Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

KSB > excess mortality > Flashcards

excess mortality Flashcards

1
Q

in terms of being biologists, why are we interested in excess mortality

A

we are interested in:

  • the health of individuals
  • what determines health
  • what factors are modifiable
  • what can we do to improve health
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

how does the male and female life expectancy in Scotland compare to Europe and the rest of the UK

A

lower than the rest of Europe

lower than England and wales

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

how does the male and female life expectancy in west and central Scotland compare to European cities

A

it is lower than other European cities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

out of all the UK cities, which one has the lowest life expectancy

A

Glasgow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is the second lowest UK city in terms of life expectancy and is the gap between this city and the life expectancy of Glasgow big or small

A

Manchester

the gap between the life expectancy of the 2 cities is quite big

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

is Glasgow the only area in Scotland that falls below the life expectancy average

A

no there are other areas but it is the lowest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what area of Scotland has the lowest life expectancy

A

west central Scotland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are Glasgow’s biggest killers

A 
CVD
T2D
stroke 
cancer
obesity 
alcohol 
drugs 
suicide
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

why can we not say that the lower life expectancy in Glasgow is due to socioeconomic deprivation and poverty

A

because other cities have similar socioeconomic background but with higher life expectancy so there must be other influencing factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what does the Dahlgen and Whitehead model show

A

the link between socioeconomic, cultural and environmental factors on health

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what factors have been used to assess deprivation for research into the Glasgow effect before

A
  • car ownership - might not show deprivation - is sometimes a choice now
  • male unemployment - why only male
  • % of social class IV and V and overcrowding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are most deaths in Scottish men caused by

A

heart disease
lung cancer
external causes (alcohol etc)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

how do we know if a factor causes a health outcome or is merely associated with it

A

we can do different types of experiments to infer this

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are the different possibilities of relationship between 2 variables

A 
X can cause Y 
Y can cause X 
X and Y are associated by artefact 
X and Y are associated by chance 
X and Y can be caused by Z, a third factor called a cofounder
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is a risk factor

A

something that increases your likelihood of getting a disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are the 2 types of risk factor

A

modifiable and non-modifiable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

give 3 examples of modifiable risk factors

A

smoking, physical activity, diet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

give 3 examples of non modifiable risk factors

A

age, ethnicity, family history

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what were Glasgow’s most prominent risk factors in the past

A

overcrowding
slums
high risk manual labour in shipyards
high unemployment when the shipyard closed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what are the most prominent risk factors in Glasgow now

A

smoking
obesity
sedentary lifestyle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

how many hypotheses are there as to why excess mortality exists

A

more than 40

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is excess mortality

A

where the number of deaths recorded is greater than the number expected on the basis of past data

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is more controlled, field or lab research

A

lab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what does a research design provide

A

a framework for the collection and analysis of data

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what are the benefits of lab research

A
  • controlled environment

- high end equipment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what are the challenges of field research

A
  • accessibility - lots of unforeseen logistics

- much less control of the environment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

a research design reflects the aims of the research, what does this include

A

in terms of the activity study

  • expressing causal connections between variables
  • generalizing beyond participants in the investigation
  • understanding health risk/outcomes/behaviour over time
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what are the steps in creating the research design framework

A
  1. previous research/gap/theory
  2. hypothesis
  3. aims and objectives/research questions - clear and neither too broad or too narrow
    - descriptive (what’s going on)
    - explanatory (why- causation)
  4. needs to be researchable
  5. research methods
    - quantitative
    - qualitative
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what are the 2 main quantitative study criteria

A

reliability and validity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what is reliability

A

refers to the consistency of an instrument/measurement

are the result repeatable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what are the 2 main types of reliability

A

internal consistency

inter rata

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

reliability is necessary but not sufficient in determining ……..…..

