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ENH 122 Study Guide - Final Guide: Odds Ratio, Rare Disease, Relative Risk

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School
Ryerson University
Department
Environmental Health
Course
ENH 122
Professor
jorantustin

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Document Summary

Very short- the shorter the better so we can define the study as of a specific point in time. Time needed to find and interview the cases and the controls, but still much faster than a cohort study. Longest as we need to wait until the time period is over before we can assess the outcome differences if any between the groups. Largest because of people who become lost to follow up during the passing time. High, due to sampling and managing larger numbers of people over long periods of time. We take the number we need to establish a relationship, or more often, we use the number that are available with no option to have larger numbers. Low, due to short time needed to find and interview the cases and controls. Easy to calculate, can be a problem with response rates. Relatively low; either mail out or telephone interviews can involve some staff time.

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Related Questions

As you may recall in the work of Triplett (1898), the presence of others in a bicycle race was found to enhance individual performance. This is called social facilitation (Williams, Harkins, & Karau, 2007). At times, however, the presence of others can detract from individual performance, which is termed social inhibition (Crisp & Turner, 2007). Similarly, social loafing can occur when an individual’s performance within a group decreases due to his or her reliance on others in the group (Crisp & Turner, 2007).

For this Discussion, review the media program, Week 5: The Virtual Office. Focus on the characters in the media and determine which characters displayed social facilitation, social inhibition, and social loafing.

With these thoughts in mind:

Post by Day 3 a description of the characters in the media program demonstrating social loafing, social inhibition, and social facilitation. Explain how you identified them. Then, select one of the characters and, using the current literature, explain two ways you might mitigate their behavior.

Media Program

(Onscreen Text: The employees at the United Cardboard Company often work individually on projects, but as with most environments, they are occasionally asked to participate in group projects. One such group is about to meet right now to plan a presentation for the Board of Directors. Observe the conversation and reactions of various group members to determine which group members exhibit signs of the following: Social Loafing, Social Inhibition, and Social Facilitation.)

(Interior of an office. Ken stands at the front of the conference room.)

KEN: OK, I guess we might as well all get started. As we all know, the big man has requested the five of us to get together and write and conceptualize a presentation to the board on our new packaging system. Maybe we can start by going around and throwing out some initial ideas.

KATHY: Sounds good to me. I think a PowerPoint presentation would do the job well.

GAVIN: I agree. We could follow it up with a physical demonstration of how the packaging looks and folds-- maybe a video of the larger pieces that won't fit into the boardroom.

KEN: Sounds perfect to me. Amanda, Brian, what do you guys think?

BRIAN: Yeah, what you guys said sounds fine.

(Amanda thinks, “I don’t know what to say!”)

KEN: Amanda?

AMANDA: I don't know. I didn't really get much chance to think about this. We only found out we needed to do this together three days ago.

KEN: OK, no worries. Let's focus on the PowerPoint idea. I've been doing a lot of them lately, so I'm happy to take the lead on the design aspect. What do you guys think we should all incorporate into the slides?

GAVIN: I think we should start with where we got the idea for this new packaging -- the company that designed it and the different sizes that it comes in.

KATHY: We should follow that with a graph comparing the old prices to the new ones to illustrate how much we'll be saving over time. Amanda, didn't you have most of that information collected at some point?

(Amanda thinks, “Oh no! What if I deleted that?)

AMANDA: I don't know, maybe, it's been so long. I didn't think I'd need it again for a group project like this.

(Gavin thinks, “I wonder what’s gotten into her. She’s not usually this tense.”)

KEN: That's OK, Amanda, I'm sure we can easily dig it up again. Brian, do you have any other ideas for the PowerPoint slides?

BRIAN: Nah, I think what you guys mentioned sounds right.

(Kathy thinks, “Wow. Way to contribute Brian.”)

KEN: OK then, Kathy and Gavin why don't you send me all of the info and I'll write it up and make the slides. Amanda, don't worry about the cost saving document, I'm sure I can dig it up from my old emails and put it into that slide too.

AMANDA: Are you sure? I'm happy to look. I mean I'm sure I have it somewhere. (Kathy thinks, “She really needs to get it together. Why is she so nervous?”) At least I think I have it somewhere. You won't tell the Board of Directors if I lost it, will you?

KEN: Of course not, we're in it together. So as I was saying, I'll write up and prepare all the PowerPoint slides. Then we can start our presentation with reading and explaining each slide. Then, what?

KATHY: Well, and then I think we should show them the packaging live, and the quick deconstructing techniques.

