Examples of Social Determinants of Health.

1) conditions in which people are born

2) grow up

3) live

4) learn

5) work

6) play

7) worship

8) age

Match the following aspects of the definition of Population Health with the examples that follow:

1. Monitor health=
2. Diagnose and investigate=
3. Inform, educate, and empower =
4. Mobilize community partnerships=

1. Inform, educate, and empower people about health issues.
2. Monitor health=status to identify community health problems.
3. Diagnose and investigate health problems and health hazards in the community.
4. Mobilize community partnerships to identify and solve health problems.

Match the following aspects of the definition of Population Health with the examples that follow:

1. Develop policies =
2. Enforce laws=
3. Assure =
4. Evaluate =
5. Research =

1. Develop policies and plans that support individual and community health efforts.
2. Enforce laws and regulations that protect health and ensure safety.
3. Link people to needed personal health services and assure the provision of health care when otherwise unavailable.
4. Assure a competent public health and personal health care workforce.
5. Evaluate effectiveness, accessibility, and quality of personal and population-based health services.
6. Research for new insights and innovative solutions to health problems

What are the six Core Public Health Functions?

• Prevents epidemics and the spread of disease
• Protects against environmental hazards
• Prevents injuries
• Promotes and encourages healthy behaviors
• Responds to disasters and assists in recovery
• Assures the quality and accessibility of health services

Match the following Essential Health Services with the examples that follow:

_{Monitor health status to identify and solve community health problems
Diagnose and investigate health problems and health hazards in the community
Inform, educate, and empower people about health issues
Mobilize community partnerships and action to identify and solve health problems
Develop policies and plans that support individual and community health efforts
Enforce laws and regulations that protect health and ensure safety
Link people to needed personal health services and assure the provision of health care when otherwise unavailable
Assure competent public and personal health care workforce
Evaluate effectiveness, accessibility, and quality of personal and population-based health services
Research for new insights and innovative solutions to health problems}

Explain Self Determination Theory?

Self-determination theory (SDT) is a macro theory of human motivation and personality that concerns people's inherent growth tendencies and innate psychological needs. It is concerned with the motivation behind choices people make without external influence and interference. SDT focuses on the degree to which an individual's behavior is self-motivated and self-determined

The steps of the P.E.R.I.E. model are re-phrased below. Put them in the correct chronological order.

P-problem

E-etiology

R-recommendations

I-implementation

E-evaluation

Match the following criteria for determining a cause-effect relationship with the following examples:

Time Order:

Context:

Time Order - The change in X must occur before the change in Y : It is often difficult to establish cause-effect relationships in social research because it can be difficult to determine which came first.

Example - The more severe an individuals substance abuse problem the more likely he/she is to commit crimes. began using drugs at 14 --> began committing crimes at 17

Context - Set of circumstances surrounding an event or situation. No cause has its effect apart from some larger context involving other variables. -When, for whom, and in what
conditions does this effect occur. A cause is really one among a set of interrelated factors require

The cause is associated with the effect- people with lung cancer are more frequently smokers

The cause precedes the effect-smoking comes before development of lung cancer

Altering the cause alters the effect-reducing smoking reduces lung cancer rates

Which of the following ancillary or supportive criterion is addressed in each of the following statements?

The mechanism that predisposes some infants to SIDS is unknown, but active research is beginning to identify predisposing factors related to brain development.

a.Strength of the association

b.Dose-response relationship

c.Consistency

d.Biological plausibility

d.Biological plausibility

Which of the following ancillary or supportive criterion is addressed in each of the following statements?

The relative risk or odds ratio for sudden infant death syndrome (SIDS) and infants that sleep prone is approximately 6.

a.Strength of the association

b.Dose-response relationship

c.Consistency

d.Biological plausibility

b.Dose-response relationship

Match the following components of the evidence-based public health approach to the description that follow:

Case-control studies were important in establishing a cause and effect relationship between having infants sleep prone and sudden infant death syndrome.

a.Problem description

b.Etiology

c.Recommendations

d.Implementation and evaluation

b.Etiology

The following is true of a primary intervention:

Takes place before the onset of the disease the aim is to prevent the disease

Match the following types of interventions with the situations that follow.

