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NURS342 - Global Health > Quiz 2 > Flashcards

Quiz 2 Flashcards

1
Q

What does a health system consist of?

A

All the people, policies and programs that work to promote health and prevent disease in a country

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2
Q

What is pooled risk?

A

Assumes that if many low-risk people and a few high-risk people all pay premiums to the insurance system over many years, then there will be a part of the money that can be used to pay for major illnesses when they occur.

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3
Q

What are health insurance systems funding based on?

A

Pooled risk

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4
Q

What do universal health care systems do?

A

Increase equity in access and improve efficiency of health system by decreasing overuse of health services by the poor

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5
Q

In the long run, which form of health care system saves on health care costs?

A

Universal health care

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6
Q

High-income countries usually spend more on what per person? And have a higher percentage of what than low-income countries?

A

Health care per person. Percentage of GDP.

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7
Q

Govt of higher-income countries pay what in relation to low-income countries?

A

Higher percentage of health-care costs.

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8
Q

In privatized health care systems, the insurance companies have what option when their customers are people with pre-existing medical conditions, elderly? What can this result in?

A

Charge higher premiums. Can prevent individuals/families from accessing health insurance and many are at risk of bankruptcy if serious illness occurs.

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9
Q

Do people living in low-income or high-income pay for health care out of pocket?

A

Low-income

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10
Q

Payment for health can be divided into what two categories?

A

Money spent of personal health and money spent on public health.

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11
Q

What are examples of things of money spent on personal health?

A

Medications, glucose test strips etc

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12
Q

What are examples of things of money spent on public health?

A

Activities that protect a community (vaccines)

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13
Q

Local and national government funds for health care.. where does this money come from?

A

Taxes collected by the government providing those services.

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14
Q

What is bilateral aid?

A

Money given directly from one country to another.

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15
Q

What are the different forms of bilateral aid?

A

Equipment, commodities (food), training and expert advice, cash transfers or economic infrastructure development (health clinics/schools)

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16
Q

What must a country be a member of to give bilateral aid to a low-income country?

A

Development Assistance Committee

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17
Q

What are the five donor nations that provide the greatest amount of official development assistance (ODA)?

A

USA, UK, France, Germany, Japan

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18
Q

What is multilateral aid?

A

Money pooled from many donors in form of loans

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19
Q

What are two multilateral agencies most involved in offering loans?

A

World Bank and IMF

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20
Q

What does the World Bank do?

A

Investment bank that makes loans to developing countries, usually for infrastructure projects

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21
Q

What does the IMF do?

A

Provides a structure for international monetary policy and currency exchanges and also makes loans to countries of any income level that have a balance of payment needs would otherwise not be able to make payments on other international loans

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22
Q

World Bank interest rates are higher/lower than market rates?

A

Higher

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23
Q

IMF interest rates are higher/lower than market rates?

A

Lower

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24
Q

What sort of private foundations give money to global heath?

A

Bill and Melinda Gates Foundation (>1 billion per year)

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25
Q

What sorts of businesses give funds to global health? In what forms might these funds be?

A

Pharmaceutical companies (drugs and other products), other companies fund health programs

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26
Q

Some individuals donate money through foundations like Save the Children/World Vision etc. What type of donation is this?

A

personal donation

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27
Q

What types of global health programs are there?

A

research and education activities, clinical services provided by hospitals etc, relief aid, community dev programs, advocacy initiatives, logistics

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28
Q

What provides the bulk of health services and payment for health systems?

A

National government

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29
Q

Which govt is responsible for public health system and sponsoring health research?

A

National

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30
Q

What is the goal for UN agencies?

A

Maintain international peace and security, develop friendly relations among nations and achieve international cooperation in solving international problems

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31
Q

What is the main agency of the UN?

A

WHO

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32
Q

What is “international cooperation” of the national govt?

A

national govt involved in sponsoring relief and dev work internationally and cooperatively

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33
Q

what are global health partnerships?

A

non profit public-private partnerships working towards accomplishing goals for selected global health issues

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34
Q

what does an NGO focus on? where do they receive funding from? what are benefits/challenges for NGOs?

A

focus on particular issues or may address multiple issues, involved in spectrum of relief aid, dev work, advocacy and logistics. funding from private sources. BENEFITS: can do important on-the-ground pub health work CHALLENGES: directed donation, autonomy for local workers, policies and neutrality

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35
Q

which high-income health care system is the only privatized one?

