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UK / Public Health / CPH 310 / What natural pass did daniel boone go through appalachians?

What natural pass did daniel boone go through appalachians?

What natural pass did daniel boone go through appalachians?


School: University of Kentucky
Department: Public Health
Course: Disease Detectives: Epidemiology in Action
Term: Fall 2016
Cost: 50
Name: Midterm Study Guide
Description: from all 15 lectures
Uploaded: 10/16/2016
7 Pages 140 Views 1 Unlocks

CPH 310 Review

What natural pass did daniel boone go through appalachians?

∙ Communicable Diseases (Lecture 3)

- Communicable disease: an illness due to a specific infectious agent or its  toxic products that arises through transmission of that agent or its  products from an infected person, animal, or reservoir to a susceptible  host.

- Infection: the entry and multiplication of an infectious agent within, or  intruding into, the body

- Infestation: the presence of an agent on the surface of the body o Lice, scabies

- Contamination: the presence of an infectious agent on articles of apparel  or soiled articles

 - Zoonosis: a disease that can be naturally transmitted between animal  (vertebrae) hosts and human

What are acute and chronic diseases give examples?

Don't forget about the age old question of Where is the thyroid gland located anatomically?

o Influenza strains, rabies

 - Emerging pathogen: an agent or infectious disease whose incidence is  increasing following its appearance in a new host population o Ebola If you want to learn more check out What does self-awareness mean to people?

- Susceptibility of a host to disease factors:

o Genetics

o Nutrition

o Prior exposure

o Vaccination

o Presence of other diseases

o Age

- Direct transmission

o Person to person contact

∙    Touching

∙    Kissing

∙    Sex

What are social environmental factors?

We also discuss several other topics like What is the major premises in constructivism?

∙    Airborne, short-distance-via droplets from coughing or  


∙    Transplacental

- Indirect transmission

o Vehicles/fomites (contaminated inanimate objects)

∙     Food

∙     Water

∙     Toys

∙     Surgical tools, syringes We also discuss several other topics like What are the four main points of dalton's theory?

o Vector (transmission through another animal)

∙     Mammals

∙     Arthropods

- Airborne, long distance-when microbes are aerosolized and remain  suspended in air for long periods of time

 - Infectivity: the ability of an agent to invade and multiply in a host  - Pathogenicity: the ability to produce disease, given infection  - Virulence: severity of the disease caused by the agent If you want to learn more check out What kind of properties is determined by the shape of the polymers?
If you want to learn more check out Who guards the guardians?

 - Incubation period: the time it takes from exposure until the infectious  agent begins producing disease symptoms

 - Herd immunity: prevalence of immunity among others, which makes it  more difficult for disease to spread throughout the population  - Convalescent carrier: infectious, but recovering from illness  - Incubatory carrier: infectious, but in early, pre-clinical stage of disease  - Endemic: usual level of disease in the population of a defined area  - Epidemic: an unusually high level of a disease in a defined area  - Pandemic: an unusually high level of a disease globally, or over a very  wide area

- Epi Curves are useful for describing:

o Magnitude

o Outliers

o Temporal trend

o Incubation period

∙     Chronic Diseases (Lecture 4)

 - Acute: diseases with a sudden onset, sharp rise, and short course  - Chronic: diseases marked by long duration or frequent recurrence - Chronic illness is characterized by:

o Uncertain etiology

o Multiple risk factors

o Long latency periods

o Prolonged course

o Non-contagious agent

o Incurability

o Functional impairment

- Leading cause of death and disability in US

- 70% of all deaths in the US

- Big 3: heart disease, cancer, diabetes

- Epidemiologic Transition

o 1st era in public health: the communicable diseases

o 2nd era: chronic disease era

∙     Began in the mid-20th century, particularly among the  

industrialized nations

o First occurred among the affluent in developed countries

o Death rate falls

o Birth rate initially stays the same, then later falls

- Prevention Types

 o Primordial: social, economic, or environmental factors

∙     Reduce air pollution, support active transportation, higher  taxes for cigarettes

 o Primary: intervene before disease develops

∙     Improving diet, quitting smoking, exercise, vaccinations

 o Secondary: intervene early in the course of the disease (usually via  screening)

∙     Colonoscopy, mammogram, pap smear

 o Tertiary: prevent disability

∙     Statins, daily aspirin, insulin

∙     Measuring Disease I & II (Lectures 5-6)

 - Incidence 

o Measures the new occurrence of a disease in a population o RISK of disease in a population

 - Prevalence 

o Measures the current existence of disease in a population  o Prevalence= Incidence X Duration of disease

o BURDEN of disease in a population

 - Death Rates 

o Case fatality

∙     # deaths from a disease/# diagnosed with disease

∙     Disease severity

o Disease specific

∙     # deaths due to a specific disease/total population

o Age-specific

∙     # deaths in a specific age group/population in same age  


o Crude mortality

∙     # deaths/ total population

o Proportionate Mortality

∙     Proportion of deaths due to a specific cause

∙     Always a percent

 - Age Standardization 

o Necessary when comparing rates of disease across populations with different age distributions

o Age-adjusted rates

∙     Multiply age specific rates from each population by  

population counts for the same age groups in a reference  


o Standardized mortality ratios

∙     (deaths observed/deaths expected)* 100

∙     <100 means lower mortality

∙     >100 means higher mortality

∙ Study Designs (Lectures 7-10)

