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I - Study Questions-

Directions- Answer each of the following questions with clarity and completeness.

1. State the ideal definition of health as promoted by the World Health Organization [WHO]. What are some of the practical assumptions of health? Illustrate and explain why health I viewed as a continuum rather than a static point.

2. List the live major criteria or indicators of health status and justify their use in assessing the health of a nation. List also the five major determinants of disease. How does the US fair in each category and rank its disease burdens in prevalence.

3. Illustrate the risk appraisal model and explain each of the six components that make up the model. What happens to residual risks and what factors influence risk acceptance?

4. State the Allen-Bergman Rule of somatotype determination and predict the type and likelihood of illness occurrences of the major body constitutions. How does the Body Mass Index DWI] correspond to these physical traits and what strategies would you suggest to an individual in order to maintain a BMI level in the low 20's?

5. List the four components of personal hygiene and defend or challenge the present strategies of care against bad breath, bladder infection, cataract, and digestive disorders.

6. Outline the broad classes of global dietary cultures and demographic distributions. Also analyze the USDA dietary recommendation and outline its flaws and suggest a common sense approach to eat a balanced diet.

7. Outline the major sexually transmitted diseases of public health importance and provide sensible approaches to reduce their impacts. Debate the issues of "condom vs conduct" in STD prevention. How do contact tracing and confidentiality affect public health intervention?

8. List, define, and provide examples where necessary for each of the following "alphabet soups":

a. The SP's of public health paradigm
b. The 5A's of health services evaluation
c. The 4D's of ill health
d. The 4G's of environmental justice
c. The 4E's of risk management
f. The 3C's of risk communication

9. Define substance abuse disorder [SAD] with respect to tolerance and dependence. Outline the major substances of abuse and their general consequences in society. How are the major intervention models used in public health to minimize substance abuse?

10. Define the terms habituation, acclimation, and acclimatization with respect to the nature of environmental stress and adaptation strategies. Outline the mechanisms of thermoregulation and describe the three types of hyperthermia and hypothermia with respect to signs and symptoms and methods of management. What are the physiological merits of fever?

11. State the "INVERSE CARE LAW" in the context of modem American Medical Practice. What do HMO's, PPO's, and DRG's represent? How would you judge the validity of a health care system? How could alternative medical concepts complement the current health care system in the United States?

12. A health surveillance campaign in a minority community of 1000 residents revealed 60 cases of a rare cancer (angiosarcoma) of the liver among a total of 400 residents allegedly exposed to vinyl chloride found in their water supply derived from underground water wells believed to be adjacent to an industrial hazardous waste site. Only 10 cases of the same rare liver cancer were registered among whiter residents in adjacent community who use tap water supplied by the city municipality.

a. Construct a contingency table and calculate the relative risk [RR], attributable risk [AR], and the odds ratio [OD].

b. If you suspect vinyl chloride to be the cause of the incidence of this rare form of liver cancer, what five steps have to be met to constitute the Hill's postulate?

c. If there are environmental justices issues in this case study, could you put them in perspective?

Part II - One of the few challenges of animal experimentation is the choice of species and dose levels. The rule of thumb in this regard suggests a species genetically close to the target species often man and a dose as close to real life exposure. Although these are hypothetical ideals, need for animal husbandry and cost limitations alone restrict us with limited choices. Invariably, rodents are often used as the species of choice for these reasons and in addition to the huge research literature that is available for comparison of results. The dose ranges can be selected from the median lethal dose or benchmark doses can be determined from pilot studies.

STUDY QUESTIONS-

1. Define risk assessment and outline and describe the risk assessment paradigm or process.

2. Distinguish between the terms hazard and toxicity as they relate to risk assessment and write general equations describing their interrelatedness.

3. Why is risk perception important in risk assessment and how does it affect risk acceptance or rejection? What factors influence risk perception and how can these factors be changed with time and place?

4. How can exposure assessment be performed and how is exposure history be used in occupational settings? Describe how exposure dose, frequency, duration, and route are assessed and outline their significance in risk assessment.

5. Describe risk characterization, analysis, and quantification using epidemiological and toxicological approaches and state equations or graphic displays in both.

6. What are the seven cardinal rules of risk communication and what three major areas should they address? Who is likely to succeed in risk communication between a politician and a community leader and why?

7. Describe and rank the four approaches of risk management and give some examples of each. Why is public health education central to health promotion and how and why could you change this approach?

8. Define the concept of biomarkers and describe their significance in risk assessment. State the three major classes of biomarkers and highlight their significance to each of the risk assessment paradigm.

9. Define mutagenicity, carcinogenicity, and teratogenicity and outline the major screening test used for detecting the potential of a chemical to cause cancer.

10. Do the problem given on your study guide on risk assessment.

III - Study Questions:

1. Define health and outline the major dimensions of health in the way you have understood it from the notes above or from your reading. Can you personalize these dimensions and rank them from 1-10 as your current health status?

2. Define public health and describe the public health paradigm. Distinguish between population health and global health; environmental health and ecosystem health.

3. Research the Human Development Index (HDI) and its widespread use in assessing the health of a nation. How is it computed and what measures contribute to the index?

4. List the major determinants of health and give at least one example of disease etiology.

5. Conduct an online research on Healthy People 2020 agenda and list its goals and objectives for the next 10 years, its methods of evaluation, resource allocation, and significant stakeholders.

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