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IMF-065-01-0001-en	Why does population health look beyond treatment to explain why illness occurs unevenly?	Because housing, income, education, food, work, discrimination, environment, commercial influence, and access determine who becomes ill and who recovers.	Integrated Medical Foundations; chapter 65, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: fa0b76b8691084e109bf9556cec701639cafea7d55043dec38909a46a4faf175; editorial review pending	imf lang::en chapter::065 module::065-01 review::pending
IMF-065-01-0002-en	Why can a chronic survivable condition have high prevalence despite only modest incidence?	Prevalence depends on both incidence and duration, so a condition people live with for a long time accumulates existing cases even when new cases are modest.	Integrated Medical Foundations; chapter 65, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: fa0b76b8691084e109bf9556cec701639cafea7d55043dec38909a46a4faf175; editorial review pending	imf lang::en chapter::065 module::065-01 review::pending
IMF-065-01-0003-en	What distinguishes a rate from a risk, and why does the difference matter when follow-up is unequal?	Risk is a probability over a defined period, whereas a rate incorporates person-time, so it remains usable when people are followed for different lengths of time.	Integrated Medical Foundations; chapter 65, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: fa0b76b8691084e109bf9556cec701639cafea7d55043dec38909a46a4faf175; editorial review pending	imf lang::en chapter::065 module::065-01 review::pending
IMF-065-01-0004-en	Why can a large relative effect on an outcome still produce only a small absolute benefit?	If the outcome is rare, a large ratio change corresponds to few additional or prevented events, which is what the absolute risk difference expresses.	Integrated Medical Foundations; chapter 65, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: fa0b76b8691084e109bf9556cec701639cafea7d55043dec38909a46a4faf175; editorial review pending	imf lang::en chapter::065 module::065-01 review::pending
IMF-065-01-0005-en	How is the number needed to treat derived, and why must time horizon and baseline risk accompany it?	It is the reciprocal of the absolute risk reduction over the study period, so its value is meaningful only with the time horizon and baseline risk it came from.	Integrated Medical Foundations; chapter 65, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: fa0b76b8691084e109bf9556cec701639cafea7d55043dec38909a46a4faf175; editorial review pending	imf lang::en chapter::065 module::065-01 review::pending
IMF-065-01-0006-en	Why are crude comparisons between populations unreliable, and what limits the fix?	Age, sex, and other population structures distort crude comparisons; stratification or standardisation allows fairer comparison but depends on the chosen reference.	Integrated Medical Foundations; chapter 65, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: fa0b76b8691084e109bf9556cec701639cafea7d55043dec38909a46a4faf175; editorial review pending	imf lang::en chapter::065 module::065-01 review::pending
IMF-065-01-0007-en	Why can ecological data not show that a relationship applies to individuals?	Ecological data describe groups, so a relationship seen at group level cannot establish that the same relationship holds for the individuals within them.	Integrated Medical Foundations; chapter 65, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: fa0b76b8691084e109bf9556cec701639cafea7d55043dec38909a46a4faf175; editorial review pending	imf lang::en chapter::065 module::065-01 review::pending
IMF-065-01-0008-en	What distinguishes primordial prevention from primary prevention?	Primordial prevention stops risk emerging through housing, clean air, education, food policy, and regulation; primary prevention stops disease before onset through measures such as vaccination and blood-pressure management.	Integrated Medical Foundations; chapter 65, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: fa0b76b8691084e109bf9556cec701639cafea7d55043dec38909a46a4faf175; editorial review pending	imf lang::en chapter::065 module::065-01 review::pending
IMF-065-01-0009-en	Why do upstream interventions such as safe water often reach more people than counselling?	They change exposure for everyone without requiring repeated individual choice, although measures such as taxes should avoid placing regressive burdens on low-income people.	Integrated Medical Foundations; chapter 65, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: fa0b76b8691084e109bf9556cec701639cafea7d55043dec38909a46a4faf175; editorial review pending	imf lang::en chapter::065 module::065-01 review::pending
IMF-065-01-0010-en	Why is finding abnormalities not by itself a justification for screening?	Screening aims to reduce future morbidity or mortality, so it is worthwhile only when effective earlier treatment, a defined pathway, and a favourable balance of benefit, harm, and cost exist.	Integrated Medical Foundations; chapter 65, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: fa0b76b8691084e109bf9556cec701639cafea7d55043dec38909a46a4faf175; editorial review pending	imf lang::en chapter::065 module::065-01 review::pending
IMF-065-01-0011-en	Why can false positives outnumber true positives in screening even when the test is good?	When disease prevalence is low, the few true cases are outnumbered by false positives arising among the many unaffected people tested.	Integrated Medical Foundations; chapter 65, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: fa0b76b8691084e109bf9556cec701639cafea7d55043dec38909a46a4faf175; editorial review pending	imf lang::en chapter::065 module::065-01 review::pending
IMF-065-01-0012-en	How do length bias and lead-time bias flatter screening, and what evidence avoids them?	Length bias preferentially detects slow disease and lead-time bias lengthens survival only because diagnosis starts earlier, so randomised mortality or meaningful morbidity outcomes outweigh stage shift.	Integrated Medical Foundations; chapter 65, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: fa0b76b8691084e109bf9556cec701639cafea7d55043dec38909a46a4faf175; editorial review pending	imf lang::en chapter::065 module::065-01 review::pending
