Week 10 Flashcards
1
Q
chronic diseases are characterized by… (7)
A
- uncertain etiology
- multiple risk factors
- long latency period
- prolonged course of illness
- non-contagious origin
- functional impairement or disability
- incurability
2
Q
what are the leading chronic diseases in Canada? (4)
A
- cancer
- CVS disease
- diabetes
- resp illness
3
Q
what are consequences of chronic disease (4)
A
- reduced QOL
- family stress
- financial costs
- loss of productivity
4
Q
define: rate
A
- a measure of the freq of a health event in a specific population in a defined time period
ex. 9.5 births per 1000 population for a year
5
Q
define: incidence rate
A
- new cases during a certain time period (i.e. calendar year)
6
Q
define: incidence rate
A
- new cases during a certain time period (i.e. calendar year)
7
Q
define: attack rate
A
- new cases during communicable disease outbreaks
8
Q
define: prevalence rate
A
- amount of total cases
9
Q
prevalence rate is influenced by.. (3)
A
- incidence
- recovery
- death
10
Q
define: risk
A
- probability that an event will occur within a specified period to determine morbidity and mortality.
11
Q
how is risk calculated
A
Risk= # times something happens/# opportunities for it to happen
12
Q
define: relative risk
A
- a measure of the probability of the occurrence of a disease for persons who are exposed and persons who are not exposed to the risk factor.
13
Q
define: attributable risk
A
- a measure of the incidence of a disease in individuals who have been exposed to the risk factor, expressed as a percentage. AR= incidence rate in exposed group – incidence rate in non exposed group.
14
Q
how is attributable risk calculated?
A
AR= incidence rate in exposed group – incidence rate in non exposed group.
In % = AR/Incidence rate in exposed group x100
15
Q
define: population attributable risk
A
Result would show what decrease in incidence you would expect if people stop smoking for instance.
16
Q
how is population attributable risk calculated
A
overall incidence rate – incidence rate of non-exposed group x 100.000
. In percentage: (overall incidence – incidence in non-exposed / overall incidence rate x 100
17
Q
define: cancer
A
- A complex family of neoplastic diseases characterized by aberrations of cellular growth that causes abnormal proliferating cells to invade or destroy normal tissue.
18
Q
who should screen via breast check and how often
A
- 50-74 yo
- every 2 years
19
Q
who should screen via cervix check and how often
A
- 21-69 yo
- every 3 years
20
Q
who should screen for colon cancer and how often? how?
A
- 50-74 yo
- every 2 years
- stool first, colonoscopy with risk factors q5years
21
Q
what is the leading cause of premature death in Canada in both males and females
A
- cancer (has overtaken CVS disease)
22
Q
approximately __% of all cancer incidence is related to preventable causes
A
50%
23
Q
what are the most common types of cancer (3)
A
- lung
- breast
- prostate
(excluding non-melanoma skin cancer)
24
Q
what are modifiable risk factors for cancer (10)
A
- smoking
- diet
- activity lvls
- microbes
- HPV
- alcohol
- sun exposure/UV radiation
- occupational exposures
- enviro exposures
- epigenetics
25
there is a strong causal link between smoking and...
- cancer
26
smoking is responsible for __% of all potential years of life lost due to cancer
27%
27
diet accounts for __% of cancers in developed countries
30%
28
what kind of diet is protective of cancer
- high fruit & veggie intake
29
describe the role of additives, substitues, residues, specific nutrients, or food groups r/t cancer
- unclear
30
high activity lvls reduce the risk of specific cancers such as... (3)
- colon
- breast
- prostate
31
what are direct and indirect benefits of activity r/t cancer (2)
- healthy body weight
- increases gut motility = reduced exposure to potential mutagens
32
excess weight increases amts of... (3)
- circulating estrogen
- androgens
- insulin
33
microbes are related to __% of cancers worldwide
15%
34
what are examples of microbes that can cause cancer (3)
- HPV
- herpes 2
- hep B
35
HPV is now considered the necessary cause for _____ and is found in __% of cases
- cervical cancer
- found in tissues of 90% of cases
36
what are examples of microbes that can cause cancer
- HPV
- herpes 2
- hep B
37
HPV also poses a risk for...
- oral cancer (HPV 16)
37
HPV also poses a risk for...
- oral cancer (HPV 16)
38
hep B virus is associated with 80% of all cases of ____ cancer worldwide
liver
39
increased consumption of alcohol causes...
- increased risk of cancer
40
alcohol is related to which kinds of cancer? (5)
- liver
- stomach
- breast
- colorectal
- mouth, pharynx, larynx, esophagus, and interacts w tobacco
41
sun exposure is related to..
