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HSCI130 > MIDTERM 2 > Flashcards

MIDTERM 2 Flashcards

1
Q

Ottawa Charter

A
  • International agreement signed at the First International Conference on Health Promotion, organized by the World Health Organization in Ottawa
  • 212 participants from 38 countries met from November 17 - 21 1986 in Ottawa to exchange experiences and share knowledge of health promotion’
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2
Q

Health promotion (2)

A
  • Process of enabling people to increase control over, and improve their health.
  • To reach a state of complete physical, mental, and social well-being, an individual or group must be able to identify and realize aspirations to satisfy needs
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3
Q

Prerequisites for health (10)

A

Peace, shelter, education, food, income, stable eco-system, sustainable resources, social justice, and equity

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4
Q

Main aspects of health promotion action (5):

A
  • Build a health public policy
  • Create supportive environments
  • Strengthen community action
  • Develop personal skills
  • Reorient health services
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5
Q

Build a health public policy and examples (HEALTH PROMOTION)

A
  • Laws, regulations and rules enforced by governments that lead to improvements in health
  • Eg. Smoke free work place, alcohol tax, compulsory wearing seatbelts
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6
Q

Create supportive environments and examples (HEALTH PROMOTION)

A
  • A supportive environment that promotes health and assists people in making healthy life styles
  • Eg. AA, Quitline (helps smokers to quit), shade areas in playgrounds
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7
Q

Strengthen community action and examples (HEALTH PROMOTION)

A
  • Full and continuous access to information, learning opportunities for health, and funding support
  • Eg. Creation of community health centres
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8
Q

Develop personal skills and examples (HEALTH PROMOTION)

A
  • Increasing options for people to exercise more control over health
  • Eg. Anger management programs, health education programs, attending healthy cooking classes
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9
Q

Reorient health services and examples (HEALTH PROMOTION)

A
  • Shifting emphasis in health care towards health promotion by increasing attention to health research and changes in professional education/training
  • Eg. Doctors incorporating dietary advice, prescribing exercise programs for high blood pressure
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10
Q

Commitment to health promotion (5)

A
  • Counteract pressure towards harmful products, and focus on unhealthy living conditions and environments
  • Respond to health gap within societies
  • Acknowledge people as main health resource (friends and family)
  • Recognize health as major social investment
  • Advocate clear political commitment to health and equity
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11
Q

Lalonde report

A

Report that recognized that determinants of health went beyond traditional public health and medical care, and argued for the importance of socioeconomic factors.

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12
Q

PARTICIPACTION

A

Non-profit organization set up to promote physical fitness focusing on social marketing, communications, and partnerships

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13
Q

Goals of PARTICIPACTION (3):

A
  • Raising awareness, educate and inspire people to do physical activity
  • Coordinate communication to ensure consistent and uniform messages across the physical activity sector
  • Forge partnerships between organizations promoting physical activity
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14
Q

Greek definition of epidemiology

A

The study of what is upon the people (Epi = among, demos = population)

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15
Q

Endemic

A

The amount of a particular disease that is usually present in a community. ·

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16
Q

Epidemic

A

Outbreak of a disease in a localized group of people spread by vectors, carriers, or sudden intro of new pathogens

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17
Q

Pandemic

A

Epidemics that have spread beyond their local region and are affecting people in various parts of the world

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18
Q

Cholera

A

Acute diarrheal illness caused by infection of intestine with Vibrio Cholerae

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19
Q

Outbreaks of cholera around the world

A
  • 1817-1824 outbreaks of cholera in India
  • 1831-1832 outbreaks in London and disappears until 1848-1849
  • 1849 - Aug 1853 disappears again
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20
Q

John Snow (2)

A
  • English physician known for his studies of cholera and is widely viewed as the father of contemporary epidemiology
  • Developed 2 theories about cholera causes: Miasma vs germ theory
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21
Q

Miasma

A

Bad vapours in the air

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22
Q

Germ theory

A

Small organisms responsible

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23
Q

Grand experiment

A

Snow’s experiment of cholera of documenting source of drinking water for people dying from cholera

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24
Q

Toxic Shock Syndrome

A

Associated with menstrual periods and cases are more likely to use tampons

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25
Q

5 important W’s in epidemiology:

