Test 2 Flashcards
(176 cards)
1
Q
What are the three G’s of colonialism from the age of discovery?
A
God, gold, glory
2
Q
When were the first and second waves of colonialism historically? What is each wave called?
A
First wave - Age of discovery in the 15th century; colonization of North and South America
Second wave - Scramble for Africa in the 19th century; divided up Africa
3
Q
Define internalization of oppression
A
Structure that allows for the maintenance and ongoing oppression to occur
4
Q
Define neocolonialism
A
the use of economic, political, cultural, or other pressures to control or influence other countries, especially former dependencies.
Countries may not use physical force or conquer land, but they use other structural forms like economics or politics to exploit another country
5
Q
List five health disparities that Indigenous people experience
A
- Lower life expectancy
- Higher infant and child mortality
- Higher maternal mortality
- Higher rates of infectious diseases
- Higher rates of substance abuse and depression
6
Q
How are TB and HIV related?
A
TB is a leading killer of HIV-positive people.
HIV increases the likelihood of progressing from latent to active TB and TB infection increases the likelihood of HIV progressing to AIDS
Often, individuals who have TB will also have HIV
7
Q
What percentage of individuals have access to ARV drugs?
A
Only 40%
8
Q
What is the UNAIDS 90-90-90
A
Wanted 90% to know their status
90% to receive treatment
90% have a low viral count
9
Q
How was TB introduced in Canada?
A
Introduced to indigenous people through colonization
10
Q
Is TB higher in Indigenous populations in Canada?
A
In Canada incidence rates are 41 times higher in Indigenous populations when compared to non-Indigenous Canadian born people
Over-crowding is one of the predominant reasons why it is so prevalent in Inuit
In addition, the remote nature of the community restricts access to services
11
Q
What happened with BCG vaccines and medical experimentation?
A
Indigenous people in North America were experimented on to determine BCG efficacy in the 1930s and 40s
Community members were not informed that they were participating in a trial
Vaccine used for TB and used amongst indigenous people
Used without complete informed consent and used to treat/determine effectiveness of TB
12
Q
How well is Canada meeting 90-90-90 for HIV?
A
87% know they are positive
85% are treated
94% have a low viral count
13
Q
Is HIV higher amongst Indigenous populations?
A
Yes
14
Q
What are the 6 structural determinants of health related to HIV?
A
Colonialism, globalization, migration, access to health care, poverty, and self-determination
15
Q
What is UNDRIP?
A
Defined the individual and collective rights of Indigenous peoples to their ownership rights to cultural and ceremonial expression, identity, language, employment, health, education, and other issues.
Emphasized the right to self-determination
A human rights document
16
Q
What group experiences the impacts of climate change first? How does this worsen issues for them?
A
Indigenous peoples
Climate change will make the problems that already exist in Indigenous communities worse
17
Q
What are the four Rs of the indigenous holistic framework
A
- Respect - Respecting all who live on the planet
- Relevance - Developing a relationship with nature that has personal meaning
- Reciprocity - Replenishing what we take from Mother Earth
- Being a steward for the Earth and the 7 generations to come
18
Q
How can indigenous groups help find climate change solutions?
A
Being key to informing how to create change to ameliorate the problem
Indigenous knowledge systems can inform climate change adaptation in three ways - social, structural, and institutional adaptation
19
Q
Define social adaptation for indigenous climate solutions
A
weather forecasting, farming activities, water conservation and irrigation processes, soil improvement practices, social cohesion, communal pooling, resource preservation
20
Q
Define structural adaptation for indigenous climate solutions
A
Cultivation, housing, and ecosystem-based strategies
21
Q
Define institutional adaptation for indigenous climate solutions
A
agricultural strategies, trading strategies
22
Q
Are there similarities between colonialism, globalization, and global nursing work?
A
Yes, global health nursing has occurred in parallel to globalization
Similarities between colonialism, globalization and global nursing work
Nursing work has the capacity to unduly influence beneficiaries of international work into abandoning their own beliefs to secure material benefits
23
Q
How have nurses historically played a role in imposing colonialism in Indigenous peoples?
A
nurses were on the frontlines of imposing the settler colonial agenda on Indigenous peoples and have been active contributors to the structural violence inflicted on Indigenous peoples.
Such examples, include residential schools and sterilization rooted in Christian views
24
Q
How to Florence Nightingale perpetuate colonialism?
A
Counselled many political figures and was a strong supporter of British colonialism.
She believe that Indigenous lives were a small price to pay for the expansion of the British Empire
She concluded that the high rates of death of Indigenous people in colonial schools and hospitals reflected the hast of British authorities to assimilate them
25
What is cultural imperialism in healthcare?
