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  • 14:10, 22 November 2022 Nikolas talk contribs created page 19. Primary and secondary factors of epidemic process (virulence, source of infection, means of transmission, susceptible host) (Created page with "Basics of infectious disease * Terminology ** Colonization = an organism is replicating in a host but causes no disease ** Sporadic case = case not connected to other cases ** Outbreak = a greater-than-expected number of cases *** Endemic = high occurence of a disease within a given geographical area or population **** Example: Malaria is endemic to sub-Saharan Africa *** Epidemic = outbreak of a disease within a region in a country, or multiple countries **** COVID-19...") Tag: Visual edit
  • 14:09, 22 November 2022 Nikolas talk contribs created page 18. Molecular basics of carcinogenesis (Created page with "* DNA damage to normal cell -> mutations in genome -> altered gene product -> Tumor suppressors ↓ or oncogenes ↑ * Protective mechanisms against carcinogenesis ** DNA repair enzymes ** Tumor suppressors * Characteristics of cancer cells ** Inhibition of apoptosis + lack of response to inhibitory factors -> capable of self-maintained replication, long survival ** Mutagenic agents/defective DNA repair -> genetic instability -> more mutations ** Capable of angiogenesis...") Tag: Visual edit
  • 14:09, 22 November 2022 Nikolas talk contribs created page 17. Genomics and epigenetics in public health. Nutrigenomics (Created page with "* Most diseases with a genetic component can not be traced back to a single gene but rather multiple ** Exceptions: Cystic fibrosis, Huntington disease * Genomics = the interactions of all genes and their combined influence on the organism ** Genetics = the study of heredity. The effect of single gene mutations on the organism * Genomics in public health – Using genome-based discoveries for health benefits of the population * Genomics are important in ** Determining wh...") Tag: Visual edit
  • 14:08, 22 November 2022 Nikolas talk contribs created page 16. Interaction of environmental and genetical factors in disease development (Created page with "* Most diseases are due to a combination of genetic and environmental factors * We cannot change the genetic factors but we can change environmental factors * Certain genes can increase the risk of disease after exposure to certain environmental factors ** Exposure + susceptible genotype -> high risk ** Exposure + not susceptible genotype -> moderate risk ** No exposure + susceptible genotype -> low risk ** No exposure + not susceptible genotype -> low risk * Gene-enviro...") Tag: Visual edit
  • 14:07, 22 November 2022 Nikolas talk contribs created page 15. Genetically modified organisms (Created page with "Genetically modified organisms – GMO * Definition: An organism whose genetic material has been altered using genetic engineering techniques ** Not necessarily with advanced machines and stuff ** Selective breeding is also a form of GMO * Genes can have been transferred within the same species, across different species and even across biological kingdoms. * New genes can be introduced, or endogenous genes can be enhanced, altered or disabled * Examples ** Spider goat *...") Tag: Visual edit
  • 14:07, 22 November 2022 Nikolas talk contribs created page 14. Chemoprevention (Created page with "* Chemoprevention refers to the use of natural compounds to try to reduce the risk of or delay the development or recurrence of cancer * However, some chemopreventative agents turned out to be carcinogenic ** Vitamin E supplements actually increase the risk for prostate cancer ** Beta-carotene supplement increases the risk of lung cancer in smokers * Recent research has determined several potentially chemopreventative natural compounds * See also topic 2 Potentially che...") Tag: Visual edit
  • 14:06, 22 November 2022 Nikolas talk contribs created page 13. Food safety, food safety testing (Created page with "Food safety * Definition: The scientific discipline describing handling, preparation and storage of food in ways that prevent food-borne illness * Five key principles of food hygiene (according to WHO) *# Prevent contaminating food with pathogens *# Separate raw and cooked foods *# Cook foods for appropriate length of time and at appropriate temperature to kill pathogens *# Store food at the proper temperature *# Use safe water and safe raw materials * Food-borne illnes...") Tag: Visual edit
  • 14:06, 22 November 2022 Nikolas talk contribs created page 12. Food additives (Created page with "* Definition: Substances added to food to preserve flavour or enhance its taste, appearance or other qualities * Examples: ** Preserving foods with vinegar or salting ** Sweetening foods ** Adding taste enhancers like monosodium glutamate (MSG) – enhances umami taste ** Adding antioxidants to prevent oxidation of the food ** Adding nitrites to preserve the food longer ** Adding sulphur dioxide to wine to preserve it * All food additives in Europe have a unique “E nu...") Tag: Visual edit
