SIAD Exam #1 definitions

Social Inequality

the unequal opportunities and rewards for different social positions or statuses within a group or society

Social positions/statuses

religion, race, age, gender, sexual orientation

rewards

income, wealth, education, employment

burdens

unemployment, incarceration, substance abuse

poverty

to lack or be denied access to goods, services, and infrastructure necessary to sustain basic human capabilities

absolute poverty

having less than an objectively defined absolute minimum; does not change over time except for inflation

relative poverty

having less than others in society; changes with economic growth

Race

socially constructed category rooted in the belief that there are fundamental differences among humans, associated with phenotype and ancestry

ethnicity

cultural values and norms that distinguish the members of a given group from others

structural racism

a system in which public policies, institutional, practices, cultural representations, etc. perpetuate racial group identity

Extreme poverty

living on less than $2.15 per day

Sustainable development goals

Zero hunger, good health and well-being, clean water and sanitation

Health inequities

health differences that are closely linked with social, economical, and/or environmental disadvantage

health equity

the attainment of the highest level of health for all people by eliminating health inequities

social gradient in health

the correlation between socioeconomic status and health; at each level of socioeconomic status there is a difference in health

social determinants of health

conditions in the places where people are born, live, learn, work, and play that affect a wide range of health and quality of life risks and outcomes

Social inequality to disease

inadequate housing, poor sanitation, malnutrition

Disease to social inequality

medical costs, reduced ability to work/loss of wages, disease stigma/discrimination

social justice

the fair distribution of wealth, opportunities, and privileges within a society

epidemiology

the study of disease frequency, determinants of disease and other conditions, and the pattern and distribution of disease and other conditions in a population

public health

the science of protecting and improving the health of communities through education, promotion of healthy lifestyles, and research for disease and injury prevention

ten great health achievements

vaccination, motor-vehicle safety, safer workplaces, family planning, control of infectious diseases

social medicine

the social conditions and characteristics of patients, the social causes of illness, and contexts of medical care

population

a group of people who share a common characteristic

distribution

the frequency and pattern of health-related characteristics and events in a population

frequency

proportion of a population that is affected by a particular disease

incidence

the number of new disease cases reported in a population over a certain period of time

prevalence

the total number of individuals in a population that have a disease or health condition at some designated time

determinants

any factor that can bring about a change in health

risk factors

activities or factors that increase an individual’s risk of developing a disease or health condition

epidemic

the occurrence of cases of an illness in a community or region which is in excess of the number of cases normally expected for that disease in that area at that time

pandemic

global epidemic

endemic

the usual presence of a disease in certain areas

morbidity

disease or injury

mortality

death

Disability Adjusted Life Years (DALYs)

number of healthy years of life lost to illness and injury and premature death

HIV

human immunodeficiency virus

virus

microscopic infectious agent that can replicate only within a living cell (therefore, an obligate intracellular parasite) consisting of DNA or RNA surround by a protein coat

AIDS

acquired immune deficiency syndrome

retrovirus

have genomes that consists of single-stranded RNA, which after infection, are reverse transcribed into double-stranded DNA which is then integrated into the hot cells chromosomal DNA

polyproteins

large proteins cleaved by proteases (break peptide bonds) to produce two or more smaller proteins

gp120

protein that has sugar molecules covalently linked to it; interacts with CD4

integrase

enzyme integrates DNA into host cell

macrophages/helper T cells

carry CD4 protein on plasma membranes; CD4+ cells; receptors for HIV

HIV co-receptors

CCR5 for macrophages; CXCR4 for T cells; chemokine receptors

Chemokine receptors

proteins that regulate the immune system

fusion

HIV is taken into the cell; the viral envelope fuses with the cell’s plasma membrane

budding

new viral particles are formed/released

CD4+ T cells

helper cells that stimulate other immune cells to produce antibodies and cytokines

cytokines

proteins that activate the immune system

antibodies

proteins produced by certain immune system cells in response to a foreign substance

antigen

any substance that can provoke the immune system to produce antibodies

eclipse period

limitation of HIV testing; typically 10-12 days during which no current test can detect a new infection

