Ch 124 Flashcards
Health
Is defined by the world health organization as a state of complete physical mental and social well-being and not merely the absence of disease or infirmity
Determinants of health
Are the biological,Behavioral, social, environmental, political, and other factors that influence the health status of individuals and populations.
Health Research
Health Research is the investigation of health and disease or any of the factors that contribute to the presence or absence of physical, mental, and social health among individuals, families, communities, nations, will the world population as a whole.
Medicine
“is the practice of preventing, diagnosing, and treating health problems in individuals and families.”
clinician
medical professional who provides direct care to
patients or clients
“Clinicians include physicians, surgeons, nurses, psychiatrists, physician assistants, midwives, registered dietitians, and other skilled professionals who work in medical settings as well as practitioners in dentistry, clinical psychology, podiatry, physical therapy, occupational therapy, pharmacy, optometry, kinesiology, rehabilitation, and other health-related fields. Clinical practice is contrasted with laboratory work and research that do not involve direct interaction with patients or clients.”
Clinical research
“evaluates the best ways to prevent, diagnose, and treat adverse health issues that adversely affect individuals and families. For example, clinical research projects may examine the progression of a disease over time, compare the effectiveness of various therapeutic regimens, or test the safety and utility of new diagnostic tests, medications, or medical devices.”
“Clinical research generally uses ——– as the unit of investigation, whereas basic medical research (also called basic science) studies molecules, genes, cells, and other smaller biological components related to human function and health. ”
“Clinical research generally uses humans as the unit of investigation, whereas basic medical research (also called basic science) studies molecules, genes, cells, and other smaller biological components related to human function and health. ”
Excerpt From: Jacobsen, Kathryn H.;. “Introduction to Health Research Methods.” Apple Books.
Translational research
“bridges basic research and clinical research by applying scientific discoveries to the improvement of clinical outcomes. The aim of translational medicine is to move research from the bench (the laboratory) to the bedside (clinical care settings).”
Population health
“focuses on the health outcomes and the determinants of health in groups of humans. Population health is a function of many factors, including human behaviors, the social and economic environment, the physical environment, access to healthcare services, and many other exposures. ”
Public health
“consists of the actions taken to promote health and prevent illnesses, injuries, and early deaths at the population level. Public health practitioners monitor health status in communities, mitigate environmental hazards, provide health education, support community health partnerships, develop public health policies, enforce safety regulations, and ensure access to essential health services.”
Population health research
“examines health outcomes at the community, regional, national, and worldwide levels. For example, public health researchers assess population needs and capacities; design, implement, and test population-based health interventions; and evaluate population-based health programs, projects, and policies.”
Research
“is the process of systematically and carefully investigating a topic in order to discover new insights about the world. No matter what the goals of a research project are or what methods are used to achieve those goals, the five steps of the research process are the same (Figure 1-1). The first two steps are identifying a study question and selecting a general study approach. These two steps are often completed concurrently, because the approach selected may require the refinement of the study question. After the objectives and the approach are set, the last three steps are designing the study and collecting data, analyzing the data, and reporting the findings. These steps apply to nearly every research project. A research project is not finished until all five steps have been completed.”
“The first step in the research process is selecting the ————. This section describes how to select a research question, review the literature, refine the scope of the project, and work with mentors and collaborators.
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“The first step in the research process is selecting the focus of the study. This section describes how to select a research question, review the literature, refine the scope of the project, and work with mentors and collaborators.
Selecting a research question
Reviewing the literature
Defining specific aims
Professional development
Coauthoring”
Brainstorming Questions
Interests
Aptitudes
Applications
Mentors
-“What are my interests? What health-related conditions have significantly ”“affected me, my family, my friends, my patients or clients, my community, and/or other populations that I care about?”
-“What knowledge and skills do I already have? What topics am I prepared to study in depth? What methods am I prepared to apply? What methods am I eager to learn?”
-“What studies would help improve health-related practices or policies? What are the gaps in the literature that I can fill?”
-“What are the areas of expertise of my supervisors, professors, and/or other mentors? What source populations and/or data sources might be available to me through professors, supervisors, colleagues, and other personal and professional ”
brainstorming
“is the process of generating long lists of spontaneous ideas about possible research questions.”
“This is not the stage for eliminating ideas because they do not appear feasible. The ideas do not yet need to be well formed. The goal of brainstorming is to generate a lengthy list of possible topics. In addition to compiling one’s own ideas, it can be valuable to check with colleagues, practitioners, and friends about their thoughts. Internet searches, journals, and books might reveal gaps in knowledge that are worth exploring. For example, many research articles end with a call for further research on a particular topic.
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“A related process is concept mapping”
“a visual method for listing ideas and then grouping them to reveal relationships. The first step of the mapping process is using brainstorming to generate a list of words or phrases that describe topics that might be integrated into a research question, such as the names of health conditions, population groups of particular interest, and the biological, socioeconomic, environmental, or other potential risk factors for various health outcomes. Next, the related ideas that show up several times on the list and appear to be part of a central theme are identified. Circles and arrows are used to group related topics and to visualize the connections between those groups. After some initial decisions about research topics that might be worth exploring have been made, the process of listing words and phrases and then visually grouping them may be repeated. This concept mapping technique can be useful when selecting and refining a study question. (A similar process can be used as part of qualitative data analysis.)”
