Shared Flashcard Set

Details

Public Health Test 1
N/A
97
Health Care
Professional
10/24/2011

Additional Health Care Flashcards

 


 

Cards

Term
What is Public Health?
Definition

The approach to medicine that is concerned with the health of the community as a whole

 

Term
What is the primary goal of public health?
Definition

the prevention of injury and disease.

 

aims to monitor and diagnose the health concerns of entire communities and promote healthy practices and behaviors to assure populations stay healthy.

Term
What is the public health continuum?
Definition

The individual's health status over a lifetime.

 

 

Expands from total health to death.

Term
What factors affect the public health continuum? (7)
Definition
  • Genetic makeup
  • Demographic characteristics
  • Environmental factors
  • Nutritional history
  • Social environment
  • Behavior
  • AGE!
Term

The public health continuum covers what 3 aspects?

 

Which do optometrists play a bigger role in?

Definition

Total Health, Subclinical disease, and Clinical Horizon

 

Subclinical Disesase and Clinical Horizon

Term
Ultimate goal of a public health intervention?
Definition
to alter the natural history of a disease in favorable way.
Term

What is primary prevention?

 

main way to provide this?

Definition

Measures taken to prevent a disesase process from getting started

 

(ex. safety glasses to prevent eye injuries)

 

cheapest method of prevention

 

main way to provide this - educate patients.

Term

What is the goal of secondary prevention?

 

Who performs this typically?

 

What are these services aimed at?

Definition

to stop the subclinical disease before it becomes symptomatic or before it can be transmitted to others.

 

mostly performed by healthcare practitioners.

 

these services are aimed at early detection.


(ex. screening for eye problems in children to establish early treatment)

Term

What is tertiary prevention?

 

What effect does this have on the condition?

 

Specifically providing patients with what?

Definition

Rehabilitative or palliative clinical treatment given when a disease of condition has become disabling.

 

Does NOT cure the disease.

 

May slow the natural course of some progressive diseases, and prevent or delay many of the complications associatted with chronic diseases.

 

Providing patients ways to deal with and manage.

Term

The 8 Public Health Disciplines..

 

(don't memorize, just know what they are)

 

Examples given..

Definition
  1. Health Policy and Management (Ex. Development of mandatory eye exam program in Kentucky)
  2. Epidemiology (ex. CLEERE Study of prevalence of refractive error in children)
  3. Behavioral Science and Health Education (ex. LALES Study of noncompliance with Vision Care Guidelines in Latinos with Type 2 Diabetes Mellitus)
  4. Occupational Safety (ex. Prevention of eye injuries among construction workers)
  5. Environmental Health Sciences (ex. Lead-induced health problems)
  6. Global Health (ex. Prevention of onchocerciasis in Tanzania and other countries of tropical climate)
  7. Maternal and child Health (ex. Retinopathy of Prematurity caused by Oxygen exposure at birth)
  8. Specific Areas (ex. Oral, Pharm, Infectious, etc.)

 

Term

What is the main reason we need to know about public health?

 

generally?

Definition

so we can make informed decisions for treatment.

 

so that we may better serve the public in general concerning: disease prevalence, probably outcomes, and behavior.

Term
What are the three areas we need to know about public health to better serve the public in general?
Definition
  1. Disease prevalence
  2. Probable outcomes
  3. Behavior
Term

What is epidemiology?

 

What does it involve?

Definition

The study of distribution and determinants of disease

 

Involves: Basic Sciences, Clinical practive, and population data.

Term

Who is the father of epidemiology?

 

What did he do?

Definition

John Snow

 

looked at different factors such as age, SES, and sex for the affected patients.

Term
Where was epidemiology first seen?
Definition

Biblical times - large #'s of death were documented, they may not have understood the reasons

 

Bubonic plague - 1400's, 25-50% of the population died. The health of the individuals was assumed to be influenced by humors (Earth, Air, Water, and Fire)

 

Beginning of "infectious" ideas - docters were concerned about the infected airs and they would recommend masks to avoid breathing in the "bad airs". Treatment may include bleeding the bad airs out of a person.

