Community Health Exam #2 Flashcards
Define Incidence
Occurrences of new cases of disease/condition over a period of time relative to the population size at risk for condition/disease
Define Prevalance
Number of all cases of a specific disease/condition in a population at the same point in time
What are some risk factors for developing a disease?
Nutrition
Chemicals
Radiation
Mechanical
Infectious agents
Genetics
Age
Sex
Ethnicity
Immunization status
Pre-existing diseases
Behavior
Environment
What are the epidemiologic triangle factors
Agent, host, and environment
-Interrelationship between host and environmental characteristics
Wheel Model of Human Enviorment Interaction
Multiple causation, useful for complex chronic conditions & identifying factors that are amenable for intervention
-Host, environment, biological, and social environment
What is the Web of Causation?
The complexity of relationships among casual variables
Ex: MI
United Nations r/t Global Health
Millennium Development Goals: Eradicate extreme poverty & hunger, universal primary education, gender equality, decrease child mortality, increase maternal health, combat HIV/AIDs & malaria, environmental stability, and develop global partners.
What is a pro of PACs?
Small donations add up to campaign a fund, this gains attention for candidate.
What is a con of PACs?
Nurse should use their power to elect candidates in favor of health care.
What is active immunity?
The body produces its own antibodies against an antigen fro infection with pathogen or introduction of pathogen in a vaccine
What is passive immunity?
Temporary resistance that is donated to the host through transfusions of plasma proteins, immunoglobulins, antioxidants, and transplant.
How to break the chain of transmission:
Improve resistance and immunity, control portals (entry & exit), control reservoir, eradicate non-human reserviors, control the agent.
Define policy
Denotes a course of action to be followed by a government, business, or institution to obtain a desired effect
Define Public policy
Denotes precepts and standards formed by governmental bodies that are of fundamental concern to the state and the whole of the general public.
What is the goal of healthy people 2020 public health infrastructure?
Make sure public health agencies at all levels have the necessary infrastructure for key public health services
What are the components to public health policy?
-Decisions are made by the government
-Everyone is affected (health organizations, providers and consumers)
-Compliance with federal program standards influences revenue
What are the components of health policy & the private health sector?
Policies evolve differently & are influences by economics & business management
-Needs are determined by consumerism, market trends, and economics.
What did the patient protection & affordable care act of 2010 do?
-All citizens are mandated to have qualifying health coverage
-Changes eligibility requirements for Medicaid & expanded CHIPs
-Subsidized premiums for lower and middle income famlies
-Required coverage of dependent adult children up to age 26
-Fostered health insurance exchanges
-Significant insurance reforms.
What did Medicaid, Title XIX Social Security Amendment (1965) do?
Combined federal and state program provides access to care for the poor and medically needy of all ages.
What did Medicare, Title XVIII Social Security Amendment (1965) do?
Pays specified health care services for all people 65 years of age and older who are eligible to receive Social Security benefits.
-People with permanent disabilities and those with end-stage renal disease are also covered.
What did Public Health Act of 1944 do?
The Public Health Act consolidated all existing public health legislation into one law.
What did the Health Insurance Portability and Accountability Act of 1996 do?
The law offered protections for patient privacy and confidentiality. Critical insurance issues were the portability of coverage and limits on the restrictions health plans place on coverage for preexisting conditions
What did the Welfare Reform Act of 1996 do?
Placed restrictions on eligibility for AFDC Medicaid, and other federally funded welfare programs
What are the components of a public health subsystem?
-Prevention of disease & illness
-Federal programs
-State programs
-Local programs
What are the components of a private subsystem?
-Personal care service from various sources
-Nonprofit & Profit
-Numerous voluntary agencies
What services do private health care subsystem?
-Services provided in clinics, physcians offices, hospitals, hospital ambulatory centers, skilled care facilities and homes
-health promotion
-Prevention & early detection of disease
-Dx & tx with focus on cure
-Rehab-restorative care
-Custodial care
Volentary organizations are major source of help in:
-Prevention of disease
-Promotion of health
-Tx
-Advocacy
-Consumer education
-Research
What does the federal-level subsystem do?
Protects against hazards, maintenance of vital and health statistics, advancement of knowledge through research, provision of disaster relief
-encourages healthy eating habits, exercise and prevention of drug or alcohol use.
What does the local health subsystem do?
-Responsible for direct delivery of public health services and protection of the health of its citizens
-Community, environmental, personal and mental health services
Communicable Disease and Healthy People 2020
Evaluate national prevention and control efforts and can guide local prevention and control efforts
-Reduce the number of courses of antibiotics prescribed for the sole diagnosis of the common cold
multicausation emphasizes that…
An infectious agent alone is not sufficient to cause disease; the agent must be transmitted within a conducive environment to a susceptible host.
