Module1 - Midterm Flashcards
What are the 6 core functions of Epidemiology?
Field Investigation
Analytic studies
Public Health Surveillance
Policy Development
Linkages
Evaluation
(F**k APPLE)
______ is intergral to determining disease burden
public health surveillance
______ is needed to identify the cause of disease
Field investigation
______ helps examine the natural history and prognosis of disease as well as the cause of disease
Analytic studies
Evaluation is a core function of epidemiology that’s used as ____________ as well as __________
an evaluation of therapeutic; non-pharmaceutical public health measures
Evaluation is a core function of epidemiology that includes _____.
policy development, disease control, and healthcare regulations and policies
_____ is one of the core functions of epidemiology, which includes associated with different professional disciplines other than epidemiology such as behavioral and environmental health, and PCP providers
Linkages
The two levels (approaches) of epidemiological studies are: ____, which investigates different levels of associations, and _____ at the population and patient level.
causation; intervention
The study of epidemiology and clinical practice integrate at the level of ____.
intervention
Intervention focused research studies and guidelines help with:
- Prognosis: Narrows down possible cause of illness
- Diagnosis: of specific cause of illness
- Therapies: that are best for specific patient and illness
clinicians utilized epidemiology to ultimately provide patient level ____ and these are concentrated in that areas of ____, ____, and ____.
interventions;
prognosis, diagnosis, and therapy
The natural history of disease is the:
natural progression of what happens after a susceptible person (one who is capable of getting the disease) is exposed
then has biological changes which then many lead to clinical disease then recovery, disability, or death
Non-clinical phase (definition, subdivision, periods)
Definition: (inapparent disease) phase of infection - no signs of sx
Subdivision: Includes pre and subclinical phases
*Pre: no signs of sx yet (pre-symptomatic)
*sub: no signs or sx and never will show (asymptomatic)
Period: time period from exposure to onset of sx
*Latency period: for chronic diseases
*Incubation period: for acute
Clinical Phase (What is it, when does it occur, what happens after)
Definition: signs and sx present
When: 4-7 days after exposure
After: person either recovers, dies, or develops some kind of disability
public health surveillance is integral to ____
determining disease burden
field investigation is needed to ____
identify the cause of disease
Analytic studies help examine ___ as well as ___
the natural history and prognosis of disease; the cause of disease
____ is a core function of epidemiology that’s used as an evaluation of therapeutic as well as non-pharmaceutical of public health measures
Evaluation
The natural history of disease applies to ____ disease
infectious and noninfectious
4 levels of Prevention
Health promotion
Primary
Secondary
Tertiary
Health Promotion: (Aim to do?, Benefits?, Includes?)
aims to maintain health and well being of whole population
Benefits: cheap and non-invasive
Includes: environmental and structural interventions by gov. and societal policies
The two approaches to prevention are ___ and ___ approach
population based; high risk
Prevention measures for high risk populations are targeted because ___, so they’re not ____.
they are more expensive and invasive;
not justifiable to use on the population as a whole
population based interventions, also know as, health promotion, are applied to _____
the whole population
The purpose of population based intervention?
maintain the health and well-being of the entire population
population based interventions include measures like?
education focused on smoking awareness, exercise, diet.
When using Primary prevention strategies, the population has a status of ___. and a goal of _____
1+ risk factors; preventing development of diseases
When using secondary prevention strategies the population has a status of ___, and a goal of ____.
limited disease (biological changes have occurred), preventing disease progression or recurrence
When using ____ strategies, the population has a status of symptomatic or advanced disease, and a goal of reaching complications, preventing disability and/or death, providing rehab
Tertiary prevention
Primary Prevention:
Goal; level; lead to; forms of;
Goal: Identify and target High risk people before they develop disease
Level: Prevention at individual level
Lead to: reduced incidence of disease/disability
Forms of: testing/immunization
What is Secondary Prevention?
asymptomatic but biological changes have begun
What phase does secondary prevention occur?
pre-clinical
Secondary prevention is detected via?
screening
goal of secondary prevention?
reduce consequences of disease by prevention progression. At times doesn’t lead to decrease in disease, but detects and earlier treatable stage
Tertiary Prevention
Prevent disability/death (reduce progression) in those with disease and sx (clinical phase)
Transmission?
manner in which a microorganism leaves its natural reservoir and is transmitted or passed to a susceptible host
Natural Reservoir?
place where microorganisms. normally lives, grows and multiplies
Susceptible host
a person or that can get infected due to their specific level of immunity or other factors such as having a cut which puts them at greater risk for not being able to resist infection.
