Epidemiology Basics
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Questions and Answers

What is the meaning of the Greek root 'epi' in the term 'epidemiology'?

  • study
  • upon (correct)
  • people
  • disease

    • What is epidemiology usually defined as?

  • The study of health care practice
  • The study of disease in a population (correct)
  • The study of epidemics
  • The study of disease in an individual

    • What is the focus of classical epidemiology?

  • Clinical practice
  • Community origins of health problems (correct)
  • Individual patients
  • Molecular biology

    • What is the difference between classical epidemiology and clinical epidemiology?

    <p>Classical epidemiology focuses on populations, while clinical epidemiology focuses on individuals</p> Signup and view all the answers

    At which level does epidemiology primarily operate?

    <p>Level of populations</p> Signup and view all the answers

    What is the primary goal of classical epidemiologists?

    <p>To discover risk factors that might be altered to prevent disease</p> Signup and view all the answers

    What is the relationship between the four levels of studying disease?

    <p>They are related and can be coordinated to maximize understanding</p> Signup and view all the answers

    What do investigators involved in clinical epidemiology often use?

    <p>Research designs and statistical tools similar to classical epidemiologists</p> Signup and view all the answers

    What is the primary focus of clinical epidemiologists?

    <p>Studying patients in healthcare settings</p> Signup and view all the answers

    What is the main difference between infectious disease epidemiology and chronic disease epidemiology?

    <p>The laboratory support required</p> Signup and view all the answers

    What is the goal of intervention in the natural history of a disease?

    <p>To alter the natural history of the disease in a favorable way</p> Signup and view all the answers

    What is the term for the cause or origin of a disease or abnormal condition?

    <p>Etiology</p> Signup and view all the answers

    During which stage of disease development can early intervention prevent the disease process from starting?

    <p>Predisease stage</p> Signup and view all the answers

    What type of epidemiology looks for patterns of signs and symptoms that might indicate an origin in bioterrorism?

    <p>Syndromic epidemiology</p> Signup and view all the answers

    What is the term for the way a disease progresses in the absence of medical or public health intervention?

    <p>Natural history</p> Signup and view all the answers

    What is the primary goal of epidemiologists in healthcare settings?

    <p>To improve patient care</p> Signup and view all the answers

    What is the term for the body of knowledge acquired by using epidemiologic methods?

    <p>The epidemiology of disease</p> Signup and view all the answers

    What is the main distinction between primary, secondary, and tertiary prevention?

    <p>The timing of intervention</p> Signup and view all the answers

    What is the primary cause of osteomalacia?

    <p>Vitamin D deficiency</p> Signup and view all the answers

    What is the role of ergosterol in the skin?

    <p>It is an important source of D vitamins</p> Signup and view all the answers

    What is the consequence of osteomalacia on future pregnancies?

    <p>It causes the pelvis to become distorted</p> Signup and view all the answers

    What is the primary goal of epidemiologists?

    <p>To discover the social and behavioral causes of disease</p> Signup and view all the answers

    What is the role of the vector in the case of measles?

    <p>It is relatively unimportant</p> Signup and view all the answers

    What is the primary factor in the spread of malaria?

    <p>The vector</p> Signup and view all the answers

    What is the relationship between nutrition and immune status?

    <p>They can work synergistically</p> Signup and view all the answers

    What is the effect of marasmus on the outcome of measles?

    <p>It increases the risk of complications</p> Signup and view all the answers

    What is the category of biologic agents that includes allergens and infectious organisms?

    <p>Biologic agents</p> Signup and view all the answers

    What is the consequence of a woman's diet being deficient in vitamin D during puberty?

    <p>She may develop osteomalacia</p> Signup and view all the answers

    What is an example of physical agents that can cause harm to humans?

    <p>Kinetic energy, radiation, and heat</p> Signup and view all the answers

    How does the environment influence the probability and circumstances of contact between the host and the agent?

    <p>It increases the probability of contact between the host and the agent</p> Signup and view all the answers

    What is an example of a vector of disease?

    <p>A mosquito associated with the spread of malaria</p> Signup and view all the answers

    What is required for a vector to be an effective transmitter of disease?

