chapter 2; evidence based public health + Chapter 3;

Question 1

the first step in addressing a health problem is to describe its […] of disease, which is the occurrence of disability and death due to a disease

Answer 1

burden

Question 2

in public health, disability is often called […] and death is called […]

Answer 2

morbidity
mortality

Question 3

in addition to describing the burden of disease, it is important to describe what we call the […] of a disease

Answer 3

course
e.g. how often it occurs, how likely it is to e present currently, and what happens once it occurs

Question 4

in addition to describing the burden and the course of a disease or other health problem, we need to ask: what is the […] of disease

Answer 4

distribution
e.g. who gets the disease, where are they located, when does the disease occur,

Question 5

defining the criteria they are using to measure the occurrence of the disease; is known as case […]

Answer 5

definition

Question 6

public health professionals called epidemiologists investigate factors known as “person” and “place” to see if they can find patterns or associations in the […] of a disease. aka group associations

Answer 6

frequency

Question 7

three basic reasons that changes in rates may be artifactual rather than real

Answer 7

• differences or changes in the interest in identifying the disease
• differences or changes in the ability to identify the disease
• differences or changes in the definition of the disease

Question 8

group associations are established by investigations that use information on the specific individuals within the group; population […] or ecological studies

Answer 8

comparisons

Question 9

to conduct age adjustment, epidemiologists look at the rates of the disease in each age group and also the age distribution, or the number of people in each age group in the population

Answer 9

yes

Question 10

contributory cause can be related with cause and effect at the individual , preceding in time, and altering the effect

Answer 10

yes

Question 11

using a chance process known as […] or random assignment, individuals are assigned to be exposed or not exposed to the potential “cause”

Answer 11

randomization

Question 12

[…] criteria, or ancillary criteria, that we can use to help us establish the existence of contributory cause

Answer 12

supportive

Question 13

efficacy implies that an […] works, that is, it increases positive outcomes or benefits in the study group compared to the control group being investigated

Answer 13

intervention

Question 14

the […] of the relationship implies that we are interested in knowing how closely related the risk factor is to the disease

Answer 14

strength

Question 15

biological plausibility implies that we can explain the occurrence of disease based upon known and accepted biological mechanisms

Answer 15

yes

Question 16

evidence based recommendations are built upon the evidence from studies of […]

Answer 16

interventions

Question 17

evidence based recommendations are based upon two types of criteria: the [..]of the evidence and the magnitude of the [..]

Answer 17

quality
impact

Question 18

well conducted [..] [..] trials that fully address the health problem are considered the highest quality evidence

Answer 18

randomized controlled

Question 19

the quality of the evidence also includes determining whether the data collected during an intervention are relevant to their use in a particular […] or […]

Answer 19

population
setting

Question 20

poor quality evidence implies that there are fatal flaws in the evidence and […] cannot be made

Answer 20

recommendations

Question 21

the magnitude of the impact is the benefits minus the harms, or the “net benefits”

Answer 21

yes
why?
- due to evidence based recommendations taking into account the potential benefits of an intervention, as well as the potential harms

Question 22

primary interventions take place […] the onset of the disease. they aim to […] the disease from occurring

Answer 22

before
prevent

Question 23

secondary interventions occur […] the development of a disease or risk factor, but […] symptoms appear. they are aimed at early detection of disease or reducing […] factors while the individual is asymptomatic

Answer 23

after
before
risk

Question 24

tertiary interventions occur after the initial occurrence of symptoms, but before […] disability . they aim to prevent irreversible […] of the disease

Answer 24

irreversible
consequences

Question 25

victim blaming is when they blame the consequences of the disease on the individual

Answer 25

yes

Question 26

effectiveness is when evaluating how well an intervention works in public health or clinical practice. the term efficacy, in contrast, is used when we address how well an intervention works under research conditions

Question 27

population prediction models aim to predict the [...] and also enhance [...] of how that future can be improved by potential interventions

Answer 27

future understanding

Question 28

the term health communications deals with the methods for [...], [...], and [...] health information

Answer 28

collecting, compiling, and presenting

Question 29

since the field of health communications has been growing at the speed of the internet. along with this is the growth has come the dramatic increase in 'incomplete information', 'misinformation', and 'disinformation'

Question 30

following aspects of health communications, ask the following questions; collecting data: where does public health data come from? compiling information: how is public health information compiled or put together to measure the health of a population presenting information: How can we evaluate the quality of the display and presentation of public health information perceiving information; what factors affect how we perceive public health information combining information: what types of information need to be combined to make health decisions decision making; how do we utilize information to make health decisions

