GI Population Health Flashcards
When is a dietary plan sufficient?
When it meets the needs of the individual and maintains body composition and function
What disturbs nutritional equilibrium?
decreased intake, increased requirements, altered nutritional utilisation
Advantages and disadvantages of 4 dietary assessments?
- 24 hour recall
A - accurate food record
D - need trained interviewer, costly and time intensive, boring to answer, only provides a snapshot - Diet History
A - reasonably precise, broader picture of intake, more specific advice given
D - dependent on interviewer skill, hard to recall, expensive and time intensive, females under report - Diet record
A - accurate, no recall problems, don’t have to estimate
D - hard/annoying, change intake because its easier to report and know you are reporting, not representative - Food frequency questionnaire
A - shorter, easier, low subject burden, cost less, no specialist needed
D - time intensive, over report, hard to remember all, not representative
Ways to change diet to prevent CVD?
less fats and sodium, more omega 3 fats, fish, potassium, fruit and veg
3 principles of food security?
- Food access - capacity to acquire and consume nutritious food
- Food availability - supply of food within a community
- Food use - appropriate food use based on knowledge of basic nutrition
Causes of food insecurity?
Poverty, war, civil unrest, forced removal, restriction on economics and trade, lack of infrastructure, poor food distribution, disease epidemics, cultural influences, population growth, climate change
What is the under nutrition intergenerational cycle?
Low nutritious food - childs growth stunted - stunted/decreased physical capacity in adults - low weight gain in pregnancy - infant with low birth weight - childs growth stunted
What is the cycle of infection?
Inadequate dietary intake - weight loss and lowered immunity - increased disease incidence, severity, duration - appetite and nutritional loss, malabsorption - inadequate dietary intake
Short and long term solutions to food security?
Short term - emergency relief, food supplementation, food fortification
Long term - education, limit waste, improve trade policies, new technology, decrease poverty
4 main causes of infectious diarrhoea?
- Viral - rota, adeno, noro
- Bacteria - Shigella, cholera
- Protozoa - Cryptosporidium, giardia
- Helminths - worm, taenia solium
Most common cause of traveler’s diarrhoea?
E. coli, shigella, campylobacter, salmonella with S/SE Asia, C/S America and N/W Africa
What does OzFoodNet do?
Identifies and responds to food borne diseases and provides information about epidemiology and conducts surveillance to identify ways to minimize disease
What two serotypes cause cholera?
01 (classical) and 0139
What are the leading causes of gastritis?
campylobacter, salmonella, E. coli, shigella
Risk factors of diarrhoeal diseases?
unsafe drinking water, poor hygiene/sanitation, no access to hand washing facilities, malnutrition, suboptimal breast feeding, low rotavirus coverage
Determinants of diarrhoeal diseases?
poor environmental sanitation and hygiene, inadequate water supply, poverty, limited education, conflict
Management and prevention of diarrhoeal diseases?
Management - oral rehydration, IV, maintain nutrients and supplements, antibiotics in severe cases of shigella
Prevention - water, sanitation, hygiene, promote breast feeding, reduce overcrowding, immunizations, education
Screening vs diagnostic?
Screening is for asymptomatic in order to classify as likely or unlikely of getting disease where diagnostic is establishing the presence or absence in a symptomatic or screen positive person
4 reasons for suitability of a test?
- Validity - can diagnostically differentiate between with and without
- Reliability - repeat tests
- Acceptable - convenient, painless, simple
- Cost effective
Sensitivity vs specificity?
Sensitivity - probability that those with the disease will test positive. High=not miss people, low= people are missed and delayed treatment
Specificity - those without disease will test negative. High=rarely classify false positives, low=false positive and unnecessary anxiety/investigation/cost
PPV vs NPV?
PPV - those that tested positive for the disease actually have it
NPV - those that tested negative for disease actually dint have it
Stages of screening?
- Aim for high sensitivity so people aren’t missed (but high FP)
- Aim for high specificity so to not classify false positives and remove them
Principles for screening?
- condition is important health problem
- Acceptable treatment
- Facilities for diagnosis and treatment
- recognised early symptomatic phase
- suitable test
- Test accepted by population
- natural history understood
- Agreed policy on whom to treat
- case finding is economically balanced
- case finding is continuous and not once off project
7 principles of managing outbreaks?
- trained team - before outbreak with necessary resources and infrastructure
- Establish existence and level of urgency of outbreak - usual incidence to current incidence and potential risk
- Confirm and verify diagnosis with clinical and lab
- Consider time, place, person - common source, propagated or mixed
- Hypothesis of causative agent and transmission linking infection
- Institute control measures - treatment and reduce spread
- Disseminate information to public, media and decision makers
