For Exam 2 Flashcards

Question

Relative Risk

Answer 1

predicts future outcomes The probability of an individual becoming diseased is risk compares the risk of exposed and unexposed RR = disease risk (incidence) in exposed / disease risk (incidence) in non-exposed *we know incidence because we have temporality* RR = 0 to infinity 1 = null (incidence is the same) >1 = positive association <1 = negative association (further from 1, the stronger the association) used in cohort studies

Answer 2

voluntary male medical circumcision

Answer 3

the amount of take-home pay earned by household members in a time period

Answer 4

the study of the size and composition of human populations

Answer 5

a woman's eggs are extracted from her ovaries, fertilized with sperm in a lab setting, and the resulting embryos are transferred to the uterus

Answer 6

taking ARVs prior to a likely exposure to HIV in order to reduce the likelihood of contracting an infection

Answer 7

estimates the additional risk (excess) attributed to the exposure group of interest: exposed, quantifies the risk of disease in the exposed group attributable to the exposure can use incidence rate (IR) or cumulative incidence (CI) Policy makers + public health practitioners use this data = Incidence in exposed group - incidence in the non exposed group incidence in exposed group = Incidence not due to the exposure (background incidence) + (incidence due to the exposure) incidence in nonexposed group = incidence not due to to the exposure (background incidence) in a 2x2 table = A/A+B - C/C+D AR = 0 if there is no association (Ie = Io) if AR>0 then there is causal association - the value indicates the number of cases of the disease among the exposed, could be attributed to the exposure Interpreations of the AR is dependent on the assumption that a cause-effect relationship exists between exposure and disease indicates potential for prevention, if the exposure could be limited (RR, on the other hand, is a measure of strength of the association and the possibility of a causal relationship) | AKA the risk difference (RD) ## Footnote removes background risk

Answer 8

focuses on helping babies and young children get their healthiest start in life The healthiest babies are born to women who were healthy before they conceived their offspring, who had access to preventive health services during pregnancy, and who had skilled birth attendants assist with delivery and the postnatal period

Answer 9

of 15 million taking ART/ARVs daily by 2015 was achieved

Answer 10

To minimize unplanned pregnancies (to reduce gravidity) and to maximize the health of babies from pregnancies that do occur (so parity is as close to possible to gravidity)

Answer 11

displays the number of males and females by age group in a population Low income countries usually have a population pyramid with a wide base of many children that gradually narrows in older age groups High income countries often have low fertility rates that make the population "pyramid" look more like a rectangle or cube

Answer 12

describes an individual's standing in a society based on individual and household income, education, gender, occuption, ethnicity and race, and other chracteristics People who have low SES tend to have significantly reduced health status compared to people from higher SES populations

Answer 13

The conditions in which people are born, grow, life, work, and age. These circumstances are shaped by the distribution of money, power, and resources at global, national, and local levels. Are mostly responsible for health inequities

Answer 14

permanent reduction to 0 of the worldwide incidence of infection caused by a specific agent as a result of deliberate efforts; intervention measures are no longer needed (e.g. smallpox)

Answer 15

The proces, in which the outbreak is characterized by time, place, and person the step after identifying and gathering basic information on the persons with the disease is to systematically describe some of the key characteristics of those persons Critical because: - can infer the population at risk for the disease - can provide clues abt etiology, source, + modes of transimission that can be turned into testable hypotheses - allows you to begin intervention + prevention measures - provides a comprehensive characterization of the outbreak - trends over time, geographic distribution (place) and the populations (persons) affected by the disease

Answer 16

of having at least 90% of people w HIV infection known their status, at least 90% of people diagnosed w HIV taking ART, and at least 90% of people on ART achieving viral suppression by 2020 not quite achieved, but still on track

Answer 17

infertility in a woman who has never had a live birth

Answer 18

reduction to 0 of the incidence of infection caused by a specific agent in a defined geographical area as a result of deliberate efforts; continued measures to prevent re-establishment of transmission are required (ex: measles, poliomyelitis)

