The Scope and Content of Epidemiology Courses in Veterinary Curricula

The Scope and Content of Epidemiology Courses inVeterinary Curricula

M. V. ThrusfieldDepartment of Animal Health, Royal((Dick) School of Veterinary Studies, University of

Edinburgh, EH25 9RG, Scotland

SummaryThe expansion of veterinary epidemiology has been accompanied by the

development of epidemiology courses in veterinary curricula. Approaches to teachingvary, because of differing interpretations of the subject. The discipline involves thecollection of data on diseases in populations, and the making of inferences from thesedata, which, with associated economic studies, form the basis of preventive medicine.The increasing importance of disease prevention is the main justification for teachingepidemiology.

Curriculum builders must consider the needs of all branches of the veterinaryprofession, when designing epidemiology courses. Though most veterinary schoolsinclude all of the components of epidemiology in different parts of their curricula, onlya small number have separate courses in the subject at primary degree level.Postgraduate specialisation in epidemiology is possible—usually at Master's degreelevel.

Future developments in education in epidemiology should include an increase innumeracy among students, and integration with other disciplines. A prerequisite forsuccessful training is an appreciation of the value of the discipline, not only bystudents, but also by clinical colleagues. The content of courses will vary, depending onthe needs of individual countries.

IntroductionThis Second International Symposium on Veterinary Epidemiology and Econ-

omics is indicative of an increasing interest in epidemiology, which has gainedmomentum within the last twenty years. The interest has developed from a necessary`population-orientated' approach to disease, which has always been fundamental toveterinary practice, in which farm animals are involved. The approach has onlyrecently been formalised as 'epidemiology' or `epizootiology' (a word used synony-mously with veterinary epidemiology). This has given the impression, commonamong those not involved in the subject, that a new discipline has developed, with thedanger—inherent in nascent subjects—of overselling.

Epidemiology needs to be put into perspective, in the veterinary curriculum. Thesubject was not included in the earlier undergraduate curricula and its intrusion intoveterinary courses over the last decade or so has taken a variety of forms—someevolutionary and some revolutionary. One reason for the varied approaches is theliberal use of the terms epidemiology and epidemiologist (Lilienfeld, 1978). In veterinarymedicine, epidemiology is most frequently linked to economics (e.g. Ellis, Shaw andStephens, 1976) and preventive medicine (e.g. Wilson, 1974). Biology and ecology arealso used in circumstances in which epidemiology is pertinent e.g. 'The ecology ofinfluenza' (Sakstelskaja, 1975) and The Natural History of Infectious Disease (Boycott,1971). The subject may appear to mean all things to all people.

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Proceedings of the 2nd International Symposium on Veterinary Epidemiology and Economics, 1979Available at www.sciquest.org.nz

The need for training in veterinary epidemiology has been recognised throughoutthe world, (P.A.H.O., 1964; Report, 1975). Doubts were expressed twenty-five yearsago as to the comprehensiveness of the training, only at primary degree level, of thoseinvolved in specialised work in the state services: 'The time has come, however, that weshould consider whether the DVM degree, with or without experience, is sufficientjustification for progressive leadership in this area. Would it not be better for men toenter this important veterinary field with special training in biostatistics, epi-demiology . . .?' (Jasper, 1954). These sentiments have been generally accepted:epidemiology is now being taught at undergraduate level, and postgraduate courseshave been devised (vide infra).

Modern curriculum requirements are based on a critical assessment of the scope ofa subject, and the tasks which students must fulfil, a prerequisite for which is a clearidea of what the subject involves. The objectives of a course should be to effect changesin the student, which will supply him with the necessary skills to perform the tasks(Bloom, 1956; Krathwohl, Bloom and Masia, 1964).

Human epidemiology courses (WHO, 1974) and veterinary epidemiology courses(P.A.H.O., 1975) have been devised, using these objective-based educational methods.

