Public Health Flashcards
Specificity
The likelihood of a test to be negative in people who do not have the disease.
TN/TN+FP
Sensitivity
Likelihood of a test to be positive in someone who actually has the disease.
TP/ TP + FN
Positive predictive value
Of the test is positive how likely is it that the person has the disease
TP/TP+FP
Negative predictive value
Of the people that test negative what percentage are truly negative
TN/TN+FN
Possible reasons to criminalize drinking in preg
Coerce women to treatment
Punish those who break social norms
Act as deterrent for behavior that risks fetus.
Reasons why criminalization of drinking in preg is bad
Lack of evidence that coercion is effective.
Shouldn’t be punished when behavior is routes in social causes.
Punishment may be discriminatory (eg father not sentenced)
Health professional drawn into criminal justice system = ethical contradiction.
Woman more likely to stay away from health services.
Taking woman to prison after giving birth isn’t wise.
Health promotion principles that should be applied when arguing against criminalization of drinking in preg
Empowerment
Re-orientating health services
Policy intervention rather than individual victim blaming
Disease specific factors for screening test suitability
Common Cause serious morbidity or mortality Is the natural history understood Is presymptomatic stage easy to detect Does early detection improve prognosis Is there an effective treatment
Features of RCT that make it superior to other study designs
Participants randomly selected - prevents selection bias
Both control and intervention groups have same baseline characteristics including known and unknown risk factors (random selection = equal chance)
Assists with control of confounding.
Blinding of researchers and participants = minimize measurement bias
What extent has smoking legislation been effective in SA
Reduced prevalence Millions have stopped smoking Drastic annual decrease in consumption Number of students who have never smoked increased Number of frequent smokers declined
Possible reasons why percentage deaths could be lower over time
Actual death rates decrease
Percentage could lower due to another cause increasing = competing cause of death
Data collection methods may have changed
The way the data was analyses may have changed
Public health strategies to decrease a lifestyle disease
Devote resources
Change certain policies
Health promotion campaigns (awareness, education)
Advise population on specific lifestyle changes
Difference between a CIT and a RCT
In RCT individuals are selected at random. In CIT groups, facilities or entire communities selected at random.
Design features of a CIT that minimize bias
Randomization
Blinding of both participants and researchers
A prospective design shows temporality
Do all woman have access to safe a abortion services in SA
No.
Most HCW refused to perform TOP.
Legislation alone cannot ensure implementation.
Legal TOP often inaccessible and seen as unacceptable.
Shortage of trained staff
Despite legislation only 15% or centers were open one year later.
TOP faces stiff opposition therefore hard to implement outside major urban centers.
