Module 2: History and Frameworks Flashcards
(32 cards)
_____ diseases are responsible for most deaths in the Western world, formerly _____ diseases were the biggest threat. This transition is called the _____ _____.
Non-communicable. Communicable. Epidemiologic transition.
What does the term “compression of mortality” mean? What do graphs visualize?
People are living longer. Graphs visualize the survival probability to different ages.
A “fire triangle” is considered the simplest way to consider a communicable disease framework. What is it?
For fire to exist, need FUEL to burn, OXYGEN to power it, and HEAT to set it off.
What are the components of the epidemiologic triad of disease?
Host: characteristics that determine susceptibility (e.g., age, sex, genetic profile, medical history, culture, occupation, income)
Agent: element that causes disease (e.g., biologic, chemical, physical, nutritional, etc.)
Environment: circumstances host and agent find themselves in (e.g., temperature, humidity, housing, water, air pollution, etc.)
What are the three modes of transmission?
Person-to-person, through a common vehicle (e.g., water or food), or through a vector (e.g., mosquitoes).
Diseases are not instantly acquired. How is COVID-19 an example of this?
You have a pre-symptomatic phase where you do not hold enough virus to make you notably sick. As viral load increases, you generate mild-moderate illness symptoms. We are not referring to simply whether a person has the disease or not.
A disease is not evident until it is. This is why some people freak out about having something before they obviously do, they worry about _____ _____.
Preclinical symptoms.
What is the difference between subclinical, preclinical, and clinical disease?
Subclinical: NOT destined to become clinically apparent. Often diagnosed by serologic (antibody) response.
Preclinical: Destined to progress to clinical disease.
Clinical: Characterized by signs and symptoms.
What is a carrier?
Harbours the organism; no evidence of an antibody response; can infect others.
One common example of preclinical disease concern applies to people aged 50 or over. What is it and why?
Dementia/Alzheimer’s. May be concerned about forgetting something - as preclinical, would fail an Alzheimer’s test, but would they in a couple years?
What is the difference between induction and latency phases?
Induction: The time between an exposure of importance and developing the disease.
Latency: Individual has the disease but it is not clinically evident.
What phase is commonly associated with screening? Provide an example.
Latency phase.
E.g., breast cancer screening - will determine whether disease starting and intervention warranted.
What is the difference between persistent (chronic) disease and latent disease?
Persistent: when a person permanently changes (e.g., postpolio syndrome).
Latent: Infection with no active multiplication of the agent, only the genetic message is present, not viable organism.
What is the difference between endemic, epidemic, and pandemic?
Endemic: Usual occurrence, background rate of disease.
Epidemic: In excess of normal, important enough to act upon.
Pandemic: Worldwide epidemic.
What are two elements that make up an outbreak?
Local sudden rise in cases. Infections in population affected by susceptibility or immunity to the disease.
What is the definition of herd immunity?
The resistance of a group of people to an attack by a disease to which a large proportion of the members of the group are immune.
What are the four things that must be true for herd immunity?
Single host species within which transmission occurs (“herd” must be the same).
Relatively direct transmission from one member of host species to another.
No reservoir other than host (e.g., humans).
Infections must induce solid immunity.
What is an incubation period? For what is this term most used?
Interval from receipt of infection to the time of onset of clinical illness (the onset of recognizable symptoms). Mostly used in infectious disease.
What is the difference between quarantine and isolation?
Quarantine: separates and restricts the movement of people who were exposed to a contagious disease to see if they become sick (appropriate duration depends on incubation period).
Isolation: separates sick people with a contagious disease from people who are not sick.
What are the three types of prevention? Provide examples.
Primary: Preventing initial development of a disease (e.g., immunization).
Secondary: Early detection of existing disease to reduce severity and complications (e.g., cancer screening).
Tertiary: Reducing impact of the disease (e.g., stroke rehabilitation).
The most effective/efficient way to improve health is sometimes framed as what?
Medical care (treatment) versus public health efforts (prevention).
The McKeown thesis suggested what? What are the implications?
Medical interventions like vaccines and curative medicine were not the causes of the decline in mortality in England/Wales from 1860-1950.
We do not need a strict understanding of a disease in order to get to the bottom of a useful intervention for treating disease.
There are treatments that act as prevention, like for Alzheimer’s or HIV. How does this impact prevention?
This is a medical intervention that can prevent cases in a population, but does not alter the data-generating process (i.e., will still see new batches of cases).
In the 1970s, universal health care insurance had been established in many countries,
including Canada. However, this did not have what anticipated effect?
Equalizing health outcomes across dimensions of concern.
