PB HLTH 150B Study Guide - Midterm Guide: Environmental Epidemiology, Disease Cluster, Public Health

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22 Oct 2018

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Lecture 5: exposure risk assessment & environmental epidemiology. Epidemiology: the study of the distribution and determinants of health conditions in human population. Prospective cohort: follow them to quantify their exposures and see if they get a disease. Retrospective conhort: cohort of people already exposed to contaminant, look back in time for exposure. Descriptive study: describe the patterns of disease occurrence in relation to variables such as person, place, and time. Analytic study: measure association between exposure and outcome. Descriptive epidemiology: examines the distribution of disease in a population, and observes the features of the distribution in terms of time, place, and person. Analytic epidemiology: tests a specific hypothesis about the relationship of a disease to an assumed cause by conduction statistical analysis that relates the exposure of interest to the disease of interest. Environmental epidemiology: the epidemiologic investigation of the relationship between environmental exposures and states of health.

Related Questions

1. The risk of acquiring disease is measured by the a. Incidence rate b. Incidence rate times the average duration of the disease c. Incidence rate divided by the prevalence rate d. Prevalence rate e. Prevalence rate times the average duration of the disease

2. The strength of an association between a factor and a disease is best measure by a. Incubation rate b. Incidence of the disease in the total population c. Prevalence of the factor d. Attributable risk e. Relative risk

3. Case fatality rate for a given disease refers to a. The crude mortality rate per 100,000 population b. Cause-specific mortality rate due to the disease c. A fatal outcome of any disease d. The percentage of deaths among cases of the disease e. The proportion of deaths due to the disease among all deaths from all causes

4. An investigator is interested in etiology of neonatal jaundice. To study this condition, he selected 100 children who were diagnosed with this condition and 100 children born in the same period and in the same hospital who did not have a diagnosis of neonatal jaundice. He then reviewed the obstetrical and delivery records of their mothers to determine various prenatal and perinatal exposures. This is an example of a(n): a. Cross-sectional study b. Case-control study c. Cohort study d. Clinical trial e. Experiment

5. Which of the following statements describes the major advantages of a randomized clinical trial? a. It avoids observer bias b. It lends itself to ethical justification c. It yields results replicable in other patients d. It rules out self-selection of participants to the different treatment groups d. It enrolls representative patients

6. A survey conducted in England revealed that of 224 families in which there had been a known case of poliomyelitis, 56 maintained parakeets as a family pet. In another British survey, 30 out of 99 poliomyelitis patients questioned kept parakeets. The inference that there is some relationship between the presence of a parakeet in a household and the occurrence of poliomyelitis among household members is a. Correct b. Incorrect because of failure to distinguish between incidence and prevalence c. Incorrect because a proportionate ratio is used when a rate is required to support the inference d. Incorrect because a failure to recognize a possible cohort phenomenon e. Incorrect because there is no control or comparison group.

7. An investigator determines the correlation coefficient between triglyceride levels and degree of atherosclerosis in sampled blood vessels to be +1.67. On the basis of this you would conclude that: a. Triglyceride level is a good predictor of atherosclerosis b. Triglyceride level is not a good predictor of atherosclerosis c. High triglyceride levels cause atherosclerosis d. Atherosclerosis cause high triglyceride levels e. The investigator has incorrectly determined the correlation coefficient

8. A screening test of known sensitivity and specificity is applied to two populations. The prevalence of the disease being screened for is 10% in population A and is 1% in population B. Which of the following is true? a. The percent of all negative tests that have false-negative results is lower in population A than in population B. b. Specificity is lower in population A than in population B. c. Reliability is higher in population A than in population B. d. The percent of all positive tests that have false-positive results is lower in population A than in population B. e. Specificity is higher in population A than in population B.

9. Serum cholesterol levels are obtained for four healthy men. The probability that all will fall below the 10th percentile of the distribution of cholesterol for healthy males is: a. 0.4 b. 1 â (0.1)4 c. (0.1)4 d. (0.9)4 e. Cannot be determined from these data

10. In a diabetes screening program, the screening level for a positive blood sugar level in test 1 is set at 160 mg/dl, and in test 2 at 130 mg/dl. The sensitivity is: a. Greater in test 1 b. Greater in test 2 c. Equal in test 1 and 2 d. Dependent on the size of the population being evaluated

Part II 1.The California Occupational Mortality study data set was employed to assess mortality data for the years 1979-1981. A 2% sample of employed persons from the 1980 census of California was used. It contains the occupation of each person who had died. This study, like any occupation-based study, is restricted to the work life span as far as age of subjects is concerned. This study used ages 16-64 years. Certain persons, because of their source of work, were excluded as subjects: homemakers, retired persons, students, disabled, military personnel, etc. Only main-stream-type employment was used in this study to establish occupations at risk for heavy alcohol drinking. Using the Table below, answer the following:

1.What occupations are most vulnerable to acquiring cirrhosis of the liver from heavy drinking?

