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_________ is the percentage of the population currently with the disease. IT is calculated by # of cases/ # of people in the population
_____________ measures the overall disease burden of the population; captures both old and new cases.
___________ gives a figure for a factor at a single point in time and can only tell us what is happening at a certain point in time.
This model of Family theory characterizes the family as a __________ and emphasizes the organization of the family and how the structure facilitates family functioning.
- Theory: Structural/Functional
- Social System
Parad and Caplan say there are four basic structural dimensions that make up family structure. What are they?
- 1. role structure
- 2. value systems
- 3. communication
- 4. power structure
__________ family theory is a useful framework for assessing family life because it enables family to be viewed holistically, as a unit, in parts (as subsystems) and interacting with other institutions
In Structural/Functional family theory there are 5 family functions. What are they?
- 1. affective function (psychological needs)
- 2. socialization/social placement
- 3. reproductive
- 4. economic
- 5. health care
___________ family theory emphasizes the identification of actual or potential problems and delineates intervention strategies.
In Systems theory, systems are either _____ or _______.
open or closed
A _______ system in systems theory maintains itself in a continuous inflow and outflow, while a ________system is isolated from its environment.
"The whole is greater than the sum of the parts" is a principle of _________family theory.
Name the two prominent theories within Systems theory category.
- Bowen's Family Systems Theory
- Minuchin's Structural Family theory
In ________theory, the nuclear family is viewed as part of the multi-generational extended family and patterns of related tend to repeat themselves over generations. Therapist may develop a _______ to assess patterns of relationships.
- Bowen's Theory
- Four generation genogram
In _________theory, the relationship between the presenting problem and the structure of the family is emphasized. The goal is to solve problems by _______. The primary focus is on ____________ interactions.
- Minuchin's System's Theory
- altering the underlying structure of the family
___________theory states that structural family therapy is a therapy of _________. The tool is to modify the present, not to explore and interpret the past.
_____________ theory emphasizes growth, development and maturation. The major thrust of this model is ___________ which is directional and occurs through stages, levels, phases or periods....
_______ theory is the most widely used developmental theory and includes eight stages. Name them.
- 1. Beginning family
- 2. Childbearing family
- 3. Pre-school age
- 4. School age
- 5. Teenagers
- 6. Launching young adults
- 7. Middle-aged parents
- 8. Retirement and old age
Drawbacks of the Duvall's developmental theory are___________
It doesn't address situational stressors or unusual events. Assumed that the family is homogenous, middle-class and stable in each stage.
What does GINA Act of 2008 do? (Federal Law)
1. Prohibits discrimination in health coverage and employment based on genetic information.
What 6 things does GINA NOT do or NOT cover?
- 1. Protections do not extend to life insurance, disability insurance or long-term care insurance.
- 2. Doesn't mandate coverage for tests or tx
- 3. Do not apply to employers with fewer than 15 employees.
- 4. Doesn't prohibit health plan from determining rates based on disease burden
- 5. Does not prohibit insurers or health plan admin from obtaining and using genetic test results in making payment determinations
- 6. Military is except from GINA law
When did the Human Genome Project start? When was it completed?
- 2003 (ahead of schedule)
Total # of genes in humans is around _________
_______% of nucleotides are exactly the same in all people.
What is the fundamental unit of genomic diversity?
SNP: Single nucleotide polymorphism
Examples of disease with non-Medelian patterns of inheritance.......
HTN, AZ, Cancer, Osteoporosis, Cirrhosis, Psoriasis, Glaucoma, CV dz, Head trauma outcome, Schizophrenia, Bipolar do, depression, asthma
SNP's interact with thew environment to result in disease. Give examples....
- 1. risk of lung cancer is increased with smoking, but vast majority of smokers DO NOT get lung cancer.
- 2. ETOH increases risk of cirrhosis but vast majority of alcoholics DO NOT get cirrhosis.
