Terminology In Nursing

hello and welcome to the epi2001 course atgeorge brown college, epidemiology is a complicated but wonderfulthing to study, and we will take a close look at a few aspects of it. first of all, we willtake a look at the definition of epidemiology. read this carefully and think about it.it comes from our textbook. we will be looking at a few aspects of epidemiology: the distribution,the determinants of disease frequency. we will be taking a look at all of these andwe will be taking a look as they apply in human populations.make sure to pause the video right now and read through the definition to make sure youunderstand it. key words in the definition: disease, thereis a specific understanding of disease, which

medical doctors and others look at, and wewill be looking at a broader understanding of disease, which includes the above disorders+ injuries, disabilities and even death - all counted as disease. in the more narrow conceptualizationof disease this would be the natural history of disease of the exposure to pathogen followedby biological onset these all are part of the pre-clinical phase; once symptoms start toappear that's when its a clinical phase that's when medical doctors and nurses in the healthindustry can start dealing with the disease, diagnosis can take place anywhere soon aftersymptoms appear or much later and therapy it shows here very closely after diagnosisbut depending on the health care system can take place much later after diagnosis. andhere we have the disease process when you

think of it as a broader definition of disease.agent can be something like hockey stick, host can be hockey player, and biologicalonset can be broken nose. and so here we have something that would not typical obviouslymedical doctors deal with this all the time but this would not be in the narrow definitionof disease would not be considered appropriate but were going to be taking a broader lookat agents, hosts and disease in general. disease distribution who, when and where are gettingdiseases. determinant a factor that bring about change in a person's health or diseasestatus. so when we think about these factors and determinants that kind of sounds likecause, and cause is going to be an issue that we will be looking at closer to the end ofthe course. disease distribution so we already

looked at who, where, and when and we seewell these are related to person, place, and time. again pause the video at this pointto read through this. and we'll be taking a look at few examples which will be similarto what you will be doing in assignments in the next few slides. descriptive comparisonof who. actually it's not just who its who and when. because we are looking at age whendo these rates of practors go up now they go up when people get more elderly so in womenwe know already that we are looking at a factor like osteoporosis, that is more common inwomen who and more common after menopause. whereas in men there's not the same kind ofdrastic increase. again we are looking at describing the distribution of disease werenot looking at determinants . when we are

looking at osteoporosis when we are lookingat menopause we are looking at determinants. here we have another descriptive visualizationof the distribution of disease in toronto specifically diabetes the prevalence of diabetesin toronto and so we can see here this is high prevalence and low income that's thewho. again high prevalence and low income. that tells you a little bit for epidemiologisti'd say okay we need to look at these neighborhoods to see what's going on here while we knowlow income and we may not be able to control that and we may not be able to control that,but how is low income related to high prevalence of diabetes and how can we reduce that. anotherdescriptive visualization of when do people go into {gp/family physician's). so here wehave a visualization of the distribution of

ambulatory care visits. which are due to variousrespiratory diseases. and what we can see is that when you look at the pattern it'sall looking for patterns these are all related to sorry the lign isn't so straight it's roughlysummer. the lower number of visits. whereas the higher number of visits are winter monthsand so knowing that we can look at predicting as health care system as public health agenciescan help hospitals in predicting. we can also see that the trend is moving looks like itsmoving down over the ten year period roughly, which is a good sign. or may just mean thatwere medicating children and adults more with puffers. another visualization when and who.we have timeline 1960 to 1995. and we have mortality rates per 1000 live births. andso what we can see is that it is decreasing

with time which is good rate. few key termsthat are very important. endemic indicates a disease that is constantly present so colds,sniffles, headaches and so on that there is something that is endemic to canada or towhich ever other country like malaria may be to endemic to india. a cluster is whenwe have new cases something that is a surprise and may be a danger and then outbreak so theseare higher and higher danger zone. so again take a minute to read through these. epidemicis when we have something happening clearly beyond normal expectancy. and that's a seriesof clusters or outbreaks. s how do we there's no clear line a cluster or an outbreak orseries of outbreaks. and then we move from epidemic to pandemic, and very tricky howto make the call for or against epidemic or