KEN: Great idea. You and Amanda can demonstrate the folding, while I narrate what you're doing.

(Amanda thinks, “Is he doing too much of the work? And what if I drop everything while he’s talking?”)

GAVIN: And after you all demonstrate the smaller packaging, we could show a quick video of how the really big ones function down at the warehouse. Brian, would you be able to go film that quickly one of these days?

BRIAN: I don't really have any experience with video cameras or anything like that, so...

(Gavin thinks, “I should have seen that one coming.”)

KEN: That's OK. My wife actually just got me this great little camera for our anniversary. It takes great videos. So I can just run down to the warehouse, get some footage, then put it together on this new editing software I just downloaded. Maybe add a little music. It's going to be really slick!

KATHY: Are you sure, I wouldn't mind doing that too.

KEN: Oh no, it's fine. I love this kind of stuff; just leave it to me. But I suppose that's enough planning. Now it's time to get to work and make the presentation a knock out. Go team!

(Everyone except Ken thinks, “Team?”) ©2012 Laureate Education, Inc.

Case Study

Skolnikland is in Eastern Africa, with a population of 30 million people. The country has a plains region, a hill region, and a region with high mountains. It has a number of ecosystems. The plains are dry for much of the year, there is some rainforest, and the rest of the country includes both hills and mountains. There are two seasons of heavy rainfall.

The citizens come from several ethnic groups that tend to live in their own regions and speak different languages. The ethnic groups largely follow one of three different religions. The large cities are mixed ethnically. One ethnic group is economically and socially very dominant. The people from this group live in the capital and most of the large cities. The national language is the language of this dominant ethnic group.

According to World Bank criteria, Skolnikland is among the poorest countries in the world. The economy has been growing at about 4% per year on average over the last decade, but the economy had very slow economic growth in the decades prior to that. The richest 10% of the population controls 80% of the national income.

About 80% of the people live in rural areas and 20% in urban areas. The number of people living in urban areas has been growing recently at an increasing pace. Most people earn their livelihood in agriculture but there is an increasing garment manufacturing industry in the two largest cities. There are also a number of mining industries. In addition, other export industries are beginning to grow, mostly focused on the export of commodities to China.

The total fertility rate is about 4.5 but it has been declining slowly over the last two decades, from over 6. There is an almost equal number of men and women in the population. Infant mortality is about 90 per 1,000 live births. Maternal mortality is about 500 per 100,000 live births. Thirty-five percent of the children are underweight for age.

The adult literacy rate is about 40%. The educational enrollment rate, especially for girls at the primary and secondary levels, has been growing slowly, but steadily. Most recently, this rate has been growing at an increasing pace and about 75% of the girls now attend school regularly, although many of them are of very low quality.

Only about 50% of citizens have access to safe water. Only about 30% have access to sanitary disposal of human waste.

HIV prevalence is 7% of the adult population. The number of new HIV cases annually has begun to plateau. About half of the people eligible for treatment for HIV are on treatment. Malaria is rampant in the plains.

Investments in the road system have been growing at a solid pace in the last decade and the use of private automobiles has begun recently to increase more rapidly.

Skolnikland has a pluralistic health system that is made up of public and private institutions, publicly financed providers, licensed private providers, unlicensed medical practitioners, and traditional healers. There is no health insurance, except for some free services for the poor in the few publicly financed hospitals, which the better off people do not attend. The health system is not very effective or efficient and is generally of low quality. The HIV, TB, and malaria programs are not effective or efficient and they are just beginning to adopt paradigms for services that follow global best practices.

QUESTION 26

What is a DALY?

Refer Case Study from question 1 to answer this question.

A. An indicator that compares the burden of deaths across the population of different countries.

B. A composite health gap indicator that measures the amount of health and disability-free life that is lost because of disease, injury, and premature death.

C. A WHO indicator used to summarize the expected number of years to be lived in good health.

QUESTION 27

What is an example of a conditional cash transfer that you can use to improve child health?

Refer Case Study from question 1 to answer this question.

A. Provide tax breaks to families with children.

B. Give money to mothers whose children received a full course of vaccination.

C. Pay higher fees to vaccination programs with better outcomes.

QUESTION 28

What usually takes place during the demographic transition?

Refer Case Study from question 1 to answer this question.

A. Fertility falls before mortality falls

B. Mortality falls and then fertility falls

C. Mortality and fertility fall at the same time

QUESTION 29

Which force is likely to have the greatest direct impact on epidemiological change in the medium and long terms on today's middle-income countries?

Refer Case Study from question 1 to answer this question.

