GI Population Health

Question 1

When is a dietary plan sufficient?

Answer 1

When it meets the needs of the individual and maintains body composition and function

Question 2

What disturbs nutritional equilibrium?

Answer 2

decreased intake, increased requirements, altered nutritional utilisation

Question 3

Advantages and disadvantages of 4 dietary assessments?

Answer 3

1. 24 hour recall
   A - accurate food record
   D - need trained interviewer, costly and time intensive, boring to answer, only provides a snapshot
2. 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
3. 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
4. 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

Question 4

Ways to change diet to prevent CVD?

Answer 4

less fats and sodium, more omega 3 fats, fish, potassium, fruit and veg

Question 5

3 principles of food security?

Answer 5

1. Food access - capacity to acquire and consume nutritious food
2. Food availability - supply of food within a community
3. Food use - appropriate food use based on knowledge of basic nutrition

Question 6

Causes of food insecurity?

Answer 6

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

Question 7

What is the under nutrition intergenerational cycle?

Answer 7

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

Question 8

What is the cycle of infection?

Answer 8

Inadequate dietary intake - weight loss and lowered immunity - increased disease incidence, severity, duration - appetite and nutritional loss, malabsorption - inadequate dietary intake

Question 9

Short and long term solutions to food security?

Answer 9

Short term - emergency relief, food supplementation, food fortification
Long term - education, limit waste, improve trade policies, new technology, decrease poverty

Question 10

4 main causes of infectious diarrhoea?

Answer 10

1. Viral - rota, adeno, noro
2. Bacteria - Shigella, cholera
3. Protozoa - Cryptosporidium, giardia
4. Helminths - worm, taenia solium

Question 11

Most common cause of traveler’s diarrhoea?

Answer 11

E. coli, shigella, campylobacter, salmonella with S/SE Asia, C/S America and N/W Africa

Question 12

What does OzFoodNet do?

Answer 12

Identifies and responds to food borne diseases and provides information about epidemiology and conducts surveillance to identify ways to minimize disease

Question 13

What two serotypes cause cholera?

Answer 13

01 (classical) and 0139

Question 14

What are the leading causes of gastritis?

Answer 14

campylobacter, salmonella, E. coli, shigella

Question 15

Risk factors of diarrhoeal diseases?

Answer 15

unsafe drinking water, poor hygiene/sanitation, no access to hand washing facilities, malnutrition, suboptimal breast feeding, low rotavirus coverage

Question 16

Determinants of diarrhoeal diseases?

Answer 16

poor environmental sanitation and hygiene, inadequate water supply, poverty, limited education, conflict

Question 17

Management and prevention of diarrhoeal diseases?

Answer 17

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

Question 18

Screening vs diagnostic?

Answer 18

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

Question 19

4 reasons for suitability of a test?

Answer 19

1. Validity - can diagnostically differentiate between with and without
2. Reliability - repeat tests
3. Acceptable - convenient, painless, simple
4. Cost effective

Question 20

Sensitivity vs specificity?

Answer 20

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

Question 21

PPV vs NPV?

Answer 21

PPV - those that tested positive for the disease actually have it
NPV - those that tested negative for disease actually dint have it

Question 22

Stages of screening?

Answer 22

1. Aim for high sensitivity so people aren’t missed (but high FP)
2. Aim for high specificity so to not classify false positives and remove them

Question 23

Principles for screening?

Answer 23

1. condition is important health problem
2. Acceptable treatment
3. Facilities for diagnosis and treatment
4. recognised early symptomatic phase
5. suitable test
6. Test accepted by population
7. natural history understood
8. Agreed policy on whom to treat
9. case finding is economically balanced
10. case finding is continuous and not once off project

Question 24

7 principles of managing outbreaks?

Answer 24

1. trained team - before outbreak with necessary resources and infrastructure
2. Establish existence and level of urgency of outbreak - usual incidence to current incidence and potential risk
3. Confirm and verify diagnosis with clinical and lab
4. Consider time, place, person - common source, propagated or mixed
5. Hypothesis of causative agent and transmission linking infection
6. Institute control measures - treatment and reduce spread
7. Disseminate information to public, media and decision makers

Question 25

4 response actions to an outbreak?

Answer 25

1. Prevention - before pandemic occurs so identify disease and transmission and disrupt cycle, surveillance is essential
2. Preparedness - develop emergency plan and practice plan
3. Response - rapid and coordinated with triaging and isolating individuals with goal of public protection and personal responsibility for rick minimization
4. Recovery - early mobilization of emergency services ad treatments and preventions

Question 26

Determinants of alcohol use?

Answer 26

Availability, age, gender, marital status, rurality, ATSI, employment, incarceration, sexuality, CALD, socioeconomic

Question 27

3 prevention strategies of alcohol minimization?

Answer 27

1. Demand reduction - prevent uptake and delay onset of use (education, restrictions, education)
2. Supply reduction - minimizing legal age, restriction of opening hours, taxation, restriction of strength
3. Harm reduction - identifying and targeting specific risks (drink driving)