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primary prevention
activities that are intended to prevent the onset of a disease or injury
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secondary prevention
activities intended to minimize the risk of progression or complications from a disease or to minimize damage from an injury
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tertiary prevention
- activities intended to minimize disability caused by a disease or injury
- ex.) rehabilitation
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public health
organized community efforts to ensure conditions in which people can be healthy
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assessment
- one of the 3 core functions of public health
- -monitor health status to identify community problems
- -diagnose and investigate a problem
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assurance
- one of the 3 core functions of public health
- -enforce laws and regualtions
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policy development
- of the 3 core functions of public health
- -inform, educate, empower people about health issues
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intervention
- term used to describe a program or policy
- -designed to have an impact on a health problem
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market justice
emphazies individual responsibility, minimal obligation to common good and fundamental freedom to all individuals to be left alone
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social justice.
minimal levels of income, basic housing, employment, education, and health care should be seen as fundamental rights
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tragedy of the commons
dilemma arising from the situation in which multiple individuals act independtly and rationally consulting their own self interest which will lead to depelation of a shared limited resource
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core functions of public health
- assessment
- policy development
- assurance
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biggest concern in public health for USA today?
chronic disease
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public health vs. medical care what the difference?
- public health- community as a whole
- medical care- individual and cure
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how does public health: science and politics work?
- science is how we understand threats to health and what intervention to make
- politics is how we as a society make decisions about what policies to implement
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public health disiplines
name 6
- epidemiology
- statistics
- biomedical sciences
- enviromental health science
- social and behaviors science
- health policy and management
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epidemiology
- study of epidemics
- aims to control spread of infectious diseases
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statistics
collection of data in a population
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biomedical science
how to treat infectious diseases, chronic diseases and genetics
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what is enviromental health science?
health effects of enviromental exposures
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what is social and behavioral sciences
- leading factors effecting peoples health
- ex. tobacco, poor diet
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what is health policy and management?
role of medical care in public health
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what are the three steps in public health prevention and intervention?
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what is the public health approach?
- define health problem
- identify risk factors
- develop and test interventions
- implement interventions
- monitor interventions
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what is the chain of causation?
- agent
- host
- enviroment
- interventions
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describe some actions the govt has taken to ensure people are safer and healthier today than 100 years ago
- cleaner water
- technology
- cleaner air
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how are the six disiplines of public health used to accomplish the core functions?
each assess, make policies and give assurance with monitoring
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what are sources of controversy?
- economic impact
- individual liberty
- moral and religious concern
- politics vs. science
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what is economic impact?
those who must pay may not be the ones that benefit
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when can govt restrict individual freedom?
to prevent harm to other - generally acceptable
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example of a measure that would benefit public health but might be expensive to implement?
- no smoking
- benefit- everyone
- pay the cost- tobacco companies and individual freedom
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Police powers
- invoked for three reasons:
- -prevent person from harming others
- -defend interests of the incompetant persons
- -protect person from harming self
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public health agency
- varies from state to state
- day to day responsibilities
- ex.) health statistics, health education, sanitation, provide screenings and immunizations
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the role of the gov't is determined by _____?
law
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who makes something a law?
president
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what level of gov't has the law over public health?
state
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what are the three branches of gov't?
- legislative
- executive
- judicial
- = inter play with each other
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what are the jobs of local public health agencies?
- sanitation
- screenings
- monitor statistics
- control programs
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where do funds come from for the state health department?
state taxes
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what do nongovernmental public health organizations do?
- lobby and educate
- - american cancer society
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what do philanthropic foundations do?
- help funding
- ex) bill and melinda gates foundation
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what is epidemiology?
- diagnostic disipline of public health
- investigates causes of diseases
- who-when-where
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what are the patterns of disease occurance?
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what is epidemic surveillance?
recognition of a new disease
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what is endemic?
different for different diseases vary with population growth and demographics
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what is epidemic?
#'s above normal in population when above it
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what did John Snow do? 1st epidemiologist
- cholera epidemic in mid 1850's
- natural experiement
- door to door correlation
- between water and company
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what is the legions air disease?
