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BIOL1900 > Epidemiology > Flashcards

Epidemiology Flashcards

1
Q

What is exercise?

A

A subset of physical activity that is planned, structured and repetitive bodily movement, done to improve or maintain one more more components of fitness, performance or health

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2
Q

What is physical activity?

A

Bodily movement that is produced by the contraction of skeletal muscle and that substantially increases energy expenditure

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3
Q

What is most ill health in Australia attributed to?

A

Non-communicable diseases (chronic)

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4
Q

What is prevalence?

A

Quantifies the proportion of the population who have a particular health problem (eg diabetes) at a specified time

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5
Q

What is incidence?

A

Quantifies the number of new occurrences that develop during a specified time (person-time incidence rate)

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6
Q

How to calculate prevalence?

A

Number of people with disease/illness etc at a particular point in time / number of people in the sample

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7
Q

How to calculate incidence?

A

Number of new cases of disease/risk factor in a specified period / number who were initially disease-free

Must involve a period of time!

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8
Q

Two main types of research design

A

Observational studies and experimental studies

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9
Q

What are the observational studies?

A

Case reports/series
Cross-sectional
Case-control
Cohort

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10
Q

What are the experimental studies?

A

Single group intervention
Quasi-experimental intervention
Randomised controlled intervention

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11
Q

What is primary prevention?

A

Preventing the disease before any symptoms appear (i.e. in a largely healthy population)

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12
Q

What is secondary prevention?

A

Preventing a biological risk factor (usually detected from screening) from worsening, once it is evident. Requires action to delay progression and reduce severity

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13
Q

What is tertiary prevention?

A

Managing an established problem to prevent it from getting worse

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14
Q

Where does almost all primary prevention evidence on physical activity come from?

A

Cohort studies

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15
Q

Who is the father of epidemiology who studied bus drivers?

A

Jeremy Morris

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16
Q

Who continued Jeremy Morris’ work in his studies of heavy work?

A

Ralph Paffenbarger

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17
Q

What are cross-sectional studies designed to do?

A

Used to assess at one point in time:

Prevalence of a health problem or behaviour and the associations between ‘exposure’ and ‘risk’

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18
Q

What does it mean by “Cohort studies are prospective”

A

They measure physical (in)activity and then compare risks of developing health problems with people in different “levels of exposure” to that risk factor

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19
Q

Characteristics of cohort studies

A

Select an identified cohort
Should be representative of the population
Follow over time for many years
Collect data on both exposures and outcomes
Expensive
Needs right questions at beginning

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20
Q

What seperates epidemiologists from other researchers?

A

They count and compare data from the population, not the laboratory.

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21
Q

What is a risk ratio?

A

Relative risk - compare risk in two or more groups

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22
Q

What is an odds ratio?

A

Comparison of odds in two or more groups

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23
Q

What is a prevalence ratio?

A

Comparison of prevalence in two or more groups

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24
Q

What does RR > 1.00 mean?

A

Higher risk

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25
Q

What does RR < 1.00 mean?

A

Protective

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26
Q

What does RR = 1.00 mean?

A

Neither risk nor protective

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27
Q

Calculation for risk ratio?

A

Occurrence [risk, prevalence, odds] in EXPOSED GROUP / Occurrence [risk, prevalence, odds] in UNEXPOSED GROUP

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28
Q

John Stewarts criteria for causation?

A

Temporal sequence
Strength of the association
Is the association consistent across studies?
Is there a dose-response relationship?
Is the association biologically plausible?

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29
Q

What is a meta-analysis?

A

A statistical procedure for combing data from multiple studies (usually of the same design).

Based on systematic review of all publications

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30
Q

What does the Australian guideline say for PA?

A

Doing some activity is better than doing none. If you currently do no PA< start by doing some and gradually building up to the recommended amount

And

Be active on most, preferably all, days of the week

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31
Q

How much time does the Australian guideline recommend for adults 18-65?

A

Accumulate 150-300 minutes of moderate intensity PA, or 75-150 mins of vigorous activity, or an equivalent combination of moderate and vigorous activities each week

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32
Q

How many days a week should adults do muscle strengthening?

A

Two days

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33
Q

What does the Australian guideline say about sitting?

A

Minimise the amount of time in prolonged sitting and break up the periods of sitting as much as possible

34
Q

What is sedentary behaviour characterised as in accordance with the Australian guidelines?

A

Any waking behaviour with an energy expenditure of <1.5 METs while sitting, lying or reclining.

35
Q

Components of PA?

A 
Frequency
Intensity
Time
Type
Domain
36
Q

Subjective measures of recording?

A

Diaries and log books (use of time)
Interviews
Surveys/questionnaires

37
Q

What is 1 MET equal to?

A

Rest (oxygen uptake of 3.5ml O2Kg^-1 * min^-1

38
Q

What is the MET of sleeping?

A

1

39
Q

What is the MET of moving about slowly (shopping etc)

A

1-<3

40
Q

What is the MET of brisk walking?

A

3-5 METs

41
Q

What is the MET for vigorous activity?

A

> 6

42
Q

What is sedentary behaviour?

A

Sedentary behavior is any waking behavior characterized by an energy expenditure ≤1.5 metabolic equivalents (METs), while in a sitting, reclining or lying posture.

43
Q

How to calculate for METs?

A

Intensity (METs) * Time (mins) = MET.mins

44
Q

PA guideline for MET minutes per week?

A

500-1000 MET minutes

45
Q

Advantages of questionnaires?

A

Extremely useful for large scale data collection–cost effective

Good for structured activity (exercise) and for people with regular PA habits

Can collect quantitative and qualitative information e.g. on type and domain

Provide an estimate of FITTD

46
Q

Disadvantages of questionnaires?

