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disease & background

Identify the disease condition and give a brief statement of incidence and prevalence in the U.S. Discuss the pathophysiology of the disease and typical clinical presentation seen in patients with the condition. 

Publication & Applicability in Primary Care

Identify the author, organization or group that developed the CPG along with the year of the original guideline publication.  Discuss why the CPG is applicable in the primary care setting.

Key Action statements and Body of Evidence

Provide each of the CPG’s “Key Action” or “Guideline Statements” up to a maximum of 5 relevant recommendations. Identify the evidence strength for each recommendation. If the statement has applicability to other groups, only discuss the relevant primary care ones.

article to be used

Kapur, V.K., Auckley, D.H., Chowdhuri, S., Kuhlmann, D.C., Mehra, R., et al. (2017). Clinical Practice Guideline for the Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline. Journal of Clinical Sleep Medicine, 13(3).

Rubric

Disease & Background

Student: 1)  Identifies the disease condition 2) Gives a brief statement of incidence and prevalence in the US 3) The student briefly summarizes the disease pathophysiology and 4) Identifies the typical clinical presentation seen in a patient with the disease (4 critical elements).

Publication & Applicability in Primary Care

The student: 1) Identifies the author, organization or group that developed the CPG, 2) Student denotes the year of the original guideline publication, 3) Student identifies  any subsequent revisions (student’s reference should be the most recent version), and 4) Student discusses the applicability for use of this CPG in the primary care setting (4 critical elements).

Key Action Statements & Body of Evidence

The student: 1)Provides each of the CPG’s “Key Action” or “Guideline Statements”  up to a maximum of 5 relevant recommendations, 2)  Provides the body of evidence strength for each, and 3) If the statement has applicability to other groups, only discuss the relevant primary care ones (3 critical elements).

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Introduction

Inequality is a central concept in sociology. Every society has a stratification system—an arrangement of society into groups that are unequal with regard to things valued in that society. In the United States, for example, we stratify people based on social class (or how much income and wealth they have). Our location within the stratification system impacts much of our lives. How would your life be different if you came from a family with billions of dollars? Would you have gone to the same school? Played with the same toys? Gone on the same vacations?

While inequality exists in every society, it tends to be different as to how it is structured according to time period or location. In earlier times, inequality was based on who owned the land. Today, it is shaped by a variety of factors including income, wealth, gender, race/ethnicity, age, and ability status. For example, women and some racial/ethnic groups make less for the same work as males. Despite this, we have a tendency in the United States to believe that neither social class nor class conflict exist. Unfortunately, research and data suggest otherwise. We still have a division of people based on their income and wealth, with some at the top and others at the bottom. While we belong to a wealthy, industrially developed country, poverty still exists.

Sociologists examine these issues of poverty and inequality in a society and try to better understand why structures of inequality exist in society. Do you think inequality is always going to exist? Focus on this as you delve into the resources and prepare for the assessment.

Demonstration of Proficiency

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

• Competency 3: Explain the significance of social inequality for the individual and society.
  • Explain whether or not economic inequality is inevitable.
  • Propose strategies to reduce inequality.
• Competency 5: Analyze the impact of social change on society and social institutions.
  • Examine potential changes to increase equality of opportunity.
  • Analyze factors that contribute to the growth of economic inequality.
• Competency 6: Compose text that articulates meaning relevant to its purpose and audience.
  • Develop text using organization, structure, and transitions that demonstrate understanding of cohesion between main and subtopics.

American culture emphasizes self-sufficiency and working hard to get where you want. It is assumed that everyone has the ability to succeed if they work hard enough. For this assessment, write a paper applying key concepts regarding social stratification to argue for or against the inevitability of economic inequality. While there are many forms of inequality in the United States, for this assessment we will be focusing solely on economic inequality.

Deliverable

Write an essay in which you complete all of the following:

• Part 1: Explain whether or not you think economic inequality is inevitable.
  • Respond to the question: Is economic inequality inevitable? Why or why not?
• Part 2: Analyze factors that contribute to growing economic inequality.
  • Analyze what factors have contributed to the growth of economic inequality in the past few decades. What factors cause economic inequality?
  • Propose strategies to reduce economic inequality.
• Part 3: Examine ways to increase equality of opportunity.
  • Reflect on ideas of equal opportunity and analyze why or why not you think American society provides everyone with an equal opportunity for success.
  • Examine what kinds of changes would help establish greater equality of opportunity for everyone in American society.​​​​

Additional Requirements

• Written communication: Develop text using organization, structure, and transitions that demonstrate understanding of cohesion between main and subtopics. Written communication is free of errors that detract from the overall message.
• Sources: Cite at least three scholarly sources.
• Length: 3–4 pages, not including title and reference pages.
• Format: Include a title page and reference page. Use in-text citations to cite your sources. [Example: Writing becomes better as the child matures (Britton, Thomas, & Miller, 1996).]
• Font and size: Times New Roman, 12-point.

