Exam 1 Flashcards
autonomy
agreement to respect another’s right to self-determine a course of action
beneficence
compassion, desire to do good, taking positive action to help others
non-maleficence
avoidance of harm or hurt
social justice
upholding concepts of fairness and equity, equal access to care
senseitivity
ability of a test to correctly identify people who have the condition that is being tested for
Poor sensitivity leads to
increased false negatives
specificity
ability of a test to correctly identify people who do not have the condition that is being tested for
Poor specificity leads to
increased false positives
Calculate sensitivity
TP/(TP+FN)
Specificity
TN/(TN+FP)
limitations/implications of screening
is it significant? can we actually detect it? is there benefit to knowing?
Primary objective of screening
detection of a disease in its early stages in order to treat it and deter its progression
Secondary objective of screening
reduce cost of disease management by avoiding costly interventions required at later stages
Mass screening
applied to an entire population (ex: scoliosis screening in school)
Selective (targeted) screening
performed for specific high-risk populations (TB skin tests for health care workers)
Periodic
screen a discrete, but well, subgroup of the population on a regular basis over time for predictable risks or problems (ex: pap smear for cervical cancer)
advantages of screening
simplicity, can target individuals or groups, options of multiple tests, opportunity for health education
disadvantages of screening
Not 100% accurate
Observational study
study doesn’t alter what occurs; cross sectional surveys, cohort studies, case-control studies
Experimental studies
researchers intervene to change reality and observe what happens; RCT, quasi experimental design
mortality
people who die from ___ over total number of deaths in population
case fatality
people who die from ___ of all those who have been diagnosed with ____
Crude mortality rate
(Number of deaths occurring in 1 year/midyear population) X 100,000
Cause specific mortality rate
(total deaths from a stated cause in one year/number of persons in the populations at midyear) X 100,000
Age specific mortality rate
(Number of people in a specific age group dying in 1 year/midyear populations of a specific age group) X 1,000
Proportional mortality rate
(Number of deaths from a specific cause within a time period/total deaths in same time period) X 100
Case fatality rate
(Number of deaths from specific disease/number of cases of the same disease) X 100
Prevelance rate
(# of cases [existing & new] of disease present in the population at a specified time period/# of persons in the population at that specified time) X 1,000
Incidence rate
(# of new cases of a disease occurring in the population during a specified time period/# of persons at risk for developing the disease during that time period) X 100,000
agent
any force causing disease
reservoir
any environment in which a pathogen lives, grows, and multiplies
portal of exit/entry
a mean by which an agent leaves/enters host
Mode of transmission
method by which the agent is transferred from one host to another
Host
susceptibility, immunity status; population at risk
Epidemiological conceptual model
Host, agent, environment, vector
Wheel of causation
deemphasizes the role of the agent and looks at biological, social, and physical environment
Web of causation
strongly represents the idea that there are multiple aspects of causation; severely deemphasizes the role of agent
assessment
monitoring and surveillance of local health problems and needs, and of resources for dealing with them
policy
development and leadership emphasizes local needs, advocated for equitable distribution of public resources
assurance
make sure high quality services are available and accessible to all persons
Minnesota wheel
Surveillance (monitor), investigation (gather data), outreach (locate risky populations), screening (identify people)
Define epidemiology
study of the distribution and determinants of health-related states in specified populations, and the application of this study to control health problems
What is the only aspect of the MW that is only at the individual level?
Case finding
What is the only aspect of the MW that is only at the community/system level
Community organization and coalition building
Population based practice
focuses on the entire population, population at interest, or population at risk; grounded in assessment of populations health status
What does population based practice consider and emphasize?
Considers broad determinants of health and emphasizes all levels of prevention (especially primary)
What are the three levels of public health practice
individual-focued, community-focused, system-focused
individual-focus
changes in knowledge, attitudes, beliefs, practices, and behaviors of individuals; direct as individual, alone or as part of a family, class, or groups
community-focused
changes in community norms, attitudes, awareness, practices, and behavior
system-focused
changes in organizations, policies, laws, and power structures; often more effective and long lasting way to impact population health
population of interest
group you want to know more about
population at risk
group we know are at risk
6 steps to conducting evaluation
engage stakeholders, identify program elements to monitor, select key evaluation questions, determine how the information will be gathered, develop a data analysis and reporting plan, ensure use and share lessons learned
Formative evaluation
Evaluating before before a program begins and at the beginning of the program started; is it working as planned
Summative evaluation
After program is either well established or its over; retrospective
What is a logic model?
a depiction of a program showing what the program what the program will do and what it is to accomplish; IF-THEN relationships
What is the core of program planning and evaluation?
Inputs, Outputs, and Outcomes
Logic model input
program investments; what we invest
Logic model outputs
activities (what we do) and participation (who we reach)
Logic model outcomes
short, medium, long term (what results)
What are quasi experiments good for?
natural disasters or pregnancy; you cant make these things happen
Which type of study is most useful in examining rare diseases?
Case-control; compare differences of normal disease to normal person
What type of study methodology is best able to examine cause and effect relationships?
Cohort study
Socio-ecological model guides us to
know who and at what levels we can impact
public health
what we do collectively to assure the conditions in which people can be healthy
public health nursing
the synthesis of nursing theory and public health theory applied to promoting and preserving health of populations