Providing care or services in such a way that it forces potential recipients of those services to choose between accessing the care being offered that would be unavailable otherwise that violates traditional norms and practices, or not receiving assistance
Often, care that is available is often misaligned with culture or values
Therefore, individuals have to either accept care that does not align with beliefs/culture or not receive care at all
Has roots in the colonial era, when Western nations set out to conquer and rule territories in North America, Asia and Africa for the dual purpose of exploiting their national resources and “civilizing” their inhabitants
26
What are the three key features of cultural imperialism in health care?
1. Imperialists intent to both dominate and reform the cultural beliefs and practices of another people
2. Imperialists feel they are entitled to do so because they believe Western culture is superior
3. Imperialists carry about their task coercively, with the aid of significant economic and military resources
27
Define necropolitics as outlined by Larocque
Living in a space between life and death
Populations are in a dying state
Communities are in a space of being not quite living and not quite dead (Not living life to the fullest)
Structural violence, oppression, etc. play into this state
28
Define necropower as discussed by Larocque
the struggle against death
Always facing death (i.e., using substances to cope and knowing that any next use could be death)
29
How do nurses participate in necropower? As discussed by Larocque
Embeddedness in colonialism and colonial processes is foundational to the pervasive racism
in healthcare and nursing
Perpetuating the biomedical model, ‘frequent flyer’, etc.
30
What are six ways that Canadian health care sustains colonization?
1. Designing and delivering services that are focused on micro, individualistic and eurocentric perspectives on the SDH;
2. Denying and minimizing Indigenous ways of healing;
3. Racism at point-of-care;
4. Failing to make cultural safety a national, policy-based priority in health and human services
5. Failing to develop national standards for embedding cultural safety in the educational curriculums of health professional education programs, and
6. Failure of health-related professional licensing bodies to systematically integrate cultural safety in their professional codes of ethics, so that practice licenses are tethered to cultural safety competence.
31
Define a humanitarian crisis
A humanitarian crisis is defined as a singular event or a series of events that are threatening in terms of health, safety or well-being of a community or large group of people.
Can be either natural or man-made disasters
32
What are six implications of humanitarian crises/complex emergencies?
1. Extensive violence and loss of life
2. Displacements of populations
3. Widespread damage to societies and economies
4. The need for large-scale, multi-faceted humanitarian assistance
5. The hindrance or prevention of humanitarian assistance by political and military constraints
6. Significant security risks for humanitarian relief workers in some areas
33
Define humanitarian aid
Intended to save lives, alleviate suffering and maintain human dignity during and after man-made crises and disasters caused by natural hazards, as well as to prevent and strengthen preparedness for when such situations occur
Short-term and focused on maximizing lives saved
34
What three organizations are involved in humanitarian aid?
Multilateral organizations - UN, WHO
Bilateral organizations - Global Affairs Canada
NGOs
35
Out of all the organizations involved in humanitarian aid, which is the most involved?
A large portion of humanitarian aid provided is done through NGOs
36
What is a critique of humanitarian aid?
It is often very short-term and does not focus on sustainable development; only provides short-term protection/assistance
37
How do natural disasters affect water?
Often, natural disasters lead to compromised water and sanitation systems, which leads to significant health impacts (i.e., cholera)
38
How has the number of war deaths changed?
Seen a decrease in war deaths since WWII, but we see increased conflict now
39
What are five general health implications of armed conflict?
1. Violence (wounds, injuries, sexual violence)
2. Death/grieving
3. Anxiety, psychological trauma
4. Child soldiers
5. Destruction of infrastructure (roads, public transport, clean water supplies, etc.)
40
List the 3 types of displacement
Internal displacement, asylum seekers, and refugees
41
Define internal displacement
An individual who has been forced or obliged to flee from their home or place of habitual residence in particular, as a result of or in order to avoid the effects of armed conflicts, situations of generalized violence, violations of human rights, or natural/human-made disasters, and who have not crossed an internationally recognized state border
42
Define asylum seekers
An individual who is seeking international protection. In countries with individualized procedures, an asylum-seeker is someone whose claim has not yet been finally decided on by the country in which the claim is submitted. Not every asylum-seeker will ultimately be recognized as a refugee, but every refugee was initially an asylum-seeker.
43
Define refugees
A person who meets the eligibility criteria under the applicable refugee definition, as provided for by international or regional instruments, under UNHCR’s mandate, and/or in national legislation
44
Define the triple burden of disease
Increases in malnutrition, dehydration, diarrhea, communicable diseases (cholera, measles, typhoid)
Non-communicable diseases
Mental illness- loss, disassociation, flashbacks, anxiety, depression, PTSD
45
What does the triple burden of disease arise from?
Displacement
46
List the 4 humanitarian principles
1. Humanity
2. Impartiality
3. Neutrality
4. Independence
47
Define the humanitarian principle of humanity
Human suffering must be addressed wherever it is found. The purpose of humanitarian action is to protect life and health and ensure respect for human beings.