- UV radiation
42
sun exposure increases the risk for which types of cancers? (3)
- basal cell carcinoma
- squamous cell carcinoma
- melanoma
43
what are examples of occupational exposures r/t increased risk of cancer (4)
- asbestos
- x-ray
- miners
- fireman
44
what are examples of enviro exposures r/t increased risk of cancer (2)
- radon
- BPA
45
define: epigenetics
- medication during pregnancy changing genes & increasing risks
- meds and behaviors changing genes
46
what is an example of how epigenetics can increase the risk of cancer
- in the 1970s, daughters of mothers who had taken Diethylstilbestrol (synthetic estrogen) during pregnancy were at high risk of a rare form of vaginal cancer
47
what are the risks for lung cancer (11)
- tobacco
- 2nd hand smoke
- air pollution
- ionizing radiation
- radon exposure
- occupational exposures (specific chemicals, fine dust)
- insufficient fruit/veggie consumption
- air pollution
- asbestos exposure
- personal history to lung disease
- genetic history
48
what are risk factors for breast cancer for females (10)
- age
- FHx
- atypical breast hyperplasis
- high education attainment
- high socio economic status
- excessive alcohol consumptions
- dietary fat
- ionizing radiation
- physical inactivity
- prolonged exposure to estrogen
49
what can lead to prolonged exposure to estrogen (5)
- Early menstruation/Late menopause
- Null parity
- First child born after age 30
- Post-menopause estrogen & progestin use
- Obesity after menopause
50
what are protective actions for breast cancer in women (2)
- breast feeding
- early children
51
what are risk factors for breast cancer in males (6)
- Age
- Family history
- Radiation exposure
- High estrogen levels
- Gynecomastia
- Obesity
52
what can cause high estrogen lvls in males
- genetic
- therapeutic
53
what are health promotion activities r/t breast cancer (5)
- non smoking --> smoking cessation
- diet --> cooking programs
- activity --> workout programs
- self screening
- provincial screen program and screening at the doctor
54
what are risk factors for prostate cancer (11)
- Prostatic hyperplasia
- Family history
- High fat diet
- Obesity
- Hormonal factors
- Herpes 2 infection
- Smoking
- Alcohol
- Physical activity
- Race(black men more in US)
- Screening at the doctor
55
what are risk factors for colorectal cancer (7)
- Family history
- Inflammatory bowel disease
- High fat, low fibre/vegetable/fruits diet
- Physical inactivity
- Alcohol consumption
- Obesity
- Smoking
56
what is included in secondary prevention for cancer
- screening for cervical, breast, and colon cancer screening
57
describe the prevention of CVS disease
- largely preventable as a great deal is known about etiology and risk factors
58
describe the impact of CVS disease (3)
- leading cause of death
- major cause of hospitalization
- significant impact on QOL
59
the prevalence of CVS diseases rises with...
- age
60
there has been a decline in CVD mortality due to.. (2)
- lifestyle changes
- better treatments
61
what is CVD
- disease related to the heart and blood vessels
62
what co-morbidities increase the risk of CVD (3)
- increased serum lipids
- diabetes
- HTN
63
there is an increased risk of CVD with what r/t increased serum lipids? (3)
- elevated cholestrol
- elevated LDLs
- elevated triglycerides
64
prevlance of elevated serum lipid lvls increases with....
- age
65
describe the relationship between DM and CVD (2)
- increases incidence of CVD
- adversely influences outcomes of CVD
66
what is considered HTN
systolic >130, or diastolic >80
67
prevalence of HTN increases with...
- age
68
describe the relationship between HTN and CVD
- increases risk for CVD 2-3x
69
HTN is associated with... (4)
- excess weight
- physical inactivity
- heavy alcohol use
- excess salt intake
70
what are modifiable risk factors for CVD (8)
- smoking
- diet
- activity lvls
- overweight/obesity
- alcohol consumption
- stress
- exertion in the cold
- social risk factors
71
how does smoking increase the risk of CVD (5)
- decreases HDL
- increases plt aggregation and fibrinogen
- increases vasospasm
- increases anti-estrogenic effects -- early menopause
- increased risk for females using oral contraceptives
72
what kind of diet can be protective for CVD (3)
- consumption of 5-10 servings of fresh fruit and veggies
- low fat intake
- avoidance of sat fats
73
how can high activity lvls reduce the risk of CVD (5)
- reduces body weight
- reduces BP
- improves serum lipid lvls
- reduces risk for diabetes
- reduces risk for HTN
74
what is considered an overweight BMI
25-29.9
75
what is considered an obese BMI
>30
76
how does being overweight/obesity increase the risk of CVD (3)
- increases risk for HTN
- increases risk of DM
- risk increases w body weight
77
what amt of alcohol consumption increases the risk of CVD
1-2 drinks per day
78
how can stress increase the risk of CVD (3)
- increased O2 demand of heart
- plt aggregation
- vasoconstriction
79
how can stress be mediated??? (2)
- coping skills
- support system
80
what is an example of exertion in the cold
- snow shovelling
81
1/2 of cold related deaths are attributed to... (2)
- MI
- CVA
82
most cold related deaths occur in people with..