A

validity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what is validity

A

refers to the accuracy of an instrument/measurement

the degree to which you are measuring what you claim to measure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

what are the different types of validity

A

measurement validity
internal validity
external validity - ecological validity - can the measurement be taken then translated and generalized to a real life situation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

what is internal validity

A

the extent to which changes in the study dependent variable can be attributed to changes in the independent variable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

what kind of studies have the highest internal validity

A

studies with control and randomisation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

what is external validity

A

the extent to which the results can be generalised to another setting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

the higher the ………….. validity the more the generalizability and external validity are compromised

A

internal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

what are the 2 different broad types of research design

A

exploratory - pilot

conclusive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

what are the 2 different types of conclusive research design

A

causal

descriptive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

what are the 2 different types of causal research

A

RCT

Quasi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

what are the 2 different types of descriptive research

A

cross sectional

longitudinal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

what is meant by powered and non powered in primary and secondary outcomes of causal evaluation

A

it is to do with the number of cases in the study
the primary outcome needs to have enough cases to be able to draw a conclusion but can’t have too many as that would be unethical and time wasting
the secondary outcome does not need to be powered

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

what is quasi-experimental design

A

impact of an intervention without random assignment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

what is the one group before and after design

A 
measure outcome in exposed group before intervention
apply intervention 
measure outcome again 
estimate the effect of the intervention 
can we immediately conclude - NO
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

what is secular change

A

saw effect due to something other than the intervention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

what is the two group before and after design

A

2 groups - one exposed to the intervention and one not
measure baseline outcome in both groups
expose one group to intervention
measure outcome of both groups again
estimate effect of intervention by comparing groups
can we conclude immediately - NO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

how can we solve participant and researcher bias

A

blinding system - researchers and participants don’t know the assignment of the groups

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

describe the Lanarkshire milk experiment

A

teachers put children into milk and non-milk groups but they generally put smaller less nourished children into the milk category which created a bias
study found that milk group were smaller and lighter but in reality the 2 groups were just not the same at baseline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

what is a randomised control trial

A

randomisation is used to allocate people to the groups
measure at baseline
intervention is applied to the intervention group
measure the outcome
estimate the effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

why do we randomise

A

to eliminate bias and ensure there are no systematic differences between groups

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

what are limitations of randomised control trials

A
  • can be large and expensive
  • participants need to be willing
  • ethics often questioned
  • cannot always randomise individuals e.g. primary school children but can randomise groups e.g. 2 primary schools
  • those randomised to control may not maintain their commitment - major threat to differential drop out
  • external validity lowered due to highly controlled manner of RCTs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

what is a cross-sectional study

A

snap shot study
each participant assessed at one point in time
allows researchers to look at many things at once
designed to determine what is happening now
cannot assume causation, only association

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

what are the 3 different types of sampling

A

random
stratified
convenience

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

what is random sampling

A

every member of the population has an equal chance of being picked

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

which type of sampling is the most representative

A

random

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

what is stratified sampling

A

separate groups e.g. ethnic minority vs. majority then sample systematically to ensure you have adequate samples in each group

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

what is convenience sampling

A

take those people who are available e.g. door knocking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

which type of sampling is least representative

A

convenience - representability is questioned

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

what is a longitudinal design

A

involves measuring participants at more than one point in time
observing change in these participants gives a better basis for causal inferences than a cross sectional design

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

what are the challenges of analysing field data

A

data often messy - needs extensive cleaning

data missing - needs imputation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

what are the different types of statistical testing

A

standard descriptive stats e.g. mean and stdv
comparison of means using t test
more complex tests (modelling) can also be carried out to look at associations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

the more risk factors you have the greater/smaller your chance of getting a disease

A

greater

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

what is another name for a non-modifiable risk factor

A

biological risk factor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

can the effect of non modifiable risk factors be reduced through changing modifiable risk factors

A

yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

modifiable risk factors could have an additive adverse effect on our health, what does this mean

A

combined risk factors increase you chance of getting a disease compared to risk factors on their own

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

what are disease genes and give 2 examples

A

genes that determine that you are going to get a disease

e.g. BRCA and CFTR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

what are susceptibility genes

A

genes that increase the risk of getting a disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

what is genomics

A

looking at the while genome and its interactions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

what is precision medicine

A

individual response to certain treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

what is ageing

A

change in physiological function/cellular metabolism over time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

what is senescence

A

the decline of fitness components of an individual with increasing age, owing to internal deterioration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

what is gerontology

A

the scientific study of the biological, psychological and sociological phenomena associated with old age and ageing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

what is geriatrics

A

the branch of medicine that deals with the diagnosis and treatment of diseases and problems specific to the aged