Try and do the greatest good for the most people we can and providing care based on need alone
Addressing suffering and triage
48
Define the humanitarian principle of impartiality
Humanitarian action must be carried out on the basis of need alone, giving priority to the most urgent cases of distress and making no distinctions on the basis of nationality, race, gender, religious belief, class or political opinions.
Regardless of who you are, what side of conflict you are on, the people with greatest need will be treated
49
Define the humanitarian principle of neutrality
Humanitarian actors must not take sides in hostilities or engage in controversies of a political, racial, religious or ideological nature.
NGOs and humanitarian providers cannot pick sides and must be neutral
50
Define the humanitarian principle of independence
Humanitarian action must be autonomous from the political, economic, military or other objectives that any actor may hold with regard to areas where humanitarian action is being implemented
Organizations should not be backed by a particular government
NGOs should be acting independently from any government
51
What are two primary risks of humanitarian crises to nurses?
1. Physical danger - The need for humanitarian nursing is often greatest in dangerous locations, including war zones, refugee camps, and remote locations with few resources.
2. Psychological stress - The stress of emergency conditions can place humanitarian nurses at risk for burnout, and exposure to suffering can lead to depression.
52
Define an emergency
Emergency - Any situation, whether imminent or one that is already in progress, that requires a rapid and skilled response to protect the health, safety, and wellness of individuals and to limit damage to property or the environment and that can be managed by a community’s existing resources
53
Define a disaster
The outcome of a natural event or a result of human action or error, whether malicious or unintentional, that negatively affects society or the environment and exceeds the capacity of the community to response with existing resources
54
Describe the difference between an emergency and a disaster
Emergencies can be managed by a community’s existing resources
Disasters exceed the capacity of the community to response with existing resources
55
What are the 5 types of disasters?
1. Natural
2. Epidemic/Pandemic
3. Man-made
4. Conflict/complex crisis
5. Technological
56
Why have the number of recorded natural disasters from 1900 to 2023 gone up?
Largely reflects increases in data reporting
We can’t assume that disasters were zero back in the 1900s, but the ability to report and track them was not significant or viable
57
Where is the first climate change famine currently happening?
Madagascar - high dependence on rain for crops and experiencing a longstanding drought
58
What are the 5 groups of people considered as vulnerable populations in natural disasters?
1. Children/youth
2. Women
3. Older adults
4. Mentally ill
5. Cultural and ethnic groups (Significant language and cultural differences may cause barriers or challenges)
59
How are inequities and disasters related?
Inequities exacerbate consequences during times of disasters... And disasters exacerbate inequities
Due to - social exclusion,
disruption of health services, breakdown of social supports,
physical barriers,
inaccessible information,
access to resources, etc
60
Discuss ebola, factors related to its outbreak in Liberia
They believe that Ebola comes from planetary health challenges
Zoonotic disease spread person to person through contact with blood and body fluids of an infected person.
Caused by poor local surveillance systems,
poor public health infrastructure, globalization/Urbanization, deforestation, and cultural and traditional practices (traditional open funerals, unprotected contact, eating specific animals)
61
What are six potential health effects of disasters?
Immediate Effects
Short term effects
Long term effects
The Social Determinants of Health
Vulnerable populations
Environmental Damage
62
What are the four stages of the disaster management continuum?
1. Mitigation
2. Preparedness
3. Response
4. Recovery
63
What is the goal of the disaster management continuum?
save lives, preserve the environment, and protect Property and the economy”
64
Define the mitigation/prevention stage of the continuum
To eliminate or reduce the impact or consequences of disasters.
Involved anticipation of the risk and the potential outcomes and measures are put into place before the disaster to minimize or limit the effect.
(e.g. flood mapping, building codes, material usage, land-use planning, insurance incentives, dyke construction)
65
What are 7 nursing roles in mitigation stage?
1. Identifying risks (for individuals and communities)
2. Community needs assessments
3. Helping to shape public policy
4. Be aware of (and inform) vulnerable persons
5. Organizing and collaborating with community partners
6. Addressing environmental hazards
7. Mass prophylaxis campaigns
66
Define the preparedness stage
To be prepared ahead of time and to be ready to respond and manage situations when disaster does strike. Ideally, response has been planned and practiced so that it becomes automatic.
i.e., Practicing mass casualty simulations is both mitigation and preparedness
67
List 11 nursing roles in preparedness
1. Personal/family plan (i.e. disaster kits)
2. Assist in the creation of emergency and response plans for self/home/hospital/community
3. Understanding of emergency/disaster plans in community and workplace
4. Response training
5. Capacity-building
6. Leadership roles
7. Promotion of, and compliance with, emergency operations plan testing
8. Knowledge of PPE
9. Plans should be simple, clear, and realistic
10. Develop trust and credibility within the community
11. Identify and educate vulnerable populations
68
Define the response stage
To act during or immediately before or after a disaster to manage its consequences through such things as emergency communication, search and rescue, triage, evacuation, etc. Focused mainly on mobilizing responders to offer relief.
