Chapter 12

Question 1

Agent

Answer 1

causative factor invading a susceptible host through an environment favorable to produce disease, such as a biological or chemical agent

Question 2

Analytic Epidemiology

Answer 2

an epidemiological study designed to investigate associations between exposures or characteristics and health or disease outcomes, often with a goal of understanding the etiology (or origins and causal factors) of disease

Question 3

Attack Rate

Answer 3

a type of incidence rate defined as the proportion of persons exposed to an agent who develop the disease, usually for a limited time in a specific population

• Another measure of morbidity, often used in infectious disease
  investigations,

Question 4

Bias

Answer 4

a systematic deviation of observed values from the true value

Question 5

Case-control Design

Answer 5

can be viewed against the background of an underlying cohort. The design uses a sample from the cohort rather than following the entire cohort over time. Because it uses only samples of cases and non cases, it is a more efficient design, although it is subject to certain types of bias

Question 6

Case-control Study

Answer 6

participants are enrolled because they are known to have the outcome of interest (cases) or they are known not to have the outcome of interest (controls)

Question 7

Case Fatality Rate (CFR)

Answer 7

the proportion of persons diagnosed with a particular disorder (i.e., cases) that die within a specified period of time

Question 8

Cohort Study

Answer 8

an epidemiological study in which subjects without an outcome of interest are classified according to past or present (or future) exposures or characteristics and followed over time to observe and compare the rates of some health outcome in the various exposure groups

Question 9

Cross-sectional Study

Answer 9

an epidemiological study in which health outcomes and exposures or characteristics of interest are simultaneously ascertained and examined for association in a population or sample, providing a picture of existing levels of all factors

Question 10

Cumulative Incidence Rate

Answer 10

reflects the cumulative effect of the incidence rate over the time period, whether it is a month, a year, or several years

Question 11

Descriptive Epidemiology

Answer 11

an epidemiological study designed to describe the distribution of health outcomes according to person, place, and time

Question 12

Determinants

Answer 12

factors that influence the risk for or distribution of health outcomes

Question 13

Distribution

Answer 13

the pattern of a health outcome in a population; the frequencies of the outcome according to various personal characteristics, geographic regions, and time

Question 14

Ecologic Fallacy

Answer 14

a bias that may occur in ecologic studies because associations observed at the group level may not hold true for the individuals that compose the groups, or associations that actually exist may be masked

Question 15

Ecologic Model

Answer 15

this approach expands epidemiologic studies both upward to broader contexts (such as neighborhood characteristics and social context) and downward to the genetic and molecular level

Question 16

Ecologic Study

Answer 16

an epidemiologic study in which only aggregate or group data, such as population rates, are used rather than data on individuals

Question 17

Environment

Answer 17

all of those factors internal and external to the client that constitute the context in which the client lives and that influence and are influenced by the host and agent-host interactions. The sum of all external conditions affecting the life, development, and survival of an organism

Question 18

Epidemic

Answer 18

occurrence of a disease within an area that is clearly in excess of expected levels (endemic) for a given time period

Question 19

Epidemiologic Triangle

Answer 19

interaction among the host, agent, and environment

Question 20

Epidemiology

Answer 20

study of the distribution of disease, or other health-related states and events in human populations, as related to age, sex, occupation, ethnicity, and economic status in order to identify and alleviate health problems and promote better health

Question 21

Health

Answer 21

a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity. Four models of health, ordered from narrow to broad, are (1) clinical health, the absence of disease; (2) role-performance health, the ability to satisfactorily perform one’s social roles; (3) adaptive health, flexible adaptation to the environment; and (4) eudaemonistic health, self-actualization and the attainment of one’s greatest human potential

Question 22

Host

Answer 22

a living organism, human or animal, in which an infectious agent can exist under natural conditions

Question 23

Incidence Proportion

Answer 23

the frequency or rate of new cases of an outcome in a population; provides an estimate of the risk of disease in that population over the period of observation

• indicates the
  proportion of the population at risk who experience the event
  over some period of time, for example, the proportion of
  the population who develop influenza during a given year

Question 24

Levels of Prevention

Answer 24

a three-level model of interventions based on the stages of disease, designed to prevent, halt, or reverse the process of pathological change as early as possible, thereby preventing damage

Question 25

Mortality Rates

Answer 25

key epidemiological indicators of interest to nurses. Mortality rates are informative only for fatal diseases and do not provide direct information about either the level of existing disease in the population or the risk of getting any particular disease

Question 26

Natural History of Disease

Answer 26

the course of a disease process from onset to resolution without intervention by humans

Question 27

Negative Predictive Value

Answer 27

proportion of persons with a negative test who are disease free

Question 28

Point Epidemic

Answer 28

a concentration in space and time of a disease event, such that a graph of frequency of cases over time shows a sharp point, usually suggestive of a common exposure

Question 29

Popular Epidemiology

Answer 29

a form of epidemiology in which lay people gather scientific data as well as mobilize knowledge and resources of experts to understand the occurrence and distribution of a disease or injury

Question 30

Positive Predictive Value

Answer 30

the proportion of persons with a positive screening or diagnostic test who do have the disease (the proportion of "true positives" among all who test positive).

Question 31

Prevalence Proportion

Answer 31

a measure of existing disease in a population at a particular time (i.e., the number of existing cases divided by the current population).

Question 32

Proportion

Answer 32

a type of ratio in which the denominator includes the numerator

Question 33

Proportionate Mortality Ratio (PMR)

Answer 33

the proportion of all deaths that are attributable to a specific cause

Question 34

Public Health

Answer 34

organized community efforts designed to prevent disease and promote health

Question 35

Rate

Answer 35

measure of the frequency of a health event in a defined population during a specified period of time

Question 36

Reliability

Answer 36

the precision of the measure; its consistency or repeatability

Question 37

Risk

Answer 37

the probability of some event or outcome within a specified period of time

Question 38

Screening

Answer 38

identifies individuals with unrecognized health risk factors or asymptomatic disease conditions in populations

Question 39

Secular Trends

Answer 39

long-term patterns of morbidity or mortality (i.e., over years or decades)

Question 40

Sensitivity

Answer 40

the proportion of persons who actually have a disease who will have a positive screening or diagnostic test; or the probability that a person with a disease will be correctly classified by the test

Question 41

Social Epidemiology

Answer 41

the branch of epidemiology that studies the social distribution and social determinants of health and disease

Question 42

Specificity

Answer 42

the proportion of persons who do not have a disease and who will have a negative screening or diagnostic test, or the probability that a person without disease will be correctly classified by the test.

Question 43

Surveillance

Answer 43

involves the systematic collection, analysis, and interpretation of data related to the occurrence of disease and the health status of a given population

Question 44

Validity

Answer 44

the accuracy of a test or measurement; how closely it measures what it claims to measure. In a screening test, validity is assessed in terms of the probability of correctly classifying an individual with regard to the disease or outcome of interest, usually in terms of sensitivity and specificity

Question 45

Web of Causality

Answer 45

the complex interrelations of factors interacting with each other to influence the risk for or distribution of health outcomes

Question 46

Incidence Rate

Answer 46

quantifies the rate of development of new cases in a population at risk