Study Guide for Exam 2 Chapters 3, 4, and 7-12 PH 300 ___________________________ WIC Program: Is a clinic-based program designed to provide a variety of nutritional and health-related goods and services to pregnant, postpartum, and breastfeeding women, infants, and children under the age of 5; Program criteria (Reside in the state in which applying, Meet income guidelines (<185% of poverty line), Are determined to be at ?nutritional risk? by a health care professional) Psychotherapy: Treatment through verbal communication with a mental health counselor Prevalence rate: Calculated by dividing all current cases of a disease (old & new) by the total population UNICEF: United Nations Children?s Fund; advocates for children Psychopharmacology: Treatment of mental illness with medications Infectivity: The ability of a biological agent to enter and grow in a host (ease of transmission) Gerontology: Study of aging from the broadest perspective (e.g., biological, psychosocial, economic) Endemic: Diseases that occur regularly in a population as a matter of course Pathogenicity: The ability of a communicable disease agent to cause disease in a susceptible host (Might the agent have a latency period? Might the infected host be asymptomatic?) Geriatrics: Medical practice specializing in treatment of the aged Epidemic: An unexpectedly large number of cases of an illness, specific health-related behavior, or other health-related event in a particular population Atherosclerosis: Narrowing of the blood vessels resulting from the build-up of fatty deposits on the walls of the blood vessel Refugees: People who flee their nations due to danger Pandemic: Outbreak of disease over a wide geographical area such as a continent; (e.g., the flu pandemic of 1918-19 that left millions of people dead worldwide) Cerebrovascular disease: Stroke; Blood supply to the brain is disrupted; third most common cause of death Immigrants: People who voluntarily migrate from one country to reside permanently in another country Incidence rate: The number of new health-related events or cases of a disease in a population exposed to that risk in a given time period Describe the period of time?for mother, infant, and child?that is covered by MIC health: The health of women of childbearing age from pre-pregnancy through pregnancy, labor, and delivery, the postpartum period and the health of the child prior to birth through adolescence Name three criteria a woman must meet before she and her infant(s)/children can receive WIC support: Reside in the state in which applying, Meet income guidelines (<185% of poverty line), Are determined to be at ?nutritional risk? by a health care professional. Explain the scope of teenage pregnancy in the U.S., its socioeconomic dimensions, and some of its health impacts: Teenagers who become pregnant and have a child are more likely than their peers who are not mothers to drop out of school, not get married or have a marriage end in divorce, rely on public assistance, or live in poverty; Have substantial economic consequences for society in the form of increased welfare costs; $7 billion annually in direct costs associated with health care, foster care, and public assistance; Result in serious health consequences for these women and their babies; Less likely to receive prenatal care; Due in large part to effective community health programs and public health campaigns, teen pregnancy and birth rates have steadily declined in recent years; Between 1991 and 2004, the teenage birth rate in the U.S. declined 33% to a record low of 41.2 births per 1,000 teenage girls in 2004.; Despite the recently declining rates, 31% of teenage girls are pregnant once before they reach age 20, resulting in approximately 750,000 pregnancies a year. Define ?family planning? and list three examples of family planning services: The process of determining the preferred number and spacing of children in one?s family and choosing the appropriate means to achieve this preference; Effective family planning includes preconception education, good obstetrics, gynecological, maternal, and child care; Governmental health programs include Title X of Public Health Service Act, Maternal and Child Health Bureau, Social Service Block Grants, State funds; Title X provides funding support to approximately 61% of the 4,000-plus family planning clinics nationwide; Annually, 4.8 million women receive health care services at family planning clinics that are funded by Title X; These clinics serve persons who are predominantly young, poor, uninsured, and have never had a child Describe four ways in which infant health can be improved: Reducing premature births, which are babies born prior to 37 weeks? gestation; Reducing low birth weight, which are infants that weigh 5.5 pounds or less at birth, by providing women with a nutritious diet; Reducing smoking during pregnancy; Eliminating maternal alcohol use; Increasing breastfeeding rates; Placing babies on their back to sleep Name the three leading causes of death among young adults: Unintentional injuries (mostly from