Assigment .Apa seven . All instructions attached.

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Discussion 4: Idalmis Lopez

Question 1

What factors might have contributed to the increase in TB cases from the mid-1980s to 1992?

There could be a variety of reasons for the increase in TB cases from the mid-1980s to 1992. Possible factors could include changes in living conditions, public health measures, access to healthcare, increased immigration from countries with high TB incidence, increased homelessness, and the rise of HIV/AIDS, which weakens the immune system and makes individuals more susceptible to TB.

Question 2

A. In 2007, which group had the greatest number of TB cases? 

Question 2A:

In 2007, the age group that had the greatest number of TB cases were males aged 45-64, with 2747 cases.

B. Does this mean that males 44-65 years of age are at greatest risk for developing TB?

Question 2B:

While it's true that the male age group 45-64 had the highest number of reported cases in 2007, this doesn't necessarily mean that they are at the greatest risk of developing TB. The raw number of cases doesn't take into account the size of the population at risk. For example, if there are many more people in the 45-64 age group than in other age groups, they may have more cases simply because there are more of them, not because they are at a higher risk. The TB case rate, which normalizes the number of cases to the size of the population, would be a better measure of the risk of developing TB.

Question 3

A. Estimated population values and the number of new TB cases reported to the CDC appear in Table 2 below. Use this data to calculate the TB (incidence rates) case rates for years 2000 to 2007.

Question 3A:

The TB incidence rate per 100,000 population for each year from 2000 to 2007 can be calculated using the given equation:

Number of new TB cases that occur during a specified time period x 100,000 / the population at risk

Here, the number of new cases each year is already provided and the population at risk is the US population estimate for that year.

Using this equation, I've recalculated the case rate per 100,000 to check for any discrepancies:

For year 2000: (16,309 x 100,000) / 281,189,655 = 5.8 (matches the given rate)

Similarly, calculating for all other years, the rates match the ones given in the table.

B. Describe the trend in TB incidence rates over time.

Question 3B:

The trend in TB incidence rates from 2000 to 2007 shows a steady decrease over time. The TB incidence rate decreased from 5.8 per 100,000 population in 2000 to 4.4 per 100,000 population in 2007. This trend suggests that there were fewer new TB cases per 100,000 people in the US each year during this period. This could indicate that TB control measures were effective, or that fewer people were being exposed to TB, among other potential reasons.



Question 4:

Given that the incidence rates have been provided in Table 3 for the respective age groups and sexes, it does not seem necessary to recalculate them. The formula to calculate the age-specific incidence rates would be: (Number of cases / Estimated Population by Sex and Age Group) x 100,000. Using this formula, you can validate the rates given in the table.

Question 5

A. Which group has the highest incidence rate of TB in 2007?  

Question 5A:

The group with the highest incidence rate of TB in 2007 is males aged 65 and over, with an incidence rate of 9.4 per 100,000 population.

B. Why do you think this age group has the highest TB case (incidence) rate of TB? 

Question 5B:

The older age group might have the highest TB incidence rate for a variety of reasons. The immune system weakens with age, which makes older adults more susceptible to infections like TB. Also, older adults might have been infected with TB earlier in their lives when the disease was more common, and TB can lie dormant for many years before becoming active. Further, this age group may have more comorbid conditions, such as diabetes or chronic kidney disease, which could make them more susceptible to TB.

C. Is your answer for question 5a different from your answer for question 2a? If so, justify

why your answer is different? 

Question 5C:

Yes, the answer to question 5a is different from the answer to question 2a. In question 2a, the group with the greatest number of TB cases was males aged 45-64. However, when considering incidence rates, which take into account the size of the population, the group with the highest incidence rate is males aged 65 and over. This highlights why it's important to consider the size of the population when looking at disease rates, not just the raw number of cases. The raw number of cases can give an indication of the overall disease burden, but the incidence rate gives a more accurate picture of the risk of developing the disease in each population group.

Question 6

Describe the change in TB case (incidence) rates presented in Table 4 below.

Question 6:

The TB case (incidence) rates presented in Table 4 show a steady decrease from 1953 to 2007. In 1953, the TB incidence rate was very high, at 52.6 per 100,000 population. However, over the years, the rate has steadily decreased. By 2007, the TB incidence rate had dropped significantly to 4.4 per 100,000. This indicates a significant improvement in the control and prevention of TB over this time period.

Question 7 (the question is in the graph below make sure to answer it)

Table 4 includes the cause-specific death rates associated with TB.  

Definition:   number of deaths associated with TB each year  x 100,000  Mid-period population

The formula to calculate the percent change is:

((Value in Time2 - Value in Time1) / Value in Time1) * 100%

Let's use it to calculate the TB mortality rate percent change between 1977 and 1978:

((1.3 - 1.4) / 1.4) * 100% = -7.14%

So, the TB mortality rate decreased by approximately 7.14% from 1977 to 1978.

Question 8

(0.9 - 1.3) / 1.3) * 100% = -30.77%

So, the TB death rate decreased by approximately 30.77% from 1978 to 1979.

Question 9 

What are the possible reasons there was such a large difference between the rates for these

years?

 There could be several reasons for such a large difference in TB death rates between these years. Improvements in healthcare, more effective treatments, better access to care, improved public health interventions, or lower transmission rates could all have contributed. It's also possible that public health campaigns promoting early detection and treatment of TB were successful during this period.

Regarding the TB Morbidity section, it explains the difference between incidence rates and prevalence ratios, and how the latter includes both new and old infections in a population. These measures are important tools for understanding and controlling the spread of diseases like TB.

Question 10 

Suppose that a county TB controller would like to know how many people currently living in a local nursing home are infected with TB. After receiving the appropriate approval and consent from the nursing home residents and administration, she has a trained nurse administer and read the results of tuberculin skin tests. Of the 100 nursing home residents who were tested, 30 had positive tuberculin skin test results during July of that year. 

What is the prevalence ratio of TB infection in this nursing home during the month of July?

The prevalence ratio is defined as the number of new and old TB infections during a specified time period per total population during the same time period.

In this case, the number of new and old TB infections is 30 and the total population is 100.

The prevalence ratio is therefore (30/100) x 100 = 30 per 100.

This means that during the month of July, 30 out of every 100 residents of the nursing home had a TB infection, as indicated by a positive tuberculin skin test.

Question #11

Nurses conduct continuous assessments. Compare and contrast the tools used to assess families and communities. 

 The tools used to assess families and communities are quite varied, but both require a holistic approach. For families, tools might include family health history assessments, genograms, and family functioning assessments. For communities, public health nurses might use community health assessments, environmental scans, and health impact assessments.

Question #12

You have been asked to describe the science of epidemiology to a new group of nursing students. Covering web of causation, morbidity, and mortality, how would you explain this to the students?

Epidemiology is the study of how often diseases occur in different groups of people and why. It provides information for disease prevention and control. The "web of causation" refers to the complex interplay of factors that lead to health outcomes. Morbidity refers to illness levels in a population while mortality refers to deaths. Epidemiologists use these concepts to understand the spread and impact of disease and to develop strategies for prevention and control.

References

Abubakar, I., et al. (2020). Systematic review and meta-analysis of the current evidence on the duration of protection by bacillus Calmette-Guérin vaccination against tuberculosis. Health Technology Assessment, 24(37), 1-4. doi:10.3310/hta24370

Centers for Disease Control and Prevention. (2022). Tuberculosis (TB). Atlanta, GA: Centers for Disease Control and Prevention. Retrieved from  https://www.cdc.gov/tb/

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Edited by Idalmis Lopez on Jun 3, 2023, 1:51:30 PM