2.List several of the occupations identified by the research studies that are more vulnerable to alcohol-induced, cirrhosis related deaths and that have the highest mortality rates.

3. What are possible confounding variables for the research in occupations and heavy drinking that lead to fatal diseases?

4. Based on available research data, develop and construct a web of causation along with the appropriate decision trees for occupational group-related alcohol deaths. Table. Alcohol Related Deaths in California, 1979-1981 Cirrhosis 5.5% Digestive organ cancers 5.7% Injuries 13.7% Suicide and homicide 5.% All other causes 64.9%

Zika and microcephaly Since May 2015, Brazil has experienced a significant outbreak of Zika virus. In recent years, Brazilian officials reported an increase in the number of babies born with microcephaly.

1. Briefly describe what we know and what we do not know about Zika virus.

2. What has been done and what should be done to prevent Zika virus epidemic in US and world-wide?

1. Biological specimens such as urine, stool and saliva samples can be useful for identifying all of the following, except

A risk factors for disease

B characteristics associated with having the disease

C blood pressure

D presence of disease

2. Abstracts provide a glimpse into the content of an article?

A true

B false

3. Acquisition of evidence for improving clinical and public health practices and policies is an example of a societal benefit of health research?

A true

B false

4. Population health research objectives may include:

A identifying and classifying new health problems

B determining risk factors

C evaluating the impact of health policies on health outcomes

D al of the above

5. All of the following are examples of tests of physiological function, except:

A spirometry

B electrocardiography

C audiometry

D all of the above

6. Which is not an example of population based research?

A compare rates of acure lung disease in several metropolitan areas and see whether the rates of disease are correlated with local air quality

B determine whether survival following breast cancer diagnosis is linked to the presencw of certain genes

C conduct a vaccine trial

D analyze biochemical composition of selected foods

7. Health researchers examine all of the following factors that contribute to health and to disease illness disability and death except:

8. ____ is physiological measurements that can be accurately taken after minimal instruction.

A anthropometry

B basic vital signs

C clinical examinations

D biological specimens

9. Population based studies are typically conducted using:

A human subjects

B animals

C research facilities

D none of the above

10. The process of systematically and carefully investigating a subject in order to learn or discover new information about the world is known as?

11. When identifying specific exposures diseases and populations of interest identifying relevant statistics is not helpful.

A true

B false

12. Which of the following is not an example of an adittional assessment that can be conducted as a way to supplement self reported information during the data collection process?

A vital signs

B test of physiological function

C physical fitness tests

D surveys

13. To look for a health science abstract in PubMed one an use all of the following search methods except:

14. When conducting anthropometric measurements, there is no need for the researcher to ensure that the methods used to take these measurements are standardized

A true

B false

15. There is no need to read the full article if the abstract is available.

A true

B false

16. Which of the following is not an example of an examination a clinician can conduct to examine many health states that machines are unable to assess well?

A breath sounds and other respiratory functions

B heart sounds

C heart rate

D the condition of the skin hair and nails

17. Which is not a step in the research process?

A identify a study question

B select a study approach

C report study findings

D all of the above

18. A paragraph length summary of an article chapter or book is known as a

19. Health science abstracts usually provide a brief description of

A study design

B the study populatio

C key findings of the study

D all of the above

20. The goal of every research project is to find and address gaps in the literature and to build on precious work.

A true

B false

21. Which is not an example of laboratory research?

A compare tests of air quality in several metropolitan areas

B identify biological mechanisms for the emergence of drug resistant bacteria

C use a food frequency questionnaire to examine dietary behaviors in a selected population

D develop a new vaccine

22. If clinical examinations are conducted as part of the data collection process an assessment form should carefully describe each component of the examination procedure to be used and diagnostic procedure for each item on the assessment form

A true

B false

23. ____ is the measurement of the size/composition of the human body

A anthropology

B vital signs

C clinical examinations

D biological specimens

24. Health research is considered to be a scientific process only.

A true

B false

25. The goal of any one research project is to contribute vast amount of information that when pooled with other researchers information will provide evidentiary foundation for change