 

Yellow Fever epidemic - 1700's, Philadelphia, a study showed that patients being bled had a higher rate of mortality than those not treated at all (STARTED DOING STUDIES!!)

 

Cholera epidemic - 1850's, London, John Snow (father of epidemiology) looked at different factors such as age, SES, and sex for the affected patients.

Term
early epidemiology calculated mortality rate by..
Definition

rate-frequency of events that occur in a defined period of time divided by the population at risk

 

Mortality Rate = #    People dying      x Unit Time

# of people in group

Term
What does evidence-based healthcare seeks to do?
Definition
seeks to make clinical decisions based on the best available evidence and unbiased information.
Term
What three aspects does evidence-based healthcare integrate?
Definition
  1. Research Evidence
  2. Clinical Expertise
  3. Patient Values
Term
What are evidence-based decisions?
Definition
In order to understand, appreciate, and apply biostatisctical and epidemiological concepts, need to: Acquire information, Assess the quality of the information in publications, and Determine scientific validity of information.
Term
What is the importance of research?
Definition

Practice is based on "art" and science

 

evidence-based practice

 

scientifically based

 

must validate a teachers' advice: Investigation, Literature search, Cross referencing.

Term
What is cause and effect?
Definition

Cannot just assume that because two things happened to the same person, one caused the other!

 

Even with evidence, may only be able to conclude that an exposure may increase the risk of a disease, vs saying that it causes it

 

Sufficient cause

Term

What is cause and effect?

 

what are the 5 aspects?

Definition

To make causal inference, need to evaluate.

 

1. Strength of association

2. Biological plausibilitu

3. Agreement with Accepted Knowledge

4. Time sequence

5. Dose response

Term
Define the strength of association?
Definition

The degree to which one variable is related to another.

 

Sufficient evidence or ...

Bias? Confounding factors? Recruitment and measurement done? possibility of two things hapenning at the same time due to chance alone?

Term
How to measure strength of association
Definition

see how much two variables hace in common..

 

Relative Risk

Correlation coefficient

Regression coefficient

Differences between groups (means and others)

Term
What is biological plausibility?
Definition
whether or not the relationship makes sense scientifically
Term
what is agreement with Accepted Knowledge
Definition
new knowledge about a disease process can be difficult to accept initially
Term
What is Time sequence?
Definition
the time sequence must make sense for an association
Term
What is dose response?
Definition

increase in exposure leads to an increase in the severity of the disease

 

may have a threshold dose-response relationship

 

does not always apply, but most times..

Term

What is bias?

 

What are the 3 types?

Definition

Must rule out before making a causal inference.

 

  1. Selection bias
  2. Confounding bias
  3. Information bias
Term
What is selection bias?
Definition

A problem in recruitment

 

When selection bias happens, the subjects are not representative of the target population

 

Can severly affect the validity of a study. Once selection bias is present, NOTHING can be done to fix the study

Term
How to avoid selection bias?
Definition

best to design the study using "random sampling methods" (ex. zip codes)

 

however, these are expensive so a lot of studies use "convenience sampling methods" (ex. clinic patients)

Term

What is confounding bias?

 

How to control it?

Definition

can be created by a "confounder" or a variable that is associated with BOTH the exposure and the disease (ex. birth weight is a confounder for oxygen therapy, exposure, and ROP, disease)

 

Need to "control" for cofounders during the design or during data analysis

Term

What are the two type of information bias?

 

How to control it?

Definition

1. Differential misclassification - usually due to use of different measuring toosl or due to examiner not being masked.

 

2. Non differential misclassification - due to lack of precision. ALWAYS PRESENT. Biases towards the null hypothesis (makes you think there was NO relationship).

 

CONTROL during design.

Term

A valid study...

 

uses what kinda of sample?

 

measures what?

 

assesses and controls for what?

 

and reports the rold of what?

Definition

A sample the reflects the population at interest

 

Measures the varialbes of interest accurately

 

assesses and controls for bias

 

reports the role of chance

Term
Funnel method of background of an article
Definition
Well-known facts -> Basic Science -> Clinical studies -> Controversy -> Unknown
Term
Purpose of a methods section
Definition

states the facts of what the researcher did. contains the information necessary to evaluate the validity of the study.

