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What is the term for an individual that harbors an infectious agent or is exposed to potential agents of disease?
Host
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What is the term for personal characteristics of an individual or group like age, sex, breed?
demographics
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What is the term for individuals with a particular disease or outcome that meet selected criteria?
Case
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What is the term for a factor that directly influences the occurrence of disease or outcome?
causal factors or determinant; syn with risk factor or exposure factor
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What is the term for encountering a potentially pathogenic agent with a susceptible human/animal host which shows immunologic response?
infection
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What is defined as clinically apparent infection accompanied by overt illness?
disease
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What is occurrence and distribution of disease in populations with emphasis on establishing causal factors and develop preventive/therapeutic protocols?
epidemiology
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What type of epidemiology focuses on identifying and reporting distribution and frequency of health events in a population?
descriptive epidemiology
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What type of epidemiology focuses on the search for determinants of health outcomes and draws statistical inferences about their role in disease causation?
analytical epidemiology
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What is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of an individual patient?
evidence based medicine
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What is the term for constant/usual frequency of disease within a population or one that occurs regularly?
endemic/enzootic
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Can a disease that is endemic become epidemic?
yes
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What is synonymous with "outbreak" and refers to occurrence of disease in excess of expected levels?
epidemic/epizootic
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Can an epidemic disease lead to endemic disease?
yes
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What is a widespread epidemic that involves more than one country?
pandemic
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What are WHO conditions that define pandemic?
- -disease new to pop/hasn't surfaced in long time
- -agent causes severe illness
- -agent spreads easily with high morbidity/mortality
- -agent spread to at least 2 countries
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What is the term for irregular, haphazard occurrence of disease?
sporadic
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Is sporadic disease one that is new to the population?
no, just occurs infrequently and is not rapidly spread
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What is the term for ongoing, systematic collection, analysis, interpretation, and dissemination of data regarding a health-related event for use in public health action?
surveillance
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What are the 3 factors in the epidemiologic triangle?
host, agent, environment
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What 3 factors interplay to influence level of disease?
individual, spatial, and temporal factors
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What is meant by individual factors?
what type of individuals tend to develop disease
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What is meant by spatial factors?
where the disease is geographically
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What is meant by temporal factors?
When is the disease occurring
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What are 4 ways to report the occurrence of disease?
- in time (temporal)
- by time series analysis
- by host related distribution of dz
- by space (spacial/geographical) location
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When considering temporal dimensions of disease, what do we specifically want to determine that gives clues as to mode of transmission and what action to take?
endemic, epidemic, pandemic, sporadic
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What is plotted on the "Y" and "X" axis of epidemic curves?
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What are the 3 basic epidemic curves?
- point source epidemic
- continuous common source epidemic
- propagating epidemic
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What type of curve shows a large number of cases exposed during short time of 1 incubation period?
point source epidemic
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What type of curve rises rapidly and contains a definite peak, followed by decline once source is removed?
point source epidemic
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What type of curve shows prolonged exposure over extended period and may have more than 1 incubation period?
in a continuous common source epidemic
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What type of curve has a sharp downward curve if source is removed or gradual if outbreak exhausts itself (no peak)?
continuous common source epidemic
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What type of curve shows disease introduced through single source (primary case) of infection then transmitted to others (secondary cases)?
propagating epidemic
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What type of curve shows a series of successively larger peaks, reflective of increasing number of cases until 2ndary cases are exhausted or controlled?
propagating epidemic
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What is the term for a set of uniformly applied criteria for a particular disease?
case definition
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What is the term for a measure of the frequency with which new cases occur over a specified time?
incidence
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What is the term for a number of cases that are present in a population?
prevalence
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What are 3 types of Time Series Analysis?
- short term (typical epidemics)
- cyclical/seasonal
- secular/long term
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What uses information on patterns of disease occurrence obtained from temporal occurrence data to identify periods of high or low risk trends to explore causal relationships?
time series analysis
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What type of trend rises and falls over more than 1 year? It is associated with regular, periodic fluctuations in occurrence.
cyclical trend
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What is a special case of cyclical trends where periodic fluctuations relate to seasons?
seasonal trend
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What causes fluctuations in cyclical trends?
host density, management practices, vector dynamics, environmental factors
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What type of trend rises/declines gradually over long period using plotted raw data?
secular trend
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How do you calculate cumulative incidence?
1/1000 = (# new cases during a period / # at risk for developing dz during that period) x 1000
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How do you calculate prevalence?
P= # with disease at point in time / # at risk at that time
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What is the the calculation to look at the relationship between prevalence and incidence?
P = I x duration of disease
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What are the 3 steps in spatial distribution?
