Exam 2: Public Health And Harm Studies Flashcards
Who was first to recognize epidemic vs. endemic?
Hippocrates
What was the Elizabethan poor act?
Legislation that attempted to care for poor in 17th century England that had increased in number after the collapse of the feudal system
Who composed Bills of Mortality- first vital statistics ever compiled
John Graunt
What are vital statistics?
recordings of the birth and death of individuals within a government’s jurisdiction
Workhouse reforms were called for by ______.
Edwin Chadwik
Workhouse reform was influenced by what writing?
Dickens Oliver Twist
Who was Florence Nightingale?
The first public health nurse, famous for her work in the Crimean war
Epidemics in early America were associated with _____ and ______.
urbanization and immigration
WHat establishment became the US public Health services?
Marine hospital service
Who directs the US Public Health Service?
The surgeon general
What was established in the US in an attempt to overcome depression era hardships?
Social security act
Medicare
Medicaid
An agency of the United Nations whose motto is that “health is a basic human right”
World Health Organization
The organization whose goal is to improve health and living standards in the Americas
Pan American Health Organization
NOTE: became a regional office of WHO, however retains own identity and mission
Organization whose mission is to protect the rights of children
UNICEF - united nations children’s fund
Government organization responsible for most non-military foreign aid
USAID - US agency for international development
The largest health program worldwide
U.S. Department of Health and Human Services (DHHS)
U.S. Department of Health and Human Services (DHHS) is under the direction of whom?
DHHS secretary
What are some examples of agencies within DHHS?
USPHS - US public health services
FDA - Food and drug administration
CDC - center for disease control
NIH - national institutes for health
Principal agency in the United States government for protecting the health and safety of all Americans
CDC
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
FDA
Responsible for advancing the public health by helping to speed innovations that make medicines and foods more effective, safer, and more affordable
FDA
funds more that 6 billion in research per year
NIH
What is primary health care?
Essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community
What are the essential components of primary care?
- Education on health problems and the methods of preventing/controlling them.
- Promotion of food supply and proper nutrition.
- An adequate supply of safe water and basic sanitation
- Maternal and child health care, including family planning
- Immunization against major infectious diseases
- Prevention and control of locally endemic diseases
- Appropriate treatment of common diseases and injuries
- Provision of essential drugs
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.
Healthy people 20/20
Largest organization of public health professionals worldwide with a. Section for Chiropractic Health Care
American public health association
What are some achievements of Public Health?
- 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
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.
Epidemiology
the study of why things occur, the study of causation
Etiology
made the observation that cowpox and smallpox are closely related. Responsible for prevention of smallpox by vaccinating with cowpox
Edward Jenner
made the observation that outbreak of cholera was linked to public
water pump, and ended the epidemic by removing pump handle
John snow
Factors necessary for disease transmission
- Pathogenic organism (microbe)
- Reactive host (susceptible human or animal)
- Environmental conditions (allow host and pathogen to come together)
Method of disease transmission by Person to person contact (touching, kissing, sexual contact)
Direct transmission
Mechanism of disease transmission by contaminated food or water or contact with inanimate object
Indirect transmission
Objects or materials that are likely to carry infection
Fomite
Mechanism of disease transmission by insect or arachnid
Vector transmission
Type of host:pathogen relationship in which both (or all) organisms benefit
Mutualistic
Type of host:pathogen relationship in which there is no obvious benefit for
organisms involved
Commensal
Type of host:pathogen relationship in which only one partner benefits at the expense of the other partner
Parasitic
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
Reservoir
Inanimate reservoir of infection can be primary or secondary. What is the difference?
Primary reservoir contains microbes that are viable and multiply (ex: food, soil)
Secondary reservoir contains microbes that do not multiply (ex: air, soil)
Living reservoirs of infection can be ____ or _____
Human or animal
any infectious disease that can be transmitted from animals, both wild and domestic, to humans
Zoonosis
Risk factors for disease include:
- Age
- Gender
- Ethnicity (genetics)
- Nutrition
- Pre-existing disease
- Occupation
- Food and water
Pattern of disease where infection is maintained in the population without the need for external
inputs. Constantly present in the population.
Endemic
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.
Epidemic
A small and localized epidemic
Outbreak
global epidemic of an infectious disease that affects people or animals
over an extensive geographical area
Pandemic
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.
Herd immunity
time elapsed between exposure to a pathogenic organism and when symptoms and signs are first apparent.
Incubation period
Measurement of the incidence of a disease
Morbidity
Measures new events, so is also measure of risk
The number of individuals affected at a specific time
Prevalence
proportion of people who are exposed to the disease during the outbreak who do become sick
Attack rate
death rate due to a given disease
Mortality
Gives information about the severity of the disease
assesses the quantity of oxygen needed by
microbes in water
BOD (biochemical oxygen demand)
Aging of a body of water due to a high BOD
Eutrophication
Gram negative, lactose fermenting, facultative microbes that produce gas
Fecal coliforms
What is the goal of coliform testing
number of coliforms in drinking water is zero
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
5%
Describe the primary treatment of water?
The physical process of removing about 50% of solids in sedimentation tanks
After the primary treatment of sewage water, what is the remaining fluid called?
Effluent
Describe the secondary treatment of water
It is a biological process that can be done via two methods: trickling filter or activated sludge process
The physical process of primary water treatment reduces BOD by _____
25%
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
Trickling filter
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
Activated sludge process
Activated sludge process results in a _____ reduction in BOD
95%
Describe tertiary treatment of water
lime or alumimum is added to remove nitrates and phosphates. May also involve filtration where tertiary effluent is dechlorinated by aeration
What is a septic system?
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
Sterilization by heat treatment of dairy products
Pasteurization
How is the effectiveness of pasteurization tested?
Phosphatase test - enzyme should be destroyed by heat treatment
What is the purpose of a harm study?
Assess the causal relationship between exposure (treatment) and disease
anything that independently affects the exposure and the outcome in a harm study
Confounded
Hill’s Criteria for Causality outlines the minimal conditions needed to establish a causal relationship
between two items
- Temporal relationship
- Experimental evidence
- Dose response relationship
- Statistical significance
- Consistency across studies
- Plausibility
What kind of study is prospective (usually but can be retrospective) and can be useful for studying interactive causes of harm?
Cohort study
What kind of study is retrospective and calculates the odds that a group was or was not exposed to some variable
Case control study
Relative risk is typically used in what kind of study?
Cohort study
Odds ratio is typically used in what kind of study?
Case control study
What does it mean if the relative risk in a cohort study is = 1
There is no association between exposure and risk
What does it mean if the relative risk in a cohort study is > 1
Exposure increase disease risk
What does it mean if the relative risk in a cohort study is < 1
Exposure reduces disease risk
What does it mean if the odds ratio in a case control study =1
No association between exposure and risk
What does it mean if the odds ratio in a case control study > 1
exposure increases disease risk
What does it mean if the odds ratio in a case control study < 1
exposure reduces disease risk
What kind of study draws no comparisons but is useful only in generating hypotheses?
Case study (aka case report)
Who discovered alternative to using boiling oil to cauterize
wounds?
Ambroise Pare
Who developed a trial with a series of test groups to determine if lime juice treated scurvy?
James Lind
What is the difference between subclinical carrier and clinical carrier?
Subclinical carrier has mild, not clinical symptoms while clinical carriers are symptomatic
Involvement in public health allows chiropractors to:
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