It is the purpose of this paper to define the subject; to summarise the tasks ofveterinary epidemiologists; to review current tuitional approaches, with particularreference to the United Kingdom in which the author has had personal experience; andto suggest future developments in an attempt to standardise the approach to thesubject. The emphasis of different components of a course will vary throughout theworld, because tasks vary from country to country.

Definition and scope of epidemiologyToo much time can be spent on redundantly defining terms. However, curriculum

builders must have some idea of what a subject involves to ensure coverage, and toavoid duplication in other components of the curriculum. This is aphoristicallyreflected in a definition. Physiology is a clearly definable discipline, and therefore, thebounds of a course can be easily set , and the contents universally agreed. This is not sowith epidemiology.

A recent review (Lilienfeld, 1978) cites twenty-three definitions of epidemiology,ranging from exclusively ecological 'the study of the ecology of infectious diseases'(Cockburn, 1963) to mathematical 'the study of the distribution and dynamics ofdiseases in human populations, (Sartwell, 1973); and from the idealistic 'the science ofmass-phenomena of infectious diseases, or as the natural history of infectiousdiseases' . . . concerned not merely with describing the distribution of disease, butequally or more fitting it into a consistent philosophy (Frost, 1941), to the practical 'thebasic science of preventive and community medicine' (Morris, 1975). There is evendoubt as to whether the subject is a discipline or a method (Terris, 1962).Epidemiological method is not unique, and shares much in common with othersubjects, such as social science, an aspect of which is to draw conclusions, by inference,from phenomena occurring in communities. Since the phenomena are biological, theyare subject to a greater degree of variation than either physical or chemical events, andit is this variation which needs a particular type of treatment—sometime (andcontentiously) called 'epidemiological method'. This strictly limits epidemiology to themaking of inferences from the occurrence of disease in populations. Attempts to defineepidemiology in such terms—' . . . epidemiology is a method of reasoning aboutdisease that deals with biological inferences derived from observations of diseasephenomena in population groups' (Lilienfeld, 1978) may appease all who callthemselves epidemiologists, but they are of little help to those who are responsible for

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organising courses on the subject. Refusing to give a definition (Taylor andKnowelden, 1964) is also unhelpful.

In practice, epidemiology is more than a technique in reasoning. A workableveterinary definition must not compromise hominal epidemiology, therefore it isnecessary to collate the approaches common to both, when delimiting the scope of thesubject. It attempts to answer these questions about disease in populations:

Why?How?When?Where?To what extent (amount)?

Answers to all of these questions can only be obtained by extending epidemiologybeyond biological inference, to include methods of data collection, collation,representation and statistical analysis—numeracy is as important as logic to theepidemiologist.

In 1850 the London Epidemiological Society was founded to determine the causeand prevention of cholera and other epidemic (i.e. infectious) diseases. Thoughepidemiology has now exceeded the bounds imposed by infectious disease, it is stillprimarily and inextricably directed towards preventing disease. It is in its role as an aidto disease prevention that epidemiology differs in human and veterinary medicine. Inhuman medicine, prevention is associated with social considerations (hence the termcommunity medicine), whereas, in veterinary work, economic factors are usually moreimportant, (there are exceptions, such as companion and sacred animals). Therefore,in order to avoid confounding human and veterinary epidemiology, it is advisable toseparate the biological and pecuniary assessments of disease and its prevention and todefine these as the epidemiological and economic components of preventive veterinarymedicine (Figure 1). Methods of evaluating the amount of disease in a population, andof collecting and improving the information necessary for biological assessment can beincluded in the subject's scope.

A suitable definition, which puts broader and practical bounds on epidemiology,assisting curriculum designers, may be: 'The collection and interpretation of data ondiseases and disease determinants in populations, and the making of biologicalinferences from these data'. This definition includes the traditional types ofepidemiology: observational, descriptive, mathematical, analytical and experimental.It also includes the two main approaches: 'vertical' and 'horizontal' (vide infra).