vehicle crashes); many include use of alcohol (45%), Homicides (16%), Suicides (12%) Explain why men are more likely than women to have a spousal caregiver in later life: More elder men are married than women because they (1) have shorter life expectancies, (2) tend to marry women younger than themselves, (3) more likely to remarry if they lose their spouse?thus, unlike elder women, most men have spousal assistance as they age Discuss three ways in which elderly persons often pay for long-term care (e.g., nursing home, assisted-living): Medicare or Medigap, Social Security, Personal Income In a democratic context, why should we address health issues in relationship to race and ethnicity?: Advances in medical technology, lifestyle improvements, and environmental protections have all led to health gains. Yet these changes have not produced equal benefit in some racial and ethnic populations. This is the continuing challenge to public health professionals and the standard we must keep in mind when measuring our progress: what is the health status of the least-empowered among us? Describe U.S. citizens of Hispanic origin in terms of their general/typical socioeconomic status: In 2005, 42.7 million or 14.4% of U.S. population; Largest minority group in America; Lowest education levels; Lower incomes; Higher poverty rates; Religious beliefs play important role in health; For many Hispanics, good health is seen as a matter of fortune or reward from God for good behavior. Articulate three of the goals of the Indian Health Service: Assist Indian tribes in developing health programs; Facilitate and assist Indian tribes in coordinating health resources; Provide comprehensive health care services; Serve as a Federal advocate for the health of Indians and Alaska Natives Explain three actions that can be taken to prevent type II diabetes: Lowering intake of simple carbohydrates and eating a balanced diet; Increasing activity/exercise; Responding to symptoms of hyperglycemia (e.g., high levels of sugar in urine and blood, frequent urination and thirst) List the six principles of cultural competence: Understand? 1. Cultural beliefs and practices of the group (e.g., sex education taboos, patriarchy); 2. Historical factors that impact health (e.g., unfamiliarity with refrigeration, prescription drugs, hospitals, etc.); 3. Psycho-social stressors that impact health (e.g., poverty, violence, ideals of ?success? within a particular culture or minority group); 4. Cultural beliefs about health (e.g., respect for plumpness, dumbfounded by exercise); 5. Indigenous healing practices (e.g., the influence of ?spirits,? coining); 6. Public health policies as they relate to the needs or rights of minority groups (e.g., IHS, WIC, free/low-cost vaccinations) Describe the scope and severity of mental illness in the U.S.: Mental illness is the leading cause of disability in the U.S., Canada, & Western Europe; Mental illness is a major health issue; 22?23% (44 million) of American adults have diagnosable mental disorders each year; another 6% have addictive behaviors; 3% have both mental & addictive disorders; Only 1/4 to 1/3 of those diagnosed receive treatment; 5 million adults in U.S. have ?serious? mental illness Briefly contrast mental healthcare in the U.S. before WWII with mental healthcare in the U.S. after WWII: Mental Health Care before WWII; In colonial America, families were seen as responsible for the mentally ill; Dorothea Dix (1802-97) was an advocate for those with mental illness; she believed that the state was responsible for the care of mentally ill persons; As a result of Dix?s work, the number of state hospitals grew rapidly during the last 25 years of the 19th century; Mental Hygiene Movement (1st decades of 20th century; Dr. Adolf Meyer (1866?1950) felt acute care should be provided in new psychopathic hospitals; Clifford Beers (1876?1943) bipolar mood disorder who was repeatedly hospitalized founded what is now called the National Mental Health Association; By 1940, care in crowded mental hospitals was very basic, non-therapeutic, and focused only on sustaining the lives of patients; Mental Health Care during/after WWII; In the 1940s, new treatments for mental illness, such as electroconvulsive therapy (ECT) and lobotomy, were developed and often used; ECT: electric current produces convulsions in the patient; today, Medicare pays/reimburses mental healthcare providers for the use of this therapy; Lobotomy involved the surgical severance of nerve fibers in the brain; between 1939 & 1951 18,000 of these surgeries were performed in the U.S.; In the 1950s, antipsychotic and antidepressant drugs were introduced, replacing lobotomies; During WWII, conscientious objectors (COs) founded the National Mental Health Foundation, served in mental health agencies, and brought the deterioration of mental hospitals to public attention; Through the National Mental Health Act of 1946, the National Institute of Mental Health (under the NIH) was established; In the early 1950s, the public became increasingly aware of the poor condition