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Introduction

Food Safety

There are environmental risks related to what we eat and what we throw away; for example, the risks to the food supply caused by pests and pesticides. Pests are unwanted plants (weeds) or animals (vectors). The most common types of vectors are insects (arthropods) and rodents. Overpopulation, poverty, and lack of sanitation provide opportunities for vector-borne diseases to spread. Global warming and resistance make control of disease-carrying vectors difficult.

Pesticides are one way to control pests, but there is much controversy surrounding their use. While the benefits of pesticides include increased food supply, lower food prices, decreased spread of vector-borne disease, and pesticides can adversely affect birds, fish, and mammals. They can be harmful to those who apply the pesticides and those who are exposed to them, especially children. Although pesticides play an important role in our society, there are many natural alternatives to pesticides that are safer to use and very efficient, especially in and around the home.

Sanitation is one important way you can reduce the incidence of pests in your home. Sanitation is also important when it comes to food safety. The Centers for Disease Control estimates that each year roughly 1 in 6 Americans (or 48 million people) gets sick, 128,000 are hospitalized, and 3,000 die of foodborne diseases (n.d.). Thus, proper handling of food is vital. Other techniques used to decrease the risk of food-borne illnesses are pasteurization, inspection of meat and produce items, and food irradiation.

Most of the processed foods in stores contain genetically engineered crops. In genetic engineering, the DNA from one species is introduced to another—sometimes the same species, sometimes another. Although genetically engineered foods require fewer pesticides and herbicides, there are concerns about food allergies and safety for humans and wildlife. Foods with the highest toxicity indexes for pesticides include:

• Fresh peaches.
• Frozen and fresh winter squash.
• Apples.
• Grapes.
• Spinach.
• Pears.
• Green beans.
• Broccoli.
• Orange juice.
• Bananas.
• Corn.

(Organic Trade Association, 2012).

Waste Disposal and Safe Living Environments

The disposal of waste is a looming problem in the country. Landfills are slowly filling up, chemicals from the breakdown of wastes have entered the soil and the water, and few steps have been taken to change the throw-away mentality of our society.

The average person generates 4.3 pounds of waste per day (Duke Center for Sustainability and Commerce, 2014). Further, waste disposal is one of the biggest expenses in city budgets. Improper disposal causes problems with vermin and insects and it pollutes surface as well as groundwater. Individuals are often unaware of the special programs for disposing of hazardous materials, so these too end up in landfills. The management of waste is a public health problem that must be addressed seriously, and soon.

As we look at how to deal with the waste generated, we must also look at the health of our homes and workplaces. According to the Environmental Protection Agency (2013), most North Americans spend ninety percent of their time indoors. Indoor air pollution is one of the top five environmental risks and can be 2–100 times higher than outdoor air pollution. Since the 1970s, buildings have been built airtight to conserve energy, which has led to an increase in health problem associated with indoor air pollution. Indoor air quality is a problem in both old and new construction, as well as in homes, business, and schools. Problems can be caused by mold and mildew, and the presence of certain construction materials such as toluene and vinyl chloride. Headaches, allergies, depression, and chronic respiratory problems are indicators of indoor pollution. Therefore, proper ventilation is essential to protect our health while we are indoors.

References

Centers for Disease Control and Prevention. (n.d.). CDC 2011 estimates: Findings. Retrieved from http://www.cdc.gov/foodborneburden/2011-foodborne-estimates.html

Duke Center for Sustainability and Commerce. (2014). How much do we waste daily? Retrieved from http://center.sustainability.duke.edu/resources/green-facts-consumers/how-much-do-we-waste-daily

Hilgenkamp, K. (2006). Environmental health: Ecological perspectives. Sudbury, MA: Jones and Bartlett.

Organic Trade Association. (2012). Nutritional considerations. Retrieved from http://www.theorganicpages.com/topo/organic/benefits/nutrition.html?fromOta=1&OtaImage=1&

United States Environmental Protection Agency. (2013). Questions about your community: Indoor air. Retrieved from http://www.epa.gov/region1/communities/indoorair.html

Demonstration of Proficiency

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

• Competency 3: Apply personal and professional decisions based upon an understanding of environmental risks.
  • Discuss specific ways to implement a local diet.
  • Supply several examples of local food sources.
  • Suggest ways to encourage others to eat locally.
  • Describe how to handle food waste in the home.
• Competency 4: Communicate effectively in a variety of formats.
  • Write coherently to support a central idea in appropriate format with correct grammar, usage, and mechanics.

Preparation

Please review the resources and assessment instructions. No extra preparation is required for this assessment.

