Running head Problem Solving 2Problem Solvi.docx

Running head: Problem Solving 2
Problem Solving Lesson Plan
EXAMPLE
Grand Canyon University: ELM 5
November 13 2019
Section 1: Lesson Preparation
Teacher Candidate Name:
Darlene Judkins
Grade Level:
4th Grade
Date:
November 13, 2019
Unit/Subject:
Measurement
Instructional Plan Title:
Measurement: Area and Perimeter
Lesson Summary and Focus:
The lesson will focus on finding the area and perimeter of
objectives in real life. The students will learn how to convert
from inches, feet, and yards. The students will be creating a
floor plan that includes at least for objects. The students will be
finding the area and perimeter of the floor plan and the objects.
The students will get the option to choose how they want to
measure their floor plan.
Classroom and Student Factors/Grouping:

The students' desks will be set up in a horseshoe design. The
horseshoe design allows the class to interact easier, encourages
group discussion and participation, encourages interaction with
the teacher, and larger areas to do presentations (Displays2go,
2019). The students with IEPs and above grade level can
interact with their peers and skill get help one on one with the
teacher. Comment by [email protected]: excellent
According to the class profile, there are six students above
grade level include the social-emotional student. There are six
students below grade level which include four IEP students.
Four ELL students are at grade level.
The students will be mixed in with their peers; however, the IEP
and ELL students will be seated next to a grade level or above
student to be able to interact ask for help. At the beginning of
the year, I will ask for volunteers to help the struggling students
in class and do the seating chart accordingly.
National/State Learning Standards:
“CCSS.Math.Content.4.MD.A.1
Know relative sizes of measurement units within one system of
units including km, m, cm; kg, g; lb, oz.; l, ml; hr, min, sec.
Within a single system of measurement, express measurements
in a larger unit in terms of a smaller unit. Record measurement
equivalents in a two-column table (Common Core State
Standards Initiative, 2019).” Comment by [email protected]:
quotation mark is always after last word quoted and pg. needed
when quoting
“CCSS.Math.Content.4.MD.A.3Apply the area and perimeter
formulas for rectangles in real-world and mathematical
problems (Common Core State Standards Initiative, 2019).”
Specific Learning Target(s)/Objectives:
· Given a problem in feet, students will be able to solve the
problem in inches.
· Given the formal, students will be able to solve the area or
perimeter.
· Give a problem in yards, students will be able to solve the
problem in feet.

· Given a problem in inches, students will be able to solve the
problem in feet.
Academic Language
· Tape measure
· Rule
· Area
· Perimeter
· Square foot
· Feet
· Inches
· Yard
· Measure
· Design
· Height
· Width
· Formula
· Yardsticks
· Floor plan
The students will receive a worksheet with the vocabulary
words to fill out during direct instruction.
Resources, Materials, Equipment, and Technology:
Resources
Inches, Feet and Yards Song – Measurement for Kids
(https://www.youtube.com/watch?v=P9sYvDCnI0g)
Materials
Whiteboard
Dry ease makers
Graph paper
Rule
Yardstick
Pencils
Pens
Color pencils
Markers
Worksheets
Technology

Document camera
Projector
Chromebooks/Laptop
PowerPoint
Sketchup
Section 2: Instructional Planning
Anticipatory Set
· I will play the YouTube video called Inches, Feet and Yards
Song - Measurement for Kids
(https://www.youtube.com/watch?v=P9sYvDCnI0g).
Comment by [email protected]: excellent
· I will explain to the students the differences between inches,
feet, and yards. This will be done with a rule and yardstick.
· I will demonstrate how to use different formals to find the
area and perimeter. This will be done by giving an example of a
floor plan for a classroom.
Time Needed
20 minutes
Multiple Means of Representation
· During the direct instruction, students will take notes in their
math notebook. The students will be able to use these notes as a
reference during the lesson.
· The students will receive a vocabulary list explaining the
terms for the lesson.
· I will demonstrate how to find the area and perimeter up on
the whiteboard. The students will get the chance to solve area
and perimeter equations on the whiteboard. There will six
different equations for the students to solve.
· The students will create a 12ft x 14ft room on graph paper.
The students will solve for the area and perimeter of the room.
Resources for helping students below grade are breaking down
the assignments/answers, remove the instruction for the page,
guided practice, and giving alternative activities on the same
worksheet (Eredics, 2016). Giving gifted students the option to

do the hardest problems can help cut down on becoming board
(Longley, 2016). Resources for ELL students are using
manipulatives, providing a vocabulary list, provide questions
according to skill level, and partner talk (Willig, Bresser,
Melanese, Sphar, & Felux, 2009). Comment by
[email protected]: excellent
· English language learners (ELL): The ELL students will
receive a list of vocabulary words and formals to help do the
assignment. The assignment questions will be modified to the
student's skill level. The teacher will provide one on one
learning if needed.
· Students with special needs: The special needs students will
receive a list of vocabulary words and formulas to help do the
assignment. The assignment will be broken down in small steps
for the students to complete so they will not get so all welled.
The teacher will provide one on one learning if needed.
· Students with gifted abilities: The gifted students will have
the option to do the five hardest problems on the worksheet to
check for understanding. The students will be able to advance to
the final project if they answer all five problems correctly.
· Early finishers (those students who finish early and may need
additional resources/support): The students will have the option
to help their peers understand the lesson, create a floor plan on
the computer for fun, or read.
Time Needed
20 minutes
Multiple Means of Engagement
· The students will help the teacher create the classroom using
PowerPoint. The students will be asked to use a tape measure to
measure different objectives in the classroom like their desk,
teachers' desks, and bookcases.
· The students will receive a worksheet with ten equations about
area and perimeter.
· The students will receive a worksheet with questions about the

