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70 Cards in this Set
- Front
- Back
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Upper extremities, lower back
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What part of the body is the most often hurt in the work environment?
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Bodily reaction, contact with equipment, falls
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What events/exposures are most often the cause of injury/illness in the work environment?
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Floors, worker motion and position, containers
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What source contributes the greatest toward workplace illness/injury?
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Sales and other service industry jobs
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What occupation has the highest stress/anxiety?
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Hearing loss caused by noise
IMPORTANT TO NOTE DURATION AND INTENSITY OF SOUND (rather than frequency) |
What is the second most commonly self reported occupational injury or illness?
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People don't use it (behavior)
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Why is personal protective equipment the least effective occupational protective mechanism?
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National Institute for Occupational Safety and Health (NIOSH)
National Center for Health Statistics (NCHS) Bureau of Labor Statistics (BLS) Occupational Safety and Health Administration (OSHA) Mine Safety and Health Administration (MSHA) |
US Agencies that Conduct Surveillance
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Occupational diseases often present like nonoccupational diseases; some may be related to occupation yet still due to a rare activity (ex mercury case study)
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Why is it difficult to establish the work relatedness of a disease?
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Outlining minimal conditions needed to establish a causal relationship between two items
Strength of association Consistency Specificity Temporality Dose-response Biologic plausiblity Coherence |
What are hills criteria for causation doing?
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Specificity
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What criteria for causation is the question " Are the symptoms and signs consistent with the diagnosis" assessing?
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Temporality
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What criteria for causation is the question " Did the exposure precede the disease" assessing?
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Consistency
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What criteria for causation is the question "Do fellow workers with similar exposure have similar problems" assessing?
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Biologic plausiblity
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What criteria for causation is the question "Is the condition biologically plausible and confirmed" assessing?
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Coherence
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What criteria for causation is the question "is epidemiologic evidence available to support a causal association?"
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Analytic Epi
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What branch of epidemiology is used to focus on the cause of diseases and test hypotheses.
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Descriptive Epi
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What branch of epidemiology is concerned with demographic distributions and developing hypotheses?
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Observational study; there is no researcher manipulation but just observation of a population over a period of time to see how outcomes might develop
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Which study design allows nature to take its course?
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Case-Control; Compares a group of people with the disease to a group without and asks WTF happened?
Case = people with disease Control = people without disease You compare the two with respect to exposures |
You have a group of people with lung cancer and a group without. You want to study each groups smoking exposure. What type of study design is this?
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They're good for rare diseases
You can study multiple exposures They're cheaper to do |
What are the PROS of case control studies?
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You can't calculate incidence (risk of developing a disease in a specified time)
Temporality may not be intact Prone to recall bias |
What are some CONs of case control studies?
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Odds ratio
Odd = ratio of probability of an event (disease) to the probability of a nonevent (no disease) Odds = P/P-1 |
What is the best statistic for case control studies?
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AD/BC
Prevalence of exposure in cases = A/A+C Prevalence of exposure in controls = B / B+D |
What is the formula for odds ratio?
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Case-Cohort
In a cohort study you start with the risk factors to see whether it increases the likelihood of disease. You ask what WILL happen? |
You have a group of patients who are smokers and a group of nonsmokers. You want to study what the relative risk of getting lung cancer is for smokers vs nonsmokers. What kind of study design is this?
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Relative Risk (RR)
'Smokers had a higher risk of developing lung cancer than did nonsmokers" |
What is the best statistic for cohort studies?
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Temporarlity is easier to establish; able to study multiple diseases; able to study rare exposures
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What are the PROS of cohort studies?
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Prospective = Expensive
Retrospective requires availability of good records People dropping out of study leads to a DECREASE in VALIDITY |
What are the CONs of cohort studies?
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Follow-up, incidence, and longitudinal
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What are some key words that indicate a cohort study?
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Cases, controls, match
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What are some key words that indicate a case-control study?
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Cross-sectional
Collects data from a group of people to assess frequency of disease (and related risk factors) at a particular point in time. Asks what IS happening? |
What type of disease is considered a "snapshot in time"?
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Prevalence Ratio/Disease Prevalence
It can show risk factor association with disease but does not establish causality |
What is the best statistic for cross sectional studies?
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Experimenter controls the population exposure!
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What is the design of a clinical trial?
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Causality can be inferred
Highest quality results if study is conducted properly |
What are the PROs of clinical trials?
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They are EXPENSIVE, TIME CONSUMING
and you might have people drop out which leads to a decrease in validity |
What are the CONs of clinical trials?
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Experiment, trial
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What key words can tip you off that they're talking about a clinical trial?
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RR, OR, Incidence Density (#cases/person-time)
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What are the best statistics for clinical trials?