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

what is biogerontology

A

the study of the biology of ageing and longevity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

what are the changes seen in the trajectories

A

the population demographic is changing
people are living longer
by 2050 over 15% of the worlds population will be over 65
in about 5 years the number of people over 65 will outnumber children under the age of 5 - this is driven by falling fertility rates and remarkable increases in life expectancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

what is a non-communicable disease

A

non-infectious - strongly linked to ageing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

what is the leading non-communicable disease

A

CVD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

what is the biggest risk factor for dementia

A

age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

five examples of age related diseases

A 
arthritis 
cancer
alzhiemers 
diabetes 
heart disease 
depression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

give examples of age related conditions

A

loss of hearing, vision etc
loss of coordination
increased proportion of fat to muscle
loss of bone density

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

worldwide women live an average of …… years longer than men

A

4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

list some sex differences in diseases

A

men more likely to commit suicide
women more susceptible to depression and anxiety
most common cancer in women - breast
most common cancer in men - prostate
prostate cancer is a bigger killer than breast cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

what is the effect of men and women having different fat and muscle distribution

A

can affect metabolic risk factors, cholesterol etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

different ethnicities have higher rates of poor health give some examples

A

some ethnic groups are more susceptible to T2D
some ethnic groups are more susceptible to CVD - indian Asian > European > african carribean - CVD risk also increase in those with diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

do reliability and validity apply to qualitative data

A

no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

what is the point of qualitative data

A

usually for understanding how things work or to get an in depth understanding or a phenomenon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

what are the 2 types of probability sampling for quantitative data

A

random

stratified

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

why don’t we use probability sampling for qualitative data

A

social factors are not predictable like objects
randomized events are irrelevant to social life
probability sampling is expensive and inefficient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

what type of sampling do we use for qualitative studies

A

non-probability sampling - purposive sampling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

what is purposive sampling

A

used to get an in depth understanding of a phenomenon

  • where you understand the population that you are interested in and you sample across that population to get a broad range of views
  • need to understand what the different types of experience may be then sample people accordingly
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

qualitative researchers seek saturation, what does this mean

A

when you stop getting new information

number aren’t an issue its more about if you have learned enough

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

do qualitative studies need to be powered

A

no

you just need to have sufficient cases in the study to be able to detect a significant difference in the outcome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

qualitative researchers seek saturation, what do quantitative researchers look for

A

statistical validity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

what is meant by qualitative data being analysed thematically

A

to answer the research question but also to reveal any unanticipated themes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

is qualitative research deductive or inductive

A

generally inductive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

what is meant by deductive

A

hypothesis and study designed to address it - hypothesis found to be correct or incorrect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

what is meant by inductive

A

looking at interview transcripts and detecting theme within them - anything related to the research question and anything unrelated also

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

what are the steps in inductive analysis from initial observation to forming a theory

A

observation
pattern
tentative hypothesis
theory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

how can we integrate quantitative and qualitative studies

A

we can use a quantitative study to test the theory or hypothesis created from a qualitative study

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

what is meant by qualitative analysis being highly subjective

A

how it is interpreted often depends on ones knowledge and background
we need teamwork to ensure analysis is robust (double coding and discussion)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

give an overview of the lecturer’s football trial

A

use the loyalty men have to their football team to encourage them to attend a weight loss programme
aim - to see if the programme was effective in helping men lose weight 12 months after being in the 12 week programme

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

what were the main reasons to do the football trial

A

male obesity increasing rapidly in Scotland

almost 4/5 of middle aged men in Scotland are overweight or obese

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

what are barriers to weight loss for men

A

slimming and dieting to them are female activities
they are happy with their size
they control their weight through exercise
avoid NHS/commercial weight loss programmes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

in the football trial why were the control group offered an opportunity to take part in the programme after the trial

