Final Flashcards
(95 cards)
1
Q
What is epidemiology?
A
Study of the distribution and determinants of health-related states or events in specified populations and the application of this study to the control of health problems
2
Q
What is big data?
A
Digital data that is produced in large volumes and have variety in sources and organizational structures. When characterized, known as spatial big data.
3
Q
What does public health informatics support?
A
Public health practice and research with information technology (IT)
4
Q
What are the 6 pollutants public health is focused on and he do they effect health?
A
Lead, mercury, chromium, arsenic, pesticides, radionuclides
Pose dangers to both physical and mental health challenges. Can cause developmental problems, cancer, immune system deterioration, or death.
5
Q
What causes outdoor pollution?
A
Auto emissions, power plants, and industry
6
Q
What causes indoor pollution?
A
Cooking and heating with coal, wood, or charcoal
7
Q
What is included in public health?
A
Environment, tobacco use, planning for natural disaster, protecting food supply, and identification and prevention or containment of epidemics
Also starting to include gun violence in the US
8
Q
How could social inequality be decreased?
A
Universal health care, day care, and subsidies to bring people above the poverty line and using tax system to reduce inequality
9
Q
How can social inequality reduce health?
A
It has been hypothesized that the constant stress on poor people in a highly stratified society may account for higher rates of illness and death.
10
Q
Compare income and wealth.
A
Income: what you make in a year
Wealth: houses, bank accounts, stocks, bonds
11
Q
Define a health disparity.
A
A particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage
12
Q
How can information technology aid in the study of disease?
A
Play a significant role in helping infection control practitioners using their surveillance tasks, outbreak monitoring, and reporting as well as identifying trends
13
Q
What are now used to model diseases?
A
Computers
14
Q
What is a what if scenario?
A
Computer model of what would happen to an infectious disease is something else were to happen (eg. If air travel increased or decreased, if their temperature rose or fell, if there was an adequate supply of anti-viral drugs, or if a vaccine existed or did not exist)
15
Q
What is an epidemic?
A
An excess in the number of cases of a given health problem
16
Q
In how many countries is polio still endemic?
A
4
17
Q
Define pandemic
A
A global disease outbreak to which everyone is susceptible
18
Q
What were some measures that were put in place to combat the spread of the flu pandemic in 1919?
A
Patients were separated by sheets and slept head to foot.
Authorities limited public meetings and recommended good ventilation
Schools, movie theatres, bars, and dance halls were closed as were public funerals.
19
Q
When were the first cases of AIDS?
A
June 1981 but wasn’t found to be spread via HIV until 1984.
20
Q
How is IT being used in AIDS research?
A
Allows researchers to look at all the genes and proteins in the virus and the human genome, allowing them to be used to investigate vaccine development and analyze health and population statistics. Several nations are using super computers and bioinformatics to help develop vaccines.
21
Q
What are biomedical informatics?
A
Integrates health-related data on all levels, such as molecule, cell, tissue, organ, people, and the entire population
22
Q
How has AIDS shaped healthcare practices?
A
Was a factor in push for living wills and health care proxies, DNRs, and hospice care. Also helped create a social movement that changes the drug approval process and introduced patients who sometimes has as much info as professionals into scientific meetings.
23
Q
What is SARS?
A
Identified in 2003, it is a form of pneumonia caused by a virus. It leads to difficulty in breathing and can cause death.
24
Q
What is Ebola?
A
Virus that causes bleeding, fever, diarrhea, and vomiting. Spreading easily via person to person through infected blood or tissue, it has a death rate exceeding 50%.
25
What is promoting antibiotic resistance?
20-50% of all antibiotics prescribed are not needed or inappropriate. That combined with use in foods have helped promote growth of new resistant strains. Occurs without the use of antibiotics but is exacerbated by the use and abuse leading to superbugs. Very few
26
What is MRSA?
Staphylococcal infection resistant to many antibiotics.
27
What is CRKP?
A deadly bacterium that is resistant to carbapenem, an antibiotic that was once called the antibiotic of last resort. Can cause pneumonia, bloodstream infections, and infections in wounds and surgical sites. Related to the overuse of antibiotics for colds and viruses.
