HLTB21H3 Chapter : HLTA01 Ch 14

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harlequinworm30

3 Jan 2012

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Ch 14: leprosy, the striking hand of god (302-312) Leprosy already existed during biblical times & the middle ages. > job was considered to be the patron of lepers. Leprosy was imagined as a disease of the soul & was highly contagious according to the story of ben-hur. > accounts have been mentioned in indian text, charaka samhit (600-400 bc) & chinese literature, nei. > symptoms are stiff joints, inflamed & nodular flesh, disfigured faces & hands, numbness, loss of eyebrows. & beard & the deterioration of the nose bridge. It s believed to have passed f/ india to greece by the soldiers of alexander the great in 4th ce bc. Aractus, a contemporary of galen describes of it in ad 150. Terms of the disease transitioned f/ ssaraath> lepros> lepra> leprosy. Lepers were believed to be crabby, sinful, suspicious & horny. The disease is also known as satyriasis- an insatiable sexual appetite.

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Investigation of Possible Bioterrorism-Related Activity

Patient History:

A 38-year-old woman who resided in the Northeast was admitted to the hospital with fever, myalgia, and weakness, which progressed over 3 days to respiratory failure requiring mechanical ventilation. On day 22, after 3 weeks of intensive care, the patient was still febrile. Cultures of blood were negative.

Hospital personnel interviewed family members who reported no history of traditional risk factors for fever of unknown origin (e.g., relevant food, infected animal contact, or travel history). On day 24, the patient's family reported to hospital personnel that the patient's illness might have been caused by exposure to laboratory flasks and cultures kept in her apartment by her boyfriend. He was described as a foreign national studying biology, but recently he had returned to his country of citizenship. On day 25, the patient's family brought laboratory flasks, Petri dishes, and culture media to the hospital from the patient's apartment. Several contained an unidentified clear liquid. The patientâs unresponsiveness and the acknowledged potential for some bacterial species to be used as bioterrorist agents raised concerns among the infection control staff that this case might be associated with a bioterrorist event or unintentional exposure to contaminated materials in the patient's home. The hospital contacted local law enforcement, the Department of Public Health, and the Federal Bureau of Investigation about the unusual circumstances surrounding the case.

On day 30, under the authority of state communicable disease statutes and in cooperation with the local police department, fire department, and hazardous materials unit, NHDHHS personnel entered the patient's apartment to assess any possibility of an ongoing public health hazard. Remaining flasks were removed and cultured. After 48 hours, growth of a translucent, pinpoint, and smooth colony appeared on blood agar and chocolate agar.

Gram stain of the colonies revealed faintly staining Gram-negative rods that were catalase positive, oxidase positive, and rapidly urea positive. On day 33, the patient began to get better after extensive antibiotic therapy.

Early detection is essential to ensure a prompt response to a biological terrorist event. Local public health authorities must rely on clinicians to recognize and report suspicious or unusual presentations of disease. However, correlating suspicious cases originating from diverse locations or discerning an increase in common presentations above the normal baseline is difficult. As in this case, public health practitioners coordinating disease surveillance may be able to receive reports of rare diseases and to determine whether they are occurring at a higher than normal rate in a large surveillance area.

The CDC, in collaboration with local, state, and territorial health departments, is enhancing existing disease surveillance systems for specific diseases that are normally rare in the United States but thought to have a high potential for public health impact if used as biological terrorism agents. This is being accomplished by improving training of clinical, laboratory, and public health personnel in recognizing suspicious disease presentations and by expanding of existing, disease-specific surveillance infrastructure. In addition, surveillance is being improved for disease presentations, such as acute respiratory distress, hemorrhagic, or meningeal symptoms normally caused by common infectious agents, but that could indicate an increase in illnesses caused by a biological agent used in terrorism. Surveillance mechanisms to rapidly assess changes in rates of disease include monitoring of calls to local emergency medical systems, regularly reviewing emergency department discharge diagnoses, and linking infection control practitioner networks.

