POPH 192 Tutorial key concepts

What is a single story?

Create a single norm

Limitations of a single story?

Can get a false perception of someone/something, you are just looking at the surface level, sterotypes, fixed mindset

What is whakapapa?

Your family ancestory, layer apon layering, passing on knowledge, subjective idea

What dilemmas can be created by over-generalizing people?

- force people into doing something they don't want to do, mis treated, mis diagnosis in a health setting

The importance of mana?

everyone has some sort of mana it comes from knowing who you are, where you come from and connection to your land, directly linked to your identity.

What is meant by the 'social determinants of health'?

What social factors determine your health

"the connections in which people are born, grow, work, live, and age and the wider set of forces and systems shaping the conditions of daily life. These forces and systems include economic polices, and systems, development agenda, social norms, social polices, and political systems".

What is meant by the phase 'social gradient of health'?

Where you are on the scales, your social factors will impact this gradient and your health

"this terms means that socioeconomic status is strongly connected with health status. In general, people occupying a lower socioeconomic position have worse health. Conversely, those occupying the highest socioeconomic position often have the best health. This gradient can be measured by aspects such as a persons income, occupation, or the highest level of education that they have".

Absolute poverty vs relative poverty?

Absolute poverty: "income level below which a minimum nutrionally adequate diet plus essential non-food requirements is not affordable. The amount of income a person, family, or group needs to purchase an absolute amount of basic neccessities of life"

Relative poverty: "the amount of income a person, family, or group needs to purchase a relative amount of the basic necessitites of life; these basic necessities identified relative to each society and economy"

Demographic transition changes?

Death rate - it is decreasing, improvement in health care, better living conditions etc

Birth rate - paloeing, decreasing, cost of living too expensive, active contraceptives.

Total population - increasing - industrial revolution, decreasing in death

median age - increasing, more people in middle age

Epidemiological transition?

Communicable - decreases - sanitation, health care advancements
Non-communicable - increases - air pollution, people living longer, life styles

What you do when given a graph to analyse?

read title, read x and y axis, read key and then how does it all relate
do 4 sentences (showing 4 different points on the figure)
then 1-2 comparative statements

What is the main purpose and benefit of randomisation?

main benefit - to eliminate bias, evenly distributed, controlled for confounding
main purpose - that 2 groups are as comparable to each other except for the intervention

Why is it important to have adequate sample size in the study?

- increasing the probability of an association if it exists
- makes CI more narrower - more precise
- as the sample size increases, the more representative of study sample population
- decreases sample variability

What is the biggest thing that shows whether selection bias has occurred in a study?

low response rate

Subjective vs objective measurements?

subjective - requires a judgement e.g. pain
objective - involves opinion - e.g. weight

Primary prevention

Prevents it from occuring

Secondary prevention

Aims to reduce prevalence of disease by shortening its duration, reducing severity or preventing reoccurance

Tertiary prevention

Aims to reduce to number or impact of complications impove rehabiliation

Population approach advantages and disadvantages

(+) - wide range of benefits across society, establish new population rules/change and shift behavioural/societal norms, radical - large sweeping changes, identitfy everyone

(-) - can't make a great change in individuals at high risk, low benefit risk rate at high risk individuals, poor motivation by population to participate

High-risk approach advantages and disadvantages?

(+) - individual needs specialized (niche to their own), more personal so can motivate more, favourably benefit risk

(-) - identifying who are at high risk (some people may not engage in health services so can't identify/help them), very costly - time consuming, don't create a norm - doesn't change behavioural norms, may go against social norms - hard to sustain long term (behavioural changes)

Why would we rely on the findings of a systematic review over one very good RCT?

Considers a large number of studies, consenus may be reached on whether an association exists (if so how strong), must set criteria to make it good

What is the difference between a systematic review and a meta analysis?

Systematic reviews focus on answering a research question by critically amphraising a number of studies, summarising the results and drawing conclusions
meta analysis - forms part of a systematic review/extension, technique that the results of multiple studies are combined into a single estimate of MoA, meta analysis within systematic review