Change of Heart: Unraveling the Mysteries of Cardiovascular Disease

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But resources are limited: It is estimated, for example, that more than , Americans may be at risk of sudden death from Brugada syndrome. As was the case with Brugada syndrome, modern techniques may elucidate the cause of a disease or lead to treatments that will allow us to live with a disease but not necessarily lead to a cure. And so we may soon have to ask: Can we afford to know the truth about the many diseases for which we may be at risk? Buy Now, Pay Later. Already a Subscriber? Log In Here.

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Epidemiology: Unraveling the Mysteries of Disease and Health

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Author Levy, Daniel C. Health risk assessment -- History -- 20th century. Contents A killer of paupers and presidents The dawn of peace and prosperity and a deadly lifestyle Gathering evidence, building on clues A struggle for identity The people who changed America's heart : voices from Framingham The launch of a gold standard Wresting control from fate : results that changed a culture A near-death experience Coming of age in a high-technology world Blood pressure : more than just a numbers games The wages of sin Renegade on the trail of the unknown The lifestyle revolution Deadly addiction Spreading the word A fifty-year promise under attack The genetic revolution.

Notes Includes bibliographical references p. View online Borrow Buy Freely available Show 0 more links Set up My libraries How do I set up "My libraries"? University of Queensland Library.

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None of your libraries hold this item. Found at these bookshops Searching - please wait We were unable to find this edition in any bookshop we are able to search. In March a total of cases of hepatitis A were reported in the county. The incidence rate for Calhoun County was 89 per ,, well above the national rate of Of the case patients, were students or staff at schools in four different school districts Centers for Disease Control and Prevention, [CDC], a.

Demographic characteristics: age, sex, ethnic background, race, marital status, religion, education, and economic status. Level of health: genetic risk factors, physiological states, anatomical factors, response to stress, previous disease, nutrition, fitness. Body defenses: autoimmune system, lymphatic system.

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State of immunity: susceptibility versus active or passive immunity. Human behavior: diet, exercise, hygiene, substance abuse, occupation, personal and sexual contacts, use of health resources, food handling. Biological: viruses, bacteria, and fungi and their mode of transmission, life cycle, virulence. Physical properties: water, air, climate, season, weather, geology, geography, pollution. Biological entities: animals, plants, insects, food, drugs, food source.

Change of Heart - E-bok - M D Daniel Levy, Susan Brink () | Bokus

Social and economic considerations: family, community, political organization, public policy, regulations, institutions, workplace, occupation, economic status, technology, mobility, housing population density, attitudes, customs, culture, health practices, health services. Investigation by public health officials did not identify a single event, food handler, or contaminated water supply as a source for this outbreak. However, most case clients ate lunch in schools, and further analysis revealed a strong association between illness and consumption of food items containing frozen strawberries.

The strawberries linked to this outbreak were grown in Mexico and shipped to a southern California company, where they were processed, packed, and frozen in lb containers to be distributed to U. Department of Agriculture—sponsored school lunch programs. Whether the strawberries were contaminated in Mexico or in the processing company in California was uncertain. Further investigations continued to track the source of the contamination.

Meanwhile, the Centers for Disease Control and Prevention CDC notified the health departments in six other states to which strawberries from the same lots as those sent to Calhoun County had been shipped. Can you think of some ways that the epidemiological concepts of host, agent , and environment relate to this clinical example? The theory of multiple causation of disease is critical to understanding epidemiological problems.

Unraveling the Mysteries of Cardiovascular Disease

Causality is generally considered in terms of a stimulus or catalyst that produces a single effect, result, or outcome. In epidemiology the interactions of the agent, person host , and environment are analyzed by statistical methods to determine whether a causal relationship exists between various factors and health status. Understanding these interactions and relationships is even more important and complex as one considers the natural history of noninfectious diseases, chronic conditions, and the health and well-being of a population.