  • 14:04, 22 November 2022 Nikolas talk contribs created page 11. Dietary supplements and functional foods (Created page with "Dietary supplementation * Definition: A manufactured product intended to supplement the diet when taken by mouth as a pill, capsule, tablet or liquid * Can provide natural or synthetic nutrients * $37 billion industry in 2015 * 50% of Americans take dietary supplements * Common types ** Multivitamins ** Sport nutrition supplements ** Calcium ** B-vitamins ** Vitamin C ** Glucosamine ** Fish oil ** Collagen ** Ginseng ** Glucosamine ** Probiotic ** Folic acid * Medically...") Tag: Visual edit
  • 14:02, 22 November 2022 Nikolas talk contribs created page 10. Epidemiology of obesity (Created page with "Obesity * Epidemiology ** Worldwide obesity has more than doubled since 1980 ** In 2014 more than 1.9 billion (39%) adults were overweight. 600 million (13%) were obese ** North Africa, the Middle East and Latin America are almost as overweight as Europe ** Obesity is growing in the developing world. Here the number of overweight adults has more than tripled since 1980 ** In Europe *** Romania, Italy least obese *** Hungary, Great Britain most obese * Definition of obes...") Tag: Visual edit
  • 14:02, 22 November 2022 Nikolas talk contribs created page File:Types of obesity.png
  • 14:02, 22 November 2022 Nikolas talk contribs uploaded File:Types of obesity.png
  • 14:00, 22 November 2022 Nikolas talk contribs created page 9. Assessment of nutritional status, nutritional screening (Created page with "Tools in the assessment of nutritional status – anthropometric measurements * Anthropometry ** = measurement of height, weight, and proportions of a person ** Especially used in infants, children, pregnant ** Advantages of anthropometry *** High specificity, high sensitivity *** Many variables are acquired and measured *** Data can be graded on charts and compared to healthy subjects ** Disadvantages of anthropometry *** Difference in measurements depending on the obs...") Tag: Visual edit
  • 14:00, 22 November 2022 Nikolas talk contribs created page 8. Special nutritional considerations: trendy diets (Created page with "Palaeolithic diet (paleo diet) * Tries to replicate the diet of hunters and gatherers during the stone age ** Assumes that people in the stone age didn’t consume starchy carbohydrates like potatoes and grains ** Based on the premise that human genetics haven’t adapted to the change in agriculture, and so a diet similar to the cavemen is best *** However, recent studies have shown that genetics can and have changed in response to changes in agriculture *** Recent stu...") Tag: Visual edit
  • 13:59, 22 November 2022 Nikolas talk contribs created page 7. Special nutritional considerations: Mediterranean diet, DASH- (Dietary Approaches to Stop Hypertension) diet (Created page with "Mediterranean diet * Based of food patterns typical of Greece, Crete and southern Italy * Not only a diet, rather a lifestyle ** Contains regular physical activity and enjoying meals with families and friends * Lower rates of multiple conditions in the region, which can be attributed to the diet ** Obesity ** Diabetes mellitus type 2 ** Cancer * Characterised by ** Abundant plant foods (fruits, vegetables, breads, cereals, potatoes, beans, nuts, seeds) ** Olive oil as t...") Tag: Visual edit
  • 13:58, 22 November 2022 Nikolas talk contribs created page 6. Special nutritional considerations: vegetarianism (Created page with "Vegetarian diet * No meat, poultry, fish or other seafood is consumed * Animal products like milk and eggs can be consumed * Not all plant products contain all essential nutrients. Thus, a vegetarian diet must be well-planned to meet the daily recommended intake of all nutrients * The vegetarian diet contains more than enough of ** Vitamins B, E, C ** Minerals ** Dietary fibre ** Unsaturated fatty acids ** Carbohydrates ** Plant sterols * The vegetarian diet often bring...") Tag: Visual edit
  • 13:58, 22 November 2022 Nikolas talk contribs created page 5. Dietary guidelines (Created page with "General dietary guidelines (according to the 2015-2020 American dietary guidelines) * Increased intake of whole grain, vegetables and fruits ** Decreases weight gain * Reduced intake of sugar-sweetened beverages ** These are a large source of calories while containing few essential nutrients * Increased intake of 100% fruit juice * Decrease alcohol intake ** Alcohol intake is associated with weight gain, cancer and liver disease * Decrease total number of calories consu...") Tag: Visual edit
