Epidemiology Final

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Dkuczajda
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Epidemiology Final
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2011-04-23 12:39:46
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epidemiology outbreak investigation sleep environmental genetic molecular
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epidemiology outbreak investigation sleep epidemiology environmental genetic molecular
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  1. Methods of Outbreak Epidemiology
    • Clinical observations
    • Epidemic curve
    • Incubation period
    • Attack rate
    • Case mapping
    • hypothesis formulation and confirmation
    • Draw conclusions
  2. The pattern of symptoms suggests possible infectious agents
    Clinical observations
  3. Possible symptoms of an outbreak include:
    • fever
    • nausea
    • vomiting
    • diarrhea
    • stomach pain
    • headache
    • rashes
  4. A graphic plottin gof the distribution of cases by time of onset.
    Epidemic curve
  5. In conjunction with information about symptoms, provides clues to possible infectious disease agents
    Incubation period
  6. Used frequently to describe the occurence of foodborne illness, infectious disease, and other acute epidemics
    attack rate
  7. Attack rate formula
    Ill/(Ill + Well) X 100
  8. Can be used to locate cases in relation to environmental exposures to pollution, identify contacts of cases, and conduct many other innovative health research investigations
    Case mapping
  9. Using the information gathered, the epidemiologist may formulate a hypothesis regarding the causative agent
    Hypothesis formation and confirmation
  10. Plan for the prevention of future outbreaks
    Draw conclusions
  11. People are exposed continuously or intermittently to a harmful source, brief or long exposure.
    Common source
  12. Intermittent exposure
    Epidemic curve with irregular peaks that reflect timing and extent of exposure
  13. Continuous exposure
    Causes cases to rise gradually and plateu rather than peak
  14. Spread person to person, may have multiple waves with an epidemic curve that has progressively taller peaks an incubation period apart
    Propagated
  15. Ability of a test to identify correctly all screened individuals who actually have the disease.
    Sensitivity
  16. Ability of a test to identify nondiseased individuals who actually do not have a disease.
    Specificity
  17. Proportion of individuals who are screened positive by a test and actually have the disease
    Predictive positive value
  18. Proportion of individuals who are screened negative by a test and actually do not have the disease
    Predictive negative value
  19. Choice of behavioral factors that affect how we live
    Lifestyle
  20. The discipline that examines the social distribution and social dterminants of states of health
    Social epidemiology
  21. The study of the role of behavioral factors in health
    Behavioral epidemiology
  22. Social adversities
    • Poverty
    • Discrimination
  23. Non-REM sleep
    • Stage 1- Muscle activity slows down, light sleep awakened easily.
    • Stage 2- Starts within 10 minutes, lasts around 20 minutes. Breathing pattern and heart rate start to slow down. Longest stage.
    • Stage 3- Brain begins to produce delta waves, large slow wave patterns. Breathing and heart rate at lowest levels.
    • Stage four- rhythmic breathing and limited muscle activity. Feel groggy after being awakened from this stage.
  24. REM sleep
    Usually begins 70-90 minutes after we fall asleep. Brain is very active, most dreams occur at this stage.
  25. Sleep cycle
    • Lasts 90-110 minutes
    • average person experiences 4-5 cycles each night
  26. Sleep ranks among the _______ most important considerations in maintaining good healt
    3
  27. ___% of US population experience sleep problems
    62
  28. ____% of US adults have NEVER discussed sleep problems with their physician
    80
  29. Characterized by persistent sleepiness, general lack of energy
    DOES- disorders of excessive sleepiness
  30. DIMS
    Disorders of initiating and maintaining sleep
  31. Sleep terror disorders and sleepwalking
    parasomnias
  32. Major Sleep Disorders
    • Insufficient sleep
    • Insomnia
    • Sleep apnea
    • Shift work sleep disorder
    • Restless legs syndrome
    • Narcolepsy
  33. Cannot initiate or maintain sleep
    May be transient
    May persist
    High likihood of psych sequelae
    Insomnia
  34. Self-limits sleep
    Transient
    Lowe liklihood of sequalae
    Insufficient sleep
  35. Effects of insomnia on health
    • Poor concentration
    • Decreased QOL
    • Contributes to depression and anxiety
    • Decrements in work quality
    • Increased healthcare utilization
  36. Sleep apnea percentage by age group
    • Children- 2-3%
    • Middleaged adults- 5-7%
    • older adults- >15%
  37. Narcolepsy epidemiology
    Men or women?
