nur 329 revision question – Flashcards
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Winslow (1920), who is sometimes described as the father of public health in the United States, defined public health as which of the following? • A science and focussed on education • An art and focussed on sanitation • Both a science and an art • Both a science and very practical • None of the above
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Both a science and an art
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Lawson and Bauman (2001) describe the traditional values of public health as doing which of the following? • Using behavioural evidence as a basis for action; focussing on the health of all sections of the population; and emphasising a collective action dimension • Using scientific evidence as a basis for action; focussing on the health of all sections of the population; and emphasising an individual action dimension • Using medical evidence as a basis for action; focussing on the health of all sections of the population; and emphasising a collective action dimension • Using scientific evidence as a basis for action; focussing on the health of all sections of the population; and emphasising a collective action dimension
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Using scientific evidence as a basis for action; focussing on the health of all sections of the population; and emphasising a collective action dimension
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The role of the public health practitioner is said to include which of the following three important elements per van der Maesen and Nijhuis (2000)? • Improving social conditions that stimulate health, preventing social conditions that threaten health, and neutralising existing social conditions that cause ill health • Improving economic conditions that stimulate health, preventing social conditions that threaten health, and neutralising existing social conditions that cause ill health • Improving economic and social conditions that stimulate health, promoting social conditions that threaten health, and neutralising existing social conditions that cause ill health • Improving social conditions that stimulate health, preventing social conditions that threaten health, and advancing existing social conditions that cause ill health • None of the above
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Improving social conditions that stimulate health, preventing social conditions that threaten health, and neutralising existing social conditions that cause ill health
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What sort of model of health has as its main focus the diagnosis of disease while virtually discounting the roles of social factors and disease prevention? • A biomedical model • A psychosocial model • An environmental model • None of the above
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A biomedical model
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Fill in the definition of public health below with the most appropriate words and phrases:"... the efforts organised by society to __________ the people's health. It is the combination of sciences, skills and beliefs that is directed to the maintenance and improvement of the health of all the people through __________ actions" (Last, 2001). • diagnose, heal, and restore; economic and political • protect, promote, and restore; economic and political • diagnose, heal, and restore; personal or individual • protect, promote, and restore; collective or social
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protect, promote, and restore; collective or social
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. Define public health
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Public health is the practice of preventing disease and promoting good health within groups of people, from small communities to entire countries (Fleming & Parker p. 6-7).
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. Why is public health important?
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The focus of public health intervention is to improve health and quality of life through the prevention and treatment of disease and other physical and mental health conditions, through surveillance cases and health indicators and through the promotion of healthy behaviors. Promotion of hand washing and breastfeeding and delivery of vaccinations and distribution of condoms to control the spread of sexually transmitted disease are examples of common public health measures (Fleming & Parker p. 6-7).
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. What the difference between old public health and new public health model? Old public health model
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Old public health model-This model is based on the discipline of epidemiology and the subject matter of the biomedical and behavioural science. New public health model-This model recognises the importance of addressing inequalities in health in the population through effective public policies such as economic, education and employment policies to ensure an adequate standard of living and better health for all (Fleming & Parker pp. 38-39).
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Define health and ill-health
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Health- is a state of a complete physical, social and emotional wellbeing and not merely the absence of disease. Illness-health- This is primary about how an individual experience disease and disease itself represents a set of signs and symptoms and medically diagnosed pathological abnormalities (Fleming & Parker p. 4).
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Describe health determinants and why it is important.
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Health determinants are those factors that raise or lower the level of health in a population and help to explain and predict trends in health and explain why some groups have better or worse health than others (Fleming & Parker Section 2).
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. Why evidence based practice essential in public health?
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-Evidenced based practice is essential in public health because it develop action plan, provide rational and effective public health care programs and develop policies for addressing public health issues. -Improve health care and health outcome by basing practice on the beast available evidence (Fleming & Parker Chapter 8).
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In what ways does the 'new public health' model differ from the 'old public health' model and which document first articulated the 'new public health' model agenda?
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New public health: • places a focus on lifestyle and enhancing of life skills • places importance on recognizing the inequalities in the health of populations • employs effective economic, educational and employment policies to ensure an adequate standard of living and better health for all • places emphasis on prevention, health promotion & a positive definition of health Old public health: • based on epidemiology, biomedical and behavioural science • causes of disease are factors in the individual within a social and physical environment • strategies aimed at interrupting 'chain of causation' for disease via education, service provision & legislation • The Ottawa Charter for Health Promotion in 1986 was the first document to articulate the agenda for the new public health model. Fleming & Parker p. 38-40 & topic 1 module 1.2 & 1.4
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What are the objectives of epidemiology and who is thought of as the father of modern epidemiology?
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The objectives of epidemiology can be summarised as describing disease patterns, analysing how and where they occur and who suffers from them & interpretation of health status of populations. John Snow in 1854 London used epidemiological investigative skills to discover the source of a cholera outbreak. By identifying a pump handle as the source and by having it removed he was able to reduce cases of the communicable disease in the area. The set text identifies Snow as having the pump handle removed in 1854 but the study guide gives the dates 1848-1853 so I'm unsure which to refer to in the answer!
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What is your understanding of the term 'determinants of health' and why are determinants important?
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A health determinant is an indirect influence which effects the likelihood of becoming ill or staying healthy. Determinants are the factors that raise or lower health level in a population or individual. Determinants help explain and predict health trends and explain why some groups have better or worse health than others. They are the key to preventing illness and injury. Australia's Health 2012 p. 11 & Fleming & Parker p. 71
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Which ethical code governs registered nurses in Australia?