  • 13:57, 22 November 2022 Nikolas talk contribs created page 4. Epidemiology of malnutrition and nutritional deficiencies (Created page with "* Micronutrient deficiency is widespread in developing countries, affecting 2 billion people worldwide * Deficiency affects the most vulnerable groups most commonly * Most common deficiencies ** Iron ** Vitamin A ** Iodine * Malnutrition = inadequate or excess intake of a nutrient, leading to infections and disorders * Underweight malnutrition – large problem in the developing world ** Affects mainly children and women ** Malnutrition increases risk for children to die...") Tag: Visual edit
  • 13:57, 22 November 2022 Nikolas talk contribs created page 3. Principles of healthy diet (Created page with "Component of diet * Nutrients ** Macronutrients *** Lipids *** Proteins *** Carbohydrates ** Micronutrients *** Vitamins *** Minerals * Dietary fibre * Bioactive components ** Alkaloids ** Flavonoids ** Carotenoids * Food additives ** Spices ** Preservatives ** Colouring ** Sweeteners ** Thickeners ** Stabilizing agents Macronutrients * Proteins should be 12 – 15% of the total calorie intake * Carbohydrates should be 55 – 60% of the total calorie intake * Fat shou...") Tag: Visual edit
  • 13:56, 22 November 2022 Nikolas talk contribs created page 2. Role of nutrition in prevention of cancers (Created page with "* 35% of cancer cases are related to nutrition * 30% of cancer cases are related to smoking * 10% of cancer cases are related to infecitons * Nutrition is the most important behavioural risk factor for cancer – more than smoking, infections β-carotene supplementation and cancer: * β-carotene can be either an antioxidant or a pro-oxidant, depending on these factors ** Concentration ** Presence of other pro-oxidant or antioxidant compounds ** Oxygen concentration * I...") Tag: Visual edit
  • 13:53, 22 November 2022 Nikolas talk contribs created page 1. Role of nutrition in prevention of cardiovascular diseases (Created page with "* Cardiovascular disease = CVD ** Ischaemic heart disease ** Stroke * Epidemiology of cardiovascular disease ** CVD is the leading cause of death in the world * Risk factors for CVD ** Behavioural (modifiable) *** Behavioural risk factors are responsible for about 80% of CVD *** Unhealthy diet *** Physical inactivity *** Tobacco use *** Harmful use of alcohol ** Non-modifiable *** Family history *** Old age * 2018 study in British Medical Journal (BMJ): ** Healthy dietar...") Tag: Visual edit
  • 13:51, 22 November 2022 Nikolas talk contribs created page Category:Public health 4 - Preventive medicine (Created page with "I wrote these notes for my public health final. The PH4 topics for the final are more or less the same as the topics for the PH2 exam itself, but there may be slight differences. Check the topic lists. Category:3rd year") Tag: Visual edit
  • 13:49, 22 November 2022 Nikolas talk contribs created page 34. Demographic indicators: measures of birth and fertility (Created page with "* Crude birth rate – annual number of live births per 1000 people ** 18 live births per 1000 people (2017) * Fertility rate – annual number of live births per woman of childbearing age (15 – 49) ** Around 5 live births per woman in Africa ** Around 1,5 live births per woman in Europe * Age-specific fertility rates – annual number of live births per 1000 women in particular age groups ** 15 – 19 ** 20 – 24 ** etc. * Natural balance = difference between births...") Tag: Visual edit
  • 13:48, 22 November 2022 Nikolas talk contribs created page 33. Demographic indicators: measures describing population groups. Population pyramids (Created page with "* Dependency ratio is the ratio of the population who are economically inactive to those who are economically active: ** Dependency ratio = population < 15 and > 65 / population between 15 and 65 * Population size – the number of individuals in the population * Population density – the number of individuals in the population per unit of area * Age structure – the age structure of a population is shown by the population pyramid ** Most developed countries have contr...") Tag: Visual edit
  • 13:46, 22 November 2022 Nikolas talk contribs created page File:Population pyramids.png
  • 13:46, 22 November 2022 Nikolas talk contribs uploaded File:Population pyramids.png
  • 13:46, 22 November 2022 Nikolas talk contribs created page 32. Demographic indicators: measures of mortality (Created page with "* Crude death rate – annual number of deaths per 1000 people ** Highest in sub-Saharan Africa, Middle East (15 – 20) ** Lowest in Western countries (1 – 10) ** Average in the world: 7 * Infant mortality rate – annual number of deaths of children < 1 year per 1000 live births ** Highest in sub-Saharan Africa, Middle East (80 – 100) ** Lowest in Western countries (0 – 10) * Maternal mortality rate – annual number of deaths from puerperal causes per 100 000 li...") Tag: Visual edit