A true

B false

26. Which is an example of health abstract databases available from libraries via subscription

27. All of the following are examples of anthropometric measurements except:

A height

B waist circumference

C skinfold measurements

D blood pressure

28. All of the following are good sources of information that a researcher can use to explore what his primary area of research interest is except:

29. Which of the following is the most important publicly available health science database?

For this assignment, Part One of your course project, assume the role of Dr. Madness. Your rogue nation seeks global domination. With a bare bones laboratory and your exhaustive microbiological and epidemiological knowledge, you (Dr. Madness) decide that the best way to rule the world is to create and disseminate the perfect biological weapon.

For this part of the assignment, you will develop your weapon from the ground up. Discuss nearly all of the epidemiological criteria related to it, and justify and discuss why it is used and how effective it is. This agent could be a hybrid of other biological pathogens or an entirely new one. If the agent is newly created, there must be some basis and epidemiological support of a similar agent by which you can base your justification. In other words, it will be unrealistic to create an airborne virus that inoculates and kills within one hour. There must be a realistic exposure and incubation time and must be supported through current agent biology or biochemistry (for example, influenza exposure and incubation takes 1â4 days).

Name of Agent: Explain why you chose the name. If it is a biological agent, be sure to provide a taxonomic name

Etiology: This will talk about the genesis of your agent. Where was it discovered? How was it made? How long has it been around? Why was this agent created? What were the social and economic factors of your rogue nation that made Dr. Madness focus on this element of the agent? What are the environmental precursors to this agent? Discuss the interaction among agent, host, and environment.

Identification: This will describe the basics of the agent. Is it a bacteria, virus, toxin, parasite, hybrid, or something else? Discuss how your agent presents within the human population. What are the symptoms in humans? What are the (zoonotic) symptoms in animals? How does the disease progress? Are there stages? Discuss the various stages including length of infection, severity, and the like. What are the diagnostic indicators? How would a doctor be able to identify this agent in a clinic or emergency room?

Laboratory Analysis: How will the agent be identified? Can it be grown in media? What type of laboratory methods can be used to identify the agent (microscopy, chromatography, PCR, and so on)?

Occurrence: This is the epi: who, what, when, where, how, and why of the disease. Where does it happen? When can it be found? Who is most and least susceptible to the agent (risk factors). More exotic and hard to find agents are harder to prevent and control but are also more difficult to initiate an epidemic or pandemic, whereas more generalized and known agents may be easier to cure, but have a much wider swath of causing pandemics. How do socioeconomic factors foster or inhibit the spread of disease?

Reservoir: What is the natural reservoir of the agent? Are there other organisms where this agent can reside without causing disease? Increasing the reservoir can enhance transmission but can also allow for easier identification and treatment in response to it.

Mode of Transmission: Consider inhalation, absorption, digestion, contact, and so forth. If you use multiple modes, justify your selections.

Incubation Period: Provide the range with an average (median) day of disease onset. Does the period change in different socioeconomic status identifiers (sex, age, race, creed, and so on)? Why or why not?

Period of communicability: How long is a person with this agent contagious? Increasing this period also increases the opportunity for study and thus treatment and control.

Susceptibility: Is the agent susceptible to reinfection of the same person? Allowing for this increases morbidity but usually mortality wanes in subsequent infections.

Taking on the role of Dr. Madness, generate your superweapon and describe the weapon using the above mentioned criteria. Remember, the focus in on creating something that becomes difficult to identify, monitor, or treat with prophylaxis. You will write out the proposal as Dr. Madness submitting this to his lead researcher to develop. This proposal should be approximately 6â8 pages in length, but some submissions may be longer.

Submit your Bioweapons and Epidemiology Part One proposal in the assignment area.

Please be sure to review the Bioweapons and Epidemiology Part One Scoring Guide for information on how this assignment is graded.

Project Requirements

To achieve a successful project experience and outcome, you are expected to meet the following requirements.

Written communication: Written communication is free of errors that detract from the overall message.

APA formatting: Resources and citations should be formatted according to current APA style and formatting.

Resources: Include all literature cited in the project.

Length of paper: 6â8 typed, single-spaced pages, not including cover page and resource list.

Font and font size: Arial, 10 point.

PB HLTH 150B Study Guide - Midterm Guide: Environmental Epidemiology, Disease Cluster, Public Health

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