Exam 2 - Intro to Applied Health Science

the oldest written documents related to heath care dating from 1600 b.c.e, which describe various surgical techniques

smith papyri

the earliest written record concerning public health

• it contained laws pertaining to health practices and physicians, including the first known fee schedule

code of hammurabi

people turned to some type of a physician or medicine man for health information, treatments, and procedures - in this place, this role was held by the priests

• eventually, the various incantations, spells, exorcisms, prescriptions, and clinical observations were comiled into written format, some of which survive in our museums and libraries

egypt

• they possessed a strong sense of cleanliness and were considered to be the healthiest people of their time

• they used numerous pharmaceutical preparations and constructed earch privies for sewage, as well as public drainage pipes

• they relied primarily on priests for their health information and used remedies such as “dung of the gazelle and the crocodile, the fat of a serpent, mammalian entrails and other excreta, tissues and organs

egyptians

extended egyptian hygienic though and formulated what is probably the world’s first written hygienic code

• it dealt with a variety of personal and community responsibilities, including cleanliness of the body, protection against the spread of contagious diseases, isolation of lepes, disinfection of dwellings after illness, sanitation of campsites, disposal of excreta and refuse, protection of water and food supplies, and specific hygiene rules for menstruating women and women who had recently delivered a child

hebrew

were perhaps the first people to put as much emphasis on disease prevention as they did on the treatment of disease conditions

• balance among the physical, mental, and spiritual aspects of the person was emphasized

• religion played an important role in health care

• however, the role of the physician began to take on a more defined shape, and a more scientific view of medicine emerged

greeks

was a thessalian chief who had received instruction in the use of drugs

• tradition had enshrined him as the god of medicine

• he had two daughters who also had health-related powers

asciepius

was given the power to prevent disease

hygeia

was given the ability to treat disease

panacea

were a brotherhood of men present at the temples who initially claimed descent from asclepius

asclepiads

the staff and serpent of the physician

caduceus

developed a theory of disease causation consistent with the philosophy of nature held by leading philosophers of this day

• taught that health was the result of a balance, and disease was the result of imbalance

hippocrates

the ideal person was perfectly balanced in mind, body, and spirit

greeks

holds an important place in the history of medicine

• his theory of health and disease was still being taught in medical schools as a valid theory of disease causation as recently as the first quarter of the 20th century

• did more than just theorize about disease - he carefully observed and recorded associations between certain diseases and such factors as geography, climate, diet, and living conditions

• has been credited with being the first epidemiologist and the father of modern medicine

hippocrates

conquered the mediterranean world, including the greeks

• did not destroy the cultures they conquered but learned from them

• accepted many greek ideas, including those related to health and medicine

• really excelled at engineering and administration

• they developed water transport systems to move large quantities of fresh safe water to population centers and sewage systems to remove waste

romans

they observed the effect of occupational hazards on health, and they were the first to build hospitals

• a system of private medical practice also developed during this era

romans

it was a time of political and social unrest, when many health advancements of previous cultures were lost

• each city had to defend itself against enemies

• as the population grew, expansion was difficult and overcrowding was common

• lack of fresh water and sewage removal were major problems

• little emphasis on cleanliness or hygiene - cleanliness was thought to betoken pride, and filthiness humility

• the health-related advancements of the greco-roman era were abandoned and shunned - entire libraries were burned, and knowledge about the human body was seen as sinful

• characterized by great epidemics - cruelest was leprosy

• bubonic plague

middle ages

means “rebirth”

• people began to view the world and humankind in a more naturalistic and holistic fashion

• although progress was slow, science again emerged as a legitimate field of inquiry, and numerous scienctific advancements were made

• disease and plague still ravaged europe and overall medical care was still rudimentary

• bloodletting was a major form of treatment for everything from the common cold to tuberculosis

• popular remedies included crabs eyes, foxes lungs, oil of anise, oil of spiders, and oil of earthworms

• a major means of diagnosing a pateints conditio consisted of examining the urine for changes in color

• disposal of human waste was a huge problem

• was a period of exploration and expanded trade

renaissance

• period of revolution, industrialization, and growth of cities

• the general belief was that disease was formed in filth and that epidemics were caused by some type of poison that developed in the putrefaction process

• discovered that scurvy could be controlled on long sea voyages by having sailors consume lime juice

• discovered a vaccine procedure against small pox

age of enlightenment

• the streets of london were filthy with animal and human waste

• formation of general board of health for england

• extraordinary advancements in biology and bacteirology took place

• germ theory of disease

• discovered how microorganisms reproduce, introduced the first scientific approach to immunizations, and developed a technique to pasteurize milk