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The Nursing and Midwifery Board of Australia, Australian College of Nursing & Australian Nursing Federation Code of Ethics for Nurses in Australia most recently revised in 2008 sets forth the principles and standards which outline the nursing profession's commitment to respect, promote, protect and uphold the fundamental rights of people. It is used to guide ethical decision-making whilst acknowledging the diversity of the Australian population and upholding a responsibility to provide culturally responsive care. Topic 3 module 3.2 & The NMBA/ACN/ANF PDF Code of Ethics for Nurses in Australia
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Provide a description of health prevention/protection and health promotion.
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Health prevention/protection is achieved through a combination of individual & population strategies including • • Societal & environmental structures designed to minimise transmission of diseases • • Immunisation programmes protecting individuals and reducing risks to unvaccinated individuals • • Vector control in the form of sanitation, personal protection (repellents & window screens) & environmental protection • • Personal protection by avoiding unsafe practises and limiting harms from exposure to infections/vectors • • Surveillance & early recognition & intervention programmes provide screening tools for the general population & investigate & manage outbreaks Health promotion principles as laid out in the Ottawa Charter can be described as • • Involving the population as a whole • Directed towards action on determinants or causes of health • Combining diverse but complementary methods of approaches • Aims at effective and concrete public participation • Health professionals play in important role Fleming & Parker p. 237-241 & topic 5 module 5.6
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Define epidemiology?
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The study of the patterns, health determinants, disease conditions of specific populations in order to determine health problems. (Fleming & Parker, 2012, p. 76)
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. What are the 5 essential actions outlined by the Ottawa Charter (1986) in a comprehensive approach to public health and health promotion practice?
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) Create public policies that support health. b) Create supportive environments c) Strengthen community action d) Develop personal skills e) Reorient health services (Fleming & Parker, 2012, p. 301)
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What is the definition of DALY
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(Disability - adjusted life year) which is used to assess and compare the different diseases and injuries on population groups. This is to determine the burden of disease. One DALY is 1 year of 'healthy life' lost due to premature death, prolonged illness or disability or a combination of these factors. The more DALYs the greater the burden. (AIHW, 2012, p.116)
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Five questions from Chapter 10 (Flemming & Parker, 2012). Q. What is the difference between a chronic disease and a chronic condition?
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A chronoic disease - refers to a specific medical condition. A chronic condition - encompases disability and disease conditioins that people "live with" over extended periods of time (more than 6 months).
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List the top 10 chronic diseases making up the leading causes of disease burdon in DALY's
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1. Coronary Heart Disease 2. Stroke 3. COPD 4. Depression 5. Lung cancer 6. Dementia 7. diabetes 8. colorectal cancer 9. Athsma 10. Osteoarthritus
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What does NCDS stand for?
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National Chronic Disease strategy.
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What are the 4 factors that the NCDS focus on?
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1. Prevention across the continuum 2. early detection and treatment 3. integrated and coordinated care 4. self-management
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What are concidered the 6 basic major requirements for healthy environment
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1.Clean air 2. Safe and sufficient water 3. Adequate and safe food 3. sagfe and peaceful settlements 5. safe workplaces 6. stable global environment
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How much water on the planet is a). fresh, and b). available for drinking?
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a). 2.5% of the world's ewater is fresh b). 0.5% of that 2.5% fresh water is available for drinking as the rest is stored frozen in glaciers and polar ice caps etc
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Which country is concidered to be the largest entire population poisioning, and what is their ground water contaminated by?
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Bangladesh. Their ground water is contaminated by arsnic (naturally occuring but in toxic amounts to human health)
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List the 5 major types of global environmental change effecting human health.
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1. Climate change 2. Statospheric ozone depletion 3. land degredation 4. fresh water decline 5. biodiversity loss and ecosystem function
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Five questions from Chapter 11 of Flemming and Parker (2012). Q. What are concidered the 6 basic major requirements for healthy environment
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1.Clean air 2. Safe and sufficient water 3. Adequate and safe food 3. sagfe and peaceful settlements 5. safe workplaces 6. stable global environment
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There are 12 chronic conditions identified by the National Health Partnership in their paper "Preventing Chronic Disease: A Strategic Framework". List at least 4 of these chronic conditions.
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Ischaemic heart disease (or coronary heart disease) • Stroke • Lung cancer • Colorectal cancer • Depression • Type 2 diabetes • Arthritis • Osteoporosis • Asthma • Chronic obstructive pulmonary disease (COPD) • Chronic kidney disease • Oral disease
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List at least 3 factors for developing type 2 diabetes
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Genetic factors, as in maturity onset diabetes of the young (MODY), or a positive family history of diabetes • Being of Asian or African-Caribbean descent • Being overweight / obese / lack of physical activity • Dietary intake of foods high in saturated fats • Dietary intake of drinks high in sugar • Personal history of gestational diabetes
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Which of the following statements is FALSE? (a) Neglect is a strong predictor of later youth offending and factors leading to neglect are poverty, poor housing, dysfunctional families and poor social support. (b) Those from most disadvantaged areas are more likely (about 2.5 times) to die of heart disease and/or stroke. (c) Indigenous pedestrians are more likely (about 33 times) to die in car accidents than non-indigenous. (d) Obesity is lowest in those from low socio-economic backgrounds. (e) Youth alcohol-related harm is highest in disadvantaged areas.
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(d) Obesity is lowest in those from low socio-economic backgrounds.
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Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) are caused by infection to what bacterial group?
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ARF is an illness caused by a reaction to a bacterial infection with group A streptococcus (GAS). ARF can cause RHD, which remains after the acute ARF episode has resolved.
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Briefly describe "Health Promotion".
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Health promotion can be described as a process of helping people and communities to take control over their health and to improve their health. The purpose of health promotion activities is to strengthen the skills and capabilities of individuals to take action and the capacity of groups or communities to act collectively to exert control over determinants of their health. The process of health promotion is not solely the role of the health professional. Both individual and community and health professional and a myriad of other services such as gyms, food manufacturers and agricultural lobbies, insurance companies, etcetera are part of the business of health promotion. Health promotion is done with the people, either as individuals or as groups. Four main routes are described for health promotion: • Health education (both professional and commercial sources) • Legislative action • Community development ([from various sources) • Healthy public policy
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What is meant by the term "chain of causation?" and what is preventions role against it?