1. Primary Intervention=
2. Primary Intervention =
3. Secondary Intervention=
4. Secondary Intervention =
5. Tertiary Intervention =
6. Tertiary Intervention=

Several levels of intervention: individual (knowledge & skills), relationship influence (peer pressure), Community (resources, access), Societal (norms, values)

1. Primary Intervention - Education
2. Primary Intervention - Obligation
3. Secondary Intervention - Education
4. Secondary Intervention - Motivation
5. Tertiary Intervention - Education
6. Tertiary Intervention - Obligation

What are vital statistics?

Information collected on births, deaths,marriages, divorces and some reportable diseases

Which of the following is/are important feature(s) of a high quality Web site?

The objectivity of the web site, recent updating of the web site, the presence of references for the data or conclusions presented on the web site

The availability of information on the source of funding for the Web site

The most important use is the compilation of data to generate summary measurements of the health group or population

Which of the following types of data is illustrated by the examples that follow?

Mad cow disease is diagnosed in a cow and the entire herd is subsequently slaughtered? - Single case or small number of cases

Which of the following are uses of qualitative data in public health?

a.Generating hypothesis

b.Provide insight into how and why people come to particular conclusions

c.Help assess possible barriers to successful implementation of an intervention

d.All of the above are correct

d.All of the above are correct

Match the following cause of information bias with the examples that follow also called measurement bias, arises when key study variables (exposure, health outcome, or confounders) are inaccurately measured or classified.

Types of bias?

1. Selection bias (area of data was chosen, not random)
2. Outliers in data
3. Overfitting or underfitting data
4. Confounding variables (outside forces that couldn't be controlled)

Match the following public health decision making strategies:

Inform of decision:

Informed consent:

Shared decision making:

Inform of decision—has all the information to make the decision

Informed consent---patient needs to give consent before intervention as surgery

Shared decision making---provide information so patient can make a decision

Which of the following best describes the contributions of social sciences to public health?

1. A) Public health can be viewed as an application of many of the social sciences
2. B) The relationship between social sciences and public health is a recent development
3. C) Public health is a quantitative discipline while social sciences are qualitative
4. D) Public health rarely utilizes social sciences

1. A) Public health can be viewed as an application of many of the social sciences

Which of the following is NOT included in the definition of socio-economic status as used in the United States?

Socioeconomic status includes your family income, educational level or your parents educational level, and professional status or parents professional status

Which of the following types of behaviors is typically easiest to change?

New behaviors that can be substituted with alternative short term needs

Match the following principles of United States health law with the examples that follow.

A World Health Organization=

A provision of International law=

A local convenience store=

World Health Organization document which attempt to restrict Internet advertising of cigarettes is ignored by tobacco companies in the United States. Which principle of United States health law does this apply?

A provision of International law does not apply in the United States unless United States law incorporates the provision such as ratification of a treaty by the United States Congress.

-A local convenience store is fined on the basis of state law for selling cigarettes to minors. Which principle of United States health law does this apply?

Police power allows states to pass legislation and take actions to protect the common good

Match the following types of law with the examples that follow.

Constitutional Law=

Legislative statutes=

Administrative regulations=

Administration=

Judicial law=

Constitutional Law - Bill of rights, First Ten Amendments ( The constitution trumps any other law).

Legislative statutes - Statutory law, ex: The entire U.S. Tax code.

Administrative regulations - the regulation and operation of the Social Security Administration (rules and regulation law)

Judicial law - Original Jurisdiction and Appellate Jurisdiction (systems of courts, court hearings) .

All of the following protections are provided to research subjects except:

The right to be informed of the treatment to which they have been assigned before beginning the treatment

Which of the following represents the status of a right to health care in the United States?