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Null (Ho)
OR = 1 |
Which statistical hypothesis is the hypothesis of "no difference" - i.e. there is no association between the disease and the risk factor in the population
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Alternative (H1)
OR not equal to 1 |
Which statistical hypothesis is that there IS some difference (i.e. there is some association between the risk factor and disease)
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Interventional study
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In what kind of study does an investigator have control over the independent variable?
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Reject null hypothesis and conclude significance
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You get a P value less than alpha. Do you accept or reject the null hypothesis?
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You accept the null hypothesis and conclude insignificance
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You get a P value greater than alpha. Do you accept or reject the null hypothesis?
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P value will be less than .05 and the result is statistically significant
Does not include one |
You get a 95% confidence interval of 1.05-3.34. Is this statistically significant and what is the P value?
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The P value will be .01 or less and the result is statistically significant
Does not include one |
You get a 99% confidence interval of 1.05-3.34. Is this statistically significant and what is the P value?
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You reject the null hypothesis and conclude significance
Less than alpha = .05 |
Using a 95% confidence interval you get a P value of .023. Is this significant?
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You FAIL to reject the null hypothesis and conclude INSIGNIFICANCE.
Greater than alpha = .05 |
Using a 95% confidence interval you get a P value of .083. Is this significant?
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The result is NOT statistically significant
INCLUDES ONE |
Using a 95% confidence interval you get .80-3.34. Is this significant?
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Selection bias
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A group is assigned in a nonrandom manner. What kind of bias is this?
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Recall bias
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An individual in a study incorrectly recalls his exposure. What kind of bias is this?
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There is no association
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You have an odds ratio of 1. What does this say about the association?
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Strong association
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You have an odds ratio far from one. What does this say about the association?
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Retrospective Cohort Study
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You have a study in which both the exposure and outcome have already occured when the study is created. You start with the exposure and follow up with subjects. What kind of study design is this?
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Prospective Cohort Study
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You start with a group of exposed and a group of unexposed individuals. You follow them for a year to determine outcomes. What kind of study is this?
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Tasks of Adolescence
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Which developmental stage is this:
Begin separation fro mfamily Develop a self identity Develop a sexual identity Begin to depend on one's peers (rather than family) for support Start to formulate plans for a means of supporting oneself |
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Birth control, pregnance, STDs, sexual identity
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What are the physicians tasks during the adolescence stage?
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Young Adulthood
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What stage is this?
Forming meaningful and lasting relationships Adjusting to the partner's lifestyle and expectations Deciding on whether or when to have children Adapting to the families of origin of each member Career choices |
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Family planning, mental health, substance abuse, accidents
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What are the physicians tasks during the young adulthood stage?
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Middle Age
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What stage is this
Development of new challenges in career Adjustment to entrance/exit of family members (children leaving home) Impact of age related physical changes Divorce Menopause |
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Concerns for elderly patients, physiologic changes, substance, preventive health screenings, therapeutic lifestyle
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What is the physicians task during middle age?
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Issues in retirement
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What stage is this?
Increased time with partner Adjustment to change in life roles Adjustment to change in income level Increased risk of development of illness |
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Diet and exercise; functional disability; chronic illness; frailty; dependence; financial distress; social isolation; longterm needs
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What is the physicians task during retirement?
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Old Age
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What stage is this?
Adjustment to losses, loss of physical capabilities, changes in income, loss of functional reserves, loss of friends and family members |
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Infancy and Childhood
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What stage is this?
Accepting new members into the family system, form a parent tea, set limits of safety while promoting independence, meet personal parent needs |
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Financial, social, physical preparation for childrearing
Well baby care (immunizations, normal growth and development, safety, health concerns) |
What is the physician role in the infancy and childhood stage?
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Relative Risk (RR) for Cohort Studies
[a/(a+b)]/[c/(c+d)] Relative probability of getting a disease in the exposed group compared to the unexposed group |
What is the formula for relative risk and what type if study is it used for?
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The treated (or exposed!) group was 1.25 times as likely or 25% more likely to improve than the untreated group.
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Interpret this: A cohort study demonstrated a RR = 1.25.
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a/b / c/d
Odds of having disease in exposed group/ odds of having the disease in unexposed group |
What is the formula for odds ratio and what type of study is it used for?
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Prevalence in the exposed/prevalence in the nonexposed
PR = A / (A+B) / C / (C+D) |
What is the prevalence ratio?
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Odds of exposure in the cases divided by the odds of exposure in the controls
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What is the exposure odds ratio?
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A cross sectional study that is repeated several times with the same panel of individuals.
It's ideal for chronic diseases |
What is a panel study?
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An ethical concern arises when the investigator believes one arm of the trial to be more beneficial than the other. Clinical equipose means that there is a genuine UNCERTAINTY about the benefits or harm that may result from different exposures or interventions. It is a required component for clinical studies.
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What is clinical equipoise?
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Subjects modify their behavior simply in response to the fact that they're being studied
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What is the Hawthorne effect?
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