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Florence nightengale

- crimean wars- helped improve soldiers health
- used population based approach

lillian wald

- first public health nurse--started public health nursing
- known fo establishmen of henry street settlements in new york
- national organization of public health established in 1912- was the president

Lina Rogers

-first school nurse
- focused on investigating the cause of absenteeism
- did not treat illness- physicians job at the time

national organization of puplic health

- presdident- lillian wald
- established 1912
- goal- standardize public health nursing, improve standards of services and education by public health nurses , and promote public health nursing


- lasted until 1960s
- made it difficult for african american nurses to get certification and graduate education

mary breckenridge

- developed health programs to improve healthcare in rural and hard to reach populations in the applachians of southern kentucky

leading cause of death from 1900-1955

pneumonia, tuberculosis, and diahrea enteritis

leading cause of death after 1955 . new challenge for nurses

- heart disease, cancer, cerebrovascular disease
- new challenge for nurses was chronic illness, and disease prevention

ruth freeman

leading healh educator, author, consultant and leader of national health organization of the 20th century
- offeren many professional oppurtunities
- saw nursing as intellectually challenging and was about caring for people

maritime hosptial service

currently known as the public health service
- attempt of united states federal government to protect health of citizens

WHO conference

- @ Alma Ata in 1978
- main focus of the conference was worldwideimplementation of primary health

population health

holistic approach that considers the total health system and focuses on the broad range of factors and conditions that have a strong influenceon the health of population
- determinants social factors, social support netweorks, education,m employmentm, and healthy child development

mulitlatral organizations

organizations that recieve fundings from mulple governmental and non-governmental sources

bio terrorism

intentiaonal use of a pathogen or biological product to cause harm to living organisms to influence or intimidatt eh conduct of a government and cause harm to other people. :
- role of PHN and healh officieals is to detect pathogen , manage services, and communicate during threat
- anthrax, plague, and smallpox biological agens highest concern

environmental health

- aspects of human health affecting quality of life that are determined by biological, cheical, and social and pssychological problems in the enviroment

chemical exposure

nurses have made discoveries based on assessing people presenting with signs and symptoms related to known chemical toxicity


studies the incidence and prevalence of disease, in POPULATIONS
- helps us to understand the strength of the association between exposure and health effects
- monitors health of populations , understands determinants of health and disease in communities, and investigates and evaluates interventions to prevent disease and maintain health
- father of epidemiology is JOHN SNOW_ because of his work with cholera


study of health effects associated with chemical exposures

rule of seven

native american concept, what will be the effect of this decision in 7 years. .
- native americans believe humans are stewards, not propieters of the land

attack rate

-a measure of morbididity often used in infectious disease investigations
- often specific to an exposure such as food specific attack rates
-rate that best indicates the proportion of people exposed to an agent who deelop the disease.

mortality rates

reflect serious health problems and changing patterns of disease
- do not give direct info about level of existing disease or the risk of getting a disease
-informative only for fatal diseases

descriptive epidemiology

seeks to describe a desiease entitiy according to person, place, and time

analytical epidemiology

directed toward understanding the etiology of the disease and attempts to dienitfy the determinants of disease in individuals
- determinants may be indvidiual, social , communal, or environmental
- Examples- cohort studies (prospective and retrospective); case control studies, cross sectional studies, ecological studies


measure of frequency of a health event in a "definied population in a specified period of time
- not a proportion because the denominator is a function of both the population size and the dimension of time while the numberator is the number of events
- one cannot tell the degree of seriousness or if it is an epidemic if you do not have a deonomiator which represents the total population


the probability an even will occur within a specified time

incidence rate

the number of new cases developing in a population at risk during a sepcified period
formula= # of new cases (divided by) total population at risk x 1,000


quantifies the rate of development of new cases in a population at risk


when the rate of disease injury or other condition exceeds the usual level of that position
- Examples- an isolatedcase of smallpox in Africa because there is no smallpox; nursing shortage in US, adult obesity in the US,