converting from feet to inches, inches to feet, inches to yards,
yards to feet, and feet to yards.
· The students will be asked to use graph paper to create a
classroom floor plan. The students will be giving a list of items
to incorporate into the floor plan like student desks, teachers'
desks, bookcase, containers, sink, and a closet.
· The students will be asked to give the area and perimeter of
their floor plan and all the objectives inside. Each square on the
graph paper will equal one foot.
Melanese, Sphar, & Felux, 2009). Comment by
[email protected]: excellent
learning if needed.
· Students with gifted abilities: The gifted students will have
the option to do the five hardest problems on the worksheet to
check for understanding. The students will be able to advance to
the final project if they answer all five problems correctly.

Time Needed
30 minutes
Multiple Means of Expression
Summative Assessment: Students will be asked to create a floor
plan of their dream bedroom or backyard. The student's floor
plan must label areas and perimeters for everything in their
floor plan. The floor plan will be sketched out on graph paper.
Each square on the graph paper equals one foot. After the
students are finished with their floor plan, the students will use
PowerPoint or Sketchup to create a digital copy of the floor
plan. The digital cover must have the same measurements as
their hard copy.
Formative Assessments: Students will turn in their inches, feet,
and yard worksheet, area and perimeter worksheet, and math
notebook. The classroom floor plan the students created will be
their exit ticket into the summative assessment.
Melanese, Sphar, & Felux, 2009).
learning if needed.

· Students with gifted abilities: The gifted students will do the
same assignment. The students will have the option to convert
all the measurements into their choice of inches, feet, or yards.
Time Needed
60 minutes
Extension Activity and/or Homework
The students will be asked to measure five objectives of their
choice from their home. The students will write the name of the
objective, area, and perimeter on a sheet of paper. Students will
have one night to do the assignment.
Time Needed
15 minutes
Part 2: Reflection Comment by [email protected]: center
heading Reflection
Communication is a big part of teaching math and consists of
listening, reading, speaking, and writing (Sammons, 2018).
Math can be communicated in different ways to help promote

problem-solving like descriptive feedback, gallery walks, and
students thinking (Beach, D’Silva, &Khan, 2014). The students
will be able to display their floor plan and show how they
solved the problems to help students’ comprehension of area
and perimeter. Providing adequate feedback to the students can
help the students understand and explain the missing gaps in the
learning. Using student thinking allows other students to see
how their classmates solved the problem and what steps they
took to achieve their goal. Peer collaboration can help build the
student's knowledge and understanding of the math concepts
being taught (Zorfass, Brann, & PowerUP What Works, 2014).
The students can discuss and share their opinion on solving the
problems while developing a better understanding of the
concept. This can be done by use fishbowl discussion or paired
verbal fluency (Zorfass, Brann, & PowerUP What Works, 2014).
Creating a good math discourse discussion helps to engage
students in wanting to learn the concept (Kersaint, 2019).
Teaching strategies that can help make a connection to the real-
world are make the lesson hands-on, provide visuals/images,
differentiate learning, have students explain their thinking
process, connect problems to real-life, and provide feedback ().
Making a connection between math and the real-world can help
the students retain the concepts and understand how math is
important. Math is important because it can help build things,
used in the grocery store, baking, travel, save money, and
manage time (Christensen, 2017). In this lesson, students are
learning the basics of creating a floor plan. The students can
visualize how they are wanting to look like and explain to
someone where things will go. The students are learning how to
ensure everything they want to display in the room/yard will fit.
Math becomes fun and engaging with students can make a
connection to their lives. Comment by [email protected]:
according to?

References
Displays2go. (2019, August 6). Effective Classroom Seating
Arrangements. Retrieved November 15, 2019, from
https://www.displays2go.com/Article/Effective-Classroom-
Seating-Arrangements-32.
Willig, C., Bresser, R., Melanese, K., Sphar, C., & Felux, C.
(2009). 10 Ways to Help ELLs Succeed in Math. Retrieved
November 15, 2019, from
https://www.scholastic.com/teachers/articles/teaching-
content/10-ways-help-ells-succeed-math/.
Longley, V. (2016, February 1). Quick Ways to Differentiate for
Gifted and Talented Learners in Math. Retrieved November 15,
2019, from
https://tenmarks.typepad.com/tenmarks/2016/02/quick-ways-to-
differentiate-for-gifted-and-talented-learners-in-math.html.
Eredics, N. (2016, August 2). 5 Easy Ways to Teach Students
Who Work Below Grade Level in Your Classroom. Retrieved
November 15, 2019, from
https://www.edutopia.org/discussion/5-easy-ways-teach-
students-who-work-below-grade-level-your-classroom.
Common Core State Standards Initiative. (2019). Grade 4 "
Measurement & Data. Retrieved November 15, 2019, from
http://www.corestandards.org/Math/Content/4/MD/.
Beach, S., D'Silva, J., & Khan, S. (2014, February 24).
Effective Math Communication. Retrieved November 15, 2019,
from https://www.smore.com/afb0-effective-math-
communication
Zorfass, J., Brann, A., & PowerUP What Works. (2014).
Interacting with Peers in Mathematics. Retrieved November 15,
2019, from http://www.ldonline.org/article/61470/.
Sammons, L. (2018). Chapter 1. The Essentials of Mathematical
Communication. Retrieved November 15, 2019, from
http://www.ascd.org/publications/books/118005/chapters/The-
Essentials-of-Mathematical-Communication.aspx.
Kersaint, G. (2019, May 7). Talking Math: How to Engage
Students in Mathematical Discourse. Retrieved November 15,

