H 100

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  1. 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
  2. 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
  3. the 3 levels of “prevention”
    • Primary Prevention: preventing the condition
    • E.g. nutrition education in schools, expanding fitness facilities in parks
    • Secondary Prevention: early diagnosis and treatment
    • E.g. pharmacological, behavioral weight loss programs
    • Tertiary "prevention": reducing impact, complications
    • E.g. gastrointestinal surgery for patients with chronic disease complications
  4. Describe and explain the 4-step cycle of taking public health action
    Problem=> (burden)=>Etiology=>(available interventions)=> Recommend=>(Populations/Setting)=>Implement=> (Evaluation)
  5. 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.”
  6. 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
  7. 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?
  8. 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
  9. Distinguish among infectious and non-infectious disease, chronic and acute conditions
    Infectious disease: often needing rapid data collection and analysis cycles
  10. Chronic disease
    Long duration and generally slow progression. Usually less intense, longer term monitoring
  11. 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
  12. 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)
  13. 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
  14. Two types of immunity
    • Active Immunity: produced by host immune
    • Passive Immunity: conferred by transfer of material
  15. Herdimmunity is achieved through
    • natural immunity
    • acquired immunity 
    • vaccination
  16. Herd Immunity threshold
    - differs by population, pathogen, environment
  17. Describe the global burden of non-infectious disease
    • Identifying distal causes
    • Identifying component causes
    • Identifying multiple pathways
    • Identifying multiple outcomes
  18. 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
    • Screening/ early detection
    • Multiple risk factor interventions
    • Genetic counseling
  20. 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
  21. 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
  22. Explain the elements of a “traditional” health risk assessment
    Hazard identification => Dose- response characteristics <=> Susceptible populations => Exposure assessment
  23. Explain and identify examples of the five methods for reducing environmental health challenges
    • prevent contamination
    • remove exposure
    • remove population
    • modify behavior
    • reduce susceptibility
  24. 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."
  25. 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
  26. 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
  27. 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.
  28. “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
  29. 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
  30. 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?
  31. 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”
  32. 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
  33. 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
  34. 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
  35. A "traditional" health risk assessment does NOT include...
    • . identification of a potential hazard 
    • b. dose-response characteristics 
    • c. exposure assessment 
    • d. potential remediation options
  36. 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
  37. 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.
  38. 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
  39. 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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H 100
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