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Epidemiology chapters 1-7


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Know something about the history of epidemiology & key figures who played a role. What did they contribute?
(p.33-34)Thucydudes-the enovironment as a factor in disease causation. Graunt-Natural & Political Observations Made upon the Bills of Mortality. Birth & Death data. Snow-study linked the cholera epidemic in water supplies. Semmelweis-founded handwashing techniques.Farr- Classification schemes (ICD). Koch- Diseases caused by living organisms.Languir-father of infectious disease, founded EIS.
Know something about the applications of epidemiology and some of the important contributions such as Framingham Study
(p.34-9)Framingham Study-1949, research investigations of risk factors for CHD.
Be able to discuss morbidity & mortality and tell what they contribute to the knowledge of epidemilogy.
(p.105-9)A common factor for rate adjuctment is age. Infant mortality rate-dying during the first year of life among infants born alive. Fetal mortality-death after 20 weeks or more gestation. Neonatal mortality-newborn death under 28 days of age. Postnatal mortality-dying among older infants during agiven year. Maternal mortality-factors:age, socioeconomic, nutritional, health care access.
Be able to examine population data and comment on the general characteristics of developed vs. less-developed nations.
(p.54-9)Socioeconomic status relate in part to the availability of health and social services and ability to pay for health care. Wealthier communities, b/c of greater tax resources, provide a better social and health-related services. Low-income residents use public services that are less up-to-date and more difficult to reach by transportation, overcrowded, unsanitary, low educationi level.
Know what birth & death rates contribute to the shape of the population in question.
(p.101,105-9)The crude birth rate is a useful measure of population growth and is an index for comparison of developed and developing countries;usually higher in less-developed areas. Infant/fetal/neonatal mortality are highest in less-developed countries
Know how legislative action impacts on public health.
(p. 59)Legislators are charged with the responsibilty of enacting laws, enforcing them, and creating policies, many of which have substantial impacts on public health. Encompass a policy cycle:examination of population health, assessment of potential interventions, alternative policy implementation, adn policy evaluation.
Know about causation as a factor in epidemiologic studies.
(p.69-74)1.Strength of association 2.Consistency upon repitition 3. Specificity 4. Time sequesnce 5.Biologic gradient 6. Plausibility
Know about risk factors in epidemiologic research.
(p.69) 1.The frequency of the disease varies by category or value of factor. 2.The risk factor must precede the onset of disease. 3.The observed association must not be due to any source of error.
Know what is meant by:incidence, prevelance, attack rate, population at risk and how they are used to describe what is happening in populations.
(p.92,94,96)Prevalence-# of existing cases of a disease ot health condition in a population at some designated time. Incidence-rate of development of a disease ina group over a certain time period. Population at risk-denominator for incidence rates is the population at risk. Attack rate-alternative form of incidence rate used when the nature of the disease or condition is such that a population is observed for a short period of time, often as a result of specific exposure.
Know what is meant by research hypothesis.
(p.129-130)Hypothesis-suppositions that are tested by collecting facts that lead to their acceptance or rejection;positive declaration.
Be able to define demographic characteristics such as time, person, place.
(p.132-52, 152-63,163-9)Person:age,sex, marital status, race/ethinicity, nativity & migration, religion, socioeconomic status, measurement, findings. Place:international comparison of disease frequency, within-country geographic variation in rates of disease, urban/rural differences in disease rates, localized place comparison, GIS, reasons for place variation in disease. Time: cyclic fluctuations, point epidemics, secualr time trends, cohort effects, clustering, temporal clustering, spatial clustering.
Be able to define terms such as cluster and know how this term applies.
(p.168-9)Case clustering-an unusual aggregation of health events grouped together in space or time. Space & time clutering might suggest an association between common exposure to an etiologic agent and development of morbidity & mortality.
Know what is meant by external validity and what it means to researchers.
(p.181)aka representativeness-generalizability of findings to the population from which the data have been taken.

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