A
  • What
  • Who
  • Where
  • When
  • Why
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26
Q

Different types of host factors (4):

A
  • Personal factors people are born with
  • Acquired host factors
  • Transitory host factors
  • Behaviors
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27
Q

Place/environmental factors that affect prevalence of disease (7):

A
  • Climate
  • Diet
  • Cultural practices
  • Methods of food preparation and storage
  • Population density
  • Exposure to pollutants
  • Insects and bugs
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28
Q

Agents (4):

A
  • Nutritive agents
  • Chemical agents
  • Physical agents
  • Infectious agents
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29
Q

Applications of epidemiology (5): **

A
  • Identifying cause of new syndrome
  • Assessing risks of exposure
  • Determining whether treatment “x” is effective
  • Identifying health service use needs and trends
  • Identifying practical prevention strategies
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30
Q

Epidemiological distribution

A

Occurrence of cases by time, place and person (Eg. According to a study of deaths in Country X in 2016, women…..)

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31
Q

Epidemiological specific population

A

A measurable group, defined by location, time, demographics and other characteristics

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32
Q

The epidemiologic approach (3):

A
  1. Counting cases and describing them in terms of time, place, and person
  2. Dividing the number of cases by an appropriate denominator to calculate rates (morbidity/mortality)
  3. Comparing the rates over time
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33
Q

Cases of children with HIV in 2021

A

1.7 million

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34
Q

Cases of children orphaned by AIDS in Sub-Saharan Africa in 2007

A

10 million

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35
Q

Significance of health status indicators

A

Useful for finding which diseases people suffer from , determining the extent to which the disease causes death or disability, and carrying out disease surveillance

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36
Q

Prevalence

A

The proportion of individuals in a population with the disease at a given point in time

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37
Q

Rules of prevalence rate (4):

A
  • Calculate by # of cases of disease / total population
  • Prevalence is often reported as “prevalence rates” but it is not a rate - NO UNTS
  • Can be reported as proportion or percentage
  • Must report time period at which people are counted
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38
Q

Point vs period prevalence

A

Point- a given point in time
Period- during specified time period

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39
Q

Significance and uses of prevalence (4):

A
  • Quantify the proportion of people with a disease
  • Estimate the probability that an individual will have the disease during a point in time
  • Project health care and other policy needs or issues
  • Estimate the costs associated with a particular disease
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40
Q

One thing prevalence CANNOT tell us

A

How long people have had their disease, or the causes

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41
Q

Cumulative incidence

A

Proportion of new cases during a specific time

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42
Q

Rules of cumulative incidence (3):

A
  • Calculated by # of new cases in time period / # of people in population at risk at beginning of period
  • Exclude people who already have disease and are immune
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43
Q

Significance and uses of cumulative incidence (2):

A
  • Estimates the probability (average risk that a person will develop the disease) during a specific time period
  • Enhances research on causes, prevention and treatment of diseases
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44
Q

Incidence rate

A

Measure of the rate of development of a disease in a population

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45
Q

Rules of incidence rate (3):

A
  • Calculated by # of new cases of disease during given time period / # of person time [years/months/days] when people were at risk of developing the disease
  • Denominator represents window of time people are at risk of disease - NOT number of people at risk at the beginning
  • Reported in unit of TIME per 100, 1000, or 100,000 person years
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46
Q

Incidence rates can sometimes be called ____

A

Force of morbidity/mortality or incidence density

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47
Q

The number of cases of disease/total population at a point in time is the formula for ____

A

Prevalence rate

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48
Q

When calculating an incidence rate, your denominator is ____

A

The number of person years at risk during observation period of the study

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49
Q

Malignant hypertrophy of the ego

A

Pathological enlargement of one’s ego

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50
Q

Lifetime prevalence

A

Number of people who have ever had the disorder at anytime In their lives

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51
Q

Mortality rate

A

Proportion of people who die from something in a given time

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52
Q

Formula for mortality rate

A

of deaths due to a disorder in a given time / number of people at risk

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53
Q

Case fatality rate

A

Proportion of people with a certain disease who die within a given time

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54
Q

Formula for case fatality rate

A

of deaths due to a disorder in a given time / # of people with the disease

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55
Q

Proportional mortality rate

A

Compares the proportion of deaths with a standard population

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56
Q

Formula for proportional mortality rate

A

of deaths due to a disorder / proportion expected for standard population

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57
Q

Standardized mortality rate

A

Ratio of the number of observed deaths from a given cause in a given time to the expected number of deaths