- underlying disease
83
what are social risk factors for CVD (5)
- social isolation
- poverty
- low educational attainment
- blue collar employment
- 6 or more years of shift work
84
what is included in secondary prevention of CVD (5)
screening for:
- HTN
- dyslipidemia
- obesity
- dietary patterns
- smoking
85
risk of diabetes increases with...
- age
86
define: DM2
- a metabolic disease in which carbohydrate use is reduced & that of lipid and protein is enhances
87
DM2 is caused by 2 processes:
- resistance to insulin action
- failure of pancreas to increase insulin production
88
DM2 is considered...
- preventable
89
DM2 is complicated by...
- other treatable conditions
ex. HTN
90
DM2 is the ___ leading cause of death in Canada
7th
91
DM2 leads to a significant risk for development of other health problems such as... (4)
- microvascular disease
- visual impairment
- renal failure
- periodontal disease
92
what decreases the risk of DM2
- walking
93
what is considered a good A1C
- 7 or less
- in older adults, 8 or 9 can be acceptable
94
what are trends r/t DM2 (3)
- increased incidence in Aboriginal populations
- increased incidence in children & adolescents
- increased incidence in other ethnic groups (hispanic, asian, south asian, african)
95
what are risk factors for DM2 (6)
- age
- genetics/race/ethnicity
- smoking
- diet
- activity lvls
- overweight/obesity
96
how is age a risk factor for DM
- risk rises w age
- prevalence is 3x higher if aged 65+, compared w the 35-64 group
97
how is genetics/race/ethnicity a risk factor for DM
due to
- socioeconomic status
- dietary pattern
- genetics
98
how is smoking a risk factor for DM (2)
- smokers at greater risk factor for diabetes
- exacerbates complications of DM
99
what kind of diet reduces the risk for DM (5)
- maintain energy balance
- limit sat fat intake
- higher dietary fibre intake
- choosing from all the food groups, different sources, adding protein
- understanding how much sugar is in food, reading labels, lactose, starches
100
what are non-modifiable risk factors for DM
- age
- genetics/race/ethnicity
101
what is included in primary prevention for DM
- behavioral interventions
102
what are examples of behavioral interventions for DM (4)
- smoking cessation
- dietary intake
- increase physical activity
- maintain optimal body weight
103
occupational health deals with...
- all aspects of health & safety in the workplace
104
Occupational health has a strong focus on..
- primary prevention of hazards
105
the health of workers has...
- several determinants, including risk factors at the workplace leading to cancers, accidents, musculoskeletal diseases, respiratory diseases, hearing loss, circulatory diseases, stress related disorders, communicable diseases and others.
106
employment and working conditions in the economy embrace other important determinants including... (4)
- working hrs
- salary
- workplace policies concerning maternity leave
- health promotion and protection provision
107
what are types of health & health safety hazards (6)
- mechanical
- chemical
- physical
- biological
- ergonomic
- psychological
108
what are causes of injury, deaths, hospitalizations, and ER visits by cause:
- transport incidents (105)
- falls (210)
- suicide or self-harm (110)
- unintentional poisoning (95)
109
healthcare works are ___ in time-loss injury
- 2nd, after trades, transport, and equipment operators
110
what are the top contributors to acute-hazard and occupational disease fatalities (8)
- Motor Vehicle
- Accidents
- Mesothelioma
- Other Cancers
- Struck by Object
- Asbestosis
- Machinery contact
- Fall from Height
111
what are the top 10 list of leading long term health issues for workers
- Lung disease
- Musculoskeletal injuries
- Occupational cancers
- Severe traumatic injuries
- Cardiovascular disease
- Reproductive problems
- Neurotoxic illnesses
- Noise-induced hearing loss
- Dermatological problems
- Psychological disorders
112
what are examples of occupational diseases (3)
- pulmonary
- cancer
- CVS
113
what are examples of pulmonary occupational diseases (6)
- Chronic obstructive lung disease
- Pulmonary fibrosis
- Mesothelioma
- Pneumoconiosis
- Silicosis
- Asbestosis
114
what is the aim of occupational health and safety
- to prevent injury/disease/death and promote health in the context of safe work environments
115
occupational health & safety programs do what?? (3)
- Prevent ill health from work-related injury or illness
- Protect workers from existing or potential health and safety hazards at work
- Diminish the effects of workplace hazards/injuries
116
workplace investigations are done to...