• developed the criteria and procedures necessary to establish that a particular microbe, and no other caused a particular disease

• developed an antiseptic method of treating wounds by using carbolic acid, and he introduced the principle of asepsis to surgery

• as a result, the years from 1875 to 1900 became known as the bacteriological period of public health

1800s

the period from 1900 to 1920

• urban areas expanded, and many people lived and worked in deplorable conditions

• federal regulations were passed concerning the food industry, states passed workers compensation laws, the US bureau of mines and US department of labor were created, and first clinic for occupational diseases was established

• by the end of 1920s, the movement for healthier workplace conditions was well established, and the average life expectancy had risen to 59.7 years

• first national voluntary health agencies were formed

reform phase of public health

was the first major recognition of the importance of lifestyle in promoting health and well-being

• this publication supproted a shift from the traditional medical model toward lifestyle and environmental strategies that emphasized prevention

healthy people

the fifth iteration of the healthy people public health objectives, includes 355 measurable objectives

• it will guide US public health practice and health education specialists through the decade of the 2020s

• for it to be effective programs must be developed and initiated to meet the established objectives - this means that partner states, counties, communities, organizations, and individuals must get involved

healthy people 2030

• reading, as the avenue to religious understanding, was the primary subject - writing, spelling, grammar, and arithmetic supplemented reading

• later geography and history were added, but the teaching of health was not part of the early education system in the US

• because only boys were allowed - work was still needed at the homes, so class was in short duration

• Horace Mann was the first advocate for teaching health in schools

• in 1850, lemuel shattuck wrote a report which provided strong support for school health

• in the 1930s, the drive for health education from the public slowed

• school health education received official recognition in 1937

• after WWII, school health education continued to grow as a profession

school health

was a major study of significance to school health education

• included 135 randomly selected school systems involving 1,460 schools and 840,832 students in 38 states

• results indicated major problems in the organization and administration of health programs

• the second phase established a curriculum based on needs identified from the first phase of the study (the quesionaire)

• over the next 8 years, the writing team developed a comprehensive curriculm package that schools could implement

school health education study (SHES)

its purpose was to evaluate the effectiveness of school health work in selected schools and colleges of the area - more specifically, the project aimed at the appraisal of the entire school health program, including administratice organizations, school health services, health instruction, and healthful school environment

school health education evaluation study (SHEES)

consists of 8 interactive components that work together to enhance the health and well-being of the students, faculty, staff, and community was devised.

• the 8 components consisted of health education, physical education, health services, nutrition services, counseling, psychology and social services, health school environment, staff health promotion and family, and community involvement

coordinated school health model

recognizes the importance of establishing health behaviors in youth

• to accomplish this, the model promotes the cooperation and collaboration of government agencies, community organizations, schools, community members, and families

WSCC

through a combination of cost controls, subsidies, and mandates, it expanded healthcare coverage to 20 million uninsured americans

• another important feature feature was the acts focus on prevention and prevention services

• the bill provided better access to clinical prevention services by removing cost barriers - furthermore, the bill encourages, promoted, and provided funding for worksite wellness programs, evidence-based community prevention and wellness programs, and school based health centers

• this bill should have created new and expanded opportunities for health education specialists to promote health

patient protection and affordable care act

was identified in wuhan, china, in december of 2019

• since then it has spread to become a worldwide pandemic

• there were approximately 130 million cases and nearly 3 million deaths worldwide

• as a result of the pandemic, public health has become more visible

• public officials are in the news daily

• health education specialists working in public health settings have important roles to play in addressing it

• public health education professionals are needed to inform the public about the disease and how it may be prevented and controlled

• behavior change programs and campaigns are needed to encourage mask wearing, handwashing, and social distancing

• further, health professionals are needed to serve as contact tracers and to accurately, concisely, and thoroughly translate complex epidemiological data to the general public

COVID-19

means a statement summarizing the attitudes, principles, beliefs, values, and concepts held by an individual or a group

philosophy

what are the six dimensions of wellness

• social

• physical

• intellectual

• emotional

• environmental

• spiritual

health has physical, emotional, spiritual, and social components, and each is just as important as the others

philosophy of symmetry

the mind and body disappear as recognizable realities and in their stead comes the acknowledgment of a whole bring…man is essentially a unified integrated organism

holistic philosophy

involves a health education specialist using behavioral contracts, goal setting, and self monitoring to try to foster a modification in an unhealthy habit in an individual with whom they are working

• allows for the establishment of easily measurable objectives thus enhancing the ability to evaluate outcomes

behavior change philosophy

focuses on the acquisition of content and factual information

• the goal is to increase the knowledge of the individuals or groups so that they are better armed to make decisions about their health

cognitive-based philosophy

a health education specialist presents simulated proglems, case studies, or scenarios to studnets or clients