A

because they were pretty certain it was going to be effective

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

how did the football trial have between group contamination and how was it minimised

A

men in the intervention group were friends of men in the control group
groups were measured at different times at 12 weeks

107
Q

why could a cluster randomised control trial not be carried out in the football trial

A

because that would involve randomising football clubs but they all needed to be treated equally

108
Q

what is mean by blinding in research

A

research don’t know the grouping and neither do the participants

109
Q

why is blinding important

A

it prevents bias as researchers and participants could influence results

110
Q

what is meant by maximising retention

A

making sure that as many people as possible that started the trial finish the trial

111
Q

why is maximising retention important

A

without is you may no longer have the power for statistical significance
it affects the validity of the results - we could get differential dropout

112
Q

what is differential dropout

A

more people dropping out of one group than another

113
Q

what was the fit for life study

A

adapted football trial for delivery to prisoners and assess the feasibility of collecting data from high security establishments

114
Q

what are the challenges of collecting data in a high security establishment

A

fieldworker safety
equipment clearance
prohibited equipment
participant generally have low literacy and attention spans and there are ethical considerations

115
Q

what was the euro fit trial

A

to determine whether the eurofit programme could help men aged 30-65 with a BMI > 27 increase physical activity and decrease sedentary time over 12 months
they also monitored many secondary outcomes e.g. blood biomarkers, food intake etc

116
Q

what are the main risk factors for CVD and indicate which are modifiable and non-modifiable

A 
smoking - modifiable 
sedentary lifestyle - modifiable 
age - non modifiable 
sex - can be both 
ethnicity - non modifiable 
hypertension - modifiable 
family history - non modifiable
117
Q

what are the biomarkers of CVD

A 
hypertension 
dyslipidaemia 
T2D 
insulin resistance/metabolic syndrome 
endothelial dysfunction 
oxidative stress 
inflammation
118
Q

how does smoking affect mortality risk

A

someone who smokes has a 57% higher risk of mortality

119
Q

what % of people smoke globally

A

26%

120
Q

how much does mortality risk increase by in physically inactive people

A

28%

121
Q

what % of people globally are inactive

A

35%

122
Q

what do we need to calculate population attributable risk

A

prevalence and hazard ratio

123
Q

smoking is attributable to what % of all death

A

8.7%

124
Q

physical inactivity is attributable to what % of all death

A

9%

125
Q

what is epidemiology

A

the study of the distribution and determinants of health related states or events in specified populations and the application of this study to control health problems

126
Q

most physical activity epidemiology is ……………. and shows associations between exposures and disease. experimental data is needed to establish ……………….

A

causality

127
Q

the higher/lower the calorie intake the lower the risk of CVD

A

higher calorie intake = lower risk

128
Q

men/women have higher CVD risk compared to men/women

A

men have higher risk

129
Q

the CVD and calorie association is strange what can we take from this

A

just because there is an association it doesn’t mean that one is causing the other
there are confounding variables - those who eat more may be more physically active and that’s why mortality is decreased as an example

130
Q

what are the criteria for causality with epidemiological evidence

A
  • appropriately sequenced - does the measure physical activity precede onset of disease
  • plausibility - is the association consistent with other knowledge
  • consistency - are findings consistent in different populations
  • strength - what is the strength of the association
  • dose response - are increased levels of physical activity associated with a greater effect
  • reversibility - is a reduction in PA associated with an increase in risk
  • strong study design - i.e. randomised control trial
131
Q

what was jerry morris’ study of PA and CVD

A

looked at bus, postmen and civil servants
rates of CVD were compared in occupations with higher vs. lower levels of PA
bus conductors found to have lower incidence than drivers
study of postmen and call centre workers showed similar results

132
Q

what were the problems with Jerry Morris’ study

A

self selection - someone less healthy may choose a less active job - less healthy at baseline
bus drivers had larger trouser sizes, higher blood pressure and cholesterol and smoked more than conductors but these factors were already present before employment

133
Q

what was the Ralf paffenbarger study

A

there was a very strong union for dock workers and they assigned your job - removal of selection bias
paffenbarger measured PA in different jobs and followed people for 22 years and measured CVD incidence
found same results as morris