Answer 19

1. developing hypotheses - the source of the agent, mode of transmission (vehicle & vector), any addtional time, person, place factors 2. Evaluating hypotheses: comparing the hypotheses with the established facts - use analytic epidemiology 3. Reconsider/Refine hypotheses 4. Use laboratory or environmental studies to evaluate hypotheses and generate data (case/control and cohort studies for ex) 5. implement control and prevention measures 6. maintain surveillance 7. Communicate the findings

Answer 20

1. Strength: stronger associations are less easily explained away by confounding variables than weak associations 2.Consistency: similar conclusions are drawn even with diverse methods and different populations under variety of circumstances + no other likely causation 3.Specificity: the exposure is linked to a specific effect or mechanism 4.Temporality: the exposure precedes the disease in time (mandatory, but not always easy to prove) - ex: what is the relationship between lead consumption and neurological impairment/encephalopathy? 5.Biological Gradient: increases in the exposure/dose leads to increased dose/response risk (or an inverse relationship (less probable)) (basically, dosage is impt) 6.Plausibility: appears worthy of belief 7.Experimentation: experimental evidence supports observational evidence 8.Analogy: similarities in things that are otherwise different (similar to consistency) 9.Coherence: the facts stick together to make a coherent whole, or logical, supportive set of conclusions

Answer 21

there is no common source, because the outbreak spreads from person to person. The graph will assume the classic epi curve shape of progressively taller peaks, each being one incubation period apart

Answer 22

Which do you need first, health or wealth? Do you need one to gain the other?

Answer 23

during an outbreak, is a histogram of the distribution of cases of a disease or condition by time of onset -used to study the distribution of the disease by time - the shape of the curve is studied to determine the type of epidemic (i.e. point source, common source, propogated) - of point source, can also be used to determine the probable time of exposure whenever the causative agent is known - in point source, can also be used when time of exposure is known and causative agent is unknown - info abt the probable causative agent can be obtained by assesing the approximated median incubation period (time between the known time of exposure and the peak of the curve). a visual display of the onset of illness among cases associated with an outbreak: can learn abt - time trend of the outbreak - outliers - general sense of the magnitude of the outbreak - inferences about the outbreaks pattern of spread - most likely time of exposure

Answer 24

each woman has on average, about 2 children, so those 2 parents will produce 2 offspring, "replacing" themselves but not increasing the size of the population

Answer 25

the physical discomfort, depressed mood, and other symptoms caused by hormonal changes during a mesntrual cycle are severe enough to interfere with daily usual activities

Answer 26

A measure of public health impact is used to place the association between an exposure and an outcome into a meaningful public health context (basically, how should we consider the results of our epi studies?) - whereas a measure of association quantifies the relationship between exposure and disease, and thus begins to provide insight into causal relationships (OR, RR), measures of public health impact reflect the burden that an exposure contributes to the frequency of disease in the population

Answer 27

the delivery of a baby before the 37th week of pregnancy survivors, especially those with very low birthweights may have long term special needs

Answer 28

the accumulated worth of the household's resources; can include a house, car, television or radio, livestock, and other consumer goods

Answer 29

the reduction of disease incidence, prevalence, morbidity, or mortality to a locally acceptable level as a result of deliberate efforts; continued intervention measures are required to maintain the reduction ex: diarrhoeal diseases

Answer 30

the average number of children a woman gives birth to during her childbearing years Countries with high fertility rates have a high percentage of children in their populations, while countries with low fertility rates have about as many older adults as children in their populations

Answer 31

addressing social determinants of health is important for improving health and reducing health disparities

Answer 32

measure of health burden, including both reduction in life expectancy (mortality) and diminished quality of life (morbidity) YLL + YLD = years lost due to premature death + years lost to disability YLL = Life expectancy at time of death - age at time of death YLD = disability weight * the average time a person lives with the disease before remission or death Looking at the distribution of DALYs across a population provides us with the burden of disease *who decides DW? This is a burden of diseaes measure and relates to the SDoH One DALY represents the loss of the equivalent of one year of full health | practice calculations!!