Through legislation, the United States Congress has established a limited right to health care under specific circumstances, such as access to care in emergencies and child birth

Match the following categories of law with the following examples:

_{An example of Constitutional law:}

_{An example of Legislative statutes:}

_{An example of Administrative regulations:}

_{An example of Judicial law/ Case Law:}

_{An example of Constitutional law: the United States Supreme Court determines that there is a right to privacy.}

_{An example of Legislative statutes: Congress authorizes funds for the states to build highways contingent on passage of state law raising the drinking age to 21.}

_{An example of Administrative regulations: The Department of Health and Human Services writes a series of rules to implement a recently passed bill designed to ensure the safety of newly approved drugs.}

_{An example of Judicial law/ Case Law: A state court rules that state law permits a resident physician to testify in a malpractice suit to provide information on the expectations of clinical practice in his future specialty.}

Place the following steps for the public health Upstream Multiple Risk Factor?

Cause of Death, Morbidity, Behaviors or Environment, SDOH and Policy

Which of the following is/are true of tests used for screening for disease?

a)One positive screening test is not usually sufficient to diagnose a disease

b) Changes within the range of normal can be due to a disease

c) The range of normal is not the same for all groups or populations

d) All of the above

d) All of the above

1. Match the following ideal criteria for a successful screening program for disease with the statements that follow:

Successful screening includes:

Disease produces substantial death/and or disability, early detection is possible and improves outcome, there is a feasible testing strategy for screening, screening is acceptable in terms of harms , costs, and patient acceptance

Which of the following can always be considered cost-effective?

An intervention that increases that reduces the cost while increasing the benefit(net effectiveness).

Which of the following is/are true of HIV?

“HIV” (Human Immunodeficiency Virus) is a virus that infects the immune system, decreasing its ability to fight off other infections and diseases (TRUE)

HIV can be transmitted through unprotected sex, transmission of infected blood, sharing infected needles or other sharp instruments, and from a mother to her baby during pregnancy, childbirth, and breastfeeding (TRUE)

Gay and bisexual men of all races are the most radically affected by HIV in the US (TRUE)

Put the following steps to an outbreak investigation in the correct order:

_{Match the following infectious agents with common examples of each:}

1. _Insects=
2. _Airborne=
3. _{Unprotected sex=}
4. _{Breast milk=}
5. _{Fomites =}
6. _{Animal feces=}
7. _{Water or food=}
8. _Blood=
9. _Bacteria=
10. Fungi
11. Protozoa
12. Viruses
13. Worms
14. Flukes
15. insects
    

_{Insects—Lyme, west nile}

_{Animals—rabies, avian flu}

_{Airborne—avian flu, chickenpox, cold, TB}

_{Unprotected sex—Gonorrhea, hepatitis, herpes, HIV,}

_{Breast milk—HIV}

_{Fomites (on surface of objects)—avian flu, chickenpox, cold}

_{Animal feces—salmonella}

_{Water or food—cholera, hepatitis, salmonellas, other bacteria}

_{Blood—many including HIV and hepatitis}

_{Bacteria—step, staph, e coli, lactobacillus}

_{Fungi —athletes food, ringworm, candidiasis}

Protozoa—malaria, giardia, amebic dysentery

Viruses—cold, flu, HIV

Worms—tapeworm, pinworm, other intestinal worms

Flukes—snail fever, lung, liver flukes

insects—lice, bedbugs, scabies

Match the following public health tools for communicable disease management with the following examples:

Barrier protections=

Physical barriers=

Immunizations=

Screening=

How will we contain the spread=

Maximize treatment =

_{Barrier protections including isolation and quarantine, immunizations to protect individuals as well as populations, screening and case findings, treatment and contact treatment, efforts to maximize the effectiveness of treatments by preventing resistance}

_{Physical barriers—condoms, masks, gloves, even a building –what about the inside of your elbow?}

_{Immunizations—herd immunity}

_{Screening—as name implies, trying to figure out where it started and how its being spread}

_{How will we contain the spread—isolation, barriers, reducing contagiousness}

_{Maximize treatment for those sick and make sure our drugs still work in the future}

Remedies for leading causes of death in developing countries

Mosquito nets, clean water, immunizations, clean cookstoves, animals for food ex: chickens, goats

Which one of the following diseases is the least likely to be eradicated?