Question 31

the methods in which public health data are collected, is public health [...]. data from public health surveillance are [...], [...], and [...] without identifying specific individuals

Answer 31

surveillance collected, published, and distributed

Question 32

the public health data, health communication, and the flow of information is collect, compile, present, perceive, combine, and decision making

Answer 32

yes

Question 33

single case or small series

Answer 33

e.g. case reports of one or a small number of cases (first report of AIDS) user; alert to new disease or resistant disease, alter to potential spread beyond initial area advantages/disadvantages; useful for dramatic, unusual and new conditions, requires alert clinicians, and rapid ability to disseminate information

Question 34

statistics I "vital statistics" I and reportable disease

Answer 34

e.g. vital statistics: birth, death, fetal death after 20 weeks, marriage, divorce, reporting of key communicable and specially selected noncommunicable disease [e.g. elevated lead levels, child and spouse abuse, etc.] also may include other government records such as motor vehicle injury and police reports users; required by law - sometimes penalties imposed for noncompliance, births and deaths key to defining leading causes of disease advantage/disadvantages; vital statistics very complete because of social and financial consequences, reportable disease often relies on institutional/laboratory reporting rather than individual clinicians, frequent delays in reporting data

Question 35

surveys sampling

Answer 35

e.g. National Health and Nutrition Examination Survey [NHANES] Behavioral Risk Factor Surveillance system [BRFSS], also includes disease specific registries users; drawing conclusions about overall population and subgroups from representative samples, registries attempt to include all those with a disease in order to be representative of the population advantages/disadvantages; well conducted surveys allow inferences to be drawn about larger populations, frequent delays in reporting data, difficult to include all potential patients in disease registries

Question 36

self reporting

Answer 36

e.g. adverse effect monitoring of drugs and vaccines as reported by those affected users; may help identify unrecognized or unusual events advantage/disadvantage; useful when dramatic, unusual events closely follow initial use of drug or vaccine; tends to be incomplete; difficult to evaluate meaning because of selective process of reporting

Question 37

sentinel monitoring

Answer 37

e.g. influenza monitoring to identify start of outbreak and changes in virus type users; early warnings of previously unrecognized events advantages/disadvantages; can be used for "real time" monitoring; requires considerable knowledge of patterns of disease and use of services to develop

Question 38

syndrome surveillance

Answer 38

e.g. use of symptom patterns (headaches, cough/fever, or gastrointestinal symptoms) plus increased sales of over the counter drugs to raise alert of possible new or increased disease users; may be able to detect unexpected and subtle changes, such as bioterrorism or new epidemic producing commonly occurring symptoms advantages/disadvantages; may be used for early warning even when no disease is diagnosed; does not provide a diagnosis and may have false positives

Question 39

social media

Answer 39

e.g. data on outbreaks using key words from social media users; detect and monitor course of influenza epidemic advantages/disadvantages; potential for immediate data obtained from a larger number of individual, accuracy and precision of the data for early and ongoing surveillance needs to be established

Question 40

data from different sources are increasingly being [...] to create integrated health data systems or *databases* that can be rapidly and flexibly accessed by computers to address a wide range of questions

Answer 40

combined

Question 41

integrated databases also create the potential for [...] of the most intimate health information. thus, protecting the privacy of data and ensuring their anonymous collection and distribution is now of great concern as part of the development of integrated databases

Answer 41

abuse

Question 42

measurements that [...] the health of populations are called *population health status measures*.

Answer 42

summarize

Question 43

in the 20th century, two measurements became standard for summarizing the heath status of populations the [...] mortality rate and life [...]

Answer 43

infant expectancy

Question 44

the infant mortality rate estimates the rate of death in the [...] year of life. has been used as the primary measurement of child health

Answer 44

first

Question 45

life expectancy has been used to measure the overall death experience of the population, incorporating the probability of dying at each year of life

Answer 45

yes

Question 46

the degree of success in reducing mortality among children aged 2 to 5 has not been as great. malnutrition and old and new infectious diseases continue to kill young children.

