2021 NCD Flashcards

1
Q

What are the current recommendations for physical activity in Canada for adults 18 to 64?

A
  • per week, at least 150 min of moderate- to vigorous-intensity aerobic physical activity (also beneficial to add muscle and bone strengthening activies using major muscle groups at least 2 days in a week) - in bouts of 10 min or more.
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2
Q

Name three types of screening?

A
  1. universal screening
    * screening all members of a population for a disease (e.g. phenylketonuria (PKU) and hypothyroidism in all newborns)
  2. selective screening
    * screening of targeted subgroups of the population at risk for a disease (e.g.mammography in women >50 yr old)
  3. multiphasic screening
    * the use of many measurements and investigations to look for many disease entities (e.g. periodic health exam)
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3
Q

List the 4 factors affecting the strength of a recommendation mady by Canadian Taskforce for Preventative Healthcare.

A

1) Quality of supporting evidence;
2) Balance between desirable and undesirable effects;
3) Variability or Uncertainty in values and preferences of citizens;
3) Whether the ntervention represents a wise use of resources.

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4
Q

List the key components of a strong recommendation for an intervention made by CTFPH.

A

Strong recommendations are those for which we are confident that the desirable effects of an intervention outweigh its undesirable effects A strong recommendation implies that most individuals will be best served by the recommended course of action.

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5
Q

What are key components of a conditional recommendation for an intervention made by CTFPH?

A
  • Desirable effects probably outweigh the undesirable effects but uncertainty exists.
  • the balance between desirable and undesirable effects is small, the quality of evidence is lower, and there is more variability in the values and preferences of individuals.
  • A conditional recommendation implies that we believe most people would want the recommended course of action but that many would not.

*Clinicians must recognize that different choices will be appropriate for different individuals, and they must support each person in reaching a management decision consistent with his/her values and preferences. Policy-making will require substantial debate and involvement of various stakeholders.

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6
Q

List 3 factors contributing to low levels of physical activity in Canada?

A

Built environment
- lack of opportunities for active transportation

Decreasing Leisure time
- trend towards decreasing free time for Canadian in which to engage in physical activity

Increased use of personal electronics
- individuals are engaging less in physical activity during leisure time and using personal electronics more frequently

Unsafe neighbourhoods
- areas of the country where neighbourhoods are considered unsafe may discourage people from spending times outdoors and exercising

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7
Q

List 3 factors contributing to poor diet in Canada.

A

Food insecurity
- individuals in many parts of Canada do not have access to health food for financial reasons or geographic regions (i.e. rural and remote parts of the country)

Marketing and Promotion
- industry promotion of unhealthy foods to Canadians particularly youth

Wide availability and consumption of processed and prepared food and beverages
- foods that undermine healthy eating (for example sugar sweetened beverages) are widely available in Canadian life including in public institutions like schools

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8
Q

List 4 populations that have high rates of harms from from alcohol use.

A
  • Men
  • Young Adults
  • Undergraduate Students
  • Individuals with low SES
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9
Q

List 4 recommendations from the Canadian low risk drinking guideline.

A
  1. Reduce long-term health risks by
    - having some non-drinking days per week; and
    - drinking no more than 10 drinks per week or 2 drinks per day for women
    - drinking no more than 15 drinks per week or 3 drinks per day for men.
  2. Reduce short-term health risks by
    - drinking no more than 3 drinks for women and no more than 4 drinks for men in a single sitting/occasion;
    - drinking with meals;
    - drinking no more than 2 drinks/3 hour;
    - alternating alcoholic drinks with non-alcoholic drinks.
  3. )Do not drink when
    - pregnant/planning to be pregnant;
    - operating any kind of vehicle, tools, heavy machinery;
    - engaging in sports or other potentially dangerous physical activities;
    - working;
    - making important decisions;
    - responsible for caring/supervising others;
    - using medications / other drugs that can interact with alcohol;
    - suffering from serious physical illness/mental illness/alcohol dependence

4.) Delay uptake of drinking until late teens and consistent with local legal drinking age law

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10
Q

List 5 interventions to improve mental health outcomes

A

Building healthy public policy - trauma informed policies

Create supportive environments - access to housing, employment, basic income

Develop personal skills - teach coping skills, ability to manage conflict, physical activity

Reorient health services - capacity building for health professionals to promote mental health and treat mental illness

Strengthen community action - reduce stigma against mental illness

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11
Q

List 5 interventions to reduce the harms of vaping

A

Build healthy public policy - regulations on max nicotine content in vaping products, plain packaging, age limits, marketing to youth

Create supportive environments - restrictions on where vaping products can be sold

Develop personal skills - educating youth on vaping related harms, low risk use

Reorient health services - including vaping in periodic health visits

Strengthen community action - work with existing anti-tobacco groups to leverage their action and apply it to vaping

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12
Q

List the 5 level of injury severity pyramid.

