Understanding Epidemiology

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Understanding Epidemiology

Week 5

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강의진행 질문

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Chapter 3 역학과 통계실무 적용 1절 역학의 이해

1. 역학의 다양한 정의를 확인해 봅시다.

*2. 역학의 정의의 공통적인 특성은 무엇인 가?

*3. 방부제를 이용한 무균수술의 선구자는 누구인가?

*4. 신선한 우유나 육류의 섭취가 부족하여 발생하는 영양결핍증을 증명한 학자는?

5. 역학의 기능 5가지를 설명하시오.

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Chapter 3 역학과 통계실무 적용 2절 질병의 자연사와 예방수준

*1. 질병의 자연사를 그림을 통하여 확인하시오.

*2. 질병발생의 원인을 파악하기 위한 감염력은 어떻게 측정하는가?

*3. 병원성을 계산할 때 분자와 분모는?

*4. 집단면역을 위하여 알아야 하는 개념 중에서 기본감염 재생산수는 무엇인 가?

*5. 생태학적 모형을 그림으로 살펴볼 때 숙주에 의하여 질병이 발생하는 (3)번 상황을 설명하라.

*6. 수레바퀴모형에서 환경은 무엇으로 구성되어 있는가?

7. 질병의 자연사와 예방단계를 연결하여 설명하시오.

*8. 질병의 발생과정 중에서 병원체와 숙주의 상호반응으로 인해 발생하는 결 과를 설명하시오.

9. 감염성질병의 직접전파와 간접전파를 구분하여 설명하시오.

10. 능동면역과 수동면역을 구별하시오.

11. 감염성 질병을 관리하기 위한 조치는 무엇인가?

12. 만성질환이 발생하기 위한 여러 원인에 대해 확인하시오.

13. 만성질환의 예방전략을 예방단계와 연결하여 설명하시오.

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보충자료

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• Epidemiology is the study of the distribution and determinants of health-related states or events (including disease), and the application of this study to the control of diseases and other health problems.

• Various methods can be used to carry out

epidemiological investigations: surveillance and descriptive studies can be used to study

distribution; analytical studies are used to study determinants.

1 Definition of epidemiology

Reference: http://www.who.int/topics/epidemiology/en/

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• Although epidemiology as a discipline has

blossomed since World War II, epidemiologic thinking has been traced from Hippocrates

through John Graunt, William Farr, John Snow, and others.

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History of epidemiology

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• Epidemiology's roots are nearly 2500 years old.

• Hippocrates attempted to explain disease occurrence from a rational rather than a supernatural viewpoint. In his essay entitled “On Airs, Waters, and Places,”

Hippocrates suggested that environmental and host factors such as behaviors might influence the

development of disease

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^-1 Circa 400 B.C.

Reference: CDC webpage, https://www.cdc.gov/ophss/csels/dsepd/ss1978/lesson1/section2.html

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• John Graunt, a London haberdasher and councilman published a landmark analysis of mortality data in 1662.

• In 1800, William Farr built upon Graunt's work by systematically collecting and analyzing Britain's mortality statistics. Farr,

considered the father of modern vital statistics and surveillance, developed many of the basic practices used today in vital statistics and disease classification.

• In the mid-1800s, an anesthesiologist named John Snow was conducting a series of investigations in London that warrant his being considered the “father of field epidemiology.” Snow

conducted studies of cholera outbreaks both to discover the cause of disease and to prevent its recurrence

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^-2History of epidemiology^1600~1800

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• In the 1930s and 1940s, epidemiologists extended their methods to noninfectious diseases. The period since World War II has seen an explosion in the development of research methods and the theoretical underpinnings of epidemiology.

• During the 1960s and early 1970s health workers applied

epidemiologic methods to eradicate naturally occurring smallpox worldwide.

• In the 1980s, epidemiology was extended to the studies of injuries and violence.

• In the 1990s, the related fields of molecular and genetic

epidemiology (expansion of epidemiology to look at specific

pathways, molecules and genes that influence risk of developing disease) took root.

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^-4 19th and 20th centuries

Reference: CDC webpage, https://www.cdc.gov/ophss/csels/dsepd/ss1978/lesson1/section2.html

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• It refers to the progression of a disease process in an individual over time, in the absence of treatment.

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Spectrum of disease

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• The process begins with the appropriate

exposure to or accumulation of factors sufficient for the disease process to begin in a susceptible host.

• For an infectious disease, the exposure is a microorganism.

• For cancer, the exposure may be a factor that initiates the process, such as asbestos fibers or components in tobacco smoke (for lung cancer), or one that promotes the process, such as

estrogen (for endometrial cancer).

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^-1Natural history of disease^Exposure

Reference: CDC webpage, https://

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• This stage of subclinical disease, extending

from the time of exposure to onset of disease symptoms, is usually called the incubation

period for infectious diseases, and the latency period for chronic diseases.

• During this stage, disease is said to be

asymptomatic (no symptoms) or inapparent.

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^-1 Pathologic change

Natural history of disease

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• The onset of symptoms marks the transition from subclinical to clinical disease.

• Most diagnoses are made during the stage of clinical disease.

• In some people, however, the disease process may never progress to clinically apparent illness.

• In others, the disease process may result in

illness that ranges from mild to severe or fatal.

This range is called the spectrum of disease.

Ultimately, the disease process ends either in recovery, disability or death.

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^-2 Onset of symptom

Natural history of disease

Reference: CDC webpage, https://

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References

• Content source: Centers for Disease Control and Prevention, Office of Public Health

Scientific Services, Center for Surveillance, Epidemiology, and Laboratory Services,

Division of Scientific Education and Professional Development

• WHO webpage

• 박인혜 외 (2017). 지역사회간호학 I. 현문사.