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NUR 422 Public Health > Week 4: Genomics/Life Course Theory/Epidemiology > Flashcards

Week 4: Genomics/Life Course Theory/Epidemiology Flashcards

1
Q

What is eugenics?

A

a scientifically inaccurate theory that humans could improve through selective breeding

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2
Q

What are some examples of eugenics in history?

A

the holocaust, forced sterilization of African Americans, segregration, and discrimination in the healthcare world

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3
Q

What are some health inequities involving genomics?

A

-all genetic knowledge is based on those from European descent
-access
-cost
-medical mistrust
-historical misuse of DNA (henrietta Lacks, fake vaccines in Pakistan)

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4
Q

What does the Genetic Information Nondiscrimination Act (GINA) protect?

A

it protects against the use of genetic information to discriminate in health insurance and employment.

e.g. if you have a genetic link to mental illness they can’t not hire you, or if you are genetically predisposed to breast cancer insurance companies can’t refuse you

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5
Q

What does GINA NOT! protect against?

A

-protect information about current health status
-life, diability, or long term care insurance
e.g. alzheimers gene may not be able to get life insurance
-applying for TRICARE (military insurance)
-certain groups such as small buisness, veterans, or federal insurance
-Any other applications such as for education or housing

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6
Q

What major event involving genomics happened in 1962?

A

genetics and genomic named as a nursing education priority

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7
Q

What major event involving genomics happened in 1998?

A

ANA added genetics/genomic to nursing scope of practice

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8
Q

What major event involving genomics happened in 2003?

A

completion of human genome project

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9
Q

How does the nurse use genomics in their practice?

A

-Direct consumer to genetic testing
-oncology
-pain management/anethsia
-psychiatric
-reproductive health

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10
Q

What is genetics?

A

the study of heredity and the transmission of characteristics from across generations

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11
Q

What types of tests are protected under GINA?

A

-family medical hx
-carrier testing
-prenatal genetic testing
-presymptomatic and predispositional testing
-analysis of tumors or any other assessments

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12
Q

what is a gene?

A

the most basic physical and functional units of heredity

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13
Q

what is a genome?

A

the total genetic makeup of an organism

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14
Q

What are the four nucleotides that make up DNA?

A

-adenine
-thymine
-cytosine
-guanine

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15
Q

what is a single nucleotide polymorphism(SNP)?

A

a single base substitution in DNA

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16
Q

What can SNPs effect?

A

-what protein is produced by the gene
-how much protein is produced by the gene

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17
Q

What is a genotype?

A

the molecular structure of an organism

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18
Q

what is a phenotype?

A

the observable characteristics of an organism

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19
Q

What determines someone genotype?

A

inheritance from ancestors including singular nucleotides, number of copies of a coding sequence, and number of chromosomes

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20
Q

what determines someones phenotype?

A

based on genotype and environmental factors

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21
Q

what problems can happen to affect the phenotype?

A

-epigenetic modifications
-lack of protein binding sites or carriers
-lack of amino acids to code certain proteins
-misfolding of proteins

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22
Q

What mutations can happen to the genotype?

A

-a singular nucleotide
-number of copies of a coding sequence
-number of chromosomes

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23
Q

what is epigenomics?

A

study of molecular signals that tell the genome how to behave and their relations to health

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24
Q

what is exposomics?

A

study of how all the exposures of an organism alter its health

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25
Q

what are three domains of the exposome across the lifespan?

A
  1. general external environment
  2. specific external environment
  3. internal environment
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26
Q

what are examples of general external environment?

A

-urban environment
-climate factors
-social capital
-systematic racism

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27
Q

what are examples of specific external environment?

A

-specific contaminants
-diet
-physical activity
-tobacco
-infections

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28
Q

what are examples of internal environment?

A

-metabolic factors
-gut microflora
-inflammation
-oxidative stress

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29
Q

nonwhat are the four areas in The Complex Disease Phenotype Pathway in order from bottom to top?

A

-genetic susceptibility
-exposome
-epigenome
-disease

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30
Q

what is epigenetics?

A

the non-genetic influences on gene expression which serves as an on/off switch for gene expression

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31
Q

what is DNA methylation? and what does it mean for the geno and phenotype?