    <p>A specific relationship between the vector, the agent, and the environment</p> Signup and view all the answers

    What are examples of extrinsic factors that contribute to cancer cases?

    <p>Man-made chemicals, viral infections, nutritional deficiencies, and reproductive activities</p> Signup and view all the answers

    What is the primary method used by epidemiologists to estimate the percentage of deaths caused by preventable risk factors in a country?

    <p>Epidemiologic methods</p> Signup and view all the answers

    What is an example of a social factor that influences the nutritional and vaccine status of a society's members?

    <p>Political structure</p> Signup and view all the answers

    What is the role of the environment in the transmission of disease?

    <p>It provides a conducive environment for the agent to breed and come into contact with the host</p> Signup and view all the answers

    What is a common misconception about the phrase 'extrinsic factors' in the context of cancer prevention?

    <p>It only refers to man-made chemicals</p> Signup and view all the answers

    What is a consequence of the long-term use of corticosteroids and cancer chemotherapy?

    <p>Severe immunodeficiency</p> Signup and view all the answers

    According to Denis Burkitt, what is a characteristic of populations with a high fiber intake?

    <p>Large stools and small hospitals</p> Signup and view all the answers

    What is the name of the disease that Burkitt suggested might be prevented or reduced by a high intake of dietary fiber?

    <p>Coronary heart disease</p> Signup and view all the answers

    What is the role of genetic epidemiology?

    <p>To examine the interaction of genes with environmental factors</p> Signup and view all the answers

    What is heritability?

    <p>The contribution of genes to disease</p> Signup and view all the answers

    What is the term for the cause or origin of a disease or abnormal condition?

    <p>Etiology</p> Signup and view all the answers

    What is the benefit of genetic screening in newborns?

    <p>Therapy can be instituted early enough to be beneficial</p> Signup and view all the answers

    What is the primary factor contributing to the increasing proportion of genetic disease?

    <p>Decrease in the incidence of non-inherited disease</p> Signup and view all the answers

    What is the primary goal of the two methods described in determining the percentage of cancers with identifiable causes?

    <p>To estimate the total percentage of cancers having identifiable causes</p> Signup and view all the answers

    What does the BEINGS acronym stand for?

    <p>Biologic, Environmental, Immunologic, Nutritional, Genetic, and Spiritual factors</p> Signup and view all the answers

    Which of the following biologic factors is a risk factor for disease?

    <p>All of the above</p> Signup and view all the answers

    What is the percentage of myocardial infarction (MI) cases among smokers attributed to cigarette smoking?

    <p>50%</p> Signup and view all the answers

    What is the health effect of obesity and overweight?

    <p>Increasing the prevalence of type 2 diabetes</p> Signup and view all the answers

    What is the focus of the second method described in estimating the total percentage of cancers having identifiable causes?

    <p>Examining annual age-specific and gender-specific cancer incidence rates in countries with low rates</p> Signup and view all the answers

    What is one potential health benefit of identifying individuals with specific genetic risks?

    <p>Responding particularly well to specific drugs</p> Signup and view all the answers

    What is a common cause of adverse events in hospitals?

    <p>Medication errors</p> Signup and view all the answers

    What is the potential consequence of unnecessary or inappropriate diagnostic or surgical procedures?

    <p>Illness or disease</p> Signup and view all the answers

    What is the term for the phenomenon where a vaccine diminishes an immunized person’s ability to spread a disease, leading to reduced disease transmission?

    <p>Herd immunity</p> Signup and view all the answers

    What is a factor that can influence an individual's ability to resist noxious stressors?

    <p>Social support</p> Signup and view all the answers

    What is the name of the bacterium that causes legionnaires’ disease?

    <p>Legionella pneumophila</p> Signup and view all the answers

    What is a potential benefit of strong religious faith on health?

    <p>Better health and quality of life</p> Signup and view all the answers

    What is the primary goal of modifying human behavior in health promotion?

    <p>To prevent premature death</p> Signup and view all the answers

    What is the name of the disease that is the first infectious disease known to have been eradicated from the globe?

    <p>Smallpox</p> Signup and view all the answers

    What is a characteristic of Mormons and Seventh-Day Adventists that may contribute to their lower-than-average death rates?