Programs to eradicate TB and Malaria have never come close to meeting their goals, getting rid of HIV/AIDS is even more unrealistic.

Influenza, smallpox

Match the following factors that facilitate elimination of a disease with the examples for the given disease?

_{SMALL POX}

_{Disease is limited to humans, no animal reservoir?
Limited persistence in the environment?
Absence of long-term carrier state?
Long-term immunity results from infection?
Vaccination confers long-term immunity?
Herd immunity prevents perpetuation of an epidemic?
Easily diagnosed disease?
Vaccination effective post exposure?}

Disease is limited to humans, no animal reservoir? YES
Limited persistence in the environment? YES
Absence of long-term carrier state? YES
Long-term immunity results from infection? YES
Vaccination confers long-term immunity? YES
Herd immunity prevents perpetuation of an epidemic? YES
Easily diagnosed disease? YES
Vaccination effective post exposure? YES

Match the following factors that facilitate elimination of a disease with the examples for the given disease?

_POLIO

_{Disease is limited to humans, no animal reservoir?
Limited persistence in the environment?
Absence of long-term carrier state?
Long-term immunity results from infection?
Vaccination confers long-term immunity?
Herd immunity prevents perpetuation of an epidemic?
Easily diagnosed disease?
Vaccination effective post exposure?}

POLIO

Disease is limited to humans, no animal reservoir? YES
Limited persistence in the environment? YES
Absence of long-term carrier state? YES- absent but may occur in immunocompromised individuals
Long-term immunity results from infection? YES- but may not be sustained in immunocompromised
Vaccination confers long-term immunity? YES- Virus used for production of live vaccine can produce polio like illness and can revert back to infection.
Herd immunity prevents perpetuation of an epidemic? YES
Easily diagnosed disease? YES/NO - large number of asymptomatic infections
Vaccination effective post exposure? NO

Match the following factors that facilitate elimination of a disease with the examples for the given disease?

_MEASLES

_{Disease is limited to humans, no animal reservoir?
Absence of long-term carrier state?
Long-term immunity results from infection?
Vaccination confers long-term immunity?
Herd immunity prevents perpetuation of an epidemic?
Easily diagnosed disease?
Vaccination effective post exposure?}

_MEASLES

_{Disease is limited to humans, no animal reservoir? YES
Limited persistence in the environment? YES
Absence of long-term carrier state? YES- absent, but may occur in immunocompromised individuals
Long-term immunity results from infection? YES- but may not be sustained in immunocompromised individuals
Vaccination confers long-term immunity? YES- but may not be sustained in immunocompromised individuals
Herd immunity prevents perpetuation of an epidemic? YES
Easily diagnosed disease? NO- disease may be confused with other diseases
Vaccination effective post exposure? NO}

Which of the following has NOT been successfully used to control communicable diseases?

The ones that are successful are: case findings, contact tracing, isolation, epidemiology treatment or treatment based on exposure

Match the following types of physical environment to the examples that follow:

_{Unaltered environment=}

_{Altered environment=}

_{Built environment=}

_{Unaltered environment}

_{Examples: AKA Natural environment. Water quality could be poor due to soil contents or natural erosion.}

_{Radon- a common naturally occurring breakdown of product uranium, increases the risk of lung cancer.}

_{Naturally occurring sunlight- increases risk of skin cancer}

_{Altered environment}

_{Examples: Industrial chemicals such as pesticides, benzene and chlorofluorocarbons (CFCs), mercury and lead. Also includes radiation from nuclear energy and medical wastes.}

_{Global warming melting the ice caps, endangering animal species such as bees and other pollinators necessary for crop growth.}

_{Built environment}

_{Examples: Includes all impacts of the physical environment as a result of human construction. Injuries and exposures in the home, the transportation system, and where we work and play. Construction methods can affect air systems leading to exposure of “sick buildings”.}

_{Methods of how we heat our buildings, cook our food and the way we travel.}

Match the following approaches to environmental problems with the examples that follow:

