KINESIOL 1C03 Lecture Notes - Lecture 1: Germ Theory Of Disease

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14 Mar 2016

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Identify risk factors for the disease: risk factors are related to the cause and increase susceptibility to the disease, prevent the disease (changing the occurrence, usually involves modifying the risk factors. Example: h1n1: an increasing number of people were infected with the virus over a large population and. It is thought that older populations were exposed to it when they were younger meaning less of them got sick. 0-4 years and more then 65 years were the ones most hospitalized because they were more prone to complications. 25-29 accounted for the greatest amount of deaths because they thought they were ne until they were very sick. John snow is the father of modern epidemiology : london cholera epidemic (of 1854) where snow related chorea (a gi tract infection) back to the broad street water pump.

Related Questions

Epidemiology

Each of the following paragraphs presents a study objective and the methodology that will be used to evaluate the types of epidemiologic study design. State what is the study design for each study? (24 points â 4 each) (Note: For study design, try to have as detailed design as possible and avoid simply âexperimental studyâ or âobservational studyâ)

c) The following abstract was obtained from PubMed (with modification by XLD).

Lishman H, et al. Exploring the relationship between primary care antibiotic prescribing for urinary tract infections, Escherichia coli bacteraemia incidence and antibiotic resistance. Int J Antimicrob Agents. 2018 Aug 23. [Epub ahead of print].

This study aimed to quantify the association between antibiotic prescribing for urinary tract infections (UTIs) and the incidence/antibiotic susceptibility of UTI-related Escherichia coli bacteraemia in adult women in England. A national study was conducted with data aggregated at the GP practice level. The study population was all adult female patients (18+) with a reported UTI-related E. coli bacteraemia in England (2012-2014). Reports of bacteraemia from the national mandatory surveillance scheme were linked with E. coli blood culture susceptibility data (where available) and the correlation with primary care exposure to trimethoprim and nitrofurantoin was quantified using longitudinal multi-level models. There were 20,274 patients in the study from 5,916 practices. Between 2012-2014, the overall incidence of UTI-related E. coli bacteraemia in the study group did not change significantly (1.3% increase, 95% CI 0.1%-2.7%, p=0.074). However, after adjusting for practice characteristics, UTI-related E. coli bacteraemia incidence increased by 3.0% and 1.5% with each increasing quintile in trimethoprim and nitrofurantoin prescribing, respectively. The incidence of trimethoprim-resistant bacteraemia increased by 4.5% (p=0.032) with each increasing quintile in trimethoprim prescribing and was not associated with nitrofurantoin prescribing. This study demonstrates an association between GP prescribing for UTIs and UTI-related E. coli bacteraemia incidence at the practice level and shows that higher prescribing of trimethoprim is associated with higher incidence of trimethoprim-resistant bacteraemia. Evidence is provided of the importance of prudent antibiotic prescribing in primary care to prevent the development of antibiotic resistance which can put patients at risk of subsequent severe infections.

Study Design: ___________________________

d. The following abstract was obtained from PubMed (with modification by XLD).

Mubarak MY, et al. Hygienic practices and diarrheal illness among persons living in at-risk settings in Kabul, Afghanistan. BMC Infect Dis. 2016 Aug 31;16(1):459.

BACKGROUND: Sustained civil and military conflict, resulting in large numbers of internally displaced persons (IDP), in combination with rapid urbanization has strained public health and sanitation within cities in Afghanistan. In order to examine the association between preventive sanitary behaviors and diarrhea within two high risk settings located within Kabul, Afghanistan, this study aimed to evaluate the prevalence of hygienic practices and diarrheal illness in an IDP camp and an urban slum.

METHODS: In this study, a convenience sample of residents of an IDP camp and an urban slum in Kabul, Afghanistan, was used. Participants were asked to describe their hygienic practices and interviewers independently documented household sanitation. The knowledge and attitudes about and practice of hygienic activities to prevent diarrhea were compared between the two settings.

