health and disease in the population e lecture

Question 1

what does epidemiology mean

Answer 1

studies upon people

Question 2

how do we find out about oral health and disease in the population

Answer 2

used to investigate outbreaks of infectious diseases

Question 3

what does WHO define epidemiology as

Answer 3

the study of the distribution and determinants of health-related states or events (including disease), and the application of this study to the control of diseases and other health problems’

Question 4

why are inspections of people undertaken

Answer 4

in order to record the pattern of oral health and disease for geographical areas or groups of people

Question 5

what is epidemiology

Answer 5

the study of patterns of oral health and diseases in a population

Question 6

what are the different types of epidemiology

Answer 6

surveillance and descriptive studies
analytical studies
experimental epidemiology

Question 7

what are surveillance and descriptive studies

Answer 7

can be used to study the distribution of disease

Question 8

what were analytical studies used for

Answer 8

determinants of disease

Question 9

what is experimental epidemiology

Answer 9

assesses the effects of treatments preventive measures and intervention programmes

Question 10

which regular surveys occur in the UK about childrens dentition

Answer 10

conducted to examine how healthy the dentition of our children is
examining different age groups and they study the pattern of caries year after year to see if oral health is improving or worsening. These surveys also help to determine which geographical areas of the UK have worst dental health

Question 11

what is proportionate universalism

Answer 11

are reading anything to do with addressing inequity in population health. The term proportionate universalism means that you would give healthcare or preventive efforts which are proportional to needs

Question 12

where do more people have caries

Answer 12

in more deprived areas

Question 13

what is descriptive epidemiology

Answer 13

distribution of disease, risk factors and determinants of health in a population or sub-group
Usually describes disease in relation to characteristics of the population e.g. time, place, personal characteristics (age, sex, ethnicity)

Question 14

give an example of descriptive epidemiology surveys

Answer 14

British Association for the Study of Community Dentistry (BASCD)

Question 15

why are descriptive epidemiology surveys important

Answer 15

pivotal to demonstrate the oral health improvement when fluoride became much more widely used

Question 16

when was fluoride toothpaste usage become more common

Answer 16

1980s

Question 17

who is john snow

Answer 17

the first person to conduct epidemiology

Question 18

which study did john snow carry out

Answer 18

outbreak of cholera in london

Question 19

how many people died of cholera in 10 days

Answer 19

500 people

Question 20

where was the central water source in london

Answer 20

water pump on broad street

Question 21

describe analytical epidemiology

Answer 21

exploring the causes or determinants
hypothesis testing
case control and cohort studies

Question 22

what is the purpose of a case control study

Answer 22

to establish association between exposure to risk factors and disease

Question 23

who can be selected as cases

Answer 23

Members of the population with disease are selected as cases and risk factor information considered retrospectively

Question 24

why is a second group also used in case control studies

Answer 24

who do not have the disease are also included often used for rare diseases or one where little is known re the association between risk factor and disease of interest

Question 25

what are the disadvantages of case control study

Answer 25

can be prone to bias and confounding

Question 26

what is the definition of prevalence

Answer 26

the proportion of a population that are cases at a specific point in time

Question 27

what is point prevalence

Answer 27

single examination at one point in time

Question 28

what is period prevalence

Answer 28

proportion of the population that are cases at any time within a stated period

Question 29

what is the incidence

Answer 29

rate at which new cases occur in a population during a specified time period

Question 30

what was the incidence of thyrotoxicosis in 1982 in Furness

Answer 30

10 per 100000 in

Question 31

what was the incidence of thyrotoxicosis in 1982 in chester

Answer 31

49 per 100000

Question 32

what is cohort study

Answer 32

another type of analytical epidemiology

Question 33

what does cohort study involve

Answer 33

follow a group of people in the population to see what happens to them overtime

Question 34

what is prospective cohort studies

Answer 34

can be tailored to collect specific info into the future

Question 35

what is the disadvantage of prospective cohort studies

Answer 35

might be a long wait till you can examine the effect of the exposure and there might be a high number of dropouts

Question 36

what is retrospective

Answer 36

historical information look at events of the past info immediately available

Question 37

what is the disadvantage of retrospective

Answer 37

may not be complete or reliable and you may also be relying in peoples memory or far events

Question 38

what is attributable risk

Answer 38

a statistic to help describe just how much of an influence something is on disease status.

Question 39

what things are included in a cohort study 8 things

Answer 39

``` Longitudinal study Fixed or dynamic Subjects are categorised on the basis of being exposed to the cause (or protective factor) or not Retrospective or prospective Data analysis Crude rates of outcome Standardised rates or ratios of outcome Attributable risk ```

Question 40

benefits of case control

Answer 40

More suitable for rare diseases Examine one effect but several exposures Cheap and quick to conduct

Question 41

disadvantages of case control

Answer 41

Prone to bias in measuring exposure | May be difficult to elucidate cause and effect

Question 42

benefits of cohort

Answer 42

Suitable for rare exposures Examine multiple effects of single exposure Can minimise bias in measuring exposure Better at elucidating cause and effect

Question 43

disadvantages of cohort

Answer 43

Expensive and slow to conduct | Prone to drop out

Question 44

what do we need to do before epidemiology studies

Answer 44

test hypotheses about possible human causes and determinants of disease

Question 45

what is the gold standard of research

Answer 45

randomised control trial

Question 46

how is epidemiology used

Answer 46

planning of services as part of oral health needs assessment

Question 47

why health inequalities occur

Answer 47

due to differences in health experiences and health outcomes between population groups.

Question 48

why do health inequalities happen

Answer 48

socio-economic status, geographical area, age, disability, gender or ethnic group.

Question 49

what is health inequities

Answer 49

to differences in life chances or opportunities that are avoidable and due to the social and economic landscape.

Question 50

what are the key messages from marmots review

Answer 50

There is a social gradient in health | Health inequalities result from social inequalities

Question 51

which six policy objective will health inequalities require action on

Answer 51

Give every child the best start in life Enable all children young people and adults to maximise their capabilities and have control over their lives Create fair employment and good work for all Ensure healthy standard of living for all Create and develop healthy and sustainable places and communities Strengthen the role and impact of ill health prevention.

Question 52

what are general and oral health influenced by

Answer 52

form lifestyle choices to national policy

Question 53

how dow e get a successful public health approach

Answer 53

need to identify the wider determinants on health and adopt a partnership

Question 54

what is the social ecological theory

Answer 54

whereby the relationships between the individual, their environment and disease are brought together. The diagram show individuals are at the centre with a set of fixed genes

Question 55

how do we address health inequalities

Answer 55

Reduce exposure to risk Address underlying causes of ill health Social, economic, environmental factors Individuals, families

Question 56

what is the inverse care law

Answer 56

who need healthcare but do not ask for it and those who do not need care but present at healthcare services

Question 57

what strategy came into play in 2005

Answer 57

choosing better oral health- more preventative treatment

Question 58

what stratergy came into play in 2006

Answer 58

NHS dental contract

Question 59

what stratergy came into play in 2009

Answer 59

delivering better oral health PCTs take over the statutory duty to monitor the oral health of their local populations

Question 60

what stratergy came into play in 2013

Answer 60

PCTs and SHAs are disbanded and a new organisation for healthcare is initiated

Question 61

who is primary care provided by

Answer 61

general dental practice

Question 62

who is secondary care provided by

Answer 62

``` in hospital trusts, restorative orthodontics oral surgery max fax ```

Question 63

who commissions dental services

Answer 63

NHS ENGLAND

Question 64

when was dental services commissioned by NHS england

Answer 64

april 2-013