Tasks of veterinary epidemiologyThe contemporary tasks of veterinary epidemiology fall into two areas of work:1.The quantitation of disease in populations, to gain information on incidence and

prevalence, in either the total population, or defined cohorts of the population.2. An appreciation of the natural history of diseases.These two fields involve two different approaches which have been termed 'vertical'

and 'horizontal' respectively (Ferris, 1967). The first approach includes themeasurement of the frequency of disease, analysis of data, and the testing ofhypotheses on disease aetiology and control—the area of concern being that of agent,host and environment, and the methods quantitative. The horizontal approach,however, involves investigation of the total biotic community, and therefore has anecological bias and tends to be more qualitative and less quantitative than the verticalapproach. It is a lack of appreciation of this dichotomy that has frequently producedepidemiologists with mutually exclusive ideas of what the subject involves.

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1. The vertical approachThe types of surveillance and monitoring systems required, the sources of data, and

the uses to which the information may be put have been discussed in detail elsewhere(Hutton and Halvorson, 1974; Ingram, Mitchell and Martin, 1975; M.A.F.F., 1976;Morris, 1976). The main requirements are for a comprehensive body of simple diseasedata, and more detailed information on specific diseases. They are acquired by:

(i) Continuous monitoring of disease—this reveals changing patterns of diseaseand indicates the degree of effectiveness of preventive and therapeutic campaigns. Italso affords a degree of priority of disease to research organisations (Cuthbertson,1978).

(ii) General surveys of ill-defined conditions, frequently of unknown aetiology.Again, this highlights areas where further research is indicated.

(iii) Specific epidemiological investigations, including the testing of hypotheses ondisease aetiology, using conventional prospective, retrospective and interventionstudies.

These techniques all require an improvement in the reliability of data sources,trace-back, and efficient methods of data storage and retrieval.

The extent to which such techniques can be employed varies between countries,since the structure of animal population units and the degree of technologicaldevelopment vary.

In most countries, this work is carried out by veterinary graduates and auxiliariesemployed by state organisations. However, private practitioners also play animportant part in such work. This also applies to small animal practice, wherepractitioners can collect information on prevalence, and can conduct epidemiologicalstudies (Reif, 1975).

2. The horizontal approachA study of the natural history of disease, by an investigation of the whole ecosystem

has found application in the investigation of reservoirs, transmission patterns, carriers,and vector cycles, e.g. the work on foot and mouth disease in Africa (Hedger, 1978). Ithas been particularly useful in investigating infectious diseases with arthropodvectors—the theory of natural nidality (Pavlovsky, 1964) emerged from this approach.The current WHO expanded program on the ecology of the influenza viruses, and thework of Rockerfeller arbovirus units in the tropics illustrate further adaptations of thehorizontal approach.

Clearly, different countries have different disease problems and priorities, whichwill govern the extent to which the two approaches are used.

EconomicsEpidemiological and economic assessments of disease should be closely linked as

the major components of veterinary preventive medical campaigns, where the costingof strategies is important (e.g. atrophic rhinitis syndrome eradication in the UK, andswine 'flu' vaccination in the USA). Such campaigns involve private generalpractitioners and state service employees, albeit at different levels: the local and thenational (and international, in large continents). Small animal private practice is theonly sector which is relatively free from economic considerations and restraints—andthis sector is only of importance in the developed (usually western) countries. In allother branches of the profession 'Most veterinary decisions and advice are stronglyinfluenced by economic considerations' (Ellis, 1978).

Preventive medical judgments, which rely on a knowledge of both the biologicaland economic variables, are best dispensed to veterinary graduates, in view of the

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knowledge which is necessary to appreciate the extent of biological variability (Ellis,1978).

