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NURS 4540: Community Health > Week 10 > Flashcards

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
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2
Q

what are the leading chronic diseases in Canada? (4)

A
  • cancer
  • CVS disease
  • diabetes
  • resp illness
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3
Q

what are consequences of chronic disease (4)

A
  • reduced QOL
  • family stress
  • financial costs
  • loss of productivity
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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

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5
Q

define: incidence rate

A
  • new cases during a certain time period (i.e. calendar year)
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6
Q

define: incidence rate

A
  • new cases during a certain time period (i.e. calendar year)
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7
Q

define: attack rate

A
  • new cases during communicable disease outbreaks
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8
Q

define: prevalence rate

A
  • amount of total cases
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9
Q

prevalence rate is influenced by.. (3)

A
  • incidence
  • recovery
  • death
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10
Q

define: risk

A
  • probability that an event will occur within a specified period to determine morbidity and mortality.
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11
Q

how is risk calculated

A

Risk= # times something happens/# opportunities for it to happen

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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.
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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.
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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

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15
Q

define: population attributable risk

A

Result would show what decrease in incidence you would expect if people stop smoking for instance.

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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

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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.
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18
Q

who should screen via breast check and how often

A
  • 50-74 yo
  • every 2 years
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19
Q

who should screen via cervix check and how often

A
  • 21-69 yo
  • every 3 years
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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
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21
Q

what is the leading cause of premature death in Canada in both males and females

A
  • cancer (has overtaken CVS disease)
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22
Q

approximately __% of all cancer incidence is related to preventable causes

A

50%

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23
Q

what are the most common types of cancer (3)

A
  • lung
  • breast
  • prostate

(excluding non-melanoma skin cancer)

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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
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25
Q

there is a strong causal link between smoking and…

A
  • cancer
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26
Q

smoking is responsible for __% of all potential years of life lost due to cancer

A

27%

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27
Q

diet accounts for __% of cancers in developed countries

A

30%

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28
Q

what kind of diet is protective of cancer

A
  • high fruit & veggie intake
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29
Q

describe the role of additives, substitues, residues, specific nutrients, or food groups r/t cancer

A
  • unclear
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30
Q

high activity lvls reduce the risk of specific cancers such as… (3)

A
  • colon
  • breast
  • prostate
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31
Q

what are direct and indirect benefits of activity r/t cancer (2)

A
  • healthy body weight
  • increases gut motility = reduced exposure to potential mutagens
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32
Q

excess weight increases amts of… (3)

A
  • circulating estrogen
  • androgens
  • insulin
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33
Q

microbes are related to __% of cancers worldwide

A

15%

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34
Q

what are examples of microbes that can cause cancer (3)

A
  • HPV
  • herpes 2
  • hep B
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35
Q

HPV is now considered the necessary cause for _____ and is found in __% of cases

A
  • cervical cancer
  • found in tissues of 90% of cases
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36
Q

what are examples of microbes that can cause cancer

A
  • HPV
  • herpes 2
  • hep B
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37
Q

HPV also poses a risk for…

A
  • oral cancer (HPV 16)
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37
Q

HPV also poses a risk for…

A
  • oral cancer (HPV 16)
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38
Q

hep B virus is associated with 80% of all cases of ____ cancer worldwide

A

liver

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39
Q

increased consumption of alcohol causes…

A
  • increased risk of cancer
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40
Q

alcohol is related to which kinds of cancer? (5)

A
  • liver
  • stomach
  • breast
  • colorectal
  • mouth, pharynx, larynx, esophagus, and interacts w tobacco
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41
Q

sun exposure is related to..

A
  • UV radiation
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42
Q

sun exposure increases the risk for which types of cancers? (3)

A
  • basal cell carcinoma
  • squamous cell carcinoma
  • melanoma
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43
Q

what are examples of occupational exposures r/t increased risk of cancer (4)

A
  • asbestos
  • x-ray
  • miners
  • fireman
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44
Q

what are examples of enviro exposures r/t increased risk of cancer (2)

A
  • radon
  • BPA
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45
Q

define: epigenetics

A
  • medication during pregnancy changing genes & increasing risks
  • meds and behaviors changing genes
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46
Q

what is an example of how epigenetics can increase the risk of cancer

A
  • 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
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47
Q

what are the risks for lung cancer (11)

A
  • 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
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48
Q

what are risk factors for breast cancer for females (10)