    Age of onset?
    Prevalence?
    • 1 in 2000 in US
    • Men and women affected equally
    • Can present at any age, but mostly 15-30 years and 6% prior to 10
  38. Fundamentally a sleep disorder
    Results in loss of boundaries between sleep and wakefulness
    Can't stay awake during the day, can't sleep during the night
    Narcolepsy
  39. Symptoms of Narcolepsy
    • Sleepiness with more or less discrete attacks
    • Cataplexy
    • Hallucinations
    • Sleep paralysis
    • Disrupted nocturnal sleep
  40. Sleep disorders are common
    • 70 million adult americans have clincially significant sleep problems
    • Insomnia affects 1/3 of the population
  41. Sleep disorders are treatable
    • Pharacotherapy
    • Behavioral therapy
    • Continuous positive airway pressure
    • Surgical therapy
  42. Sleep disorders are underdiagnosed
    95% of people with as leep problem ramin unidentified and undiagnosed
  43. Populations Pyramid Structure
    • Males on the left, females on the right
    • Population in five year age bands
    • From top to bottom: Old dependants, economically active, young dependants.
    • Usually in % to make for easier comparisons between countries
  44. Slope of the pyramid indicates
    death rate
  45. WIdth of the base is related to
    birth rate/fertility rate
  46. Height of the graph can indicate
    life expectancy
  47. Proportions of men and women can suggest
    male or female migrations
  48. "kinks" indicate dramatic
    reductions in brith rate or increases in death rates in the past
  49. Area of graph indicates
    total population
  50. Overall shape can indicate
    whether it is an economically more developed country or an economically less developed country
  51. A broad base population pyramid means:
    • Increase food production
    • Build more homes and schools
    • Plan fo rmore job oppurtunities for the young in the future
    • Implement birth control program/campaigns
    • Usually agricultural with problems of overpopulation
    • Many dependants
  52. Triangle shaped pyramid is
    typical of countries in poorer parts of the world (LEDCs)
  53. In triangle shaped pyramids with a shortened base, what is happening?
    The gobernement is encouraging couples to have smaller families.
  54. A narrow based population pyramid means:
    • Work out incentives to encourage more births
    • Hiring foriegn labor
    • Proper medical services and health care for the aged
  55. Population pyramid with both low birth and low death rate
    Typical of MEDCs in richer parts of the world
  56. Characterized by high birth and high but fluctuating death rates. When births only slightly exceed deaths, the population gros slowly.
    Stage 1
  57. Declining death rates with high birth rates
    2nd stage
  58. Birth rate falls and death rate remains low, population size levels off
    Stage 3
  59. Very low birth and death rates. Very slight % increases in population
    4th stage
  60. Human Genome Project
    Jointly coordinated by the US department of Energy and the National Institutes of Health
  61. Year HGP completed
    2003
  62. One goal of HGP
    TO identify all of the genes in human DNA
  63. A subfield of epidemiology that uses molecular markers in additiont o genes to establish exposure-disease relationships
    Molecular epidemiology
  64. Genetic Marker
    Used in reference to susceptibility genes
  65. Field concerned with the identification of inherited factors that influence disease and how variation in the genetic material interacts with environmental factors to increase or decrease risk of a disease.