2019, from https://www.gettingsmart.com/2015/09/talking-
math-how-to-engage-students-in-mathematical-discourse/
Christensen, R. (2017, April 25). Real World Math: 6 Everyday
Examples. Retrieved November 15, 2019, from
https://www.imaginelearning.com/blog/2017/04/math-real-life-
examples.
© 2019. Grand Canyon University. All Rights Reserved.
Chapter 12
Epidemiology of Infectious
Diseases
Learning Objectives
• State modes of infectious disease
transmission
• Define three categories of infectious
disease agents
• Identify the characteristics of agents

• Define quantitative terms used in
infectious disease outbreaks
• Describe the procedure for investigating a
disease outbreak
Infectious Diseases (Importance)
• They are a significant cause of morbidity and
mortality worldwide.
• Infectious agents are associated with some
types of cancer.
• Due to increasing world travel, infected
passengers can transmit the communicable
disease from within the time span of a long-
distance plane flight.
• They cause disease outbreaks in institutions.
Epidemiologic Triangle
• A model used to explain the etiology

of infectious diseases.
• Recognizes three major factors in the
pathogenesis of disease: agent, host,
and environment.
Diagram of Epidemiologic
Triangle
Microbial Agents of Infectious
Disease
• Bacteria
• Viruses
• Rickettsia
• Mycoses (fungal
diseases)
• Protozoa
• Helminths
• Arthropods

Bacteria
• Once were the leading killers, but now are
controlled by antibiotics.
• Remain significant causes of human
illness.
• Tuberculosis and salmonellosis are
common diseases caused by bacteria.
• Emergence of antibiotic-resistant strains a
growing concern.
Viruses
• A microorganism composed of a piece of
genetic material (RNA or DNA)
surrounded by a protein coat. To replicate,
a virus must infect a living cell.
• Viral hepatitis A, herpes, and influenza are
caused by viruses.

Rickettsia
• A genus of bacteria that can grow within
cells.
• Ectoparasites (e.g., fleas, lice, and ticks)
transmit the majority of rickettsial agents,
which cause a variety of diseases.
• Rickettsial agents produce typhus fever,
Q fever and Rocky Mountain spotted
fever.
Mycoses (Fungal Diseases)
• Mycoses cause diseases such as
coccidioidomycosis, ringworm, and athlete’s foot.
– Example of disease: A fall 2012 outbreak of fungal
meningitis was associated with a contaminated
steroid medication and associated with more than
400 cases and 30 deaths in at least 19 states.

• Opportunistic mycoses infect immunocompromised
patients.
– Candidiasis, cryptococcosis, and aspergillosis.
Protozoa
• Microscopic single-cell organisms.
• Responsible for diseases, such as
malaria, amebiasis, babesiosis,
cryptosporidiosis, and giardiasis.
• Example: malaria is transmitted by
mosquitos in endemic areas.
Helminths
• Organisms found most frequently in
moist, tropical areas.
• Include intestinal parasites such as
roundworms, pinworms, and
tapeworms.

• Are responsible for trichinellosis and
schistosomiasis.
Arthropods
• Act as insect vectors that carry a disease
agent from its reservoir to humans.
• Examples: mosquitos, ticks, flies, mites,
and other insects.
• Transmit diseases such as Dengue fever,
Lyme disease, viral encephalitis, Rocky
Mountain spotted fever, trypanosomiasis,
and leishmaniasis.
Characteristics of Infectious
Disease Agents
• Infectivity
– The capacity of an agent to enter and
multiply in a susceptible host and
produce infection or disease.
– Polio and measles are diseases of high
infectivity.
– Measured by the secondary attack rate.

Disease Agents
• Pathogenicity
– The capacity of the agent to cause overt
disease in the infected host.
– Measles is a disease of high pathogenicity,
whereas polio is a disease of low
pathogenicity.
– Measured by the ratio of the number of
individuals with clinically apparent disease to
the number exposed to an infection.
Disease Agents (cont’d)
• Virulence
– Refers to an agent’s capacity to induce
disease in the host.
– Sometimes used as a synonym for
pathogenicity.

– Measured by the ratio formed by the number of
total cases with overt infection divided by the
total number of infected cases.
– If fatal, use case fatality rate (CFR).
• Toxigenicity
– Refers to the capacity of the agent to
produce a toxin or poison.
– The pathologic effects of agents for
diseases such as botulism and shellfish
poisoning result from the toxin produced
by the microorganism rather than from
the microorganism itself.