A
  • 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
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49
Q

what can lead to prolonged exposure to estrogen (5)

A
  • Early menstruation/Late menopause
  • Null parity
  • First child born after age 30
  • Post-menopause estrogen & progestin use
  • Obesity after menopause
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50
Q

what are protective actions for breast cancer in women (2)

A
  • breast feeding
  • early children
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51
Q

what are risk factors for breast cancer in males (6)

A
  • Age
  • Family history
  • Radiation exposure
  • High estrogen levels
  • Gynecomastia
  • Obesity
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52
Q

what can cause high estrogen lvls in males

A
  • genetic
  • therapeutic
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53
Q

what are health promotion activities r/t breast cancer (5)

A
  • non smoking –> smoking cessation
  • diet –> cooking programs
  • activity –> workout programs
  • self screening
  • provincial screen program and screening at the doctor
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54
Q

what are risk factors for prostate cancer (11)

A
  • 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
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55
Q

what are risk factors for colorectal cancer (7)

A
  • Family history
  • Inflammatory bowel disease
  • High fat, low fibre/vegetable/fruits diet
  • Physical inactivity
  • Alcohol consumption
  • Obesity
  • Smoking
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56
Q

what is included in secondary prevention for cancer

A
  • screening for cervical, breast, and colon cancer screening
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57
Q

describe the prevention of CVS disease

A
  • largely preventable as a great deal is known about etiology and risk factors
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58
Q

describe the impact of CVS disease (3)

A
  • leading cause of death
  • major cause of hospitalization
  • significant impact on QOL
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59
Q

the prevalence of CVS diseases rises with…

A
  • age
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60
Q

there has been a decline in CVD mortality due to.. (2)

A
  • lifestyle changes
  • better treatments
61
Q

what is CVD

A
  • disease related to the heart and blood vessels
62
Q

what co-morbidities increase the risk of CVD (3)

A
  • increased serum lipids
  • diabetes
  • HTN
63
Q

there is an increased risk of CVD with what r/t increased serum lipids? (3)

A
  • elevated cholestrol
  • elevated LDLs
  • elevated triglycerides
64
Q

prevlance of elevated serum lipid lvls increases with….

65
Q

describe the relationship between DM and CVD (2)

A
  • increases incidence of CVD
  • adversely influences outcomes of CVD
66
Q

what is considered HTN

A

systolic >130, or diastolic >80

67
Q

prevalence of HTN increases with…

68
Q

describe the relationship between HTN and CVD

A
  • increases risk for CVD 2-3x
69
Q

HTN is associated with… (4)

A
  • excess weight
  • physical inactivity
  • heavy alcohol use
  • excess salt intake
70
Q

what are modifiable risk factors for CVD (8)

A
  • smoking
  • diet
  • activity lvls
  • overweight/obesity
  • alcohol consumption
  • stress
  • exertion in the cold
  • social risk factors
71
Q

how does smoking increase the risk of CVD (5)

A
  • decreases HDL
  • increases plt aggregation and fibrinogen
  • increases vasospasm
  • increases anti-estrogenic effects – early menopause
  • increased risk for females using oral contraceptives
72
Q

what kind of diet can be protective for CVD (3)

A
  • consumption of 5-10 servings of fresh fruit and veggies
  • low fat intake
  • avoidance of sat fats
73
Q

how can high activity lvls reduce the risk of CVD (5)

A
  • reduces body weight
  • reduces BP
  • improves serum lipid lvls
  • reduces risk for diabetes
  • reduces risk for HTN
74
Q

what is considered an overweight BMI

75
Q

what is considered an obese BMI

76
Q

how does being overweight/obesity increase the risk of CVD (3)

A
  • increases risk for HTN
  • increases risk of DM
  • risk increases w body weight
77
Q

what amt of alcohol consumption increases the risk of CVD

A

1-2 drinks per day

78
Q

how can stress increase the risk of CVD (3)

A
  • increased O2 demand of heart
  • plt aggregation
  • vasoconstriction
79
Q

how can stress be mediated??? (2)

A
  • coping skills
  • support system
80
Q

what is an example of exertion in the cold

A
  • snow shovelling
81
Q

1/2 of cold related deaths are attributed to… (2)

82
Q

most cold related deaths occur in people with..