28
What is NDM-1?
A gene that causes bacteria to produce an enzyme that makes them resistant to the antibiotics, spreading from one kind of bacteria to another through horizontal gene transfer.
29
What is a vector borne disease?
A disease transmitted to a human or animal host via a tic, mosquito, or other arthropod that carried the bacteria or virus. They are effected by the climate, emerging and re-emerging int he last decade.
30
What is west nile virus?
Form of encephalitis that cycles between mosquitoes and birds, the former spreading it to humans and is diagnosed via MRI. Most do not become sick but can become very serious. Now a seasonal epidemic in north america.
31
What is Zika virus?
Declared a world health emergency in 2016 and spread via mosquitos and sex, there is no vaccine to prevent it and no treatment. Can cross the placenta during pregnancy and cause severe birth defects.
32
How was IT used to track and compact cholera in Haiti?
Public health officials used text messages and radio to warn the population of health risks. Cell phones were used to track the spread of the disease, tracking peoples movements and enabling the prediction of new outbreaks. Helped know where to send medical personnel.
33
What is syndromic surveillance?
An approach to containing infectious disease which uses health-related data that precede diagnosis and signal a sufficient probability of a case or an outbreak. Ex. looking for signs and symptoms and reporting them in shelters where there are no medical personnel.
34
What are registries for?
With as organized systems for the collection, storage, retrieval, analysis, and dissemination of information on people with a disease, a predisposition towards a disease, and exposure to anything thought to cause illness. They can be used to define a problem and its size as well as examine trends over time.
35
What is SATELLIFE?
A personal digital assistant what is used for the collection and dissemination of information, warnings, education, and so on. It increases access to current information without land lines, selectivity, or internet.
36
What is the NNDSS?
The national notifiable diseases surveillance system. It allows the local, national, and international sharing of info that public health officials can use to monitor, control and precent outbreaks or reportable conditions. Uses the NEDSS to connect the healthcare system to public health and CDC departments. Allow epidemics to be identified quickly.
37
What are GIS?
Geographic information systems. Computer systems for capturing, storing, checking, and displaying data related to positions on earths surface. Can display any digitized data on a map, such as the spread and occurrence of a disease, making it easy to see patterns and relationships among data.
38
What is MIDAS?
A plan to model diseases by building predictive models of infectious disease outbreaks based on mathematics and statistics applied to real-life data. Some projects and information bases include EpiFire, global epidemic model, TranStat, and WHONET. Used to model H1N1.
39
How did the deepwater horizon oil spill affect public health?
Direct threats via inhalation or dermal contact as well as indirect threats to seafood safety and dental health.
40
What is proteomics?
The large scale study of proteins.
41
What are the different multi-lmic approaches to disease?
Transcriptomics: examine RNA levels of genome-wide
Metabolomics: quantifies multiple small molecule types
Microbiomics: study all the microorganisms of a given community together
Holy grail of biology: tame the complexity of these multi-omics to detect, measure, and cure diseases.
42
When did next generation sequencing come out?
Came out in 2007, and has since dropped drastically in price.
43
What was the celera approach to sequencing genomes?
Skipped mapping phase altogether. They cut up the genome into a soup of overlapping bits and sequenced each fragment. They then pieced it back together using only the overlaps. Used the HPG public data.
44
What was the human genome project approach to sequencing the genomes?
They cut the DNA into 150K overlapping sequences. They were grown in bacteria and expressed, informing researchers about where this sequence was in the genome. They sent fragments to the lab to piece the genome together. It was done very methodically and all data was made public as it was discovered.
45
What is high-throughput sequencing?
A type of next generation sequencing. A laser showing through shows what base pair is being added by labeling each nucleotide with a different fluorescent colour. Also known as illumina sequencing (genetics)
46
What has come from mapping the genome?
Personalized medicine, gene therapy/genome editing, disease eradication, studying evolution, studying complexity of life: proteins.
47
What is CRISPR?
Clustered Regularly Interspaced Short Palindromic repeats. Works by cutting a dsDNA in the same spot, then using Cas9 to input a proper code. Allows manipulation of DNA to help eradicate diseases.