Economic assessments of disease include estimations of the financial losses due todisease, and cost-effectiveness and benefit-cost analysis. The techniques have beendescribed in detail in the first symposium in this series (Ellis, Shaw and Stephens, 1976).Though most examples are of diseases for which there are nationally co-ordinatedcontrol campaigns, such as brucellosis and foot and mouth disease, the application ofeconomic strategies at the individual farm level (e.g. in bovine mastitis) involvesprivate general practitioners.

Current courses

(i) UndergraduateTable 1, extracted from curriculum summaries in the most recent edition of the

World Directory of Veterinary Schools (WHO, 1973), shows those countries withveterinary schools which specifically mention either epidemiology or epizootiology asparts of their undergraduate curricula. This information is somewhat out of date: newschools have opened; some schools have closed; curricula have evolved. Ninety-threeschools in nineteen countries, out of a total of 254 schools in sixty-eight countries,include epidemiology in their curricula. This in no way reflects the genuine extent oftuition in the subject, but does indicate the degree of acceptance of the subject, by

Table 1: Countries with veterinary schools citing epidemiology (epizootiology) as partof the curriculum"

Country No. of schoolsYear of course

in which subjectis studied

Length ofcurriculum

( years)

Albania 1 4 4Australia 3 5 5Bulgaria 1 4 & 5 5Cuba 3 4 5Czechoslovakia 2 6 6Egypt 3 5 5Finland 1 4 & 5 6Federal Republic

of Germany 4 3 & 4 5Hungary 1 5 5Iran 2 5 or 6 5 & 6Japan 16 4 4Morocco 1 6 6Peru 4 ? 5Poland 4 5 6Spain 4 4 5

(one of 3 options)Sweden 1 5 5Turkey 2 4 & 5 5Russia 37 5 & 6 5Venezuela 3 4 5

Source: World Directory of Veterinary Schools, 1971. World Health Organisation, Geneva, 1973.(a) No information available for the People's Republic of China.

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BiologicalAssessment =Epidemiology

Clinical and Sub—clinicaldisease in the

animal population

EconomicAssessment

Sources of data

Collection of unbiased data

Reliable data base

Identification ofdisease

Quantitation ofdisease

Strategies forDecreasing amount

of disease:

Genetic improvement

Improvement of nutrition

Improvement of environment

Removal of agent

Removal of vectors

Treatment of diseased animals

Chemo—prophylaxis

Culling

Reduction in amount ofdisease in the population

Figure 1: Components of Preventive Veterinary Medicine

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Microbiology

Pathology

Immunology

Toxicology

Parasitology

name. Inspection of the curricula shows that a variety of subjects of relevance toepidemiology are taught without specific references to it: statistics, plant and animalecology, climatology, biostatistics, veterinary public health, zoonoses, rural sociology,environmental science, ethology and agronomy, as examples. All of the components ofan epidemiology course are therefore now taught, but the organisation of these coursesthroughout the different years of the curriculum suggests that the necessary integrationis lacking. One cannot be certain of the degree of co-ordination between thesecomponents without detailed prospectuses from all of the schools, the gathering ofwhich would be a formidable task.

Figure 2:THE EPIDEMIOLOGY COMPONENT OF THE UNDERGRADUATE VETERINARYCURRICULUM (i)

Animal Husbandry

AnatomyPhysiologyBiochemistryGeneticsPharmacology

ENVIRONMENT)I AGENT I VECTORSHOST

ECOLOGY

DESCRIPTION

TRANSMISSION &MAINTENANCE IN POPULATIONS In individuals

ONTOGENY StateMedicine*

MedicineTherapeutics

1PHYLOGENY II Surgery

UPPER CASE—COMPONENTS OF AN EPIDEMIOLOGY COURSE.Lower Case—Other courses in the veterinary curriculum.Lower Case"—Courses, part of which could be included in a self-contained course in epidemiology and preventivemedicine.