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The chain of causation refers to a diseases' need for an AGENT, a HOST, and an ENVIRONMENT to be present for it to have an effect. Health prevention interrupts the chain of causation by, for example, providing immunization or antibiotics to restore health.
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How does the WHO (1948) definition of health differ from the biomedical perspective on health? A. (Page 4.)
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The Biomedical perspective focus on diagnosis of disease, and the disease in general. It is not a holistic approach. The WHO (1948) definition incorporates a holistic picture of the multifaceted layers pertaining to human health. " A state of complete physical, socila and emotional wellbeing and not merely the absence of disease or infirmity".
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How does WHO define the word "lifestyle"?
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Lifestyle refers to the behavioral choices made from alternatives that are available to people according to their socioeconomic circumstances.
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What is meant by the term 'intersectorial approach'?
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Intersectorial approach refers to the need for the loop that connects governments and their departments, the private health sector and NGO's in health policy if it is to be successful and effective in achieving maximum positive health outcomes for the population.
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. What are the 4 modifiable risk factors identified by WHO for prevention and management of non-communicable diseases such as CVD, diabetes, cancer and chronic respiritory diseases?
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1. Tobacco use 2. unhealthy diets 3. physical inactivity 4. alcohol misuse
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. Which country is at the bottom of the list of wealthy 1st world nations working towards improving health and life expectancy of their indigenous population?
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Australia.
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What do indigenous people mean when they refer to "country"?
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"Country' refers to specific tribal group/clan/nation odf aboriginal people who belong to specific geographic areas.
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List as many aspects of colonization that have had a dramatic impact on indigenous health.
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A. (page 352) 1. Massacre of their families 2. Dispossession 3. Forced removal of children 4. Introduction of infectious diseases they had little immunity to. 5. Loss of traditional food and lifestyle 6. Forced settlement 7. Loss of social cohesion 8. Complete disempowerment and control of their own lives
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When did the Australian government stop forcibly taking aboriginal children away from their families?
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The 1960's
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What is meant by the term 'intergenerational trauma'?
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A. (page 353) The cumulative trauma of indigenous people as a result of unresolved or misaddressed grief and loss continuing over the generations since colonization of Europeans. All questions below taken from Chapter 2 - Flemming & Parker 2012.
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Why is the name John Snow so important in the history of epidemiology?
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John Snow was the first person to make the link between what is happening gin the environment and how it effects human health by pinpointing a water pump in Broad Street, England as being responsible for a massive cholera outbreak. He removed the hand pump and dramatically reduced the rates of cholera.
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What is the 'germ therory' that developed in the 19th Century?
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The germ theory states that every disease has a corresponding pathogen.
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What are some of the health issues resulting from the British running penal colonies in Australia?
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1. Forced and cruel control over the convicts and indigenous populations. 2. New diseases introduced to indigenous populations who has little to no immunity. 3. increased population density in poor living conditions equated in increased transmission of infectious diseases.
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What are the main differences between 'old' and 'new' public health?
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The 'Old public health model' was based on epidemiology, biomedical and behavioral sciences and its main strategies were aimed at interrupting the 'chain of causation' (e.g. with antibiotics). The "new public health' shifted its focus from behavioral change to healthy public policy and is more interested with enhancing life skills in an environment experiencing unstoppable and unsustainable increases in human population, economic activity, environmental destruction which are all negatively impacting on human health (e.g with the introduction of chronic diseases).
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What is Ecological Public health?
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Ecological Public Health continues on from where 'new public health' ;left off by incorporating all the important aspect of both 'old' and 'new' as well as focusing on ecological management and sustainable development. Ecological Public health understands that the earth and the healthy and effective functioning of its ecosystems are central to our existence on this planet. A sick planet equals sick people.
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What are the three fundamental elements essential for human health that are missing from the term 'economic capital'?
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1. human capital 2. social capital 3. ecological/natural capital
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List some reasons why health for older Australians is so important.
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Prevents disease and functional decline 2. extends longevity 3. enhances quality of life and wellbeing 4. moderates the demand for health and aged care services 5. Cost of curative and long term care in future may not be sustainable in the future.
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What are the three key factors in managing infectious diseases?
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. disease prevention 2. surveillance, early detection, early intervention 3. managing disease outbreaks
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What are some examples of biotechnology that raise ethical issues?
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1. Stem cell research 2. cloning 3. genetic engineering 4. slowing the aging process
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The Future of Public Health in the 21st Century Report written by the Institute of Medicine identified 3 important issues concerning unmet potential in the area of population health. What were they?
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1. Too much focus on medical care and not enough on prevention 2. Too much attention to biomedical research and not enough on preventative research 3. The ongoing disparity in health between different population groups such as gender/race/ethnicity/socioeconomic status.
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When did globalization begin?
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About 100 000 years ago when our ancestors started migrating out of Africa to spread the human population across the globe.
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What are two forms of globalization communication?
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Mobile phone and the Internet.
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75% of the world's cigarette/tobacco market is owned by how many companies?
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Four companies.
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By 2015 what percentage of the world's human death will be directly attributed to cigarette smoking?
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10%. (And that EXCLUDES the millions that die every year from passive smoking).
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Why is imported food a health concern for Australians?
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Because food grown, harvested and processes in foreign countries has different health standards than Australia. For example, in 2007, tests revealed 1/3 of all seafood imported from China, Thailand, Vietnam and Indonesia contained a banned antibiotic. Considering 70% of the seafood Australians consume annually comes from these countries, it is easy to see that it can impact on our health.