48
What was found about Zika using sequencing?
Found candidate Zika-Human PPIs (protein-protein interactions) potentially linked to neonatal microcephaly. Aimed to predict new interactions of the zika virus.
49
What is machine learning?
A suite of method used to devise complex models and algorithms that lend themselves to prediction.
50
Describe the study of the Zika virus.
They broke down the cellular processes of the proteins that might be involved in the virus, specifically looking for ones involved in neurodevelopment. They predicted that the infection might be sex transmitted as well as go all the way back to conception not just infection. They used binding affinity testing to determine if the virus interfered with binding.
51
Describe hearing.
Sound reaches the ear canal and vibrates the tympanic membrane. The vibration is transmitted via the ossicular chain and to the cochlea through the oval window. The hair cells in the cochlea move and carry the pulse up the nerve into the brain.
52
What is sensorineural hearing loss?
Use hearing aids or cochlear implants.
53
What is conductive hearing loss?
Can generally be fixed with surgery.
54
What is pure-tone audiometry?
The gold standard of hearing assessment. Pure tones are delivered at standard frequencies to determine the threshold of hearing of the patient in a controlled environment.
55
Describe the threshold of hearing estimation graph of pure-tone audiometry.
X-axis: presentation
Y-axis: amplitude (dB)
Giving different amplitudes, a circle means it could be heard. They start high and keep getting lower by 10dB intervals until it is no longer heard, then, marked by an X, increased by 5dB until they can hear again, thus establishing the hearing threshold. This is done for both ears for bone and air frequencies (actually audiogram).
56
What can audiograms be used to determine?
By looking at the pattern, it can be used to deduce the cause of hearing loss.
57
What is shoebox audiometry?
Audiometry application for iPad that has been clinically validated for use outside the sound booth. It reduces the need for a sound proof booth, making it much cheaper and easier to use as it is automated.
58
What are the benefits and risks of shoebox audiometry?
Benefits: ability to bring healthcare to underserved communities, low cost, high accessibility.
Risks/Hazards: misinterpretation of the device's output (false negatives), misuse of the device (uncalibrated device, etc.)
59
What is an issue with shoebox audiometry?
Many non-specialist users have limited experience interpreting audiograms. therefore aimed to automatically classify audiograms through machine learning.
60
What is the idea behind supervised learning?
A machine was fed an asymmetrical audiogram and if it tells you it is symmetrical, you tweak the parameters. This process keeps occurring until you get the correct results every time.
61
Describe supervised learning.
Very popular for healthcare applications by predicting risk of diseases based on EHR. The model learns from exposure to data and the desired target variable. It requires labelled data and assumes that there is a single right answer.
62
What are some advantages and disadvantages of supervised learning?
Advantages: powerful, improves with data, requires little understanding of problem
Disadvantages: requires limited understanding of the problem, blackbox approach, requires a lot of annotated data.
63
What was the research plan for the shoebox audiogram?
1. Assembling a dataset
2. Ambiguity labelling
3. Mining (clustering and sampling)
4. Annotation
5. Train machine learning models.
64
Describe the shoebox audiogram research methods.
Using 15k audiograms, the Katz classification system classified both ears as flat, gradually slopping, sloping, or rising, rising in clusters for the audiograms. They then picked a representative example in each cluster and assigned a score that accounts for dissimilarity and cluster size. Through this they trained the machine learning models and integrated it into a single system.
65
What are the different classes of medical devices?
Class 1: low risk (reusable scalpels, bandages, cultural media)
Class 2: low risk (contact lenses, epidural catheters, pregnancy test, surgical gloves)
Class 3: moderate risk (orthopaedic implants, glucose monitors, hemodialysis systems, diagnostic ultrasound systems, dental implants)
Class 4: high risk (HIV test kit, pacemakers, angioplasty catheters)
66
What are the objectives of standardization?
Advance national economy
Support substantial development
Improve health and safety of workers and the public
Facilitate domestic and international trade
Strengthen international cooperation
Assist and protect consumers
67
What are the different types of standards?
```
Data to be provided standard
Design standard
Interface standard
Management system standard
Performance standard
Prescriptive standard
Process standard
Product standard
Terminology standard
Testing standard
Service standard
```
68
What is a data to be provided standard?
