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NUR600 Week 11 Test With Complete Solution
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NUR600 Week 11 Test With Complete Solution Principles of Causality - Answer - causation requires the factor to be present for the outcome (e.g., disease) to occur; - an adverse outcome might be related to a multitude of fac tors; and that when we identify - an association between two factors, it does not mean causation. What is an example for "Causation requires the factor to be presen t for the outcome"? - Answer If the outcome is a car accident, I have to be driving or i n the car before it happens. What is an example for "an adverse outcome might be related to a multitude of factors"? - Answer If the outcome is a car accident, then the factors occu rring might be a) texting, b) driving too fast, c) not alert to the driver stopping sudde nly in front, and/or d) swerving unexpectedly because a tire fell off a nearby truck. What is an example for "when we identify an association between two fac tors, it does not mean causation"? - Answer If the outcome is a car accident, the n it is possible that texting while driving and driving too fast are associated with one another, but it does not mean that they caused the accident. Likewise, texting while drivin g and driving too fast are associated with the accident occurring, but may not have ca used the accident. History of Causation (Christian) - Answer - At one point many scien tists believed that disease and other events were caused by a higher power. History of Causation (John Snow) - Answer - John Snow and the Chol era outbreak, in the Victorian period the prevailing thoughts on causation related t o "miasmas," which were toxic vapours from filthy cesspools of water. History of Causation (Hippocrates) - Answer Time of Hippocrates w here disease was caused by the humours - bile, phlegm, and blood. History of Causation (Holmes) - Answer In 1843, Oliver Holmes, a prof essor at Harvard Medical School, identified that if obstetricians washed their hand s, they could reduce the spread of puerperal fever - a fatal post-childbirth disease . "Henle-Koch Postulates". These postulates, grounded in germ theory, w ere: - Answer - Bacteria must be present in every case of the disease - Bacteria must be isolated from the host with the disease or b e grown in pure culture - Specific disease must be reproduced when a pure culture of t he bacteria is inoculated into a healthy susceptible host; and - Bacteria must be recoverable from the experimentally infected host. "Henle-Koch Postulates" Limitation - Answer But by the mid-20th cen tury, non-infectious disease was receiving more attention, and these cr iteria were limited in their application to all disease. - Multi-variant causality such as Chronic Disease Multiple Causes - Answer - The iceberg theory, not everyone w ho is exposed to the disease becomes infected with tuberculosis. - But it is too simplistic to believe that every disease has just one ca use. - Heart disease, which we learned about in earlier modules, has mult iple causes, from cigarette smoking, hypertension, hypercholesterolemia, diabe tes, inflammation, and heredity Web of Causation - Answer When many factors come together to create disease - which is clear for degenerative disease or chronic disease like cancer, but is also possible for infectious disease such as HIV and AIDS A "web of causation" is - Answer a graphic, pictorial, or paradigm r epresentation of complex sets of events or conditions caused by an array of activitie s connected to a common source or event David Hume - Answer In the 18th century, David Hume argued that ca usation was a concept that required logical induction. This means that we c an never know for sure if exposure or risk factor X causes disease Y. Causation can be inferr ed by observing the variables over time Karl Popper - Answer Hume's theory was later developed further by Karl Pop per, who was revered as a famous philosopher of science, who stressed the concept of hypothesis testing, where one either refines or rejects a scient ific (or statistical) hypothesis. Much of what we do to this day in terms of health re search is founded on the principle of identifying hypotheses, testing hypotheses, and refuting hypotheses Bradford Hill Criteria - Answer -Sir Austin Bradford Hill created postu lates about causality in 1965 after his research on smoking and lung cancer. -Hill's research partner Sir Richard Doll stated that the Hill criteria sh ould be a "guide." At minimum there must be a valid statistical association and a temporal se quence of events before causality can be concluded Bradford Hill Criteria: strength of association - Answer - The larger the association between exposure and disease, the more likely it is to be causal Bradford Hill Criteria: consistency - Answer - When multiple epidemiolog ical studies using a variety of locations, populations, and methods show a con sistent associationThe benefits of buying summaries with Stuvia:
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