A

when methyl molexule serves asa roadblock to transcription. since there is no protein that means that they gene isn’t expressed and the phenotype changed

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32
Q

what is the main function of epigenetics?

A

to cause some genes to be silent and others to be active

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33
Q

how does public health address genetic susceptibility?

A

-Assess relationships between genetic and environmental factors
-minimize negative exposures
-support healthy behaviors
-precision medicine targeting specific genetic risk factors

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34
Q

What is Life Course Theory?

A

a body of theoretical models that attempt to explain how life contests shape health, behavior, and development

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35
Q

what are the main ideas of the Life Course Theory?

A

-experience and exposures are cumulative
-early life context (including fetal period) may effect them in old age
-risks and protections can be transmitted across generations and populations
-multidisciplinary paradigm: biological, behavioral, and social contexts

36
Q

What is the Baker Hypothesis?

A

adverse fetal life context leads to increased risk of adult disease including increase risk for CVD, metabolic syndrome, T2DM, HTN, renal failure, asthma, HLD, and autoimmune diseases, as well as gene expression

37
Q

Why does fetal life impact adult life?

A

the body prioritized immediate survival over long term health so the fetus adapts causing lasting effects

38
Q

What is the Dutch Hunter Winter?

A

in 1944 food supply was cut off bc of the Nazis and they were able to study the effects of starvation on different stages of pregnancy

39
Q

What was the major findings associated with trimesters during the Dutch Hunter Winter?

A

that babies exposed to poor nutrition during the second and third trimester had smaller birthweight compared to those that started in the first trimester but those exposed in the first trimester had higher rates of adult disease

40
Q

What is Intergenerational Transmission?

A

The idea that since woman are born with all their eggs that in biological females the health of the grandmother can impact their grandkids

41
Q

what can public health nurse do to improve intergenerational transmission?

A

-improve the health of childearing persons via better nutrition, reduced stress, more exercise, etc.
-recognize and intervene in high risk populations
-interventions for low birthweight

42
Q

how does short term stress effect the body?

A

make someone more adaptive and improve survival

43
Q

how does chronic stress effect the body?

A

causes wear and tear on the body’s regulatory systems causing gradual degradation in health

44
Q

What is allostasis?

A

the body’s adaption to predictable and unpredictable change’s in the environment

45
Q

What is allostatic load?

A

the cost of chronic exposure to elevated or constantly fluctuating endocrine and neural responses due to stress

46
Q

What physiological changes happens with acute stress?

A

-increased cardiac output
-increased available glucose
-enhanced immune function
-growth of neurons in hippocampus and prefrontal cortex

47
Q

what physiological changes happen during chronic stress

A

-HTN and CVD
-glucose intolerance and insulin resistance
-infection and inflammation
-atrophy and death of neurons in hippocampus and prefrontal cortex

48
Q

what is adverse childhood events?

A

A traumatic experience in a person’s life before the age of 18 that the person remembers as an adult

49
Q

What is the ACE score?

A

measure of cumulative exposure to adverse childhood conditions discovered through 10 questions

50
Q

What are examples of ACEs?

A

-physical abuse
-emotional abuse
-sexual abuse
-physical neglect
-emotional neglect
-mental illness
-mother treated violently
-divorce
-incarcerated relative
-substance abuse

51
Q

What are the lasting effects of ACES?

A

-health (obesity, DM, depression, SI, STDs, heart, cancer, stroke, COPD, broken bones)
-behaviors (smoking, alcoholism, and drug use)
-life potential (graduation rates, academic achievement, lost time from work)

52
Q

What are the ways we can intervene with ACEs?

A
  1. PREVENTION!!!
  2. Replacing maladaptive behaviors with adaptive ones
  3. Enhancing social support
  4. Addressing the trauma in therapy
53
Q

How do Public Health nurses address ACEs?

A

-increase system capacity
-create policies to foster cross sector care coordination
-foster collaboration and alignment across sectors systems

54
Q

what is the definition of research?

A

a scientific method by which data is systemically collected to describe, explain, and/or predict event

55
Q

what is the definition of evidence-based practice?

