Exam 2: Public Health And Harm Studies

Question 1

Who was first to recognize epidemic vs. endemic?

Answer 1

Hippocrates

Question 2

What was the Elizabethan poor act?

Answer 2

Legislation that attempted to care for poor in 17th century England that had increased in number after the collapse of the feudal system

Question 3

Who composed Bills of Mortality- first vital statistics ever compiled

Answer 3

John Graunt

Question 4

What are vital statistics?

Answer 4

recordings of the birth and death of individuals within a government’s jurisdiction

Question 5

Workhouse reforms were called for by ______.

Answer 5

Edwin Chadwik

Question 6

Workhouse reform was influenced by what writing?

Answer 6

Dickens Oliver Twist

Question 7

Who was Florence Nightingale?

Answer 7

The first public health nurse, famous for her work in the Crimean war

Question 8

Epidemics in early America were associated with _____ and ______.

Answer 8

urbanization and immigration

Question 9

WHat establishment became the US public Health services?

Answer 9

Marine hospital service

Question 10

Who directs the US Public Health Service?

Answer 10

The surgeon general

Question 11

What was established in the US in an attempt to overcome depression era hardships?

Answer 11

Social security act
Medicare
Medicaid

Question 12

An agency of the United Nations whose motto is that “health is a basic human right”

Answer 12

World Health Organization

Question 13

The organization whose goal is to improve health and living standards in the Americas

Answer 13

Pan American Health Organization

NOTE: became a regional office of WHO, however retains own identity and mission

Question 14

Organization whose mission is to protect the rights of children

Answer 14

UNICEF - united nations children’s fund

Question 15

Government organization responsible for most non-military foreign aid

Answer 15

USAID - US agency for international development

Question 16

The largest health program worldwide

Answer 16

U.S. Department of Health and Human Services (DHHS)

Question 17

U.S. Department of Health and Human Services (DHHS) is under the direction of whom?

Answer 17

DHHS secretary

Question 18

What are some examples of agencies within DHHS?

Answer 18

USPHS - US public health services
FDA - Food and drug administration
CDC - center for disease control
NIH - national institutes for health

Question 19

Principal agency in the United States government for protecting the health and safety of all Americans

Answer 19

CDC

Question 20

Responsible for protecting the public health by assuring the safety, efficacy, and security of human and veterinary drugs, biological products, medical devices, our nation’s food supply, cosmetics, and products that emit radiation

Answer 20

FDA

Question 21

Responsible for advancing the public health by helping to speed innovations that make medicines and foods more effective, safer, and more affordable

Answer 21

FDA

Question 22

funds more that 6 billion in research per year

Answer 22

NIH

Question 23

What is primary health care?

Answer 23

Essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community

Question 24

What are the essential components of primary care?

Answer 24

1. Education on health problems and the methods of preventing/controlling them.
2. Promotion of food supply and proper nutrition.
3. An adequate supply of safe water and basic sanitation
4. Maternal and child health care, including family planning
5. Immunization against major infectious diseases
6. Prevention and control of locally endemic diseases
7. Appropriate treatment of common diseases and injuries
8. Provision of essential drugs

Question 25

Program managed by the Office of Disease Prevention and Health Promotion (under DHHS) that sets science-based, 10-year national objectives for improving the health of all Americans.

Answer 25

Healthy people 20/20

Question 26

Largest organization of public health professionals worldwide with a. Section for Chiropractic Health Care

Answer 26

American public health association

Question 27

What are some achievements of Public Health?

Answer 27

- Deaths from infectious diseases declined in U.S. in 20th century - Impact of vaccines - Motor vehicle safety - Improvements in workplace safety - Control of infectious disease - Decrease in deaths due to coronary heart disease and stroke - Safer, healthier foods - Healthier mothers and babies - Family Planning - Fluoridation of Drinking Water - Recognition of hazards of tobacco

Question 28

The study of the distribution and determinants of health-related states or events in specified populations, and the application of this study to control of health problems.