Assignment:

For this case study, write a 1-page report that describes the possible agent of bioterrorism along with pathogenesis, treatment, and prevention. Include a brief discussion of sentinel labs and their role in recognizing potential episodes of bioterrorism.

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1. Biological specimens such as urine, stool and saliva samples can be useful for identifying all of the following, except

A risk factors for disease

B characteristics associated with having the disease

C blood pressure

D presence of disease

2. Abstracts provide a glimpse into the content of an article?

A true

B false

3. Acquisition of evidence for improving clinical and public health practices and policies is an example of a societal benefit of health research?

A true

B false

4. Population health research objectives may include:

A identifying and classifying new health problems

B determining risk factors

C evaluating the impact of health policies on health outcomes

D al of the above

5. All of the following are examples of tests of physiological function, except:

A spirometry

B electrocardiography

C audiometry

D all of the above

6. Which is not an example of population based research?

A compare rates of acure lung disease in several metropolitan areas and see whether the rates of disease are correlated with local air quality

B determine whether survival following breast cancer diagnosis is linked to the presencw of certain genes

C conduct a vaccine trial

D analyze biochemical composition of selected foods

7. Health researchers examine all of the following factors that contribute to health and to disease illness disability and death except:

8. ____ is physiological measurements that can be accurately taken after minimal instruction.

A anthropometry

B basic vital signs

C clinical examinations

D biological specimens

9. Population based studies are typically conducted using:

A human subjects

B animals

C research facilities

D none of the above

10. The process of systematically and carefully investigating a subject in order to learn or discover new information about the world is known as?

11. When identifying specific exposures diseases and populations of interest identifying relevant statistics is not helpful.

A true

B false

12. Which of the following is not an example of an adittional assessment that can be conducted as a way to supplement self reported information during the data collection process?

A vital signs

B test of physiological function

C physical fitness tests

D surveys

13. To look for a health science abstract in PubMed one an use all of the following search methods except:

14. When conducting anthropometric measurements, there is no need for the researcher to ensure that the methods used to take these measurements are standardized

A true

B false

15. There is no need to read the full article if the abstract is available.

A true

B false

16. Which of the following is not an example of an examination a clinician can conduct to examine many health states that machines are unable to assess well?

A breath sounds and other respiratory functions

B heart sounds

C heart rate

D the condition of the skin hair and nails

17. Which is not a step in the research process?

A identify a study question

B select a study approach

C report study findings

D all of the above

18. A paragraph length summary of an article chapter or book is known as a

19. Health science abstracts usually provide a brief description of

A study design

B the study populatio

C key findings of the study

D all of the above

20. The goal of every research project is to find and address gaps in the literature and to build on precious work.

A true

B false

21. Which is not an example of laboratory research?

A compare tests of air quality in several metropolitan areas

B identify biological mechanisms for the emergence of drug resistant bacteria

C use a food frequency questionnaire to examine dietary behaviors in a selected population

D develop a new vaccine

22. If clinical examinations are conducted as part of the data collection process an assessment form should carefully describe each component of the examination procedure to be used and diagnostic procedure for each item on the assessment form

A true

B false

23. ____ is the measurement of the size/composition of the human body

A anthropology

B vital signs

C clinical examinations

D biological specimens

24. Health research is considered to be a scientific process only.

A true

B false

25. The goal of any one research project is to contribute vast amount of information that when pooled with other researchers information will provide evidentiary foundation for change

A true

B false

26. Which is an example of health abstract databases available from libraries via subscription

27. All of the following are examples of anthropometric measurements except:

A height

B waist circumference

C skinfold measurements

D blood pressure

28. All of the following are good sources of information that a researcher can use to explore what his primary area of research interest is except:

29. Which of the following is the most important publicly available health science database?

For this assignment, Part One of your course project, assume the role of Dr. Madness. Your rogue nation seeks global domination. With a bare bones laboratory and your exhaustive microbiological and epidemiological knowledge, you (Dr. Madness) decide that the best way to rule the world is to create and disseminate the perfect biological weapon.

