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epidemiology

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study of distribution and determinants of disease in human populations

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distribution

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pattern of disease occurrence in and among populations or subgroups

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determinants

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factors capable of bringing a change in health

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preventative, causal

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determinants can be ---- or ----

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random

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epidemiology is based on two assumptions; disease does not occur at --- is one of them

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determinants

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epidemiology is based on two assumptions; _____ of disease can be identified through systematic investigation of populations or subgroups within populations is one of them

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history,etiology

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epidemiology is used to describe the natural ___ of disease and to identify ___ or cause of disease

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epidemiology

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this word means "upon the people"

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descriptive epidemiology

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examination of distribution of disease in population in terms of person place and time

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distribution

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descriptive epidemiology examines the ____ of disease in population in terms of person place and time

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subgroups,highest

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descriptive epidemiology identifies ____ that may have ___ risk of disease or outcome of interest

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causes, hypotheses

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descriptive epidemiology helps to find clues about potential ___ of disease and to generate ____ about relationship between exposures and outcomes

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analytic epidemiology

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investigation of determinants of disease

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determinants

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analytic epidemiology investigates ____ of disease

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hypothesis,etiology

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analytic epidemiology consists of ___ testing and is used to determine ___ of disease or health related outcomes

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EBP

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epidemiology in nursing practice supports ___

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effect, extent

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epidemiology in nursing practice helps determine ___ and ___ of disease in population

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prevention,treatment,control,research

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epidemiology in nursing practice helps decision making regarding ___. ___, ___, and ___ of disease in populations

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etiology

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epidemiology in nursing practice helps identify ___ or cause of disease

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factors

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epidemiology in nursing practice helps determine ___

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strategies

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epidemiology in nursing practice helps to identify ___ to improve health outcomes

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best

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epidemiology in nursing practice helps to implement various strategies to determine ___ practice

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control,eradicate

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the goal for epidemiology is to ___ infectious diseases and to ___ them when possible

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endemic

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diseases localized to a particular geographic area

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eradication

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when an infectious agent no longer exists in human population

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smallpox

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this is the only eradicated disease

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host

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the human is the ---

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human

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the host is the __

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organism

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the agent is the __

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agent

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the organism is the __-

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environment

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this is the world in which we live

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host,agent,environment

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what makes up the epidemiologic triangle?

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direct, indirect

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transmission of infectious diseases may either be ___ or ___

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person,person

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direct transmission is from ___ to ___

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vehicles,vectors,airborne

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indirect transmission is either through ___ ___ or ___ mechanisms

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epidemic

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a widespread occurrence of an infectious disease in a community at a particular time

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pandemic

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infectious disease prevalent over a whole country or the world

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transmission

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the purpose of an outbreak investigation is to stop the ___ of disease from environment to host, host to agent, or agent to environment

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environment, host

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handwashing, water chlorination, and food safety are strategies to reduce the transmission of disease from the ___ to the ___

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agent,host

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immunization, isolation, and treatment are strategies to reduce transmission of disease from the ___ to the ___

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agent, environment

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insect and vector controls (mosquito netting) are strategies to reduce transmission of disease from the ___ to the ___

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prevent

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during an outbreak investigation, the disease is researched, outbreak existence is verified, diagnosis is then verified, define identify cases, describe data in terms of person place and time, develop hypotheses, test hypotheses, implement measures to control oubteak and --- further occurrences

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count data

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raw number of health phenomena under investagion in epidemiology. includes health events births cases of a disease and deaths.

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different

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count data is not useful when comparing populations of ___ sizes

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ratios

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highest level of measurement. involves numeric values that begin with an absolute zerio and have equal intervals. mathematic relationship between two numbers. used to compare and contract health outcomes across populations

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proprtion

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type of ratio where the numerator is included in the denominator. numerator and denominator have association

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cases

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numerator= number of ___. deaths or events (proportion)

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population

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denomenator= ___ being studied (proportion)

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prevalence

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proprtion is used to describe the ____ cumulative incidence case fatality rates and attack rates

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rate

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measure of disease frequency in defined populations over specific period of time. used to describe incidence density mortality rates and fertility rates.

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people

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numerator= number of ___ affected (rate)

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population

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denominator= entire ___ (rate)

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incidence and prevalence

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rates that describe extent to which disease is present in a population

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prevalence

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number of existing cases of disease present in a population. indicator of extent of a health problem. used for planning healthcare needs for communities

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point prevalence

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comparing number of flu cases on a certain day (1/1/14, 1/1/15)

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period prevalence

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comparing number of flu cases from Jan2014-Jan2015

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descriptive

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prevalence describes ___ study designs including case reports and serios ecologic studies and cross sectional studies. hypothesis generating and examines different types of phenomena

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case reports or series

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epidemiologic reports used to describe rare diseases or outcomes.