69
How will children often react to disasters?
Regressive behaviours (bedwetting, thumb-sucking, crying, clinging to parents)
Fantasies that disasters didn’t occur
Nightmares
School-related problems, including inability to concentrate and refusal to go back to school
70
List 10 nursing roles in the response stage
1. Providing physical care
2. Providing mental care
3. Management of scarce resources
4. Coordinating care
5. Identifying critical needs
6. Monitoring of survivors for mental health implications
7. Advocacy of survivors and families
8. Training of volunteers
9. Ongoing identification of patterns of illness and diseases (collect data for analysis)
10. Facilitate effective communication
71
What are the three levels of prevention in disaster management? Define them.
Primary Prevention - participating with a community committee in developing a disaster plan
Secondary Prevention - triaging disaster victims
Tertiary Prevention - preventing additional injuries/harms to victims
72
Define utilitarian ethics and when it is predominantly used
the greatest amount of good for the greatest number people
Used in disasters when resources are scarce
73
When is the START triage typically used?
In disasters when there are more victims than rescuers
Usually, time and resources are limited
Instills utilitarian ethics
74
What are the four START triage categories?
Green - minor
Yellow - delayed
Red - Immediate
Black - deceased
75
Define the green START category
Minor
walking wounded / injuries that can be treated with first aid, did not fail any of three steps (Breathing, circulation, mental status)
76
Define the yellow START category
Delayed
injuries requiring medical treatment but not life threatening, okay to delay care
77
Define the red START category
life threatening injuries requiring rapid treatment
78
Define the black START category
Deceased
79
What is the first step of triage in a disaster?
Identify yourself.
Conduct voice triage.
Assign someone to tag those who respond to the voice triage and pass assessment step tag Green.
80
Describe step 1 (respiratory) of START
Open airway and check breathing
>30 indicates shock. Treat shock and tag as immediate/red
No breathing after two attempts to open airway. tag as deceased/black
<30 Move to step 2 (pulse)
81
Describe step 2 (pulse) of START
Check circulation and bleeding
Cap refill >2 seconds tag as immediate/red
- stop the bleeding (pressure, elevate limb, bandage, tourniquet)
- elevate legs for shock
Cap refill <2 seconds move to step 3 (mental)
82
Describe step 3 (mental) of START
Check mental status- follow simple commands
If they pass test tag as delayed/yellow
If they fail test tag as immediate/red
83
Define the recovery stage
Repairing and restoring conditions to an acceptable level through measure taken after a disaster.
Return of evacuees, trauma counselling, reconstruction, economic impact studies, financial assistance, further mitigation and preparation, etc.
84
What are the six phases of emotional recovery following disaster?
1. Pre-disaster
2. Impact
3. Honeymoon/community cohesion
4. Disillusionment
5. Reconstruction (new beginning)
85
List the 6 nursing roles in the recovery stage
1. ongoing care
2. reduction of complications
3. referrals and community outreach
4. recovery of infrastructure
5. leadership in planning and reconstruction
6. evaluation of disaster plan - alter and revise if necessary
86
Describe the evaluation stage of disaster
NOT part of the continuum
Occurs during Recovery Phase and informs the Mitigation Phase
Receives the least attention of the phases
Determines:
What worked
What did not work
What specific problems, issues & challenges identified
87
Define planetary health
The attainment of elevated health, wellbeing, and equity globally by protecting environmental limits within which humanity can flourish
Intricate connection of human health to the vitality of natural systems of the Earth’s biosphere
88
What is a central component to planetary health?
The interdependence of humans and the environment is central to Planetary Health
89
Define environmental health
Environmental health addresses all the physical, chemical, and biological factors external to a person, and all the related factors impacting behaviours. 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.
90
What are the four environmental health principles?
1. Everything is connected to everything else.
2. Everything has to go somewhere
3. Impact is proportional to dose.
4. Today’s solution may be tomorrow’s problem.
91
Describe the ‘everything has to go somewhere principle’
Waste, landfills, water discharge
How unused pharmaceuticals are excreted and re-entering the water system
92
Describe the ‘impact is proportional to dose’ principle
Led poisoning (paint in older homes), BPA in plastic water bottles as carcinogenic
93
Define bioaccumulation
build-up of chemicals in living organisms
Organisms can’t break up the chemicals fast enough (i.e., methylmercury, microplastics)
* Increased risk for cancer
94
Describe the ’today’s solution may be tomorrow’s problem’ principle
Incinerators caused air pollution, fossil fuels
Solutions we have today may be good now but will later cause problems in the future
95
Define the precautionary principle
Where there are threats of serious or irreversible damage, lack of full scientific certainty shall not be used a reason for postponing cost-effective measures to prevent environmental degradation
It emphasizes preventive action to protect public health and the environment, even if some cause-and-effect relationships are not fully established scientifically. The principle aims to avoid harm by addressing uncertainties proactively.
