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242 Cards in this Set
- Front
- Back
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Four governmental levels of community dental health? |
-international -federal -state -local |
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International Level of community health |
-coordinates programs for underdeveloped nations and gathers epidemiological data for comparison across nations -develops means to summarize treatment needs of international population utilizing minimal equipment (ex. community periodontal index of treatment needs CPITN) |
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World health organization (WHO) is a prime example of |
international level |
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Federal level of community dental health |
-acts on oral health problems of national significance |
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What level of community dental health is primarily within the jurisdiction of the department of health and human services (DHHS) |
federal |
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who published Health People 2010 |
Department of public health (DHHS) |
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Examples of federal agencies involved with community health issues: |
-Centers for disease control (CDC) -Health resources and services administrations (HRSA) -national institute of health (NIH) -national institute of dental and craniofacial research (NIDCR) -agency for healthcare research and quality (AHRQ) |
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State level of community health |
-provides consultation services to local health departments -directly administers some programs (especially statewide programs) |
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Where is the CDC located |
Atlanta, Georgia |
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Local (county) level of community dental |
-directly administers county and city programs -initiates dental health legislative measures (fluoridation) |
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Epidemiology |
-refers to the study of health and disease in populations
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epidemiology requires that disease be measures ______ |
quantitatively ex: graphs |
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quantitative data |
information that can be counted or expressed numerically and is often collected in experiments, manipulated and statistically analyzed -represented visually in graphs and charts |
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epidemiologic studies usually report findings in terms of either _____ or _____ of disease |
prevalence or incidence |
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Prevalence |
usually refers to the estimated population of people who are managing a disease at any given time |
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Incidence
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refers to the anual diagnosis rate or the number of new cases of a particular disease diagnosed each year
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True/False: A short lived disease like flu can have high annual incidence but low prevalence while a life long disease like diabetes has a low annual incidence but high prevalence |
True |
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What does epidemiology examine? |
-effects of host factors (age, gender, race, immunity) -biological causes (bacteria, virus, fungus) -physical environment (sun exposure, industrial pollutants, radiation) -lifestyle considerations on health(socioeconomic status, drug/alcohol consumptions, diet) |
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Know this epidemiology list: C.U.M.I.T.P
Sorry terrible card but its bolded!
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-Collecting data to describe normal biological processes -Understanding the natural history of a disease process -Measuring the distribution of a disease in a given population -Identifying determinants of disease -Testing hypotheses for prevention and control of a disease through studies -Planning and evaluating health care services |
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Epdiemic |
an unexpectedly large number of cases of disease in a particular population at a particular place and time (Ex. meningitis outbreak among senior high school students enrolled at Borah high school during fall quarter 2010) |
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Endemic |
a disease that occurs regularly in a population as a matter of course (Ex. hay fever during spring) |
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Pandemic |
an outbreak of disease over a wide geographical area; often worldwide (Ex. worldwide swine flu scare) |
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Types of research methods |
-descriptive studies -experimental -Analytical |
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Descriptive Studeies |
-designed to describe the extent of disease or condition within a population and its relationship -Determines who is getting the disease and where and when the disease is occurring |
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What research method deals with the who, what, when |
descriptive |
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Experimental studies |
tests hypotheses to establish cause |
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hypothesis |
suggested explanation of a phenomenon |
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null hypothesis |
-hypothesis which a researcher tries to disprove or nullify -referred to as "H0" |
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alternative hypothesis |
-alternate way to explain the phenomenon -referred to as "H1" |
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H0 or H1: Daily flossing decreases interproximal caries rates |
H1(alternative hypothesis) |
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H1 or H0: Daily flossing does not lower interproximal caries rates |
H0 (null hypothesis) |
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What type of research method is carried out under controlled situations (ex. in labratory) |
experimental |
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What research method uses control groups and treatment groups
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experimental
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control groups |
experimental treatment is withheld; test subjects receive placebo |
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treatment groups |
receives experimental treatment |
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what research method involves blindness/ double blindness |
epxerimental |
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blindness |
researcher is unaware of wheather test subject is in the control or treatment group during the study; helps prevent bias |
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double blinded |
-neither researcher nor subject knows who is receiving experimental treatment -best way to prevent bias |
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best way to prevent bias |
double blinded |
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analytical studies |
aimed at testing hypotheses |
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three main types of analytical studies |
-retrospective (case control) -prospective -longitudinal study |
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Retrospective studey |
-"case control" -examines whether a past association exists between an exposure of interest and development of a present condition
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Prospective study |
-study in which subjects are observed and data is collected over time to determine if a disease or condition develops
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Ingestion of lead containing paint and subsequent development of learning disabilities is an example of what type of analytical study |
retrospective (case control) |
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Caries rates of children who live in non fluoridated areas over a period of ten years is an example of what type of analytical study |
prospective study |
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Longitudinal study |
group is studied over an extended period of time -refers to ANY type of study that is long term |
