Module 1-5 Flashcards
1948 Defintion of Health
health is a state of complete, physical, mental, and social well-being and not merely the absence of disease or infirmity
1984 defintion of Health
the extent to which an individual or group is able, on the one hand, to realize aspirations and satisfy needs. And on the other hand, to change or cope with environment. Resource for everyday life, not the objective of living. It is a positive concept emphasizing social and personal resources as well as physical capacities
Charles Winslow’s defintion of Health
art of preventing disease, prelonging life and promoting physical and mental health through organized community efforts. - social machinery which will ensure every individual in the community a standard of living adequate for the maintenance of health
Assess and monitor
population health status, factors that influence health, community needs and assets
investigate, diagnose, and address health problems
and hazards affecting the population, root causes
communicate effectively
inform and educate people about health. factors that influence it, and how to improve
strengthen, support, mobilize
communities and partnerships to improve health
create, champion, and implement policies
plans, and laws that impact health
utilize legal and regulatory actions
designed to improve and protect the public’s health
assure and effective system
that enables equitable access to the individual services and care needed to be healthy
build and support
a diverse and skilled public health workforce
improve and innovate public health functions
through ongoing evaluation, research, and continuous quality improvement
build and maintain
strong organization infrastructure for public health
Meikirch Model of Health
individual, society, environment
complex adaptive system, linked nature of health, whole government, responsibility, integrative apprach
photo in notes
top 10 causes of death
heart disease
cancer
covid
accidents
stroke
chronic lower respiratory disease
diabetes
chronic liver disease and cirrhosis
kidney disese - nephritits, nephrotic syndrome, nephrosis
levels of prevention
upstream - societal
midstream - community
downstream - individual and family
Primordial
laws and policies that advocate to improve health, upstream and less costly
primary
educating, creating programs, altering individual lifestyle choice
secondary
screenings and early detection/diagnosis
tertiary
treatment and prevention of diseases once it has attacked the body
quaternary
avoiding over medicalization/over medication
social determinant of health
The conditions in which people are born, grow, live, work, and age, including the health system.. Shaped by the distribution of money, power, and resources at a global, national, and local levels are mostly responsible for health inequities, the unfair and avoidable differences in health status seen within and between countries
solar and irwin model
picture on phone
health in all policies
approach to public policies across sectors that systematically takes into account the health implications of decisions, seeks synergies, and avoids harmful health impacts in order to improve population health and health equity. It improves accountability of policymakers for health impacts at all levels of policy-making. It includes an emphasis on the consequences of public policies on health system, determinants of health and well-being.
○ If we all work together we would all improve health together
dispariteis
not simply differences in health.. May connate a difference that is inequitable, unjust, or unacceptable
inequities
Moral and ethical dimension, resulting from avoidable and unjust differentials in health status
HPA axis
chronic stress pathway
picture on phone
primary health care
universally accessible, affordable health care
drivers of health inequities
gender bias, resources, entitlements, norms, values, position of women in society
social determinants of health
circumstances and systems in which people are born, grow up, live, work, age
social gradient
Lower on SE position, worse health
health inequalities
differences in health outcomes
health inequities
life expectancy at bith is different for people
health disparities
difference in health outcome
Health belief model
Hochbuam & Rosenstock
perceived susceptability
perceived severity
perceived benefits
perceived barriers
cues to action
self-efficacy
Perceived susceptibility
one’s opinion of chances of getting condition
perceived severity
opinion of how serious a condition is and what its consequences are
perceived benefits
belief in the efficacy of the advised action to reduce risk or seriousness of impact
perceived barriers
one’s opinion of the tangible and psychological costs of the advised action
cues to action
strategies to activate readiness
self-efficacy
confidence in one’s ability to take action
HBM
individuals course of action depends on the person’s perceptions of the benefits and barriers related to health behavior
○ Why people did or did not use preventive services
Address concerns in prevention and detection
Theory of Planned Behavior
attitude
behavioral intention
subjective norm
social norm
perceived power
perceived behavioral control
attitude
degree to which a person has favorable or unfavorable evaluation of the behavior
behavioral intention
motivational factors that influence a given behavior, stronger the intention, more likely to perform behavior
Social norms
customary codes of behavior in a group or people or large cultural context. Normative, standard in group of people
Subjective norm
belief about whether most people approve or disapprove of the behavior.
Perceived power
perceived presence of factors that facilitate or impede performance of a behavior
Perceived behavioral control
perception of ease or difficulty performing the behavior.