Answer 33

a person who provides emotional and physical support during pregnancy and childbirth. Not medical professionals. Dont 'deliver' babies or provide medical care. A certified doula has taken a training program and passed an exam in how to help pregnant women and their families

Answer 34

an aggregation of cases in a given area over a particular period without regard towhether the number of cases is more than expected

Answer 35

the inability to have additional offspring when attempting to conceive after having given birth to a child

Answer 36

Compliance: passive: the degree to which the patient conforms to medical advice about lifestyle and dietary changes as well as to keeping appts for follow up and taking treatment as prescribed Adherence: active: the extent to which a persons behavior - taking medication, following a diet, and/or executing lifestyle changes -- corresponds with the agreed recommendations from a healthcare provider

Answer 37

estimate of national development based on composite data on longevity (life expectancy at birth), knowledge (such as the mean and expected years of schooling), and income higher HDI is correlated with better health status and greater levels of happiness has increased in most countries over the past 25 years, but still significant gaps between the richest and poorest countries (increases as people live longer, spend more years in school, and earn more)

Answer 38

a lay midwife who has been trained through an apprenticeship rather than a formal educational program, who may be able to handle uncomplicated births, but does not have the advanced training to safely manage complications

Answer 39

The PAR helps us determine which exposures have the most relevance to the publics health can help guide the allocation of resources aimed at interventions to a whole population instead of intervening on high risk individuals (i.e. the exposed) Among both the EXPOSED and NONEXPOSED (total pop) - estimatest the excess rate of the disease in the "total study population" of exposed and nonexposed that is attributable to the exposure Estimates the excess rate of disease in the total study population *This is where we see th real value for policy makers - what can be avoided through an intervention? PAR = (incidence in total pop) - (incidence in non-exposed group) = incidence attributable to exposure = (A/ (A+B)) - (C / (C+D)) Can also be calculated as PAR = (AR)*Pe (Pe is the proportion of exposed people in the population)

Answer 40

treatment of people with HIV is a critical part of prevention strategies, changing the impact of HIV/AIDS and STIs worldwide

Answer 41

remember when analzying the mode of spread: the shape of an epi curve rarely fits any of these descriptions exactly. but you can still get a general sense about the mode of spread of an outbreak from its epi curve

Answer 42

an obstetrician or gynecologist, another type of physician, a nurse midwife, a nurse, or another trained person who can recognize and treat potential complications during and after labor and delivery 1/4 of births worldwide occur without the assistance of an SBA

Answer 43

the occurrence of more cases of disease than expected in a given area or among a specific group of people over a particular of time - usually the cases are presumed to have a common cause or be related to one another in some way.

Answer 44

Strengths: can calculate DALYs at the community/populatin level too Limitations: They focus solely on health and still do not fully capture the broader societal impact of diseases. (e.g. intestinal nematodes which have lasting impacts on child development and education) There is also an important equity issue that goes beyond health: ascariasis and other neglected tropical diseases affect the poorest communities and are diseases of neglected populations

Answer 45

refers to the number of years a person of a given age can expect to live in good health (taking account of mortality and disability) In principle, each country should strive to help its people live as long and as healthy as possible - if that is the case - life expectancy and a HALE should converge at a relatively high number

Answer 46

the average number of births/woman over lifecourse (assumes she lives and age-speciic rates remain constant)

Answer 47

people are able to have a satisfying and safe sex life and that they have the capability to reproduce and the freedom to decide if, when, and how often to do so Higher-income women experience a much lower mortality rate than lower-income women The vast majority of maternal mortality cases occur in low income countries It encompasses issues of fertility and infertility, contraception, pregnancy and childbirth, gynecologic and urologic health, and the prevention and treatment of STIs

Answer 48

the proportion of disease in the study population that is attributable to the exposure and could be eliminated if the exposure was eliminated PAR% = (It - Iu)/ /It or = (CIt - CIu) / CIt

Answer 49

suggests that a person's believ in a personal threat of an illness or disease together with a person's belief in the effectiveness of the recommended health behavior or action will predict the likelihood the person will adopt the behavior 6 components: 1. perceived susceptibility 2. perceived severity 3. perceived benefits 4. perceived barriers 5. cue to action 6. self-efficacy

Answer 50

a reduction in the average number of offspring the typical female gives birth to over her lifetime

Answer 51

persons are exposed over a brief time to the same source, such as a single meal or an event . The number of cases rises rapidly to a peak and falls gradually. The majority of cases occur within one incubation period of the disease