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PREVALENCE

INCIDENCE

Researchpriorities

Disease preventionand control*

Figure 3:THE EPIDEMIOLOGY COMPONENT OF THE UNDERGRADUATE VETERINARYCURRICULUM (ii)

DATA SOURCES

SEROEPIDEMIOLOGYCOLLECTION

DATA BAS E

INTERVENTIONSTUDIES

COHORT CASE/CONTROLSTUDIES STUDIES

CROSS-SECTIONALSTUDIES

1

0,--1 ANALYSIS HY POTHESIS TESTINGStatistics *

UPPERCASE—COMPONENTS OF AN EPIDEMIOLOGY COURSE.Lower Case—Other courses in the veterinary curriculum.Lower Case—Courses, part of which could be included in a self-contained course in epidemiology and preventivemedicine.

In those schools citing epidemiology, its association with other courses hints at thetype of approach to the subject. In Germany, the subject is linked to microbiology inthe curriculum summary. In Peru it is linked to public health; in Morocco to infectiousdiseases; in Australia to medicine. In some schools' curricula, the subject stands alone.The associations suggest a varying emphasis on the vertical and horizontalapproaches.

Preventive medicine is mentioned by only seven countries, but 50 per cent includeeconomics (the greater number being developing countries). This indicates that

EconomicImplications*

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economics is taught to a considerable extent, but there is no indication of the extent towhich the subject is integrated with the teaching of disease control strategies.

In the British schools, there is diversity in the teaching of the subject (Thrusfield,1978). Four universities have specific courses in epidemiology, sometimes consideredas a part of preventive medicine. The remaining three colleges teach the subject as partof either pathology or parasitology or medicine, again reflecting different emphases.Formal teaching ranges from two or three hours of seminar study to a thirty-hourlecture course. The reasons for this range are, firstly the extent to which topics arecovered in other courses (e.g. statistics) and secondly the different views on the need forcertain topics. Edinburgh, for example, teaches a considerable amount of basicecology—a topic which some teachers from other schools consider to be unnecessary.

The approaches can be summarised as follows:1.Preventive medicine, with emphasis on agent, host and environment (the `triad').

and the economics of disease control and prevention.2. A study of specific diseases, with an analysis of the factors governing the

occurrence of the diseases, enabling the development of preventive procedures.3. Inclusion of epidemiological concepts in all separate relevant courses:

parasitology, pathology, microbiology and clinical subjects.4. A separate epidemiology course, excluding economic and preventive con-

siderations, but preparing students for later studies in preventive medicine.In North America, a detailed epidemiology course has been devised as part of a

veterinary public health and preventive medicine programme (P.A.H.O., 1975). Thisfollowed an evaluation of attitudes of teachers of public health and preventivemedicine towards the then current methods of teaching. Over half of the respondentswere involved in teaching epidemiology; other subjects included food hygiene, statemedicine, zoonoses, statistics and ecology. The main topic headings for the coursewhich emerged were: meaning and scope; diseases in populations; field epidemiology;ecological approach; mathematical approach; temporal and spatial patterns of disease;environmental, host and agent determinants of disease; surveillance; retrospectivestudies; prospective studies; economic parameters; applications.

One factor common to all of these courses is the increasing need for numeracyamong students in relation to the quantification of disease.

(ii) PostgraduateAt postgraduate level, epidemiology is taught either as a separate Master's degree,

with a variety of names, or as part of other more general higher qualifications. There isno easily available information on the trend towards epidemiology-based Doctorates.

In the United States at least three universities offer Master's degrees inepidemiology:

1. University of CaliforniaThe degree of Master of Preventive Veterinary Medicine is awarded, following

successful completion of a one year course, involving formal teaching, and a researchproject. There are basic courses in statistics, the collection of field data etc., andnumerous electives in three areas—population medicine, food hygiene and avianpreventive medicine.

2. University of MinnesotaThe School a Public Health awards the degree of Master of Public Health, after

one year of successful study. The program is flexible and epidemiology may be chosenas a special area of interest. Numeracy is particularly important on this course, sinceconsiderable emphasis is placed on statistical analysis and modelling techniques.