Answer 28

Epidemiology

Question 29

the study of why things occur, the study of causation

Answer 29

Etiology

Question 30

made the observation that cowpox and smallpox are closely related. Responsible for prevention of smallpox by vaccinating with cowpox

Answer 30

Edward Jenner

Question 31

made the observation that outbreak of cholera was linked to public water pump, and ended the epidemic by removing pump handle

Answer 31

John snow

Question 32

Factors necessary for disease transmission

Answer 32

- Pathogenic organism (microbe) - Reactive host (susceptible human or animal) - Environmental conditions (allow host and pathogen to come together)

Question 33

Method of disease transmission by Person to person contact (touching, kissing, sexual contact)

Answer 33

Direct transmission

Question 34

Mechanism of disease transmission by contaminated food or water or contact with inanimate object

Answer 34

Indirect transmission

Question 35

Objects or materials that are likely to carry infection

Answer 35

Fomite

Question 36

Mechanism of disease transmission by insect or arachnid

Answer 36

Vector transmission

Question 37

Type of host:pathogen relationship in which both (or all) organisms benefit

Answer 37

Mutualistic

Question 38

Type of host:pathogen relationship in which there is no obvious benefit for organisms involved

Answer 38

Commensal

Question 39

Type of host:pathogen relationship in which only one partner benefits at the expense of the other partner

Answer 39

Parasitic

Question 40

long term host of pathogen of an infectious disease, usually without injury to itself and serves as a source from which other individuals can be infected

Answer 40

Reservoir

Question 41

Inanimate reservoir of infection can be primary or secondary. What is the difference?

Answer 41

Primary reservoir contains microbes that are viable and multiply (ex: food, soil) Secondary reservoir contains microbes that do not multiply (ex: air, soil)

Question 42

Living reservoirs of infection can be ____ or _____

Answer 42

Human or animal

Question 43

any infectious disease that can be transmitted from animals, both wild and domestic, to humans

Answer 43

Zoonosis

Question 44

Risk factors for disease include:

Answer 44

- Age - Gender - Ethnicity (genetics) - Nutrition - Pre-existing disease - Occupation - Food and water

Question 45

Pattern of disease where infection is maintained in the population without the need for external inputs. Constantly present in the population.

Answer 45

Endemic

Question 46

Pattern of disease that appears as new cases in the population in a period of time at a rate that substantially exceeds what is "expected”. Higher incidence.

Answer 46

Epidemic

Question 47

A small and localized epidemic

Answer 47

Outbreak

Question 48

global epidemic of an infectious disease that affects people or animals over an extensive geographical area

Answer 48

Pandemic

Question 49

When a critical portion of a population is immune to a disease, either through natural immunity or vaccination, results in the inability of an infectious disease to spread due to the lack of a critical concentration of susceptible hosts.

Answer 49

Herd immunity

Question 50

time elapsed between exposure to a pathogenic organism and when symptoms and signs are first apparent.

Answer 50

Incubation period

Question 51

Measurement of the incidence of a disease

Answer 51

Morbidity Measures new events, so is also measure of risk

Question 52

The number of individuals affected at a specific time

Answer 52

Prevalence

Question 53

proportion of people who are exposed to the disease during the outbreak who do become sick

Answer 53

Attack rate

Question 54

death rate due to a given disease

Answer 54

Mortality Gives information about the severity of the disease

Question 55

assesses the quantity of oxygen needed by | microbes in water

Answer 55

BOD (biochemical oxygen demand)

Question 56

Aging of a body of water due to a high BOD

Answer 56

Eutrophication

Question 57

Gram negative, lactose fermenting, facultative microbes that produce gas

Answer 57

Fecal coliforms

Question 58

What is the goal of coliform testing

Answer 58

number of coliforms in drinking water is zero

Question 59

Water treatment systems are tested between 1 to 480 times a month. If collect at least 40 samples per month, system is in violation if over _____ are coliform positive in one month

Answer 59

5%

Question 60

Describe the primary treatment of water?