A

USA

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36
Q

what is GH funding targeted at?

A

aiding mutual goals

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37
Q

what does the Ottawa charter outline?

A

Things needed for pub health (food, shelter, peace etc)

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38
Q

what are the main goals of the PHAC?

A

promote health, prevent and control chronic diseases/injuries, prevent/control ID, prep for/respond to pub health emergencies, central point for sharing Canada’s expertise with world, apply international research and dev, strengthen inter govt collaboration.

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39
Q

How many member countries are apart of UN?

A

193

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40
Q

What does global affairs Canada do?

A

Strengthen Canadas contribution to decrease poverty/inequality, support fragile states, build resilience and respond to humanitarian needs

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41
Q

what are some goals of global affairs Canada?

A

create policy/framework to focus Canadas assistance on helping poorest/most vulnerable, improve health of women/adolescents/children, foster dev/innovation/effectiveness, provide timely effective and coordinated needs-based responses to humanitarian needs

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42
Q

What are the MDGs?

A

8 goals to decrease global poverty

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43
Q

How many countries endorsed the MDGs

A

200

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44
Q

How many targets and indicators used to assess whether targets are being reached for MGDs?

A

8 targets and 48 indicators

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45
Q

What are the 8 MDGs?

A
  1. Eradicate extreme hunger and poverty
  2. Achieve universal primary education
  3. Promote gender equality and empower women
  4. Decrease child mortality
  5. Improve maternal health
  6. Combat HIV/AIDS, malaria, TB
  7. Ensure environmental sustainability
  8. Develop a global partnership for development
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46
Q

What is sustainability?

A

Aims to provide for current human needs without compromising the ability of future generations to meet their needs.

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47
Q

What is cost-effectiveness analysis?

A

Aim to ensure that funds are used for a global health initiative are effective at achieving planned outcomes and make efficient use of financial and other resources

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48
Q

In the 1800s, what was the theory of disease causation?

A

Miasma atmospheres - epidemics spontaneously occurred in places with poor sanitation/accompanying foul odours from human waste

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49
Q

What aspects does environmental health look at?

A

Where people live, work, materials used to construct buildings, food, air quality etc.

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50
Q

What 5 factors need to be considered for safe drinking water?

A

Quality, quantity, proximity, reliability and cost.

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51
Q

What is considered when discussing quality of drinking water?

A

Water must be clean enough to drink safely.

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52
Q

What is considered when discussing quantity of drinking water?

A

Enough water available to drink

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53
Q

What is considered when discussing proximity of drinking water?

A

Water is easy to access and people don’t have to walk far to get water.

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54
Q

What is considered when discussing reliability of drinking water?

A

Water source must be available and functioning

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55
Q

What is considered when discussing cost of drinking water?

A

Water must be affordable

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56
Q

What percentage of urban and rural population has access to improved drinking water?

A

Less than 90% urban and less than 40% rural

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57
Q

What percentage of fresh water is used for irrigation and livestock?

A

70%

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58
Q

What are the “6 F’s” contributing to diarrheal diseases?

A

Feces, fluids, fingers, food, flied, fields.

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59
Q

6 F’s: Feces

A

Feces not properly disposed of

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60
Q

6 F’s: Fields

A

Feces not being properly disposed of contaminate fields (soil)

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61
Q

6 F’s: Fluid

A

Feces to properly disposed of contaminate body of water

62
Q

6 F’s: Fingers

A

Feces not properly washed off of hands

63
Q

6 F’s: food

A

Feces not properly washed off of hands transmitting to food

64
Q

6 F’s: flies

A

Flies spread faces to food

65
Q

What is the issue in households without electricity?

A

Burning fuel for light leading to air pollution.

66
Q

What are some hazardous compounds found in the smoke in homes when fuel is burned?

A

Sulfur oxides, nitrous oxides, aldehydes etc.

67
Q

What issues can chemicals in the air cause?

A

Lung diseases

68
Q

What are some ways to decrease exposure to indoor air pollution?

A

Improved cooking devices, use alternative energy sources (solar panels), increase ventilation, change behaviours (keep kids away from smoke etc)

69
Q

What was one of the first public health specialities?

A

Occupational health

70
Q

What is toxicology?

A

Study of harmful effects the chemicals and other environmental hazards like radiation have on living things

71
Q

What are carcinogens?

A

Can cause genetic mutations that lead to CA

72
Q

What are teratogens?