Key components of TPB
behavioral intent on likelihood that behavior will have expected outcome
social cognitive theory
Albert Bandura
personal factors, environemental influence, behavior
constructs of SCT
reciprocal determinism
behavioral capability
observational
reinforcements
expectations
self-efficacy
reciprocal determinism
can be both agent and responder to change. Thus changes in the environment, examples of role models, and reinforcements can be used to promote healthier behavior
purpose of SCT
explain how people regulate their behavior through control and reinforcements to achieve goal-directed behavior that can be maintained over time
Unique feature: emphasis on social influence and external and internal social reinforcement. Accounts for a person’s past experience in determining if behavioral action will occur
transtheoretical model
prochaska and diclemente
at any point there can be a relapse
propose that people are at different stages of readiness to adopt healthful behaviors
diffusion of innovation
used to accelerate the adoption of important public health programs that aim to change the behavior of a social system. Successful adoption of PH program results from understanding the target population and the factors influencing their rate of adoption
distribution
innovators: 2.5
early adopters: 13.5
early majority: 34
late majority: 34
laggards: 16
scientist for diffusion of innovation
E.M Rogers
socioecological model
urie bronfenbrenner
○ Individual, interpersonal, community, organizational, policy/enabling environment
Purpose: Propose that all influences are important to health. Healthy behaviors are maximized when environments and policies support healthful choices
developmentla origins of health and disease
david barker
development of child
1st trimeter
increase chance of hemorrhage, stroke
2nd trimester
increased chance of coronary heart disease
3rd trimester
increased chance of coronary heart disease or thrombotic stroke
life course theory
glen elder
○ Timing in live
○ Time and place
○ Human agency in constrained situation
○ Human development and aging in lifelong process
Linked lives
harvard model
Problem and solution to health condition
Rothman’s causal pies
○ Sufficient cause - complete pie that represents a causal pathway for a disease
○ Component cause - individual pieces of the pie
Necessary cause - a component that appears in every pie or pathway
sufficient cause
complete pie that represents a causal pathway for a disease
component cause
individual pieces of the pie
Necessary cause
a component that appears in every pie or pathway
descriptive epidemiology
person, place, time
person
characteristics: age, sex, occupation, of individuals affected by outcome
place
geography, residence, work, hospital of affected individuals
time
when events diagnosis, reporting, testing occurred
vasodilation
increase blood flow and cell permeability
analytical epidemiology
○ Test hypotheses about exposure and outcome relationship
○ Measure the association between exposure and outcome
○ Includes comparison group
○ Experimental and observational
Prevalence - know how to read a table of stats
extravasation
movement of WBC from capillaries to tissue
diapedesis
netrophils migrate
chemotaxis
macrophages transferred to the site
Exudate
the fluid, leukocytes, and debris that accumulate as a result of inflammation
Serous
Fluid containing little protein; colorless - simple cuts
Purulent/Suppurative:
Creamy yellow pus containing mostly inflammatory cells - infection
Fibrinous
Forms adhesions - sticky - burn
Hemorrhagic
Occurs when inflammation ruptures small capillaries - blood, dark red
Sanguineous
bright red, fresh blood (may be hemorrhagic), indicates active bleeding
percent of adults in US that are obese
41.9%
syndrome of hypers
○ More than 1 in 5 americans have metabolic syndrome
○ Apple shape
○ Blood pressure
○ Triglyceride level
○ Fasting blood glucose
HDL cholesterol ○
BMI classes
○ Underweight - under 18.5
○ Normal 18.5-24.9
○ Overweight 25-29.9
○ Obese 1 30-34.9
○ Obese 2 35-39.9
○ Obese 3 over 40
underweight
under 18. 5
normal weight
18.5-24.9
oveweight
25-29.9
obese 1
30-34.9
obese 2
35-39.9
obese 3
over 40
sleeve gastrectomy
cut off outer portion of the stomach so your stomach can’t expand as much as it could before, and you get full much quicker
Less risk, hormones that make you hungry are secreted in this part of the stomach
roux-en-Y
take a loop of your duodenum and connect it to top of stomach and disconnect most of the stomach - higher risk of bleeding and malnutrition
gastric banding
burst bands because just can’t stop eating
thrombus
stationary clot
embolus
moving clot
intrinsic pathway
caused by endothelia damage - veins and arteries
extrinsic pathway
caused by cellular injury - cellular injuries, poked
Vit K factors
2, 7, 9, 10
prevent DVT
○ Don’t smoke
○ Stay active/exercise
○ Maintain normal body weight and diet
○ Identify risk of birth control or HRT with physician
§ Hormone replacement therapy
○ Avoid alcohol