RESULTS: Two hundred participants, 100 from each setting, were enrolled. Knowledge, attitudes, and practices regarding hygienic activities to prevent diarrhea were greater among the slum dwellers than the IDP. Fewer than half of participants washed their hands with soap before eating or after eating: 31 % of slum dwellers washed before eating compared to 11 % of IDPs (Pâ=â0.0050), and 25 % of slum dwellers washed after defecating compared to 4 % of IDPs (Pâ=â0.0020). The IDPs were more likely to share a latrine (Pâ=â0.0144) and less likely to disinfect their latrine than slum dwellers. Diarrhea in the household within the past 3 months was more common in the IDP camp (54 %) than the slum (20 %) (Pâ=â0.0020).

CONCLUSIONS: Even though certain sanitary and hygienic practices were more common among slum dwellers than IDPs, the lack of hygienic activities in both setting indicates that interventions to change behavior, like increasing the availability of soap and encouraging hand washing, are needed. Any initiative will have to be developed in the context of pervasive illiteracy among persons in these settings.

Study Design: ___________________________

CASE STUDY

It used to be that epidemiologists at the CDC only knew that you had the flu when you visited your doctor and the doc- tor then reported that information to other agencies. By the time this information made its way to the CDC or state health departments, it was often several days old, which meant that the medical community was always playing catch-up. And of course, your doctor was only aware of your illness if you showed up at his office, not when you decided to tough it out at home. Nowadays, however, before you ever go to the doc- tor, you are likely to search the Internet for âflu symptoms,â tweet your suddenly declining health status, or Instagram yourself lying in bed. Study the case below, which shows how the Internet and social media have impacted the field of epi- demiology, and then answer the questions that follow.

Google Used to Predict Influenza Outbreaksâ2008

In 2008, Google launched Google Flu Trends, an applica- tion that compiles aggregated data from key word searches

for clinical terms, such as thermometer, chest congestion, muscle aches, or flu symptoms. Google reports the data on a website, which then provides an early-warning system for the locations of new flu outbreaks. Because the data are collected from searches performed each day, trends in flu symptoms become apparent much more quickly than when they are based on data reported during office vis- its or in lab reports from physicians around the country. When the CDC compared actual cases over the course of a year with Googleâs findings, the data from the two sources matched.

Initially, Google was only compiling information about flu trends in the United States and Canada. But after the H1N1 virus appeared in Mexico in 2009, the CDC asked Google to go back and look at Internet searches conducted by people in Mexico during that time. Evaluation of the data indicated that Google detected an uptick several days before the CDC did (Figure 23.1).

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Figure 23.1 2009 Inflenza activity (a) Data from the Centers for Disease Control, based on physical examination by health care providers, shows a peak in influenza cases in late April. (b) Google âFlu Trendsâ shows an influenza peak in February.

No. of cases

Case Study Exercise 23 Morbidity and Mortality Weekly Report 199

Epidemic tracking based on Internet searches reflects what is called collective intelligence. It works because indi- viduals using their personal computers tend to search for terms related to their immediate needs and intentions, and they generally do this before presenting in a doctorâs office or emergency room. The methodology used in the Google search was published in the prestigious science journal Nature, and another independent study has been published about a similar search analysis conducted by Yahoo, showing that it was effective in predicting flu trends.

Some people worry that data collected from Internet searches may compromise individualsâ privacy. However,

Google maintains that Flu Trends cannot be used to iden- tify individual users because the data are anonymous and are aggregated before being presented. Another potential drawback is that this data collection method is less likely to be useful for tracking epidemics in societies having a low percentage of computer ownership, namely, developing countries. However, considering the high stakes involved in identifying an epidemic quickly, Internet search term analy- sis holds great promise for public health. And, unlike most health innovations, itâs free!

3. How might data collected in this way not be representative of a particular population?

4. Explain why the two graphs in Figure 23.1 do not show influenza activity peaking at the same time.

6. In 2013, Google Flu Trends vastly overestimated the number of cases of the flu in the United States. One explanation for this was that there was a greater than usual number of media reports about influenza early in the flu season. Based on your knowledge of how Flu Trends works, explain why Google missed the mark in 2013

cyanyellowjacket531

For this assignment, Part One of your course project, assume the role of Dr. Madness. Your rogue nation seeks global domination. With a bare bones laboratory and your exhaustive microbiological and epidemiological knowledge, you (Dr. Madness) decide that the best way to rule the world is to create and disseminate the perfect biological weapon.