Instructions

In a 2–3-page report, make a case for eating locally. Address the following in your report:

• Identify the benefits of implementing a local diet.
  • What are the benefits to the environment?
  • How does a local diet conserve natural resources?
  • What are the potential benefits to human health?
• Discuss specific ways in which you could implement a local diet. How could you (or do you) integrate a local diet into your lifestyle?
  • Identify several examples of local food sources you have access to. Are there farmers’ markets in your area?
  • What is community supported agriculture (CSA)? What is the history of the CSA movement? Where is your nearest community supported agriculture farm (CSA)?
• Identify sustainable methods for dealing with food waste in your home. How do you currently handle your family’s food waste?
• Describe ways you could encourage others to eat locally.

Additional Requirements

Your report should follow a logical structure and be evidence based. Use the APA Paper Template (linked in Resources: Food and the Environment) as a resource for citations and formatting.

• Written Communication: Written communication should be free of errors that detract from the overall message.
• Length: The report should be 2–3 pages in content length. Include a separate title page and a separate references page.
• Font and Font Size: Times New Roman, 12-point, double-spaced. Use Microsoft Word.
• APA Formatting: Resources and in-text citations should be formatted according to the current APA style and formatting.
• Number of Resources: You are required to cite a minimum of 2 scholarly resources. You may conduct independent research for resources and references to support your report. Provide a reference list and in-text citations for all your resources, using APA format. You may cite texts and authors from the Resources.

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Introduction

To understand emerging and reemerging diseases, you must understand the interconnectedness between human health and the environment and have a grasp on epidemiology.

Human Health

Epidemiology, the study of determinates and distribution of disease in populations, is essential in protecting public health and controlling health problems. Before moving into the specifics of epidemiology, you need to understand some of the basics of human anatomy and physiology; specifically, how the immune system protects us from disease.

Your body’s first line of defense against a foreign invader is keeping the invader out. The skin is part of that defense, as it creates a barrier over most of the body. This defense continues with the mucous membranes lining your nasal pathway, and the hairs help catch particles and keep them from entering your lungs. Tears and saliva both contain lysozymes, which can break down foreign invaders. Bleeding from an open wound helps to rinse away dirt and other particles, and clotting helps keep anything from entering the body through that wound. Your body contains many different types of white blood cells that can fight off a variety of pathogens.

If an invader gets past the first line of the defense, the body’s second line of defense is the immune system. We can acquire natural immunity in two different ways: naturally acquired active immunity occurs when we are exposed to a disease-causing agent (for example, getting chicken pox as a child), and naturally acquired passive immunity occurs when antibodies are received through the placenta or breast milk. We can also attain immunity through vaccinations; this is called artificially acquired active immunity. Persons with severe immunodeficiency may be given antibody-containing serums or immunoglobins from a person or animal.

Many cells and chemicals that are part of the immune system work to destroy foreign substances as they enter the body. Macrophages circulate throughout the body and digest any foreign substances they run into. Interferons are chemicals released when a cell is attacked by a virus. These and other chemicals signal surrounding cells to shut down and prevent the virus from spreading. Lymphocytes are a type of white blood cell that produces antigens that respond to specific viruses. So, if you had chicken pox as a child, then your body will produce antibodies to protect you if the chicken pox virus enters your body again.

The state of the environment also plays a role in disease transmission. For example, the changing weather patterns associated with global warming affect disease patterns. The increased rainfall and flooding in some areas has increased the populations of a major carrier of disease—mosquitoes. The warm winters and hot dry summers in many areas are also affecting the transmission of vector-borne diseases; for example, ticks spread Lyme disease and bacteria spread cholera. There is significant evidence that outbreaks of Ebola are related to unusual patterns in the wet or dry cycle. Increases in international travel have also increased the spread of diseases worldwide. In the United States, emerging diseases such as West Nile Virus cause severe illness and sometimes death (World Health Organization, 2011). As diseases spread, or new diseases are recognized, fear of a major epidemic has caused public health agencies to prepare plans for mass epidemics or bioterrorism events.

Disease Transmission Routes

• Airborne (coughing, sneezing).
• Fecal-oral transmission (improper hand washing contaminating food, untreated sewage contaminating water supply).
• Waterborne (drinking, swimming, eating, improper hand washing).
• Direct contact (athlete’s foot, warts, STDs).
• Zoonoses (animal bites, scratches, meat, hides, feces).
• Vector-transmitted (insects, rodents).
• Soil contamination (landfill leaching).
• Fomite (transferred from inanimate objects like handrails, doorknobs, grocery carts, clothing, toys).
• Nosocomial (transferred from health workers). (Hilgenkamp, 2006, p. 54).

