SM01 Mini 1 Flashcards
Epidemiology
study of the distribution and the determinants of health related states or events in specified populations, and the application of this study to the control of health problems
science of public health and preventive medicine
Public Health
application of science, policy & service to optimize the health of the population through social actions
Epidemic
Occurrence of disease at rates in excess of what is expected for the given population
The occurrence in a community or region of cases of an illness, specific health-related behavior, or other health-related events clearly in excess of normal expectancy. The community or region and the period in which the cases occur are specified precisely
Outbreak
Epidemic that is limited to a localized increase in incidence of health-related event or disease
Pandemic
an epidemic that crosses at least two geographic areas
(Americas, Africa, Eurasia, Antarctica, Oceania)
Endemic
usual prevalence of disease in a given area
constant presence of disease in normal proportions for a given area
Biostatistics
application of statistics to a biological problem, NOT just medical
Evidence Based Practice
integration of: 1. clinical expertise, 2. external scientific evidence, 3. patient/provider perspectives to needs
Quantitative Variable
numerical
ie. weight, age, number of incidents
Qualitative Variable
categorical
ie. sex, race, social class, disease stage
Variable
any attribute, event or phenonmena that can have different values
Dependent Variable
variable that is related to the outcome of interest
Independent Variable
variable that may influence the outcome
Nominal Variable
categories are mutually exclusive & unordered
type of qualitative/categorical variable
ie. sex, race
Ordinal variable
categories are mutually exclusive and ordered
type of qualitative variable
ie. socioeconomic class
Discrete variable
counted integer
type of quantitative variable
ie. number of incidents
Continuous variable
measured, can have any value
type of quantitative variable
ie. weight, height
Distribution Frequency
frequency with which the different possible values of a variable occur in a group of subjects
Mean
=Σxi
n
Median
middle value in a data set
50th percentile
Mode
most frequent value in a data set
Range
max & min values of a data set
usually recorded as a single number (difference between max and min)
Percentiles
p th percentile of a distribution is the value such that p percent of the observations fall at or below it
most frequently quartile (p=25) or p=50
Interquartile Range
central portion of the distribution
calculated by the difference between the third and first quartile
approximately 1/2 of obervations
Complete Wellness
spirital, environmental, mental, physical, emotional, social
Health Promotion
process of enabling people to increase control over their health & well-being
Defense
Primary Prevention
action: educate community & individuals
outcome: prevent disease
ex. sunscreen, seatbelt use, helmet use
pt. denies illness/doctor doesn’t suspects disease
Secondary Prevention
action: community screening
outcome: early detection
ex. paps, routine colonoscopy, HIV screening
pt. denies illness/doctor suspects disease
Tertiary Prevention
action: diagnosis & treatment of disease
outcome: reduce/slow progess of disease
ex. surgery, chemotherapy
pt. perceives illness/doctor observes disease
Quaternary Prevention
action: do no harm
outcome: reduce hazard/ don’t over medicate
ex. excess testing or repeats of normal test
pt. perceives illness/doctor observes absence of disease
Preventative Medicine
board certified medical specialty focused on clinical & public health promotion
requires MPH & clinical focus on: Aerospace, general preventative & public health, OR occupational & environmental medicine
Offense
Medical Home
NOT a building
the use of a PCP to coordinate all care through secondary & tertiary care (team based approach)
offers pt.s comfort, convenience, & optimal care as well as decrease costs
Health Home
team-based approach for individuals with approved chronic conditions on Medicaid
PCP, mental health center, or other qualified clinic
strong focus on behavioral health, social support, & other services
Obesity
BMI greater than 30
Overweight
BMI 25-30
Normal weight
BMI of 18.5-25
Underweight
under 18.5
Modifiable Health Risk Behaviors
- smoking (tobacco use)
- sedentary lifestyle
- poor nutrition/obesity
- excess alcohol
- poor sleep (too much or too little)
there are plenty of other possibilities, these are the top offenders
Stages of Change
- Precontemplation
- Contemplation
- Preparation
- Action
- Maintenance
try to encourage patients to move one step at a time, if you try to force all the way they will shutdown (feel lectured to)
Precontemplation
not considering change/”in denial”
may have tried repeatedly but given up
remind them why they should try again
Contemplation
unsure about making change, weighing cost/benefit or pro/cons
identify barriers to change, support
Preparation
prepared to make small changes
help them to set realistic goals
Action
takes action to change
provide positive reinforcement
Maintenance
strives to maintain new behavior
provide encouragement
Medical model of substance abuse
gender, genetics (child of addict is 4x more likely to also be an addict), behavior, environment (availability), culture (acceptable or not)
Criteria for Substance Use Disorders
- often taken in larger amts or longer period than intended
- persistent desire to cut down or control
- large amt time spent in obtaining, using, or recovering from
- craving
- failure to fulfill role at work, school, or home
- continued uses despite problems caused by use
- important activities given up or reduced b/c of use
- recurrent use in hazardous situations
- use despite knowledge that it is causing or exacerbating other physical or psych. problems
- tolerance: needing more or diminished effect
- withdrawal or taken to relieve withdrawal symptoms
Mild abuse
2-3 criteria
suggest early intervention or outpatient services
Moderate Abuse
4-5 criteria
intensive outpatient services: 10-12 hours/week of counseling, therapy, and workshops OR rehab (28 day residential)
Severe Abuse
6 or more criteria met
inpatient medical intensive care
Addiction
brain disease involving compulsive behavior, continued abuse despite knowledge of negative consequences, & persistent changes in brain structure & function
Screening for Abuse
CAGE interview
1 or more positive answers= at risk for use
2 or more= probable use
sensitivity= 43-94%; specificity= 78-96%
CAGE
- have you felt you should Cut down use?
- Have people Annoyed you by criticizing your use?
- Have you felt Guilty about use?
- Eye Opener ex: have you ever taken a drink first thing in the morning to get rid of a hangover?
Overdose Risk Factors
- opioid prescription
- high dose opioid prescription
- poverty
- age (55+)
- poly-substance abuse
- illness
- recent abstinence