• each problem, case, or scenario requires decisions to be made in seeking a “best approach or answer”

decision making philosophy

was proposed by greenberg as a reaction to traditional approaches of health education/promotion that he felt ran the risk of blaming victims for practicing health behaviors that were often either out of their control or not considered in their best interests

• has the ultimate goal of freeing people to make the best health decisions possible based on their needs and interests - not necessarily the interests of society

freeing or functioning philosophy

emphasizes the role of health education specialists in creating social, economic, and political change that benefits the health of individuals and groups

• are often at the forefront of the adoption of policies or laws that will enhance the health of all

social change philosophy

health education specialists are adaptable and resourceful, and they will use any health education/promotion approach that seems appropriate to the situation

eclectic health education/promotion philosophy

are published studies or eyewitness accounts written by the people who actually conducted the experiements or observed the events in question

primary data (sources)

usually written by someone who was not present at the event or did not participate as part of the study team

secondary data (source)

how to evaluate accuracy of non-research sources

• what are the authors qualifications

• what is the style of presentation

• are references included

• what is the purpose of the publication

• what is the reputation of the publication

• is the information new

a journal that publishes oroiginal manuscripts only after they have been read by a panel of experts in the field and recommended for publication

peer-reviewed journal

provide links to articles from many peer-reviewed journals, books, and research reports

indexes and abstracts

range from official documents including laws, court decisions, and records of congressional actions to the results of government-sponsored technical and scientific studies

• are not organized under the same classification scheme as a traditional general collection - instead are organized and shelved according to super intendent of documents numbers

government documents

often provide a preferred alternative to manually searching indexes or abstracts

electronic databases

what are the components of a research article

• abstract - brief description of results

• introduction - give more detailed description, review related literature, and explain need for study

• methodology - research design used, subjects who took part, instruments used to gather data, administrative procedures involved

• results and discussion sections

guides our practice and approach

philosophy

defines acceptable and unacceptable

ethics

sets standards for righ and wrong

morality

addresses good and evil

religion or spiritualism

describes human existence without judging it

philosophy

• centers on individual values, beliefs, and life principles

• influenced by personal experiences, cultues, and unbringing

• guides personal decisions and interactions with others

personal philosophy

• relates to ethical standards and practices in a profession

• often shaped by industry norms, regulations, and collective values

• affects decision-making and behavior in a workplace

professional philosophy

influences

• culture, religion, education, morals, environment, experiences, and family

• people who have influenced how you feel about yourself and others, your spirit, you optimism, or pessimism

personal philosophy

• scientific method

• priority to prevention and community perspective

• emphasis on the common good

• autonomy

philosophy of public health

using behavioral contracts, goal setting, and self-monitoring to try to foster a modification

behavior change

increase the knowledge of the individuals or groups so that they are better armed to make decisions about their health

cognitive

• creating and analyzing potential solutions

• emphasize critical thinking and lifelong learning

decision making

• goal of freeing people to make the best health decisions possible based on their needs and interests - not necessarily the interests of society

• advocate for change only if it infringes on the rights of others

freeing/functioning

creating social, economic, and political change that benefits the health of individuals and groups

social change

• all begins with self-examination and reflection

• three questions - what is the origin, nature, and purpose of human existence

• what can this do for you

philosophy

accurate, legitimate, authoritative, and authentic health information, health products, and health services

valid

trustworthy, dependable, and appropriate information, products, and services

reliable

what is the CRAAP method

• currency (timeliness)

• relevance (does it meet your needs)

• authority

• accuracy

• purpose

• the journey of data from collection to publishing

• publication date (5 years)

• revised or updated?

• does it need to be current?

  • does if youre using data

currency (timeliness)

• does it actually help - is it what youre looking for

• appropriate level - is it for kids or adults

• comparison to similar sources

• if you put it in a report for your boss, would you still have a job tomorrow

relevance

• who is the author - person vs. organization

• credentials? affiliations?

• contact info for author

• URL

• we can no longer trust .org

  • be careful

authority

• where did it come from

  • importance of looking at methodology in articles

• evidence-based support?

• peer-reviewed?

