midterm study materials
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| Public Health | The totality of all evidence-based public and private efforts that preserve and promote health and prevent disease, disability, and death
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| Public Health Changes over Time | Now is the “Era of Population health”.
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| Events Germ Theory has led to: | Scientists were able to diagnose TB through skin testing, bacterial culture, and chest X-rays. Concepts of vaccination advanced. Antibiotics and other effective cures come about.
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| Germ Theory of Disease | The demonstration of infectious origins of disease
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| Health protection | Quarantine for epidemics; sexual prohibitions to reduce disease transmission; dietary restrictions to reduce food-borne disease
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| Hygiene movement (1840-1870’s) | Snow on Cholera; Semmelweis and puerperal fever; collection of viral statistics as empirical foundation for public health and epidemiology
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| Contagion control (1880-1940’s) | Linkage of epidemiology, bacteriology, and immunology to form TB sanatoriums; outbreak investigation, e.g., Goldberger and pellagra
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| Filling holes in the medical care system (1950’s-1980’s) | Antibiotics; randomized clinical trials; concept of risk factors; Surgeon General reports on cigarette smoking;
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| Health promotion/ Disease prevention (Mid 1980’s-2000) | AIDS epidemic and need for multiple interventions to reduce risk; reductions in coronary heart disease through multiple interventions
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| Population health (21st Century) | Evidence-based medicine and public health; information technology; medical errors; antibiotic resistance; global collaboration, e.g., SARS, tobacco control, climate change
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| High Risk approach | focuses on those with the highest probability of developing the disease and aims to bring their risk close to the levels experienced by the rest of the population
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| Improving the Average approach | focuses on the entire population and aims to reduce the risk for everyone
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| Determinants of Disease | Behavior
Infection
Genetics
Geography
Environment
Medical care
Socio-economic-cultural
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| P.E.R.I framework | types of info to describe evidence based public health approach. Drawn as Problem --> Etiology-->Recommendations--> Implementation--> Problem
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| PERI | Problem
Etiology
Recommendations
Implementation
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| Incidence rate | Measure chances of developing a disease over a period of time, generally one year. Calculated as Incidence rate = # of new cases of a disease in a year/ # of people in the at-risk population
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| Prevalance rate | the proportion of individuals who have the disease. # living with a particular disease/ # in the at-risk population
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| Case Fatality rates | estimates the chances of dying from a disease once it is diagnosed. (mortality/ incidence)
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| 3 Requirements to establish contributary clause | 1) The cause is associated with the effect at the individual level
2) The cause precedes the effect
3) Altering the cause alters the effect
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| Case Control Study | Establishes "the cause is associated with the effect".
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| Cohort Studies | Establish "the cause precedes the effect".
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| Randomized Clinical Trials | Establish "Altering the cause alters the effect".
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| Hills Criteria for Causation | 1) Strength of relationship
2) Dose-response relationship
3) Consistency of the relationship
4) Biological plausibility
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| Recommendation scores | A= Must
B= Should
C= May
D= Don't
I= Indeterminent, insufficient or I don't know
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| Primary Intervention | Prior to disease
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| Secondary Intervention | Prior to symptoms
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| Tertiary Intervention | Prior to irreversible complications
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