Public Health

Question 1

The purpose of public health is to

Answer 1

Prevent disease
Prolong life

Promote health and efficiency through organized community effort for
Sanitation, Communicable infections, Personal hygeine education, organize medical services, ensure a standard of living

Question 2

Hippocrates

Answer 2

Association of disease:
Location, water, climate, eating habits, housing

Recorded disease outbreaks
endemic - restricted to a certain region; Epidemic - large amount of a population or region

Question 3

Europe (1600-1700)

Answer 3

Military hygiene - intro of gunpowder lead to a change of wound care. Most soldiers and sailors died of disease than injury
Elizabethan Poor Act - Collapse of feudal system lead to an increase in number of poor. Crowded cities and pauperism became more common. POOR LAW - defined poor and services that they were to recieve.
Bills of Mortality - John Graunt kept vital statistics, records of disease and deaths per week

Question 4

Effects of industrial revolution

Answer 4

Urbanization
Condition of streets in cities became deplorable. Children could become apprentice slaves. under 12 and 12-14 hour days
Workhouses for those too old or poor to support themselves

Question 5

English Sanitary Reform

Answer 5

In England 1837 the first sanitary legislation was passed
Report on an Inquiry into the Sanitary Conditions of the Labouring
Population of Great Britain - by Edwin Chadwick
Establishment of general board of health in 1848
Improvements were made in sanitation and hygiene
legislation passed regarding factory management, child welfare, care of the aged

Question 6

Florence Nightingale

Answer 6

1845- entered nursing profession in response to a
pauper’s death in a workhouse in London that became a public scandal
Contirbution in 1854
treated 2,000 patients. Nightingale School of Nursing

Question 7

Native Americans

Answer 7

Severely affected by diseases introduced by Europeans. Smallpox blankets.

Question 8

Colonies

Answer 8

Suffered signifcantly due to disease. Smallpox decimated jamestown from 500 to 50

Question 9

Nineteenth century america

Answer 9

territory and population increasedbut medical practices stagnated. Disease increased due to increased immigration.
Local health injuries began to form.
Marine Hospital Fund - one doctor in each port town to care for seamen
1870 - Marine Hospital Service as a national agency, later leader became surgeon general

Question 10

Port quarantine act

Answer 10

1878, due to yellow fever outbreaks
Immigration restricted to ports
Allowed for application of bacteriology, first learned about carriers, administered immunization

Question 11

U.S. Public Health Service (USPHS)

Answer 11

Formally Marine Hospital Service, under surgeon general. Exploration of disease in laboratory and field. Responsible for examination of all immigrants at Ellis island, another wave of immigration in 1921.
Narcotics division was formed in 1928 in response to opium use and recognition of addiction

Question 12

USPHS as a part of the military

Answer 12

militarized as a result of impending entry into WW1
1946 Hospital services and construction act and at the end of WW2 USPHS became responsible for building and administering hospital.

Question 13

Social security act

Answer 13

Respond to great depression
funding for health protection and promotion
Provided money to poor, elderly, disabled, unemployed
Funding for priority diseases

Question 14

Developing country vs. Least developed country

Answer 14

Developing countries include many eastern European countries, South American countries, and countries in Africa

UN lists some nations as LDC, based on the factors listed above; population, GDP, infant mortality, average life expectancy, and number of people living with HIV/AIDS.

Question 15

Factors affecting development

Answer 15

Isolation leading to agricultural underdevelopment, poor quality of life due to poverty, unsanitary conditions and malnutrition, parasitic infections, distribution of lands, Social Hierarchy, Education, literacy, Racism, religious intolerance, Population Explosion

Question 16

WHO

Answer 16

Established in April of 1948 as an agency of the United Nations
Regional centers on every continent
Health is a basic human right

Question 17

PanAmerican Health Organization

Answer 17

Founded in 1902
Goal is to improve health and living standards in the Americas
In 1949 became a regional office of WHO, however retains own identity and mission

Question 18

US Department of Health Human Services

Answer 18

Largest health program in the world

USPHS-united states public health service
FDA- food and drug administration
CDC- centers for disease control
NIH- national institutes for health

Question 19

Primary Health Care

Answer 19

Essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that the community and the country can afford to maintain at every stage of their development in the spirit of self-determination

Question 20

Essential components of Primary Care

Answer 20

Education of health problems and methods for prevention and control
Promotion of proper food supply and nutrition
Adequate supply of safe water and basic sanitation
Maternal and child health care
Immunization
Prevention and control of locally endemic diseases
Appropriate treatment of common diseases and injuries
Provision of essential drugs

Question 21

American Public Health Association

Answer 21

Largest organization of public health professionals
APHA brings together researchers, health service providers, administrators, teachers, and other health workers in a unique, multidisciplinary environment of professional exchange, study, and action
Section for Chiropractic Health Care established 1995

Question 22

Achievements in Public Health

Answer 22

Control of infectious disease
Vaccinations
Motor safety
Workplace safety
Decrease in death to Coronary Heart Disease death
Better foods 
Healthier mothers and babies
Family Planning
Flouride in drinking water
Hazards of tobacco

Question 23

Healthy People 2020

Answer 23

Program managed by the Office of Disease Prevention and Health Promotion.
10-year national objectives for improving the health of all Americans. It can be used by many different people, states, communities, professional organizations, and others to help them develop programs to improve health.

Question 24

Chiropractic Health Care Section of APHA

Answer 24

Established in 1995
Public health represents the efforts made by a society to protect, promote and restore health. Public health supports prevention and health promotion. To increase impact on society by adding chiropractic skills and knowledge to those of the rest of the public health community.