Risk assessment=

Public Health assessment=

Ecological Assessment=

Interaction analysis=

_{Risk assessment- aims to measure potential impact
Ex: Risk: of child poking himself with stick 1:10,000}

_{Public Health assessment- show the major impacts on large numbers of people often the population as a whole
Ex: Pub H: 50% of the children in the U.S. will be exposed to candied apple at least one per year}

_{Ecological Assessment- impacts of environmental contamination or pollution on plants and animals and the ecosystem in which they exist cause important long term consequences
Ex: Ecological: 5,000 trees are harvested each year to make sticks, adding 2 million cubic yards to landfills each year}

_{Interaction analysis- controls the impacts of environmental exposures , and taking into account the effect of two or more exposures . the interactions of the exposures have greater impacts. Example ozone layer depletion
Ex: Interaction: with rates of obesity and diabetes increasing do we really want to increase exposure to more sugary foods}

All of the following are true of lead as an environmental hazard except?

Paint in homes is no longer a source of led exposure since lead is no longer allowed in paint. (in powerpoint).

This is false because older homes still have paint in them that contains lead.

_{Match the four types of impact assessment with examples of each:}

_{Global assessments=
Policy impact assessment =
Strategic environmental assessment =
Environmental impact assessment =}

Global assessments (global level)
Policy impact assessment (policy level)
Strategic environmental assessment (programme and plan level)
Environmental impact assessment (project level)

How environmental health issues affect people differently
Both young and old:
Poor:
Disabled:

Both young and old: weaker immune systems,
Poor: worse living conditions, less resources, can’t move to better environments
Ill: interaction effects we already talked about (eg asthma)
Disabled: particularly getting around the build environment or avoiding accidents

All of the following are true of public health professions EXCEPT:

Graduate public health degrees require previous graduate credentials such as medicine nursing, or law

Which of the following is not true of the ideal of primary care in the United States?

The 6 c’s of Ideal Primary Care ]
Contact=
Comprehensive=
Coordinated=
Continuity=
Caring=
Community=

The 6 c’s of Ideal Primary Care (page 202 in book)
Contact- implies first contact
Comprehensive- ability to completely or least initially address most health issues
Coordinated- primary care should have responsibility to ensure that parts of healthcare system work together
Continuity- primary care teams see themselves hold together the system
Caring- implies personalized relationship
Community- implies primary care provides link with with broader community and with public health institutions and services

Which of the following is true of primary care in the United States?

There are approximately 2 specialty physicians for every primary care physician in the United States.

Match the following methods of payment with the descriptions that follow:
Fee for service=
Capitation=
Episode of care=
Salary=
Pay for performance=

Fee for service- paid for covered service
Capitation- paid set amount per time period for each patient
Episode of care- institution or clinician aid set amount for comprehensive services
Salary- set amount per time period
Pay for performance- compensation adjusted based on measures of quality care delivered

All of the following are true of hospitals in the United States EXCEPT:

All hospitals are operated as not-for-profit institutions

Match the following health insurance programs to the descriptions that follow.

•Group insurance plans=
•Private insurance=
•Medicare=
•SSDI=
•Medicaid=

•Group insurance plans (employed)
•Private insurance (self-employed)
•Medicare (retired)
•SSDI (disabled)
•Medicaid (poor)

Which of the following is/are true of the employment based health insurance system in the United States?

Employment-based health insurance is the largest single category of health insurance in the United States

The U.S healthcare system is unusual in the following ways compared to health care systems in other developed countries: (check all that are true)

The United States has a higher percentage of specialists compared to generalists than most other developed countries.

