TEST 2 STUDY GUIDE DIE4310 Fall 2012 Chapter 5 Principles of Epidemiology 12 questions Define Epidemiology initially used to investigate control and prevent epidemics of infectious diseases Current Definition Study of the distribution and determinants of health related states and events in specified populations and the control of health problems nutritional epidemiology Epidemiological method lends itself to the study of the relationship of diet to health and disease Epidemiological method lends itself to the study of the relationship of diet to health and disease Incidence proportion of a population that develops a disease over time Prevalence proportion of a group possessing a disease at a specific time Risk likelihood of individuals exposed to risk factors developing a particular health Relative risk comparison of the risk between two groups risk of disease or death for exposed persons Risk of disease of death for unexposed persons Case a particular instance of a disease or outcome of interest single individual Risk factor variables that are suspected to increase the likelihood of developing a problem disease Compare and contrast design features of the following types of epidemiological studies Ecological or correlational different populations with the per capita consumption of certain dietary factors Compare frequency of events or disease rates in The data from an ecological study cannot be used to draw conclusions rather to generate hypotheses Class definition Disease rates with per capita consumption of specific food components Cohort or incidence Cross sectional or prevalence Snapshot of a population comparing dietary intake disease other variables in a population at one time particular disease or condition and what risks they have been exposed to have it Comparing a group with a disease with a group that does not A group of people are followed over time to see who develops a Case control studies Controlled trials Useful when a rare condition is being studied The most rigorous evaluations of a dietary hypothesis The primary drawback is its expense Compare intervention group with usual care group Be able to identify the type of epidemiological study given a particular study design Chapter 6 Policy Making 7 questions Define Policymaking the process by which authorities decide which actions to take to address a problem or set of problems Identify and describe the steps in the policy making process Step 1 Define problem and set agenda goal is to convince other people that a public problem exists During the first step the objective is to get the issue on the legislative policy agenda by obtaining broad based public support for the problem Effective description of the problem is tantamount during this step including information on the etiology occurrence and determinants of the problem Step 2 Formulate alternatives Possible solutions to the problem are devised and discussed by various groups Once on the agenda it is the legislative executive and judicial branches of the government s job to formulate solutions to the problem Step 3 Adopt policy The adoption step of policy making provides the tools and instruments for dealing with the problem are chosen Government sponsored programs regulations public promotions and cash grants commonly used to combat public health nutrition problems Step 4 Implement policy Implementation is the process of putting a policy into action Governmental employees and community administrators the private sector organizations and others work together to implement public policy in the U S Step 5 Evaluate policy Determine if a program is achieving its stated goals and reaching its intended audience Step 6 Terminate policy Valid reasons for policy termination include resolution of the problem an ineffective program and more efficacious approaches to solving the problem Outline the steps in how an idea becomes a law Subcommittee most important time for constituent involvement Bill Introduction Sponsorship Committee grass root advocacy is also important Conference opportunities are more limited Floor communication b w all senators and representatives Floor once conference committee has worked out differences passage of a bill is routine Know that the Federal Register is a weekly publication that contains all regulations and proposed regulations and that the Code of Federal Regulations is the compendium of all regulations currently in force Define and discuss Medical Nutrition Therapy MNT in relation to the political process of policymaking See page 170 of text MNT a service provided by a registered dietician or nutrition professional that includes counseling nutritional support and nutrition assessment and screening to improve people s health and quality of life It spent 8 years in the legislative process till it was finally passed Describe emerging policy issues Medical nutrition therapy the ADA is advocating for an amendment to the Medicare Act to expand of Medicare coverage of medical nutrition therapy service Aging increased research efforts on nutritional needs and optimal diets for nursing home home care and the elderly Child nutrition improving school nutrition environments to help children make sound choices for healthful eating and physical activity Nutrition research increased funding Nutrition monitoring increased funding for nutrition monitoring and behavioral research aimed at improving diet and preventing obesity Obesity Obesity prevention legislation that ADA is attempting to re vitalize is the Improved Nutrition and Physical Activity Act of 2003 Chapter 9 Healthcare 6 questions Define Public Insurance 2 forms charges for each service rendered accounts for only a small Group contract insurance Fee for service percentage of insurance coverage today employer or other entity and covers a group of persons identified as individuals by reference to their relationship to the entity a health insurance contract that is made with an o managed care system HMOs PPOs POSs o accounts for around 99 of coverage for employees Consumer Directed Health Plans Government Public Insurance Medicare Medicaid SCHIP PPS a payment system under which hospitals are paid a fixed sum per case according to a schedule of diagnosis related groups DRG diagnosis related groups a method of classifying patients illnesses according to the principle diagnosis and treatment requirements for the purpose of establishing payment rates Medigap insurance supplemental insurance policy sold