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3. University of MissouriAn interdisciplinary study program leads to the degree of Master of Science in

Public Health. Principles of Epidemiology' is a core course, and there is a range ofsuggested electives for this course in three areas: microbiological, social and statistical.

In Britain, there are no Master's degrees specifically orientated towardsepidemiology. However, several postgraduate courses do incorporate epidemiology.These include the MSc in Animal Health at London University and a similar degreerecently instituted at Edinburgh.

Other postgraduate courses throughout the world may include substantialamounts of epidemiology, but it is again difficult to acquire comprehensiveinformation.

Future developments in educationTwo questions must be answered: What should we teach? (contents) and How

should we teach it? (method).These questions are easy to answer in subjects such as anatomy and biochemistry—

the anatomy and physiology of oxen are similar over the world. Disease problems inanimal populations differ globally, and therefore require complementary applicationof the vertical and horizontal approaches to differing extents.

A discussion of teaching method cannot produce unanimity because educationalmethods vary from country to country. Application of Bloom's taxonomy ofeducational objectives, in which cognitive and affective goals are defined (Bloom,1956; Krathwohl, Bloom and Masia, 1964), may be of assistance.

The starting-point of veterinary epidemiology training must be the primary degreecurriculum. The detailed contents of an undergraduate course again will vary,depending on national needs. However, both vertical and horizontal componentsshould be involved. The author's experience of British veterinary curricula suggeststhese requirements:

(i) A dependence on the pre-clinical, para-clinical and clinical components of thecurriculum.

(ii) An expansion of the teaching of ecology.(iii) An increase in the level of numeracy among students.

The dependence on the clinical components would be more readily satiated by anincreased awareness of the value of epidemiology among clinical colleagues (Aalund,1978)—students generally copy their teachers (Butterfield, 1973).

In Britain, modern biological interest in molecular biology is reflected in a reducedecological component of secondary school biology syllabuses. A return to a schoolingat all levels of the biological hierarchy (Wright, 1959) would benefit epidemiologyteachers.

An increase in numeracy among veterinary students could be effected at secondaryschool level. However, biological competence is still deemed of greater importancethan mathematical competence when selecting entrants (this is certainly true inBritain). This attitude is understandable—professional sympathies excuse mathemati-cal ignorance more readily than a lack of biological knowledge. Many modern medicalcurricula include separate statistics courses, frequently containing material of anepidemiological nature (e.g. Anon., 1975) which attempt to correct the deficiency.

Epidemiology contributes uniquely to the undergraduate curriculum in severalways (Jenicek and Fletcher, 1977):I. it teachers what is common to groups;2. it deals with methods—logic, and the concepts of choice and variation;

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3. it completes the clinical picture;4. it establishes the collection of a data base; and, in veterinary medicine;5. it also provides the means of biological assessment which, together with economic

assessment, form the basis of preventive medicine.The content of a course should therefore encompass all of the above elements. If a

course is to include economic aspects in the form of an integrated course in preventivemedicine, then a simple course in the relevant economic techniques should also beincluded. Figures 2 and 3 illustrate the associations between epidemiology and othercomponents of the undergraduate veterinary curriculum and also suggest howimprovements might be made—they are based on the structure of the Britishveterinary curricula.

The postgraduate courses in the United States, with their varied approaches, wouldseem to be good models for the future. The state services require graduates trained insophisticated techniques beyond the scope of the undergraduate course, especially inthe fields of analysis and modelling (a bibliography of the uses to which modelling hasalready been put is given by Miller, 1976). As techniques become more sophisticated,there will be a greater need for inter-disciplinary teaching, since the necessary expertisewill not be found exclusively within the profession. Graduates could specialise, bychoosing specific electives—again similar to those available at the American graduateschools.

