C1M1

• Epidemiology


  Study of factors determining disease occurrence and distribution in a population
• Epidemiology

  Data is from groups/populations, level of populations in the scientific study of disease
• Clinical medicine


  Single patient, level of individual patients in the study of disease
• Classical epidemiology

  • Studies distribution and determinants of disease
  • Studies origins of health problems in communities, mostly infectious agents, others include nutrition, environment, behavior, economics, etc
  • Determines risk factors to be altered to prevent/delay disease, injury, or death
• Clinical epidemiology

  • Epidemiology applied in clinical medicine
  • Setting is in health care facilities vs community (classical)
  • Studies are done to improve management of patients
• Infectious disease epidemiology


  Historically depended on lab sciences/laboratory (i.e., microbiology, serology) but now also uses statistical analysis
• Chronic disease epidemiology


  Depended on complex sampling and statistical methods but now also uses molecular laboratory markers
• Natural history of disease

  The way a disease progresses in the absence of medical or public health intervention
• Stages of disease

  • Pre-disease stage
  • Latent stage
  • Symptomatic stage
• Pre-disease stage


  Before the disease process begin, primary preventive measures intervene to avoid exposure to agent of disease
• Latent stage


  Disease process started but without symptoms, secondary prevention measures intervene to prevent/delay progression to symptomatic
• Symptomatic stage


  Disease manifestation is evident, tertiary prevention measures slow, arrest, or reverse progression of disease
• Epidemiologic triangle

  Cause of disease are considered in terms of host, agent, and environment
• Host


  The "who" in the epidemiologic triangle, the degree to which an individual can adapt to stressors in the environment
• Agent


  The "what" in the epidemiologic triangle, what causes the disease (biological agents, chemical, physical agents, social and psychological stressors)
• Environment


  The "where" in the epidemiologic triangle, external factors allowing for disease transmission; influence the probability and circumstances of contact between the host and the agent
• Vector


  Transmitter of disease, has specific relationship with the agent, the environment, and the host
• BEINGS model

  • Biologic
  • Environmental
  • Immunologic
  • Nutritional
  • Genetic
  • Health services
  • Social
  • Spiritual
• Genetic factors


  The most difficult to change