nucleotides

nitrogenous base, pentose sugar, and phosphate

nucleosides

nitrogenous base and pentose sugar

DNA

polynucleotide linked by phosphodiester bonds; 5’-3’ polarity

DNA polymerase

enzyme that synthesizes chromosomal DNA; only add new nucleotides to 3’ OH group

Reverse transcriptase

special type of DNA polymerase that uses RNA instead of DNA as a template

nucleoside/nucleotide RT inhibitors

structural analogs of nucleotides required for DNA synthesis; azidothymidine

non-nucleoside RT inhibitors

block RT activity by binding at a site different than the site bound by NRTI; Efavirenz

combination therapy

use combinations of at least two different classes of drugs; commonly integrase inhibitor and two NRTIs

mutation

a heritable (inherited) change in the genetic material; occur randomly with respect to location and time

induced mutations

mutations caused by mutagens; not relevant to HIV

spontaneous mutations

occur naturally and continually, and are the ultimate source of natural genetic variation; major source: replication errors

amino acid substitutions

alter the structure and function of the protein

phenotype

the physical characteristics of an organism

natural selection

the differential survival and reproduction of different phenotypes in a population

Evolution

a change in the genetic composition of a population over time

basic mechanism of evolution by natural selection

variation, heritability, overproduction, differential survival and reproduction

variation

there is variation in phenotype among individuals in a population

heritability

some of the variation is heritable, can be passed from one generation to the next

overproduction

in any population of living organisms, more offspring are produced that can possibly survive, leading to a “struggle for existence”

differential survival and reproduction

some of the heritable variations confer individuals with a greater ability to survive and reproduce in a given environment than other individuals; selective advantage

Resistance of humans to HIV infection

rare individuals are homozygous for mutations that lead to the production of non-functional CCR5 chemokine receptor, the co-receptor required for HIV infection.

obesity

weight that is higher than what is considered healthy for a given height, commonly defined as having a body mass index greater than or equal to 30

diabetes mellitus

a metabolic disorder in which defects insulin production or utilization lead to dangerously high levels of blood glucose

type 1 diabetes

about 5% of cases, insulin cannot be produced

type 2 diabetes

about 95% of cases, reduction in the body’s ability to use insulin (insulin resistance)

glucose

hexose 6 carbon sugar

glycogen

storage polysaccharide; polymer of glucose

homeostasis

process of maintaining a stable physiological condition

hormone

chemical or protein secreted by an endocrine gland into the blood that is transported to target cells

peptide

a relatively short protein; usually less than 50 amino acids

insulin

released by beta cells in the pancreas to decrease blood glucose levels; stimulates tissues to take in glucose, excess glucose is converted to glycogen/fat; composed of a covalently linked polypeptides composed of 51 amino acids

glucagon

released by alpha cells in the pancreas; stimulates the liver to release glucose to raise blood glucose levels

signal transduction

the sequence of biochemical events in a cell by which an external signal is detected and converted into an intracellular signal leading to a change in the cell’s activities

insulin resistance

reduced ability of cells to respond to insulin

adipocytes

fat cells; store energy in the form of triglycerides

triglycerides

consist of a molecule of glycerol with three fatty acids covalently linked to it

lipolysis

specific type of hydrolysis where fatty acids are cleaved form triglycerides, creating free fatty acids

GLUT4 translocation

in insulin resistance, the cells do not take up as much glucose from the blood as they previously could, leading to higher blood glucose level characteristics of diabetes

microvascular complications

tissue surrounding capillaries becomes abnormally thick; leads to retinopathy and nephropathy

peripheral neuropathy

microvascular circulatory problems combined with hyperglycemia can damage peripheral nerves; injuries can occur unknown to patient

macrovascular complications

increase risk of stroke and heart attack

metformin

increases insulin sensitivity of target tissues; usually used with lifestyle modifications

sodium-glucose transport protein 2 (SGLT-2) inhibitors

block glucose reabsorption in the kidney

glucagon-like peptide 1

peptide hormone that binds to receptors on pancreas and other organs where they have numerous effects including release of insulin and lowering blood glucose

receptor agonists

molecules that bind to receptors and mimic the effect of the normal ligand for the receptor

bariatric surgery

gastric bypass or sleeve; size of stomach is drastically reduced, reducing the amount of food people can eat