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58
Q

Formula for standardized mortality rate

A

of deaths due to a disorder in a given time / # of expected deaths

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59
Q

Risk determinant

A

Something that is casually related to an outcome

60
Q

Risk marker

A

A factor that is related to a higher prevalence of an outcome and may or may not be casually related

61
Q

Cohort

A

Group that hares a common characteristic like birth year or exposure to risk

62
Q

Absolute risk reduction

A

Decrease in risk in the treatment group compared to the control or comparison group

63
Q

Population attributable risk

A

How much the incidence of the outcome can be reduced in the population

64
Q

Number needed to treat

A

Number of people who must be treated for there to be one additional positive outcome

65
Q

Number needed to harm

A

How many people must be treated to produce undesirable side-effects in one more person

66
Q

Crude mortality rate

A

Overall incidence of death in a population

67
Q

Formula for crude mortality

A

of new deaths / average population during year x 10^5

68
Q

Crude mortality rate from IHD in German

A

211/100,000 per year

69
Q

rude mortality rate from IHD in Brazil

A

47/100,000 per year

70
Q

Two categories of mortality rates

A

Age-specified mortality rates and sex-specific mortality rates

71
Q

Infant mortality rate

A

The number of deaths that die within one year of life expressed per 1,000 live births

72
Q

Formula for infant mortality rate

A

of deaths in children up to 1 year in specific year / # of live births in same year

73
Q

Age-standardized rate

A
  • Weighted average of the age-specific mortality rates per 100 000 persons
  • Important because aage structure has an impact on a population’s overall mortality.
74
Q

To use DIRECT standardization, you need to have _____ (2):

A
  • Age-specific disease/death rates in population of interest
  • Age distribution of a standard population
75
Q

Steps for calculating direct standardization

A
  • Calculate mortality rate for each age group in population
  • Multiply age specific rate X standard population
  • Add up total of expected deaths in a standard population
  • Expected deaths/standard population
76
Q

Standarized rate

A

Statistical measure of any rates in a population. It is adjusted to take into account the vital differences between populations that may affect their birthrates or death rates

77
Q

Why do we use standarized rates **

A

It removes the confounding effect of variables that we know or think differ in populations we wish to compare

78
Q

Cause

A

An event, condition, or characteristic without which the disease would not have occurred

79
Q

Establishing causation (5):

A
  • Temporality: Exposure must come first Essential
  • Strength of association: Strong effect?
  • Biological plausibility: What is the likely biological mechanism?
  • Consistency: Found across a range of studies?
  • Dose response: Level and duration of exposure?
80
Q

Sufficient cause

A

Factor (usually several factors) that will inevitably produce disease

81
Q

Component cause

A

Factor that contributes towards disease causation but is not sufficient to cause disease on its own

82
Q

Necessary cause

A

Any agent (or component cause) that is required for the development of a given disease

83
Q

Types of exposures (4):

A
  • Infectious agents
  • Behaviours
  • Intrinsic characteristics of individuals
  • Social or environmental factors
84
Q

Observational studies and purpose (4):

A
  • No intervention
  • Measurement of occurrence of disease or health outcome
  • Comparing patterns of exposure and disease outcomes
  • Identifying risk factors associated with health/disease
85
Q

Experimental studies

A

Includes intervention - tries to change something and measure effect on disease outcome

86
Q

Descriptive studies

A

Research that describes the occurrence of disease and/or exposure (eg. Routine data: mortality, life expectancy, prevalence surveys, or migrant studies)

87
Q

Case reports/case studies

A

Unusual/interesting case of illness

88
Q

Analytic studies

A

Evaluate association between an exposure or characteristic and the development of a particular disease

89
Q

Ecological studies

A

Compare the prevalence of exposures and disease occurrence in populations

90
Q

Cross-sectional studies

A

Study group chosen to be representative of a subgroup of society/cross-section of the population; not targeted specifically for symptoms

