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Welcome – Intro’s

Welcome – Intro’s. Class House Keeping - Handouts. Syllabus Products Research Project Posting of Articles/Reading Assignments Text. Class House Keeping… continued - 6-8:30p time slot; feel free to bring food with you. - Discussion makes the time go faster.

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Welcome – Intro’s

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  1. Welcome – Intro’s

  2. Class House Keeping - Handouts • Syllabus • Products • Research Project • Posting of Articles/Reading Assignments • Text

  3. Class House Keeping… continued • - 6-8:30p time slot; feel free to bring food • with you. • - Discussion makes the time go faster. • - I don’t have all the answers. If I don’t • know I will tell you. • - Epidemiology Competencies

  4. What do YOU want out of this class?

  5. Annotated Bibliography Ellen Rasnake, M.A.

  6. Annotated Bibliography • Pick a topic • Choosing your sources • Writing • Style • Content • Uses • References

  7. Topic Choice • Interesting to you • Available material • Books • Documents • Peer-reviewed journal articles • Start broad, then narrow

  8. Peer-reviewed Journal • Professional; “Scholarly” authors • Articles reviewed for inclusion by people in the field • Valid • Reliable • Purpose: research results • Little or no advertising • Statistical graphs

  9. Peer-reviewed Journal • Footnotes or bibliography • When in doubt: • Editorial statements • Instructions to authors • Ulrich’s International Periodicals Directory University of Kentucky’s Glossary of Library Terms. (n.d.) Retrieved August 21, 2007, from http://www.uky.edu/Libraries/page.php?lweb_id=135#subp/ University of Illinois Urbana Champaign’s Library Gateway. (n.d.) Retrieved August 21, 2007, from http://www.library.uiuc.edu/alx/peer.htm

  10. Writing your A.B. • Style: • APA, Chicago, MLA… Be Consistent! • Style manual • Valid internet resources

  11. Writing your A.B. • Content (may include) • About the author • Ability to speak to subject; references used • How they reached conclusions (logical based on research?) • Who was this article/doc/book written for? • What is it about? (couple of sentences) • How does it contribute to the body of research? • Strengths and weaknesses? • What do YOU think?

  12. Why an A.B.? • Not only a description • Helps a reader know more about your research • Helps you: • Organize research • Remember important details Cornell University Library’s How to prepare an annotated bibliography. (n.d.) Retrieved August 9, 2007, from http://www.library.cornell.edu/olinuris/ref/research/skill28.htm Concordia University’s How to prepare an annotated bibliography. (n.d.) Retrieved August 9,2007, from http://library.concordia.ca/help/howto/annotatedbibliog.php

  13. References • Where to find a peer-reviewed journal: • http://www.uky.edu/Libraries/ • PubMed, CINAHL, ERIC, etc. • Medical Center Library: • http://www.uky.edu/Libraries/ choose “News and Events” (PubMed, EndNote, InfoCat) • Librarians • Ellen Rasnake 539-0238 7am-8pm; ellen2@uky.edu

  14. Epidemiology Review • Epidemiology is defined as “the study of the distribution and determinants of disease in human populations.” • These descriptive statistics are most commonly presented in the form of rate. A rate is defined as your risk of getting a disease (or experiencing some other event or outcome) if you live in a defined population during a defined period of time. Thus, all rates must be clearly defined in terms of person, time and place.

  15. Epidemiology Review • There are three primary methodologies which epidemiology employs to identify factors that are associated with a disease or health event being more common in one group as compared to another group. These methodologies are case-control studies, cohort studies and randomized clinical trials.

  16. Epidemiology Review • Randomized clinical are experiments in which individuals are randomly allocated to an experimental group or a control group. Only the individuals in the experimental group receive the treatment (or factor) thought to influence the onset of disease or some relevant outcome. These individuals are followed forward in time to determine which get the outcome of interest and which do not.

  17. Epidemiology Review • There are three dimensions that are measured to determine whether one group is different from another. The dimensions are direction, probability and strength. Whenever possible, all three measures are used.

  18. Epidemiology Review • Epidemiology relies on statistics to describe the burden of disease in human populations. • The most common types of rates used in epidemiology are incidence, period prevalence, point prevalence, mortality and survival. Other important types of rates include age specific, age-adjusted, and case fatality.