Leg compression pump, low blood thinner
virchow’s triad
○ Vessel wall injury
○ Stasis - not moving
Hypercoaguability
large pulmonary embolism
§ Completely block main pulmonary artery
§ Lungs not infarcted because of collateral blood flow
Cyanosis and shortness of breath
small pulmonary embolism
§ Raises pulmonary pressure
Wedge-shaped pulmonary infarct
pulmonary diagnosis
§ Patient’s clinical history
§ Lunch scan
§ Pulmonary angiogram
□ Gold standard
CT scan
ABC’s of diabetes
○ A1c test - less than 7%
○ Blood pressure less than 140/90
Cholesterol level for LDL less than 100
ketoacidosis
seen in type 1 more often
cardinal signs of inflammation
heat
redness
tenderness
swelling
pain
loss of function
intrinsic pathway factors
1,2,9,10,11,12
extrinsic pathway factors
1,2, 7, 10
A1c -normal, prediabetes, diabetes
normal - less than 5.7
prediabetes - 5.7- 6.4
diabetes - greater than 6.5
type 1 diabetes
○ Polyuria, polydipsia, weight loss associated with random plasma glucose greater than 200 mg/dL
○ Plasma glucose greater than 126 after overnight fast, documented on more than one occasion
○ Ketonemia, ketonuria, both
Islet autoantibodies are frequently present
type 2 diabets
○ Most patients are over 40 years of age and obese
○ Polyuria and polydipsia, ketonuria and weight loss are generally uncommon at time of diagnossis. Candidal vaginitis in women may be an initial manifestation many patients have few or no symptoms
○ Plasma glucose greater than 126 mg/dL after an overnight fast on more than one occasion two hours after 75g oral glucose, diagnostic values are greater than 200 mg/dL
○ HbA greater than 6.5
Hypertension, dyslipidemia, and atherosclerosis are often associated
acute inflammation
physical, chemical agent
immediate onset
hours to days
neutrophils, macrophages, eosinophils, mast cells, basophils
innate immunity, rash, pus, abscess
self-limited tissue injury
chronic inflammation
persistenet irritation infection, autoimmunity
slow, month to years onset
weeks, months, years duration
macrophages, lymphocytes, plasama cells, fibroblasts
acquired immunity, rash, fibrosis, granulosa
progressive tissue injury
metabolic syndrom
visceral obesity
insulin resistance
hypertension
high triglycerides
low HDL cholesterol
visceral obesity
men above 40
women above 35
insulin resistence
fasting gluclose greater than 100
hypertension
BP greater than 130/85
high triglycerides
above 150
low HDL cholesterol
women less than 50
men less than 40
metabolic syndrome
constellation of interrelated risk factors of metabolic origin that appear to directly promote the development of atherosclerotic cardiovascular disease (ASCVD) commonly manifest prothrombotic and proinflammatory state
homeostasis phase 1
thromboplastin formation
homeostasis phase 2
prothrombin to thrombin
homeostasis phase 3
fibrinogen to fibrin
bleeding problems phase 1
Hemophilia A, B, C, von willebrand’s disease
hemophilia A
classic hemophilia - factor 7 antihemophilic factor
hemophilia b
christmas disease. factor 9 christmas factor
hemophilia c
factor 11. plasma thromboplastin antecedent
von willebrand’s disease
vWF + factor 7
phase 2 bleeding problems
vit k synthesis or absoption problems. use of coumadin, broad-spectrum antibiotics, gallstone/tumor in common bile duct
phase 3 bleeding problems
afibrinogenemia, dysfibrinogenemia
local effects of inflammation
capillary dilation
incrased capillary permeability
attraction to leukocytes
systematic: fever, leukocytes
capillary dilation
incrased blood flow, warmth, redness
increased capillary permeabillity
extravasation of fluid swelling
attraction of leukocytes
chemotaxis, migrate to injury
adhere to endothelium of small blood vessells
step 1 of inflammation
- Release of vasoactive and chemotactic factors - trigger local increase in blood flow and capillary permeability
Mast cells release histamine and mediates vasodilation
step 2 of inflammation
- Capillaries dilate - increase blood flow to site of injury
i. Extravasation/diapedesis
Clotting begins via release of clotting factors and platelets
step 3 of inflammation
- Chemotaxis - cells migrate to site of inflammation
i. Inflammatory response continues until pathogen is eliminated and wound is repaired
histamine function
Histamine regulates a plethora of pathophysiological and physiological processes, such as secretion of gastric acid, inflammation, and the regulation of vasodilatation and bronchoconstriction (29, 30). In addition, it can also serve as a neurotransmitter
histamine agents?
- Agents may be physical (heat or cold) , chemical (concentrated acid) , or microbiologic (bacterium or virus)
HPA axis
mediates the effects of stressors by regulating numerous physiological processes, such as metabolism, immune responses, and the autonomic nervous system
disseminated intravascular coagulation system (DIC)
○ DIC- abnormal bleeding
○ Activates clotting mechanism using clotting factors
○ Fibrinolysin is activated
Net result? Hemorrhage - excessive bleeding
DIC
cause blood levels to drop
fibrinogen levels elevate
