FA Behavioral Science 62-74
Terms
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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