A. Population growth

B. Population aging

C. Urbanization

QUESTION 30

Which is the most accurate statement about the distribution of age at death in Niger (a very low income country) and Norway (a very high income country) today?

Refer Case Study from question 1 to answer this question.

A. About 5% of the deaths in Niger are among those under 15, while the overwhelming majority of deaths in Norway are among those over 65.

B. About 30% of the deaths in Niger are among those under 15, while the overwhelming majority of deaths in Norway are among those over 65.

C. The overwhelming majority of deaths in both countries occur among people aged 65 and over.

Case Study

Skolnikland is in Eastern Africa, with a population of 30 million people. The country has a plains region, a hill region, and a region with high mountains. It has a number of ecosystems. The plains are dry for much of the year, there is some rainforest, and the rest of the country includes both hills and mountains. There are two seasons of heavy rainfall.

The citizens come from several ethnic groups that tend to live in their own regions and speak different languages. The ethnic groups largely follow one of three different religions. The large cities are mixed ethnically. One ethnic group is economically and socially very dominant. The people from this group live in the capital and most of the large cities. The national language is the language of this dominant ethnic group.

According to World Bank criteria, Skolnikland is among the poorest countries in the world. The economy has been growing at about 4% per year on average over the last decade, but the economy had very slow economic growth in the decades prior to that. The richest 10% of the population controls 80% of the national income.

About 80% of the people live in rural areas and 20% in urban areas. The number of people living in urban areas has been growing recently at an increasing pace. Most people earn their livelihood in agriculture but there is an increasing garment manufacturing industry in the two largest cities. There are also a number of mining industries. In addition, other export industries are beginning to grow, mostly focused on the export of commodities to China.

The total fertility rate is about 4.5 but it has been declining slowly over the last two decades, from over 6. There is an almost equal number of men and women in the population. Infant mortality is about 90 per 1,000 live births. Maternal mortality is about 500 per 100,000 live births. Thirty-five percent of the children are underweight for age.

The adult literacy rate is about 40%. The educational enrollment rate, especially for girls at the primary and secondary levels, has been growing slowly, but steadily. Most recently, this rate has been growing at an increasing pace and about 75% of the girls now attend school regularly, although many of them are of very low quality.

Only about 50% of citizens have access to safe water. Only about 30% have access to sanitary disposal of human waste.

HIV prevalence is 7% of the adult population. The number of new HIV cases annually has begun to plateau. About half of the people eligible for treatment for HIV are on treatment. Malaria is rampant in the plains.

Investments in the road system have been growing at a solid pace in the last decade and the use of private automobiles has begun recently to increase more rapidly.

Skolnikland has a pluralistic health system that is made up of public and private institutions, publicly financed providers, licensed private providers, unlicensed medical practitioners, and traditional healers. There is no health insurance, except for some free services for the poor in the few publicly financed hospitals, which the better off people do not attend. The health system is not very effective or efficient and is generally of low quality. The HIV, TB, and malaria programs are not effective or efficient and they are just beginning to adopt paradigms for services that follow global best practices.

QUESTION 26

What is a DALY?

Refer Case Study from question 1 to answer this question.

A. An indicator that compares the burden of deaths across the population of different countries.

B. A composite health gap indicator that measures the amount of health and disability-free life that is lost because of disease, injury, and premature death.

C. A WHO indicator used to summarize the expected number of years to be lived in good health.

QUESTION 27

What is an example of a conditional cash transfer that you can use to improve child health?

Refer Case Study from question 1 to answer this question.

A. Provide tax breaks to families with children.

B. Give money to mothers whose children received a full course of vaccination.

C. Pay higher fees to vaccination programs with better outcomes.

QUESTION 28

What usually takes place during the demographic transition?

Refer Case Study from question 1 to answer this question.

A. Fertility falls before mortality falls

B. Mortality falls and then fertility falls

C. Mortality and fertility fall at the same time

QUESTION 29

Which force is likely to have the greatest direct impact on epidemiological change in the medium and long terms on today's middle-income countries?

Refer Case Study from question 1 to answer this question.

A. Population growth

B. Population aging

C. Urbanization

QUESTION 30

Which is the most accurate statement about the distribution of age at death in Niger (a very low income country) and Norway (a very high income country) today?

Refer Case Study from question 1 to answer this question.

A. About 5% of the deaths in Niger are among those under 15, while the overwhelming majority of deaths in Norway are among those over 65.

B. About 30% of the deaths in Niger are among those under 15, while the overwhelming majority of deaths in Norway are among those over 65.

C. The overwhelming majority of deaths in both countries occur among people aged 65 and over.