BONUS: In the study described in the abstract, logistic regression was used to analyze the association between pet ownership and the risk of Z pathogen infection, adjusting for age and sex. However, there may be other factors that could confound this association. Can you think of any additional variables that should have been included in the analysis to control for potential confounding? How might the inclusion of these variables have affected the results? (Think about what behaviour can be associated with taking care about different pets, what the pets need - what the owners can do differently?). Explain your answer (not enough to just name "usual confounders in medical studies"!)

Zombie disease as a zoonosis? Maybe! It is well established that homeless people are under a higher risk and that you can catch the zombie pathogen by being bitten. These authors, however, believe that pet ownership can be another risk factor - at least for some pets. Read carefully the presented abstract and answer the questions!Title: The Association between Pet Ownership and Risk of Z Pathogen Transmission: A Retrospective Cohort StudyBackground: The Z pathogen can probably be transmitted through various modes, including direct contact with an infected individual or exposure to contaminated materials. One hypothesis suggests that the Z pathogen can be considered as an anthropozoonosis, which means that it can be transmitted between humans and animals. This study aims to investigate the association between pet ownership and the risk of Z pathogen transmission.Methods: A retrospective cohort study was conducted among the population living in the city centre of an European capital, which was infested by the Z pathogen. City register of pet owners combined with electronic medical records (recording zombie infections) was used to recruit the participants based on their pet ownership status. The odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression with adjustment for age and sex.Results: A total of 2,000 participants were included in the study, with 500 dog owners, 400 cat owners, 300 hamster owners, 200 fish owners, 100 owners of other animals (snake, turtle, etc.), and 500 participants without a pet. The results showed that dog owners had the highest risk of getting the disease (OR 14.6, 95%CI 12.3 - 16.9), followed by cat owners (OR 1.5, 95%CI 0.98 - 2.0), hamster owners (OR 0.87, 95%CI 0.57 - 1.2), and owners of other animals (OR 0.93, 95%CI 0.83 - 1.03), while fish owners had the lowest risk (OR 0.45, 95%CI 0.30 - 0.96) in comparison to not-owners.Conclusion: The results of this study suggest that pet ownership, particularly dog ownership, is associated with an increased risk of Z pathogen transmission. Therefore, pet owners should take appropriate measures to prevent the transmission of the disease from their pets.What was the original objective of the study (PICO)?1 pointTo investigate the effectiveness of different treatments for Z pathogen infection.To investigate if the pet owners in comparison to non-owners are at higher risk of Zombie infectionTo investigate the geographic distribution of Z pathogen infection.To see if dog owners are at higher risk of zombie infection than cat owners

For which pet there is clear statistical evidence of positive or negative association with the Z pathogen infection? (Check the OR+95%CI, select all animals)1 pointDogsHamsterCatFish

What was the exposition investigated in the study?1 pointBeing infected or notOwnership of dogs, cats, hamsters, fish, or other animals.Being a city residentNot possible to say

at least one example of how irresponsible pet ownership can harm a pet

two reasons for why responsible pet ownership is important