For this part of the assignment, you will develop your weapon from the ground up. Discuss nearly all of the epidemiological criteria related to it, and justify and discuss why it is used and how effective it is. This agent could be a hybrid of other biological pathogens or an entirely new one. If the agent is newly created, there must be some basis and epidemiological support of a similar agent by which you can base your justification. In other words, it will be unrealistic to create an airborne virus that inoculates and kills within one hour. There must be a realistic exposure and incubation time and must be supported through current agent biology or biochemistry (for example, influenza exposure and incubation takes 1â4 days).

Name of Agent: Explain why you chose the name. If it is a biological agent, be sure to provide a taxonomic name

Etiology: This will talk about the genesis of your agent. Where was it discovered? How was it made? How long has it been around? Why was this agent created? What were the social and economic factors of your rogue nation that made Dr. Madness focus on this element of the agent? What are the environmental precursors to this agent? Discuss the interaction among agent, host, and environment.

Identification: This will describe the basics of the agent. Is it a bacteria, virus, toxin, parasite, hybrid, or something else? Discuss how your agent presents within the human population. What are the symptoms in humans? What are the (zoonotic) symptoms in animals? How does the disease progress? Are there stages? Discuss the various stages including length of infection, severity, and the like. What are the diagnostic indicators? How would a doctor be able to identify this agent in a clinic or emergency room?

Laboratory Analysis: How will the agent be identified? Can it be grown in media? What type of laboratory methods can be used to identify the agent (microscopy, chromatography, PCR, and so on)?

Occurrence: This is the epi: who, what, when, where, how, and why of the disease. Where does it happen? When can it be found? Who is most and least susceptible to the agent (risk factors). More exotic and hard to find agents are harder to prevent and control but are also more difficult to initiate an epidemic or pandemic, whereas more generalized and known agents may be easier to cure, but have a much wider swath of causing pandemics. How do socioeconomic factors foster or inhibit the spread of disease?

Reservoir: What is the natural reservoir of the agent? Are there other organisms where this agent can reside without causing disease? Increasing the reservoir can enhance transmission but can also allow for easier identification and treatment in response to it.

Mode of Transmission: Consider inhalation, absorption, digestion, contact, and so forth. If you use multiple modes, justify your selections.

Incubation Period: Provide the range with an average (median) day of disease onset. Does the period change in different socioeconomic status identifiers (sex, age, race, creed, and so on)? Why or why not?

Period of communicability: How long is a person with this agent contagious? Increasing this period also increases the opportunity for study and thus treatment and control.

Susceptibility: Is the agent susceptible to reinfection of the same person? Allowing for this increases morbidity but usually mortality wanes in subsequent infections.

Taking on the role of Dr. Madness, generate your superweapon and describe the weapon using the above mentioned criteria. Remember, the focus in on creating something that becomes difficult to identify, monitor, or treat with prophylaxis. You will write out the proposal as Dr. Madness submitting this to his lead researcher to develop. This proposal should be approximately 6â8 pages in length, but some submissions may be longer.

Submit your Bioweapons and Epidemiology Part One proposal in the assignment area.

Please be sure to review the Bioweapons and Epidemiology Part One Scoring Guide for information on how this assignment is graded.

Project Requirements

To achieve a successful project experience and outcome, you are expected to meet the following requirements.

Written communication: Written communication is free of errors that detract from the overall message.

APA formatting: Resources and citations should be formatted according to current APA style and formatting.

Resources: Include all literature cited in the project.

Length of paper: 6â8 typed, single-spaced pages, not including cover page and resource list.

Font and font size: Arial, 10 point.

HLTB21H3 Chapter : HLTA01 Ch 14

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