pandemic for public health officials and epidemiologists.here we have a map of levels of pandemic except it's a little inaccurate in the title becausethese are not pandemics. this sounds like cluster, working towards epidemic. and thenup to pandemic. okay because we said pandemic is when we have at least two countries. measuringdisease frequency, quantification of the occurrence in disease in a population. okay sounds kindof easy just count how many people have a disease. well how do we know whether a persona has a disease x we need to define. so remember well defined sets. and disease and mechanismfor deciding who has it typically who decides, so doctors typically decide. and then we needto find a way another mechanism to count so do gps report it? do we need to have peoplereport it into some kind of a public health

center? typically we've asked gps to do thatkind of work and what we're looking for is prevalence and incidence and as you'll seethey're not necessarily easy to count. math 1112 would have given you a taste. and you'llget more complex taste in this course. and again we need to find the population of interest,what does that mean here? okay population at risk which is going to be called the candidatepopulation. and so you'll see that in the formulas for incidence and prevalence at least.moving to determinants of disease now, everything is based in the notion of this scientificworld view and in the assumptions that or the beliefs that epidemiologists bring tothe table. and so what we are assuming is that disease occurrence is not random, ie.we can find the cause. systematic investigation

can identify causal and preventative factorsso we need to do systematic investigation we don't wait for anything we have to do work.making comparisons is the cornerstone of systematic investigations and so you've seen that instat 1013 course and in the stat 2001 course how that's very important and i would addnot just making comparisons or looking correlations. making comparisons, if you're exposed thenyou need to get the disease kinda makes sense if you are not exposed then you don't getthe disease. so if exposed equals yes outcome equals yes if exposed equals no then outcomeequals no. and the key is to look for this link between exposure and outcome and not100% will get the outcome, that's what makes the whole science of this complicated.what is exposure, you've looked at exposure

in two other courses so you have some senseof what it is. we also called it the independent variable.these are all possibilities for that- typically these are categorical, in this course we will be mostly looking at yes/no.what is an outcome? we've looked at is also as a dependent variable - it could be categorical,then it would be a comparison of rates, or it could be a measurement variable, whichwould be a comparison of means. visualization of the determinants of health.these are all possible independent variables, or exposures that could lead to health orto illness. same thing here we have 12 determinants ofhealth, described by health canada. take a minute to read over these.other terminology, illness, sickness are slightly

different than disease. health and wellness;these are all terms you need to think about and understand.role of epidemiology in all of this (i.e. determinants of health) is to work with prevention,treatment and promotion of health: promotion of course is related to prevention and treatment.if you want to have a healthy society you will need to come up with better treatmentsand prevention programs of various sorts. those are tied in with the goals of publichealth. |in order to work at prevention and treatment, what do epidemiologists do?they provide scientific information to politicians, they establish priorities - they say to politicians"listen" we had a previous government that did not listen to scientists, and did notwant them to speak, and now we have a government

that at least promises to listen to scientistsand scientific information. but they often don't if they think they can't get electedon it. epidemiologists establish priorities for researchand action. or they influence politicians and government to try to do that.they identify areas into which government should invest energy and money and they evaluatethe effectiveness of health programs. here's a mandala of health which is pseudo-scientific.so far we've been talking about scientific or based on scientific world view.when we talk about notions like spirit then we start getting into a realm where the medicalsystem kind of goes i don't know about spirit. if we can't measure it, if we can't see it,then is it really there?

mind is there because of mental health. wecan measure mental health but it often just gets bunched in with the body so the brain.there's huge tension between the medical system, which wants to see if it's biological andthe non medical world which most of us live in, where we think of mind, spirit, behavioras being so important. and i'll leave it there as a food for thought.welcome to the course! good luck with the rest of it!