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A retrospective or prospective study can also be considered ______ if the study is conducted over a long period of time |
longitudinal |
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Research samples |
representation portion of the population |
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Random sample |
every element in the population has an equal chance of being selected and reduces the chance of bias
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what type of research sample: pick names out of a phone book |
random |
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stratified sample |
-selecting an element according to certain subgroups -accomplished by selecting a proportionate number of participants from each subgroup for the sample |
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what type of research sample: identify all of the dental hygiene schools attending the board review and select two members from each school |
stratified sample |
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systematic sample |
select every "nth" to participate -group by #'s |
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What type of research sample: count off by 6 then form groups based on like numbers |
systematic sample |
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judgment sample |
-someone familiar with the population selects the sample -high chance of bias |
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Convenience sample |
sample group is chosen bases solely on convenience |
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What type of research sample: the first 10 people to walk through the door today were asked to fill out a questionnaire |
convenience |
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Variables |
what is being observed or measured |
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outcome of interest |
dependent variable |
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what variable should change in response to some intervention |
dependent variable |
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what type of variable is the intervention |
independent variable |
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what variable is manipulated to produce a response in the other variable |
independent (other variable is the dependent) |
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what are the two types of statistics |
-descriptive -inferential |
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data matrix |
arranges data scores from lowest to highest measures
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frequency of distribution |
measures how often each schore occurs |
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what are the three main methods to group scores? |
-ungrouped -cumulative -grouped |
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Ungrouped scores |
data is presented in ascending or descending order along with the frequency of each score |
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Cumulative scores |
frequency of occurrence of scores up to and including any given value in the data set |
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grouped scores |
grouping variables into consecutive intervals |
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Measures of central tendency |
frequency of distribution is plotted out on an x-y graph resulting in a pictorial representation of the data |
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what are the three measures that describe the central tendency of a distribution of scores: |
-mean -median -mode |
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the arithmetic average of scores |
mean |
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most common measure of central tendency |
mean |
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what type of measurement is sensitive to extreme values |
mean |
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what type of measurement of central tendencies is found by adding all the scores together and then divide by the number of scores |
mean |
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divides the distribution of scores into two equal parts |
median |
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True of False: 50% of scores will be above the median and 50% of the scores will be below |
True |
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True or False: median is affected by extreme high or low scores |
False |
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What is calculated by placing scores in a data matrix and locate the midpoint |
median |
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The most frequently occurring score within the data matrix |
mode |
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What type of measure of central tendency affects the skew of the graph |
mode |
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what type of measure of central tendency is calculated by using an ungrouped tally system you identitfy the score that occurs most often |
mode |
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When data is plotted using a normal curve the mean, median and mode are _____ |
equal |
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another name for a _____ curve is also known as a bell or gaussian curve that represents plotted data that are equally distributed around the mean median and mdoe |
normal |
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measures of dispersion |
describes how wide the scores are around a central point |
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in a normal cure the central point would be the ____, _____, and _____
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mean, median, and mode
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range |
the difference between the high and low score of a data matrix |
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True/False: the range is affected by extremely high or low scores |
True |
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Standard deviation |
represents the square root of the sample variance |
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The most commonly used method of dispersion in oral hygiene research and refelects the range of scores within the data matrix |
standard deviation |
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the bigger the range or standard deviation the ____ the distribution curve |
wider |
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True/False: the measure of any given standard deviation is variable and represents a measure that corresponds to calculation based on the data being analyzed |
True |
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When a graphed data demonstates and asymmetrical appearance (not like a symmetrical bell curve) it is said to be |
skewed |
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positive skew |
when more scores fall in the lower rance |
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If everyone in your head and neck anatomy class received a score of 65% or lower on a quiz except for Susie who scored a 98% the data would demonstrate a _____ skew |
postive |
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Negative skew |
when more scores fall in the higher range |
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23 of the 26 senior dental hygiene students participate in the friday night study club at clark college. club members outscored non club member on the community dental health final examination by and average of 21%. when graphed the scores would demonstrate a ____ skew |
negative |
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allows one to generalize findings from the sample study to a larger pupulation |
inferential statistics |
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the hopewood house study found that orphans living in an Austrailian facility where their diet consisted primarily of vegetables with little or no dietary sucrose had substantially fewer caries that individuals on non restricted sucrose diets. the conclusion of the study suggested a strong correlation between diet and dental caries incidence. This is an example of what type of statistic? |
inferential statistics |
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Valididty |
degree that a study or procedure can be conclusive yet sufficiently realistic |
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"does the test measure what it claims to be measuring?"