- air conditioning cooler in hotel had contaminated water
- now all air conditioners have certain requirements
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federal vs. state authority
- federal- most traditional public health activities other than enviromental
- ex) HHS , CDC, FDA, NIH
- state- primary constitutional responsibility and authority of the health, safety and general welfare of the population
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federal agencies involved with public health
name 4
- FDA- food and drug administration
- CDC- center for disease control and prevention
- HHS- department of health and human services
- NIH- national institute of health
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what is endemic?
usual prevelance of a disease with a geographical area
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what is epidemic?
occurance in a community or geographical area of a disease at a tate that clearly exceeds the normally expected rate
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what is epidemic surveillance?
- certain "notifiable" disease that is reported as soon as it is diagnosed
- major line of defense in protecting the public against disease
- sooner it kicks in sooner the epedemic stops
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epidemiology?
- diagnostic displine of public health
- study of populations to seek the causes of health and disease
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what is a notifiable disease?
disease that the law requires to be reported to public health authorities as part of the public health survelliance system
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what are risk factors?
characteristic that has been demonstrated statisically to increase a persons chance of developing a disease or being injured
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what is different about finding the causes of chronic diseases?
- chronic diseases develop over time
- more complicated
- different factors
- cannot be cured by a vaccine
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what is case control study?
- epidemeology study
- individuals affected by a disease with a comparable group of persons who dont have the disease.
- to see the causes
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what is a cohort study?
study of a group of people followed over time to see how some disease develop
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what is a disease?
health outcome to be studied
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what is the distrubtion of disease?
compomrised of answers: who, when, where questions
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what is exposure?
state of being exposed to something
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what is incidence?
measure of the new number of new cases reported in a given amount of time: usually a year
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what is an intervention study?
- epidemiological study
- the impact of interventions on one group of subjects in compared to the effect of placebo
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what is the odds ratio?
ratio of odds of an event occuring in one group
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what is the placebo effect?
improvement in health behavior not attributed to a medication
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what is the population risk?
exposure to pathogenic agent under discussion and suspitibilty
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what is prevelance?
proportion of persons in a population who have a particular disease or attribute at specified point in time
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what is randomized double blind clinical trial?
doctor nor patient know who is in the control or experient group
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what is the rate?
proportion of some disease or condition in a group per unit of time with numerator and denomentor
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what is the relative risk?
comparison of two morbidity or mortality rates using calculation of the ratio of one to the other
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what are confounding variables?
variables that researchers are unable to control
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what is informed consent?
consent by patient to undergo medical treatment/experiement
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what is the institutional review board?
comittee of people desginated to approve, monitor, research involving humans
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what is the recall bias?
systemic error due to differences in accuracy or completeness to recall to memory or past events
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what is selection bias?
error choosing individuals/groups to take part in study
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what is random variation?
minor differences among individual people in the population
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what is epidemiology?
- study of populations to seek the causes of health and disease
- the study of distribution and determinants of disease frequency in human population
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what are the three major types of epidemiological studies?
- intervention study
- cohort study
- case-control study
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why was the Tuskegee study significant?
- raised ethical issues
- deception
- racist
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adjusted rate?
way of comparing two groups that differ in some important variable by mathmatically eliminating the effect of that variable
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what is cost-benefit analysis?
economic analysis assessed as health outcome per cost expended
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what is crude rate?
actual rate of events in a population with out adjustment
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what is a false negative?
mistaken identification of person being healthy or uneffected when in fact they have the disease or condition being tested for
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what is a false positive?
mistaken identification of persons as affected by some disease or condition when in fact they are uneffected by disease or condition being tested for
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what is life expectancy?
# of additional years of life expected as a specific point in time.
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what is probability?
calculation of what may be expected based on what has happened in the past under similar conditions
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what is birth rate?
# of live births per 1000 of the population per year
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death rate?
