PRIMER EPIDEMIOLOGY
Author: Nevena Festchieva
More than 50 years passed since Doll and Hill investigated the relationship between smoking and carcinoma of the lung - a study which exited considerable interest towards epidemiology, per se*.
The emerging chronic disease problem for the health of population, a major dilemma for western civilization, gave an additional impetus for developing new approaches in epidemiology. Thus, it is a common phrase, the definition which Last gave in his "A dictionary of epidemiology".
"… and to study the distribution and determine the risk factors of health statuses and health occurrences in a defined population, … to apply the epidemiology resources for control of health problems."
Today, the contribution of epidemiology in identifying determinants of health and disease, the measurement in quantity and quality of risk and the promotion-prevention mix strategies in health sciences are the dominant parameters of the system. This is, beyond doubt, a priority in Bulgaria. However, some people from the scientific community are still at odds with epidemiological studies, eliminating important theoretical and practical implications from the public memory. While making every effort to keep in pace with progress, defined on a large philosophical canvas, health politicians must be aware of the many side effects coming from their mentors, otherwise, the "horse mouth" effect.
The concentration of epidemiology in Bulgaria is exemplified by TEMPUS JEP-3604, named "Support for Public Health Disciplines" and with co-ordinators: Prof. John Powles from Cambridge University, UK and Prof. Ivan Chernozemsky, National Oncology Center, Bulgaria. During the period 1992-1995, considerable effort was focused on modern epidemiology education and partnership with Western European institutions developed - Cambridge, Rotterdam, Edinburgh, Bilbao, etc. Further, in compliance with TEMPUS JEN for years 1994-1997, a cycle of seminars was held for four consecutive years at Golden Sands, Bulgaria. The aims of the seminars was training young epidemiologists and incorporating their knowledge in health policy reform.
So far, this book aimed at fulfilling the need for a syllabus at the summer courses. Manifested in the text are the close links between epidemiology and biostatistics. The chapter on epidemiology of non-infectious diseases gives not so much the fundamentals of these "modern epidemics", as some aspects of the distribution and public health burden in the society. The superficiality of the transfer of knowledge and standards on an international agenda, as exemplified with JEP and JEN, does not harm the effect of epidemiological specialization. But I wonder, whether in Bulgaria's medical science and practice are still left unerring people who doubt that joining the European Community Standard is fact, already?
Finally, epidemiology is not a panacea but it is worth a try …
CONTENTS
Introduction
Chapter 1: Measurement of health and disease
Chapter 2: Types of epidemiological studies
| Cross-sectional design |
| Case-control design |
| Cohort design |
| Clinical trial |
| Screening |
Chapter 3: Biostatistics in epidemiology research
Chapter 4: Epidemiology of non-infectious diseases
| Coronary risk as an undetermined problem |
| Some methodological aspects of diabetes mellitus |
| On the registration of cancer disease |
| Stroke in Bulgaria - looking for new incentives |
Index