Please do a paragraph about this post with this instruction . 

post most have  4 or more  sentences .

 you also have to have a high quality post from a content perspective. This means it also needs to do more than agree with or praise a class mate. If you agree with a classmate, explain why, give an example, share what you learned in the readings

Healthy People 2020 explains Social determinants of health are how and where we live, go to school, have our recreation, and make our living. It is our community and how it affects our health.  These social determinants contribute to illness in many ways.

This is a story of a girl I knew in my daughter’s class that I would help tutor. I changed her name for my example. Didi would wake up late for school. Her family lived above the bar they owned and operated so it was very loud for her to try to sleep. She had to get up and dress herself and would walk to school without breakfast.  Her parents were present but did not attend to her in the mornings as they were up late each night. They had a dog, which defecated and urinated in the little apartment, no one would clean it up. Didi would sleep on a mattress on the floor, with a thin blanket next to the fecal material. She had lice.  This was the second time Didi was doing third grade.  She was not a healthy young girl. She had multiple respiratory issues, was not bathed regularly, had poor eating and sleeping habits and was rarely clothed appropriately for the rainy weather.  Didi’s social living situation was making her sick, and keeping her in an unhealthy state.  Lack of a clean environment, lack of nutritious food, lack of cleanliness, lack of quality sleep all kept Didi in a state of illness.

The communicable disease chain is a way which illustrates the way a communicable disease travels and what it needs to continue on its path. There are 6 elements, the infectious agent, the reservoirs, a portal of exit, a means of transportation, a portal of entry and a susceptible host.  I will use lice as her communicable disease chain. In Italics I will list what a nurse could do to break the chain.

  1. The infectious agent is the lice.
  2. The Reservoir was human, perhaps someone else in the home had lice. More than likely another school aged child. They may have complained of their head itching, they needed to be assessed by school nurse, or parent. At this point you wash all bedding in hot water, wash all coats, hats and scarves, take all toys and stuffed animals out of the room and place in plastic bags. If something cannot be washed, place it in a hot dryer for 30 minutes as lice cannot withstand the heat.  Start shampooing with anti-lice shampoo and using the lice comb to get rid of lice and eggs. Do not return to school until free from lice.
  3. The portal of exit was the scalp or hair. attaching to a vector, a pillow, scarf, coat, or hat.
  4. The means of transportation was attaching to a vector; a pillow, scarf, coat or hat. Teach and instruct all children to not share coats, hats, scarves or anything personal they lay upon. Never share a brush or comb. Coats should not be touching when hanging. 
  5. The portal of re-entry was Didi putting on the article of clothing and lice would then get in her hair and scalp. Again, no sharing. At the first sign of scalp irritation or itch visual inspections need to be made. If no signs or symptoms, this should be done on a monthly basis.
  6. The susceptible host is Didi. She had low defense mechanisms and did not wash regularly nor did she have anyone who was looking after her.

PS No none knew Didi’s living situation was so grim, a social worker did a home visit and Didi was removed from the home due to neglect and left school and hopefully went to live somewhere healthy, clean and valued.

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