question of what? |
valididty |
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reliability |
extent to which the method of measurement consistently performs |
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intraexaminer reliability |
consistent performance by the same evaluator |
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interexaminer reliability |
-consistent performance between different examiners
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what type of examiner reliability decreases bias
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interexaminer
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what type of examiner reliability increases with calibration |
interexaminer |
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sensitivity |
the ability of a test to correctly identify the presence
diagnoses
-think of a pregnancy test being really sensitive at detecting pregnancy |
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specificity |
the ability of a test to identify the absence of disease
rules out disease |
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Correlation Co-efficient |
-determines the strength of relationship between two variables -shows probable cause and effect |
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What is given as a number between +1 and -1 |
correlation co-efficient |
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True or False: the closer the correlation co-efficient is to either +1 or -1 the stronger the correlation |
true |
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positive correlation |
as the value of x increases, the value of y increases
as the value of decreases the the value of y decreases |
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positive or negative correlation: the more garlic you eat, the more halitosis you will have |
positive |
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negative correlation |
as the value of x increases, the value of y decreases
as the value of x decreases the value of y increases |
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positive or negative correlation: the more you brush your tongue the less halitosis you will have |
negative |
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statistical measure used to test the hypothetical difference between two mean scores |
t-test |
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used when comparing the statistical difference between three or more mean scores |
ANOVA (analysis of variance) |
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refers to the probability that a condition or circumstance would happen just by chance without experimental intervention and is used when testing hypothesis |
p-value (probability value) |
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True/false: standard of acceptability is 1 out of 20 or a p-value of less than or equal to 0.05 |
true |
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True/false: a p-value greater than 0.05 will affect the student results |
True |
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what type of preventative therapies is designed to prevent, reverse or arrest a disease process |
primary |
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mechanical plaque removal, dietary restriction of sucrose and fluoride treatments are all example of what type of preventative therapy |
primary |
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treating or controlling a disease or condition after it occurs |
secondary service |
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involves replacing lost tissues in order to rehabilitate oral structures |
tertiary |
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periodontal therapy and some restorative procedures (composite restorations and crowns) |
secondary |
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involves replacing lost tissues in order to rehabilitate oral structures |
tertiary |
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what type of prevention include implants and bridges |
tertiary |
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Characteristics of an ideal index |
-Simple -valid -reliable -clear -sensitive -quantifiable -objective -accepted
S-slutty V-vaginas R-are C-covered S-smothered Q-queefs O-on A-a$$holes |
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What category of indices measures conditions that can be resolved or reversed |
reversible |
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gingivitis indices are examples of |
reversible |
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what type of indices measures cumulative conditions that connot be resolved |
irreversible |
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caries and periodontal disease indices are examples of |
irreversible |
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what indices measures the presence or absence of a disease
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simple
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what type of indices measures all the evidence of a condition (both past and present)
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cumulative
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DMFT/DMFS |
-decayed, missing filled teeth/decayed, missing, filled surfaces -irreversible -measures past and present caries experience in populations with adult dentitions |
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deft |
-decayed, need for extraction, filled teeth -irreversible -measures observable caries experience in deciduous teeth |
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does deft take into account teeth that have been extracted or exfoliated due to past caries experience |
no |
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dft/dfs |
-decayed, filled teeth/decayed, filled surfaces -irreversible -measures observable caries experience in deciduous teeth
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RCI |
-root caries index -irreversible -requires recession |
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What index requires recession |
RCI (root caries index) |
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CAMBRA |
-caries management by risk assessment -encompasses a methodology of identifying the cause of disease through the assessment of risk factors for each individual patient and then managing those risk factors through behavioral, chemical, and minimally invasive procedures |
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how does CAMBRA manage risk factors for caries? |
-behavioral -chemical -minimally invasive procedure
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What form is used in the risk assessment in CAMBRA |
Caries risk assessment form |
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Even though there are several forms of the caries risk assessment form what is the most well known |
California Dental Associations (CDA)
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The California dental associations form for caries risk assessment lists how many factors that doctors can use to evaluate patients level of caries risk |
24 |
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True or False: there is a separate form for pediatric patients that adapt factors into a format for parental questioning and clinical examination |
True |
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CAMBRA results of assessment form helps the dental team divide patients into categories (low, moderate, high, or extreme risk) which allows them to make informed recommendations for helping each patient ______________________. |
prevent caries and manage existing issues |
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Common gingivitus indices |
-GI (gingival index) -SBI (sulcular bleeding index) |
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GI |