91
Q

Case control study

A

Choose individuals with disease or outcome of interest (cases) and a comparison group without the disease (controls)

92
Q

Prospective cohort studies

A

Follow-up studies: following people over time to see what happens. Compare rates of occurrence of disease in people with or without a particular exposure

93
Q

Randomized control trial

A

Test effects of a digital health product to an alternative (eg. Compare diabetic patients with implanted insulin pumps against diabetic patients who receive multiple insulin injections)

94
Q

Findings about alcohol intake by SMYTH ET. AL (3):

A
  • High alcohol intake associated with increased mortality
  • Different associations between alcohol and outcome depending on level of income in region
  • Alcohol = increased risk of cancer or injury
95
Q

Findings about alcohol intake by SMYTH ET. AL (3):

A
  • High alcohol intake associated with increased mortality
  • Different associations between alcohol and outcome depending on level of income in region
  • Alcohol = increased risk of cancer or injury
96
Q

Ecoli (4):

A
  • Bacteria that lives in cattle and other animals
  • Usually transmitted to humans through food
  • Causes cramps and diarrhea that can be bloody
    -Can lead to kidney failure/death
    About 159 cases/year in BC
97
Q

Rate ratio

A

Tells us how many times higher the rate of disease is in one group than in another group

98
Q

Formula for rate ratio

A

Incidence rate exposed / incidence rate unexposed

99
Q

Rate difference

A

Tells us how much extra disease occurred in one group compared with another group

100
Q

Formula for risk ratio

A

Cumulative incidence in exposed / cumulative incidence in unexposed

101
Q

Sufficient cause

A

Factor (or more usually a combination of several factors) that will inevitably produce a disease

102
Q

Component cause

A

Factor that contributes towards disease causation but is not sufficient to cause disease on its own

103
Q

Necessary cause

A

Any agent (or component cause) that is required for the development of a given disease

104
Q

TB (6):

A
  • Top 10 causes of deaths worldwide in 2015
  • 10.4 million people ill from TB 2015
  • 1.8 million dead from TB in 2015
  • Begins with latent infection and results ro exposure to TB bacillus
  • Latest infection is asymptomatic
  • TB affects lungs and respiratory tract
105
Q

TB as disease (3):

A
  • Pulmonary disease (primarily)
  • Extra-pulmonary disease
  • Systemic infection when lymphatic dissemination spreads TB bacilli throughout body
106
Q

Symptoms of pulmonary disease (9)

A
  • Bad coughs lasting longer than two weeks
  • Chest pain
  • Coughing up blood
  • Weakness
  • Weight loss
  • Loss of appetite
  • Chills
  • Fever
  • Night sweats
107
Q

Robert Koch

A

Discovered mycobacterium tuberculosis (bacteria that causes TB)

108
Q

Mycobacterium tuberculosis complex findings by Robert Koch (4):

A
  • Group of five closely related mycobacteria
  • Slender, slightly curved rod shaped mycobacteria
  • Slow growing generation time
  • High molecular weight of lipids in cell wall
109
Q

TB diagnostic tests:

A
  • TB skin test
  • Sputum smear microscopy
  • Xpert MTB/RIF
110
Q

Sensitivity tests

A

Ideally your test will identify all people with disease

111
Q

True positive

A

Have the disease and test positive

112
Q

False positive

A

Do not have the disease but test positive

113
Q

False negative

A

Have the disease but test negative

114
Q

True negative

A

Do not have the disease and test negative

115
Q

Cons of sensitivity and specificity test

A

If a screening test is so sensitive that it detects almost every true case, the test is likely to produce a larger percentage of false positives than less sensitive tests. However, if the test is so specific that nearly every case that test negative is truly full of disease, the test is likely to miss a large percentage of true cases.