A

Things that cause birth defects

73
Q

What is ecotoxicology?

A

Examine the impact of toxic exposures on populations, communities, and ecosystems

74
Q

What are some of the main hazardous substances present in the USA?

A

Arsenic, lead, mercury, vinyl chloride, PCB, benzene, cadmium,PAH

75
Q

What are the two main types of eukaryote parasites?

A

Protozoa and helminths

76
Q

What are the characteristics of protozoa?

A

They are single-celled organisms that have animal-like characteristics and often live in water.

77
Q

What is becoming a concern for many parasitic infections?

A

Drug resistance

78
Q

When do fungal infections typically occur?

A

After bacteria normally live in or on the body are disrupted by antibiotics or immunosuppression

79
Q

Where does fungi thrive?

A

Dark, moist environment.

80
Q

Natural history of an infectious disease?

A

Usual timeline from exposure to a particular agent to either recovery or death

81
Q

Infectivity?

A

Capacity of an infectious agent to cause infection in a susceptible human

82
Q

How is infectivity sometimes measured?

A

Secondary attack rate

83
Q

What is the secondary attack rate?

A

Average number of other people that one contagious person infects

84
Q

When is it considered “infection”?

A

When the infectious agent begins to reproduce inside a person

85
Q

What occurs in the latent phase/incubation period?

A

Infectious agent multiplies in the host but the infected individual doesn’t feel sick, even if he or she is contagious.

86
Q

Do all infections lead to disease?

A

no

87
Q

What is pathogenicity?

A

Capacity of an infectious agent to cause disease I an infected human.

88
Q

How is pathogenicity measured?

A

By the proportion of individuals with lab-confirmed infection who became ill

89
Q

What is virulence?

A

Ability of an infectious agent to cause severe disease or death in a host

90
Q

How is virulence measured?

A

Measured by the proportion of severe or fatal cases among all people who have the disease

91
Q

Virulent infections will have what?

A

A high case fatality rate

92
Q

What is a reservoir?

A

Environmental home for an infectious agent

93
Q

What is anthroponoses?

A

Infectious diseases that only occur in humans

94
Q

What is zoonoses?

A

Infectious diseases that usually occur I animals and only occasionally infect humans

95
Q

What is the cycle of infection?

A

Describes how an infectious agent cycles between different species

96
Q

How can diarrheal diseases and food borne diseases be prevented?

A

Safe food handling, frequent hand washing, consistent access to clean drinking water, community-wide sanitation

97
Q

What are arthropods?

A

Insects and arachnids (spiders, ticks, mites)

98
Q

What are arboviruses?

A

Viruses spread by arthropods

99
Q

How can vector-borne diseases be prevented?

A

Minimize insect bites via use barriers/chemical repellents, insecticides to decrease insect population

100
Q

What are neglected tropical diseases (NTDs?)

A

Infectious diseases that primarily infect the poorest regions of the world and haven’t been a priority for funding agencies, pharmaceutical companies, or global policy makers

101
Q

What is the health belief model?

A

Decision of an individual to engage in a healthier behaviour is dependent on person’s perceptions about susceptibility to disease, severity of disease, ability of behaviour to prevent disease, barriers to implementing change and the cost-benefit ratio for taking action.

102
Q

What environmental control methods can be done to reduce infection transmission?

A

Change breeding groups, sanitation, increase drinking water quality, waste management, decrease air pollution, decrease mosquito/rodent/snail population, food safety regulation.

103
Q

What is active immunity?

A

Body has lasting memory of infection

104
Q

What is passive immunity?

A

Acquired through breast milk

105
Q

What is herd immunity?

A

Contains epidemics. People who aren’t vaccinated are safer because of people who are.

106
Q

What is mass-drug administration (MDA)?

A

Routine distribution of antibiotics/antiparasitics to population with increased prevalence of treatable infections. Often used to de-worm school children.

107
Q

What does surveillance do?

A

Tracks ID reports from hospitals and other sources to look for patterns and outbreaks

108
Q

What is spatial clustering?

A

High incidence of disease in a particular place

109
Q

What is temporal clustering?

A

High incidence disease in a particular time

110
Q

What is passive surveillance?

A

Collects reports or notifiable disease diagnoses from medical labs

111
Q

What is sentinel surveillance?

A

Information from continuous monitoring at several selected ‘sentinel’ sites issued to alert public health officials to possible changes in community health status

112
Q

Active surveillance?