# of residents deaths per 100,000 population
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what is sensitivity?
ability of a test to avoid false negatives, its ability to identify a disease or condition in those who have it
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what is National Center for Health Statistics?
componant of the CDC charged with providing statistical information that will guide actions, policies to raise health in america
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what are vital statistics?
systemically collected statistics on life events, measuring progress or lack of it against disease
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what is BRFSS?
us health survey that looks at behavioral risk factors
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what is the census?
collects data about different types of health insurance coverage
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what us confidentiality of data?
is whether the information stored on a system is protected against unitended or unauthorized access
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what are statistics?
numbers that describe the health of a population
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science that is used to interpret statistics?
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for statistics P= .05 or lower is significant or not?
significant
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what is power of the study?
probability of finding an effect if there is in fact an effect
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large numbers in a power of effect will?
more likely to have effect
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example of screening test?
mamography
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when sensitivity test is done there are fewer what?
false negative/positives
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what does YPL stand for?
years of potential life loss
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what is easier to calculate than benefit?
cost
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what are the uses of data?
- assess health of a community
- raw material for research
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what are some collections of data?
- local records- death birth
- surveys- done by CDC for census planning
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what is the census?
- serves as denominator for most public health data
- every 10 years
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what effects the public health of the community stats taken by census?
- population
- age
- ethnicity
- education
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aerosol?
water droplets produced when infected person coughs or sneezes
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bacteria?
one celled microorganism of the plant kingdom
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fecal-oral route?
route of transmission from feces to oral
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host?
a living cell in which a virus reproduces
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immunization?
stimulating immunity to an infectious disease by exposing an individual to a weakened or dead pathogen
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parasites?
organisms that live in or on another host and benefits by deriving nutrients at the hosts expense
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pathogen?
bacteria, virus, microorganism that can cause disease
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reservoir?
place where a pathogen lives and multiples before invading non infected person
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viruses?
small pathogen that is not capable of independent metabolism can only reproduce in a living cell
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chain of infection?
- way infections spread
- leave host-transmission-to new host
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rabies?
- contagious and fatal virus disease of dogs
- saliva to humans
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small pox, measles, polio
infectious disease unique to humans
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antibiotic resistance?
type of drug resistance where organism is able to survive exposure
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AZT?
first antiviral therapy for HIV/AIDS
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bioterroism?
terrorism involving release of toxic biological agents
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E.Coli 0157:H7
dangerous form of e.coli that lives in human colon
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emerging infections?
incidence in humans has increased the past decade
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influenza?
contagious viral infection of the respitory passages
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multidrug-resistant tuberculosis
resistant to common antiTB drugs
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prions?
particles contain protein but no nucleic acid and no traditional genetic material
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retrovirus?
RNA virus that inserts DNA copy of its genome into host in order to replicate
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T4 cells?
T helper cells, sub group of lymphocytes
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how is typhoid fever, small pox, malaria, rabies spread among human populations?
- one person to another
- water, food, vectors, objects
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why do public health practitioners not recommend that ever person be immunized by rabies?
- epidemiological surveillance
- -relatively rare
- vaccine expensive
- inconvient to deliver
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how could small pox, polio and measles be eliminated from the earth?
- vaccine
- -no human resevoir
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how is AIDS, hantavirus, influenza spread within human populations?
- blood
- person to person
- aerosol
- feces
- vectors
- enviromental factors
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why does the immunization against influenza not remain effective from year to year?
- RNA virus constantly changing
- replicating to become stronger
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what are three public health measures that could reduce the probability that bacteria will develop resistance to antibiotics?
- dont put antiobiotics in cow feed
- finish antibiotic
- unnessary prescriptions to antibiotics
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what are some infectious diseases that were major killers?
- bubonic plague
- small pox
- measles
- typhoid
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how were the infectious diseases conquered?
-
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what the chain of infection?
- pathogen
- reservoir
- transmission
- host
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why do we talk about chain of infection in public health?
try and break chain is what public health does
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what are kochs 4 postulates
why dont they work on viruses
- found in abundance
- must be isolated
- introduce disease to healthy suspect
- must be resisolated, diseased host again, identical
virus goes thru filter paper
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means of transmission?
- aerosol
- touching
- contaminated water food
- vectors
- sexual contact
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how can you interupt the chain of infection?