• Resistance
– The ability of the agent to survive adverse
environmental conditions.
• Antigenicity
– The ability of the agent to induce antibody
production in the host. Related to
immunogenicity.
Host: Definition
(Refer to Glossary)
• A person (or animal) who permits
lodgment of an infectious disease
agent under natural conditions.
Host
• Once an agent infects the host, the
degree and severity of the infection
will depend on the host’s ability to
fight off the infectious agent.

• Two types of defense mechanisms
are present in the host: nonspecific
and disease-specific.
Nonspecific Defense
Mechanisms
• Examples include skin, mucosal
surfaces, tears, saliva, gastric juices,
and the immune system.
• Host responses to infectious agents
– immunity may decrease as we age.
– nutritional status of the host
– Genetic factors
Disease-Specific Defense
Mechanisms
• Immunity (resistance) of the host to a
disease agent.

• Types of immunity:
– Active: A disease organism stimulates the
potential host’s immune system to create
antibodies against the disease. Long lasting,
but requires time to develop.
– Passive: short-term immunity provided by a
preformed antibody.
Active Immunity
• Natural, active or natural immunity
– Results from an infection by the agent.
– Example: A patient develops long-term
immunity to measles because of a naturally
acquired infection.
• Artificial, active or vaccine-induced
immunity
– Results from an injection with a vaccine that
stimulates antibody production in the host.
Passive Immunity
• Natural, passive--preformed antibodies
are passed to the fetus during pregnancy
and provide short-term immunity in the
newborn.

• Artificial, passive
– Preformed antibodies are given to exposed
individuals to confer protection against a
disease.
– Example: Prophylaxis against hepatitis by
administration of immune globulin to
individuals who have been exposed.
Environment
• The domain external to the host in which
the agent may exist, survive, or originate.
• The environment consists of physical,
climatologic, biologic, social, and
economic components that affect the
survival of the agents and serve to bring
the agent and host into contact.
Reservoirs of Infectious
Diseases
• The environment can act as a
reservoir that fosters the survival of
infectious agents.

• Examples: contaminated water
supplies or food; soils; vertebrate
animals.
Animal Reservoirs
• Animals can be reservoirs of
infectious agents.
• Zoonoses--infectious diseases that
are potentially transmittable to
humans by vertebrate animals.
Examples: rabies and the plague.
Direct Transmission from
Reservoir
• Spread of infection through
person-to-person contact.
• Example
–Direct contact with the blood or
bodily fluids of an infected person
as in the spread of sexually
transmitted diseases.

Indirect Transmission from
Reservoir
• Spread of infection through an
intermediary source: vehicles, fomites, or
vectors.
– Examples of vehicles - Contaminated water,
infected blood on used hypodermic needles,
and food.
– Examples of fomites – Inanimate objects,
such as a doorknob or clothing – laden with
disease-causing agents.
– Examples of vectors – flies and mosquitos
Portals of Exit and Entry
• Portal of exit—sites where infectious agent may
leave the body, e.g., respiratory passages, the
alimentary canal, and the openings in the
genitourinary system, and skin lesions.
• Agent must exit in large enough quantities to survive
in the environment and overcome the defenses at the

portal of entry into the host.
• Portal of entry--locus of access to the human body,
e.g., mouth and digestive system and the mucous
membranes or wounds in the skin.
Inapparent Infection
• A subclinical infection that has not yet
penetrated the clinical horizon--No symptoms of
infection present.
• Important because disease can be transmitted
to unsuspecting hosts.
• In asymptomatic individuals, clinicians can look
for serologic evidence of infection.
– Example: Increase in antibodies and enzymes in
patients with hepatitis A virus.
Incubation Period
• The time interval between exposure to an
infectious agent and the appearance of the
first signs and symptoms of disease.

• Applies only to clinically apparent cases of
disease.
• Provides a clue to the time and
circumstance of exposure to the agent.
• Useful for determining the etiologic agent.
Herd Immunity
• Immunity of a population, group, or
community against an infectious
disease when a large proportion of
individuals are immune either through
vaccinations or prior infection.
Generation Time
• Time interval between lodgment of an infectious
agent in a host and the maximal
communicability of the host.
• Can precede the development of active
symptoms.
• Useful for describing the spread of infectious

agents that have large proportions of subclinical
cases.
• Applies to both inapparent and apparent cases
of disease.
Colonization and Infestation
• Colonization--agents multiply on the
surface of the body without invoking
tissue or immune response.
• Infestation--the presence of a living
infectious agent on the body’s
exterior surface, upon which a local
reaction may be invoked.
Iceberg Concept of Infection
• The tip of the iceberg, which
corresponds to active clinical disease
accounts for only a small proportion
of host’s infections and exposures to
disease agents.

Iceberg Concept (cont’d)
Measures of Disease
Outbreaks
• Attack rate
• Secondary attack rate
• Case fatality rate
Attack Rate
• The proportion of a group that experiences the
outcome under study over a given period.
• Similar to an incidence rate.
• Used when the occurrence of disease among a
population at risk increases greatly over a short
period of time.
• Formula: Ill X 100 during a time period
Ill + Well

Secondary Attack Rate
• An index of the spread of disease in a
family, household, dwelling unit,
dormitory or similar circumscribed
group.
• A measure of contagiousness.
• Useful in evaluating control
measures.
Secondary Attack Rate:
Definition
• The number of cases of infection
that occur among contacts within
the incubation period following
exposure to a primary case in
relation to the total number of
exposed contacts.