96
How does climate change broadly negatively affect health globally?
climate change is expected to cause approximately 250 000 additional deaths per year from malnutrition, malaria, diarrhea and heat stress
Climate change affects the social and environmental determinants of health
- Clean air, safe drinking water, sufficient food, and secure shelters
97
What are the five groups most vulnerable to climate change?
1. Children
2. Women
3. People living in poverty
4. Indigenous people
5. Global south
98
Define climate justice
those who are the least responsible for climate change will likely be disproportionately affected by its adverse outcomes.
99
How is nursing’s commitment to social justice related to climate justice?
Nursing’s commitment to social justice offers an opportunity to offer significant global leadership in addressing the health implications related to climate change.
100
What is the health burden of climate change on global disease?
Environmental risks account for a large fraction of the global burden of disease
LMIC bear the greatest share of environmental disease
101
List 9 health effects of climate change
1. Injury and mortality from extreme weather events
2. Heat-related illness
3. Resp illness
4. Water-borne diseases and other water-related health impacts
5. Zoonoses
6. Vector-borne diseases
7. Malnutrition and food-borne diseases
8. NCDs
9. Mental and psychosocial health
102
What are two primary direct health effects of climate change?
Heat stress and injuries due to natural disasters
103
What 5 groups are at highest risk for the direct health effect of heat stress/stroke/exhaustion?
1. Less abled, pregnant, and infirm
2. Poor, displaced, and homeless
3. Children and elderly
4. Athletes
5. Outdoor and manual workers
104
List 5 indirect health effects from climate change
1. Water scarcity
2. Increased malnutrition
3. Infectious diseases (i.e., diarrhoeal diseases)
4. Chronic diseases (i.e., asthma due to agriculture, MSK injuries, strokes due to air pollution)
5. Zoonotic diseases
105
What is the most common type of natural disaster globally today?
Floods
106
What causes 20% of deaths in children under the age of 5? What is the most common virus and bacteria?
Diarrhoeal diseases
Rotavirus and cholera or shigella
107
What are three key measures to treating diarrhea?
1. Rehydration (IV or oral rehydration salts)
2. Zinc supplements
3. Nutrient-rich foods
108
What are 7 key measures to preventing diarrheal diseases in children?
1. Access to safe drinking-water
2. Use of improved sanitation
3. Hand washing with soap
4. Exclusive breastfeeding for the first six months of life
5. Good personal and food hygiene
6. Health education about how infections spread
7. Rotavirus vaccination
109
List 6 common NCDs that result from environmental burden
Cancer, unipolar depressive disorder, CVD, COPD, asthma, and MSK diseases/injuries
110
Where do the highest number of strokes occur?
LMIC
111
How does household air pollution in LMIC relate to deaths/disease?
Around 2.1 billion people cook using polluting open fires or simple stoves fuelled by kerosene, biomass (wood, animal dung and crop waste) and coal
Household air pollution was responsible for an estimated 3.2 million deaths per year in 2020, including over 237 000 deaths of children under the age of 5.
112
List 5 health impacts arising from household air pollution in LMIC
1. Pneumonia, stroke, ischemic heart disease, COPD, lung cancer
2. Musculoskeletal damage from gathering fuel
3. Time considerations from gathering fuel
4. Poisonings and burns
5. Contributing to climate change and its health impacts
113
How and where does ambient air pollution disproportionately affect health?
Around 91% of the world’s population lives in places where air quality levels exceed WHO limits.
While ambient air pollution affects developed and developing countries alike, low- and middle-income countries experience the highest burden, with the greatest toll in the WHO Western Pacific and South-East Asia regions.
114
What regions experience the greatest toll of ambient air pollution?
Western Pacific and South-East Asia regions
115
Which SDG discusses and targets clean water and sanitation? What does this SDG broadly address?
SDG 6
Goal 6 not only addresses the issues relating to drinking water, sanitation and hygiene, but also the quality and sustainability of water resources worldwide.
116
How does the collapse of fish stocks related to climate change threaten health?
It may exacerbate the nutritional transition and those living in LMIC would replace seafood with starches or fast foods, leading to increased NCDs and deaths
117
What is the overarching goal of SDG 2 - zero hunger?