REFERENCESAalund, 0. (1978) Personal communication.Anon. (1975) Proposal for a core curriculum in

medical biostatistics. Report of a Committee ofthe American Statistical Association on teach-ing of statistics on health sciences. Clin. Phar-mac. Ther. 18 pp. 127-131.

Bloom, B. S. (1956) Taxonomy of EducationalObjectives. Handbook I: Cognitive Domain.David McKay Company Inc., New York.

Boycott, J. A. (1971) Natural History of InfectiousDisease. Studies in Biology No. 26. EdwardArnold, London.

Butterfield, W. J. H. (1973) Epidemiology in theplanning of the Undergraduate Medical Cur-riculum. Int. J. Epidemiol. 2 pp. 391-394.

Cockburn, A. (1963) The Evolution and Eradi-cation of Infectious Diseases. John HopkinsPress, Baltimore.

Cuthbertson, J. C. (1978) Epidemiology in vet-erinary research. in Thrusfield (ed.), VeterinaryEpidemiology, The Developing University Cur-riculum. Proceedings of a seminar, Edinburgh,25 January 1978, pp. 13-16. Department ofAnimal Health, Royal (Dick) School of Vet-erinary Studies, Edinburgh.

Ellis, P. R. (1978) The link between epidemiologyand economics. In Thrusfield (ed.), VeterinaryEpidemiology, The Developing University Cur-riculum. Proceedings of a seminar, Edinburgh,25 January 1978, pp. 10-12. Department ofAnimal Health, Royal (Dick) School of Vet-erinary Studies, Edinburgh.

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Krathwohl, D. R., Bloom, B. S. and Masia, B. B.(1964) Taxonomy of Educational Objectives.Handbook II: Affective Domain. David McKayCompany Inc., New York.

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M.A.F.F. (1976) Animal Disease Surveillance inGreat Britain. The report of a M.A.F.F.working party, May 1976.

Miller, W. M. (1976) A state-transition model ofepidemic foot and mouth disease. In NewTechniques in Veterinary Epidemiology andEconomics. Proceedings of a Symposium, Uni-versity of Reading, England,' July 12-15 1976,pp. 56-76.

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Morris, R. S. (1976) Animal health informationsystems. In New Techniques in Veterinary Epide-miology and Economics. Proceedings of a Sym-posium, University of Reading, England, July12-15 1976, pp. 5-23.

P.A.H.O. (1964) Seminar on the Teaching ofPreventive Medicine and Public Health inSchools of Veterinary Medicine. Pan AmericanHealth Organization/World Health Organi-zation, Washington, D.C.

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Pavlovsky, E. N. (1964) Prirodnaya Ochagovost'Transmissivnykh Bolezney v Svyazi s Landshaf-tnoy Epidemiologiey Zooantroponozov. Trans-lated as Natural Nidality of Transmissible Dis-ease with Special Reference to the LandscapeEpidemiology of Zooanthroponoses. Pious, F.K., trans., Levine, N.D., ed., University ofIllinois Press, Urbana, 1966.

Acknowledgments:I am indebted to Gordon Scott and Pat Imlah,

both of Edinburgh veterinary school, and to JohnCuthbertson of the Moredun Institute, Edin-burgh, for helpful comments on this paper.

Reif, J. S. (1975) Ecologic Factors in Disease. InEttinger (ed.), Textbook of veterinary internalmedicine, diseases of the dog and cat, vol. 1. W.B. Saunders Company, Philadelphia, Londonand Toronto.

Report (1975) The report of the Committee ofInquiry into the veterinary profession (Cmnd6143). Her Majesty's Stationery Office, London.

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Wilson, G. (1974) The use of epidemiology inanimal disease. Br. vet. J. 130 pp. 207-213.

Wright, S. (1959) Genetics and hierarchy ofbiological sciences. Science (NY) 130 pp.959-965.

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The Scope and Content of Epidemiology Courses in Veterinary Curricula

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