primary prevention

interventions aimed at preventing the occurence of disease, injury or diability: before it happens
EXAMPLES- immunizations, diet, exercise

secondary prevention

focuses on ealy detection and prompt treatment of disease injury or disability. things before symptoms occur . ie screening for hearig defects, mammograms

tertiary prevention

interventions aimed at disability limitation, and rehabilitation from disease, injury and disability
- EXAMPLES- rehbilitative job training, vocational training


a screening test has high specificity - meaning that the test accuately identifies those without the trait
-the test accuractely identigying those without the trait

routinely collected data

-obtained through vital recors such as birth and death certificates , - things that are uniform across the country
- example of a category of data sources commonly used in epidemilogical investigations

most important predictor of overall mortality


mortality curve by age

decreases during and after first year of life, low point in childhood, increases in adolescents and young adulthood, then increases sharply through middle and old ages

point epidemic

- temporal and spatial pattern of disease distribution
- illustrated with freuqncy of disease plotted against time
0 shapr peak indicates concentration of cases in some short interval of time
- example- outbreak of GI illness from a food borne pathogen

cohort study

describes a group of persons enroled in a study that share the same characteristic of interest for a period of time

cross sectional study-

uses info on current health status, personal characteristics, ad potential risk factors or exposures all at once

community trial

as opposed to clinical trials * treatment of existing disease) is focused on health promotion and disease prevention
Example: Residents of a city have recently voted to add fluoride to the H20. Epidemiologists wanting to study the effect on dental caries would be conducting a....

provide the highest level of evidence

randomized double blind controlled trials

research utilization projects in 1970s

0 provided a guide to clinical practice and was the forerunner of evidence based nursing practive.

systemetic review

- one of the two ways nurses can read research in condenced format
- method of identifying, appraising and synthesizing research evidence to evaluate all available research to a particular question
- usually done by more than one person and describes the methods used to search for the evidence

evidence based research

- began in canada
- nurses can participate by doing active research or reviewing best available evidence

community development model

focuses on achieving community goals and includes t a partnership where power and decision making are shared between community members and academic community

information access project

serves as a reource for community healh nuses as they indentify the findings from research that have direct links to population focuses and communty based care

public health nurse

informs, educates, and empoowers people about health issues.
- does not solve problems but identifies them,
- participates with regulators to protect commnties and empower populations to address health issues globally and locally
- BSN is the necessary basic preparation to function as a beginning saff public health nurse


a collection of individuals who share at least one common characteristic


definied poplation made up of individuals in communities fo a specific geographic regions


making sure that community oriented helath servies are avaiable .
a core function

core functions

assurance, policy development, assessment, and ascietific based care

community health nursing

practice inlclueds the delivery of personal health services to individuals, families and groups
- practie in the community wheter or noth they have had preparation in public health nursing (a BSN)
-ie- school nurse, a nurse in a clinic, nurses who make home visits, to provide tertiary car


- implement quality performance standards in public health. which are used to guid e improvents in the public health system.
- 1998

primary goal of public health

concern for the health of many people not as much the individual


one of the core functions includes collecting data and monioting the health status of the population ,

policy development

one of the core functions of public health needed to provide leadership in deveoping policies.


- factors, exposures, characteristics and behaviors that determine patterns of disease.
- may be individual , relational or social, communal, or environmental


the measure of existing disease in a population at a particular time
Ex: a screening for HTN revleaed 20 previously diagnosed hypertensive individuals and 10 probable new cases , which were later confirmed for a total of 30 cases.
total # of cases divided by total population at risk times 100,000

cause specific mortality rate

estimate of the risk of death from some specific disease in the population

crude death rate


predictive value

Positive predictor value refers to the proportion of persons with a positive test who actually have the disease, interpreted as the probability that an individual with a positive test has the disease.

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