    Genetic epidemiology
  66. Examples of conditions with a genetic bases
    • hemophilia
    • Tay-Sachs
    • Sickle cell
    • Down's syndrome
    • BRCA1 and BRCA2 genes
    • COngenital malformations
  67. Sex-linked disorder
    hemophilia
  68. Hemophilia
    • Affected persons are always males
    • Males inherit the trait from mothers who are carriers
    • Females inherit the carrier gene from affected fathers
  69. Treatment for hemophilia
    • Prophylaxes- continued injection of clotting factors
    • After injury- transfusion of clotting factors
  70. Denotes those diseases for which two copies of an altered gene are required to increase risk of the disease
    Autosomal recessive
  71. Examples of autosomal recessive diseases
    • Sickle cell
    • Tay-Sachs
  72. Refers to a situation in which only a single copy of an altered gene located on a non sex chromosome is sufficient to cause an increased risk of disease
    Autosomal dominant
  73. Down's syndome
    Caused by the presence of an extra 21st chromosome
  74. Results of Down's syndrome
    • Heart disease
    • Visual/hearing impairments
    • Ahlzheimer's
    • Thyroid problems
    • diabetes
  75. Edward's syndrome
    Caused by abnormality in chromosome 18, low survival rate, similar to Down's
  76. Congenital malformations
    Defects present at birth
  77. Causes of congenital malformation
    • Genetic/chromosomal
    • Environmental
  78. Incidence
    • 2-3% newborn
    • 40-60% have unknown cause
    • Genetic cause- 10-15%
    • Environmental cause- 10%
    • Multi- 20-25%
  79. Major Structural Birth Defects
    • Result from a malformation, deformation, or disruption in one or more parts of the body
    • Are present at birth
    • Have a serious adverse effects on health, development, or functional ability
  80. Refers to the study of diseases and conditions that are linked to environmental factors.
    Environmental epidemiology
  81. Effects of radiation on unborn children
    • Microencephaly
    • Skull defects
    • Spina bifida
  82. Effects of atomic bomb in Japan
    • 25% aborted
    • 25% had abnormalities of CNS
    • 25% died by <1 year
  83. Any infection can by pyrogenic, hyperthermia can be
    teratogenic
  84. 6 criteria pollutants
    • CO- vehicle exhaust
    • Sulfur dioxide- coal burning
    • Nitrogen dioxide- vehicle/industry
    • Ozone- smog
    • Particulate matter
    • Lead- gasoline additive
  85. Air pollution consequences
    Mortality, coronary heart disease, chronic obstructive pulmonary disease, asthma, and lung cancer
  86. Factors contributing to global warming
    • Use of fossil fuels
    • Widespread deforestation
  87. Global warming linked to
    • Northward movement of disease-carrying arthropods
    • Melting glaciers
    • Extreme climatic conditions such as heat waves
  88. Alcohol effects on unborn child
    Fetal alcohol syndrome
  89. DDT
    Use discontinued because of possible adverse animal and human health effects, eg, damage to bird species
  90. Dioxins
    Possible disrupters of immune, endocrine, reproductive, and nervous systems.
  91. Polychlorinated biphenyls
    Dioxin-like chemicals designated as probable human carcinogens
  92. Heavy metals
    • Lead
    • Mercury
  93. Lead
    Exposure is assoicated with serious central nervous system effects and other adverse health consequences, even when ingested at low levels.
  94. Mercury
    Highly toxic metal that is particularly hazardous to the unborn children of pregnant women.
  95. Nuclear facilities
    • Include weapons production palnts, tests sites, and nuclear power plants
    • Potential sources for exposure of the population to ionizing radiation
  96. Focuses on adverse health outcomes associated with the work environment.
    Epidemiology and Occupational Health
  97. Potential hazards at work
    • High noise levels
    • Fumes and dusts
    • Toxic chemicals
    • Biohazards
    • Stress
  98. studies the distribution and determinants of injuries (intentional and unintentional) in the poulation
    Injury epidemiology
  99. 5th most frequent cause of mortality in the US
    Unintentioal injury

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