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Final Exam Flashcards

1
Q

What is public health?

A

the science and art of promoting health, preventing disease, prolonging life, and improving quality of life through the organized efforts of society
-based on principles of primary health care

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2
Q

What is the Public Health Agency of Canada?

A

an agency whose role is to promote and protect that health of Canadians through research, innovation and collaboration

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3
Q

Define prevalence

A

refers to the total number of people in a population (including new and existing) affected by a particular health condition (disease/injury) at a particular time

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4
Q

What increases prevalence?

A

-decreased mortality
-improved life expectancy
-increasing incidence of disease

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5
Q

What decreases prevalence?

A

-recovery (cure)
-death

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6
Q

What causes the incidence rate to increase?

A

-rise in development of disease (epidemics)
-sudden, improved disease-reporting procedures

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7
Q

What causes the rate of incidence to decrease?

A

-resolution of epidemics
-cure
-excellent prevention measures

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8
Q

What is age-adjusted rates?

A

-adjustment of rates so that meaningful comparisons of rates for important health outcomes between different geographic regions can be done and allows comparisons over time to be made by accounting for an aging population

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9
Q

What is the web of causation?

A

an illustration of the complex interrelationships of numerous factors sometimes interacting in subtle ways to increase (or decrease) the risk of disease

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10
Q

What are Bradford Hill’s criteria for causation?

A

9 criteria for causation

-strength of association
-consistency
-specificity
-temporal relationships
-plausibility
-biological gradient (dose-response)
-coherence
-experimental evidence
-analogy

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11
Q

Describe Strength of Association

A

-a Bradford Hill’s criteria
-says that a strong association provides firmer evidence of causality than do weak ones
-quantified by a measure (ex. ratio)
-the reverse, however, is not true

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12
Q

Describe the Bradford Hill criterion Consistency

A

-similar findings found in multiple studies through diverse methods, in different populations, and under a variety of circumstances shows strong association
-consistency along, however, does not prove causation

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13
Q

Describe the Bradford Hill criterion Temporality

A

-exposure to the causal factor must PRECEDE the onset of disease
-this criterion is REQUIRED to establish causation

retrospective studies and cross-sectional studies will also NOT be able to show temporality

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14
Q

Describe the Bradford Hill criterion Biological Gradient

A

-an increase in the level, intensity, duration or total level of exposure to an agent leads to progressive increase in risk
-ex. smoking and lung cancer
-if a threshold exists below which no further harm is done, further reduction in exposure is unwarranted

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15
Q

What is analytic epidemiology?

A

-testing the hypothesis
-addressing the question “why?”
-seeks to explain already observed patterns
-usually more rigorous study design, so more expensive
-“why are certain groups at high or lower risk of disease X than others?”

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16
Q

What are the types of experimental analytic studies?

A

-randomized control trials
-non-randomized studies

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17
Q

What are the types of observational analytic studies?

A

-cross-sectional
-longitudinal (cohort and case-control)

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18
Q

Describe randomized control trials

A

-most rigorous of the studies
-random allocation of population into 2 groups (experimental or control)
-blinding (double blind? placebo?)
-results observed at some future time (always prospective)
-ethical/logistical problems
-directionality always Exposure -> Outcome

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19
Q

Describe cross-sectional studies

A

-information about outcome and exposure in a defined population is collected at one point in time
-attempt to address question of strength of association between exposure and outcome
-difficult to establish temporality (did E occur before D?) therefore cannot establish causation
-multiple sampling strategies (random, systemic, stratified, cluster)
-measure– point prevalence

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20
Q

Describe a Cohort study

A

-tracks groups of individuals over time
-selection based on exposure
-forward directionality (E–>D) prospective
-study one exposure, many outcomes
-not suitable for studying rare disease
-measure: relative risk (RR)

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21
Q

Describe Case-control studies

A

-selection based on outcome/disease
-backward directionality (E<–D) retrospective
-study one disease, many exposures
-persons with rare disease of interest are compared to another group without the disease
-purpose: do 2 groups differ in proportion of exposure to specific risk factors?
-measure: Odds Ration (OR)

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22
Q

Describe the risk ratio

A

-the ratio of the incidence of a health outcome (disease) among the exposed to that among the unexposed

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23
Q

Define reliability

A

the precision of a measuring instrument, which depends on its consistency from one time of use to another, and its repeatability

24
Q

What is positive predictive value vs negative predictive value?

