state and national levels should increase efforts to develop and implement appropriate interventions for population health issues and monitor progress to ensure effectiveness.

References

Alzheimer’s Association Report, (2020). 2020 Alzheimer’s disease facts and figures. The Journal of the Alzheimer’s Association. https://doi.org/10.1002/alz.12068

Centers for Disease Control and Prevention (2018). Healthy brain initiative, state, and local public health partnerships to address dementia: The 2018-2023 road map. Alzheimer’s Association. https://www.cdc.gov/aging/pdf/2018-2023-Road-Map-508.pdf

Healthy People 2020. (n.d.). Dementias, including Alzheimer’s disease. https://www.healthypeople.gov/2020/topics-objectives/topic/dementias-including-alzheimers-disease

Hwang, A. B., Boes, S., Nyffeler, T., & Schuepfer, G. (2019). Validity of screening instruments for the detection of dementia and mild cognitive impairment in hospital inpatients: A systematic review of diagnostic accuracy studies. In Plos One, 14(7). https://doi.org/10.1371/journal.pone.0219569

Ross, K. L., Beld, M., & Yeh, C. J. (2021). Alzheimer’s disease and related dementias facts and figures in California: Current status and future projections. California Department of Public Health. https://www.cdph.ca.gov/Programs/CCDPHP/DCDIC/CDCB/CDPH%20Document%20Library/Alzheimers%27%20Disease%20Program/151764_Alzheimers_Disease_Facts_and_Figures_Reportv3_ADA.pdf

Zhang, X. X., Tian, Y., Wang, Z. T., Ma, Y. H., Tan, L., & Yu, J. T. (2021). The Epidemiology of Alzheimer’s Disease Modifiable Risk Factors and Prevention. In Journal of Prevention of Alzheimer’s Disease, 8(3). https://doi.org/10.14283/jpad.2021.15

NR 503 Week 2 Discussion – Epidemiological Methods

In this week’s discussion I will be focusing on Gestational Diabetes, GDM, and identify one specific screen test for this topic. Preventing and or controlling GDM is important because if left untreated, can cause harm to mother and baby.   

• Describe the diagnostic or screening tool selected, its purpose, and what age group it targets. Testing for gestational diabetes, GDM, is a primary test used early on in pregnancy. One of the screen tests used is the glucose challenge test or similarly the oral glucose tolerance test (OGTT) (Rodgers, G., 2017). According to the National Institutes of Health, NIH, these tests are primarily preformed on pregnant woman between 24 and 28 weeks of pregnancy. The physician or APN can determine if the patient is at a higher risk of developing GDM starting as early as the first visits after becoming pregnant. 

• Has it been specifically tested in this age group?  GDM can happen to anyone who becomes pregnant however older woman or woman with predisposed health conditions can be more at risk of developing the condition. Woman over the age of 25 years old who are of African, Native American, Hispanic, or Pacific Island descent are at a higher risk and between 2% and 10% of woman develop GDM in the United States (Clevland Clinic, 2021). Some increased factors also include heart disease, hypertension, obesity, and family history. OGTT has many risk factors but is specifically tested in all pregnant woman, especially gestationally between 24 and 28 weeks of pregnancy.  

• Next, discuss the predictive ability of the test. For instance, how do you know the test is reliable and valid? What are the reliability and validity values? What are the predictive values? Is it sensitive to measure what it has been developed to measure, for instance, HIV, or depression in older adults, or Lyme disease? Would you integrate this tool into your advanced practice based on the information you have read about the test, why or why not?The OGTT test is currently the gold standard reference test diagnose pregnant woman. Since this is only tested on pregnant woman and there are such high variables, it has been known to be challenging for validity and accuracy and “there is currently no universal agreement over diagnostic methods” (Pintaudi, B., et el., 2022). A journal article reports a study preformed with 1015 pregnant woman who underwent the exact same glucose measurement taking a 2 hour, 7g gram OGTT between the gestations of 24 and 28 weeks. They found the study concluded with the lowest and the highest maximal allowable error, therefore indicates does not show 100% accuracy.  

      I would still integrate the OGTT method into my advanced practice because this test is continuous and followed up on through pregnancy. If a       OGGT tested positive however the next negative, the mother should always be aware of this condition and continue to follow a healthy diet throughout pregnancy.   

                                                                                                                        References  

Gestational Diabetes. (2021) Clevland Clinic. Retrieved from my.clevlandclinic.org. Last reviewed by a Clevland Clinic medical professional on 01/14/2021.  

Pintaudi, B., Di Vieste, G., Anna, R., Chiereghin, F., Biamonte, E., Corrado, F., & Benedetto, A (2022). The Analytical Reliability of the Oral Glucose Tolerance Test for the Diagnosis of Gestational Diabetes: An Observational, Retrospective Study in a Caucasian Population. Journal of Clinical Medicine. doi.org/10.3390/jcm11030564 

Tests & Diagnosis for Gestational Diabetes. (2017). National Institutes of Health.gov. Retrieved from http:/niddk.nih.gov.