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new

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case reports /series are used to describe ___ dieseas, explain a change in dissease patterns or alert healthcare community to unusaul signs and symptoms in an indiviudal patient or rare findings among a few patients

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case reports

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____ or series are used describe new dieseas, explain a change in dissease patterns or alert healthcare community to unusaul signs and symptoms in an indiviudal patient or rare findings among a few patients

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ecologic studies

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correlational studies that are population based rather than invidual based. analysis of population

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frequency

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ecologic studies are used to compare summary measure of disease ___ across summary measures of exposure comapre distribution and determinants of dieasese

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exposure

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contact with a disease or a disease producing agent

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aggregate data

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data collected from individauls that are grouped to represent a population

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ecologic fallacy

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when false assumptions are made about individuals based on aggregated data and associtions from populations

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temporal ambiguity

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inability to control for confounding variables and the inability to determine wheteher the exposure turly occurrred before the disease

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cross sectional

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nonexperimental design used togather data from a group of subjects at only one point in time study design used to measure exposed and disease as each exists in a population or represenative sample at one specific point in time. snap shot. estimates magnititue of association between expsorue and disease

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prevalence studies

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estimates magnitude of association between exposure and disease

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incidence

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number of new cases of a disease in a population during a specific period of time. measure of disease occurrence. used for investiagtion causes of diease. investiage risk of diease in pops or subgroups r/t many factors such as age gender occupation and expsoures.

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descriptive epidemiology

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used to identify subgroups in populations that may have highest risk for a specific disease or outcome . used to find clues about potentioal causes of diease. used so nurses can genearte hypotheses about relationship between exposures and diseases or other healthcare outcomes

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subgroups, highest

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descriptive epidemiology is used to identify ___ in populations that may have the ____ risk for a specific disease or outcome

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descriptive epidemiology

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this is used to measure frequency by person place and time to determine why disease occurs more frequently under certain conditions

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person

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factors that contribute to frequency of diseases and health related outcomes. age, diet/exercise, ethnicity, marital status, parity, religion, smoking, alcohol, education, genetic markers, occupation, race, sex, socioeconomic status

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place

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altitude, country, distance from exposure site, pollution, rural, sunlight, zip code, city, county, latitude, rainfall, state, urban, spatial clustering

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time

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secular, cyclical, or short term

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secular

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changes occur over a long period of time. difficult to interpret

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cyclical

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seasonal. trend. often predictable recur over time seen more rapidly in health care

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short term

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brief unexpected changes in disease distribution. measles outbreak at disney land for example.

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endemic

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expected occurrence of a particular disease within a community or population. ongoing. usual. constant presence. example influena. malaria in asia.

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epidemic

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widespread occurrence of a disease in a community or population that is in excess of what is expected. attacks many people at the same time. community region. sars 2010 outbreak.

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pandemic

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epidemic that has spread worldwide. covers extensive region, country, or continent.

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analytic study design

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hypothesis testing. used to test association between exposure and disease

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case control study

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type of retrospective study in which researchers begin with a group of people who already have the disease; studies that compare two groups those who have a specific condition and those who do not have the condition. selected based on absence or presence of disease. cases with disease. control is without

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odds ratio

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statistic reported when epidemiologists ocnduct a case control study

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cohort studies

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quasi experimental studies using two or more groups; epidemiologic designs in which subjects are selected based on exposure to a determinant. people followed over time.

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relative risk

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statistic reported by epidemiologists when they conduct a cohort study

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intervention study

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a study that has a treatment that can be manipulated by the reseracher. placebo and soc group. random assignment

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screening

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testing people without known disease to determine whether they have a disease; used to reduce morbidity and mortality in populations

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sensitivity

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ability of a test to correctly identify people with the disease by positive test results

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specificity

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ability of the test to correctly identify people without the disease by negative results

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positive predictive value

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probability that a person who screens positive actually has the disease

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false negative

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when a screening gives negative results despite presence of the disease

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false positive

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when a screening gives positive results even though the disease is not present

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epidemiologic designs

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provide sound methodology to investigate patterns of disease to best determine contributing factors to improve health outcomes and services. measures frequency of disease in clinics hospitals and communities. and describes diseases by persons place and time. examines cost benfit screening initiatives by examining sensitivyt, specificity, and PPV of screening tests. outbreaks can be investigated when there appears to be an excess of disease. analyze best practice wtih case control and cohort studies. evaluabe EBP interventions using these and meaures

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