Epidemiology Midterm Flashcards
What are 4 characteristics of Community Health Nursing:
group over individual
combines nursing science with public health
focuses on POPULATION outcomes
emphasis on primary prevention
Frieden’s Health Impact Pyramid ranked from least population impact to most population impact:
- counseling/education
- clinical interventions
- protection interventions
- changing the context to make individual default decisions healthy
- socioeconomic factors
Note: this backwards increases individual effort needed
3 Types of Community:
geographic: a city/town
common interest: church, professionals organization, people with mastectomies
community of solution: a group of people who come together to solve a problem
Levels of Prevention:
Primary: education, vaccinations, lifestyle changes
Secondary: health screening/ preventative
Tertiary: treating a disease that’s in progress
Healthy people 2020 goals:
attain high-quality, longer lives
attain health equity and get rid of disparities
create environments that promote good health
promote quality of life, healthy. development and healthy. behaviors
Levels of Prevention:
Primary: stops illness from happening. ex. education, vaccinations, lifestyle changes
Secondary: treat/detect disease before it becomes symptomatic. ex. health screening/preventative
Tertiary: treating a disease that’s in progress
Public health vs. community health:
Public health: focused on general population wellbeing - more preventative
Community health: IDs an issue w/i the community and makes a plan to fix it
Community health nursing roles:
CM CLEAR
Collaborator
Manager
Clinician Leader Educator Advocate Researcher
Define epidemiology:
the study of the distribution and determinants of health events and the application of this study to control the problem
Disease is:
Not random
Measurable
incidence vs. prevalence:
incidence: all new cases of a disease
prevalence: all people with a condition within a population
causality:
the relationship b/w cause and effect
Which are descriptive study designs?
Investigations that observe and describe patterns
Group associations
Cross sectional studies
Case reports
Case series
Pandemic
epidemics in several parts of the world
Pandemic
epidemics in several parts of the world
Define the Epidemiological Triad Model:
Host, environment, agent triad
Define the Web of Causation Model:
a map of relationships between factors and a health condition
includes direct and indirect cause of disease
helps to determine areas where efforts at control would be most effective
Per diem and cobra
DON’T DO IT
The 7 steps for establishing a research process:
- ID the px
- Review the literature
- design the study
- collect the data
- analyze the findings
- develop conclusions
- disseminate the findings.
Per diem and cobra
DON’T DO IT
3 types of epidemiology investigation:
descriptive
analytic
experimental
Quality of care
US is best
and sucks at everything else
The 7 steps for establishing a research process:
- ID the px
- review the literature
- design the study
- collect the data
- analyze the findings
- develop conclusions
- disseminate the findings.
Per diem and COBRA
DON’T DO IT
IT WON’T BE THE ANSWER
What are 3 recent pandemics:
HIV/AIDS
Ebola
H1N1
How does the U.S. healthcare system measure up?
US is best at quality of care and sucks at everything else
What are 3 recent pandemics?
HIV/AIDS
Ebola
H1N1
Burden of disease =
rate of occurrence
Passive immunity vs. Active Immunity:
passive: becomes immune through antibodies they did not produce themselves
active: vaccines or having the disease gives immunity
What cross immunity?
being immune to one thing indirectly gives you immunity to something else
What type of studies allow us to determine disease risk?
cohort studies
How do you determine relative risk ratio? (food poisoning example)
Food poisoning in people who ATE the burger
over
Food poisoning in people did NOT EAT the burger
What are the 4 stages of the natural history of a disease? Why is this important to note?
- Susceptibility (not yet exposed to pathogen)
- Subclinical (exposed but still asymptomatic)
- Clinical (symptomatic)
- Resolution (recover or die)
These stages help us to target interventions
Incubation period can also be called:
latency period
What is the limitation of a cross-sectional (prevalence) study?
temporality is unknown
Cohort studies begin with ______.
exposure status
Who rules Medicaid?
ICC
What gave prisoners the right to healthcare?
Eighth amendment
What is covered under each sector of Medicare?
A: hospital and emergency care
B: optional doctor visits
C: A&B with additional coverage (medicare advantage)
D: drugs (downside = donut hole)
What is medicare?
mandatory federal insurance for adults >65 who have paid social security
Medicare v. Medicaid funding, program administration, and beneficiaries.
MediCARE:
Funding - social security
Admin. - federal
beneficiaries - elderly/disabled
MediCAID:
funding - taxes
admin - state
beneficiaries - medically indigent (those who need power of attorney)
What is the problem with retrospective reimbursement?
fee is made in advance, but payment is after service
Problems:
limited accountability for cost
encourages sickness
What is the problem with prospective reimbursement?
payment is at a fixed rate
Problems:
constraints on spending
Ten leading global health risks
- high cholesterol
- obesity
- HTN
- tobacco
- alcohol
- unsafe water
- iron deficiency
- indoor smoke
- underweight
- unsafe sex
What must be listed as a limitation in a study?
“self-report”
What is epidemiological transition?
shifting disease focus from acute to chronic
Diabetes is a _____ risk factor.
modifiable
Rank the most pressing risk factors for health in order of most to least important
- chronic disease
- metabolic risk factors
- behavioral risk factors
- general momentums
What kind of insurance do people in the US under 65 use?
private
most common cancer death for men. women.
men - lung then prostate
women - lung then breast
Describe the chain of infection:
1. pathogen reservoir means of exit mode of transmission portal of entry at risk person 1. pathogen
What is exposure in terms of infectious agents?
dose
What is infectivity in terms of infectious agents?
capacity to enter host and multiply
What is pathogenicity in terms of infectious agents?
capacity to cause disease
What is virulence?
severity of disease
What is toxigenicity?
capacity to produce a toxin
What is antigenicity?
ability to induce antibody response
What is resistance?
ability of agent to survive environmental conditions
What is the difference between vector and vehicle born transmission?
both are indirect.
Vehicle-borne: fomites
Vector-borne: non-human living carrier
What is the difference between horizontal and vertical transmission?
horizontal: person to person
vertical: parent to offspring
U.S. communicable disease trends:
southeastern states are not reducing their use of antibiotics while the west coast has
Largest cause of communicable disease spread:
antibiotic resistance
Active vs. passive health surveillance
Passive: ongoing
Active: outbreaks
Which is better, low herd immunity or high herd immunity?
High.
Who falls under the private sector of the U.S. healthcare system?
proprietary services including:
health service providers
non-profit health orgs
professional orgs
Who falls under the public sector of the U.S. healthcare system?
federal and state government
What is the greatest mortality in the US?
heart disease
Do chronic conditions need to be reported?
no
Why is chronic disease increasing in the US?
people are living longer
Which is the most expensive health insurance?
PPO b/c they can go to an outside provider
What is the difference b/w a co-payment and a deductible?
co-payment: pay at the office
deductible: insurance won’t cover until deductible is paid