    <p>Prohibited behaviors such as smoking and drinking</p> Signup and view all the answers

    What is the term for disease that occurs as a result of medical treatment or diagnostic procedures?

    <p>Iatrogenic disease</p> Signup and view all the answers

    What is the term for the temporary weakening of the immune system after some infections or vaccinations?

    <p>Transient immune deficiency</p> Signup and view all the answers

    What is the potential benefit of identifying susceptibility genes?

    <p>Receiving targeted medical treatment</p> Signup and view all the answers

    What is the result of a deficiency in the immune system, which can be caused by genetic abnormalities and other factors?

    <p>Immunodeficiency</p> Signup and view all the answers

    What is often the outcome of the initial hypotheses about disease causation provided by epidemiologists?

    <p>Suggestion of ways to prevent diseases</p> Signup and view all the answers

    What is a consequence of the rapid growth in world population and increased travel and contact with new ecosystems?

    <p>Development of new diseases or resurgence of previous disorders</p> Signup and view all the answers

    What is a characteristic of the first identified cases of a new disease?

    <p>They are often fatal or severe</p> Signup and view all the answers

    What is often discovered as more becomes known about a disease?

    <p>Less severe (and even asymptomatic) cases</p> Signup and view all the answers

    What is a consequence of global climate change on diseases?

    <p>It extends the range of some diseases or helps create others</p> Signup and view all the answers

    What is a current concern in the field of epidemiology?

    <p>The threat of bioterrorism and newly emerging disease problems</p> Signup and view all the answers

    What is the role of epidemiologists in providing hypotheses about disease causation?

    <p>To provide initial hypotheses about disease causation for other scientists to test</p> Signup and view all the answers

    What is a challenge in the field of epidemiology?

    <p>The many newly emerging disease problems and the threat of bioterrorism</p> Signup and view all the answers

    What is considered when setting disease control priorities?

    <p>The potential of a disease to spread, its likelihood of causing death and disability, and its cost</p> Signup and view all the answers

    What was a major factor in allocating a larger proportion of national resources to the study and control of AIDS in the early 1980s?

    <p>The rapid increase in incidence over a brief period</p> Signup and view all the answers

    What is the focus of clinical epidemiology?

    <p>Improving disease diagnosis, treatment, and prognosis</p> Signup and view all the answers

    What has been achieved regarding AIDS in the 21st century?

    <p>A degree of control has been achieved through antiretroviral drugs</p> Signup and view all the answers

    What was the cause of severe acute respiratory syndrome (SARS) that appeared in China in 2003?

    <p>An animal coronavirus traced to unusual food animals</p> Signup and view all the answers

    What is considered when determining the best diagnostic tests?

    <p>The selection of the best diagnostic tests, the determination of the best cutoff points, and the development of strategies to use in screening for disease</p> Signup and view all the answers

    What is the focus of epidemiologists in healthcare settings?

    <p>Improving clinical medicine</p> Signup and view all the answers

    What is a primary goal of epidemiologists in health planning?

    <p>To determine present and future community health needs</p> Signup and view all the answers

    What is the primary goal of epidemiologists in setting disease control priorities?

    <p>To allocate resources effectively</p> Signup and view all the answers

    What is a use of epidemiologic methods in patient care?

    <p>To estimate the probable course and outcome of a disease</p> Signup and view all the answers

    Why did support for syphilis control efforts decline in the United States in the 1950s?

    <p>Due to a sharp drop in reported syphilis rates</p> Signup and view all the answers

    What is an area where epidemiologists are being called to testify?

    <p>All of the above</p> Signup and view all the answers

    What is the term for the study and control of AIDS?

    <p>AIDS research</p> Signup and view all the answers

    What is a way that epidemiologic methods can be used in health services research?

    <p>To evaluate medical care in health program evaluation</p> Signup and view all the answers

    What is a component of epidemiology?

    <p>All of the above</p> Signup and view all the answers

    What is a type of analysis used in epidemiology?

    <p>Risk estimation</p> Signup and view all the answers

    What is a goal of epidemiologists?

    <p>To understand the occurrence, distribution, and determinants of diseases</p> Signup and view all the answers

    What is an application of epidemiologic methods?