What is a subclinical infection
Unapparent or asymptomatic
Infectious disease and communicable disease refer to
the pathophysiological responses of the host to the infectious agent manifesting as an illness.
would be considered a ‘case’?
The occurrence that the disease is diagnosed in a person
Stages of Infection
This period of replication before shedding is called the latent period or latency. The communicable period, or communicability, follows latency and begins with shedding of the agent. The incubation period is the time from invasion to the time when disease symptoms first appear.
Define endemic
Occur at a consistent, expected level in a
geographic area
What is the order of the chain of transmission?
->Pathogenic agent ->reservior ->portal of exit-> transmission-> portal of entry-> host susceptibility ->
Example of direct mode of transmission
Person to person
example of Indirect mode of transmission
Implies a vehicle of transmission (biological or mechanical vector, common vehicles or fomites, airborne droplets)
What is natural immunity?
an innate resistance to a specific antigen or toxin
What is aquired immunity?
Derived from actual exposure to the specific infectious agent, toxin, or appropriate vaccine.
-2 types active and passive
What is active immunity?
Active immunity occurs when the body produces its own antibodies against an antigen, from either infection with the pathogen or introduction of the pathogen in a vaccine.
What is passive immunity?
Passive immunity is the temporary resistance that has been donated to the host either through transfusions of plasma proteins, immunoglobulins, or antitoxins or transplacentally (from mother to fetus).
Primary vaccine failure:
The failure of a vaccine to stimulate any immune response. It can be caused by improper storage that may render the vaccine ineffective, improper administration route, or exposure of a light-sensitive vaccine to light.
Secondary vaccine failure:
The waning of immunity following an initial immune response. It often occurs in patients with immunosuppression and in those who have undergone organ transplantation, in whom the immune memory is essentially destroyed.
Herd immunity
A state in which those not immune to an infectious agent are protected if a certain proportion of the population has been vaccinated or is otherwise immune
Immunization
A broad term used to describe a process by which active or passive immunity to an infectious disease is induced or amplified
Vaccination
A narrower term referring to the administration of a vaccine or toxoid to confer active immunity by stimulating the body to produce its own antibodies.
How to break the chain of admission?
-Control the agent
-Eradicate the nonhuman reservoir
-Control the human reservoir (quarantine)
-Contol the portal of exit and entry (isolation and universal precautions
Define eradication
Reducing the worldwide incidence of a disease to zero as a fuction of deliberate efforts
Define elimination
Controlling a disease within a specific geographical area and reducing the prevalence and incidence to near zero.
Example & definiton of natural active immunity
Natural contact and infection with the antigen
-measles
-temp or permanent
Example & definiton of Natural passive immunity
Natural contact with antibody trans placentally
-Infant born with temp. antibodies to measles
-Temp or through breast milk
Example & definiton of Artifical active immunity
Inoculation of antigen
-Tetanus vaccine to stimulate production of antibodies to tetanus
-May be temp or permanent
Example & definiton of artificial passive immunity
Inoculation of antibody or antitoxin
-Injection of tetanus antitoxin to an unimmunized person
-Temporary
Ex of primary prevention for transmission or infection
- Educate health care workers and others about TB infection and disease.
- Educate staff on airborne precautions and the proper use of respiratory protection.
- Design and implement signage throughout the hospital to remind staff and patients about respiratory hygiene, cough etiquette, and hand hygiene.
Ex of secondary prevention for transmission or infection
- Establish regular screening of health care workers for positive skin test conversions.
- Establish mechanisms for detection, referral, and treatment of staff with latent TB infections and with active TB.
- Implement procedures for rapid detection and treatment of patients with active TB.
- Coordinate efforts with the local health department.
Ex of tertiary prevention of infection or transmission
- Monitor medication compliance and follow-up testing.
What are vaccine hypersensitivity and contraindications that should be considered?
-Adverse reactions: rash, redness and or pain at injection site, & mild fever
-Allergies to eggs, egg proteins, antibiotics, preservatives, and adjuvants
What vaccination considerations are there for pregnant patients?
-Use inactivated vaccines, antitoxins, or immune globulins
-Avoid live vaccines
What vaccination considerations are there for immunocompromised patients?
-Avoid live vaccines
-Killed or inactivated can be given but may not produce optimal antibody response
What should be included in documentation for vaccines?
-Name
-Date immunized
-Type
-Vaccine manufacturer & lot number
-Date of VIS
-Name, title, and address of person givng vaccine
Human Nature Orientation
Innate human nature may be good, evil, or a combination of good and evil.