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How much money does each Australian contribute to overseas Aid each week?
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$2.40
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Which of the following do not determine morbidity and mortality? o The social and spatial organisation of a population o The individual's genetic endowment and exposure to a range of risk factors o The physical environment, including patterns of relationships and mobility o All of the above o None of the above
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None of the above
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Who supported the environmental theory of disease and pushed for sanitary reform in nineteenth-century Britain? o Lord Sydney o Marc Lalonde o Edwin Chadwick o Edwin Landseer
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Edwin Chadwick
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During the Industrial Revolution of the nineteenth century, the greatest triumphs of public health occurred in relation to what? o The physical environment and occupational hazards (e.g., water, sewage, food, working conditions, housing) o DNA sequencing o The discovery that illness was a sign of dirty air or, as it was known at the time, miasma o Equitable access to health promotion, treatment, and prevention services
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The physical environment and occupational hazards (e.g., water, sewage, food, working conditions, housing)
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This model of public health is based on the discipline of epidemiology as well as the biomedical and behavioural sciences; it analyses causes of disease in terms of factors found in the individual as well as in the social and physical environments. What is it known as? o New public health o Ecological public health o Old public health o Environmental public health
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Old public health
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Which of the following have been important influences on the development of public health in Australia? o The government's promotion of national efficiency and national development o The bureaucratic ascendancy of Australian society o The existence of a well-organised and politically sophisticated medical profession o All of the above o None of the above
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All of the above
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1. Which of the following is not a National Health Priority Area in Australia? Asthma Cancer Diabetes Infectious diseases Injury
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Infectious diseases
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2. Various types of public policies affect the ways that communities live, their quality of life, and their access to services. Medicare is an example of which type of policy? A regulatory policy A distributive policy A redistributive policy A self-regulatory policy as well as a distributive policy
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A redistributive policy
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3. The National Health and Hospitals Network, as part of the federal government's agenda, aims to do which of the following? Inject more money into the states to improve efficiencies in public hospitals Alter the funding arrangements of public hospitals so that the commonwealth government became the majority (60%) funder of public hospitals Implement the National Primary Health Care Strategy All of the above
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Alter the funding arrangements of public hospitals so that the commonwealth government became the majority (60%) funder of public hospitals
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4. The success of Australia's National HIV/AIDS Strategy and subsequent policy development was attributed to which of the following unique approaches? The inclusion of those most affected by the virus in the development of the strategy The controversial "Grim Reaper" television campaign A reliance on overseas strategies A reliance on drugs administered in health services to treat those with HIV/AIDS
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The inclusion of those most affected by the virus in the development of the strategy
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For what reasons do we monitor health and disease? To determine priorities for public health programs (e.g., burden of disease) To understand change over time in causes of death and disease (e.g., pandemic influenza, motor vehicle accidents, suicide) To measure the positive or negative effects of community health programs and services (e.g., community health promotion, expansion of paramedic services) To improve the quality of the science underlying clinical medicine, nutrition, emergency health care, nursing, and allied health care All of the above
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All of the above
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2. Fill in the definition below with the most appropriate words and phrases: "Epidemiology is the study of the __________ and __________ of __________ or events in specified populations and the application of this study to __________." distribution; determinants; illness-related states; control disease and health-related conditions distribution; determinants; health-related states; control of health problems dimensions; distribution; illness-related states; control disease and health-related conditions distribution; dimensions; illness-related states; control disease and health-related conditions
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distribution; determinants; health-related states; control of health problems
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What are the definitions, respectively, of the following three terms: mortality, morbidity, and disability? Death; sickness or disease; and a significant loss of function that impairs daily life Illness; sickness or disease; and a significant loss of function that impairs daily life Death; illness; and a significant loss of function that impairs daily life Death, sickness or disease; and a significant loss of sight that impairs daily life
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Death; sickness or disease; and a significant loss of function that impairs daily life
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Cumulative incidence refers to which of the following? A subsection of the population that was determined to be at risk at the beginning of a study period has been followed for the entirety of the specified time period The female members of the population who were determined to be at risk at the beginning of a study period have been followed for the entirety of the specified time period The male members of the population who were determined to be at risk at the beginning of a study period have been followed for the entirety of the specified time period The entire population that was determined to be at risk at the beginning of a study period has been followed for the entirety of the specified time period None of the above
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The entire population that was determined to be at risk at the beginning of a study period has been followed for the entirety of the specified time period
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What is the technical term used by epidemiologists to describe the situation that occurs when a third factor influences the relationship between an exposure and a disease? Selection bias Random error Information bias Relative risk Confounding
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Confounding
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Which of the following terms can be defined as follows: "the number of new cases of disease, injury or death in a population during a specified time period"? Incidence Cumulative incidence Point prevalence Prevalence Mortality rate
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Incidence
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Genetic determinants are important factors that affect individual health, and they will continue to be important for which of the following reasons? Nearly every disease has a genetic element in its natural history Very few diseases have genetic elements in their natural history Nearly every disease has a chromosomal abnormality as part of its natural history Nearly every disease has constitutive or acquired genetic components Nearly every disease has a chromosomal component that causes lots of diseases
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Nearly every disease has constitutive or acquired genetic components
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Which of the following statements is correct? Midstream factors include treatment systems, disease management, and investment in clinical research. Downstream factors include lifestyle, behavioural, and individual prevention programs. Upstream factors involve government policies and investment in population health research. Both a and b
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Upstream factors involve government policies and investment in population health research.