A

Public health officials contact healthcare provider to ask about whether they’re seeing a particular disease

113
Q

Endemic disease?

A

Always present in a population

114
Q

Epidemic/outbreak?

A

Disease is occurring more often than usual and there are more than a few sporadic occurrences of a disease

115
Q

Pandemic?

A

Worldwide epidemic, like some influenza epidemics

116
Q

What is elimination of an infectious agent?

A

Control measures remove all risk of new infection in a region?

117
Q

What is quarantine?

A

Limit movement of ill individuals

118
Q

What is eradication of an infectious agent?

A

Achieved when there is no risk of infection or disease anywhere in the world even in abstinence of immunization or any control measures

119
Q

What is extinction of an infectious agent?

A

Complete when an agent no over exists in nature or in the lab

120
Q

What are the ‘big three’?

A

HIV, TB, malaria

121
Q

How is HIV transmitted?

A

Blood, semen, vaginal fluid, breastmilk. Sharing needles, sexual contact, MTCT.

122
Q

What does the HIV virus do?

A

Destructs CD4 cells necessary to fight infections.

123
Q

What is AIDS?

A

A syndrome that occurs as a result of the destruction of the immune systems

124
Q

What are opportunistic infections?

A

Occur when the body’s immune system is weakened enough to give the infectious agents an opportunity to invade

125
Q

Clinical stages are grouped into 4 stages. What happens in the 1st and 2nd stages?

A

Asymptomatic, or if symptoms are present they’re mild.

126
Q

Stage 3 clinical stage of HIV?

A

More severe manifestations, increased viral load and decreased CD4 count

127
Q

Stage 4 clinical stage of HIV?

A

Serious OI’s mark onset of AIDS. Very low CD4 count/undetectable CD4 levels

128
Q

What is HAART?

A

Best current treatment for HIV extending lives from years to decades

129
Q

AIDS orphans?

A

Children who have lost both parents and at least one of them to HIV/AIDS

130
Q

Are people with latent TB contagious?

A

No

131
Q

What is the number of people who have been exposed to TB bacteria? What percentage actually develop active TB?

A

1/3. 10%

132
Q

What is DOTS?

A

Observer must watch TB patient take all medications every single day.

133
Q

Case detection rate?

A

Proportion of those with TB disease who are diagnosed as having the disease.

134
Q

Default rate?

A

Proportion of people who are diagnosed but don’t complete full course of treatment.

135
Q

If someone stops their treatment part way through for TB and develops MDR-TB, what type of regimen are they put on? How much longer is the course of treatment extended?

A

DOTS-plus. Extended from 6 months to 2years.

136
Q

What are new concerns in regards to TB?

A

Extensively drug resistant TB (XDR-TB) and totally drug resistant TB (TDR- TB)

137
Q

The BCG vaccine protects what proportion of individuals who get it?

A

50%

138
Q

What is the screening for TB?

A

PPD test (intradermal injection of TB proteins) then if that comes back positive need to get CXR

139
Q

What are the manifestations of malaria?

A

Cyclic fevers, headaches, joint pain, organ failure (maybe)

140
Q

What transmits malaria?

A

Female anopheles mosquitoes

141
Q

Where do more than 90% of deaths due to malaria occur?

A

Sub-Saharan Africa

142
Q

What is the growing concern with malaria?

A

It is becoming resistant to many anti-parasite drugs (chloroquine)

143
Q

What is Artemisinin-Based Combination Therapy (ACT)?

A

Treatment regimen for malaria. Slows the emergence of drug resistant malaria

144
Q

What is a good method of preventing malaria?

A

Insecticide-treated bednets (ITN) acts as a barrier to mosquitoes and kills them too

145
Q

Who is most at risk for death related to influenza?

A

Elderly and immunocompromised

146
Q

Does influenza only affect humans?

A

No, it affects chickens, ducks, horses, dogs, whales, and bats too.

147
Q

Which strains of influenza are most common in humans?

A

A and B

148
Q

The influenza A virus is further classified how?

A

By the surface antigens (hemagglutinin and neuraminidase)

149
Q

Antigenic drift

A

Small genetic mutations bring about small changes to surface antigens of influenza virus

150
Q

Antigenic shift

A

Occurs when two very different influenza viruses attack the same cell and genetic material from both recombines to form a new type of influenza

NURS342 - Global Health (3 decks)

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