Epidemiological Perspectives and Challenges

This article discusses epidemiological perspectives and challenges in healthcare, including disease prevention, surveillance, and management. It also covers the role of nurse practitioners in addressing emerging infectious diseases and lifestyle-related epidemics like obesity and diabetes. The article includes references to relevant studies and provides guidance for healthcare professionals.

Running head: EPIDEMIOLOGICAL PERSPECTIVES AND CHALLENGES
EPIDEMIOLOGICAL PERSPECTIVES AND CHALLENGES
Name of the Student
Name of the University
Author Note

2EPIDEMIOLOGICAL PERSPECTIVES AND CHALLENGES
Answer 1
Inability to describe protective equipment in use or available.
Answer 2
In a cohort study, information is collected on the subjects disease status, whereas a case
control study is based on exposure status.
Answer 3
Cross-sectional study.
Answer 4
The hypothesized exposure or risk.
Answer 5
Endemic.
Answer 6
Mode of Transmission.
Answer 7
The minimum value will remain the same.
Answer 8
25/80.
Answer 9
50
Answer 10
Incidence rate
Answer 11

3EPIDEMIOLOGICAL PERSPECTIVES AND CHALLENGES
The proportion reduction in disease among vaccinated persons compared with
unvaccinated persons.
Answer 12
Two by two table.
Answer 13
Probable short term direction of the epidemic, e.g., more or fewer cases.
Answer 14
True
Answer 15
To guide public health policy for disease control
Answer 16
Underreporting by those expected to report.
Answer 17
Within one mile radius Beyond one mile radius
Case patients (40) 32 8
Controls (80) 20 60
Odds ratio is 12.0.
Answer 18
Confirm the existence of an outbreak and confirm the diagnosis.
Answer 19
As early as possible.
Answer 20
Ability to design preventive actions.
Answer 21

4EPIDEMIOLOGICAL PERSPECTIVES AND CHALLENGES
True.
Answer 22
False.
Answer 23
Individuals consuming a high fat diet are 3% more likely to develop colon cancer while
green tea consumption has a protective effect (negative odds ratio).
Answer 24
Mean weight is unchanged but median weight is actually higher after dieting.
Answer 25
1.627/100,000 population.
Answer 26
Diseases with a low case fatality rate.
Answer 27
125/10,000.
Answer 28

5EPIDEMIOLOGICAL PERSPECTIVES AND CHALLENGES
Statins are known to reduce low density lipoprotein cholesterol (LDL cholesterol). Apart
from lowering of cholesterol levels, Statins have other pleiotropic functions like restoration and
improvement of endothelial function, attenuation of vascular remodeling, stabilization of
atherosclerotic plaques and inhibition of vascular inflammatory response. It inhibits the
isoprenoid synthesis pathway, since the products of this pathway acts as lipid attachments for the
Rho, Cdc42 and Rac intracellular signaling molecules. Statin therapy is a secondary prevention
strategy for management of coronary artery disease (Mega et al., 2015)
Studies have shown that Statins can reduce cardiovascular mortality and cardiovascular
events in patients with high cholesterol levels and coronary artery disease. The Cholesterol and
Recurrent Events (CARE) Trial have demonstrated the cardioprotective role of Statins in patients
suffering from myocardial infarction and high cholesterol levels. Statin therapy has been shown
to demonstrate 20% reduction of adverse cardiovascular events and strokes. Administration of
Atorvastatin within 24-96 hours have been demonstrated to reduce myocardial infarction,
recurrent ischemia, myocardial arrest and subsequent death (Zemánek et al., 2013).
The nurse practitioners play roles in improving adherence to medical regimens like Statin
therapy with the single goal of providing favorable patient outcomes, decrease of cardiovascular
disease risks, among others. The nurse practitioners are meant to determine the lipid profile of
the patients and a Statin therapy is to be initiated. However, Statin therapy is associated with
side-effects and the nurse practitioner has the role of identifying the best Statin for treatment.
Statins should be provided at a dose that reduces the LDL cholesterol levels to less than
100mg/dl. Patients with triglyceride levels of greater than 200mg/dl should be provided with
Statins in order to lower the high density lipoprotein cholesterol levels to less than 130mg/dl
(Harbman, 2014).

6EPIDEMIOLOGICAL PERSPECTIVES AND CHALLENGES
Answer 29
The topic chosen is disease and lifestyle-the epidemics of obesity and diabetes mellitus.
In the World, about 70% of adults are either obese or overweight. Intake of high calorie rich
foods, consumption of sugar-sweetened beverages, lack of physical activity has led to the
development of obesity in adults as well as in children. Obesity is the leading risk factor for the
development of Type 2 diabetes. Lifestyle modifications for the treatment and prevention of
obesity and diabetes mellitus involve calorie restriction, physical activity and subsequent
involvement in weight loss programs (Malik & Hu, 2012).
Emerging infectious diseases poses a significant threat to the health of individuals. The
role of nurse practitioners in addressing the challenges associated with emerging infectious
diseases involve epidemiological approaches like determining the route of transmission of the
disease and the use of personal protective equipments for preventing further spread of the
disease. The nurses are responsible for detecting the new disease-causing agent by assessment of
the patient’s signs and symptoms and determination of host characteristics that predisposes them
to infection (Veenema, 2012).
The epidemiological approaches used by the nurse practitioners to address the issue of
increasing rates of obesity among individuals is to carry out a surveillance, where the nurse
practitioner determines the eating habits of the individuals, physical activity level and
determination of any genetic factors associated with the individuals of a family (Cunningham,
Kramer & Narayan, 2014).
No, the challenges are the same and is ever growing with new additions like the increased
number of diabetes cases, cardiovascular death resulting from lifestyle changes like poor

7EPIDEMIOLOGICAL PERSPECTIVES AND CHALLENGES
physical activity and high calorie consumption apart from lack of knowledge. These were and
are still involved in significantly contributing to the challenges faced by the nurse practitioners.

8EPIDEMIOLOGICAL PERSPECTIVES AND CHALLENGES
Reference List
Cunningham, S. A., Kramer, M. R., & Narayan, K. V. (2014). Incidence of childhood obesity in
the United States. New England Journal of Medicine, 370(5), 403-411.
Harbman, P. (2014). The development and testing of a nurse practitioner secondary prevention
intervention for patients after acute myocardial infarction: A prospective cohort
study. International journal of nursing studies, 51(12), 1542-1556.
Malik, V. S., & Hu, F. B. (2012). Sweeteners and risk of obesity and type 2 diabetes: the role of
sugar-sweetened beverages. Current diabetes reports, 12(2), 195-203.
Mega, J. L., Stitziel, N. O., Smith, J. G., Chasman, D. I., Caulfield, M. J., Devlin, J. J., ... &
Poulter, N. R. (2015). Genetic risk, coronary heart disease events, and the clinical benefit
of statin therapy: an analysis of primary and secondary prevention trials. The
Lancet, 385(9984), 2264-2271.
Veenema, T. G. (2012). Disaster nursing and emergency preparedness: for chemical, biological,
and radiological terrorism and other hazards, for chemical, biological, and radiological
terrorism and other hazards. Springer Publishing Company.
Zemánek, D., Branny, M., Martinkovičová, L., Hájek, P., Malý, M., Tesař, D., ... & Veselka, J.
(2013). Effect of seven-day atorvastatin pretreatment on the incidence of periprocedural
myocardial infarction following percutaneous coronary intervention in patients receiving
long-term statin therapy. A randomized study. International journal of
cardiology, 168(3), 2494-2497.