A
  • fatal
  • hospitalizations
  • ED visits
  • primary care visits
  • not reported
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13
Q

List 2 data sources for Canadian Chronic Disease Surveillance System

A
  • health insurance registry
  • hospitalization databases
  • physician billing claims databases
  • prescription drug databases
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14
Q

List the top 10 leading cause of death.

A

As of 2019

Malignant neoplasms

Disease of the heart

Accidents (unintentional injuries)

Cerebrovascular disease

Chronic lower respiratory diseases

Diabetes mellitus

Influenza and pneumonia

Alzheimer’s disease

Intentional self-harm (suicide)

Kidney Disease

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15
Q

List the 4 cancers in terms of both prevelence and mortality.

A
  • Lung cancer
  • Colorectal cancer
  • Breast cancer
  • Prostate cancer
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16
Q

Approximately 1 in 3 cancer is preventable, please list 5 broad categories that people get exposed to carcinogens

A
  • UV radiation
  • Tobacco
  • Alcohol
  • Infections including HBV, HCV, HPV, EBV, H. pylori, schistosomiasis, liver fluke
  • Environmental pollutants including arsenic, dioxins, aflatoxins, air polution
  • occupational exposure
17
Q

List 5 strategies to reduce preventable cancers.

A
  • Avoid smoking: Tobacco is the greatest avoidable risk factor for cancer
  • Healthy lifestyle: Healthy eating + physical activity + maintenance of a healthy body weight can prevent 1 in 3 of the 12 major cancers worldwide
  • Healthy eating: Increase consumption of vegetables, fruits, and fibres; reduce consumption of red and processed meats
  • Reduce alcohol consumption
  • Reduce UV exposure
  • Avoid carcinogens: E.g., by receiving the HPV or hep B vaccine, by reducing radon exposure, by wearing PPE when exposed to occupational carcinogens
18
Q

What are the criteria for screening?

A

Framework 1: Wilson and Jungner’s framework: DTTS (gotta make sure the deets are right)

Disease

  • Public Health Importance
  • Known natural history
  • Dectectable Pre-clinical stage

Test

  • Performance (Sensitivity & Specificity)
  • Acceptability to public (Rapidity & Cost)

Treatment

  • Established Tx?
  • Facilities for Tx?
  • Agreement on who to Tx?

System

  • Screening part of continuous progress
  • Cost

2nd Framework: WHO Criteria for Screening Programs - 2008 (if they don’t meet, they NOT BE RIPE)

Need

Objectives

Targeted population

Benefits > risks

Equity of access

Risk minimization

Integrated (clinical, educational, treatment)

Planned evaluation

Ethics: autonomy, confidentiality

19
Q

List 3 examples of data sources and the categories of data for surveillance or population health assessment?

A
  1. Survey - Canadian Health Measures Survey (CHMS); Canadian Community Health Survey (CCHS); Canadian Tobacco, Alcohol, and Drugs Survey (CTADS); Canadian Student Tobacco, Alcohol, and Drugs Survey; First Nations Regional Health Survey (RHS); RRFSS: Rapid Risk Factor Surveillance System (Survey)
  2. Census
  3. Administrative - Discharge Abstract Database (DAD); The Canadian Chronic Disease Surveillance System (CCDSS); Canadian Coroner and Medical Examiner Database
  4. Vital statistics - Death
  5. Registry - Canadian Cancer Registry
20
Q

What are four diseases that physical activity reduces the development of

A

Cancer
Heart Disease
Osteoporosis
Obesity
Type 2 diabetes
High blood pressure

21
Q

What are some health benefits of physical activity beside disease prevention?

A

Physical activity can lead to improved:

  • Fitness
  • Strength
  • Mental health (morale and self-esteem)
22
Q

What are 4 risk factors for falls in elderly individuals.

What are interventions to reduce falls

A

1) Previous falls,
2) Uncorrected visual impairment
3) Polypharmacy
4) gait impairment or movement disorder
5) cognitive impairment
6) Arthritis

Exercise
- development of an individualized exercise regimen (strength, gait, and balance exercises; eg, Tai Chi or physiotherapy)

Deprescribing
- Gradual withdrawal of psychotropic medication reduces the rate of falls, and a prescribing modification program implemented by primary care physicians substantially reduces the risk of falling among elderly patient

Home modification
- home safety assessment by occupational therapist highly effective at reducing falls in those with history of falls