    <p>All of the above</p> Signup and view all the answers

    What is a factor considered in epidemiology?

    <p>All of the above</p> Signup and view all the answers

    What is a use of demographic projection techniques?

    <p>To estimate future service needs</p> Signup and view all the answers

    What is the term used to describe the variation in the severity of a disease process?

    <p>Biologic spectrum of disease</p> Signup and view all the answers

    In the diphtheria outbreak investigated by James F. Jekel, what was the ratio of symptomatic to asymptomatic cases?

    <p>1:4</p> Signup and view all the answers

    Why is ongoing surveillance of vaccine side effects essential after a vaccine is introduced?

    <p>To detect rare adverse reactions</p> Signup and view all the answers

    What was the problem with the Salk inactivated polio vaccine that led to an outbreak of vaccine-associated poliomyelitis in 1955?

    <p>The vaccine was contaminated with live virus</p> Signup and view all the answers

    Why were measles outbreaks detected in 1971, 1977, and 1990 despite initial progress in vaccination?

    <p>The vaccine was given too early, before maternal antibodies had disappeared</p> Signup and view all the answers

    What is the term for the study of the distribution and determinants of health-related events in a population?

    <p>Epidemiology</p> Signup and view all the answers

    What is the purpose of surveillance in the context of immunization programs?

    <p>To monitor the disease pattern and severity</p> Signup and view all the answers

    What was the outcome of the vaccine surveillance program in the case of the Salk inactivated polio vaccine?

    <p>The vaccine was found to contain live virus</p> Signup and view all the answers

    What was the reason for the development of a smallpox response plan in the United States after 2001?

    <p>The risk of bioterrorism</p> Signup and view all the answers

    What was the outcome of the surveillance of the small number of persons vaccinated against smallpox after 2000?

    <p>The vaccine was found to be associated with cardiomyopathy</p> Signup and view all the answers

    Study Notes

    Epidemiology Definition and Scope

    • Epidemiology is the study of the distribution and determinants of health-related events, diseases, or health-related characteristics among populations.
    • It is a scientific approach to understanding health and disease in populations.

    Origins of Epidemiology

    • Derived from Greek roots: epi (upon), demos (people), and logos (study or discussion)
    • Originated in the 19th century as a response to the need to study and control infectious diseases

    Levels of Disease Study

    • Submolecular or molecular level (e.g., cell biology, genetics, biochemistry, immunology)
    • Tissue or organ level (e.g., anatomic pathology)
    • Level of individual patients (e.g., clinical medicine)
    • Level of populations (e.g., epidemiology)

    Types of Epidemiology

    • Classical epidemiology: focuses on population-oriented studies of health problems, particularly infectious diseases
    • Clinical epidemiology: focuses on patients in healthcare settings, aiming to improve prevention, detection, diagnosis, treatment, and care of illnesses

    Etiology and Natural History of Disease

    • Etiology: the study of the cause or origin of a disease
    • Natural history of a disease: the progression of a disease in the absence of medical or public health intervention
    • Stages of disease:
      • Predisease stage: before disease process begins
      • Latent stage: disease process has begun, but no symptoms yet
      • Symptomatic stage: disease manifestations are evident

    Host, Agent, Environment, and Vector (HAEV)

    • Host: human who is susceptible to disease
    • Agent: disease-causing factor (e.g., virus, bacteria)
    • Environment: external factors that influence disease transmission (e.g., poor sanitation, crowding)
    • Vector: intermediate host or transmitter of disease (e.g., mosquito, tick)

    Risk Factors and Preventable Causes

    • Risk factors: characteristics or exposures that increase the likelihood of developing a disease
    • Preventable causes: factors that can be changed or eliminated to reduce disease occurrence
    • BEINGS model: categories of preventable causes of disease
      • Biologic and behavioral factors
      • Environmental factors
      • Immunologic factors
      • Nutritional factors
      • Genetic factors
      • Services, social, and spiritual factors### Infectious Diseases
    • Respiratory therapy equipment rinsed with water can become a reservoir for Legionella, causing hospital-acquired legionnaires' disease.
    • Lyme disease, first reported in 1975, was found to be caused by the bacterium Borrelia burgdorferi, transmitted by Ixodes ticks.