A
  • underlying disease
83
Q

what are social risk factors for CVD (5)

A
  • social isolation
  • poverty
  • low educational attainment
  • blue collar employment
  • 6 or more years of shift work
84
Q

what is included in secondary prevention of CVD (5)

A

screening for:
- HTN
- dyslipidemia
- obesity
- dietary patterns
- smoking

85
Q

risk of diabetes increases with…

86
Q

define: DM2

A
  • a metabolic disease in which carbohydrate use is reduced & that of lipid and protein is enhances
87
Q

DM2 is caused by 2 processes:

A
  • resistance to insulin action
  • failure of pancreas to increase insulin production
88
Q

DM2 is considered…

A
  • preventable
89
Q

DM2 is complicated by…

A
  • other treatable conditions
    ex. HTN
90
Q

DM2 is the ___ leading cause of death in Canada

91
Q

DM2 leads to a significant risk for development of other health problems such as… (4)

A
  • microvascular disease
  • visual impairment
  • renal failure
  • periodontal disease
92
Q

what decreases the risk of DM2

93
Q

what is considered a good A1C

A
  • 7 or less
  • in older adults, 8 or 9 can be acceptable
94
Q

what are trends r/t DM2 (3)

A
  • increased incidence in Aboriginal populations
  • increased incidence in children & adolescents
  • increased incidence in other ethnic groups (hispanic, asian, south asian, african)
95
Q

what are risk factors for DM2 (6)

A
  • age
  • genetics/race/ethnicity
  • smoking
  • diet
  • activity lvls
  • overweight/obesity
96
Q

how is age a risk factor for DM

A
  • risk rises w age
  • prevalence is 3x higher if aged 65+, compared w the 35-64 group
97
Q

how is genetics/race/ethnicity a risk factor for DM

A

due to
- socioeconomic status
- dietary pattern
- genetics

98
Q

how is smoking a risk factor for DM (2)

A
  • smokers at greater risk factor for diabetes
  • exacerbates complications of DM
99
Q

what kind of diet reduces the risk for DM (5)

A
  • 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
Q

what are non-modifiable risk factors for DM

A
  • age
  • genetics/race/ethnicity
101
Q

what is included in primary prevention for DM

A
  • behavioral interventions
102
Q

what are examples of behavioral interventions for DM (4)

A
  • smoking cessation
  • dietary intake
  • increase physical activity
  • maintain optimal body weight
103
Q

occupational health deals with…

A
  • all aspects of health & safety in the workplace
104
Q

Occupational health has a strong focus on..

A
  • primary prevention of hazards
105
Q

the health of workers has…

A
  • 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
Q

employment and working conditions in the economy embrace other important determinants including… (4)

A
  • working hrs
  • salary
  • workplace policies concerning maternity leave
  • health promotion and protection provision
107
Q

what are types of health & health safety hazards (6)

A
  • mechanical
  • chemical
  • physical
  • biological
  • ergonomic
  • psychological
108
Q

what are causes of injury, deaths, hospitalizations, and ER visits by cause:

A
  • transport incidents (105)
  • falls (210)
  • suicide or self-harm (110)
  • unintentional poisoning (95)
109
Q

healthcare works are ___ in time-loss injury

A
  • 2nd, after trades, transport, and equipment operators
110
Q

what are the top contributors to acute-hazard and occupational disease fatalities (8)

A
  • Motor Vehicle
  • Accidents
  • Mesothelioma
  • Other Cancers
  • Struck by Object
  • Asbestosis
  • Machinery contact
  • Fall from Height
111
Q

what are the top 10 list of leading long term health issues for workers

A
  • Lung disease
  • Musculoskeletal injuries
  • Occupational cancers
  • Severe traumatic injuries
  • Cardiovascular disease
  • Reproductive problems
  • Neurotoxic illnesses
  • Noise-induced hearing loss
  • Dermatological problems
  • Psychological disorders
112
Q

what are examples of occupational diseases (3)

A
  • pulmonary
  • cancer
  • CVS
113
Q

what are examples of pulmonary occupational diseases (6)

A
  • Chronic obstructive lung disease
  • Pulmonary fibrosis
  • Mesothelioma
  • Pneumoconiosis
  • Silicosis
  • Asbestosis
114
Q

what is the aim of occupational health and safety

A
  • to prevent injury/disease/death and promote health in the context of safe work environments
115
Q

occupational health & safety programs do what?? (3)