134
Q

what is meta analysis

A

take results form lots of studies and pull them all together to find the true results

135
Q

what is cardio respiratory fitness

A

the ability of your body to use oxygen to do work

136
Q

what % if fitness is heritable

A

50%

137
Q

are fitness and PA the same thing

A

no but a large proportion of fitness is changeable by PA

138
Q

what was found in the longitudinal study of men in Copenhagen looking at fitness and cumulative incidence of all cause mortality

A
  • over time more less fit people died than more fit people
139
Q

we can predict life expectancy after adjustment for various ………….. ……………

A

confounding factors

140
Q

is being fat worse for men or women and why

A

worse for men because they store fat higher up in the body whereas women store it lower which is less dangerous

141
Q

smoking reduces ………….. ……….. and increases …………… this is why we need to take out smokers when looking at ……….. and ……………

A

body weight
mortality
BMI and mortality

142
Q

what is lean mass and how is it calculated

A

lean mass is protective fat free mass calculated by subtracting body fat weight from total body weight

143
Q

what other measurement can we take in conjunction with BMI and why doe we do this

A

waist circumference

because BMI cant differentiate between muscle and fat

144
Q

what is the main factor that increases risk of T2D

A

obesity

145
Q

which ethnicities have higher risk of diabetes than whites

A

south African
Chinese
black

146
Q

what is the fat that you can pinch called

A

subcutaneous fat

147
Q

what is the fat on the inside of our body/ectopic fat called

A

visceral fat

148
Q

which type of fat is more dangerous

A

visceral

149
Q

how can people have low BMI and not be skinny

A

because they have less lean mass

150
Q

in the diabetes prevention programme which intervention was most effective out of placebo, metamorphin (increases insulin sensitivity) and lifestyle (increases PA)

A

lifestyle

151
Q

what were the results form the Da Quing 30 year study follow up

A

lower risk of CVD and diabetes with lifestyle intervention

intervention also associated with increased life expectancy

152
Q

what is the problem with longitudinal studies

A

take a long time to get data - need to wait for people to die

153
Q

what is the WHO definition of health

A

a complete physical, mental and social well-being and not merely the absence of disease or infirmity

154
Q

what are the problems with the definition of health

A
  • it was formed in 1948 when acute diseases presented the main burden of illness and disease patterns have since changed
  • the definition declares those with chronic diseases and disability as definitively ill
  • it minimises the role of the human capacity to cope with life’s ever changing physical, emotional and social challenges
  • the term complete is neither operational or measurable
155
Q

what have some of the proposed changes to the health definition been

A
  • emphasis on social and personal resources as well as physical capacity
  • that an increase in copying capacity may be more relevant and realistic than complete recovery
  • remove the word complete
156
Q

what is the preferred view on health

A

the ability to adapt and self manage

the movement of the static formulation towards a more dynamic one based on resilience or coping capacity is needed

157
Q

in the physical domain, a healthy organism is capable of ………..

A

allostasis

158
Q

what is allostasis

A

the maintenance of physiological homeostasis through changing circumstances
the healthy organism is able to mount a protective response to reduce potential for harm and restore equilibrium

159
Q

id the physiological coping strategy is not successful ……..…. …………. remains which may finally result in illness

A

allosteric load

160
Q

in the mental health domain ……….. ………. ………… is a factor that contributes to a successful capacity to cope, recover form strong psychological stress and prevent ptsd

A

sense of coherence - enhancing the comprehensibility, manageability and meaningfulness of a difficult situation

161
Q

how can sense of coherence and other mental health factors influence physical health

A

it improves subjective well being and may have a positive impact between mind and body

162
Q

what is social health

A

people’s capacity to fulfil their potential and obligations - their ability to manage their life with some degree of independence despite a medical condition

163
Q

give 2 examples of what social health can be affected by

A

social and environmental challenges

164
Q

how do we measure health

A

measurement instruments should relate to health as the ability to adapt and self manage
good tools include existing methods for measuring functional status and measuring quality of life and well being
a new formulation of health could help us measure is more successfully