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What are the implications of the integration of genetics into public health? Treatment for affected high-risk individuals Prevention for at-risk individuals Health-promotion activities among the general population Crop modification, pharmaceuticals, and the cloning of animals All of the above
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All of the above
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The National Mental Health Strategy (NMHS) is a commitment by the Australian federal, state, and territory governments to improve the lives of people with mental illnesses. Which of the following aims are not part of this strategy? Promoting the mental health of the Australian community Where possible, preventing the development of mental disorders Recognising that the risks of developing mental health problems and mental illnesses are the same for everyone Reducing the impact of mental disorders on individuals, families, and the community
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Recognising that the risks of developing mental health problems and mental illnesses are the same for everyone
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The scope of what constitutes an environmental determinant is generally restricted to external physical, chemical, and microbiological exposures and processes that affect individuals and the community at large and that are beyond their immediate control. Which of the following are not considered environmental determinants? Seasonal, latitudinal, or altitudinal differences in exposure to solar radiation Cigarette smoking The microbiological quality of drinking water and food Exposure to environmental tobacco smoke (i.e., passive smoking)
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Cigarette smoking
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Turrell′s model of upstream, midstream, and downstream, which is presented in the figure, is a mechanism for which of the following? Determining the range of factors that may contribute to ill health Listing biological and physiological contributors to disease and death Showing us how big the problem is, particularly from a policy perspective Suggesting that employment and education impact on health and illness None of the above
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Determining the range of factors that may contribute to ill health
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Social capital is defined as which of the following? People's trust and sense of belonging to networks and communities, which can strengthen social cohesion within communities The amount of investment by industries to ensure that workers have healthy lifestyles A community-development approach to strengthen people's ability to access services The reduction of social isolation in communities
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People's trust and sense of belonging to networks and communities, which can strengthen social cohesion within communities
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What are the implications of social and economic disadvantages on the emotional health of children? Children from low-income families are more likely to manifest cognitive development problems (Najman et al, 2004). Socioeconomic disadvantages during the early years have the potential to have deleterious effects on adult health. There should be an emphasis on public health and health-promotion programs during the early years of life. All of the above
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All of the above
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Fill the gaps in the statement below with the most appropriate words or phrases: "There is evidence to suggest that people's health is produced and sustained by __________ circumstances that they experience __________ throughout their life." economic and emotional; equally social and economic; differentially geography and material; similarly work opportunity and gender; equally
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social and economic; differentially
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The effects of geographical location or place that are significantly connected to health and well-being are called which of the following? Compositional effects Compositional and contextual effects Contextual effects All of the above
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Contextual effects
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Which of the following is one of the crucial challenges of public health ethics? Ensuring that there is consensus among government departments, the general public, and nongovernmental organisations with regard to health policies and programs Balancing the rights of the individual with the well-being of the population as a whole Ensuring that you can persuade stakeholders that your values are the best values Restricting the rights of an individual to ensure the well-being of a whole population None of the above
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Balancing the rights of the individual with the well-being of the population as a whole
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As a health-promotion worker who is practicing in a community with high rates of diabetes, you decide that the best intervention is to provide information about the role of diet and exercise in controlling diabetes, and you establish an exercise group. The results of the intervention are disappointing, because the community is not enthusiastic about the project. What did you fail to consider? That exercise plays no role in diabetes That diet is not important That the community was not consulted That diabetes rates are not really that high That most people have prediabetes anyway
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That the community was not consulted
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What does the term medical ethics generally refer to? A medical or health care provider's ethical responsibility toward a patient or client A medical or health care provider's ethical responsibility toward the population at large A medical or health care provider's ethical responsibility toward subpopulations A medical or health care provider's ethical responsibility toward nobody in particular A medical or health care provider's ethical responsibility toward people with diabetes
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A medical or health care provider's ethical responsibility toward a patient or client
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The Genographic Project commenced in 2005. This 5-year study of genetic anthropology aimed to collect 100,000 blood samples from indigenous people to investigate human migration in the region. Such research has the potential to contribute benefits to health, including an understanding of the genetic foundations of susceptibility to particular diseases. Why do you think indigenous groups might oppose a project like this? The study was too well constructed and too easy to complete. The study had too small a sample to draw conclusions about the population. The study had too large a sample and would be too difficult to analyse. The study did not account for privacy, autonomy, or ownership. The study took account of the personal preferences of nonindigenous people
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The study did not account for privacy, autonomy, or ownership.