    Immunologic Factors

    • Smallpox is the first infectious disease to be eradicated globally, due to vaccination conferring individual immunity and herd immunity.
    • Herd immunity occurs when vaccination reduces the ability of immunized individuals to spread diseases, leading to reduced transmission.
    • Immunodeficiency can be caused by genetic abnormalities, infections, vaccines, cancer chemotherapy, and long-term corticosteroid use.

    Nutritional Factors

    • Dietary variations were found to be the main factor in the differing rates of myocardial infarction (MI) between Japanese Americans in Hawaii and Japan.
    • The Japanese diet, rich in fish, vegetables, and fruit, with smaller portions, was associated with lower rates of MI.
    • Denis Burkitt's research showed that a high intake of dietary fiber may prevent diseases such as diabetes and hypertension.
    • Cross-cultural studies revealed that many diseases common in the US are rare in tropical Africa, suggesting that diet and environmental factors contribute to these diseases.

    Genetic Factors

    • Genetic inheritance interacts with diet and environment to promote or protect against illnesses, including heart disease and cancer.
    • Genetic epidemiology studies the distribution of normal and abnormal genes in a population and their interaction with environmental factors.
    • Ongoing research examines the interaction of genes with environmental, nutritional, and behavioral factors, as well as pharmaceutical treatments.

    Services, Social Factors, and Spiritual Factors

    • Medical care services can be beneficial but also dangerous, with iatrogenic disease occurring when a disease is induced by treatment or diagnostic procedures.
    • Adverse events occur in 2.9-3.7% of hospitalized patients, with 19% caused by medication errors and 14% by wound infections.
    • Social and spiritual factors, such as personal beliefs, social support, and religious faith, have been found to influence health and disease.
    • Studies have shown that social support from family, friendship networks, and membership in groups can improve health outcomes.
    • Meditation, massage, and other spiritual practices have also been found to have positive effects on health and quality of life.

    Epidemic Investigation and Disease Control

    • Epidemiologists use surveillance and investigative methods to provide initial hypotheses about disease causation, which are then tested in the laboratory.
    • These methods have suggested the probable type of agent and modes of transmission for diseases, often within months of their recognition as new or emergent diseases.

    Biologic Spectrum of Disease

    • The biologic spectrum of disease refers to the variation in the severity of a disease process, including asymptomatic and mild cases.
    • The iceberg phenomenon illustrates this concept, where most cases remain unseen, below the surface, analogous to asymptomatic and mild cases of disease.
    • Studying only symptomatic individuals may produce a misleading picture of the disease pattern and severity.

    Surveillance of Community Health Interventions

    • Surveillance is essential to ensure the continued safety and effectiveness of vaccines and other preventive measures.
    • The importance of continued surveillance is illustrated in the case of immunization against poliomyelitis, where a vaccine-associated outbreak was detected and addressed through surveillance.

    Setting Disease Control Priorities

    • Disease control priorities should be based on the potential of a disease to spread, its likelihood of causing death and disability, and its cost to individuals, families, and the community.
    • Funding for disease control efforts should be allocated based on these factors, rather than solely on the number of reported cases.

    Improving Diagnosis, Treatment, and Prognosis of Clinical Disease

    • Epidemiologic methods are used to improve clinical medicine, particularly in the diagnosis, therapy, and prognosis of disease.
    • These methods are used to select the best diagnostic tests, determine the best cutoff points for tests, and develop strategies for screening for disease.

    Improving Health Services Research

    • Epidemiologic methods are used in planning and evaluating medical care, including determining present and future community health needs.
    • These methods are also used to estimate the effects of medical care in health program evaluation and cost-benefit analysis.

    Providing Expert Testimony in Courts of Law

    • Epidemiologists are increasingly called on to testify regarding the state of knowledge about topics such as product hazards and environmental exposures.
    • Epidemiologic data is used in lawsuits involving claims of damage from environmental exposures, occupational illness, medical liability, and product liability.

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    Description

    Learn about the definition, origin, and scope of epidemiology, a scientific study of disease distribution and occurrence in populations. Understand what epidemiology entails beyond the study of epidemics.

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