Which of the following is true of the U.S. healthcare system when compared to the healthcare systems in most other developed countries such as Canada and the United Kingdom? (check all that are true)

Spends more per person
Has higher percentage of uninsured individuals, even after ACA
Healthcare system more complex for patients and providers, and costs far more to administer
Places more emphasis on specialized physicians & on nurses and physician assistant to provide primary care
Greater emphasis on giving patients a wider choice of clinicians
More complex system for ensuring quality and unique system of malpractice law

Which of the following are needed for a healthcare market to operative effectively? (check all that are true)

Informed purchaser
Multiple competing providers
Negotiation

_{Match the following insurance terms to the descriptions that follow:}

<sub>1. Name of Policy=
2. Annual Premium=
3. Annual family deductible =
4. PCP co-pay and/or co-insurance%-=
5. Specialist co-pay and/or co-insurance%=
6. Generic drug co-pay and/or co-insurance%=
7. ER co-pay and/or co-insurance%-=
8. co-insurance% for everything else=
9. Annual family “out of pocket” max (cap)=</sub>

_{Copay=
Co-insurance=}

<sub>1. Name of Policy-
2. Annual Premium- the amount you pay the insurance company or in some cases the gov. to provide you with healthcare coverage.. Pay it on a monthly basis.. Still have to pay it no matter if you use it or not
3. Annual family deductible (sometimes individual also)- pay up front a certain amount out of your own pocket
4. PCP co-pay and/or co-insurance%- paying out of pocket to receive service and does not count toward deductible
5. Specialist co-pay and/or co-insurance%- same as #4
6. Generic drug co-pay and/or co-insurance%- same as #4
7. ER co-pay and/or co-insurance%- same as #4
8. co-insurance% for everything else- needed to have an mri or other procedures, ex: you pay 20% of whatever the procedure cost
9. Annual family “out of pocket” max (cap)- you pay 20% of these procedures up to a maximum of $10,000 and once you pay this max out of your own pocket then you don’t pay co-insurance anymore and they take care of everything else. When the new year starts you start your max all over again</sub>

_{Copay- fixed dollar amount
Co-insurance- a percentage..ex: if you visit the emergency room you pay 20% of that emergency room visit, if it’s $2,000 you pay $400}

Why U.S. Healthcare costs more.

Our doctors, nurses, clinicians, pharmacies, hospitals charge more for the same procedure or drug than comparable countries

But, we also perform more tests, imaging, and prescriptions per person than in most comparable countries.

Challenge for the Medicare program.

Many items needed by elderly are not covered such as hearing aids and eyeglasses. Medicare is a complicated program because there are four different parts all covering different things.

Match the Federal Agency with the roles that follow:

Center for Disease Control (CDC)=
Nation Institute of Health (NIH)=
Health Services and Resources Administration (HSRA)=
Substance Abuse and Mental Health Services Administration (SAMHSA)=

_{Center for Disease Control (CDC)- the lead agency for prevention, health data, epidemic investigation, and public health measures aimed at disease control and prevention;outbreaks; PH function
Nation Institute of Health (NIH)- lead research agency; funds training programs and communication of health information to the professional community and public; biomes and health research
Health Services and Resources Administration (HSRA)- provide quality and healthcare to unsure; seeks to ensure equitable access to comprehensive quality healthcare
Substance Abuse and Mental Health Services Administration (SAMHSA)- prevention;works to improve quality and availability of prevention, treatment and rehabilitation for substance abuse and mental illness}

Match the Federal Agency with the roles that follow:

United States Agency for International Development (USAID)=
Food & Drug Administration (FDA)-=
The U.S. Department of Health and Human Services (HHS)=
Department of Aging and Disability Services (DADS)=

United States Agency for International Development (USAID)- objective is to improve global health by focusing on three strategic priorities: 1) Preventing Child and Maternal Deaths; 2) Controlling the HIV/AIDS Epidemic; and 3) Combating Infectious Diseases
Food & Drug Administration (FDA)- 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.
The U.S. Department of Health and Human Services (HHS)- is the U.S. government's principal agency for protecting the health of all Americans and providing essential human services, especially for those who are least able to help themselves. Medicaid, CHIP, women's health, SNAP food, family violence, refugee, disaster assistance
Department of Aging and Disability Services (DADS)- administers long-term services for people who are aging as well as for people with physical, intellectual or

Match the Federal Agency with the roles that follow:

Department of assistive and rehabilitative services(DARS)=
Department state health services=
Department of Family and Protective Services (DFPS)=