• Number of new cases in group - initial case(s)
Number of susceptible persons
in the group - initial case(s)
• Initial case(s) = Index case(s) + coprimaries
• Index case(s) = Case that first comes to the
attention of public health authorities.
• Coprimaries = Cases related to index case so
closely in time that they are considered to
belong to the same generation of cases.
Secondary Attack Rate (%)
(Multiply fraction by 100.)
Case Fatality Rate (CFR)
• Proportion formed by the number of
deaths caused by a disease among those
who have the disease during a time
interval.
• Provides an index of the virulence of a
particular disease within a specific
population.

• Examples of diseases with a high CFR are
rabies and untreated bubonic plague.
Formula for CFR
• Number of deaths due to disease “X” x 100
Number of cases of disease “X”
• Sample calculation: Assume that an
outbreak of plague occurs in an Asian
country during the month of January.
Health authorities record 98 case of the
disease, all of whom are untreated.
Among these, 60 deaths are reported.
• CFR = (60/98) x 100 = 61.2%
Basic Reproductive Rate (R0)
• A measure of the number of
infections produced on average by an
infected individual in the early stages
of an epidemic when virtually all

contacts are susceptible.
• Can be used as a measure of the
transmissibility of influenza.
Investigation of Infectious
Disease Outbreaks
• Define the problem.
• Appraise existing data.
– Case identification
– Clinical observations
– Tabulation and spot maps
– Identification of responsible agent
Investigation (cont’d)
• Formulate a hypothesis.
• Test the hypothesis.
• Draw conclusions and formulate
practical applications.

Epidemiologically Significant
Categories of Infectious
Diseases
• Foodborne illness
• Water- and foodborne diseases
• Sexually transmitted diseases
• Vaccine-preventable diseases
• Diseases spread by person-to-person contact
• Zoonotic diseases
• Fungal diseases (mycoses)
• Arthropod-borne diseases
Foodborne Illness
• One of the most common infectious
disease problems in the community.
• Examples include:
– Staphylococcus aureus--present in
contaminated food that have been

stored at improper temperatures.
– Trichinosis--associated with
inadequately cooked pork products.
Foodborne
Agents
Water- and Foodborne
Diseases
• Examples include:
– Amebiasis--intestinal disease.
– Cholera--acute enteric disease.
– Giardiasis
– Legionellosis
– Schistosomiasis--infection caused by adult
worms in the bloodstream. The cycle
involves alternate human and snail hosts.

Sexually Transmitted
Diseases: HIV/AIDS
• High-risk populations in the U.S.
– Men who has sex with men (MSM)
– African Americans, Hispanics or Latinos
– Injection drug use
• In 2008, the estimated prevalence of AIDS
diagnoses in the general U.S. population was
157.7 per 100,000 population.
• The human immunodeficiency virus (HIV) is an
acute problem worldwide.
– Approximately 34.2 million people were living with
HIV in 2011.
Vaccine-Preventable Diseases
• Vaccines are routinely given to children
(0-6 years) for the prevention of several
diseases, including:
– Chickenpox, Diphtheria, Haemophilus
influenzae type b infections, hepatitis A,
hepatitis B, influenza, measles,

meningococcal meningitis, mumps, pertussis,
paralytic poliomyelitis, pneumococcal
disease, rotaviral enteritis, rubella, and
tetanus.
Diseases Spread by Person-
to-Person Contact
• One example is tuberculosis.
• Resurgence of TB (from late 1980s
until mid-1990s) due to:
– Increase in persons infected with HIV.
– Increase in homeless population.
– Importation of cases from endemic
areas.
U.S. TB Cases, 1980-1992
Source: Reprinted from Centers for Disease Control and
Prevention. Tuberculosis morbidity—United States, 1992.

MMWR, vol 42, p 696, September 17, 1993.
U.S. TB Cases
• By 2010, TB incidence had declined.
• Most affected groups were foreign-born
individuals and racial and ethnic minorities.
• Current high-risk populations
– Migrant farm workers
– Homeless persons
• Extensively drug-resistant tuberculosis
(XDR TB) was the focus of media attention
in 2007.
Zoonotic Diseases
• Zoonosis--a disease that under natural
conditions can be spread from vertebrate
animals to humans.
• Examples: Anthrax, brucellosis,

leptospirosis, Q fever, and rabies.
• Zoonotic diseases may be either:
– Enzootic--similar to endemic in human
diseases.
– Epizootic--similar to epidemic in human
diseases.
Fungal Diseases (Mycoses)
• Three major types:
– Opportunistic infections among persons who
have weakened immune systems
– Hospital-associated and Community-acquired
infections
– Coccidioidomycosis (San Joaquin Valley fever )
• Manifests as a lung disease and is caused by the
fungus Coccidioides immitis.
• Cases of infection usually have had contact with
contaminated soil.