Environmental Health

As the human population and technology have grown, our impact on the environment—and subsequently, on our own health—has also grown. The World Health Organization (2014) defines environmental health as “all the physical, chemical, and biological factors external to a person, and all the related factors impacting behaviors. It encompasses the assessment and control of those environmental factors that can potentially affect health. It is targeted towards preventing disease and creating health-supportive environments. This definition excludes behavior not related to environment, as well as behavior related to the social and cultural environment, and genetics.”

To understand environmental health, we must first understand the environment and its many interrelated systems. We do not often think about the Earth beyond what we see around us every day, but the environment spans from the core of the Earth to the outer reaches of the troposphere. The four main divisions of the Earth system are the lithosphere (crust and mantle), hydrosphere (water), atmosphere (gases surrounding earth), and biosphere (area supporting life). Life on Earth depends on the biogeochemical cycles that occur within each of these regions. Biogeochemical cycles recycle energy and chemicals through the lithosphere, hydrosphere, atmosphere, and biosphere. Within the biosphere there are specific divisions called biomes. Biomes are characterized by similar climate, soil, plants, and animals. Because humans dominate most ecosystems on Earth, we have a large impact on the environment. Overpopulation and demands on natural resources can degrade the environment. Since the environment provides us with so many resources such as clean air, clean water, and nutrients, environmental degradation directly influences human health.

Environmental scientists and government officials look for ways to preserve the environment and conserve environmental resources. By monitoring human demand on the environment, laws such as the Endangered Species Act, Clean Air Act, and Clean Water Act have worked to protect the environment for future generations. While technology has created many problems for the environment, it is also being used to benefit the environment and human health. New farming techniques, waste management methods, and pollution control devices all help to keep the environment healthy and protect human health. Environmental health is everyone’s responsibility. Public health officials and governmental leaders are on the front lines, but the decisions made daily by businesses and individuals directly affect our health and the health of the environment.

References

Hilgenkamp, K. (2006). Environmental health: Ecological perspectives. Sudbury, MA: Jones and Bartlett.

World Health Organization. (2011). West nile virus. Retrieved from http://www.who.int/mediacentre/ factsheets/fs354/en/

World Health Organization Regional Office for Europe. (2014). Environmental health. Retrieved from http://www.who.int/topics/environmental_health/en/

Demonstration of Proficiency

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

• Competency 1: Assess basic environmental health principles, theories, and issues.
  • Analyze an emerging or reemerging disease.
  • Describe how an emerging disease is transmitted.
  • Describe the incubation period of an emerging disease.
  • Describe how an emerging disease is treated.
  • Predict prognosis of recovery and residual effects of an emerging disease.
  • Assess the role of vaccines in disease prevention.
• Competency 4: Communicate effectively in a variety of formats.
  • Write coherently to support a central idea in appropriate format with correct grammar, usage, and mechanics.

Preparation

Select one emerging or reemerging disease to research for this report. Note: You may use the WHO Infectious Diseases and CDC websites (both linked in Resources: Diseases and Pathogens), which list a variety of relevant diseases.

Instructions

To begin, select one emerging or reemerging disease to research for this report.

Then, craft a 3–4-page report that analyzes the disease and addresses the following points:

• Provide a brief historical account of the disease selected. Consider why this disease is emerging or reemerging.
• What areas of the globe are currently affected by this disease?
• How is it transmitted?
• What is the incubation period?
• What is the treatment for this disease?
• What is the role of vaccines in combatting this disease? If there is no vaccine, why not?
• What is the predicted prognosis of recovery and residual effect?

Your report should be logically organized around a point you would like to make regarding the emerging or reemerging disease you select. Consider the MEAL Plan to help organize your thoughts:

• Main Idea: What is the main point or idea that you want your reader to remember about this disease?
• Evidence: What does the research say? Support your point with evidence from the literature you have researched. (This is where you would include facts about the history, transmission, incubation, treatment, and prevention of the disease. Refer to your sources when you provide your evidence.)
• Assess: Summarize main ideas from articles related to the disease. Apply health principles and theories that relate directly or indirectly to your main point. Make explicit links between source articles and your current report.
• Link: Integrate and combine information from your source articles to your main point or idea.

Additional Requirements

Use the APA Paper Template (linked in Resources: Writing, Research, and APA) to format your report.

• Written Communication: Written communication should be free of errors that detract from the overall message.
• Length: This report should be 3–4 pages in content length. Include a separate title page and a separate references page.
• Font and Font Size: Times New Roman, 12-point, double-spaced. Use Microsoft Word.
• APA Formatting: Resources and in-text citations should be formatted according to the current APA style and formatting.
• Number of Resources: You are required to cite a minimum of 2 scholarly resources. You may conduct independent research for resources and references to support your report. Provide a reference list and in-text citations for all your resources, using APA format. You may cite texts and authors from the Resources.

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