A

the conscientious and judicious use of current best evidence to guide health care decision

56
Q

what is the definition of epidemiology?

A

the study of the distribution, frequency, and determinants of health and disease in human populations to understand causation

57
Q

what are the objectives of epidemiology?

A

to find out the
who, what, when, where, why, and how

58
Q

what are the major subdivisions of epidemiology?

A

-infectious disease
-genetics
-molecular
-injury
-occupation
-chronic disease
-cancer
-environmental
-social
-behavioral

59
Q

What are the commonly used methods commonly used in epidemiology?

A

-focus
-surveillance
-descriptive epidemiology
-analytic epidemiology

60
Q

Describe the focus method

A

identifying factors and characteristics that cause, predict, or are associated with the development of a health condition

61
Q

describe the surveillance method?

A

the ongoing collection, analysis, and interpretation of health related data

62
Q

describe the descriptive epidemiology method?

A

purpose is to DESCRIBE who what where and when

63
Q

describe the analytic epidemiology method?

A

purpose is to EXAMINE between who what where and when to determine why

64
Q

what are the two most commonly used epidemiological models?

A

-epidemiological triangle
-web of causation

65
Q

what are the three parts of the epidemiological triangle?

A
  1. agent
  2. host
  3. environment
66
Q

what is an agent?

A

factor that causes disease

67
Q

what is a host?

A

a living species (human or animal) capable of being infected or affected by the agent

68
Q

what is an environment?

A

all that is external to a given host or agent that is influenced and influences the host and/or agent

69
Q

what needs to be considered with an agent?

A
  1. type of agent (infectious, chemical, physical)
  2. Ability to cause injury
70
Q

what needs to be considered with the host?

A

-exposure
-susceptibility
-response

71
Q

what needs to be considered with the environment?

A

-physcial factors
-biological factors
-psychosocial factors

72
Q

what are intrinsic factors for the host?

A

-genetics
-age
-sex
-physiological state
-immunity
-concurrent or preexisting
-human behavior

73
Q

what are extrinsic factors for the environment?

A

-physical
-biological (flora, fauna)
-socioeconomic (occupation, urbanization)

74
Q

what are the two assumption of the epidemiological triangle?

A
  1. Disease occurs when an agent is present in a susceptible
    host under environmental conditions favorable to the
    development of disease.
  2. Changes in one component of the triangle can influence
    whether or not a disease occurs.
75
Q

what is the web of causation concept?

A

used to investigate relationships between factors. used to study chronic disease

76
Q

what is common data sources?

A
  1. routinely collected date (vital statistics, US census, national center for health statistics)
  2. epidemiologic data (scientific studies, population screening, and surveillence data)
  3. other (by hcp, health department, and insurance)
77
Q

how to calculate a rate

A

Numerator: number of occurences
denominator: number of population of interest during the SAME time
K: constant

numerator/denominatorx K

78
Q

What are commonly used rates?

A
  1. Fertility rate
    (number of live births/number of people who can be pregnant during the same year)
  2. crude mortality rate
    (number of deaths from ALL causes/estimated population)
  3. Cause specific
    (number of deaths by a certain cause/population)
  4. subpopulation
    (number of deaths in a certain group/estimated population)
  5. Morbidity
    (can be either incidence of prevalence)
79
Q

what is the difference between risk and odds

A

of people who expereince the event/ # of ALL people at risk

  • Risk
    # of people who experience an event/
    # of ALL people at risk for experiencing the event
  • Odds
    # of people who experience an event/
    # of people who DO NOT experience the event
80
Q

how is a risk normally expressed?

A

precentage

81
Q

how is an odd normally expressed?

A

ratios

82
Q

what is years of potential life lost (YPLL)

A

an age adjusted measure of premature mortality. indicates how many people who could have lived who died earlier than expected

83
Q

what is sensitivity?

A

the ability of a test to correctly identify those WITH the disease or a true positive rate

84
Q

what is specificity?

A

the ability of a test to correctly identify those WITHOUT the disease or a true negative rate

85
Q
A
86
Q
A

NUR 422 Public Health (4 decks)

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