of state mental hospitals; Deinstitutionalization, which involves the discharging of patients from state-owned mental hospitals to less-restrictive community settings, became increasingly common; Deinstitutionalization was propelled by economics (e.g., Medicaid reimbursements for outpatient mental health services), legal considerations (i.e., court decisions re mental patients as citizens with full rights), and the use of antipsychotic drugs; In 1961, a report of the Joint Commission on Mental Illness and Health recommended that acute mental illness be treated in community-based settings; So, from 1966 to 1989, 750 community mental health centers were created and were eligible for Medicare dollars if core services were provided; The 1970s and ?80s saw the failure of CMHCs to meet the needs of the deinstitutionalized mentally ill; Initiation of Community Support Program (CSP) to promote recovery in persons with serious and persistent mental disorders; CSPs recognized chronic mental illness problems as social welfare problems because the mentally ill often lack income, housing, vocational training, etc.; CSPs focus on the psychosocial rehabilitation of the mentally ill by providing services (e.g., employment and education support) Articulate the three, significant problems that a national mental healthcare program in the U.S. should address: (1) mental illness among the homeless (2) mental illness among inmates in jails and prisons (3) making mental healthcare services accessible and affordable Describe three personal and/or community consequences of drug use: Absenteeism from school/work, lost productivity, marital/family problems, crime, imprisonment, healthcare costs, etc. Contrast over-the-counter (OTC) drugs and prescription drugs: Over-the-counter (OTC) drugs: Legal drugs, with the exception of alcohol & tobacco that can be purchased without a doctor?s prescription; Regulated by the FDA; Misuse examples: not following dosage directions (e.g. laxatives & appetite suppressants) & taking after expiration dates; Prescription drugs: Require a physician?s (or dentist?s) prescription; Also regulated by FDA; More than 4,000 prescription drugs; Misused in similar ways as OTC, e.g., one person?s giving his/her prescription drug to another person; Abuse levels much lower than for alcohol & tobacco; Concerns: dependence, adverse drug reactions, and creating drug-resistant pathogens Describe a particular substance abuse problem (your choice); next, list the 6 factors affecting health; finally, cite examples of four of those factors in relationship to the substance abuse problem: Alcoholism; environmental, social, biological, psychological, intellectual, and spiritual; peer pressure as a social factor; heredity as a biological factor, low self respect as a psychological factor and family and family and living arrangement for environmental factor. Describe the scheme/graph for the reporting of notifiable diseases (do not include the summary reports): Infectious diseases that health officials request or require reporting; National Electronic Telecommunications System (NETS)? the electronic reporting system used by state health departments and the CDC; Morbidity and Mortality Weekly Report (MMWR)? a report of CDC used to present notifiable disease data; Re epidemiological studies, describe an example of a case/control study and an example of a cohort study: Case/control study (retrospective): one that seeks to compare those diagnosed with a disease with those who do not have the disease for prior exposure to specific risk factors; Cohort study (prospective study): one in which a cohort is classified by exposure to one or more specific risk factors and observed to determine the rates at which disease develops in each group List three ways of classifying diseases and the alternatives under each classification (e.g., duration of illness; acute and chronic): Causative agents for a disease: biological, chemical, physical; duration of illness: acute and chronic; transmittable: communicable vs. non communicable Draw a chain of infection for a particular disease (your choice), label each of its ?links,? and, for that disease, identify each ?link?: HIV; Pathogen: Virus; Reservoir: Human; Portal of Exit: wound, urogenital tract; Modes of Transmission: Direct immediate transfer, direct contract, droplet spread; Portal of Entry: oral, wound, intravenous, urogenital tract; New Host: Another Human Define primary, secondary, and tertiary prevention; in relationship to a particular disease (your choice), give an example of each of these ?levels? of prevention: Primary Prevention? measures that forestall the onset of illness or injury during the pre-pathogenesis period (Gardasil immunization); Secondary Prevention? measures that lead to early diagnosis & prompt treatment of a disease or injury to limit disability or prevent more severe pathogenesis (Pap Smears); Tertiary Prevention? measures aimed at rehabilitation following significant pathogenesis (counseling, safe sex practice)
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