  19. Epidemiology Review • In addition to describing the variation of disease in human populations, Epidemiology also attempts to identify the factors that cause disease to be higher or lower in one group or population as compared to another.

  20. Epidemiology Review • Case-Control studies are those in which the cases (a group of individuals with a disease or outcome of interest) and the controls (a group of individuals without the disease or outcome of interest) are identifiers. Efforts are then made to look back in time and determine what proportion of the cases and controls had some exposure or characteristic of interest thought to be related to the occurrence of the disease.

  21. Epidemiology Review • Cohort studies are conducted by identifying a group of individuals who have an exposure or characteristic of interest and a group that does not. These groups are followed forward in time to determine which develop the disease (or outcome of interest) and which do not.

  22. Epidemiology Review • Direction means which group has a higher rate, larger population or higher average and how large is the difference between groups which are being compared. • Probability refers to the statistical probability that observed differences are due to random chance.

  23. Epidemiology Review • Strength refers to the number of times more likely one group is to have an outcome of interest or a characteristic of interest as compared to another group. • The type of statistical test used to determine probability depends on whether the dependent variable (outcome variable) is categorical or continuous.

  24. Epidemiology Review • A considerable amount of the remainder of this course will focus on how do we use these epidemiological tools to develop the evidence needed to make causal inferences.

  25. Leading Causes of Death in the U.S. in 1900?

  26. Cause of DeathPercent of Total Death All causes 100.0 Pneumonia and influenza 11.8 Tuberculosis 11.3 Gastric, enteritis, colitis 8.3 Heart diseases 8.0 Symptoms, senility, ill-defined conditions 6.8

  27. Cause of DeathPercent of Total Death Vascular lesions affecting central nervous system 6.2 Chronic nephritis and renal sclerosis 4.7 Unintentional injuries 4.2 Malignant neoplasms 3.7 Diptheria 2.3 All other causes 32.6

  28. Leading Causes of Death in the U.S. in 1995?

  29. Cause of DeathPercent of Total Death All causes 100.0 Disease of heart 32.0 Malignant neoplasms 23.2 Cerebrovascular diseases 6.8 Chronic obstructive pulmonary diseases 4.5 Accidents 3.9

  30. Cause of DeathPercent of Total Death Pneumonia and influenza 3.6 Diabetes mellitus 2.6 Human immunodeficiency virus infection 1.8 Suicide 1.3 Chronic liver disease and cirrhosis 1.1 All other causes 19.2

  31. WHY the Shift?? ??

  32. Chronic illnesses….. are characterized by uncertain etiology, multiple risk factors, long latency periods, prolonged course, noncontagious origin, and incurability

  33. Ongoing Collection, Analysis & Use → Ongoing Versus a Point in Time Survey

  34. P H Surveillance Evolution • Individual ↓ • → System → Disease Risk Factor

  35. Organizational Model • Reflects Definition • Collects-Analysis-Use • Evaluation • Planning • Implementation

  36. Data Sources • 7 Types of Information Systems • 1. Notifiable Diseases • 2. Vital Statistics • 3. Sentinel Surveillance • 4. Disease Registries • 5. Health Surveys • 6. Administrative Data • 7. U.S. Census

  37. Data Sources • A. Notifiable Disease • Require Prompt PH Action Who Report? Physician Labs Hospitals

  38. Lead Poisoning • Infectious Diseases • CANCER → Why • - Cigarette Smoking

  39. Vital Statistics • Info at Birth and Death • * 1850 – 1st Publishing of Mortality Stats

  40. Discuss uses of each from an epidemiology perspective • Data Analysis & Interpretation • Descriptive Epidemiology Person – Place - Time

  41. Sentinel Surveillance A preventable disease, disability, or death Usually focuses upon occupationally- related health conditions.

  42. Chronic Disease Registries Cancer Registries * Lecture later in the year

  43. Health Surveys – Next Week NHIS – Annually since 1957 BRFSS – YRBS -

  44. Administrative Data Hospital Discharge ? Completeness/Usability

  45. Census Data Population Projections

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