Answer 46

however, improvements in the care of severely ill newborns have extended the lives of many children - only to have them die after the first year of life

Question 47

once a child survives to age 5, he or she, has a very high probability of [...] into adulthood in most countries . thus, a new measurement known as *under-5 mortality* has now become the standard health status measure used by the World Health Organization (WHO) to summarize the health of children

Answer 47

surviving

Question 48

life expectancy is a snapshot of a population incorporating the probability of dying at each [...] of life in a particular year

Answer 48

age

Question 49

despite its name, life expectancy cannot be used to accurately predict future life spans, especially for the young

Answer 49

yes

Question 50

life expectancy does not reflect the impact of [...] only of dying. when considering the health status of a population in the 21st century, we need to consider disability, as well as death

Answer 50

disabilities

Question 51

two important measures of mortality are "years of potential life lost (YPLL)" and "excess mortality". measured from premature deaths before age [...]. puts more importance on deaths at younger ages

Answer 51

75 e.g. death at age 74 counts as only 1 year of life lost, at age 5, as 70 years lost

Question 52

measurement of YPLL has highlighted the "deaths of [...]" from drug overdoses, alcohol abuse, and suicide which have all increased substantially among those in the "[...] of life" from ages 15 to 64

Answer 52

despair prime

Question 53

[...] deaths are increasingly being used to measure the impact of disasters, epidemics, pandemics, and other large-scale events. measure the number of deaths that occur in a geographic area of interest during each month of the event [...] to the number of deaths that occurred during the same month in the same geographic area during several previous years

Answer 53

excess compared side note; do not generally take into account the age of the individuals who died

Question 54

today, the WHO uses a measurement known as the *health-adjusted life expectancy (HALE)* to [...] the health of populations. starts with life expectancy and then [...] measurement of the quality of health

Answer 54

summarize incorporates

Question 55

the health-adjusted life expectancy (HALE) includes; mobility, cognition, self care, pain, mood, sensory organ function

Answer 55

mobility (ability to walk without assistance) cognition (mental function, memory) self care (activities of daily living, dressing, eating) pain (regular pain that limits function) mood (alteration in mood that limits function) sensory organ function (impairment in vision or hearing that impairs function)

Question 56

an additional measure known as the *disability-adjusted life year (DALY)*, has been developed and used by the WHO to allow for [...] and [...] based on categories of diseases and conditions

Answer 56

comparisons changes

Question 57

DALYS are designed to examine the impacts that [...] disease and [...] factors have on populations, as well as provide an overall [...] of population health status

Answer 57

specific risk measure

Question 58

DALYs are measured by comparing a country's performance to the country with the longest life [...], which is currently Japan of 85 years. in a country with zero (DALYs) the average person would live approximately 85 years without any [....] and would then die suddenly

Answer 58

expectancy disability (ALL countries have DALYs greater than zero)

Question 59

the WHOs Global Burden of Disease (GBD) project has produced a number of important conclusions using DALYs

Answer 59

- Depression is a leading cause of disability and may become the top contributor in both developing and developed countries in the coming decades. - Chronic diseases like hookworm, malaria, HIV, and asthma, which affect young and working-age people, are major causes of disease in many developing countries. - Cancers (e.g., breast, liver, colon) in working-age adults are significant contributors to the disease burden in developing countries. - Injuries from accidents, including motor vehicle and workplace accidents, cause long-term disabilities and deaths, especially in younger people, impacting the disease burden more than just deaths alone. - Obesity is becoming a bigger problem than malnutrition in developing countries, with rising cases of diabetes, heart disease, and strokes among younger populations.

Question 60

toady, the internet is a great source of information but it also includes; incomplete information, misinformation, and disinformation

Answer 60

- incomplete information is correct or accurate information that does not provide the full picture and may therefore be misleading. decisions that could have been different - misinformation is any inaccurate or false information which is believed by the user to be accurate. need to identify in order to address - disinformation is incorrect information intentionally presented to encourage specific actions. increased dramatically w/ social media

Question 61

public health information is often presented as [...], which may be combined with other ways to display information into an infographic

Answer 61

graphics

Question 62

understanding the degree of health literacy of the intended audience is so important . it refers to the degree to which individuals have the [...]to obtain, process, and understand basic health information and services needed to make appropriate [...] decisions

Answer 62

capacity health

Question 63

at least three types of effects can greatly influence our perceptions of potential harms and benefits. called the [...] effect, the [...] effect, and the [...] effect

Answer 63

dread unfamiliarity uncontrollability

Question 64

the dread effect is present with hazards that easily produce very [...] and feared [...]

Answer 64

visual consequences

Question 65

the uncontrollobility effect may have a major impact on our perceptions and actions

Answer 65

perceptions actions

Question 66

the unfamiliarity effect