• data triangulation

• unbiased?

accuracy

• why is the info here - why does this source exist

  • persuade vs. inform

• fact or opinion

• impartial or biased

purpose

the process in which the activities of professional workers are assessed by others with comparable qualifications and experience, who are not close colleagues and preferable are not known to those by assessed

peer review

• is the customary and usual way to evaluate the quality of scientific endeavors in all fields of science

• proposed research projects

• proposed programs and interventions

• manuscripts submitted to scientific journals

peer review

gap between what is and what should be

need

a process that helps program planners determine what health problems might exist in any given group of people, what assests are available in the community to address the health problems, and the overall capacity of the community to address the health issues

needs assessment

the extent to which an entity has the ability (assets) to address a need and the extend to which the assets are readily available

capacity

how to establish a need

• trends over time

• comparison

• demographic differences

• threshold

• high prevalence or incidence

• mortality

• gather data and prioritize later

questions to ask during prioritization

• scope of the problem

• how serious is the problem

• how urgent or critical is the problem

• inverventions?

a well conceived and well conducted needs assessment determines if a health education/promotion program is justified - it defines the nature and scope of a program

needs assessment

what it takes to sell it

rationale

health problem

• needs and wants

• prevalence and/or incidence of the problem in the PP and geographic location

• impact of the condition on physical psychological health

• morbidity and mortality data

• disparities

• 
  

rationale

components of a rationale

• health problem

• propose a solution

• what can be gained

• what about programmic cost

surveys

• supervised, unsupervised, internet, mail, phone

• factors to consider

quantitative

• interviews, focus groups, observatoins, photovoice, nominal group process and delphi technique

• factors to consider

qualitative

assemble the team

• assemble before any work is completed

• PP members, stakeholders, partners

• doers and influencers

• partnerships - improved capacity, credibilitiy, perspectives

recruiting the team

• word of mouth

• election

• appointing

• application process

how do we keep people motivated

needs assessment team

employee satisfation

healthcare administrators

medical errors, patient support, access barriers, etc.

nurses

sports injuries (e.g. concussions among football players)

athletic trainers

common issues/topics, resilience, etc

mental health

treatment compliance, dental anxiety, etc

dental hygiene

5 steps for evaluation

• plan needs assessment

• conduct assessment

• review and rate data

• record and review consolidated data

• develop action plan

a person’s right to make choices, to hold views, and to take actions based on personal values and beliefs

autonomy

obligation not to inflict harm

nonmaleficence

provide benefits to persons and contribute to their welfare - refers to an action done for the benefit of others

beneficence

treat others equitably, distribute benefits/burdens fairly

justice

1901

• karl landsteiner, an australian scientist introduced ABO blood typing system

• he noted the pattern of agglutination to show how blood could be divided in groups

• he was rewarded a nobel prize for this discovery

• transfustions became fundamentaly safe

• procedures and surgeries that were previously impossible, now highly survivable

blood typing

1909

• “magic bullet”

• salvarsan was developed by paul ehrlich, alfred bertheim, and saharchiro hata

• identified in 1909 and was officially introduced in 1910

• proved that chemicals had the ability to kill specific pathogens without destroying human tissue

• nicknamed the 606 compound

• previous treatments relied on mercury which is highly toxic

• revolutionized medicine by effectively creating the field of antimicrobial chemotherapy

salvarsan

1918

• also called the spanish flu, was one of the deadliest pandemics in history

• it infected about 500 million people worldwide and caused at least 50 million deaths

• public health officials - used quarantine, isolation, masks, handwashing, and limiting large gatherings to slow the spread

• after the pandemic - public health became more focused on disease prevention and preparing for future outbreaks

• the pandemic showed how quickly a disease could spread when people did not have the tools to stop it

• today - we now have flu vaccines, testing, and better disease tracking

influenza pandemic

• hormone made by beta cells in the pancreas that helps control how our bodies metabolize carbohydrates, fats, and proteins by taking glucose from the blood into fat in muscles, liver, and fat

• 1910 - sir edward albert sharpey-schafer suggested a chemical was missing from the pancreas and labeled it insulin, coming from “insul” in latin, meaning island

• 1921 - a surgeon named frederick banting removed insulin from a dogs pancreas, which kept another dog alive for 70 more years, and then tried it with cattle

• 1922 - 14y/o boy was the first to receive insulin (he had near normal levels within 24 hours, and that is when it took off)

• 1923 - banting and his assistant received a nobel prize in medicine for the discovery

• 1978 - up until 1978 animal insulin was used; then they started to produce human insulin

• the only thing doctors knew was to put people with diabetes on very strict diets (with as little as 450 calories a day)

• before insulin was discovered, people with diabetes did not live for long because they did not have a cure

• today - insulin is produced in many different formulations and can be taken in many different forms

insulin

1921

• first federally funded social welfare program

• provided support to states for prenatal and infant health care to reduce infant and maternal mortality

• states used the funding from the act to set up prenatal clinics, hold conferences, and distribute education

• although many considered the sheppard towner act as a success, it still faced opposition and was dismantled entirely in 1929

• few states were able to continue their programs due to lack of funds and the early onset of the great depression

sheppard towner act