Question 25

Epidemiology

Answer 25

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.

Question 26

Epidemiological studies

Answer 26

Descriptive, analytical (determine relationships), Objectives: Identify the etiology of disease Determine the extent of disease in a community in order to appropriately plan health services Study the natural history of disease and the possible prognosis Evaluate new preventive and therapeutic measures Provide the foundation for public policy and regulatory decisions

Question 27

Edward Jenner

Answer 27

Made the observation that cowpox and smallpox are closely related Prevention of smallpox by vaccinating with cowpox

Question 28

John Snow

Answer 28

Observation the outbreak of cholera was linked to a water pump

Question 29

Factors Necessary for Disease Transmission

Answer 29

Pathogen Reactive host Conditions that allow for pathogen and host to meat

Question 30

Methods of Transmission

Answer 30

Direct transmission Person to person, Carriers may not have symptoms Indirect transmission Contaminated food or water, contact with inanimate objects Vector transmission Insects, arachnids

Question 31

Host/Pathogen Patterns

Answer 31

Mutualistic - symbiosis in which both organisms benefi Commensal - no obvious benefit or deficit Parasitic - Only one partner benefits

Question 32

Reservoirs of Infection

Answer 32

Long term host of a virus and usually not injured Inanimate reservoire Primary - microbes are viable and may multiply. Food, Soil. ``` Secondary - Microbes are viable but do not multiply. Soils and water. Droplet nuclei = particles 1-10 um in diameter, implicated in spread of airborne infection ``` Living reservoir Human Animals Zoonosis is any infectious disease that can be transmitted from animals, both wild and domestic, to humans

Question 33

Risk factors for disease

Answer 33

Age, gender, ethnicity, nutrition, pre-existing disease, occupation, food and water Morbidity per 1000 people

Question 34

Herd Immunity

Answer 34

When a critical portion of a population is immune to a disease, either through natural immunity or vaccination, a phenomenon called herd immunity develops. Inability of an infectious disease to spread due to the lack of a critical concentration of susceptible hosts Herd immunity is responsible for dramatic declines in childhood diseases, both in the U.S. and in developing countries

Question 35

Water quality

Answer 35

BOD - Biochemical Oxygen Demand, assesses the quality of water required for the survival of microbes. High BOD results in the aging if a body of water. Indicator Microbes - Fecal coliforms are Gram negative, lactose fermenting, facultative microbes that produce gas. Goal for number of coliforms in water is zero.

Question 36

testing water quality

Answer 36

MacConkey Lactose (+) = dark purple colonies Lactose (-) = colorless colonies EMB agar Lactose (+) = colonies with dark center, E. coli – metallic green Lactose (-) = colorless colonies

Question 37

Sewage Treatment

Answer 37

Goal is to reduce BOD Primary treatment - Physical process, remove about 50% of solids in sedimentation tanks, remaining is effluent and reduced BOD by 25% Secondary Biological process - Trickling filter: Effluent sprayed over rocks. Organic material adheres to stone and is digested by microbes present in tank. Used in treatment plants, - Activated sludge process: Slime forming bacteria added to effluent and stirred in aeration tank. Bacteria digest remaining organic materia forming flotsam, significant reduction in BOD (95%) Tertiary Expensive, add lime or alum to remove nitrates and phosphates. May also involve filtration. Dechlorinated by aeration as it flows down a series of steps.

Question 38

Individual sewage treatment systems

Answer 38

Septic tanks Anaerobic digestion of organic material Effluent overflows into drain field of soil or gravel and further digestion by aerobic microbes. Only effective for a small amount of sewage.

Question 39

Industrial hygiene for milk and dairy

Answer 39

Milk grades determined by USPHS determined by letters. Now assigned by USDA. Pasteurization - originally 30 minutes at 62 degrees, now 72 degrees at 15 seconds. Test effectiveness using phposphatase test as the enzyme should have been destroyed by pasteurization.

Question 40

Harm Studies

Answer 40

Assess the causal relationship between exposure (treatment) and disease: Confounder = anything that independently affects the exposure and the outcome

Question 41

Hill's Criteria for Causality

Answer 41

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

Question 42

Cohort Study

Answer 42

Better for detecting harm Individuals exposed to those not exposed Prospective Look at multiple causes

Question 43

Case Control Study

Answer 43

Retrospective True risk of event occurring in the population can't be calculated because it is a retrospective study instead calculate the odds that a group was exposed or not exposed to some variable Odds Ration If OR = 1.0 risk is equal, no association If OR > 1.0 exposure increases disease risk If OR < 1.0 exposure reduces disease risk

Question 44

Case Study

Answer 44

No comparison is made with an untreated group or with a group receiving some other treatment Comparison is important to derive a causal relationship between treatment and outcome Useful for generating hypotheses and demonstrating need for further studies

Question 45

Ambroise Pare

Answer 45

Discovered alternative to using boiling oil to cauterize | wounds

Question 46

James Lind

Answer 46

Developed a trial with a series of test groups to determine if lime juice treated scurvy

Question 47

Measuring Disease Occurence

Answer 47

Morbidity - Measurement of the incidence of disease. Measures new events, so it is also a measure of risk. calculate morbidity to determine how fast the disease develops in a population. Prevalence - number of individuals expected at a certain time. Mortality - Death rate of a certain disease.

Question 48

Involvement in public health allows chiropractors to

Answer 48

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

Question 49

UNICEF

Answer 49

Founded in 1946, but officially part of UN in 1953 Mission is to protect the rights of children  Includes: Food and supplies Disease control Family planning Child development