The two primary modes of transmission are direct which includes ___ and indirect, which includes ___.
contact of projections (droplets); vehicle, vector, air borne
Direct transmission includes ___ such as skin to skin, kissing, sex, and projections
contact
Vehicle borne?
when microorganism is transmitted from one person to another via food, inanimate objects, etc.
vector borne?
transmission includes mechanical (something mechanically carries the organism) and biological vectors (bugs or insects)
airborne transmission?
very small droplet nuclei that can remain sustained in the air for prolonger periods of time (hours); indirect form of transmission
Infectious agents are described by ___ (3)
infectivity, pathogenicity, and virulence
The components that are required for transmission and subsequent disease in a population are:
agent (microbe)
environment
susceptible host
Infectivity
Characteristics of infectious agent that influence its ability enter, survive, and develop in a host (person or animal)
Pathogenicity?
ability of infectious agent to cause changes in our bodies or the way they function.
Signs and sx
____ refers to the manner in which a microorganism leaves its natural reservoir and is transmitted or passed to a susceptible host
Transmission
____ includes contact such as skin to skin, kissing, sex, and projections
Direct transmission
____ is when microorganism is transmitted from one person to another via food, inanimate objects, etc.
Vehicle borne
Virulence
characteristics that allow an infectious agent to cause severe disease or death
Epidemic
increase, often sudden, in the number of cases of a disease what is normally expected in that population in that area
Outbreak
same as epidemic (increase in # cases of disease in area)
used for far more limited geographic area
Cluster
aggregation of cases grouped in place and time
that are suspected to be greater than the number expected, even though the expected number may not be known
Endemic
constant presence of disease in a population and geographic region (baseline)
persistently high = hyper endemic (increase in the baseline)
Pandemic
epidemic spread over several countries or continents
affecting large number of people
endemic that has crossed borders
An outbreak can be considered “over” typically after ___
2 incubation periods from the day of onset of the last case
____ is the distribution of an outbreak’s cases over time
Time trend
____ is a graph of time (X) and number of cases (Y)
Epidemic curve
Epidemic curves can show us:
- general sense of outbreak’s magnitude
- inference about outbreak’s pattern of spread
- most likely time period of exposure
Patterns of epidemic curve - common source
originates from a single source; further divided into point, continuous, intermittent
Patterns of epidemic curve - propagated
propagated from one person to another (contagious)
time between peaks is ~1 incubation period
1st step of an outbreak investigation
Establish existence –> make sure not dealing with pseudo-outbreak
2nd step of outbreak investigation
Confirm dx –> need to know organism to begin to control it
3rd step of outbreak investigation
Prepare to Investigation/field work (Identify investigation team) –> want team/resources that will be good for investigation
4th step of outbreak investigation
create case definition –> who are going to be your case patients? should include elements of place, person, and time
5th step of outbreak investigation
Find cases (systematically) –> put out info to cast a wide net to find cases
6th step of outbreak investigation
develop hypothesis (perform studies) –> put together time list, conduct interviews to develop
7th step of outbreak investigation
evaluate hypothesis –> perform descriptive/analytic studies
8th step of outbreak investigation
implement control measure –> use case control studies to see if associations outside of disease
9th step of outbreak investigation
Communication findings –> inform appropriate organizations, gov agencies (internal and external communication)
10th step of outbreak investigation
Maintain surveillance –> keep track, to note if increase in cases
Reasons for outbreak investigations
Control/Prevention
Research/Training opportunities
Address public, political, and legal concern
____ and ___ integrate at the level of intervention
study of epidemiology; clinical practice
the ____ phase is also known as inapparent disease
non-clinical
there are always caveats to outbreaks including:
they are not linear and some steps may not always be applicable
Examples of primary prevention
smoking cessation programs, weight loss programs, population based genetic testing
Examples of Secondary Prevention
breast cancer screening
BP screening
pap-smear
disease is usually diagnosed at the ____ phase
clinical