165
Q

what are 5 physical aspects of CVD

A
  • stroke
  • congenital heart disease
  • angina
  • heart attack
  • coronary heart disease
166
Q

what is atherosclerosis

A

the build up of plaque in the blood vessels which constricts blood flow and can underlie CVDs

167
Q

what is the first stage of atherosclerosis

A

the build up of a fatty streak this is due to macrophages engulfing lipids - but at this point you can still be perfectly healthy

168
Q

what happens after the build up of a fatty streak during atherosclerosis development

A

the next stage is the atheroma stage where there is a fatty core in the middle with plaque growing around it keeping it all localised in one place

169
Q

what is the next step in atherosclerosis development after atheroma formation

A

this structure becomes more permanent and becomes a fibrous plaque with the tissue growing around it

170
Q

when an atheroma gets really large what can it cause

A

angina - reduced blood flow to the heart muscles

171
Q

what happens if the plaque ruptures in atherosclerosis

A

parts break off and get into the blood and into smaller vessels supplying the heart and brain which can lead to heart attack or ischaemic stroke

172
Q

what is the main cause of death in people with T2D

A

CVD

173
Q

what are the 4 basic steps in development of a cancer cell from a normal cell

A

normal –> hyperplasia –> dysplasia –> cancer

174
Q

what happens to cells in hyperplasia

A

there is an increase in the number of cells in an organ or a tissue that still appear normal under a microscope

175
Q

what happens to cells in dysplasia

A

the cells look abnormal under a microscope but are not cancer

176
Q

do hyperplasia and dysplasia always become cancer

A

no

177
Q

what is metastasis

A

when cancer cells break away from the main tumour (primary cancer) and travel through the blood or lymph system and form metastatic tumours in other parts of the body

178
Q

what is asthma

A

airway inflammation that causes wheezing and shortness of breath

179
Q

what is COPD

A

a branch of respiratory diseases including bronchitis and emphysema

180
Q

what is bronchitis

A

where the airways are inflamed and narrowed

181
Q

what is emphysema

A

where the alveoli lose structure and trap air

182
Q

what is cystic fibrosis

A

mutation in both copies of the gene for CFTR leads to a thick sticky mucous which leads to chromic infections and reduced lung function

183
Q

what is unusual about the genetic basis of cystic fibrosis

A

it is caused by a polymorphism in a single gene

184
Q

what is depression

A

a low mood which lasts for a long time and affects your everyday life

185
Q

what is the risk of more chronic depression

A

suicide

186
Q

what is dementia

A

the brad term used to describe a range of progressive neurological disorders - some people may present with a combination of dementia diseases

187
Q

what is the most common type of dementia in the UK

A

Alzheimer’s

188
Q

what is the second most common type of dementia to be diagnosed

A

vascular dementia

189
Q

what 2 characteristics does frontotemporal dementia generally affect

A

behaviour and personality

190
Q

what are lewy bodies and what is the effect of dementia sufferers having them

A

lewy bodies - abnormal deposits of alpha synuclein protein in the brain
cognitive impairment can fluctuate and movements are particularly affected with poor motor control

191
Q

which type of dementia can be particularly problematic

A

young onset 1

192
Q

what is alzhiemer’s disease

A

it is characterised by memory loss, language deterioration, impaired mental manipulation if visuals, poor judgement, confusion, restlessness and mood swings

193
Q

what are plaques

A

clumps of beta amyloid protein can damage and destroy brain cells in several ways including
- interfering with cell-cell communication
the collection of plaques in brain cells is thought to be one of the causes of cell death

194
Q

what are tangles

A

in alzhiemer’s threads of tau proteins twist into abnormal tangles inside brain cells leading to failure of the transport system which is strongly implicated to the death of brain cells

195
Q

what is the transport system of brain cells

A

they depend on an internal support and transport system to carry nutrients and other materials throughout their long extensions
this requires the normal structure and functioning of tau proteins

196
Q

what is vascular dementia caused by

A

small strokes

areas of the brain stop getting oxygen and die

197
Q

do the strokes that cause vascular dementia generally have other symptoms other than memory loss