In these instances, multiple causes or factors are usually interacting to affect health status. A significant number of multiple causation models in epidemiology can be found. The model of Dever recognizes input from human biology, lifestyle, environment, and the health care system in the development of a particular health condition. The Web of Causation model is a metaphoric model that has been used in epidemiology texts since the early s to describe the multifactorial causes of disease Krieger, All the models point to the interplay of numerous factors in the presentation of a specific disease.

Figure illustrates factors associated with heart disease. Some of these factors are easily amenable to change, whereas others are not.


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These categories include the following:. Obviously, the factors in some of these categories are harder to change than others. For example, genetic factors remain the most difficult to manipulate, whereas nutritional factors are more easily changed. Because disease occurs over time, there are many potential points at which intervention may prevent, halt, or reverse the pathological change.

A three-level model developed by Leavell and Clark based on the idea that disease evolves over time continues to be used in the conceptualization and structure of health programs Figure Primary prevention is aimed at altering the susceptibility or reducing the exposure of persons who are at risk for developing a specific disease. Primary prevention includes general health promotion and specific protective measures in the prepathogenesis stage, which are designed to improve the health and well-being of the population. Nursing activities include health teaching and counseling to promote healthy living and lifestyles.

Specific protective measures aimed at preventing certain risk conditions or diseases—such as immunizations, the removal of harmful environmental substances, protection from ultraviolet rays, or the proper use of car safety seats for infants and children—are also primary prevention activities.

Recent advances in genetic screening have initiated a debate over its role in disease or disability prevention. Although genetic scientists hail research advances as one step on the road to ridding the world of disease and disability, others view that step more as a slippery slope. Is a child with less potential for disease or disability a more perfect child? If we have the technology to produce such a child by selective abortion or gene manipulation , does the public have the right of access to this technology?

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What message does this send to the disabled community? From a community perspective, what other dilemmas can you imagine surfacing in relation to genetic screening? Secondary prevention is aimed at early detection and prompt treatment either to cure a disease as early as possible or to slow its progression, thereby preventing disability or complications. Screening programs in which asymptomatic persons are tested to detect early stages of a disease are the most frequent form of secondary prevention.

Early case finding and prompt treatment activities are directed toward preventing the transmission of communicable diseases, such as the spread of impetigo in a school. Preventing or slowing the development of a particular disease or condition and preventing complications from a disease, such as scoliosis in teenage girls, are also examples of secondary prevention.

Tertiary prevention is aimed at limiting existing disability in persons in the early stages of disease and at providing rehabilitation for persons who have experienced a loss of function resulting from a disease process or injury. Health information is the data collected about the significant health-related events that occur over a period within a population.

Health information systems are data collection systems for gathering health statistics and other health-related information at the population level and may include collection of vital statistics, surveillance, surveys, and records. Data used in epidemiology are systematically collected by government agencies and private groups to measure the size and scope of health problems and factors contributing to them; to study trends and predict the future course of health problems; to identify subgroups to target for interventions; and to evaluate the outcomes of intervention programs and their costs.

Types of health information collected include vital statistics and health statistics on morbidity and disability, health behaviors, nutrition, and health care access, utilization, and costs.


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  7. Data on personal, behavioral, environmental, and occupational risk factors associated with illness are collected and analyzed, and sometimes information on related political and economic issues that affect health is also collected. Much epidemiological information is now available on the Internet, for example, the home pages of the U. Census Bureau and the CDC. These two websites also contain many helpful links to other websites. See the resource list at the end of the chapter for additional information.

    A major source of information about a population comes from the vital statistics that are recorded about them. Vital statistics is the term used for the data collected from the ongoing registration of vital events, such as death certificates, birth certificates, and marriage certificates. Surveillance is the ongoing systematic collection, analysis, and dissemination of health information for the purpose of monitoring and containing specific, primarily contagious, diseases. Notifiable disease reports are received from all U. Noninfectious chronic diseases, such as diabetes, arthritis, and asthma, are not notifiable.

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