Arthropod-Borne Diseases
• Include arboviral diseases.
• Blood-feeding arthropod vectors transmit
disease agents to vertebrate hosts.
• Examples of vectors: sand flies, ticks,
mosquitoes.
• Examples of diseases: Dengue fever,
Lyme disease, malaria, viral encephalitis,
West Nile Virus, and plague
Emerging Infections
• Infectious disease that have recently been
identified and taxonomically classified.
• Refers to certain ‘old’ diseases that have
experienced a resurgence because of a
changed host-agent-environment
conditions.
– Examples: HIV/AIDS, hepatitis C virus
infections, Lyme disease, E.coli O157:H7
foodborne illnesses, and hantavirus pulmonary
syndrome.

Emerging Infectious Diseases
Chapter 11
Screening for Disease in the
Community
Learning Objectives
• Define and discuss reliability and
validity, giving differentiating
characteristics and interrelationships
• Identify sources of unreliability and
invalidity of measurement
• Define the term screening and list
desirable qualities of screening tests
Learning Objectives

(Cont’d)
• Define and discuss sensitivity and
specificity, giving appropriate
formulas and calculations for a
sample problem
• Identify a classification system for a
disease
Screening for Disease
• Screening--the presumptive identification
of unrecognized disease or defects by the
application of tests, examinations, or other
procedures that can be applied rapidly.
• Positive screening results are followed by
diagnostic tests to confirm actual disease.
– Example: phenylalanine loading test in
children positive on PKU screening

Multiphasic Screening
• Defined as the use of two or more
screening tests together among large
groups of people.
• Information obtained on risk factor status,
history of illness, and physiologic and
health measurements.
• Commonly used by employers and health
maintenance organizations.
Mass Screening and
Selective Screening
• Mass screening--screening on a large
scale of total population groups regardless
of risk status.
• Selective screening--screens subsets of
the population at high risk for disease.
– More economical, and likely to yield more
true cases.
– Example: Screening high-risk persons for
Tay-Sachs disease.

Mass Health Examinations
• Population or epidemiologic surveys--
purpose is to gain knowledge
regarding the distribution and
determinants of diseases in selected
populations.
• No benefit to the participant is
implied.
Mass Health Examinations
(cont’d)
• Epidemiologic surveillance--aims at the
protection of community health through case
detection and intervention (e.g., tuberculosis
control).
• Case finding (opportunistic screening)--the
utilization of screening tests for detection of

conditions unrelated to the patient’s chief
complaint.
Appropriate Situations for
Screening Tests and Programs
• Social
• Scientific
• Ethical
Social
• The health problem should be important
for the individual and the community.
• Diagnostic follow-up and intervention
should be available to all who require
them.
• There should be a favorable cost-benefit
ratio.
• Public acceptance must be high.
Scientific

• Natural history of the condition should be
adequately understood.
– This knowledge permits identification of early
stages of disease and appropriate biologic
markers of progression.
• A knowledge base exists for the efficacy
of prevention and the occurrence of side
effects.
• Prevalence of the disease or condition is
high.
Ethical
• The program can alter the natural
history of the condition in a significant
proportion of those screened.
• Suitable, acceptable tests for
screening and diagnosis of the
condition as well as acceptable,

effective methods of prevention are
available.
Characteristics of a Good
Screening Test
• Simple--easy to learn and perform.
• Rapid--quick to administer; results
available rapidly.
• Inexpensive--good cost-benefit ratio.
• Safe--no harm to participants.
• Acceptable--to target group.
Evaluation of Screening Tests
• Reliability types
– Repeated
measurements
– Internal
consistency

– Interjudge
• Validity types
– Content
– Criterion-
referenced
• Predictive
• Concurrent
– Construct
Reliability (Precision)
• The ability of a measuring instrument
to give consistent results on repeated
trials.
• Repeated measurement reliability--
the degree of consistency among
repeated measurements of the same
individual on more than one occasion.

Reliability (cont’d)
• Internal consistency reliability--
evaluates the degree of agreement or
homogeneity within a questionnaire
measure of an attitude, personal
characteristic, or psychological
attribute.
• Interjudge reliability--reliability
assessments derived from agreement
among trained experts.
Validity (Accuracy)
• The ability of a measuring instrument
to give a true measure.
• Can be evaluated only if an accepted
and independent method for
confirming the test measurement
exists.
Validity (cont’d)
• Content validity--the degree to which
the measurement incorporates the

domain of the phenomenon under
study.
• Criterion-referenced validity--found by
correlating a measure with an
external criterion of the entity being
assessed.
Validity (cont’d)
• Two types of criterion-referenced validity:
– Predictive validity--denotes the ability of a
measure to predict some attribute or
characteristic in the future.
– Concurrent validity--obtained by correlating a
measure with an alternative measure of the
same phenomenon taken at the same point
in time.
Validity (cont’d)

• Construct Validity--degree to which
the measurement agrees with the
theoretical concept being
investigated.
Interrelationships Between
Reliability and Validity
• It is possible for a measure to be
highly reliable but invalid.
• It is not possible for a measure to be
valid but unreliable.
Representation of Reliability
and Validity
Sources of Unreliability and
Invalidity
• Measurement bias--constant errors

that are introduced by a faulty
measuring device and tend to
reduce the reliability of
measurements.
– Example: A miscalibrated blood
pressure manometer.
Invalidity (cont’d)
• Halo effect—the influence upon an
observation of the observer’s perception of the
characteristics of the individual observed. The
influence of the observer’s recollection or
knowledge of findings on a previous occasion.
– Example: a health care provider’s tendency to
rate a patient’s sexual behavior use in a
particular manner, based on a general opinion
about a patient’s characteristics without
obtaining specific information about past
sexual behavior.