A

Subject to recall problems, reporting bias (social desirability)

Questions could be misinterpreted

Sometimes too difficult to estimate total time spent eg walking

Not good with young children (under 10); older people may have memory problems

Physical activity is a complex behavior –it does not come in handy and easy to measure packages (e.g. packets of cigarettes/day)

47
Q

Surveys used are VALIDATED against objective measures

A
  • Active Australia (AA)
  • National Health Survey (NHS)
  • International Physical Activity Questionnaire (IPAQ)
  • Global Physical Activity Questionnaire (WHO)
  • Behavioural Risk Factor Surveillance System (BRFSS)
48
Q

What are cross-sectional studies?

A

measure PA at one point in time

interview, telephone or mail or objective measures

determine prevalence of risk factors, disease, knowledge and attitudes

do not show temporal relationships

serial surveys can track changes over time –but not in the same people (eg National Health Survey)

49
Q

Positives and benefits of pedometers?

A

+Cost-effective
+Useful for detecting change (in steps)
+Some have indirect measures of energy expenditure
-No data on frequency, intensity, duration PA
-Insensitive to some forms of PA
-Step counts influenced by body size and speed of locomotion

50
Q

Best way to measure data?

A

Direct observation

51
Q

Two types of accelerometers?

A

Actigraph and ActiPAL

52
Q

What do accelerometers do?

A

Monitor intensity of movement in a specific plane

53
Q

What does an activPAL do?

A

Measures posture
Good estimate for sedentary behaviours
Based on ‘not moving’ and ‘moving’ with posture
Expensive and a burden

54
Q

Conclusions of fitness watches?

A

Measure heart rate accurately, but estimates of energy expenditure are poor and implications for weight loss are not great

55
Q

What is a higher number of breaks from sitting associated with?

A

Lower average waist, BMI, triglycerides and 2-hr plasma glucose

56
Q

Different stages of elderly?

A

Young-old 65-74yrs
Mid-old 75-84yrs
Old af - 85+ years

57
Q

What percentages of adults over 65 years have at least one chronic health condition?

A

88%

58
Q

What percentage of people >65 years living in the community fall ever year?

A

30-40%

59
Q

What percentage of people over 70 years of age have arthritis?

A

60%

60
Q

What percentage of women ages 70-80 have difficulty walking a fair bit or doing housework?

A

50%

61
Q

What percentage of those aged over 85 years have moderate or severe cognitive impairment?

A

A third

62
Q

2009 PA recommendations for elderly?

A

Do some form of physical activity, no matter your age, weight, health problems or abilities

Be active every day in as many ways as possible, doing a range of physical activities that incorporate fitness, strength, balance and flexibility

Accumulate at least 30 minutes of moderate-intensity physical activity on most, preferably all, days.

63
Q

Life events associated with decreasing physical activity in YOUNGER women?

A

In order of strongest evidence

Getting married
Birth of first child
Birth of second child
Decreased income
Divorce
64
Q

Life events associated with decreasing physical activity in MID-AGED women?

A

In order of strongest evidence

Retirement
Decreased income
Death of spouse/partner
Child or other family member leaving home (p=0.051) - debatable

65
Q

Life events associated with decreasing physical activity in OLDER women?

A

Diagnosis with chronic illness
Injury - fall/fracture
Hospitalisation - major surgery
Move to institutional care

66
Q

What is a correlate?

A

A variable that is statistically associated with physical activity

usually from cross-sectional surveys

no causal relationship can be implied

67
Q

What is a determinant?

A

evidence of statistical association in a longitudinal study (ie a observational (cohort) or experimental (randomised intervention trial)

relationship MAY be causal

68
Q

Challenges facing older adults?

A

Disability - inability to perform

Functional limitations - restriction in performing generic tasks

69
Q

Demographic determinants of PA in older adults?

A

Gender
Retirement
Ethnicity
Marital Status

70
Q

Psychological determinants of PA in older adults?

A

Knowledge
Lack of interest
Self-efficacy

71
Q

PA guidelines for infants under 1 year of age?

A

Being physically active several times a day -if not mobile, 30 minutes of tummy time

Not being restrained for more than one hour at a time

72
Q

Sleep recommendations for infants under 1 year of age?

A

14-17 hours of sleep for 0-3 months, 12-26 hours for 4-11 months

73
Q

PA guidelines for infants 1-2 years of age?

A

At least 180 minutes of physical activity

Not being restrained for more than one hour at a time

74
Q

Sleep recommendations for infants 1-2 years of age?

A

11-14 hours of good quality sleep, including naps, and consistent times of the day

75
Q

PA guidelines for infants 3-5 years of age?

A

At least 180 minutes of PA with at least 60 minutes of energetic play

76
Q

Sleep recommendations for infants 3-5 years of age?

A

10-13 hours of good quality sleep, including naps, and consistent times of the day

77
Q

Screen time recommendations for children?

A

If under 2 years of age, screen time not recommended

No more than an hour for 2-5 year olds

Less than 2 hours for 5-17 year olds

78
Q

PA guidelines for infants 5-17 years of age?

A

60 minutes or more of moderate to vigorous PA including mainly aerobic activities

Several hours during a day of light PA

Breaking up long periods of sitting as often as possible

79
Q

Sleep recommendations for children 3-5 years of age?

A

9 to 1 1 hours for 5-13 year olds, and 8 to 10 for 14-17 years

80
Q

Do active children become active adults?

A

It is weakly related

81
Q

Demographic determinants of PA in older adults?

A

Gender
Retirement
Ethnicity
Marital Status

BIOL1900 (10 decks)

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