Exam 1 Flashcards
In Ghost map, what factor placed an individual in London at risk of getting Cholera?
Cool water at the pump so it was enticing, close proximity to the pump
What’s wrong with people recommending cures they believe to be effective based on their personal experience? What is the standard of evidence needed to deem a drug useful?
Bias, lack of evidence
Heresay is often the first step to start research.
Quantitative and qualitative in clinical settings. If the benefits outweigh the risks. If it is effective in clinical trials.
Correlation is not causation- explain two difference in the text of how this is true
Miasma theory: “miasma was present if there was a bad smell.
Lower altitude= people are more likely to get sick
The poor the person, the dirtier the house, more likely to get sick= not true because whitehead stopped in one of the dirtiest homes and found that no one had fallen ill with cholera
What about a city creates or intensifies an epidemic?
Dense urban areas, very little sanitation and food sources
Explain the contagion model. How did Snow become convinced of the truth of the contagion model. What question did he wrestle with and how did he resolve those questions?
the contagion theory is that there is an “agent” or particle which spreads to people causing the disease. Snow became convinced of this by the lodging house spreading to others as well as linking it to a common water source among towns. He wrestled with the question of why it would affect some people in the household but not everyone he was also trying to figure out how the water got infected In the first place.
How did a public health intervention actually lead to cholera’s lucky break? Can you think of any modern parallels in which public health intervention has actually made a problem worse?
The sewer systems that London had built to make the city “cleaner” ended up dumping cesspools into the river but Londoners were drinking the river water which led to cholera.
GMO’s, nutrition (fat free)
What was the miasma theory? why did so many intelligent individuals falsely hold to the miasma theory even though there was lot of evidence to disprove it? How did social prejudice blind people to the evidence against the miasma theory?
If the air stinks then that means that there is a disease present
Very instinctual, “if food smells good then eat it, if food smells bad then don’t eat it.”
Poor people stink more which means that there is more disease present.
What did John Snow determine was actually the cause of cholera epidemic and how did he “build the case” for how cholera was transmitted? What evidence did he use? What comparisons did he make? Describe the background of the problem, the methods used to gather data, the results of the investigation and the conclusion.
He discovered the actual cause of cholera to be the drinking water at Broad Street Pump. John Snow walked around to where major outbreaks occurred and found a common correlation being the water. He used Farr’s list to help. Looked for deviations from his hypothesis (Who died from cholera that didn’t live near Broadstreet) He was getting out into the community going door to door asking people about their illnesses.
Make a list of what John Snow did and didn’t know about cholera
He knew: ratios of survival, exemptions of people who didn’t drink water and convinced it was waterborne, if cholera was really coming from the poor there would be a greater discrepancy between the poor and rich contracting cholera
Didn’t know: How it originated in the pump, why not every household would be affected
What convinced Whitehead of Snow’s theory? What information did whitehead have that snow didn’t
Whitehead talked to people who fled areas and was able to track down baby Lewis. He was investigating the survivors.
Mom of baby Lewis admitted to throwing feces in the water
Tracked the kids getting water for the family
What is an index case? Who was it? Why was it important to find?
An index case is the first that begins the epidemic
Baby Lewis
The family had a unique pathway to the main pump
How did John Snow famously test the role of the water supply in causing cholera deaths in London? How else could the role of the water supply be tested?
The pump handle was removed from the broad street pump which led to a drastic reduction of cholera cases. The best results would come from intervention studies.
What conclusions can be drawn from figure 1.1 and how does this evidence strengthen the conclusion drawn by Doll and Hill based on their 1948 study?
It is a very linear relationship between number of cigarettes and lung cancer. This is strong evidence of a causal relationship.
What conclusions can be drawn from figure 1.2
The graph shows that smoking only causes excess mortality in the age ranges greater than 50
what factors need to be considered when interpreting geographical distribution of disease. How might researchers miss the distribution of disease in certain geographical regions and areas
distribution of the population
knowing whether the search for cases has been as intensive in the areas without cases as it has been in the areas with cases
epidemiology
the study of distribution and determinants of health-related states or events in specified populations, and the application of this study the prevention and control of health problems
Strength of Association
if measures of affect are large, association is likely to be causal
what is the strength of the association between the cause and the effect?
Consistency
similar results with different studies, different investigators, different methods and different populations