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Gostin (2003) suggested a framework for analysing public health interventions. Which of the following best describes this framework? Assess the nature, probability, and severity of the risk. Assess whether the proposed action will be effective for the meeting of objectives. Assess the economic costs and the burden on human rights. Assess the just allocation of benefits and burdens. All of the above
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All of the above
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What is a code of ethics? A collection of issues that practitioners make decisions about with regard to practice A collection of standards for practitioners and organisations A collection of evidence-based activities that do not guide practice A collection of random ideas and self-directed practices that influences activity A collection of ideas that guide practice and that influence what practitioners do
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A collection of standards for practitioners and organisations
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The development of evidence-based guidelines for practice began with the development of evidence-based medicine. Who was it that criticised the medical profession for not providing reviews of clinical medicine? A surgeon, Dr John Snow A nurse, Florence Nightingale A teacher, John Dewey A public health practitioner, Dr Edwin Chadwick An epidemiologist, Dr Archie Cochrane
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An epidemiologist, Dr Archie Cochrane
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Hand washing in hospitals is still not undertaken by all health care staff. A number of initiatives have been introduced to increase hand-washing rates, including raising awareness of the need for hand washing. Michie and colleagues (2005) suggest that hand washing is not performed in hospitals for which of the following reasons? Organisational reasons (e.g., time, facilities) Motivational factors (personal reasons that individuals do not wash their hands) Action initiation (it is seen as important, but practice is not consistent) All of the above Only a and b
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All of the above
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Closing the gap between evidence and practice requires which of the following? Recognising situations in which evidence-based practice is not being practised Identifying and addressing barriers to new practice Challenging past beliefs and practices Implementing new practices All of the above
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All of the above
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An abundance of information underlies the justification for evidence-based practice. Practitioners have access to a lot of information, so it is important for them to know how to do which of the following? How to interpret information and critically analyse it How to use all of the information obtained from the Internet How to use newspaper articles How to read journal articles How to memorise information from lectures
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How to interpret information and critically analyse it
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Which of the following is not a barrier to the use of evidence-based practice (EBP)? Reasons related to the evidence base, such as gaps in the evidence base or a poor quality of evidence Personal reasons related to the individual practitioner, such as a lack of skills to undertake EBP or a lack of time Evidence that demonstrates that qualified allied health workers make the best decisions about how not to practice Reasons related to the organisation, such as inappropriate or inadequate support for EBP or the perceived threat of EBP A lack of understanding of the process, economic constraints, or inadequate access to evidence
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Evidence that demonstrates that qualified allied health workers make the best decisions about how not to practice
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1. Which of the following models is not one of the three models that, according to Lenihan (2005), have typified planning in public health practice? Problem/program planning and community assessment Advocacy planning Strategic planning Systems perspective planning
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Systems perspective planning
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Which of the following does Green and Kreuter (2005) PRECEDE/PROCEED model analyse the influences of? Behavioural factors on community health Environmental factors on community health Both of the above Neither of the above
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Both of the above
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What are the four types of needs that are commonly identified in public health? Normative needs, relational needs, expressed needs, and observational needs Normative needs, comparative needs, expressed needs, and felt needs Conventional needs, relational needs, articulated needs, and felt needs Conventional needs, comparative needs, expressed needs, and observational needs
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Normative needs, comparative needs, expressed needs, and felt needs
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Fill in the gaps in the statement below with the most appropriate words and phrases: ¿A program logic model is a diagrammatic representation of the __________ the elements of a program, including its __________; its impact and outcomes; and its evaluation plan.¿ stakeholders of; placement aims and objectives of; evidence granting body¿s relevance to; settings logical connections among; goals, objectives, and activities
answer
logical connections among; goals, objectives, and activities
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What are the two main purposes of completing an evaluation? Ensuring accountability to stakeholders and making judgements about the program Ensuring accountability to stakeholders and making sure that you can justify your conclusions Ensure that you have spent all of the allocated funds and making judgements about the program Ensuring that you have correctly described the program or project to the participants and justifying your conclusions
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Ensuring accountability to stakeholders and making judgements about the program
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Which of the following can be considered chronic diseases or conditions? Coronary heart disease Diabetes Rabies Only a and b Only b and c
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Only a and b
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Which of the following statements is not true about chronic diseases? They often involve multiple risk factors. It is predicted that, by the year 2020, they will be the leading cause of disability worldwide. They require prevention across the continuum, early detection and treatment, integrated and coordinated care, and self-management. They remain the leading cause of death and disability in low-income countries.
answer
They remain the leading cause of death and disability in low-income countries.
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Which of the following is a disease that can spread from one individual to another? An infectious disease A communicable disease A chronic disease An eradicated disease
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A communicable disease
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For any infectious disease to occur, what three elements must be present? Transmission, agent, and environment Person (or host), portal of entry, and agent Person (or host), agent, and environment Portal of exit, agent, and protozoa
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Person (or host), agent, and environment
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Which of the following terms is not used to describe the capacity of particular microorganisms to cause disease? Antigenicity Infectivity Pathogenicity Virulence Prokaryotic
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Prokaryotic
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What is the easiest way to describe the term environmental health? It is the protection of human health by ensuring the purity of water and the control of vermin. It is the protection of the health of wilderness areas, rivers, and oceans. It involves creating and maintaining environments that promote good public health. None of the above
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It involves creating and maintaining environments that promote good public health.
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Insert the correct number range in the following statement: "Despite Australia having one of the safest food supplies in the world, it is estimated that there are between __________ cases of gastroenteritis each year." 2 and 4 million 4 and 7 million 4 and 7 billion 2 and 4 billion
answer
4 and 7 million
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Traditional environmental health hazards include which of the following? Lack of access to safe drinking water; food contamination with pathogens; and urban air pollution from motor vehicles, coal power stations and industry Water pollution from populated areas, industry, and intensive agriculture; food contamination with pathogens; and inadequate solid waste disposal Lack of access to safe drinking water; chemical and radiation hazards after the introduction of industrial and agricultural technologies; and inadequate solid waste disposal Lack of access to safe drinking water; food contamination with pathogens; and inadequate solid waste disposal
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Lack of access to safe drinking water; food contamination with pathogens; and inadequate solid waste disposal
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Fill in the gaps in the statement below with the most appropriate words and phrases: "__________ is one of the primary drivers of public health. I often refer to it as 'Health 101,' which means that once we can secure access __________ facilities for all people, irrespective of the difference in their living conditions, a huge battle against all kinds of diseases will be won" (World Health Organisation, 2004). Water and sanitation; to clean water and to adequate sanitation Nutrition; to safe food-producing Exercise; to recreational Money; to banking
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Water and sanitation; to clean water and to adequate sanitation
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The most important anthropogenic greenhouse gas, which is responsible for more than 60% of the greenhouse effect, is which of the following? Carbon dioxide Carbon monoxide Methane Nitrous oxide
answer
Carbon dioxide
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What are the key elements of flood management? Mitigation strategies to divert or store water Construction standards to withstand the floods Evacuation strategies to remove people from the danger All of the above Only a and c
answer
All of the above
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According to the World Association for Disaster and Emergency Medicine, mixed hazards are those that are derived from the interaction of human development with the natural environment. Examples include which of the following? Desertification from land clearing and erosion and landslides from deforestation Conflict, including armed and unarmed conflict Technological, including transport and industrial technology All of the above
answer
Desertification from land clearing and erosion and landslides from deforestation
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The comprehensive approach to disaster management seeks to ensure consistency throughout the life cycle of a disaster, which consists of which of the following? Preparation, prevention, response, and recovery Response, recovery, prevention, and preparation Prevention, preparation, response, and recovery Prevention, preparation, recovery, and response
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Prevention, preparation, response, and recovery
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The management of the response and relief phase may be considered to encompass the "eight Cs" of response management. The third "C" is for coordination, which refers to which of the following? The direction of members of an organisation in the performance of roles and tasks: Its arrangements operate vertically within an organisation and ensure that the organisation's resources can be directed to the delivery of its roles and responsibilities. The bringing together of organisations and elements to ensure an effective response: It is mainly concerned with the systematic acquisition and application of resources from various agencies and locations. The strategies required to limit the scope and spread of an event: The concept has most relevance for pandemic preparedness, whereby strategies seek to limit the spread of an infectious disease through quarantine, isolation, and containment strategies The strategies needed to maintain functionality: When events are long term, it is neither possible nor safe to maintain key personnel on duty. They need to be relieved from duty, particularly if their own families are under threat or if they have suffered personally as a result of the incident
answer
The bringing together of organisations and elements to ensure an effective response: It is mainly concerned with the systematic acquisition and application of resources from various agencies and locations.