A

generally there are no other symptoms

198
Q

what was the leading cause of death in males in 2015

A

heart disease

199
Q

what was the leading cause of death in females in 2015

A

dementia and alzhiemer’s

200
Q

in 2015 what did 4 out of 10 of all of the leading causes of death have in common

A

they were all cancers

201
Q

what is obesity typically measured by

A

BMI

202
Q

what do we need to calculate BMI

A

BMI = weight/height squared

203
Q

what has happened to the average BMI in the last few years

A

it has increased - people are on average more overweight

204
Q

in 2010 what % of the UK were overweight or obese and what had this increased to by 2015

A

50% –> 65%

205
Q

how are BMI and mortality associated

A

increased BMI results in increased mortality rate

206
Q

how are obesity and CVD mortality related

A

being underweight or overweight increases your risk o developing CVD and dying form them

207
Q

name the obesity gene that has been found

A

FTO

208
Q

how does having the obesity risk FTO gene affect people

A

they have higher circulating levels of the hunger hormone grehlin in their blood meaning that the start to fell hunger again soon after eating
people eat more and prefer higher calorie foods compared to chose with the low risk version of the gene

209
Q

what are the 3 scenarios for the FTO gene

A

1 - no copy of the risk variant
2- 1 copy of the risk variant - weigh 1.7 kg more
3 - 2 copies of the risk variant - weigh 3.5kg more

210
Q

how many regions of the genome have been found to be associated with increased BMI so far

A

97

211
Q

is everyone who has the obesity risk genes obese

A

no - environmental factors have a very large impact

212
Q

how many genes do we have

A

24 000

213
Q

why did scientists think we should have lots of genes

A

because we are complex

214
Q

outline the food for me study

A

looked at risk based on different food categories using participants from across 12 countries
looked at the risk of BMI > 25 depending on how much of each food category was consumed

215
Q

how does consuming veg affect excess mortality

A

consumption decreases excess mortality and progressively more effective with increased number of portions

216
Q

intake of what 2 substances partly explain the Glasgow effect

A

alcohol and drugs

217
Q

is alcohol related death greater in men or women

A

men

218
Q

what are the national physical activity recommendations

A

moderate activity - 30 mins - 5 days - 150 mins
vigorous activity - 25mins -3 days - 75 mins
build strength 2 days per week
improve balance 2 days per week

219
Q

what % of the population is physically inactive and what % don’t meet guidelines

A

31%

39%

220
Q

if 2 people have the same genetic risk score and one person is inactive and the other is active what is the difference in their BMI - what type of test is this

A

this is an interaction test

the people who are active have a lower BMI

221
Q

how many calories does 150 mins of moderate exercise burn

A

800-1200 calories

222
Q

what kind of relationship is the link between exercise and all cause mortality

A

does response relationship

223
Q

what is the effect of increasing walking pace on mortality risk

A

it decreases mortality risk

224
Q

what is hand grip strength a good measurement for

A

overall muscle mass

225
Q

what is the effect on mortality of decreased grip strength

A

mortality risk increases

226
Q

what are the main barriers to physical activity

A

lack of time - high commuting time - could actively commute
lack of interest
lack of accessibility

227
Q

list some diseases related to outdoor air pollution

A 
ischaemic heart disease 
cerebrovascular disease 
lower respiratory infections 
COPD
trachea bronchus and lung cancers
228
Q

what is the relationship seen between age and sedentary time

A

as you get older, sedentary time increases

229
Q

what conditions do we have increased risk for with increased sedentary time

A 
all cause mortality 
CVD 
diabetes 
colorectal cancer 
endometrial cancer 
lung cancer
230
Q

what are the 4 things we should all try and do to keep healthy

A

sleep well
sit less
be active
eat healthy

231
Q

what are the 2 major demographic changes

A

population ageing

population migration

232
Q

births outnumber ……….

A

deaths

233
Q

immigration outnumbers ………..