  • 13:45, 22 November 2022 Nikolas talk contribs created page 31. Demography: definition, methods, data sources (Created page with "* Demography is the scientific study of the determinants and consequences of changes in human population * You can only enter a population by birth or migration, and you can only leave it by death or migration ** Therefore, fertility, mortality, and migration are important in the study of demographics ** Keeping record of birth and death is simple; migration is not always registered and therefore more difficult to keep record of * Variables in demography ** Age ** Gender...") Tag: Visual edit
  • 13:45, 22 November 2022 Nikolas talk contribs created page 30. Optional and mandatory screening (Created page with "* Mandatory screening ** Breast cancer *** Clinical breast exam every 3 years after 20 *** Yearly mammogram after age 40 *** High-risk women must be screened earlier and more often ** Colorectal cancer *** After age 50 *** By colonoscopy, CT colonography, sigmoidoscopy, faecal occult blood test, etc. *** High-risk persons must be screened earlier ** Cervical cancer *** After age of sexual debut *** Pap smear every year ** Tuberculosis screening for health workers * Optio...") Tag: Visual edit
  • 13:43, 22 November 2022 Nikolas talk contribs created page 29. Basic principles of screening (Created page with "* Screening program = comprehensive program on identification of persons with unrecognized disease or risk factors for disease * Screening test = a test used for the identification of persons with unrecognized disease or risk factors for disease * Screening is a simple process which classifies persons into one of two groups ** The first group is for those with a positive screening test. They should undergo further testing or initiate treatment ** The second group is for...") Tag: Visual edit
  • 13:43, 22 November 2022 Nikolas talk contribs created page 28. Molecular epidemiology (Created page with "* Molecular epidemiology focuses on the contribution and interaction of genetic and environmental risk factors, identified at the molecular level, to disease * Uses techniques of molecular biology, like PCR, next generation sequencing (NGS), ELISA, western blot, etc. * Aims to identify: ** Biomarkers of genetic susceptibility ** Biomarkers of exposure ** Biomarkers of effect ** Biomarkers of disease * Genetic susceptibility ** Some genotypes are protective against a risk...") Tag: Visual edit
  • 13:42, 22 November 2022 Nikolas talk contribs created page 27. Confounders, effect modifiers and possibilities for elimination (Created page with "* Confounding ** A confounding variable is a variable which has not been considered in the study, but which correlates with the risk factor and disease ** What the study observes: risk factor exposure –> disease ** What the reality is: risk factor exposure < –> confounding variable –> disease *** There is no direct association between risk factor exposure and disease ** Example 1: *** A study finds that people who drink coffee have increased risk for lung cancer, a...") Tag: Visual edit
  • 13:42, 22 November 2022 Nikolas talk contribs created page 26. Errors and bias in epidemiological studies (Created page with "* Chance, bias, and confounding should be ruled out in order to talk about a valid statistical association ** A valid statistical association does not imply causation! ** For example, incidence of prostate cancer has increased recently, as have the sales of flat-screen TVs. But there is no causation * The two types of errors in epidemiology ** Type 1 error – when we conclude that there is a difference when in reality there is no difference *** To avoid type 1 errors, w...") Tag: Visual edit
  • 13:41, 22 November 2022 Nikolas talk contribs created page 25. Meta-analysis, systematic review (Created page with "* These are the highest-quality studies * No new data is collected; results from previous studies are combined * Combining multiple studies reduces biases and improve statistical power * Meta-analysis ** Data from multiple similar studies is processed with statistical methods ** Can be performed when there are multiple studies addressing the same question ** Answers questions like: *** What is the size of the effect? *** Is the effect consistent across studies? *** What...") Tag: Visual edit