_{Department of assistive and rehabilitative services(DARS)- administers programs that help Texans with disabilities find jobs through vocational rehabilitation, ensure that Texans with disabilities live independently in their communities, and assist families in helping their children under age 3 with disabilities and delays in development to reach their full potential. autistic, blind, deaf, other disabled, working with employers etc.
Department state health services- to improve the health, safety, and well-being of Texans through good stewardship of public resources, and a focus on core public health functions. The department provides state-operated healthcare services, including hospitals, health centers, and health agencies. like the CDC for the state a lot of public health work, infectious, vital records, health data, mental health, substance use, licenses, etc.
Department of Family and Protective Services (DFPS)- is responsible for investigating charges of abuse, neglect or exploitation of children, elderly adults and adults with disabilities. child protective services, elder protection, daycare licensing, etc.}

Which of the following is true of local health departments? (mark all that are true)

They may provide direct services or they may delegate services and authority to local health departments depending on decisions made at the state level

https://quizlet.com/106660564/pbh-exam-3-practice-qs-flash-cards/

The Goals of FDA regulations
Phase I =

Phase II =

Phase III

Phase IV

Phase I studies assess the safety of a drug or device. T

Phase II studies test the efficacy of a drug or device.

Phase III studies involve randomized and blind testing in several hundred to several thousand patients.

Phase IV studies, often called Post Marketing Surveillance Trials, are conducted after a drug or device has been approved for consumer sale.

Trends in antibiotic resistance
-we have to stay ahead of the resistance (producing newer and newer antibiotics) or we could be dying from infectious diseases again
-want to change the patterns to stop using antibiotics to create superbugs
Culprits:
1.Self prescribing=
2.Doctors=
3.Not finishing prescriptions
4.Personal products=
5.Other products=
6. Livestock production=

1.Self prescribing—keeping antibiotics for later use, borrowing from others, (over-the-counter in many countries)
2.Doctors—misdiagnosed or overprescribed (don’t do cultures)
3.Not finishing prescriptions
4.Personal products—soaps, sanitizers, wipes, toothpaste, first aid items, etc., etc.
5.Other products—baby products, school supplies, kitchenware, etc., etc.
6. Livestock production- PRIMARY CULPRIT (⅔ to ¾ of all antibiotics in US are used on livestock to make them bigger) not used to cure a sickness therefore creating antibiotic resistant bac

Why prescription medicine costs more

----the cost for a company to develop a drug is $3-4 billion, so companies sell to meet the desired profit (patent laws in the US to protect their drug so no one can copy it (generic drugs), so US patients are paying more because other places in the world are paying less for the same drug.

This can be best described as which of the following? (think Systems Thinking)

It is a way of thinking in approaching problems and in designing solutions that appreciates the very nature of complex adaptive systems as:

-dynamic, constantly changing,

-governed by history and by feedback,

-where the role and influence of stakeholders and context is critical, and

-where new policies and actions (of different stakeholders) often generate counterintuitive and unpredictable effects, sometimes long after policies have been implemented

- policy resistance.

Match the following uses of systems analysis with the examples that follow:
Complex biological relationships
Biologists=
Epidemiologists =

Biologists - human body is a complex set of organ systems, which is why one drug doesn’t work the same for every person
Epidemiologists - ex: H1N1 flu, have to look at whole natural system to understand spread of disease

Match the following uses of systems analysis with the examples that follow

Organizational relationships or processes
Health policy =
Community health workers =

Health policy - ex: how the FDA has influence of the food industry in the US
Community health workers - stakeholders in a community should be involved in revising a community health system

Developing new solutions

1. Drug researchers

1. Epidemiologists

Factors that influence outcomes

1. Community health educators
2. epidemiologists

In Module 14, you learned the steps to systems thinking. Place the following steps in the correct order:

Match the following types of Systems interaction with the correct arrows on the diagram:

Match the following types of Systems interaction with the correct arrows on the diagram:

Positive feedback - green arrow +

Negative feedback - green arrow -

positive/negative feedback loop - blue arrow + / green arrow -

Multiple factors influencing outcome - multiple arrows pointing at one outcome (i.e. speeding, alcohol, slow response all point to collision)