 

must have enough detail so that a reader can evaluate the validity and potentially replicate the experiment

 

includes something about informed consent and IRB (institutional review board)

 

3 parts: subjects, equipment, and procedures.

Term
Statistics are a set of mathetmatical tools used to..
Definition
  • Summarize
  • Describe
  • Compare
  • Interpret
  • Data Sets
Term

Descriptive Epidemiology characterizes what?

 

What are the 3 aspects?

Definition

characterizes the distribution in a population.

 

3 aspects: person, place, time.

Term
The person component of descriptive epidemiology covers..
Definition
  • age (most important determinant)
  • sex
  • race/ethnicity
  • marital status
  • religion
  • occupation (stress, environment)
Term
The place component of descriptive epidemiology concerns..
Definition
  • World-wide
  • Regional
  • Local
  • Urban vs Rural
Term
The time component of descriptive epidemiology concerns..
Definition
  • Short term
  • Recurrent/periodical/seasonal
  • long term
Term
What are the three types of variables?
Definition
  1. nominal
  2. ordinal
  3. continuous
Term
What are nominal variables?
Definition

Values that are categorical and there is NO order associated with them

 

(ex. male & female; white, African America, & Hispanic)

Term
What are ordinal variables?
Definition

Values are categorical, but there IS an order associated with them

 

(ex. A, B, C, F; 1, 2, 3, 4-for grading angles; Mild, moderate, severe)

Term
What are continuous variables?
Definition

Values that are continuous (decimals, fractions) and there IS an order associated with them

 

(ex. Hemoglobin AiC: 6.3, 7.8)

Term
What is statistical testing used for?
Definition

used to make inferences about a population based on information obtained from samples

 

about a data set.

Term

What is a sample?

 

Why is it selected?

 

Why must the sample be chosen carefully?

Definition

A subset of a population

 

Selected becayse in most cases is it impossible to test the enire population.

 

Must be chosen carefully to truly reflect the population is it intended to.

Term
What are the measures of central tendency?
Definition

Describe the average of the distribution of values.

 

  1. Mean
  2. Median
  3. Mode
Term
What is the mean?
Definition

The sum of all values divided by the # of values

 

outliers can skew the mean in one direction

Term
What is the median?
Definition

The middle value when the values are organized in order

 

Outliers do not affect the median much.

Term
What is the mode?
Definition

the most common value

 

a set of data may or may not have a mode

Term
When are the measures of central tendency used?
Definition

The mean is preferred for normally-distributesd samples

 

The median is preferred for data sets with high variability (large standard deviation)

 

The mode is not used much but may be mentioned in some studies.

 

When comparing two groups, it's important to compare "means to means" and "medians to medians"

Term
How are normally distributed data presented?
Definition
bell-shaped curve
Term
What is a Bell-Shaped Curve?
Definition
That in which the mean, median, and mode are equal and 68% of the population lie within one SD.
Term

what are Measures of Variability?

 

what 4 are they?

Definition

Summarize how much the values differ from the average

  1. range
  2. standard deviation
  3. variance
  4. confidence intervals
Term
What is the range?
Definition

The difference between the lowest value and the largest value in a sample.

 

Useful for finding out where values may lie.

Term
What is standard deviation?
Definition

The average of the deviation of all values from the mean.

 

In a bell-shaped curve:

The mean +/- 1 SD = 68% of the values

The mean +/- 2 SD = 95% of the values

The mean +/- 3 SD = 98% of the values

Term
What is variance?
Definition

Standard Deviation squared.

 

Not often used in descriptive statistics

Term
What are Confidence Intervals (CI)?
Definition

Most powerful measures of variability for normally distributed (parametric) data.

 

Contain the mean and the variability in one measure.

 

Most often used are 95% CI.