- Hierarchy of Evidence

o Systematic Review ***Top

o Experimental

o Cohort

o Case-control

o Cross-sectional

o Case report/case series

o Ecological (population) **Bottom

- Types of Studies

o Ecological

∙ A study in which the units of analysis are populations or  

groups, rather than individuals

∙ Geography based

∙ Temporal trend

∙ Strengths

∙ Good for hypothesis generation

∙ Especially good for rare diseases

∙ Good for evaluation of population-wide changes or  differences, perhaps related to policies, law

∙ Inexpensive and quick, since they are relying on  

existing data

∙ Weaknesses

∙ Ecological fallacy: inappropriate conclusions regarding  relationships at the individual level, based on  

observations at the group level

∙ Group-level data are not always good evidence of a  casual link at the individual level

∙ Atomistic fallacy: the opposite, where group level  

relationships are erroneously based on observations at the individual level

∙ Very difficult to control for confounding

∙ Exposure and disease unknown at individual level

o Cross-Sectional

∙ Examines the relationship between diseases and exposures  as they exist at one particular point in time

∙ Strengths

∙ Can often be completed with existing data, so  

relatively quick, inexpensive

∙ Can adjust for effects of other variables

∙ Exposure usually current, easier for subjects to recall ∙ Weaknesses

∙ Cannot establish temporal relationship

∙ Prevalent cases are not necessarily representative of  incident cases

∙ Selection bias: some people are more likely to  

participate based on their exposure or disease status

o Case-Control

∙ Observational, analytic epidemiologic investigation in which  subjects are selected on the basis of whether they do (cases) or do not (controls) have a particular disease

∙ Retrospective

∙ Controls

∙ Patients at clinics/hospitals

∙ Population

∙ Friends/spouses/relatives

o Cohort

∙ Subsets of a defined population cane identified who are… exposed or not exposed, or exposed in different degrees  ∙ Starts with people free of disease

∙ Prospective, longitudinal, and follow-up studies

∙ Strengths

∙ Good for rare exposures

∙ Can evaluate multiple effects of exposure

∙ Clear temporal relationship

∙ Weaknesses

∙ Loss to follow-up

∙ Costly

∙ Requires very large sample

∙ General comparison groups

∙ Internal comparison (exposed vs. unexposed members

of same cohort)

∙ External comparison (members of cohort vs.  

unexposed cohort from another study)

∙ General population (members of cohort vs. general  


o Experimental

∙ Assign treatments/interventions in an attempt to change  

disease exposures or outcomes and/or to determine causality

Biostatistics (Lectures 11-12)

- Descriptive: summarize a sample selected from a population  - Inferential: make inferences about population parameters based on  sample statistics

o Asking questions about a population based on a sample

- Estimation: what is the average value in the population, based on a  sample?

- Hypothesis Testing: is the average value in the population above a  certain value? Is it different than the corresponding values in another  population?

- Normal distribution

o Mean=median=mode

o “Gaussian”

o Used as model for continuous data

o Described by mean and standard deviation

- P-value

o Probability that the observed result (from test statistic) would occur, assuming the null hypothesis is true

o A p-value of 0.05 represents a 5% chance that the conclusion is  incorrect

- Categorical data

o Ordinal: order is important

o Nominal: unordered categories (race, state, occupation, color) o Binary: two categories

- Continuous data

o Represents measurable quantities, not restricted to specified  values. Can have an infinite number of selected values between two numbers (range)

- Summary of statistical tests



Does the  

frequency /  

rate /  

distribution of a(n) exposure / disease  

differ among  groups?

Types of Data

2 categorical  


Key Words


rate, frequency

Statistical  Test

c2 (chi



Was there a  

change in  

mean values  after  

treatment /  

education /  


1 categorical  

(before/after),  1 continuous  


Change, mean  values



pair) t-test

Are the mean values of two  groups  


1 categorical, 1 continuous  


Mean values,  

two groups



nt sample)  


Is there a  

difference in  mean values  between  

groups (three or more)?

1 categorical, 1 continuous  


Mean values,  

three or more  groups


Is there a  



between two  variables?

2 continuous  


Linear, two  



regression /  correlation

∙ Correl ation  


Causation (Lecture 13)

 - Correlation: statistical dependence between two or more events,  characteristics or ther variables

 - Causation: the act of causing something

- Bradford Hill Criteria

o Strength

∙     The stronger the relationship between independent and  dependent variables, the less likely it is due to an extraneous variable or chance

o Consistency

∙     Multiple observations of association by different people under different circumstances increase the belief the association is  real

o Specificity

∙     An outcome is predicted by one primary factor adds  

credibility to a causal claim

o Temporality (time relationship)

∙     The cause needs to precede the outcome

o Biological gradient

∙     There should be a direct relationship between the degree of  risk and probability of outcome

o Plausibility

∙     Rational, theoretical basis for association between the risk  factor and disease

o Coherence

∙     The association does not conflict with other knowledge about the risk and disease

o Experiment

∙     Research based on experiments makes the casual inference  more believable

o Analogy  

∙     Using a commonly accepted association in one area to  

another similar area

- Sufficient cause: a complete causal mechanism that inevitably produces  disease

- Necessary cause: a required component cause for disease to occur - component cause

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