-gingival index -reversible -based on severity versus extent of inflammation -can be used in individuals or study participants |
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SBI |
-sulcular bleeding index -reversible -detects early signs of gingivitus
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which gingival index is useful in short term trials |
SBI (sulcular bleeding index) |
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periodontal indice that is both irreversible and reversible because it measures ginigvitis and periodontitis separately |
PDI (periodontal disease index)
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what periodontal indices was developed by Ramfjord? |
PDI (periodontal disease index) |
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what perio indices was developed by Russel? |
PI (Periodontal index) |
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What indices looks at the surrounding tissues and is questionable for validity (no Calibration) = limitations |
PI (periodontal index) |
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What perio indices rapidly assesses periodontal health |
PSR (periodontal screening and recording) |
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what perio indices requires a special probe |
PSR (periodontal screening and recording)
CPITN (community periodontal index of treatment needs) |
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what perio indices useful as a preliminary screening technique and for use in large populations |
PSR (periodontal screening and recording) |
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What perio indices was developed by WHO |
CPITN (community periodontal index of treatment needs) |
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what perio indices determines perio needs versus perio status
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CPITN (community periodontal index of treatment needs)
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What oral hygiene indices measures oral hygiene status by assessing sub and supra gingival plaque and calculus and is reversible |
OHI-S (simplified oral hygiene index) |
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what oral hygiene indicies is better for group versus individual assessment |
OHI-S (simplified oral hygiene index) |
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what indices is reversible and used in conjunction with the gingival index |
PlI (plaque index) |
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what indices scores plaque according to its thickness at the gingival margin |
plI (plaque index) |
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what indices is reversible and measures plaque after toothbrushing (assesses patients skill) |
PHP (patient hygiene performance) |
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What indices is reversible and is used to test agents for plaque control and calculus inhibition; measures supragingival calculus formation following prohpylaxis |
VMI ( volpe-manhold index) |
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What is the first step in planning a community program? |
conduct a needs assessment |
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process by which the planner identifies gaps between what is and what ought to be |
needs assessment |
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the needs assessment depends on recognizing and understanding the ________ that will benefit the program |
target population |
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what are the reasons for a needs assessment |
-collects baseline data!!!! -defines extent and severity of problem -identifies causes of problem -provides a profile of the community |
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Ways to conduct needs assessment: |
-direct observation -interview -questionnaire -survery -epidemiological surveys -records, documents, charts
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time consuming, not cost effective, requires manpower) (way to conducts needs assessment) |
direct observation |
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not time or cost effective, not recommended for large groups (way to conducts needs assessment) |
interview |
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GOOD choice for large population; must be well written and easy to understand for target population (way to conducts needs assessment) |
questionnaire |
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BEST choice for large groups; must be well written and understandable (way to conducts needs assessment) |
survey |
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research based (way to conducts needs assessment) |
epidemiological surveys |
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access dependent; time consuming (way to conducts needs assessment) |
records, documents, charts |
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Most common risk factor for disease |
socio-economic status |
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What are the access to care issues? |
-need -demand -utilization -barriers |
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type of care available (Access to care issue) |
need
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one dental office accepting Medicaid patients in a town of 65,000 is an example of what access to care issue |
need |
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type of care desired (Access to care issue) |
demand |
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whitening versus restorative procedures is and example of what access to care issue |
demand |
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actual use of services available by the public (Access to care issue) |
utilization |
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obstacles which interfere with care to be provided or received (Access to care issue) |
barriers |
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lack of financial funding for low cost dental services is an example of access to care issue |
barriers |
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what are the two ways to observe needs |
-through the eyes of the planner -through the eyes of the target population |
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the real needs based on health issues (objective) is the way the ______ observes needs |
planner |
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the perceived needs or wants (opinion/subjective) is the way the ________ observes needs |
target population |
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the study participants want whitening versus restorative procedures is an example of the way the ________ observe needs |
target population |
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Comprehensive examination using mouth mirror, explorer, lighting, radiographs, study models, and any other diagnostic tests that may be warranted |
Type I |
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which examination method is not practical for most community program due to cost, time constraints and equipment needs |
Type I |
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Limited examination including mouth mirror, explorer, lighting and limited radiographs |
Type II |
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Which examination methods access to radiology equipment limits use in community programs |
Type II |
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examination using mouth mirror and lighting only |
Type III |
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examniation using tongue depressor and lighting only |
Type IV |
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Gathers info about the target population and is generally included in the needs assessment |
Population profile |
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Information included in the public profile |