A
  • 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
Q

workplace investigations are done to…

A
  • determine causes and prevent reoccurrence
  • not intended to find fault
117
Q

what are the components of Occupational Health and Safety (OHS) programs

A
  • mngmt commitment
  • worker involvement
  • work enviro
118
Q

describe the component “mngmt committment” in OHS programs (2)

A
  • mngmt is responsible
  • essential to OHS programs
119
Q

describe the component “worker involvement” in OHS programs (3)

A
  • training of workers
  • assessment of job & work enviro
  • joint committees
120
Q

describe the component “work enviro” in OHS programs (2)

A
  • recognition of the hazards & protection from them
  • job hazard assessment
121
Q

What are 3 types of hazard control (3)

A
  • engineering controls
  • admin controls
  • PPE
122
Q

most legislated standards for workplace health & safety are… (2)

A
  • set at a provincial or territorial lvl in Canada
  • outline both employer and employee obligations
123
Q

describe workers compensation legislation

A
  • form of no fault insurance
124
Q

describe workers compensation legislation (3)

A
  • form of no fault insurance
  • prevent employers from being sued
  • workers receive compensation for work-related injuries
125
Q

what is included in workplace health & safety rights for Manitoba workers (3)

A
  • the right to know
  • the right to participate
  • the right to refuse
126
Q

both union * non-union workers are protected by health and safety legislation

127
Q

what are 13 workplace psychological factors

A
  • 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
Q

what are the principles and processes that protect workers (6)

A
  • 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
Q

OHNs are nurses with..

A
  • experience and knowledge of health hazards in a variety of occupations
130
Q

OHNs receive certifications through

131
Q

OHNs work..

A
  • independently but also part of a IP team
132
Q

what is the role of OHNs (3)

A
  • communicate w all department lvls of an organization
  • assist employees to take charge of their own health
  • help develop & evaluate safety policies
133
Q

who are OHS team players (10)

A
  • OH physicians
  • occupational hygienists
  • ergonomists
  • safety professionals
  • psychologists
  • physio
  • rehab
  • massage therapists
  • natural sciences
  • nurses
134
Q

the highest rate of injury-related absenteeism is reported by _____? what is the 2nd highest group?

A
  • nursing aides and orderlies
  • 2nd = RNs (83% higher absenteeism than Canadian work force)
135
Q

what type of healthcare worker injury is most freuqent

A
  • musculoskeletal (nurses have highest reported prevalence of back injuries)
136
Q

the probability of healthcare worker injuries increases with… (3)

A
  • Number of hours of overtime worked
  • Higher than average previous sickness episodes
  • Poor working relationships with physicians
137
Q

what are significant challenges r/t healthcare workers (3)

A
  • musculoskeletal injury
  • violence
  • fear of contracting infections
138
Q

what are other additional points of interest r/t healthcare workers (6)

A
  • 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
Q

what is an example of a OHS primary prevention strategy (8)

A
  • Incident/injury prevention
  • health risk appraisal
  • health education
  • weight control
  • nutrition
  • physical activity
  • coping
  • stress management
140
Q

what are examples of OHS secondary prevention strategies (5)

A
  • Pre-placement assessments
  • health surveillance
  • incident reporting
  • injury treatment
  • Post-exposure Protocol (PEP)
141
Q

what are examples of OHS tertirary prevention strategies (3)

A
  • Return-to work programs
  • work hardening programs
  • monitoring employees with chronic health conditions
142
Q

what are the 4 injury prevention E’s

A
  • education
  • enviro/engineering
  • enforcement
  • economics
143
Q

describe education approaches to injury prevention (1)

A
  • Increase awareness, knowledge and understanding of injury by providing information and skills
144
Q

what are enviro/engineering approaches to injury prevention

A
  • making changes in the enviro to reduce the risk/severity of injury
145
Q

what are enforcement approaches to injury prevention (4)

A
  • Laws, regulations and policies + enforcement to prevent injury or reduce severity
  • Legislation
  • Codes, standards
  • Policies / rules
146
Q

what are economic strategies to injury prevention

A
  • financial benefits for those who act safely or disincentives for safety violations
147
Q

what is meant by “2 E’s are better than 1”

A
  • combo of approaches most effective
148
Q

which E is the most essential

149
Q

education is required at multiple lvls such as… (4)

A
  • policy makers
  • industry
  • care/service providers
  • end-user (individuals, groups)

NURS 4540: Community Health (12 decks)

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