Contains a list of characteristics for which values or other data are to be stated for specifying the product, process, or service
69
What are design standards?
Identify specific design or technical characters of a product
70
What are interface standards?
Have to be able to show that the product interacts with everything around it perfectly and is easily able to interact with that environment.
71
What are management system standards?
Define and establish an organization quality policy and objective
72
What are performance standards?
CRITICAL
| Simulating performance under actual service conditions
73
What are prescriptive standards?
Identify characteristics
74
What are process standards?
Specifies requirements to be fulfilled by a process to establish its fitness for purpose
75
What are product standards?
Specifies requirements to be fulfilled by a product or group of products, to establish its fitness for purpose
76
What are terminology standards?
Concerned with terms, usually accompanied by their definitions, and sometimes explanatory notes, illustrations, examples, etc.
77
What are testing standards?
Concerned with test methods, sometimes supplemented with other provisions related to testing such as sampling, use of statistical methods, and sequences of tests (go to third party organization to test and have them say yes)
78
What are service standards?
Specifies requirements to be fulfilled by service
79
What must you have everywhere in the world to get a medical device registered?
ISO1435 (third party requirement)
80
What are standards applied to?
Regulatory, commercial, safe and efficacy, interoperability, emerging technologies
81
What is the SCC?
Standards Council of Canada
Coordinates Canada's participation in the international standardization bodies and approves national standards. It also manages programs and services designed to support the integration of standardization into F/P/T regulatory practices
82
Define machine learning.
An application of artificial intelligence that provides systems the ability to automatically learn and improve from experience without being explicitly programmed.
83
What are the three main AI research institutions in Canada?
Vector institute, Evato/Mila, AMII (together make up PILO0
84
What is canova?
A robotic arm that attaches to the general core of a machine that has touch and sensory as well as auditory and visual cues. It is wanted to help with prosthetics but the investment was too much so they applied it to automotive instead, designing with surgical level precision but marketed to factories, allowing them to price it high and gain an income.
85
Why is class I approval easier to get than the others?
You only have to apply for the medical device establish license and submit the application. The others have series of steps that have to implement standards (ex. prepare an MDL, give info about risks, technology, permits, etc.)
86
Why were pressure mats converted to a class II from class I?
When it was applied to the use on neonates, the risk increased resulting in a higher class ranking.
87
What is ROP?
Abnormal growth of blood vessels in the brain, potentially altering nerves and causing blindness
88
What is E-ROP?
Form of telemedicine that sends images to a centre where they are graded by trained readers, freeing up the time of on-site ophthalmologists as well as being less expensive and catching things earlier.
89
What are some drawbacks to telemedicine?
Lose face to face interactions with clinicians
Lack of rapour
Talk about life things might affect diagnosis without even knowing it
Impersonal
Lack of patient involvement in care (not patient centred)
90
How has a patient monitor changes from 1960 to now?
1960: only measured ECG with no alarms, no data, no software, paper charts as records, easy to install
1970's: 4 or 5 parameters with alarms and strip chart recording, no data, no software, paper charts as records
2000s: 15+ parameters, trend adata, saved alarm event strips, touchscreen, software driven unit, data available external to monitor, data available on network for connection to central stations (alarms, review, printing from nurses station), easy to install
2010: smaller and more portable, wireless network connectivity, can run applications, software driven, data available outside monitor manufacture units, export to electronic records, hard to install, involves software compatibility testing.
91
What are some different mode of ventilation?
Volume, pressure, pressure controlled+vol. regulation, assisted ventilation
92
What are some different types of ventilators?
HFO
Jet
NCPAP
CMV
93
What are some different technologies to measure/monitor flow, breathing?
Ultrasonic, flow sensor, MAP
94
What are the three types of 3D printing?
FDM (fused deposition modeling): uses filaments of plastic
SLA (stereolithography apparatus): uses resin and UV light but needs to cure after cleaned
SLS (selective laser sintering): powder and laser
95
How do you do 3D printing?
Caliper and other measuring tools
Computer software to create STL and Gcode files
3D printer
