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Understand and apply the definition of public health
The science and art of preventing disease, prolonging life and promoting physical health and efficiency through organized community efforts. EA Winslow, 1929
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List and define
a. fields allied with public health
- Nutrition: recommendations for intake- safe and nutritious; diet change methods
- 2. Exercise Science: PA is essential part of weight control; safe and effective lifestyle activity
- 3. Human Development/ FS: sequelae of overweight; family and social aspects
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the 3 levels of “prevention”
- Primary Prevention: preventing the condition
- E.g. nutrition education in schools, expanding fitness facilities in parks
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- Secondary Prevention: early diagnosis and treatment
- E.g. pharmacological, behavioral weight loss programs
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- Tertiary "prevention": reducing impact, complications
- E.g. gastrointestinal surgery for patients with chronic disease complications
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Describe and explain the 4-step cycle of taking public health action
Problem=> (burden)=>Etiology=>(available interventions)=> Recommend=>(Populations/Setting)=>Implement=> (Evaluation)
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Understand and apply the definition of epidemiology
The study if the occurrence and distribution if health- related states or events in specified populations, including the study of the determinants influencing such states, and the application of this knowledge to control the health problems.”
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Goal of Epidemiology
- Explanation: identification of casual mechanisms
- Example: Low SES is associated with health status partly through decreased access to timely care.
- • Prediction: identifying likelihood of outcomes
- Example: people with sedentary lifestyles are more likely to experience premature disability
- • Control: interventions to promote health or discourage disease, disability and death
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Describe the basic surveillance cycle
- Surveillance: What is the problem?
- Risk Factor Identification: What is the cause?
- Intervention Evaluation: What are the options?
- Implementation: How do you do it?
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Goals of surveillance
- Goals of surveillance
- Describe trends, natural history of
- • Diseases
- • Exposures
- • Health behavior
- Detecting unexpected increases (epidemics) or decreases in incidence
- • Detect rare or emerging diseases
- Evaluating prevention and control efforts
- Detect effects of health behavior, healthcare changes
- Hypothesis generation and confirmation
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Distinguish among infectious and non-infectious disease, chronic and acute conditions
Infectious disease: often needing rapid data collection and analysis cycles
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Chronic disease
Long duration and generally slow progression. Usually less intense, longer term monitoring
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List some Chronic diseases
- Health behavior: focusing on behavior with direct health impact
- • Injury: may be geographical or activity- oriented
- • Birth Defects: often part of larger peri-natal monitoring
- • Occupational illness and injury: Sometimes by jurisdiction or by occupation
- • Pharmacosurveillance: less, common but increasing
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Explain and apply the infectious disease “triad” of agent, host, environment
- Agent (microorganisms or pathogens)
- Environment (external factors that influence exposure)
- Host (human or other animal)
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Use the “chain of infection” to describe the course of an outbreak and potential points for intervention
Method of Transmission (Quarantine) => Port of entry => Susceptible host (Immunization) => Pathogen (Antimicrobials) => Reservoir (Waste water treatment) => Place of exit
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Two types of immunity
- Active Immunity: produced by host immune
- Passive Immunity: conferred by transfer of material
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Herdimmunity is achieved through
- natural immunity
- acquired immunity
- vaccination
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Herd Immunity threshold
- differs by population, pathogen, environment
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Describe the global burden of non-infectious disease
- Identifying distal causes
- Identifying component causes
- Identifying multiple pathways
- Identifying multiple outcomes
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global burden of non infectious disease
- longer to develop and longer to have clinical outcomes.
- - most chronic conditions have multiple causes, temporal sequence of causes
- - more than one casual pathway
- chronic disease have varied outcomes
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TREATMENT
- Screening/ early detection
- Multiple risk factor interventions
- Genetic counseling
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Define environmental health
addresses all the physical, chemical and biological factors external to a person, and all the related factors impacting behaviors. How those can potentially affect health. Targeted towards preventing disease and creating health supportive environments
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Describe the routes through which environments influence health
- Unaltered: naturally occurring
- • Radon is soil
- 1. Altered: exposures introduced to environment
- • Pesticide runoff in rivers
- 1. Built: resulting from human construction
- • Roadways/ highways
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Explain the elements of a “traditional” health risk assessment
Hazard identification => Dose- response characteristics <=> Susceptible populations => Exposure assessment
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Explain and identify examples of the five methods for reducing environmental health challenges
- prevent contamination
- remove exposure
- remove population
- modify behavior
- reduce susceptibility
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According to the CDC website on public health, the public health system...
is a web of interrelated groups and agencies.