- data visualization (mapping)
- data description (cluster analysis)
- data modeling
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What type of mapping is used to provide info on locality and shows how dz moves through a country?
aerial maps
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What type of map requires computer software to enter each case based on its location?
spot map
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What type of map requires computer software to shade areas to show which areas are affected more often?
frequency map
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What is the measure of disease in time and space to identify geographical clustering of disease and define endemic, epidemic, etc. based on time:location to decide is the occurrence is enough for concern?
data description/cluster analysis
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What type of modeling is used to test hypothesis and plan health policies?
data modeling
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What are 3 causal factors that should be taken into account?
agent factors, environmental influences, host factors
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What are 3 aspects of agent factors, which impact disease occurrence?
- infection (establish in a host)
- pathogenic (produce disease in host)
- virulence (severity of disease caused by agent)
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What are some host factors that affect host response to exposure?
- innate resistance due to age, breed, sex, etc.
- competent immune system (poor when stressed)
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What is herd immunity?
resistance in population
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What are 3 types of associations?
non-statistical (chance), statistical, risk factors
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Should a non-statistical relationship be considered a causal association?
no, it is only by chance that the two factors seem related
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A positive statistical association may indicate a ___ relationship, while a negative association may indicate a ____ factor.
- causal relationship
- protective factor
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What is the term for a causal or something that increases likelihood of disease?
risk factor
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What are some risk factors?
genetic predisposition; behavioral; environmental
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What type of relationship shows a connection between amount of cause and amount of effect?
dose-response relationship
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What is biological plausibility?
research on mechanisms of disease provides the biological basis that associations are causal
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What is "consistency" with regard to causal relationships?
evidence for a causal relationship are strengthened where various studies all come to same conclusion
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What is a reversible association regarding causal relationships?
if removal of a factor results in decreased/increased frequency of disease, it is more likely causal
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What is the strongest study design? The weakest?
- strongest = randomized clinical trial
- weakest = case series/report
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What are 2 things that measure strength of association?
relative risk (used in cohort studies) and odds ratio (in case-control studies)
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What are some things that impair making causal inferences?
- long time between cause and disease
- multiple "causes" lead to same disease/outcome
- causal factor requires other factors for disease
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What is a factor that directly influences occurrence of disease/outcome?
causal factor
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What is the term for any of the possible changes in health status that result from exposure?
outcome
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What is the term for the result of a cause and includes disease or outcome?
effect
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What is the term for contact with a cause of a particular disease/outcome?
exposure
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What is any systematic error that results in incorrect estimate of association between exposure and risk of disease?
bias
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What are the 2 main types of bias?
selection and informational
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What are types of selection bias?
surveillance, non-responsive, inappropriate comparison group
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How do you avoid selection bias?
randomly select subjects, ensure response rates are high, and ensure withdrawal rates are low
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What are some types of information bias?
interviewer, recall, using incomplete data, misclassification, observer biases
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What is the term for random error?
chance
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What is the term for distortion/masking association between an exposure and disease because of a 3rd factor?
confounding
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Are case reports, cross sectional and correlational studies descriptive or analytical?
Descriptive
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Are cohort, case-control and randomized trial studies descriptive or analytical?
analytical
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What are the earliest studies done on new disease that do not have much statistical analysis involved?
descriptive studies
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What descriptive study describes a single case or group of cases that leads to formulation of new hypothesis bc its often the 1st report of new disease?
case reports
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What descriptive studies show the case can happen repeatedly?
case series
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What is the main weakness of care reports/case series?
no control groups
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What are prevalence studies that give a snapshot of health at a point in time?
cross-sectional studies
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What is the main weakness of cross sectional studies?
cannot assess cause and effect bc it's one point in time
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What type of descriptive study evaluates exposures and disease on a group level rather than individual to look for geographical correlations?
ecological/correlational studies
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What is committed if an assumption is made that the association found at the herd/group level is also true at individual level?
ecological fallacy
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Can ecological studies determine cause or control for confounding factors?
no
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What studies seek to identify and explain causes of disease and assign numerical value to risk factors?
analytical studies
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What type of studies are cohort and case-control studies?
analytical observational studies
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What type of studies are therapeutic and prevention trials?
analytical non-observational
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In cohort studies, start with identifying "?" cohort and "?" cohort and then measure "?" in each to compare.
- exposes, non-exposed
- measure disease occurrence
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What is a group of persons sharing common experience within defines time period?
cohort
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What type of study compares disease incidence over time between 2 groups that differ in exposure to factor of interest?
cohort study
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What type of study selects exposed and non-exposed groups and follow them forward to measure amount of disease from present to future?
prospective cohort studies
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