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epidem transtion
infectious to chronic
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non commuicable diseases should be involved with 5
- screening
- interventions
- cost effective tx
- counsel
- research
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screening for non commuicable purpose 3
- test for ppl who dont show symptoms
- early dections
- to reduce death
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screening qualifications
- disease will cause death
- early detection will improve outcome aka LEAD TIME BIAS
- strategies are possible
- acceptable
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multiple risk factor
look at lots of risk facts to reduce outcome. DUH
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cost/net effective
benefits must be greater than harms
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counsel 5 types
- like tay sachs-jews
- sickle cell-blacks
- down synd
- pku
- cystic fibrosis-whites
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outbreaks are recognized by....
clinicians, patients, data, media
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why to recognize outbreaks
- prevent more cases
- prevent more outbreaks
- describe/learn/teach the new disease
- evaluate prevention
- talk to the public
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to investigate
- epidemiological
- environmental
- media and legal side
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was grilled above hurricane Isabel, West Nile, and measles
Dr. Gerberding
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note when investigating outbreak
- find source
- quickly tell public
- limit case
- the well publicized outbreaks can be bias
- pressure to investigate > errors
- delays > no samples
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5.A goals of outbreak investigations
- define
- are they real
- whats hte rate
- case finding
- descriptive in epi way
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5. B goals of outbreak investigations
- make hypo
- test hypo
- test samples
- implement control measures
- tell public
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case definitions
- lab confirmed
- clinical
- definitive vs probable
- outbreak associated vs. nonoutbreak
- primary vs. secondary
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case def drives>>>
analysis
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lab confirmed case
gastroenteritis
note: did he even go to the restaurant?
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definitive vs. probable
probable: once confirmed, not needed both
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outbreak associated vs nonoutbreak
outside of school vs. school
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primary vs. secondary
1st wave children vs. teacher
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case confirmation
- some asymptomatic ones have positive tests b/c of lab errors
- deals with emerging disease like legionnaires, aids, SARS
- ex.) vault blood
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case confirmation are based upon
- direct observation
- med records
- provides
- lab results
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background disease rate
- scope of outbreak geographically and temporally
- compare current outbreak vs. current backdrop
- see for additional cases
note: important when Hep C shows in one hospital!!!!
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affect rates
- under/over sampling
- un/over reported
- financial
- media
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endemic
background/expected cases like mosquito in tx
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epidemic
EXCEEDS expect disease in defined area like anthrax
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describe outbreak
person, place, time
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epi curve
graph shows the number of cases by illness by the date
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cardio disease affects
heart, brain, kidney, extremities>ulcers, eyes
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where of us
more in SE states
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race is most affected
blacks
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health systems level factors***
- financing
- structure of care
- culture barriers
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patient level factors***
- patient preferences
- refusal of tx
- poor adherence
- bio diff
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non modifiable risk
age, gender, heredity
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modifiable risk
smoke, chol, BP, inactivity, obesity, diabetes, stress, alcohol
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there is a relationship with cvd
Blood pressure
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cvd prevention
- cut down salt in communities
- manage hypertension
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challenges
obesity, lazy, stress, diet, genes
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overcome challenges
improve access to care, healthy foods, healthy environments, note disparities, focus preventing
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resources
- centers for disease control and prevention
- american heart association
- american diabetes association
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passive immunity
injections of antibodies>>>short term
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