Epidemiology and Evidenced Based Practice Flashcards
define epidemiology
study of Distribution and Determinants of health and illness in human populations for the purpose of controlling disease and health problems
what does the term Distribution mean r/t epidemiology
spread (who, what, where, when of diseases)
what does the term Determinants mean r/t epidemiology
the why of diseases
current epidemiological news today
Zika virus
HPV vaccine
Distribution r/t the Zika virus
Who = host = pregnant women, men (sexual partners) What = flaki virus When = hottest times of year when mosquito's are most prevalent Where = S. America, Florida, Caribbean (demographics)
Determinant r/t the Zika virus
Why (care?) = causes microcephaly
Distribution r/t HPV vaccine
Who - women 14-34 years of age
What - human papillomavirus
When - adolescence
Where - America
Determinant r/t HPV vaccine
Why - decreased risk of HPV infection
who is John Snow
soldier against disease (Cholera) in the mid 1800’s in England
what did John Snow do?
asked people who was dying, where, what they were dying of and when it was all occurring
who is known as the father of public health/epidemiology
John Snow
noxious miasma theory
“pig pen” dirty, poor people theory
what is cholera
a water born disease, bacterial
taking the pump handle of means
getting to the source/issue
epidemiological triad
agent (disease process/cholera)
host
environment
these factors interacting cause disease
wheel of causation
inner circle - genetic core
middle circle - host
outer circle - biologic, social, physical environment
web of causation helps to
determine the why (determinant)
primary prevention
promote health before disease/behavior occurs
eg: Teen Pregnancy (condoms, pill); Vaccines (flu)
secondary prevention
state of disease - not interventions
eg: Teen Pregnancy (screening for preg. itself); HIV tested; assessing, interviewing, identify people (domestic violence)
tertiary prevention
preventing death/disability from disease state
eg: Teen Pregnancy (prenatal care)
define endemic
usual presence of disease within a geographic area
flu virus is endemic to North-Eastern U.S. in winter
define epidemic
significant increase in number of cases of a disease (beyond endemic)
define pandemic
an epidemic affecting multiple countries/regions of the world
define common source outbreak
exposure to a common, harmful substance
define propagated outbreak
transmission of infectious agent from one person to the next
how to calculate rates
Events measured (infant deaths) are in the Numerator
All who could have died are in the Denominator
Specific period of time must be indicated
Multiply by base (multiple of 10)
what is a crude rate
occurrence of a health problem in a community at a certain time
what is an adjusted rate
adjust for the effected (gender, ethnicity) - removes differences in populations
***what is relative risk ratio
your chances of getting disease if exposed
incidence rate in an exposed group vs the non-exposed group:ratio
define ratio
fraction representing relationship between 2 numbers
define rate
state of health in a specific group of people in a given time period - measurement
rate calculation
number of events in a population at a specific period/total population
crude mortality rate calculation
number of deaths occurring in 1 yr/midyear population
cause specific mortality rate calculation
number of deaths from a stated cause (cardiovascular disease) in 1 yr/midyear population
age specific mortality rate calculation
number of people in a specific age group (ages 5-15) dying in 1 yr/midyear population of the specific age group
infant mortality rate calculation
number of death under 1 yr of age in 1 yr/number of live births in the same year
infant mortality rate is used as greatest indicator of health in certain country, t or f
true - reflects how healthy Mom is
define incidence rates
new cases in a community
define prevalence
who already has it - number of existing cases
*define sensitivity
true positive - ability of a test to find those that have a disease
*define specificity
true negatives - ability of a test to find those who truly do not have a disease
term for incidence rate in exposed group and the incidence rate in the non-exposed group
relative risk ratio
West Nile Virus is endemic to summer time in North Eastern U.S., T or F
True
Malaria is endemic to Ecuadorian parts of the world, T or F
True
host factor that influences peoples malarial infections
**genetic traits - sickle cell trait is protective against malaria
secondary prevention of tuberculosis
PPD plus chest x-ray (white infiltrates)
primary prevention of tuberculosis
vaccine or PPE (personal protective equipment, masks) - will get positive PPD
is PPD sensitive or specific
sensitive; chest x-ray is specific
Tertiary prevention of tuberculosis
rifampin and INH
what are behavior change models
models that assist clients, groups and communities to redirect activities toward health and wellness
how many behavior change models are there
3
what are the 3 behavior change models
learning model
health belief model
trans-theoretical model
what is the learning model
people do things that reward them - incremental steps towards a final goal
what is the health belief model
Cues (r/t smoking) - friends/drinking
Barriers - friends do it/habit
Benefits - lower risk for lung cancer
what is the trans-theoretical model (weight loss, smoking)
Precontemplation - grandma smoked never got lung cxr, lived forever
Contemplation - know I need to stop smoking, but its working for me right now
Preparation - quitting on sons birthday
Action - i quit yesterday
Maintenance - I’ve been sober for 6 months
Relapse - I just used again after being sober for 6 months
when asking questions to find (smokers) you are doing which type of prevention
Secondary prevention - to intervene at an early stage of disease
what is motivational interviewing***
Client-centered communication to elicit change
helps clients explore/resolve ambivalence to change
ADDRESSES AMBIVALENCE
move from pre-contemplation to contemplation
“motivation for change occurs when people perceive a discrepancy between where they are and where they want to be” T or F
True
descriptive studies describe
Distribution - disease according to person, place, time
summarizes health event
analytic studies investigate
Determinant - causes and associations between factors (the why)
cohort studies look at (analytic)
graduates of nursing school from a certain year(s), follows them for life
cross-sectional studies look at (analytic)
cross - section of student population right now, assess for (risky behaviors/smoking..)
retrospective studies look at (analytic)
incidence of disease process in a specific year (looking back)
analytical studies are trying to find
causation - the why
2 types of analytical studies
Cohort studies - following over a period of time
Case-Control studies - retrospective
golden standard of research studies
experimental designs
2 categories of experimental designs
preventative intervention (primary) - before exposure to disease, tests and intervention Therapeutic intervention (secondary) - those currently experiencing disease, testing interventions
best way for you to know research is valid
having a control group
elisa HIV
specific
western blot HIV
sensitive - start off with