- b. centered on healthcare providers to assure access to care.
- c. consists primarily of public health groups and organizations..
- d. does not include private organizations, since they are by definition not "public."
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According to the CDC website on public health, the essential service to "monitor health" is associated with which of the three larger functions of public health?
- Policy development
- b. Outbreak investigation
c. Assessment
d. Assurance
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The definition of epidemiology focuses on
- a. determining whether healthcare interventions improve population health.
- b. determining the causes of outbreaks.
- c. diseases and other health states in populations.
- d. eliminating sources of infectious disease in the population
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2. Saying "physical inactivity is a risk factor for disability" means
- physical inactivity is unrelated to disability.
- b. physical inactivity is associated with disability.
- c. disability causes physical inactivity.
- d. physical inactivity causes disability.
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“The relative risk of liver disease among binge drinkers was 3.2, compared to those who
did not engage in binge drinking.” This means
- binge drinking causes liver disease at three times the rate in binge drinkers
- compared to others
- b. reductions in binge drinking will lead to substantial reductions in liver disease
- c. a friend who is a binge drinker is eventually likely to suffer from liver disease
- d. binge drinking is associated with approximately three times the risk of liver disease, compared to those who do not binge drink
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Prevalence refers to ____ cases during a specified period, while incidence refers to____ cases during a specified period.
- non-fatal; fatal
- b. fatal; non-fatal
- c. new; all
- d. all; new
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An effective surveillance system must be
- very rapid, so that public health action can be taken
- b. based on laboratory confirmation of disease status
- c. ongoing and systematic
- d. global, so that patterns of disease can be determined Which statement is true?
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Which statement is true?
- It is impossible for a disease to have both an infectious and non-infectious cause
- b. Chronic diseases may have infectious or non-infectious causes
- c. Chronic diseases and non-infectious diseases are essentially the same thing
- d. Infectious diseases cannot also be chronic diseases The "chain of infection”
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The "chain of infection
- is most often successfully stopped through reservoir elimination
- b. is best broken by blocking the mode of transmission
- c. is nearly impossible to stop once started, and will last until the epidemic runs its natural
- course
- d. can (in principle, anyhow) be broken at any of the points in the cycle, through public health or clinical activity
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Malaria continues to be a public health challenge in Nigeria because...
- a. there are no effective control measures
- b. the impact of malaria on Nigerian health and economic well-being is not large
- c. effective control measures have not been universally adopted
- d. the route of transmission and underlying pathobiology are not well known
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An official was quoted in the article "Malaria still a silent killer...," as saying: "...we have achieved significantly in the area of control through provision of ACT drugs for free distribution through our health facilities, we have also provided tools for rapid diagnostic test[ing] even in our primary health facilities..." These two approaches to malaria control are...
- primary prevention
- b. secondary prevention
- c. tertiary prevention
- d. quaternary prevention
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A "traditional" health risk assessment does NOT include...
- . identification of a potential hazard
- b. dose-response characteristics
- c. exposure assessment
- d. potential remediation options
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How does “socioeconomic position” (SEP) affect health?
- a. SEP effects are primarily due to the influence of income on health status
- b. SEP can affect health throughout the lifespan
- c. SEP effects are largely limited to the US--in countries with other economic and healthcare systems, SEP does not affect health
- d. SEP affects health primarily in childhood, when poverty and access to healthcare are most important
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3. How is income related to health status?
- a. greater wealth is associated with lower mortality- as income rises, mortality falls
- b. There is a sharp divide in mortality between people who are poor vs. those who are not poor
- c. Income and health status are not related
- d. Health status is best for the rich (they can pay for healthcare) and the poor vs. those who are not poor.
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In the article "On the front lines..." the source of arsenic in the water was
- ...contamination from industrial mine tailings
- b. ...contaminated water used in food production
- c. contaminate well water
- d. ...contaminated surface water
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The main point of "Scarier than Ebola" was...
- we have underestimated the potential threat of Ebola because there have not been many cases
- b. Ebola is likely to become a major threat to US health
- c. Ebola constitutes a bigger threat than existing causes of death in the US
- d. we tend to overemphasize new threats while ignoring proven solutions to more common health threats.
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