“A next step toward refining the areas of interest identified through brainstorming and concept mapping is compiling a list of ______ pertaining to the selected research area”
“A next step toward refining the areas of interest identified through brainstorming and concept mapping is compiling a list of keywords pertaining to the selected research area”
“A _______is a word, a MeSH term (described in the following paragraph), or a short phrase that can be used in a database search. For example, a person whose brainstorming and concept mapping processes identify an interest in aging might list keywords like osteoporosis, falls, bedsores, physical therapy, calcium, bone density, home safety, rehabilitation, healthy aging, and prevention. A person who identifies an interest in child health in lower-income countries might list words like children, malaria, bednets, Uganda, measles, vaccination, preschool children, malnutrition, vitamin A deficiency, and community gardens. These keywords can then be explored as potential study foci within the major area of interest.”
Excerpt From: Jacobsen, Kathryn H.;. “Introduction to Health Research Methods.” Apple Books.
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“MeSH (Medical Subject Headings)”
“is a vocabulary thesaurus that can be used for searches of MEDLINE and other health science databases.”
“An exposure is a”
“personal characteristic, behavior, environmental encounter, or intervention that might change the likelihood of developing a health condition (Figure 2-2). Health research often seeks to determine whether an exposure is risky or protective.”
risk factor
“is an exposure that increases an individual’s likelihood of subsequently experiencing a particular disease or outcome.”
protective factor
“is an exposure that reduces an individual’s likelihood of subsequently experiencing a particular disease or outcome.”
“A nonmodifiable risk factor”
“is a risk factor for a disease that cannot be changed through health interventions. For example, age is the leading risk factor for many noncommunicable diseases. Although there are many interventions that can promote healthy aging, there is no way to reduce age.”
“A modifiable risk factor is a ”
“risk factor for a disease that can be avoided or mitigated. Identifying modifiable risk factors enables effective preventive interventions to be developed.”
“_____ levels of prevention address modifiable risk factors at different stages of disease progression. ”
“Three levels of prevention address modifiable risk factors at different stages of disease progression. ”
Primary prevention
“encompasses health behaviors and other protective actions that help keep an adverse health event from occurring in people who do not already have the condition. Examples of primary prevention actions include nutritious diets frequent exercise, adequate sleep, vaccinations, and use of seatbelts and other safety equipment. ”
Secondary prevention
“is the detection of health problems in asymptomatic (nonsymptomatic) individuals at an early stage when the conditions have not yet caused significant damage to the body and can be treated more easily. Secondary prevention interventions include cancer screening, blood pressure checks, and routine vision and hearing tests. ”
Tertiary prevention
“consists of interventions that reduce impairment, minimize pain and suffering, and prevent death in people with symptomatic health problems. Tertiary prevention interventions include rehabilitation, palliative care, medications, and surgery.”
“An outcome is an ”
“an observed event such as the presence of disease in a participant in an observational study or the measured endpoint in an experimental study. ”
disease
“defined as the presence of signs or symptoms of poor health (Figure 2-3). Clinically, a disease is a pathophysiological condition ”
disorder
“is a functional impairment that may or may not be characterized by measurable structural or physiological changes.”
“In the EDP framework“exposure, disease, and population—the term “disease” encompasses diseases, disorders, injuries, and other health conditions and outcomes. ”
“The particular outcome of interest associated with a disease might be _____or might be ______ (nonfatal illnesses).”
“The particular outcome of interest associated with a disease might be mortality (deaths) or might be morbidity (nonfatal illnesses).”
comorbidity
describes two or more adverse health conditions occurring at the same time. Comorbidities can complicate the management of chronic health disorders, so comorbid conditions are sometimes classified as exposures that affect outcomes associated with the primary disease of interest.) Alternatively, the outcome might be related to quality of life or use of health services.”
population
“is a group of individuals, communities, or organizations “a hospital, the clients of a community-based organization, the students attending a school, the employees of a large corporation, the residents living in a town or county, or any other well-defined set of people.”
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One for exposures or interventions
One for diseases or other outcomes
One for specific populations”
“For studies examining the links between two different health conditions, one disorder may be classified as an exposure of interest and a second disorder as the outcome. For experimental studies, the intervention being investigated is the exposure.”
“These EDPs—exposures, diseases (or other health-related outcomes), and populations—can then be combined to form potential study questions using a standard format of “Is [exposure] related to [disease/outcome] in [population]?” For example:”
Are exercise habits [exposure] related to the risk of bone fractures [disease] in adults with diabetes [population]?
Is reproductive history [exposure] related to the risk of stroke [disease] among women living in rural Ontario [population]?
Is household wealth [exposure] related to the risk of hospitalization for asthma [disease] in Australian children younger than ”
“Evidence-based medicine (EBM)”
“uses the results of rigorous research studies to optimize clinical decision making. EBM starts with a comprehensive literature search about a particular aspect of risk, prevention, diagnosis, therapy, harm, prognosis, or another aspect of clinical care. The most relevant, high-quality reports are then evaluated and synthesized. Key findings are summarized in practice guidelines and other documents that clinicians can use to enhance patient care and improve outcomes. EBM is not intended to depersonalize the practice of medicine. EBM enables skilled clinicians to integrate the best research into their assessments of the most appropriate ways to care for individual patients. ”
“A similar process of evidence-based practice
“is used in a variety of fields to encourage experienced professionals to integrate research into their decision-making processes.”