Invalidity (cont’d)
• Social desirability effects - - Respondent
answers questions in a manner that
agrees with desirable social norms.
– Example: Teenage boys might respond to a
screening interview about sexual behavior by
exaggerating their frequency of sexual
activities because these behaviors might be
perceived as socially desirable among some
male peer groups.
Fourfold (2 by 2)Table
Measures of the Validity of
Screening Tests
• Sensitivity--the ability of the test to identify
correctly all screened individuals who
actually have the disease (a/a+c).
• Specificity--the ability of the test to identify
only nondiseased individuals who actually
do not have the disease (d/b+d).
Measures of the Validity of
Screening Tests (cont’d)

• Predictive value (+)--the proportion of
individuals screened positive by the test
who actually have the disease (a/a+b).
• Predictive value (-)--the proportion of
individuals screened negative by the test
who do not have the disease (d/c+d).
Other Measures from the
Fourfold (2 by 2) Table
• Accuracy of a screening test
– determined by the following formula:
(a+d)/(a+b+c+d).
• Prevalence
– determined by the formula:
(a+c)/(a+b+c+d)
Sample Calculation
Effects of Disease Prevalence

on the Predictive Value of a
Screening Test
• When the prevalence of a disease
falls, the predictive value (+) falls,
and the predictive value (-) rises.
Exhibit 11-4
• Illustrates the importance of positive
predictive value in the prostate cancer
screening controversy.
• PSA routine screening was widespread in
the U.S. by 1991.
• The U.S. Preventive Services Task Force
calculated that the harms of PSA
screening outweigh the benefits.
Relationship Between
Sensitivity and Specificity

• To improve sensitivity, the cut point used
to classify individuals as diseased should
be moved farther in the range of the
nondiseased (normals).
• To improve specificity, the cut point
should be moved farther in the range
typically associated with the disease.
Relationship Between Sensitivity
and Specificity (cont’d)
Procedures to Improve
Sensitivity and Specificity
• Retrain screeners--reduces the amount of
misclassification in tests that require
human assessment.
• Recalibrate screening instrument--reduces
the amount of imprecision.

• Utilize a different test.
• Utilize more than one test.
Evaluation of Screening
Programs
• Randomized control trials
– Subjects randomly receive either the new
screening test or usual care.
• Ecologic time trend studies
– Compare geographic regions with screening
programs to those without.
• Case-control studies
– Cases--fatal cases of the disease.
– Controls--nonfatal cases.
– Exposure--screening program.
Sources of Bias in Screening
• Lead time bias
– The perception that the screen-detected case
has longer survival because the disease was
identified early.
• Length bias
– Particularly relevant to cancer screening.

– Tumors identified by screening are slower
growing and have a better prognosis.
• Selection bias
– Motivated participants have a different
probability of disease than do those who
refuse to participate.
Natural History of Disease
Issues in the Classification of
Morbidity and Mortality
• The nomenclature and classification of
disease are central to the reliable
measurement of the outcome variable in
epidemiologic research.
• Nomenclature--a highly specific set of
terms for describing and recording
clinical or pathologic diagnoses to
classify ill persons into groups.
Issues in the Classification of
Morbidity and Mortality (cont’d)

• Classification--the statistical compilation of
groups of cases of disease by arranging
disease entities into categories that share
similar features.
• Two types of criteria used for the
classification of ill persons:
– Causal (e.g., tuberculosis or syphilis)
– Manifestational (e.g., affected anatomic site:
hepatitis or breast cancer)
GCU College of Education
LESSON PLAN TEMPLATE
Section 1: Lesson Preparation
Teacher Candidate Name:
Grade Level:
Date:
Unit/Subject:

Instructional Plan Title:
Lesson Summary and Focus:
In 2-3 sentences, summarize the lesson, identifying the central
focus based on the content and skills you are teaching.
Classroom and Student Factors/Grouping:
Describe the important classroom factors (demographics and
environment) and student factors (IEPs, 504s, ELLs, students
with behavior concerns, gifted learners), and the effect of those
factors on planning, teaching, and assessing students to
facilitate learning for all students. This should be limited to 2-3
sentences and the information should inform the differentiation
components of the lesson.
National/State Learning Standards:
Review national and state standards to become familiar with the
standards you will be working with in the classroom
environment.
Your goal in this section is to identify the standards that are the
focus of the lesson being presented. Standards must address
learning initiatives from one or more content areas, as well as
align with the lesson’s learning targets/objectives and
assessments.
Include the standards with the performance indicators and the
standard language in its entirety.

Specific Learning Target(s)/Objectives:
Learning objectives are designed to identify what the teacher
intends to measure in learning. These must be aligned with the
standards. When creating objectives, a learner must consider the
following:
· Who is the audience
· What action verb will be measured during
instruction/assessment
· What tools or conditions are being used to meet the learning
What is being assessed in the lesson must align directly to the
objective created. This should not be a summary of the lesson,
but a measurable statement demonstrating what the student will
be assessed on at the completion of the lesson. For instance,
“understand” is not measureable, but “describe” and “identify”
are.
For example:
Given an unlabeled map outlining the 50 states, students will
accurately label all state names.
Academic Language
In this section, include a bulleted list of the general academic
vocabulary and content-specific vocabulary you need to teach.
In a few sentences, describe how you will teach students those
terms in the lesson.