By 2030, end hunger and ensure access by all people, particularly the poor and people in vulnerable situations, including infants, to safe, nutritious and sufficient food all year round.
118
Define zoonotic diseases
Zoonosis are infectious diseases that are transmissible under normal conditions from animals to humans
119
List 2 examples of vector-borne and zoonotic diseases
Vector - West Nile virus and malaria
Zoonotic - Rabies and anthrax
120
Describe the differences between vector-borne and zoonotic diseases
Vector - transmitted through vectors (e.g., mosquitoes, ticks), the vector carries the pathogen
Zoonotic - transmitted through direct/indirect contact with animals, primary source is the infected animal itself
121
How does climate change impact the mechanisms of vector and zoonotic diseases?
1. Range shifts in vectors or hosts
2. Changes in population density of host or vectors
3. Changes in prevalence of infection in host or vector
4. Changes in pathogen loads
5. Changes in human behaviours
122
What three ways does climate change affect VBDs in Canada?
1. Changes in the spatial and temporal locations of existing diseases
2. Emerging and re-emerging diseases from warming and climate variability
3. Local transmission of exotic diseases - shipping of products and people from exotic areas introduces new vectors into Canada
123
What is the primary goal of SDG 3 - good health and well-being?
By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases.
Increase the countries capacity to develop and implement comprehensive plans, programs or strategies for the surveillance, prevention, control, or elimination of neglected, tropical or zoonotic diseases.
124
_______ risks account for a large fraction of the global disease burden
Environmental
125
_____ are closely interlinked with environmental and social determinants of health
SDGs
126
Nearly two thirds of all deaths attributable to the environment are now composed of ____
NCDs
127
_____ and ______ are most affected by the environment
Children under 5 and older adults
128
What are 8 steps we can take toward healthy environments?
1. Focus on primary prevention
2. Systematically consider health in all sectors
3. Promote local governance to address environmental health planning
4. Create healthy environments to support SDG achievement
5. Integrate actions to address the SDOH
6. Introduce strategies with low-carbon approaches
7. Promote assessments of health impacts
8. Manage and prevent emerging risks including climate change
129
What is the aim of one health?
To improve health and well-being through the prevention of risks and the mitigation of effects of crises that originate at the interface between humans, animals and their various environments.
For the purpose of promoting a whole of society and multi-sectoral approach to health hazards, as a systemic change of perspective in the management of risk
130
What are the three main focuses of one health (very broad)?
1. Human health
2. Enviornmental health
3. Animal health
131
What are three general health related issues stemming from health care?
Healthcare waste, pharmaceutical waste, and antimicrobial resistance
132
How does healthcare waste affect health? Is most of the waste hazardous or non-hazardous?
Most waste is general, non-hazardous waste, however, some material may be infectious, toxic, or radioactive
Open burning and incineration of health care wastes can, under some circumstances, result in the emission of dioxins, furans, and particulate matter.
133
How does SDG 12 - responsible consumption and production relate to healthcare health issues/waste?
Measures to ensure the safe and environmentally sound management of health care wastes can prevent adverse health and environmental impacts from such waste including the unintended release of chemical or biological hazards, including drug-resistant microorganisms, into the environment thus protecting the health of patients, health workers, and the general public.
134
Define antimicrobial resistance. Is it a public health issue?
The misuse and overuse of antimicrobials in humans, animals and plants are the main drivers in the development of drug-resistant pathogens.
Antimicrobial resistance (AMR) is one of the top global public health and development threats.
135
What are the three main causes of AMR?
Failure of
The patients
The prescribers
The regulatory systems - agriculture
136
Where do we see the greatest increase in antibiotic consumption globally?
Middle-income countries
137
What is the relationship between antibiotics and livestock?
There is a worldwide increase for animal protein
Intensify production by the misuse of antibiotics in livestock
138
Why is AMR missing from the SDGs?
Part of a larger ecological phenomenon and thus not amenable to easy technical interventions.
Responding to outbreaks of resistant infections involves coordination of efforts across national boundaries, varied health systems and involving international agencies like the WHO
139
What are the 4 nursing roles in planetary health?
1. Environmental scan
2. Risk assessment
3. Risk management
4. Risk communication
140
Define environmental scan in nursing
An environmental scan assesses the environment and is often used to assess population health issues, SWOT format
141
What is the SWOT format in environmental scans?
Strengths (internal), weaknesses (internal), opportunities (external), and threats (external)
Examples
S - Experienced staff, access to advanced diagnostic tools.
W - Insufficient funding, limited outreach in rural areas.
O - Availability of new vaccines, increased public awareness.
T - Rising vector populations due to climate change, political instability.
142
Define risk assessment
Risk assessment is a qualitative and quantitative evaluation of the risk posed to human health or the environment by specific pollutants.