Person nature orientation
- Destiny, in which people are subjugated to nature in a fatalistic,
inevitable manner - Harmony, in which people and nature exist together as a single
entity - Mastery, in which people are intended to overcome natural forces
and to put them to use for the benefit of humankind
Time orientation
-The focus may be on the past, with traditions and ancestors playing an important role in the client’s life.
-The focus may be on the present, with little attention paid to the past or the future.
-The focus may be on the future, with progress and change highly valued.
Activity orientation
-Being, in which a spontaneous expression of impulses and desires is
largely nondevelopmental in nature
-Growing, in which the person is self-contained and has inner control,
including the ability to self-actualize
-Doing, in which the person actively strives to achieve and accomplish
something that is regarded highly
Social orientation
-Lineal relationships: These exist by virtue of heredity and kinship ties.
-Collateral relationships: The focus is primarily on group goals, and family orientation is important.
-Individual relationships: These refer to personal autonomy and independence. Individual goals dominate, and group goals become secondary.
Cultural negotiation
Refers to the process in which messages, instructions, and belief systems are manipulated, linked, or processed between the professional and lay models of health problems and preferred treatment
Category 1. Literally Homeless:
Individuals and families who lack a fixed, regular, and adequate nighttime residence and includes a subset for an individual who resided in an emergency shelter or a place not meant for human habitation and who is exiting an institution where he or she temporarily resided
Category 2. Imminent Risk of Homelessness:
Individuals and families who will imminently lose their primary nighttime residence
Category 3. Homeless Under Other Federal Statutes:
Unaccompanied youth and families with children and youth who are defined as
homeless under other federal statutes who do not otherwise qualify
as homeless under this definition
Category 4. Fleeing/Attempting to Flee Domestic Violence (DV):
Individuals and families who are fleeing, or are attempting to flee, domestic violence, dating violence, sexual assault, stalking, or other dangerous or life-threatening conditions that relate to violence against the individual or a family member.
What is point-in-time (PIT) count?
Count of sheltered homeless people on a single night in late January of every year and submit these data to HUD via HMIS
What is a runaway youth?
A person under 18 who absents themselves from home or place of legal residence without permission of his or her family
What is a homeless youth?
A person under 18 who is in needs of services and without a place of shelter where he or she recsieves supervision and care
What factors contribute to homelessness?
-Shortage of affordable housing
-Income insufficient to meet basic needs
-Inadequate and scarce support services
Healthy people 2020 goals for violence are:
-Causes of violence and abuse
-Improve data collection & analysis
-Provide input for legislative funding
-Facilitate research efforts
-Concentrate public health efforts on models that demonstrate effectiveness
Secondary prevention goals for violence:
Assess, diagnose, and tx victims and perpetrators
Tertiary prevention goals for violence:
Rehabilitation of victims and perpetrators of violence.
What is the National Incident Management System (NIMS)
Provides systematic way for government and nongovernmental agencies to work to:
-prevent, protect against, respond to, recover from effect of disasters
Primary prevention for disasters:
Preventing occurance or limiting consequences
-risk map: geographic map of area analyzed for potential disaster
-resource map: geographic map outlines resources available if area affected by disaster
Secondary preventions for disasters
Strategies are implanted once the disaster occurs
Tertiary prevention for disasters:
Recovery
What are local government responsibilities for disasters?
-Prepare citizens for all kinds of emergencies and disasters
-Office of Emergency mangement
-Mock Drill
What are the state government responsibilities for disasters?
-Assist local officals with emergency plans
-Workshops and training courses
-Advise and support local gov
-National Response Framework is the core operational plan for domestic incident management
What is the federal government responsibilities for disasters?
-U.S. Dep of Homeland Security: prevent terrorism and ensures resilience to disasters
-Federal Emergency Management Agency: support citizens & 1st responders to build sustain and improve the capacity to mitigate all hazards
-CDC: Surveillance to ensure clean drinking water, food, shelter, and medical care
Disaster Mangement stages: Prevention stage:
-ID potential risks (risk maps)
-Edu. citizens about actions to be prepared
-Develop a plan (resource maps)
Disaster Mangement stages: Preparedness/planning stage:
-1st aid training
-Assesmbling disaster emergency kit
-Practice drills
-Est. a predetermined meeting place away from home
-Make a family communication plan
Disaster Mangement stages: Response stage
Begins immediately after disaster occurs
-Shelter in place
-Evacuation
-Search and rescue
-Staging area
Disaster Mangement stages: Recovery stage:
Begins when danger from the disaster has passed
-All levels of gov present
-Help rebuild lives
-Restore public services
-Clean up
-Eval and revision of plans
-Understand financial impact
Community Responses to Disaster Phases:
- Heroic phase—helping others
- Honeymoon phase—relive event and tell stories; express gratitude
- Disillusionment phase—feelings of despair and exhaustion
- Reconstruction phase—rebuilding, return to normalcy