question
The key aspects of pandemic management include which of the following? Early isolation and containment, enhanced infection-control procedures, and the rapid development of immunisation Early isolation and containment, enhanced infection-control procedures, and the rapid development of quarantine procedures Early isolation and containment, enhanced risk-assessment procedures, and the rapid development of immunisation Early isolation of the population, enhanced infection-control procedures, and the unhurried development of immunisation
answer
Early isolation and containment, enhanced infection-control procedures, and the rapid development of immunisation
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Which of the following are the five essential actions of the Ottawa Charter for Health Promotion? Build healthy public policy; change individual behaviour; strengthen community actions; develop personal skills; and reorient health services Build healthy public policy; create supportive environments; strengthen community actions; develop personal skills; and publicize health services Build healthy public policy; create supportive environments; strengthen community actions; develop personal skills; and reorient health services Build healthy public policy; create supportive environments; strengthen community actions; reward good personal skills; and reorient health services
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Build healthy public policy; create supportive environments; strengthen community actions; develop personal skills; and reorient health services
question
The Health Promoting Schools Framework is an example of community development that makes use of which three integrated components? Fair disciplinary actions; school organisation, ethos, and the environment; and partnerships and services Curriculum, teaching, and learning; school organisation, ethos, and the environment; and anti-bullying policies Curriculum, teaching, and learning; school organisation, ethos, and the environment; and partnerships and services Curriculum, teaching, and learning; school lunch provision; and partnerships and services
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Curriculum, teaching, and learning; school organisation, ethos, and the environment; and partnerships and services
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What is one of the major criticisms of health education? It relates to healthy public policy and the development of individual issues The overemphasis on group responsibility at the expense of the individual The overemphasis on individual responsibility and potential victim blaming The implications for preventative medicine and the care of the individual Its vulnerability to political and community influences and environments
answer
The overemphasis on individual responsibility and potential victim blaming
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A published review of successful health promotion revealed which of the following successful health-promotion actions? Community participation and engagement in planning and decision making, the creation of healthy settings, and human resource investments Intersectoral collaboration and interorganisational partnerships at all levels, community participation and engagement, and marketing and human resource investments The creation of healthy settings, community participation and engagement in planning and decision making, and intersectoral collaboration and interorganisational partnerships at all levels. None of the above
answer
The creation of healthy settings, community participation and engagement in planning and decision making, and intersectoral collaboration and interorganisational partnerships at all levels.
question
Community development is the process of which of the following? The top-down management of community development activities and approaches The fostering of a climate that encourages professional management The involvement of communities in their own decision making from the ground up The fostering of a climate that engages health professionals in community care All of the above
answer
The involvement of communities in their own decision making from the ground up
question
There are a number of major global trends that have been identified as having an impact on health. Which of the following issues is one of these global trends? The decreasing costs of health and health care systems The limited importance of community and environment Increases in the incidence of chronic diseases The improving social circumstances of the poor Increasing the quality and amount of medical technology available
answer
Increases in the incidence of chronic diseases
question
Fill in the gaps in the statement below with the most appropriate words and phrases: "Globalisation is the movement across national boundaries of __________, which results in the world becoming politically, economically, and culturally __________." wildlife, especially birds; interconnected and interdependent people, ideas, money, goods, and services; unconnected and independent pandemic diseases; interconnected and interdependent people, ideas, money, goods, and services; interconnected and interdependent
answer
people, ideas, money, goods, and services; interconnected and interdependent
question
How could global trade contribute to increasing an individual's risk for chronic diseases? The marketing of unhealthy products and risk behaviours, such as tobacco smoking and the consumption of fast food Too many people catching planes, trains, and buses instead of walking and cycling Medical tourism, which involves patients travelling to other countries for medical treatments (e.g., dentistry, surgery) Rapid cross-border transmission as a result of fast transportation (e.g., air travel)
answer
The marketing of unhealthy products and risk behaviours, such as tobacco smoking and the consumption of fast food
question
Refugee crises affect Australia and many other countries, and there are misunderstandings about refugee resettlement in Australia. What are three popular myths regarding refugees? "Most refugees would prefer to stay in their countries of origin"; "resettlement leads to a 'brain drain'"; and "resettlement costs too much" "Most refugees want to be resettled"; "many resettled refugees contribute their knowledge and skills to improving the society"; and "resettlement leads to a 'brain drain'" "Most refugees would prefer to stay in their countries of origin"; "resettlement leads to a 'brain drain'"; and "resettlement costs too much" "Most refugees want to be resettled"; "resettlement leads to a 'brain drain'"; and "resettlement costs too much
answer
"Most refugees want to be resettled"; "resettlement leads to a 'brain drain'"; and "resettlement costs too much
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Which of the following is not one of the Millennium Development Goals? Achieve universal tertiary education. Reduce child mortality. Eradicate extreme poverty and hunger. Ensure environmental sustainability. Promote gender equality and empower women.