143
Define risk management
Risk management which is the development and evaluation of strategies to reduce the health implications of environmental hazards
144
Define risk communication
Risk communication is the exchange of information on the potential harm of environmental hazards
145
What are the triple threats as outlined in this statement - Nurses often work very closely with individuals and communities who experience direct impacts of the triple threats
Climate Change, Biodiversity Loss, Pollution
146
List the 4 calls to action for planetary health in nursing
1. Climate change and planetary health content should be considered for all accredited nursing education programs, so the future nurses are prepared to deal with the planetary health crisis.
2. Advance planetary health within nursing education and nursing practice.
3. Empower future nurses to engage in advocacy and promotion of planetary health on various levels of health policy.
4. Promote further research exploring the integration of planetary health into nursing education.
147
What are three components of a nursing leader?
1. knowing your own strengths and limitations
2. knowing when to follow
3. maintaining workplace civility
148
In Kurth’s reading, what does the author say about global urbanization and its effect on health?
In Kurth’s reading, what does the author say about global urbanization and its effect on health?
149
In Kurth’s reading, what does the author say about cities and the global burden of disease in LMIC?
Cities are the main drivers of climate change, but also the recipients of deleterious climate impacts
The global burden of disease is vastly and disproportionately borne by LMIC
150
What does author Kurth say about climate change and its ‘time lagged’ nature?
The author states that temperature rise and some of its unstoppable consequences are already ‘baked in’ to our system and future
Meaning, the harmful things that occurred in 2016 will not have noticeable effect until 2030
151
In the Kurth reading, what does the author say in regard to current health of the global population and sustaining these health
The organizing premise of planetary health is that, while the global human population is healthier than ever before, the ecological cost to attain this standard has required an unprecedented and unsustainable exploitation of the planet.
On our current un-sustainable trajectory, we could see a reversal of health progress made as well as destabilized governments due to resource scarcity and inequities.
152
In the Kurth reading, the author discusses global conflicts and water scarcity. Discuss this.
Increasingly, global conflicts are not based on religious differences, but on water scarcity: a study on the impact of heat and drought on human behavior, inclusive of economic productivity as well as violence, found that for each standard deviation in temperature and rainfall, there was a 14% increase in violence between groups, and a 4% increase in violence between individuals
153
How do climate change issues disproportionately affect LMIC and how do HIC contribute to the problem? (Kurth reading)
These changes will have a disproportionate impact on the poorest individuals, amplifying health inequities. It has been estimated that 88% of persons facing health consequences due to environmental threats reside in LMICs, though HICs contribute to the problem to a much larger extent.
154
What does the author, Kurth, state about nurses, resilient health systems, and planetary health as a solution to current issues?
Nurses help plan and build resilient health systems, but in order to develop health beyond health care, nurses must move into expanded roles, working with other sectors and individuals, to support the development of resilient communities.
Nurses are key to achieving the sustainable development goals that, like the planetary health framework, focus on environmental sustain- ability and human well-being. Nurses contribute to resilient health systems, as trusted leaders and providers of health care, and as advocates and change makers impacting the world.
155
In the CNA position statement on planetary health, what are the three primary calls for action for nursing?
1. Education and research
2. Advocacy and policy
3. Practice and leadership
156
Within the CNA position statement, what do they state in regards to Indigenous groups and biodiversity protection?
Indigenous Peoples are acknowledged as key to protecting nature, with 80% of the world’s remaining biodiversity within their care, even though they constitute only 5%
of the global population
157
What does the CNA position statement suggest about the triple threats and equity/human rights?
The triple threats are not just
health concerns but also issues of justice and human rights as those most affected have the
least resources to counter impacts or to adapt to accelerating changes
158
According to the CNA position statement, which groups will/are most impacted by the triple threats?
Populations that have least contributed to these problems and have the fewest resources to
adapt are historically subject to the worst impacts of the triple threats. In Canada, this is
particularly the case with First Nations, Inuit and Métis populations due to ongoing
inequities, poverty, discrimination, marginalization and the close relationships many have
with local ecosystems
159
What does Ferguson state regarding mental health trends and SDOH in LMIC?
This issue disproportionately affects lower-income populations, with more than 80% of people with mental disorders residing in low- and middle-income countries. Climate catastrophes exacerbate social determinants that have already created massive mental health burdens around the globe
160
According to Ferguson, who are the first to witness climate change effects on health? Why?
Nurses - because as public health leaders and climate first responders, nurses are often the first to witness the impact of climate change on people’s health.
In addition, nurses and nursing leaders are at the intersection of health and climate
161
In the Crosschild reading, how do nurses currently fail at addressing Indigenous health/clients?
Despite having completed mandatory cultural sensitivity training, many nurses failed Indigenous clients and their fami- lies by labelling and stereotyping them based solely on their appearance and/or medical diagnosis and failing to challenge such practices by others.