The SNP involved in lung cancer is
polymorphism in GST-1
SNP involved in alcoholic cirrhosis is
polymorphism in epoxide hydrolase
Only 10 % of those exposed to TB ever develop clinical infection. SNP involved is______
Head trauma outcome polymorphism is_______
apo E polymorphism
An important concept in how we use SNP genome association studies
RISK does not = diagnosis
How many generations do you need to look at in a genogram for breast cancer risk?
________ is the first gentic-based breast cancer risk test from Iceland that incorporates __________ and ________ to calculate a woman's individual risk
- individualized genetic-based SNP's
- personal hx
New colorectal cancer screening guidelines involve___________
- sDNA (stool testing for DNA mutations.
- (PreGen Plus)
The ________ test is used to predict reoccurance in lymph node negative breast cancer patients under 61 with tumors less than 5 cm.
Genetic screening in the First Trimester (2)
- 1. nuchal translucency/folds (11-14 weeks)
- 2. chorionic villus sampling (10-12 weeks)
Genetic testing in 2nd trimester? (3)
- 1. Quad or triple screen (15-20 weeks)
- 2. Amniocentesis (15-18 weeks)
- 3. Level 2 ultrasounds
What are the tests included in a Quad Screen verses a Triple Screen?
- 1. unconjugated estradiol
- 2. AFP (high-neural tube defect, advanced preg; low-trisomy 21, 18))
- 3. Beta HcG (
4. Inhibin A
What does the Quad screen look for?
The quad screen is used to evaluate whether your pregnancy has an increased chance of being affected with certain chromosomal conditions, such as Down syndrome. The alpha-fetoprotein part of the test can help evaluate the chance for neural tube defects, such as spina bifida, and abdominal wall defects, such as omphalocele.
Definition of preterm labor
regular uterine contractions causing cervical dilation and effacement prior to 37 weeks and after 20 weeks.
How many cigarettes smoked increases your risk of preterm birth?
10 per day
When is the oral glucose tolerance test performed?
How is performed?
- 24-28 weeks
- drink the glucose, blood draw at 1 hr.
- If +, drink another
When are prenatal visits?
- 1. Q month until 28 weeks
- 2. Q 2 weeks 28-36
- 3. Q week 36-40 weeks
When is Rhogam given?
28 weeks and 72 hours after delivery
5 A's for smoking cessation during pregnancy
- 1. Ask (about use)
- 2. Advise (to quit)
- 3. Assess (readiness to quit)
- 4. Assist (with a plan, management program)
- 5. Arrange (follow-up care)
The theory of _________ was developed by Knowles in the 1970's specifically for the adult learning model. Emphasizes__________
- adults are self-directed and take responsibility for decisions
Prochaska and DiClemente's theory dev in the 1980's
"Transtheoretical Model of Change" and the "Stages of Change" Model
The _______________ Model dev by the US Public Health Service in the 1950's addresses patient compliance and preventive health care practices; addresses relationship btw person's beliefs and behaviors
Health Belief Model (HBM)
4 MI Traps
- 1. Confrontational-Denial trap
- 2. Question-answer trap
- 3. Expert-trap
- 4. Premature Focus Trap
The ____________Model developed by Pender in 1980's, 1990's has as an ultimate goal to improve a patient's wellbeing
Health Promotion Model (HPM)
What are the 5 stages of Change?
- 1. Precontemplation
- 2. Contemplation
- 3. Preparation
- 4. Action
- 5. Maintenance
_____ % of population in US is obese and _____% is overweight.
More than ____ % of all Americans are overweight or obese.
BMI for overweight =
BMI for obese =
- obese: 30 or >
At risk waist circumference for men, women
Primary Health Care is a _________ and is ______-based.
Primary Care is a _______ and is ________-based.
- verb: the activity of a HC provider
the study of the distribution of health-related states or events in specified populations and the application of this study to the control of health problems.
________ is the # of new cases relative to those considered at risk
_________ is measured as #of new cases/number of people at risk x 1000.
________________ is helpful in determining causes and likelihood od developing disease @ a certain period of time
___________ rfers to your chances of getting the disease
_____________refers to all persons in a specific population who become critically ill, injured or disabled during a defined period of time
___________ refers to the # of deaths from a specific disease divided by the # of persons considered at risk