 

Expressed as P (low range, high range)

Term
What is a sporadic disease?
Definition
a disease that occurs occasionally, irregularly
Term
What is an endemic?
Definition
a disease that stays in population at low frequency
Term
What is an epidemic?
Definition
A sudden outbreak in disease aboce typical level
Term
What is a pandemic?
Definition
Epidemic over wide area (may be entire world)
Term
What is morbidity?
Definition
all reported cases of disease, illness, and disability
Term
What is mortality?
Definition
reported deaths due to a disease
Term
US life expectancy
Definition
77.9 years
Term
US infant mortality rate
Definition
6.75 deaths per 1000 live births
Term
(8) Main causes of death in the US
Definition
  1. Heart disease
  2. Cancer
  3. Stroke (cerebrovascular diseases)
  4. Chronic lower respiratory diseases
  5. Accidents (unintentional injuries)
  6. Alzheimer's disease
  7. Diabetes
  8. Influenza and Pneumonia
Term
(5) Main Health risk factors
Definition
  1. Smoking
  2. Overweight
  3. Diabetes
  4. High Blood Pressure
  5. Risky Behaviors (alcohol and drug use, promiscuity)
Term
Leading cause of death in low-income countries
Definition
  1. Coronary heart disease
  2. Lower respiratory infections
  3. HIV/AIDS
  4. Perinatal conditions
  5. Stroke (but don't typically live long enough)
Term
Childhood mortality is a good indicator of what?
Definition
good indicator of health and wealth of country
Term

What constitutes visually impaired?

 

Definition
BCVA 20/70 or worse in the better eye
Term
distribution of visual impairment
Definition

is unequally distributed across age groups.

 

more than 82% of all people who are blind are 50 years of age and older, although they represent only 19% of the world's population

 

due to the expected number of years lived in blindness (bling years), childhood blindness remains a significant problem, with an estimated 1.4 million blind children below age 15.

Term
Distribution of visual impairment across gender
Definition
available studies consistenly indicate that in every region of the world and at all ages, females have a significantly higher risk of being visually impaired than males.
Term
distribution of visual impairment across geographically..
Definition

visual impairment is not distributed uniformly throughout the world. more than 90% of the world's visually impaired live in developing countries

 

comparisons among countries are difficult due to different examination techniques and different data gathering capabilities.

Term
leading cause of blindness globally?
Definition
cataracts
Term
the second leading cause of blindness globally?
Definition
glaucoma
Term

third leading cause of blindness globally?

 

Definition
age-related macular degeneration (AMD)
Term
in developing countries, what is becoming the leading cause of blindness, due to the growing number of people over 70 years of age
Definition
AMD
Term
cataracts have a higher prevalence in countries where?
Definition
higher prevalence in countries near the equator and in countries where farm labor is more common.
Term
what are cataracts are found to be associated with what?
Definition

diabetes, smoking, steroid, and dietary factors, but no cause-effect relationship established.

 

high altitude = higher prevalence

Term
leading cause of blindness in the US?
Definition
cataracts
Term
by what age do hald of all americans have cataracts
Definition
age 80
Term
what countries have a higher prevalence of glaucoma
Definition

countries with higher number of black inhabitants have a higher prevalence of POAG

 

diabetes = higer prevalence, or higher detection rates (more eye exams?)

Term
what is the leading cause of blindness among African Americans in the US
Definition
glaucoma
Term
what is the leading cause of legal blindness for people over 50 in the western world
Definition
AMD
Term

what is the leading cause of permanent impairment of central vision

 

Definition
AMD
Term
prevalence of what is at least 2 to 4 times higher among minorities in the US
Definition
diabetes
Term
leading cause of new cases of blindness in adults 20-74 years of age in the US
Definition
diabetes
Term
what percent of occupational eye injuries could be prevented with protective eyewear?
Definition
90%
Term
high risk for visual impairment?
Definition
greater than 65 years old, with predisposing systemic condition, poor vision, or ocular disease
Term
3 main causes of visual impairment for children in developed countries
Definition
  1. perinatal (ROP)
  2. genetic (albinism)
  3. traumatic
Term
 4 main causes of visual impairment for children in developing countries
Definition
  1. xerophthalmia
  2. onchocerciasis
  3. measles
  4. trachoma
Term
what underlies not only the causes, but also the perpetuation of ill health, including eye health
Definition
poverty
Term
the WHO estimates that globally up to what percentage of all blindness is avoidable?
Definition
75%
Term
how many of the cases of childhood blindness are avoidable?
Definition

half

 

Supporting users have an ad free experience!