HLTH-3800 Lecture Notes - Lecture 2: Infant Mortality, Perinatal Mortality, Maternal Death

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27 Nov 2017

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Study questions for second exam, hlth 380, fall 2016. In addition to the study questions and exercises at the end of each chapter in your textbook, i have provided additional questions which reflect the sections in each chapter i consider particularly important. **if a formula isn"t on the formula sheet, you aren"t expected to calculate it. ***check formula sheet to see what type of problems will be expected on the exam. ***some problems you pick k, for some it is given. However, if you pick k, be consistent with it (ex: if you pick 100,000 you have to use it throughout the whole problem so you can compare answers) **rate adjustment problem on exam for 10 pts at end. ---ages 1-44, death rate should be 518 and 511. 3 for another making total deaths 12271. 9 and overall death rate. 3: measures of morbidity and mortality used in epidemiology.

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Please help answer 4 questions:

1. Using the information provided thus far by both Parts I and II, answer the following questions.

What problems both stated and unstated does Phyllis seem to be experiencing? What pieces of background information (patient environment and social/family history) have been provided by the family?

2. Distinguish between the relevant and non relevant symptoms/lab results needed to form a diagnosis. Of the relevant symptoms/lab results, rank them in priority and defend your answer.

3. Given what you know about the role of myelin in action potential propagation and the key information previously identified in questions 1 and 2, explain why multiple sclerosis is the appropriate diagnosis.

4. Consider you are the physician, what would be your strategy to slow progression of the disease and compensate for reduced neuronal function? What is the long-term prognosis with treatment?

The Soccer Mom:

A Case Study on the Nervous System

Jennifer Bolognese, Misti Coronel, Anita Intorre, and

Phil Stephens Biology Department Villanova University

Part IâAt the Soccer Game

Thirty-two-year-old Phyllis Jackson was sitting on the bench at the side of the soccer ?eld, sipping a bottle of

Gatorade. Her husband, Steven, sat next to her with a concerned expression. âIâm really worried about you, honey,â he said.

âIâm just a little dehydrated; Iâll be ?ne.â

âIf this were the ?rst incident, then maybe Iâd agree with you. But your boss has been on your case about your lack of concentration at work, you forgot to pick up the kids from school last week, and quite frankly, you havenât exactly been yourself with me lately. Now youâre having fainting spells during games? Something doesnât seem right.â

âI know things havenât been going well for me lately, but I donât know why. I try so hard at work, at home, with the kids, to be a good wife. So maybe all this stress has made me a little unfocused and disoriented. What do you want me to do about it?â Phyllis said, blinking back tears.

âI think you should see a doctor,â Steven replied, putting his arm around her and drawing her close. âThe kids are getting worried, too.â

Phyllis sighed. âAlright, if it will make you feel better. I really just think I need some time to relax, though.â âWellâ¦ I could drop the kids of at my sisterâs tonight; that would give us a little free timeâ¦â

âThatâs really thoughtful of you. I could de?nitely use a quiet night at home, maybe even go to bed early.â Steven seemed disappointed.

Part IIâThe Doctor Visit

âSo, what seems to be the problem, Mrs. Jackson?â Dr. Warner asked Phyllis.

âMy husband wanted me to come in and see you after I fainted during my soccer game Saturday. Iâve also been having some problems at work, but I think Iâm just stressed.â

âWhat kinds of problems have you been having at work?â

âItâs been hard to concentrate on tasks. Iâve also had some problems typingâIâve been making more errors than usual, and oftentimes my ?ngers will go numb.â

âI see,â said Dr. Warner, taking a few notes on his clipboard. âAccording to my records you are not on any long term medication. Have you noticed any problems outside of work?â

âWell, my husband has been complaining about our personal life lately. And last week, I completely forgot that I was supposed to pick up our two daughters after school. Iâve been feeling really tired lately; even my coordination seems of.â

âHow long has this been going on for?â

âA few weeks, but this isnât the ?rst time. These problems seem to come and go, but itâs getting to the point where I canât just ignore them anymore. I donât know, maybe Iâm just depressed.â

âWhy do you say that?â

âMy mother suffered from depression throughout my childhood.â

âWell, depression certainly could cause some of the symptoms youâre experiencing,â Dr. Warner said thoughtfully. âIs there a history in your family of any neurological disorders?â âI donât think so. I have some vague recollection of my grandfather in a wheelchair when I was really young, but I donât know what was wrong with him.â

âOkay,â said the doctor, nodding. âWell, the few preliminary tests weâve run show that you are not pregnant, and that you are not going through menopause. Iâd like to send you to see Dr. Thrush, a friend and colleague of mine. She is a neurologist at the local hospital and she will run a few tests to explore your symptoms a little further.â

Questions: Analyze

1. Using the information provided thus far by both Parts I and II, answer the following questions.

Part IIIâDiagnostic Tests

Dr. Thrush looked over the results of Phyllisâs Magnetic Resonance Imaging (mri) and evoked potential tests. She was thinking how glad she was that Steven had accompanied Phyllis on this visit as she showed them the MR images of Phyllisâ brain.

âThe machine took pictures of Phyllisâ brain in slices. The dark areas are the brain tissue, Phyllis, and the white areas in the middle and around the outside are the cerebrospinal ?uid.â

âIs that normal? Am I ok?â Phyllis asked. âAnd what are those little white dots in the tissue?â

âThe white dots are what concerned me,â replied the doctor. âSo we did another type of mri, called dark ?uid, so that your cerebrospinal ?uid would not show up white.â

âBut I still see the white dots in my brain tissue. What does that mean?â

The doctor looked down, knowing that this was never an easy thing to tell a patient.

