Essential Epidemiology: An Introduction for Students and Health Professionals (Essential Medical Texts for Students and Trainees)
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The new edition of this popular textbook remains a clear and practical introduction to epidemiology for students in all areas of health. By emphasising the role of epidemiology across a broad range of health monitoring and research, it gives students an understanding of the fundamental principles common to all areas of epidemiology. It also integrates the study of infectious and chronic diseases as well as public health and clinical epidemiology. Avoiding complex mathematics, it steps through the methods and potential problems underlying health data and reports, while maintaining a balance of rigour and clarity. The nuts-and-bolts of epidemiology are embedded in the wider international health perspective through recent and classical examples across different areas of health to engage students from a range of backgrounds. Concepts are illustrated with charts and graphs, and end-of-chapter questions test understanding (with answers provided). Online resources include further exercises, slides for teaching and useful weblinks.
study Conclusion Questions References 282 285 286 293 295 299 300 304 304 305 Watching not waiting: surveillance and epidemiological intelligence The scope of surveillance Types of surveillance Surveillance in practice Evaluation of surveillance Summary References 307 14 Prevention: better than cure? Disease prevention in public health The scope for preventive medicine Strategies for prevention The population attributable fraction as a guide to prevention Prevention in practice Evaluation of
usually come from medical practitioners and pathology laboratories, often under legal compunction. Despite this, and in contrast to cancers, most such diseases are poorly reported. Exceptions are those conditions which are perceived to be more severe, presenting either an acute challenge to a health system (SARS, AIDS) or a long-standing threat, such as tuberculosis. We will come back to discuss surveillance in more detail in Chapter 13. Hospital records Hospital records can provide useful
individual patients and sometimes their physicians as well. Rapidly changing and expanding privacy legislation in many countries is adding to the challenges. While properly highlighting ethical use of data, the increasing emphasis on the principle of autonomy has created tensions between the need to protect personal information on the one hand and the desire for public good, which may require some access to individual data, on the other. Summary You have now seen the most common types of
the tensions between maximising individual autonomy (by protecting against inappropriate access to personal health data) and ensuring that the public good delivered by health research is not compromised (Lawlor and Stone, 2001). Prognostic or survival studies As we mentioned above, cohort studies can also be used to see what happens to patients after they are diagnosed with a condition. In this case the cohort would comprise patients with the condition of interest who were at the same point in
in the early 2000s. This description captures the essence of the problem and prompts the next question: what caused these epidemics? What changed in the circumstances of younger Russian men to reverse the pattern of falling mortality in the 8 Epidemiology is . . . Table 1.3 An historical event. Adult males SESa Total Adult females % Dead Total % Dead Children (both sexes) Total population Total % Dead Total % Dead High 175 67.4 144 2.8 6 – 325 37.5 Medium Low Other 168