-number of individuals who will be part of the program -geographical distribution of the target population -rate of growth in the community -degree of urbanization -ethinic and language profile -nutritional status -standard of living -amount and type of community services and utilities (including public transportation) available -profile of school system (public vs. private) -general health profile (including drug abuse patterns |
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planning a community program is a systematic approach involving what 5 components? |
-Collection of preliminary information -establishment of priorities -determine goals and objectives -consulting and coordination activities -drafting a plan
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Collection of preliminary information when planning a community program (2 components) |
-attitudes toward oral health issues by community leader (includes politicians, educators, school superintendents) -funding and resources |
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What are the 5 main funding/resources for community programs |
-medicare -medicaid -COBRA -Block grants -Line item grants |
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Health insurance for elderly and disabled |
medicare |
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health insurance for the poor |
medicaid |
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both medicare and medicaid were created by the |
social security act of 1965 |
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COBRA |
-consolidated omnibus budget reconciliation act of 1985 |
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requires most employers with group health plans to offer employees the opportunity to continue temporarily their group health care coverage under their employer's plan if their coverage otherwise would cease due to termination, layoff or other change in employment status |
COBRA (consolidated omnibus budget reconciliation act) |
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lump sum of money given to a group to use at their discretion to meet a need |
block grants |
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funding resource that specifies where monies are to go to |
line item grant |
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What step of planning a community program involves ranking the problems of the needs of the target population |
establish priorities |
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broad based statement of desired outcome of a program |
goals |
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dental hygiene students are working to achieve their goal of becoming a registered dental hygienist is an example of a |
goal |
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specific statements describing the steps that must be taken to achieve the overall goal |
objectives |
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Goal or objective: must be measurable |
objective |
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what steps need to be taken when consulting and coordinating activities when planning a community program? |
-secure an appropriate facility where the program will be carried out (obtain permission for use) -make sure the necessary manpower is in place (supervising dentist, volunteers, clinicians) -cooridinate plan of action between those involved with the program (paperwork needs,clinical set ups, length of work shifts) |
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What is the objective of drafting the plan for a community program? |
develop a lesson plan and implementation strategy
preferably one that has been successful in the past. |
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what things do you need to consider when implementing a community program? |
-motivation -stages of learning -principles of teaching |
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promise of reward |
external motivation |
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change as a result of self awareness; better predictor of behavior change |
internal motivation |
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learning only progresses as far as the learner wants and proceeds more rapidly if what is being taught has ______ to the target audience |
value |
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True/False: you should not teach the way skills are to be used
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false
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when teaching you need to identify the learners needs and establish _____ and ______. |
goals and objectives |
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design learning strategies based on _____ |
objectives |
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Evaluation needs to be _____ |
ongoing |
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what type of information delivery involves lecture, demonstration, discussion, ect. |
foraml delivery |
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what type of information delivery involves brochures, pamphlets, billboards, video, etc? |
informal delivery |
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what are the stages of learning? |
-Unawareness -awareness -self interest -involvement -action -habit
ugly apes sit in a hut |
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the learner has incomplete or inaccurate information |
unawareness |
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correct information is obtained but it does not have personal meaning for the learner |
awareness |
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learner personlizes information |
self-interest |
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old ideas are replaced by new ones; learner is motivated to act |
involvement |
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the learner tests new concepts based on perceived needs |
action |
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the learner begins to experience gratification and self satisfaction; it is at this stage that behavior is modified. |
habit |
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what part of the community program provides information for future program revisions and analyses where or not goals and objectives were met |
evaluation |
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formal evaluation |
pre and post tests |
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informal evaluation |
questioning audience during presentation |
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in order to conduct an evaluation after a program has been implemented, it is necessay to have the _____ from the needs assessment to determine the groups progress |
baseline data |
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what items are evaluated? |
-effectiveness and efficiency of the program -appropriateness of the program for target audience -educational and instructional materials -organization/planning of the program -behaviors and attitudes of learners and administators |
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outcome evaluation; measures impact of program/ teacher |
summative |
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a comprehensive final exam is an example of what kind of evaluation |
summative |
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conducted druing the program; making sure audience is engaged |
formative |
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asking learners if they understand a concept before moving on to another topic is an example of what kind of evaluation |
formative |
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if it is apparent that the audience is not responding to the teaching activity a _____ evaluation allows the teacher to make the necessary adjustments |
formative |