answer
Achieve universal tertiary education.
question
In general, at the time of colonisation, accounts from early British and European explorers show that Aboriginal and Torres Strait Islander peoples had which of the following health conditions? They suffered from a range of lifestyle-related diseases. They had the same health status as they do now. They were physically inactive and suffered from malnutrition. They were fairly fit, healthy, and free of disease.
answer
They were fairly fit, healthy, and free of disease
question
Which of the following is true about the life expectancy at birth for Aboriginal and Torres Strait Islander people as compared with nonindigenous Australians? The life expectancy for Aboriginal and Torres Strait Islander men is about 20.5 years less than other Australian men; for women, it is about 9.7 years less than nonindigenous Australian women. The life expectancy for Aboriginal and Torres Strait Islander men is about 11.5 years less than other Australian men; for women, it is about 9.7 years less than nonindigenous Australian women The life expectancy for Aboriginal and Torres Strait Islander men is about 11.5 years less than other Australian men; for women, it is about 19.7 years less than nonindigenous Australian women. The life expectancy for Aboriginal and Torres Strait Islander men is about 11.5 years more than other Australian men; for women, it is about 9.7 years less than nonindigenous Australian women.
answer
The life expectancy for Aboriginal and Torres Strait Islander men is about 11.5 years less than other Australian men; for women, it is about 9.7 years less than nonindigenous Australian women
question
What is the goal of the Close the Gap campaign? Closing the life-expectancy gap between indigenous and nonindigenous Australians Promoting equal rights for Aboriginal and Torres Strait Islander peoples Improving educational opportunities for Aboriginal and Torres Strait Islander peoples Closing the gap between the educational achievements of Aboriginal and Torres Strait Islander peoples and nonindigenous Australians
answer
Closing the life-expectancy gap between indigenous and nonindigenous Australians
question
Why did the Human Rights and Equal Opportunity Commission's Social Justice Report 2007 claim that the Northern Territory's "Emergency Response" intervention was controversial? It guaranteed strict monitoring and evaluation provisions to ensure that only those measures that are appropriate are maintained. It repealed the proviso of the legislation that limited indigenous peoples' rights to obtain remedy. It produced or intensified discord and mistrust between the federal government, the Northern Territory government, the indigenous communities and numerous community organisations. It reinstated the Community Development Employment Projects scheme in the Northern Territory, with community fiscal development plans progressed into the future to guarantee the conversion from Community Development Employment Projects into "real jobs."
answer
It produced or intensified discord and mistrust between the federal government, the Northern Territory government, the indigenous communities and numerous community organisations.
question
The National Health and Medical Research Council's Road Map: A Strategic Framework for Improving Aboriginal and Torres Strait Islander Health Through Research (2004) sets out criteria for health and medical research with and of Aboriginal and Torres Strait Islander Australians that include which of the following? That research be based on identified need; be action oriented; contain a skills- and knowledge-transfer strategy; and involve the institutional control of research That research be based on the needs identified by the relevant university; be action oriented; contain a skills- and knowledge-transfer strategy; and involve the institutional control of research That research be based on identified need; be action oriented; not involve the participants with the research designs and aims; and involve the community control of research That research be based on identified need; be action oriented; contain a skills- and knowledge-transfer strategy; and involve the community control of research
answer
That research be based on identified need; be action oriented; contain a skills- and knowledge-transfer strategy; and involve the community control of research
question
What were the three important issues highlighted by The Future of the Public's Health in the 21st Century (Institute of Medicine, 2003)? The focus on medical care rather than socioeconomic status; the attention to biomedical research rather than prevention research; and the ongoing disparity in health between different population groups The focus on medical care rather than prevention; the attention to biomedical research rather than prevention research; and the ongoing disparity in health between different population groups The focus on medical care rather than prevention; the attention to biomedical research rather than genetic research; and the ongoing disparity in health between different population groups The focus on medical care rather than prevention; the attention to biomedical research rather than prevention research; and the increasing rates of overweight and obesity in certain population groups
answer
The focus on medical care rather than prevention; the attention to biomedical research rather than prevention research; and the ongoing disparity in health between different population groups
question
Regardless of the health issue under consideration, what is one of the salient themes of public health in the twenty-first century? The notion of global effects and responses The need for each nation to make decisions about its own public health priorities More education and more resources More personal responsibility for health
answer
The notion of global effects and responses
question
Fill in the gaps in the statement below with the most appropriate words and phrases: "One of the major concerns for public health workers in countries like Australia is that __________ has/have a strong association with cardiovascular risk factors, obesity, and diabetes." a lack of income and motivation inadequate nutrition and too much physical activity a high income a lack of physical activity and the overconsumption of food
answer
a lack of physical activity and the overconsumption of food
question
In Australia, 13% of the population is 65 years old or older (Australian Institute of Health and Welfare, 2010). During the past decades, the number and proportion of the population in this age group have increased rapidly in Australia. How can we reduce the impact of this on our health services? Rationing health services to particular population groups on the basis of criteria such as age or a person's responsibility for his or her condition Allocating more resources to preventative health and screening Providing environments and policies that encourage people to adopt healthier lifestyles, no matter their age All of the above Only b and c
answer
Only b and c Allocating more resources to preventative health and screening Providing environments and policies that encourage people to adopt healthier lifestyles, no matter their age
question
Public health workers in the future will need to do which of the following? Have a focus on equity and equality Acknowledge and act on the issues that affect ecological sustainability Understand the multiple determinants of population health patterns All of the above Only a and b
answer
All of the above
