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### 74 Cards in this Set

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 difference between case-control and cohort study case-control: sample based on presence or absence of disease cohort: subjects followed over time to see who gets the disease describe meta-analysis pooling data from several studies to get greater statistical power 4 kinds of bias selection bias - nonrandom assignment recall bias - knowledge of d/o alters recall sampling bias - subjects not representative late-look bias - info obtained at inappropriate time 4 ways to reduce bias blind studies, placebo responses, crossover studies, randomization incidence x disease duration is approximately = prevalence high ___ for a screening test sensitivity high ____ for a confirmatory test specificity false negative rate = 1 - Sn false positive rate = 1 - Sp Sn vs. PPV Sn: number of TP divided by number of people with disease a/(a+c) PPV: number of TP divided by number of people who test (+) for disease a/(a+b) specificity vs NPV sp: number of true (-) divided by # of people who don't have the disease d/(b+d) NPV: number of true (-) divided by # of people who test (-) for the disease d/(c+d) OR used for ___ studies; RR used for ___ studies case-control; cohort How is OR calculated? ad/bc; number with disease divided by number w/o disease What does OR approximate if the prevalence of disease is not too high? RR How is RR calculated? a/(a+b) / c/(c+d); number with disease divided by number in group random error vs systematic error random: reduced precision systematic: reduced accuracy mean > median leads to ___ skew positive mean < median leads to ____ skew negative type I error to accept H1 when H0 is true; ie. stating there is an effect when none exists alpha type II error to fail to reject H0 when H0 is false; ie stating there is NO effect when an effect DOES exist beta probability of rejecting H0 when it is in fact false power what does power depend on? total number of end points, difference in compliance between treatment groups, size of expected effect SEM = sigma / sqrt n range of values in which a specified prob of means of repeated samples would be expected to fall confidence interval 3 types of disease prevention primary - prevent disease occurence secondary - early detection tertiary - reduce disability preventive measure for homeless, recent immigrant, or inmate TB test. reportable diseases B.A. S(3)M(2)ART Chicken or you're Gone: Hep B Hep A Salmonella Shigella Syphilis Measles Mumps AIDS Rubella TB Chickenpox Gonorrhea #1 leading causes of death in: infants 1-14 15-24 25-64 65+ infants: congenital anomalies 1-14: injuries 15-24: injuries 25-64: cancer 65+: heart disease informed consent requires: discussion of pertinent info (risks, benefits, alternatives) patient's agreement freedom from coercion 4 exceptions to informed consent - waiver - therapeutic privilege - not legally competent - implied consent (emergency) durable power of attorney pt designates surrogate to make decisions if pt loses decision-making capacity exceptions to confidentiality infectious diseases, Tarasoff decision, child and elder abuse, impaired auto drivers, homicidal/suicidal 3D's for malpractice dereliction (breach of duty), damage, direct Situation: a child wishes to know more about his illness. Ask what parents have told child. Parents of child decide what info can be given. APGAR appearance (color) pulse grimace (reflex irritability) activity (muscle tone) respiration holds head up, Moro reflex disappears, social smile 3 mo rolls front to back, sits when propped, recognizes people 4-5 mo Sits alone, crawls, stranger anxiety, orients to voice 7-9 mo upgoing Babinski disappears 12-14 mo walks, few words, separation anxiety 15 mo climbs stairs, stacks 3 blocks, object permanence 12-24 mos stacks 6 blocks, rapprochement 18-24 mos parallel play 24-48 mos core gender identity 24-36 mos stacks 9 blocks, toilet training 30-36 mos rides tricycle, copies lines or circle drawing, group play 3 years simple drawings (stick figure), hops on 1 foot, cooperative play, imaginery friends 4 years reads; understands death, development of conscience, same-sex friends, identification with same-sex parent 6-11 yrs abstract reasoning, formation of personality 11 yrs (girls), 13 yrs (boys) time period for normal bereavement 6 mos - 1 year Kubler-Ross denial, anger, bargaining, grieving, acceptance differential diagnosis of sexual dysfunction drugs (antihypertensives, neuroleptics, SSRI, ethanol) diseases (depression, diabetes) psychological (performance anxiety) BMI wt in kg / (ht in meters)^2 IQ < ___ for mental retardation 70 learning in which a natural response is conditioned classical conditioning learning in which a particular action occurs b/c of reward operant conditioning oedipus complex repressed sexual feelings of child for opposite-sex parent, accompanied by rivalry with same-sex parent guilty feelings alleviated by unsolicited generosity toward others altruism appreciating the amusing nature of an anxiety-provoking or adverse situation humor replacing unacceptable wish with wish that does not conflict with one's value system sublimation voluntary withholding of idea or feeling from conscious awareness suppression mature ego defenses SASH suppression altruism sublimation humor unacceptable feelings and thoughts are expressed through actions acting out temporary, drastic change in personality, memory, consciousness, or motor behavior to avoid emtional stress dissociation avoidance of awareness of some painful reality denial process whereby avoided ideas and feelings are transferred to some neutral person or object displacement partially remaining at a more childish level of development fixation modeling behavior after another person who is more powerful identification separation of feelings from ideas and evcents isolation an unacceptable internal impulse is atributed to external source projection proclaiming logical reaosns for actions actually performed for other reasons rationalization warded-off idea is replaced by opposite idea reaction formation going back to earlier modes of dealing with world regression involuntary withholding of idea or feeling repression