Resources, Materials, Equipment, and Technology:
List all resources, materials, equipment, and technology you and
the students will use during the lesson. As required by your
instructor, add or attach copies of ALL printed and online
materials at the end of this template. Include links needed for
online resources.
Section 2: Instructional Planning
Anticipatory Set
Your goal in this section is to open the lesson by activating
students’ prior knowledge, linking previous learning with what
they will be learning in this lesson and gaining student interest
for the lesson. Consider various learning preferences
(movement, music, visuals) as a tool to engage interest and
motivate learners for the lesson.
In a bulleted list, describe the materials and activities you will
use to open the lesson. Bold any materials you will need to
prepare for the lesson.
For example:
· I will use a visual of the planet Earth and ask students to
describe what Earth looks like.
· I will record their ideas on the white board and ask more
questions about the amount of water they think is on planet
Earth and where the water is located.
Time Needed

Multiple Means of Representation
Learners perceive and comprehend information differently.
Your goal in this section is to explain how you would present
content in various ways to meet the needs of different learners.
For example, you may present the material using guided notes,
graphic organizers, video or other visual media, annotation
tools, anchor charts, hands-on manipulatives, adaptive
technologies, etc.
In a bulleted list, describe the materials you will use to
differentiate instruction and how you will use these materials
throughout the lesson to support learning. Bold any materials
you will need to prepare for the lesson.
For example:
· I will use a Venn diagram graphic organizer to teach students
how to compare and contrast the two main characters in the
read-aloud story.
· I will model one example on the white board before allowing
students to work on the Venn diagram graphic organizer with
their elbow partner.
Explain how you will differentiate materials for each of the
following groups:
· English language learners (ELL):

· Students with special needs:
· Students with gifted abilities:
additional resources/support):
Time Needed
Multiple Means of Engagement
Your goal for this section is to outline how you will engage
students in interacting with the content and academic language.
How will students explore, practice, and apply the content? For
example, you may engage students through collaborative group
work, Kagan cooperative learning structures, hands-on
activities, structured discussions, reading and writing activities,
experiments, problem solving, etc.
In a bulleted list, describe the activities you will engage
students in to allow them to explore, practice, and apply the
content and academic language. Bold any activities you will use
in the lesson. Also, include formative questioning strategies and
higher order thinking questions you might pose.
For example:
· I will use a matching card activity where students will need to
find a partner with a card that has an answer that matches their
number sentence.
· I will model one example of solving a number sentence on the

white board before having students search for the matching
card.
· I will then have the partner who has the number sentence
explain to their partner how they got the answer.
Explain how you will differentiate activities for each of the
following groups:
Time Needed
Multiple Means of Expression
Learners differ in the ways they navigate a learning
environment and express what they know. Your goal in this

section is to explain the various ways in which your students
will demonstrate what they have learned. Explain how you will
provide alternative means for response, selection, and
composition to accommodate all learners. Will you tier any of
these products? Will you offer students choices to demonstrate
mastery? This section is essentially differentiated assessment.
In a bulleted list, explain the options you will provide for your
students to express their knowledge about the topic. For
example, students may demonstrate their knowledge in more
summative ways through a short answer or multiple-choice test,
multimedia presentation, video, speech to text, website, written
sentence, paragraph, essay, poster, portfolio, hands-on project,
experiment, reflection, blog post, or skit. Bold the names of any
summative assessments.
Students may also demonstrate their knowledge in ways that are
more formative. For example, students may take part in thumbs
up-thumbs middle-thumbs down, a short essay or drawing, an
entrance slip or exit ticket, mini-whiteboard answers, fist to
five, electronic quiz games, running records, four corners, or
hand raising.Underline the names of any formative assessments.
For example:
Students will complete a one-paragraph reflection on the in-
class simulation they experienced. They will be expected to
write the reflection using complete sentences, proper
capitalization and punctuation, and utilize an example from the
simulation to demonstrate their understanding. Students will
also take part in formative assessments throughout the lesson,
such as thumbs up-thumbs middle-thumbs down and pair-share
discussions, where you will determine if you need to re-teach or
re-direct learning.

Explain how you will differentiate assessments for each of the
following groups:
Time Needed
Extension Activity and/or Homework
Identify and describe any extension activities or homework
tasks as appropriate. Explain how the extension activity or
homework assignment supports the learning targets/objectives.
As required by your instructor, attach any copies of homework
at the end of this template.

Time Needed
Instructions: For this assignment, select a K-8 grade level and
state standard in the area of measurement and use the "COE
Lesson Plan Template" to design an original lesson plan. Be
sure to focus on problem solving in a real-world context (e.g.,
building a house, measuring for carpet, etc.), and include a
media component to enhance the lesson to facilitate conceptual
understanding and higher order thinking processes
Reflection: In 250-500 words, provide a rationale that explains
how you will use effective verbal, nonverbal, and media
communication techniques to foster students’ active inquiry,
collaboration, and supportive interaction in the mathematics
content area. Explain mathematical instructional strategies that
create a real-world context and relevance to students.
Support your findings with three scholarly resources.
© 2019. Grand Canyon University. All Rights Reserved.

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