  • 13:41, 22 November 2022 Nikolas talk contribs created page 24. Experimental (interventional) epidemiological studies (Created page with "* Clinical trials vs field trials ** Clinical trials *** Are performed on patients *** Involve treatments *** Determine secondary and tertiary preventative measures ** Field trials *** Are performed on healthy people *** Involve prophylactic measures *** Determine primary preventative measures * Randomized control trials (RCT) ** Gold standard of clinical trials ** Steps *** People from a sample population are randomly allocated into an intervention group and a control g...") Tag: Visual edit
  • 13:41, 22 November 2022 Nikolas talk contribs created page 23. Cohort studies (Created page with "* Also called follow-up studies, incidence studies, longitudinal studies, etc. * Can be prospective or retrospective ** Prospective cohort study – healthy people with and without exposure to a factor is found and followed up until disease *** At the point of the study only the exposure, not the disease, has occurred *** Example: People who smoke and people who don’t smoke are chosen. They’re followed up until disease develops. ** Retrospective cohort study – a po...") Tag: Visual edit
  • 13:40, 22 November 2022 Nikolas talk contribs created page 22. Case-control studies (Created page with "* Most frequently performed epidemiology studies * A retrospective study – healthy and sick people are found, and their previous exposure to a factor is determined * Aim: to study if an exposure (usually a risk factor) is associated with a disease * Steps ** Select patients with the disease = the cases ** Select persons without the disease with similar baseline characteristics as the cases = the controls ** Compare the exposure of risk factors between these groups ***...") Tag: Visual edit
  • 13:40, 22 November 2022 Nikolas talk contribs created page 21. Ecological studies. Immigrant studies (Created page with "* Ecological study ** Also called a correlational study ** A study which aims to identify a correlation between a risk factor or protective factor and a disease ** Use data which is already collected, from *** Census data *** Registries *** Etc. ** Doesn’t use data based on individual cases ** Uses data based on the whole population, like disease prevalence, incidence, mortality ** Focuses on specific problems, like within a region or population ** Advantages *** Inexp...") Tag: Visual edit
  • 13:39, 22 November 2022 Nikolas talk contribs created page 20. Descriptive epidemiological studies, cross-sectional studies (Created page with "* Descriptive studies ** These studies try to identify the relation between a disease and factors like age, gender, occupation, place, time, etc. ** In descriptive studies no hypothesis is formed and no analysis is performed * Case report ** Description of a case, usually a patient, in a manner which provides information ** Not a true epidemiological study, as only one case is reported ** However, many case reports with similar features may raise suspicion of an underlyi...") Tag: Visual edit
  • 13:39, 22 November 2022 Nikolas talk contribs created page 19. Epidemiological studies: parameters, design (Created page with "* Epidemiological studies can be classified according to ** What the aim is *** Descriptive = describe patterns of disease occurrence in relation to variables **** Case reports **** Case series *** Analytical = test specific hypotheses **** Ecological studies **** Cross-sectional studies **** Case control studies **** Cohort studies **** Clinical trials ** The time period evaluated *** Retrospective = back in time *** Concurrent = current point in time *** Prospective =...") Tag: Visual edit
  • 13:39, 22 November 2022 Nikolas talk contribs created page 18. Standardization (Created page with "* Standardization is used to reduce the effects of confounding variables like age and gender * Standardization is necessary to compare mortality or morbidity rates of populations with different age or gender distribution ** Comparing the crude rates of these populations would be misleading due to different age and gender distribution * Direct and indirect methods of standardization exist * These methods compare the mortality or morbidity rate of the measured population t...") Tag: Visual edit
  • 13:38, 22 November 2022 Nikolas talk contribs created page 17. Epidemiological indicators II: definition and measures of relative risk and odds ratio (Created page with "* Risk is a proportion; odds is a ratio * Risk ** = the probability that an event will occur ** Risk = number of times an event occurred / total number of possible occurrences ** Estimated based on incidence ** If there are 10 people with cancer, and 6 die, the risk of dying is 6/10 = 60% * Odds ** = the chance that an event will occur ** Odds = number of times an event occurred / number of times the event didn’t occur ** If there are 10 people with cancer, and 6 die,...") Tag: Visual edit