IMF-065-01-0013-en	Why does screening often favour sensitivity and then add a separate confirmatory test?	Choosing sensitivity avoids missed disease, and a specific confirmatory test follows because sensitivity and specificity trade off as the threshold changes.	Integrated Medical Foundations; chapter 65, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: fa0b76b8691084e109bf9556cec701639cafea7d55043dec38909a46a4faf175; editorial review pending	imf lang::en chapter::065 module::065-01 review::pending
IMF-065-01-0014-en	How can a screening programme that improves average outcomes still widen inequity?	If access is hardest for the people at greatest risk, the gains concentrate among those at lower risk while the highest-risk groups are left behind.	Integrated Medical Foundations; chapter 65, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: fa0b76b8691084e109bf9556cec701639cafea7d55043dec38909a46a4faf175; editorial review pending	imf lang::en chapter::065 module::065-01 review::pending
IMF-065-01-0015-en	How do conjugation, adjuvants, and boosters each strengthen vaccine protection?	Conjugation recruits T-cell help against polysaccharides, adjuvants enhance innate signalling, and boosters restore or broaden protection that has waned.	Integrated Medical Foundations; chapter 65, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: fa0b76b8691084e109bf9556cec701639cafea7d55043dec38909a46a4faf175; editorial review pending	imf lang::en chapter::065 module::065-01 review::pending
IMF-065-01-0016-en	Why is there no fixed herd-protection threshold for a vaccine?	Herd effects arise from interrupting spread, and that depends on transmissibility, clustering, waning, and vaccine performance, which all vary.	Integrated Medical Foundations; chapter 65, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: fa0b76b8691084e109bf9556cec701639cafea7d55043dec38909a46a4faf175; editorial review pending	imf lang::en chapter::065 module::065-01 review::pending
IMF-065-01-0017-en	An illness follows vaccination. Why does this not establish that the vaccine caused it, and how is it assessed?	Events after vaccination are not necessarily caused by it; assessment compares background rates, timing, mechanism, and controlled evidence.	Integrated Medical Foundations; chapter 65, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: fa0b76b8691084e109bf9556cec701639cafea7d55043dec38909a46a4faf175; editorial review pending	imf lang::en chapter::065 module::065-01 review::pending
IMF-065-01-0018-en	Why are live vaccines generally avoided in severe immune suppression, and how do inactivated vaccines differ?	Live vaccines can replicate, whereas inactivated vaccines cannot cause the target infection but may give weaker responses, so indicated vaccines are given before immune-suppressive treatment when feasible.	Integrated Medical Foundations; chapter 65, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: fa0b76b8691084e109bf9556cec701639cafea7d55043dec38909a46a4faf175; editorial review pending	imf lang::en chapter::065 module::065-01 review::pending
IMF-065-01-0019-en	Why is absolute cardiovascular risk estimated rather than treating each risk-factor number in isolation?	Risk factors such as smoking, pressure, lipids, diabetes, and age act together, so only their combined effect reflects a person's actual cardiovascular risk.	Integrated Medical Foundations; chapter 65, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: fa0b76b8691084e109bf9556cec701639cafea7d55043dec38909a46a4faf175; editorial review pending	imf lang::en chapter::065 module::065-01 review::pending
IMF-065-01-0020-en	Why is antiplatelet therapy valuable after established atherosclerotic disease but often not in low-risk primary prevention?	In low-risk primary prevention bleeding often outweighs the small benefit, whereas after established disease the benefit is substantial.	Integrated Medical Foundations; chapter 65, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: fa0b76b8691084e109bf9556cec701639cafea7d55043dec38909a46a4faf175; editorial review pending	imf lang::en chapter::065 module::065-01 review::pending
IMF-065-01-0021-en	Why is thyroid, ovarian, pancreatic, or whole-body imaging not appropriate screening in average-risk asymptomatic people?	Screening is not justified merely because a test exists, and in these people such testing can generate substantial overdiagnosis.	Integrated Medical Foundations; chapter 65, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: fa0b76b8691084e109bf9556cec701639cafea7d55043dec38909a46a4faf175; editorial review pending	imf lang::en chapter::065 module::065-01 review::pending
IMF-065-01-0022-en	Why is personal protective equipment described as only one layer of infection prevention?	It fails when systems, training, ventilation, staffing, or supply are poor, so precautions must also be matched to the route of transmission.	Integrated Medical Foundations; chapter 65, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: fa0b76b8691084e109bf9556cec701639cafea7d55043dec38909a46a4faf175; editorial review pending	imf lang::en chapter::065 module::065-01 review::pending
IMF-065-01-0023-en	Why combine long-acting and short-acting nicotine, and how should relapse be interpreted?	The combination improves control, and relapse reflects chronic dependence, so it prompts renewed support rather than blame.	Integrated Medical Foundations; chapter 65, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: fa0b76b8691084e109bf9556cec701639cafea7d55043dec38909a46a4faf175; editorial review pending	imf lang::en chapter::065 module::065-01 review::pending
IMF-065-01-0024-en	What distinguishes equitable care from equal care?	Equal care gives everyone the same resource, whereas equitable care responds to each group's barriers and need.	Integrated Medical Foundations; chapter 65, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: fa0b76b8691084e109bf9556cec701639cafea7d55043dec38909a46a4faf175; editorial review pending	imf lang::en chapter::065 module::065-01 review::pending