- antibiotics
- eliminate resevoir
- prevent transmission
- increase resistance
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what are some public health matters to watch for infectious diseases?
- epidemiologic surviellence
- contact tracing
- quarintine
- immunization
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how was SARS controlled?
vaccine?
how treat?
- classic public health measures
- no vaccine
- tx symptoms
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what is eradication?
what is eraditcated?
- completely get rid of
- small pox
- measles
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what is the fear of vaccines?
urban myths created about autism SIDS
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what is herd immunity?
more immunized the better
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chronic deaths:
leading cause of ______ and _______
_____ causes - risk factors
_____ period of onset
possiblility of _____ prevention
importance of _____ models
- death and disability
- multiple
- long
- secondary
- animal
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what are some secondary preventions for chronic diseases?
- blood test
- mamogram
- papsmear
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why is there importance for animal models?
- short life span
- more ethical
- some of the same genetics
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who is mainly effected by chronic diseases?
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why is it better to use animal models than a petri dish?
- different risk factors
- isolation= problem
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major factor of cardiovascular?
widespread use of ______ for secondary prevention
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what is atherosclerosis?
hardening of the artieries from plaque
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what is hypertension?
high blood pressure
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how does a heart attack happen?
carbon monoxide binds to hemoglobin and cuts off the oxygen to the heart and lungs
-
what does cancer arise from?
what are mutations caused by?
- mutations
- chemicals, viruses, radiation
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what is a carcinogen?
chemicals and radiation
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what cancer is from a virus?
-
what is the primary prevention in cancer?
prevent exposure to carcinogens
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what are 4 complications of diabetes?
- blindness
- kidney failure
- poor wound healing
- amputations
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what are some medical approaches to saving lives from cardiovascular disease?
- CABG
- stint
- public health says: exercise and eat healthy
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when does huntingtons disease strike?
midlife
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who has the trait for huntingtons disease?
father
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who is the most effected population of sickle cell anemia ?
african americans
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if both mother and father have sickle cell anemia what does it cause?
recessive gene
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what are teratogens?
infectious pathogens that effect fetus
-
what did thalidomide (no more morning sickness) do to babies?
abnormalities - no arms no legs
-
what effects genetics diseases?
genetics and teratogens
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who does tay-sachs effect?
dominant or recessive?
- jewish populations
- recessive
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what is done for newborn screenings?
what does it prevent ?
- test of blood for metabolic abnormalties
- reduce or prevent damage
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what is carrier screening?
- screens for recessive genes in highrisk populations
- ex. tay sachs
- sickle cell anemia
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what is genomic medicine?
human genome project
-
what is the human genome project?
are there benefits?
- determine what sequence that makes up DNA
- mapping of the genes of human genome
BENEFITS: understand human evolution
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genetic screening is only beneficial when there is ______ and _______ for infant
treatment and followup
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what is prohibition?
U.S gov't trying to regulate the behavior of its citzens
-
what is education?
informs the public about healthy and unhealthy behaviors
-
what is regulation?
intent to restrain people from harming themselves
-
what is RDA?
listing of daily values of the 6 food groups a person should consume in a day
-
what ways do people choose their own health?
- eating habits
- participation in activties
- recreational activites
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what way is peoples health effected by factors they dont do?
- someone else is doing it
- enviroment
- genetics
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what is the ecological model?
- the way to look at a social enviroment
- 1.intrapersonal-attitudes
- 2.interpersonal-family friends
- 3.institutional
- 4.community
- 5.public policy
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what is the health belief model?
several factors that determine whether a person is likely to change a behavior when faced with a health threat
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what is locus of control??
individuals belief that they can control what effects them
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what is self efficacy?
sense of having control over ones life
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what is social support?
physical or emotional comfort given to us by friends or family
-
what is socioeconomic status?
concept that includes income, education, occupational status = all strongly associated
-
what is stress?
adverse physical and social conditions associated with lower SES
-
would the health belief model help predict whether someone would quit smoking?
depends on the stage
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ecological model to explain why US has high rate of adolescent pregnancies?
all 5 steps of the ecological model are included to explain the high rate
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