  • 13:38, 22 November 2022 Nikolas talk contribs created page 16. Epidemiological indicators I: indicators of disease frequency and population impact of a disease (Created page with "* Maths ** A fraction = number of cases / population ** A ratio = a number in relation to another one ** A proportion = the ratio of a part of the population to the total ** A rate = a proportion over time * Indicators of disease frequency ** Number of cases *** Simplest measure, but doesn’t take into account the size of the population *** Useful for allocating health resources ** Incidence rate *** New cases of a disease in the population over a period of time *** Goo...") Tag: Visual edit
  • 13:38, 22 November 2022 Nikolas talk contribs created page 15. Causation in epidemiology: association and causation (Created page with "* Causation: whether an exposure actually causes a specific disease ** or: whether the association between an exposure and a disease is causative ** Bias, confounding and chance must all be eliminated to establish a causal relationship * Koch’s postulates for causation (of infectious diseases) states that the causative agents can: ** Be isolated from the affected organism in a culture ** Be cultured ** Produce the same disease in a second animal ** Be isolated from the...") Tag: Visual edit
  • 13:37, 22 November 2022 Nikolas talk contribs created page 14. History and objectives of epidemiology (Created page with "* Epidemiology is the study of determinants and distribution of disease * Clinical epidemiology is the use of epidemiology to improve prevention, detection, and treatment of disease * History of epidemiology ** Hippocrates: “Quality of water, how people live, what they drink and eat, whether they exercise, affect their health” ** Ignaz Semmelweis discovered that hand disinfection reduced the incidence of puerperal fever ** John Snow *** The father of epidemiology ***...") Tag: Visual edit
  • 13:36, 22 November 2022 Nikolas talk contribs created page 13. Evidence-based medicine and prevention (Created page with "* Evidence-based medicine (EBM) is “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.” ** = the process of turning clinical problems into questions and then systematically locating, appraising, and using contemporaneous research findings as the basis for clinical decisions * EBM is the gold standard of clinical practice * Uses information gathered from randomized control trials, case cont...") Tag: Visual edit
  • 13:34, 22 November 2022 Nikolas talk contribs created page Category:Public health 2 - General epidemiology and demography (Created page with "I wrote these notes for my public health final. The PH2 topics for the final are more or less the same as the topics for the PH2 exam itself, but there are slight differences. Check the topic lists. Category:1st year") Tag: Visual edit
  • 13:33, 22 November 2022 Nikolas talk contribs created page 12. Health issues and disparities of people living with disabilities (Created page with "* Disability = lack of ability compared to a standard or norm ** Mental disability (impaired intellectual ability) ** Physical disability (mobility) ** Sensory disability (visual/hearing) * Physical disability ** = impaired ability to move or coordinate movements ** The most frequent disability (10% of USA) ** Due to musculoskeletal or neurological problems ** Causes *** Accidents, injuries *** Genetic diseases (muscular dystrophies, etc.) *** Developmental disorders (in...") Tag: Visual edit
  • 13:32, 22 November 2022 Nikolas talk contribs created page 11. Minorities: Health issues and disparities (Created page with "* Unemployed persons ** 8 – 9% in Hungary ** Stages of unemployment *** 1 – sense of relief *** 2 – unsuccessful in seeking work *** 3 – gives up hope of finding work *** 4 – crumbling life ** Consequences *** Hypertension *** Increased risk for poor habits *** Stress *** Depression *** Suicide * People in poverty ** Subsistence level of poverty – barely enough money to exist *** Increased risk of infectious disease, STD, malnutrition ** Social minimum level...") Tag: Visual edit
  • 13:32, 22 November 2022 Nikolas talk contribs created page 10. Health concerns of elderly. Aging societies (Created page with "* The society is aging – elderly health is becoming more and more important * Ageing (= ''greying'') of Europe ** Refers to the increase in elderly population relative to the workforce ** Due to decreased fertility, decreased mortality, and higher life expectancy * Most deaths in developed countries are due to diseases closely related to ageing, like cancer, stroke, heart disease * There is no evidenced-based proof that dietary supplements delay or stop ageing ** The f...") Tag: Visual edit
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