Answer 60

The physical process of removing about 50% of solids in sedimentation tanks

Question 61

After the primary treatment of sewage water, what is the remaining fluid called?

Answer 61

Effluent

Question 62

Describe the secondary treatment of water

Answer 62

It is a biological process that can be done via two methods: trickling filter or activated sludge process

Question 63

The physical process of primary water treatment reduces BOD by _____

Answer 63

25%

Question 64

The process of secondary water treatment where effluent is sprayed over rocks. Organic material adheres to stone and is digested by microbes present in tank

Answer 64

Trickling filter

Question 65

The process of secondary water treatment where slime forming bacteria are added to effluent and stirred in aeration tank. Bacteria digest remaining organic material. Following aeration, water is treated chemically or with UV light

Answer 65

Activated sludge process

Question 66

Activated sludge process results in a _____ reduction in BOD

Answer 66

95%

Question 67

Describe tertiary treatment of water

Answer 67

lime or alumimum is added to remove nitrates and phosphates. May also involve filtration where tertiary effluent is dechlorinated by aeration

Question 68

What is a septic system?

Answer 68

An individual sewage treatment system that involves anaerobic digestion of raging material. Effluent then overflows into a drain field of soil and gravel to further digest microbes

Question 69

Sterilization by heat treatment of dairy products

Answer 69

Pasteurization

Question 70

How is the effectiveness of pasteurization tested?

Answer 70

Phosphatase test - enzyme should be destroyed by heat treatment

Question 71

What is the purpose of a harm study?

Answer 71

Assess the causal relationship between exposure (treatment) and disease

Question 72

anything that independently affects the exposure and the outcome in a harm study

Answer 72

Confounded

Question 73

Hill’s Criteria for Causality outlines the minimal conditions needed to establish a causal relationship between two items

Answer 73

- Temporal relationship - Experimental evidence - Dose response relationship - Statistical significance - Consistency across studies - Plausibility

Question 74

What kind of study is prospective (usually but can be retrospective) and can be useful for studying interactive causes of harm?

Answer 74

Cohort study

Question 75

What kind of study is retrospective and calculates the odds that a group was or was not exposed to some variable

Answer 75

Case control study

Question 76

Relative risk is typically used in what kind of study?

Answer 76

Cohort study

Question 77

Odds ratio is typically used in what kind of study?

Answer 77

Case control study

Question 78

What does it mean if the relative risk in a cohort study is = 1

Answer 78

There is no association between exposure and risk

Question 79

What does it mean if the relative risk in a cohort study is > 1

Answer 79

Exposure increase disease risk

Question 80

What does it mean if the relative risk in a cohort study is < 1

Answer 80

Exposure reduces disease risk

Question 81

What does it mean if the odds ratio in a case control study =1

Answer 81

No association between exposure and risk

Question 82

What does it mean if the odds ratio in a case control study > 1

Answer 82

exposure increases disease risk

Question 83

What does it mean if the odds ratio in a case control study < 1

Answer 83

exposure reduces disease risk

Question 84

What kind of study draws no comparisons but is useful only in generating hypotheses?

Answer 84

Case study (aka case report)

Question 85

Who discovered alternative to using boiling oil to cauterize | wounds?

Answer 85

Ambroise Pare

Question 86

Who developed a trial with a series of test groups to determine if lime juice treated scurvy?

Answer 86

James Lind

Question 87

What is the difference between subclinical carrier and clinical carrier?

Answer 87

Subclinical carrier has mild, not clinical symptoms while clinical carriers are symptomatic

Question 88

Involvement in public health allows chiropractors to:

Answer 88

o Promote preventative health care o Participate in the public health effort o Interact with a variety of other healthcare professions o Work within health care system used evidence based approach o Evaluate and design clinical trials o Recognize individuals at risk