A

-ability of test to predict the presence or absence of disease

Positive Predictive Value: the proportion of persons with a positive result who actually have the disease

Negative Predictive Value: the proportion of persons with a negative result who are actually disease free

25
Define Validity
-the accuracy of a test or measurement; how closely it measure what is claims to measure -in a screening test, validity is assessed in terms of sensitivity and specificity
26
Define sensitivity
-quantifies how accurately the test identifies those with the condition and represents the proportion of persons with the disease whom the test correctly identifies as positive (true positives) -how likely will someone with the disease test positive?
27
Define specificity
-indicates how accurately the test identifies those without the condition and represents the proportion of persons whom the test correctly identifies as negative for the disease (true negatives) -how likely will someone without the disease test negative?
28
Who is at risk for lower health literacy?
-people over 65, recent immigrants, low income, low education, Indigenous peoples, people of diverse cultures who primary language other English or French, people who are unable to read and write, and people with learning disabilities
29
What are the steps of policy development?
-agenda setting -policy formulation -decision-making -policy implementation -monitoring and evaluation
30
Define collaboration
denotes a range of strategies for building relationships to address health and social issues -flexible and iterative
31
Define partnerships
occur when the purpose of collaboration is to advance a shared vision of a need and the expected outcome is to develop and implement a joint agreement to address the problem and bring the vision into reality
32
What factors are needed for the transmission of a communicable disease?
agent host environment -changes in any of these factors affects disease transmission
33
Define Attack Rate (case rate)
total number of people who develop clinical disease divided by population at risk -marker of infectivity -expressed as a percentage
34
Define case-fatality rate
proportion of persons with disease who die from the disease
35
What are the types of epidemics/outbreaks?
-common source -propagated
36
Describe a common source epidemic
-exposure to a single, noxious influence a) point source-- exposure is brief, most people get sick at one incubation period following exposure, characterized by sudden rise in cases then rapid decline b) continuous source-- prolonged exposure to a single source of infection continuous; only ceases when the source is removed
37
Describe a propagated epidemic
-begins with an index case (first identifiable case in an epidemic) -initial infection from index case, then secondary cases of the disease act as sources to infect new people -maintained by person-to-person transmission
38
What are the types of infections
-bloodborne -waterborne -foodborne -vectorborne -diseases of travellers -zoonotic -parasitic -nosocomial -airborne
39
What can we do to prevent lung cancer?
-eliminate smoking/ETS -increase consumption of fresh fruits and vegetables -reduce occupational exposure to carcinogens -screening CT-- has not yet been implemented
40
What are the risk factors of skin cancer?
-unprotected or prolonged exposure to sunlight/tanning beds (UV light) -fair skinned, fair haired, blue/green eyes -living in areas of intense sunlight -male -smoking
41
What are the colon check screening guidelines?
-most people age 50-74 should complete a fecal immunochemical test (FIT) every two years
42
What are the breast check screening guidelines?
most women age 50-74 should have a screening mammogram every 2 years
43
What are the cervix check screening guidelines?
most people with a cervix age 21-69 who have ever had sexual contact should have a Pap test every 3 years
44
What does ETS stand for?
environmental tobacco smoke
45
What are the causes of obesity?
30% genetics 70% environment and extrinsic factors (social determinants, culture, behaviour, psychosocial)
46
What BMI is considered underweight?
under 18.5
47
What BMI range is considered normal weight?
18.5-24.9
48
What BMI range is considered overweight?
25-29.9
49
What BMI range is considered obese?
anything over 30
50
What is the waist-to-hip ratio?
WHR= waist circumference/hip circumference >1.0 for men= at risk >0.8 for women= at risk
51
What is active immunity?
long lasting immunity conferred by antibody development -natural (disease) -artificial (vaccines- live or killed viruses or bacteria)
52
What is passive immunity?
antibody transferred from another person or animal -natural (mother to fetus) -artificial (antibodies, injection of antibodies)
53
What vaccines are received in grade 6?
-hep B -HPV -Meningococcoal
54
Who can receive the influenza vaccines?
-all Manitobans 6 months and older are eligible for influenza vaccine each year
55
What are the age considerations for immmunizations?
-age at which passive immunity from mother is lost (6 months) -age at which disease poses threat to infant (ex. pertussis risk exists at birth) -age at which infants immune system capable of adequate response (around 2 months) most immunization programs begin at 2 months
56
What is the primary goal of harm reduction?
to decrease risk of infection

Epidemiology (2 decks)

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