A

emigration

234
Q

by how much does the population of the UK grow by each year

A

200,000

235
Q

life expectancy is inc/dec

A

increasing

236
Q

what are some of the issues with increased longevity

A

proportion of those of a working age is shrinking
proportion of those of a pensionable age is growing
pressure and questions the sustainability to provide social services such as education, healthcare and housing
increase in pressure for elderly and social care services

237
Q

list some age related conditions

A 
dementia 
frailty
sarcopenia 
depression 
chronic conditions (heart, musculoskeletal, circulatory)
social isolation
238
Q

can dementia be cured

A

no bur research is working in developing drugs, vaccines and other treatments

239
Q

why is the prevalence of dementia increasing

A

because the population is getting older - there are more people alive in the age category where dementia is most prevalent

240
Q

what is frailty

A

a state of increased vulnerability due to poor resolution of homeostasis after a stressor event and this increases the risk of adverse outcomes including falls, delirium and disability
people can become lonely and isolated, struggling to care for themselves with decreased quality of life

241
Q

does everyone become frail

A

no but it increases in prevalence with age

242
Q

what are some of the outcomes that frailty can lead to

A 
increased risk of falls 
poorer mobility 
inability to perform activities of daily living 
disability 
incident hospitalisation 
death
243
Q

what is sarcopenia

A

the reduction in mass and function of muscle

we get more fat within the muscle which can lead to metabolic abnormalities and increased diabetes risk

244
Q

what factors is the rate of muscle loss form sarcopenia dependent on

A

exercise level
co-morbidities
nutrition and other factors

245
Q

what is the muscle loss in sarcopenia caused by

A

changes in muscle synthesis signalling pathways

246
Q

which sex does sarcopenia affect most

A

women

247
Q

what happens to the subcutaneous fat layer with increasing age

A

it gets thinner

248
Q

what is the biggest risk factor for many chronic conditions

A

age

249
Q

what is polypharmacy

A

difficulty of prescribing so many drugs to people with multiple difficulties as many things cannot be taken together because they interact

250
Q

between 1981 and 2001 what happened to the % of excess mortality and CVD explained by socioeconomic deprivation

A

it decreased

251
Q

what were the 4 indicators for the carstairs index

A

male unemployment
lack of car ownership
overcrowding in households
low occupational social class

252
Q

what were the pros of the indicators for the carstairs index

A

simple

doesn’t include health measures

253
Q

what are the cons of the indicators for the carstairs index

A

only male unemployment considered
lack of car
neither a very fair reflection

254
Q

what factor hit Glasgow much harder than other cities

A

deindustrialisation period - one of the reasons for EM to this day

255
Q

has smoking in Scottish adults increased or decreased since 2003

A

decreased

256
Q

explain lung cancer and mortality in each sex

A

mortality is increasing in females
mortality is currently higher in males
mortality is decreasing in males

257
Q

what factor makes you more likely to die from CVD

A

smoking

258
Q

what diseases have been established as causative from smoking

A 
oral cancer 
lung cancer
oesophageal cancer
liver cancer 
stroke 
diabetes 
pancreatic cancer 
atherosclerosis 
ischaemic heart disease 
laryngeal cancer etc etc
259
Q

which diseases have been established to have an association with smoking

A 
infections
breast cancer 
ischaemic intestine disorders 
prostate cancer 
hypertension 
rare cancers 
liver cirrhosis etc etc
260
Q

how are stopping smoking and coronary heart disease related

A

when you stop smoking your relative risk of coronary heart disease decreases and the longer you have been quit for the lower the risk becomes

261
Q

what are the steps in liver cirrhosis

A

healthy liver
fatty liver - deposits of fat lead to liver enlargement
liver fibrosis - scar tissue forms
liver cirrhosis - growth of connective tissue destroys liver cells

262
Q

what is the most vulnerable group to alcohol abuse

A

working class men living in deprived areas

263
Q

what combined effects on alcohol affordability and consumption for particular socioeconomic groups explains the greater rise and fall in alcohol related mortality in Scotland compared to the rest of the UK

A
  • income falls
  • higher proportion of scots in deprived areas
  • higher proportion of alcohol related deaths in Scotland

KSB (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions