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Epi > Unit Test 1 > Flashcards

Unit Test 1 Flashcards

1
Q

epidemiology

A

the study of health in populations specific to diseases and conditions and how they’re acquired

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2
Q

goals of epidemiology:

A
  1. describe distribution of a disease
  2. identify risk factors for the disease
  3. prevent the disease
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3
Q

epidemic

A

larger than normal outbreak of a disease within a certain region

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4
Q

pandemic

A

if a disease outbreak spreads to other parts of the world

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5
Q

who is the father of epidemiology?

A

John Snow, english physician: the first to determine that cholera epidemic in London was a result of the lambeth company water supply contamination from the Thames river

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6
Q

John Snow’s legacy

A

paved the way for:

  • cleaning the water supply in London
  • Germ theory
  • population and preventative medicine
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7
Q

what is the leading cause of death in first world countries?

A

chronic disease where it used to be infection, acute disease, etc.

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8
Q

behavioural epidemiology

A

the observation and study of behaviours that lead to health related states
- also the distribution of these behaviours

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9
Q

comorbidity

A

having more than one disease at a time

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10
Q

3 goals of physical activity epidemiology:

A
  1. examine the relationship b/w morbidity and mortality
  2. identify patterns and determinants of PA
  3. use evidence to determine things for disease prevention
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11
Q

morbidity

A

having a diseased state

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12
Q

mortality

A

dying

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13
Q

PA can be considered a burden in canada for a few reasons. what are some direct and indirect costs?

A

direct: drugs, hospitals, physician care
indirect: work loss due to disability, things don’t get done when people are sick

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14
Q

physical benefits of PA on morbidity

A
  • decreased risk of CVD, colon cancer and type 2 diabetes
  • protects against breast and prostate cancer, osteoporosis
  • prevents and reduces obesity
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15
Q

the most healthcare dollars are spent on these diseases

A 
coronary artery disease
stroke
colon cancer
breast cancer
type 2 diabetes
hypertension
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16
Q

psychological benefits of PA

A

relieved symptoms of depression, anxiety

improves mood, body image and quality of life

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17
Q

history of PA and health

A

see slide pack for this one bc wow this is a lot

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18
Q

what are the landmark studies in epi?

A

they provide evidence that PA and health outcomes are related

  • London bus study
  • Framingham heart study
  • Longshoremen study
  • Harvard alumni study
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19
Q

London bus study

A

1950s UK by Jerry Morris
- a retrospective study
examined link b/w occupations PA and health by measuring heart disease in double decker bus drivers vs conductors

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20
Q

what is myocardial infarction?

A

heart attack

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21
Q

results of london bus study

A

found that conductors were at lower risk of heart disease than drivers regardless of their age

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22
Q

what were some limitations of the london bus study?

A

we can’t conclude anything based on this evidence.

  • we don’t know about their leisure activities, daily activities (eating, smoking)
  • job stress?
  • self selection for the job, could this be just coincidence that lazy people get CVD and choose to be bus drivers than conductors
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23
Q

Framingham heart study

A

1949 to present in the US in small town Massachusetts
- a prospective study that followed people over time to see what happens
is there a link b/w lifestyle and health,
>5000 people : men and women, predominantly white, testing and surveyed every 2 years

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24
Q

whats the difference between a retrospective study and a prospective study?

A

retrospective: take what you know now and look into history to find out more
prospective: follows people over time and see what happens

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25
Q

results of framingham heart study

A

there were controllable and uncontrollable risk factors

  • most things were controllable: smoking, diet, PA rates, alcohol and obesity levels
  • uncontrollable: gender, genetics, ethnicity
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26
Q

limitations of framingham heart study

A

only white people, not a very ethnically diverse pop

- this has changed now to incorporate a more diverse pop of people but initially not

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27
Q

Longshoremen study

A

3500 longshoremen studied in 1951-1972
prospective cohort study
- dockworkers vs supervisors; looked at PA throughout the day

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28
Q

results from the longshoremen study

A

8500kcal/week reduced risk of death due to CHD (coronary heart disease) by 50% WOW

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29
Q

limitations of longshoremen study

A

all men
we don’t know about leisure time activities
had some screenings tests but people weren’t self selecting which jobs they had

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30
Q

Harvard alumni study

A

1960s
retrospective but also kept track over time prospectively
- researchers sent questionnaires to alum. about PA habits

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31
Q

results from harvard alumni study

A

3 hrs/week of PA could reduce overall death rates by 50%

  • even walking helped decrease rate by 33%
  • active men lived 2 years longer than inactive men
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32
Q

limitations of harvard alumni study

A

white men all of high socioeconomic status (they were in uni)

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33
Q

PA guidelines

** these are important **

A

WHO in 2011
“ 150 min mod-intensity PA/week or 75 min vigorous PA/week “ - in bouts of 10 mins or more
increase moderate PA to 300 min/week over time or 150 vigorous PA/week but w/e
– resistance exercise 2 or more days/week

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34
Q

risk factor

A

not necessarily cause of disease but increases the probability of getting that disease, compared to groups that don’t have that characteristic

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35
Q

incidence

A

new cases of a health related state that occurs in a population during a specific time period

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36
Q

prevalence

A

number of existing cases (new and old) in a population at a specific point in time

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37
Q

how to calculate prevalence rate:

A 
# of cases in pop/
# of people in the pop
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38
Q

why is it not particularly useful to know the number of incidence or prevalence rates

A
  • it doesn’t give any info about total pop or if this is a good or bad thing
    THUS, it’s more important to know the rates of incidence or prevalence
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39
Q

how should we express prevalence rates?

A

as a percent or per 100, 1000, 10,000, etc

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40
Q

what does it mean when prevalence rates are high?

A

bad: lots of people have the disease
good: people aren’t dying from the disease

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41
Q

how to calculate incidence rates:

A 
# of new cases/
# of people in the pop
42
Q

categories of rates

A

crude, specific, and standardized (adjusted)

43
Q

crude rates

A
  • based on total pop w/o considering pop characteristics
44
Q

specific rates

A
  • computed separately for different sub-populations

ex. diseases that only affect women/men

45
Q

standardized rates

A

are adjusted so that they make sense by factoring in the effects of some known population characteristics
– used for comparing 2 or more populations

46
Q

what is the scientific method?

A

a systematic way of collecting data so we can have fact based explanations about things
- results need to be reproducible

47
Q

what is research design?

A

an analytic approach used to evaluate a research question

- how you set up a study to examine the assoc b/w 2 or more variables

48
Q

what are the 4 steps in the scientific method?

A
  1. developing and defining the problem
  2. formulating the hypothesis
  3. gathering data
  4. analyzing and interpreting the results
49
Q

dependent vs independent variables

A

dependent: is observed and measured, does not receive manipulation
independent: is manipulated by the researcher and looked at change it causes to the DV

50
Q

hypothesis

A

a prediction that involves facts and guides observations

- the prediction must be testable

51
Q

how does the process of publishing scientific research work?

A
  • submit research to a journal, the more reputable the better
  • article is peer reviewed and avoids conflicts of interest
  • study is accepted or rejected
    • once published, it can’t be removed, it can only be retracted
52
Q

primary vs. secondary source articles

A

primary: actual research study that’s been run
secondary: summarize a lot of research out there based on keyword searches and put it all together

53
Q

what is the goal of research design in PA epidemiology?

A

to answer the research question and:

  • determine the effect PA has on a particular disease or condition
  • determine the consequences PA has on env’t, personality char, etc
54
Q

what are the 2 general types of study designs?

A

observational designs and experimental designs

55
Q

observational study designs

and ex.

A

examine the association b/w IV and DV as they occur naturally
ex. cross sectional study, prospective cohort study, case-control study

56
Q

experimental study designs

and ex.

A

the investigator manipulates the IV and looks at the effects on the DV
ex. randomized control trials

57
Q

cross-sectional studies

A

looks at one pop at a particular point in time
advantages: fast and easy to conduct

    • disadvantages: can’t determine direction of assoc (what caused what)
  • also can’t determine cause and effect
58
Q

case-control studies

A

pops of people w similar char. are compared to to people in a diseased pop and looks at events that may have put them at risk for the disease
adv: cheap and easy, good for studies of rare things

disadv: can’t determine cause and effect
can’t determine incidence rates bc not following over time
recall bias - sub can’t remember correctly 10 ya

59
Q

prospective cohort studies

A

follows a group of people over time and sees what diseases they dev’p
adv: can study many outcomes simultaneously AND can measure incidence

disadv: can’t determine cause and effect
v. resource intensive, also problem w loss of follow up

60
Q

randomized control trials

A

randomly assign people to experimental and control groups, change IV in exp group and don’t in control
adv: GOLD STANDARD bc can determine cause and effect

disadv: v. expensive, ethical concerns (don’t ask tough questions), loss of follow up, hard to examine rare outcomes

61
Q

relative risk (RR)

A

aka risk ratio

- risk of disease in people exposed to a risk factor relative to the people not exposed to the risk factor

62
Q

what are threats to determining cause and effect in epi studies?

A

confounding variables and effect modifiers

63
Q

how do we determine causes in epi studies?

A

5 criteria (Mills Cannons): determines if data has statistical significance

  • temporal sequence
  • strength of association
  • consistency
  • dose-response relationship
  • biological/conceptual plausibility
64
Q

what is a confounding variable?

A

no relationship b/w A and B, it’s actually a separate variable that has an effect

65
Q

effect modifiers

A

alters the relationship b/w A and B but a relationship still exists

66
Q

physical activity definition

A

any body movement produced by skeletal muscle that results in energy expenditure
ex. beings asleep then getting up

67
Q

exercise def

A

any form of PA w an objective such as improving health, fitness, etc

68
Q

what is physical fitness?

A

physical attributes relating to one’s morphological, muscular, motor, cardioresp and metabolic capabilities
ex. fit but fat

it is the number one predictor of risk!

69
Q

sedentary behaviour

A

any waking activity (not asleep) char by energy expenditure of or less than 1.5 METS (metabolic equivalents)

70
Q

risk difference

A

aka attributable risk
- what’s actually attributed to the risk itself
== risk of diseased among exposed - risk of disease among non exposed
- shows how much of the risk is attributable to the disease

71
Q

how many METs of energy are we using at rest?

A

about 1 MET

72
Q

what are some challenges of measuring PA?

A
  • its a complex construct with many varying aspects
    ie. FITT - Frequency, Intensity, Type, Time can all change
  • there are diff ways people do PA (occupational, leisure, activities of daily living)
73
Q

3 things a study must be:

A

valid
reliable
feasible

74
Q

reliability

A

a study is reliable if it produces the same results over and over again

75
Q

validity

A

a study is valid if it actually measures what you think you’re measuring
- the most valid measures are often v. expensive, making them less feasible

76
Q

feasibility

A

is the measurement tool you’ve chosen realistic to use with the resources you’ve got available

77
Q

3 types of measures

A

subjective/self report
objective
criterion
- validity increases as you go down the list
- feasibility decreases as you go down the list

78
Q

subjective measures of PA

A

get info through interview questionnaires or activity diaries

79
Q

advantages and disadvantages of subjective measures of PA

A

adv: can be done on large scale, recording a variety of measures, cheap, easy to administer and add up data

disadv: social desirability, recency effects have an influence on whether person is honest
- sometimes confusion w questionnaires

80
Q

objective measures of PA

A

you measures someone’s PA w some type of tool collecting data
includes heart rate monitors, pedometers, accelerometers

81
Q

advantages and disadvantages of heart monitors

A

is an objective measure of PA, as you increase your HR you typically use more energy

adv: valid, easy to collect data and see change over time, small, noninvasive and fairly cheap
disadv: can’t use on large scale studies, only measures HR, not intensity of PA

82
Q

criterion measures of PA

A

reference methods/gold standards

  • measure things like kcals used and energy expenditure throughout the day
    include: direct observation, doubly labeled water, indirect calorimetry
83
Q

advantages and disadvantages of pedometers

A

an objective measure of PA, where # of steps = distance travelled = general amount of energy used

adv: get immediate feedback, CHEAP
disadv: can’t tell the difference b/w types, intensity, duration of PA, if worn on hip it only monitors activities when moving up and down

84
Q

advantages and disadvantages of accelerometers

A

an objective measure of PA, that measures acceleration in different planes

adv: small, moderate price range, not intrusive, memory GPS avail

disadv: error is wearing on your wrist bc not accurate for activities when you move your arms a lot
- not as good if not research grade

85
Q

advantages and disadvantages of behavioural observation

A

criterion measure of PA, where 2 trained observers watch and record daily activities

adv: non-invasive, valid, accurate
disadv: expensive to pay people to observe, people may be more motivated to do more activity, not an option for large pop. studies and better for short durations

86
Q

advantages and disadvantages of double labeled water

A

criterion measure of PA, considered to be the gold standard for measuring energy expenditure (4-7% error)
- ingesting H and O isotope drink and measure CO2 production from urine output

adv: stays accurate for 3 weeks
disadv: VERY expensive (drink, urinalysis) all you know is total energy expenditure for the day

ideal for small experimental studies and establishing validity of other measures such as part of a pop survey

87
Q

advantages and disadvantages of indirect calorimetry

A

adv: very accurate, gives info re: intensity and duration of PA in a lab setting
disadv: costly and invasive where you have to wear a mask

88
Q

direct vs indirect calorimetry

A

both criterion measures of PA

direct: uses bomb calorimeter where energy expenditure=heat production from a sealed chamber
- very expensive

indirect: analysis of O2 consumption and CO2 production in expired air
- like a VO2max test

89
Q

factors affecting physical fitness

A

genetics: some people have to do v little PA to improve their PF, some people who do PA get worse PF

type and amount of PA- those more active generally have better physical fitness, certain types of PA are good for different aspects of physical fitness

90
Q

reasons epidemiologist measure physical fitness:

A

to determine if PF is:

  1. an outcome of PA
  2. a mediator of PA
  3. a moderator of PA
91
Q

explain fitness as an outcome of physical activity

A

questions how PA has an impact on fitness variables directly

92
Q

explain fitness as a mediator of PA

A

as a middle step, PA changes the fitness variable and the fitness variable the determinant of risk
ex. PA -> PF factors -> risks of certain disease

93
Q

explain fitness as a modifier of PA

A

aka as an effect modifier

94
Q

how is PA prevalence studied in the world?

A

most developed nations use surveillance but its hard to compare a lot of the data
- so the WHO has created a standardized survey used in 40 countries

95
Q

how is PA prevalence studied in the US?

A

BRFSS - behavioural risk factor surveillance system

a randomized telephone survey about inactivity levels, diet, smoking, alcohol, etc

96
Q

how is Canadian PA data collected?

A

the canadian physical activity monitor takes national telephone surveys
respondents are 51% and most are females w a uni degree

97
Q

canada health measures survey

A

an accelerometer study found that surveys weren’t actually true about 50% of canadians being accurate, it was more like 15%

98
Q

Factors related to PA levels

A
  1. age: older get less exercise
  2. gender: men exercise more
  3. ethnicity
  4. income
  5. education level
99
Q

what does ethnicity have to do w PA levels?

A
  • lowest PA rates in Asian Canadians

- highest PA rates in Aboriginal Canadians

100
Q

what does income have to do w PA levels?

A

it affects your ability to participate in organized PA

use sports as socialization

Epi (3 decks)

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