116
Q

Formula for sensitivity

A

True positives x 100 number with disease. True positive/true positive + false negative

117
Q

Formula for specificity

A

True negatives x 100 number without disease. True negative/false positive + true negative

118
Q

Why is increasing sensitivity of TB tests important for TB prevention

A

Decreases the number of false negatives

119
Q

Why is improving the specificity of TB test important for TB prevention

A

Decreases the number of false positives

120
Q

Factors that influence false positives (7):

A
  • Non-tuberculosis mycobacteria (tropical/subtropical climates)
  • BCG vaccination
  • Corticosteroid use
  • Concurrent viral illness
  • Recent TB infection
  • Very young age (immune system not developed)
  • Malnutrition
121
Q

TB skin test

A

Injecting fluid under skin. Errors in technique that can lead to false positive and false negative

122
Q

Anergy

A

Non-responsiveness of immune system

123
Q

Sputum smear microscopy

A

Sputum specimen spread on microscope slide. Was developed over 100 years ago

124
Q

Xpert MTB/RIF

A

Rapid molecular test with diagnosis in 100 minutes

125
Q

Strengths of XPERT MTB/RIF (4):

A
  • Better sensitivity and specificity than smear microscopy
  • Rapid - approx 2 hours
  • Operators don’t need laboratory training/biosafety equipment
  • Can test HIV viral load and test for resistance bacteria
126
Q

Weakness of XPERT MTB/RIF:

A
  • Expensive
  • Sophisticated hardware and computer training needed
  • Need electrical supply and AC
  • Cannot differentiate between live and dead M.Tuberculosis
127
Q

Why is treatment of TB difficult (3):

A
  • Duration of treatment
  • Asymptomatic early
  • Regimen of pills
128
Q

DOTS

A

Directly observed therapy that helps prevent TB from spreading to others. It decreases risk of drug-resistance and the chances of treatment failure and relapse

129
Q

How can prevention be done for TB? (5):

A
  • Preventing transmission: Recommended guidelines
  • Suspected cases in respiratory isolation: ideally in hospital
  • Quasi-isolation at home: No work, school public
  • No contact with people susceptible to TB
  • Compliance with therapy
130
Q

Two types of prevention

A

Prevent new cases of infection and prevent activation and reactivation of disease

131
Q

3 critical things in prevention of TB

A

Vaccination, diagnosis and treatment

132
Q

BCG vaccination

A

Created by Albert Calmette and Camille Guerin, a vaccine for TB disease

133
Q

How many TB cases in Canada

A

Approximately 1630 cases of TB per year in Canada n 2015

134
Q

Vancouver Eastside incidence rate of TB before and after program

A

Before: 85.1 per 100,000 in 2001
After: 28.9 per 100,000 in 2004

135
Q

VPM1002 (2):

A
  • Vaccine containing mycobacterium bovis
  • The only recombinant BCG vaccine candidate currently in clinical trials
136
Q

Relationship between media communication of health issues and the health-related beliefs, behaviors, and choices of media audiences:

A
  • Public health decision makers depend on the media when alerting the public about threats of disease and opportunities for health protection strategies
  • Media determines what information is relevant to the public
  • Media influences policymaking
137
Q

Stats of immigrants diagnosed with TB

A

Over the last 40 years, TB increased 3.7 times from 18% to 66%

138
Q

According to the TB articles, what factors contributed to the health risks

A

Race, ethnicity, culture, and immigration status

139
Q

Press coverage cons

A
  • Certain reports can lead to discrimination against communities
  • Eg. Press coverage of SARS outbreak contributed to discrimination/harrassment of Chinese and South Asian communities
  • Press should not release information about nationality and ethnicity
140
Q

Population health framework is advanced by ____

A

Public Health Agency of Canada

141
Q

Why are TB cases higher in Aboriginals

A

Crowded and poor quality housing, food insecurity, and barriers to health care access.

142
Q

Two divisions to which TB reported cases were divided into

A
  1. Registered Indians
  2. Canadian born others
143
Q

In the article, how were clinical cases diagnosed

A

Diagnosed based on a positive tuberculin SKIN TEST; an abnormal chest radiograph or physical examination

144
Q

Manitoba vs Alberta gender aboriginal TB cases

A

Higher proportion of cases were male in Manitoba compared to Alberta

145
Q

Epidemiology definition **

A

The study of the distribution and determinants of health related states in specified populations, and the application of this study to control health problems

146
Q

Estimated adult and child deaths from AIDS in 2021

A

650,000

HSCI130 (7 decks)

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