âI am afraid that this indicates that there are plaques or scars in your brain, and that you may have multiple sclerosis.â

Tears began to form in her eyes as Phyllis squeezed her husbandâs hand.

âI am afraid that the evoked potential test and the elevated levels of myelin basic protein in you cerebrospinal ?uid indicate the same thing.â

Questions: Evaluate and Apply

2. Distinguish between the relevant and non relevant symptoms/lab results needed to form a diagnosis. Of the relevant symptoms/lab results, rank them in priority and defend your answer.

Part IVâThe Diagnosis

Dr. Thrush informed Phyllis that she was probably suffering from the relapsing-remitting form of multiple sclerosis (ms), in which relapses of symptoms are separated by periods of remission. ms is a disorder in which the myelination of axons is degraded due to unknown factors. The most commonly accepted explanation is that ms is an autoimmune disorder in which myelin in the central nervous system is attacked by the bodyâs own immune system. There is no known cure for multiple sclerosis. During remission, axons affected by the disorder regain their function. Voltage-gated sodium channels are concentrated in the nodes of Ranvier and the distribution changes at disease onset.

Questions: Create

4. Consider you are the physician, what would be your strategy to slow progression of the disease and compensate for reduced neuronal function? What is the long-term prognosis with treatment?

Thank you for your time with this

greyporcupine565

Essay questions are due at the end of the course. It is strongly recommended that you accumulate your answers as you complete each unit and don't leave them all until the last minute. Please type your responses to the following short answer/discussion questions and short problems. Although your answers need not be lengthy (generally, 1-2 short paragraphs is fine), you should be careful to respond to all parts of the question asked. It is very important that your answers demonstrate that you have made the effort to read the chapter that relates to the question and thoroughly studied the relevant topic. Answers should be submitted in complete sentence and paragraph form, and writing presentation is important. Please remember that late essay questions are NOT accepted. 1. How is a "market" defined? Distinguish between an industry and a market. (1 point) 2. Suppose a market becomes more competitive over time. What happens to the elasticity of demand for a particular firm's good as its market becomes more competitive? (1 point) 3. Why are the monopolist's and the monopolistically competitive firm's demand curves downward sloping while the competitive firm's demand curve is horizontal? (1 point) 4. Why is a perfectly competitive firm's long-run supply curve the same as its marginal cost curve above the average total cost curve? (1 point) 5. Explain why monopolists do not achieve efficiency. (1 point) 6. Another student advocates the forced break-up of large firms, such as Microsoft and AT&T, on the grounds that they have a lot of monopoly power, which they use to charge inefficiently high prices. According to Schumpeter, would breaking apart these gigantic firms guarantee consumers lower prices? Explain. (1 point) 7. Explain why firms should not shut down in the short run until price falls below average variable cost. (2 points) 8. Suppose your economics professor publicly states that she grades on a curve (i.e., the top 10% of the students get an A, the next 20% get a B, the next 40% get a C, the next 20% get a D, and the lowest 10% fail). The whole class could save itself a lot of work by agreeing privately not to study at all for the final exam and just letting the rankings thus far determine the final grades. Why might such an agreement be difficult to maintain and enforce? Which market structure, if any, is this situation most analogous to? (1 point) 9. Why do firms practice price discrimination? Is efficiency affected by price discrimination? If so, how? (1 point)

magentaplatypus337

Case Study 8
THE OUTSOURCING SYNDROME

In Case Study # 3, we discussed some of the economic and ethical problems related to Wal-Mart. However, is it fair to blame Wal-Mart for this downsizing of our standards? What about the other large U.S. corporations that have been sending manufacturing and other jobs overseas? Lou Dobbs, on CNN, in late 2003, started listing during each evening program those corporations which have sent jobs overseas. The list keeps growing and growing. It is a virtual Whoâs Who of American business.

In late December, 2003, the Wall Street Journal reported that IBM told its managers that it will be moving as many as 4,700 high paying white-collar jobs overseas. This type of change represents the latest threat to employment in the U.S. It was bad enough to see the exodus of manufacturing jobs but, now, this move overseas is extending to the higher-paying technical and white-collar employees.

When U.S. corporations first started shipping factory jobs overseas, workers were advised that they should become better educated and acquire more skills, enabling them to achieve an even higher standard of living. There would be more and better jobs in technology and information processing. Now, it is these more educated and skilled workers at IBM and other corporations who are losing their jobs. To be fair to IBM, many other technical companies have also moved these higher paying jobs overseas. An executive at Microsoft, the ultimate American success story, told his department heads last year to âpick something to move offshore todayâ.

Globalization may be a fact of life but does that mean that its destructive impact on any
single countryâs families can't be mitigated? Should the exportation of jobs and the effect on the standard of living be monitored by the government, the civic center sector and the media of the base country? Should trade agreements and tax policies be examined and updated to encourage the creation of employment that enhances the quality of life at home?

If we donât do something about all of these issues, we may all end up working at Wal-Mart, by one name or another. If we donât do something, then who will be able to afford the IBM and Microsoft products?

Almost 100 years ago, Henry Ford was astute enough to realize that he had to pay his workers a living wage so that they could afford to buy his automobiles. Evidently, American manufacturers have forgotten that strategy. Will the rest of the world follow suit?

HOW DO YOU FEEL ABOUT THIS SITUATION?
WHAT SUGGESTIONS DO YOU HAVE TO ADDRESS THIS ESCALATING PROBLEM?
WHAT WOULD YOU RECOMMEND IF YOU HAD AN IMPORTANT GOVERNMENT POSITION?

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HLTH-3800 Lecture Notes - Lecture 2: Infant Mortality, Perinatal Mortality, Maternal Death

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