- determine causes and prevent reoccurrence
- not intended to find fault
117
what are the components of Occupational Health and Safety (OHS) programs
- mngmt commitment
- worker involvement
- work enviro
118
describe the component "mngmt committment" in OHS programs (2)
- mngmt is responsible
- essential to OHS programs
119
describe the component "worker involvement" in OHS programs (3)
- training of workers
- assessment of job & work enviro
- joint committees
120
describe the component "work enviro" in OHS programs (2)
- recognition of the hazards & protection from them
- job hazard assessment
121
What are 3 types of hazard control (3)
- engineering controls
- admin controls
- PPE
122
most legislated standards for workplace health & safety are... (2)
- set at a provincial or territorial lvl in Canada
- outline both employer and employee obligations
123
describe workers compensation legislation
- form of no fault insurance
124
describe workers compensation legislation (3)
- form of no fault insurance
- prevent employers from being sued
- workers receive compensation for work-related injuries
125
what is included in workplace health & safety rights for Manitoba workers (3)
- the right to know
- the right to participate
- the right to refuse
126
*both union * non-union workers are protected by health and safety legislation*
127
what are 13 workplace psychological factors
- Psychological support
- Civility & respect
- Recognition and reward
- Balance
- Organizational culture
- Psychological job fit
- Involvement & influence
- Psychological protection
- Clear leadership & expectations
- Growth & development
- Workload managent
- Engagement
128
what are the principles and processes that protect workers (6)
- Right to know that the work is hazardous
- Right to refuse hazardous work
- Right to participate in workplace safety & health committees
- Incorporation of occupational histories into routine health assessments
- Selective examinations to guide worker placement & monitor exposure to occupational risks
- Adopt, wherever possible of passive rather than active safety devices
129
OHNs are nurses with..
- experience and knowledge of health hazards in a variety of occupations
130
OHNs receive certifications through
CNA
131
OHNs work..
- independently but also part of a IP team
132
what is the role of OHNs (3)
- communicate w all department lvls of an organization
- assist employees to take charge of their own health
- help develop & evaluate safety policies
133
who are OHS team players (10)
- OH physicians
- occupational hygienists
- ergonomists
- safety professionals
- psychologists
- physio
- rehab
- massage therapists
- natural sciences
- nurses
134
the highest rate of injury-related absenteeism is reported by _____? what is the 2nd highest group?
- nursing aides and orderlies
- 2nd = RNs (83% higher absenteeism than Canadian work force)
135
what type of healthcare worker injury is most freuqent
- musculoskeletal (nurses have highest reported prevalence of back injuries)
136
the probability of healthcare worker injuries increases with... (3)
- Number of hours of overtime worked
- Higher than average previous sickness episodes
- Poor working relationships with physicians
137
what are significant challenges r/t healthcare workers (3)
- musculoskeletal injury
- violence
- fear of contracting infections
138
what are other additional points of interest r/t healthcare workers (6)
- Nurses perceive better health status when compared with reported injury & absenteeism rates
- Absenteeism rising since 1999
- Moderate to high levels of emotional exhaustion
- 40% report working with back, neck or buttock pain some of the time
- 25% worked while in pain most to all of the time
- Needle-stick injuries likely under-reported
139
what is an example of a OHS primary prevention strategy (8)
- Incident/injury prevention
- health risk appraisal
- health education
- weight control
- nutrition
- physical activity
- coping
- stress management
140
what are examples of OHS secondary prevention strategies (5)
- Pre-placement assessments
- health surveillance
- incident reporting
- injury treatment
- Post-exposure Protocol (PEP)
141
what are examples of OHS tertirary prevention strategies (3)
- Return-to work programs
- work hardening programs
- monitoring employees with chronic health conditions
142
what are the 4 injury prevention E's
- education
- enviro/engineering
- enforcement
- economics
143
describe education approaches to injury prevention (1)
- Increase awareness, knowledge and understanding of injury by providing information and skills
144
what are enviro/engineering approaches to injury prevention
- making changes in the enviro to reduce the risk/severity of injury
145
what are enforcement approaches to injury prevention (4)
- Laws, regulations and policies + enforcement to prevent injury or reduce severity
- Legislation
- Codes, standards
- Policies / rules
146
what are economic strategies to injury prevention
- financial benefits for those who act safely or disincentives for safety violations
147
what is meant by "2 E's are better than 1"
- combo of approaches most effective
148
which E is the most essential
- education
149
education is required at multiple lvls such as... (4)
- policy makers
- industry
- care/service providers
- end-user (individuals, groups)