162
In the Crosschild reading, how does the author connect colonialism and nursing leadership/management?
Management was accustomed to structures infused with colonial frame- works that emphasize the individual.
In addition, the system perpetuates blame and shame as a means of addressing inappropriate behaviour or culturally discriminating care
163
According to Crosschild, can diversifying the workforce ethnically be an appropriate solution to racism?
Cannot be undone only by increasing the ethnic diversity of the nursing workforce. Indeed, increasing the ethnic diversity of the workforce without meaningful attention to racism has created harm for racialized and Indigenous nurses.
164
What does Crosschild mean when she says “we must dispense with the bad apples understanding of racism”?
Racism is a systemic issue that is not targeted by a few bad people, but rather is deeply rooted.
There certainly are nurses who are worse than others in their practice of racism, but there are also those who collude by standing by without action, and then there are those who are strongly committed to social justice, equity and antiracism. The latter can be supported by leadership to reach a critical mass.
165
Briefly discuss the summary of the Freeman article
This article is discussed from the position of a nurse who has worked in international, humanitarian nursing for over 10 years. She discusses the frustrations of working in tumultuous conditions, as the needs are often much greater than what any one individual or organization can address. However, the writer emphasizes the importance of providing compassionate care, no matter the circumstances.
166
According to Spence, what are the five drivers of health inequity?
1. Structural discrimination
2. Income equality and poverty
3. Disparities in opportunity
4. Disparities in political power
5. Governance that limits meaningful participation
167
What type of relationship do disasters and deaths have, according to Spence? (i.e., mutual, inverse, etc). Why is this the case? Is this relationship seen amongst all populations?
Inverse - number of events have increased but deaths have gone down
This is because of greater preparedness
No, while higher-income countries experienced the majority of recorded disasters (56%) since 2000, lower-income countries suffered 68% of the disaster death toll
168
According to Spence, how are rural and underserved communities affected by climate change? In addition, how does preparedness underserve these populations?
Rural and underserved communities are the most vulnerable to these risks and exacerbating present non-climatic inequities.
Regions experiencing the greatest increase in climate-related diseases and events are the communities that are the least responsible for the increase in greenhouse gas emissions.
Often have the least amount of resources to adapt, become prepared, withstand, and recover from extreme events
Increase preparedness for some, but that very development creates disaster risk and threatens development for others.
169
According to Spence, what is at the centre of improving disaster management for Indigenous and all populations in Canada?
A framework that actively reduces inequities experienced in times of disaster is imperative
Along with determining the unique needs and circumstances of specific populations being critical to managing emergencies
170
How does Spence suggest the principles of equity be integrated into disaster management?
They suggest that the principles of equity (i.e., partnering, humility, inclusion, commitment to future, shared benefits, and responsiveness to inequity contributors) should be imbedded in the four stages of the disaster continuum
171
What does Spence discuss in regard to disasters, resilience, and gender?
Disasters are spaces that allow opportunity to build resilience and challenge existing power dynamics, and can act as a catalyst to progressive changes in gendered relations.
i.e., the earthquake in Chile leading to women being allowed to work in fishing labour industries
172
What principle is foundational to the topics discussed in the Spence article?
Adopting an equity lens in disaster management and relief
It is essential to not only reducing disproportionate impacts on populations but also for creating a more sustainable and equitable approach within disaster management
173
What seven components are quality nursing practice environments characterized by, according to the CNA/CNFU?
1. Communication & collaboration
2. Responsibility & accountability
3. Safe and realistic workload
4. Leadership
5. Support for information and knowledge management
6. Professional development
7. Workplace culture
174
How does meaningful appreciation contribute to better outcomes for all, according to the CNA/CNFU?
Meaningful appreciation for employees in any workplace is the key to quality practice environments.
In such settings,
outcomes are improved for clients (i.e., patient experience), nurses (i.e., retention) and employers (financial return on
investment).
Understanding and optimizing roles and relationships that contribute to positive work environments are important for nurses to fulfil their professional mandate to provide safe, compassionate, competent and ethical care
175
What does Rosser discuss in terms of investment in nursing, sustainability, and retention of nurses to avoid migration?
Investment in nursing is everyone’s business, and investment in nursing and its leadership is necessary to global health sustainability.
Nations that wish to retain their own nurses need to demonstrate their support for nurses and nursing through providing safe and well-equipped workplaces and also showing respect through appropriate professional remuneration and working conditions.
176
Provide a summary about Crawford’s discussion on incivility in nursing
Incivility and bullying in nursing is extremely prevalent and a ‘nurses eat their young’ mentality has become normalized.
To appropriately address incivility, there must be a consistent and uniform response to it by everyone.