For this part of the assignment, you will develop your weapon from the ground up. Discuss nearly all of the epidemiological criteria related to it, and justify and discuss why it is used and how effective it is. This agent could be a hybrid of other biological pathogens or an entirely new one. If the agent is newly created, there must be some basis and epidemiological support of a similar agent by which you can base your justification. In other words, it will be unrealistic to create an airborne virus that inoculates and kills within one hour. There must be a realistic exposure and incubation time and must be supported through current agent biology or biochemistry (for example, influenza exposure and incubation takes 1â4 days).

Name of Agent: Explain why you chose the name. If it is a biological agent, be sure to provide a taxonomic name

Etiology: This will talk about the genesis of your agent. Where was it discovered? How was it made? How long has it been around? Why was this agent created? What were the social and economic factors of your rogue nation that made Dr. Madness focus on this element of the agent? What are the environmental precursors to this agent? Discuss the interaction among agent, host, and environment.

Identification: This will describe the basics of the agent. Is it a bacteria, virus, toxin, parasite, hybrid, or something else? Discuss how your agent presents within the human population. What are the symptoms in humans? What are the (zoonotic) symptoms in animals? How does the disease progress? Are there stages? Discuss the various stages including length of infection, severity, and the like. What are the diagnostic indicators? How would a doctor be able to identify this agent in a clinic or emergency room?

Laboratory Analysis: How will the agent be identified? Can it be grown in media? What type of laboratory methods can be used to identify the agent (microscopy, chromatography, PCR, and so on)?

Occurrence: This is the epi: who, what, when, where, how, and why of the disease. Where does it happen? When can it be found? Who is most and least susceptible to the agent (risk factors). More exotic and hard to find agents are harder to prevent and control but are also more difficult to initiate an epidemic or pandemic, whereas more generalized and known agents may be easier to cure, but have a much wider swath of causing pandemics. How do socioeconomic factors foster or inhibit the spread of disease?

Reservoir: What is the natural reservoir of the agent? Are there other organisms where this agent can reside without causing disease? Increasing the reservoir can enhance transmission but can also allow for easier identification and treatment in response to it.

Mode of Transmission: Consider inhalation, absorption, digestion, contact, and so forth. If you use multiple modes, justify your selections.

Incubation Period: Provide the range with an average (median) day of disease onset. Does the period change in different socioeconomic status identifiers (sex, age, race, creed, and so on)? Why or why not?

Period of communicability: How long is a person with this agent contagious? Increasing this period also increases the opportunity for study and thus treatment and control.

Susceptibility: Is the agent susceptible to reinfection of the same person? Allowing for this increases morbidity but usually mortality wanes in subsequent infections.

Taking on the role of Dr. Madness, generate your superweapon and describe the weapon using the above mentioned criteria. Remember, the focus in on creating something that becomes difficult to identify, monitor, or treat with prophylaxis. You will write out the proposal as Dr. Madness submitting this to his lead researcher to develop. This proposal should be approximately 6â8 pages in length, but some submissions may be longer.

Submit your Bioweapons and Epidemiology Part One proposal in the assignment area.

Please be sure to review the Bioweapons and Epidemiology Part One Scoring Guide for information on how this assignment is graded.

Project Requirements

To achieve a successful project experience and outcome, you are expected to meet the following requirements.

Written communication: Written communication is free of errors that detract from the overall message.

APA formatting: Resources and citations should be formatted according to current APA style and formatting.

Resources: Include all literature cited in the project.

Length of paper: 6â8 typed, single-spaced pages, not including cover page and resource list.

Font and font size: Arial, 10 point.

KINESIOL 1C03 Lecture Notes - Lecture 1: Germ Theory Of Disease

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