PUBHLTH 1 Lecture Notes - Lecture 8: Cohort Study, Field Trial, Polio Vaccine

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mauvemole377

10 Dec 2018

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Definition of epidemiology: epidemiology is the study of the distribution and determinants of disease frequency in human populations. Disease frequency, ctd: if causes or risk factors increase, incidence and prevalence increase, if ability to diagnose increases, incidence and prevalence increase, prevalence depends on incidence and prognosis. Distribution of disease: who sex, age, occupation, race, when season, year (long-term trends), elapsed time since an exposure (epidemic curve, where neighborhood (e. g. clusters), latitude (climate), urban vs. rural, national variations. Determinants of disease: why is distribution as it is, can make inferences from distribution, risk factors human population, epidemiology observes humans, in contrast to biomedical sciences, which can do experiments on laboratory animals. Kinds of epidemiologic studies: goal is to determine an association between an exposure and a disease or other health outcome, may be prospective or retrospective, intervention study, cohort study, case-control study.

Related Questions

QUESTION 1 1. The relative importance or burden of a disease within a population will depend on a number of factors including : A. Disease frequency B. Disease severity C. Disease consequences D. All of the above

QUESTION 2 1 . With the epidemiologic transition, there is a reduction in malnutrition and _____ . A. Communicable diseases B. Injuries C. Non-communicable chronic diseases D. Mental health disorders

QUESTION 3 1. A major challenge to developing a burden of disease profile in low and middle-income countries relates to A. Unwillingness to share complete information B. Conflicting disease definitions C. Challenges obtaining information related to cause of death D. All of the above

QUESTION 4 1. The demographic transition describes which of the following changes to society A. Changes in birth and death rates that reflect a modern society B. Declines in mortality followed by a reduction in fertility C. A change in the age structure of the population D. All of the above

QUESTION 5 1. Measures of health status that combine mortality and morbidity data A. Facilitate comparisons both within and across populations B. Help estimate the quantitative health benefits from interventions C. Serve as tools to assist with resource allocation D. All of the above

QUESTION 6 1. The disability-adjusted life year is defined as A. A health gap population summary measure that combines time lost due to disability with that lost due to death B. A measure to compare the gap between the current situation to that of an ideal situation C. A measure that combines the amount of healthy life lost due to morbidity with that lost due to injury. D. Answers B and C

QUESTION 7 1. True or false? A key limitation to mortality-based indicators is that they fail to account for the morbidity caused by disease. True False

QUESTION 8 1. The most widely used composite measure of population health is the DALY, and this epidemiological measure is the sum of morbidity and ________data. A. Years of life lost (YLL) B. Morbidity C. Infant mortality rates (IMR) D. none of the above

QUESTION 9 1. What would be the best source of information on adult and infant mortality (in high income countries)? A. Disease registers B. Vital statistics C. Special survey study D. Hospital clinic statistics

QUESTION 10 1. Which term is best used to describe the proportion of people in a population who have a defined disease at a specific point of time? A. DALY B. Incidence C. Mortality rate D. Prevalence

QUESTION 11 1. Which term is best used to describe new cases of disease occurring in a population? A. DALY B. Incidence C. Mortality rate D. Prevalence

QUESTION 12 1. Which term is used to describe the absence or presence of illness or disease? A. Demography B. Morbidity C. Mortality D. Vitality

QUESTION 13 1. Mortality (death indicators) include: A. Mortality rate B. Infant mortality rate C. Neonatal morality rate D. All of the above

QUESTION 14 1. True or false? The value of life is often implicit in the way resource allocation decisions are made, which suggests that these decisions should be as explicit, open, and transparent as possible. True False

QUESTION 15 1. _________________is projected as the number one leading cause of disease burden in 2030. A. Ischemic heart disease B. Diabetes mellitus C. HIV/AIDS D. Unipolar depression

QUESTION 16 1. Some of the negative aspects of globalization include A. Greater insecurity of employment B. Poorer housing and sanitation due to rapid urbanization C. Greater vulnerability to environmental degradation D. All of the above

QUESTION 17 1. Current concerns about climate change focus on several developments including A. Rising global average land and sea surface temperature B. Increasing frequency of extreme weather conditions C. Both A and B D. None of the above

QUESTION 18 1. True or false? Diseases carried by mosquitoes are especially sensitive to meteorological conditions because they are vulnerable to changes in the ambient temperature. As a result of changing temperatures, infectious diseases such as malaria and dengue have decreased in incidence and geographic range. True False

QUESTION 19 1. True or false? International cooperation of infectious disease control has a long history that includes obligatory reporting of outbreaks of specific diseases. However, compliance with obligatory reporting has been poor due to economic consequences that have often accompanied notification of disease outbreaks. True False

QUESTION 20 1. True or false? Globalization is a relatively new phenomenon that began in the mid-20th century. True False

PLEASE ANSWER ALL QUESTIONS..PLEASE NOT ONLY 1 QUESTION. THANK YOU

QUESTION 1. Chronic diseases generally have several underlying characteristics, including a.A long latency period between exposure to risk and disease outcomes b. Low degree of preventability c. High curve rate d.None of the above

QUESTION 2.Which of the following risk factors collectively explain a significant proportion (not incidence) of most chronic diseases. a.Tobacco, alcohol, diet b.Tobacco, alcohol, diet, physical activity c. Alcohol, physical activity d.Tobacco, diet, physical activity

QUESTION 3.Adherence to treatment is influenced by several interacting dimensions including a.Social and economic factors b. Healthcare system factors c.Condition-related factors d.Therapy-related factors e.Patient related factors f.All of the above

QUESTION 4. _________ is the leading cause of cancer in both developed and developing countries worlwide a.Radiation exposure b. Tobacco use c.Pesticide exposure d.Air pollution

QUESTION 5.This week's YouTube video on treating non-communicable diseases in Rwanda showed how a community health worker helps to treat heart disease, diabetes and _______ a.Cancer b.Asthma c.Hepatitis d.HIV/AIDS

QUESTION 6.Which of these are myths of chronic disease control a.Benefits of chronic disease control accrue not only to the individual but also to the population b.Economic growth improves all health conditions c. Chronic diseases are associated with low SES/poverty d.Chronic disease only occurs in the elderly e.a and c f.b and d

QUESTION 7 ___________ remains the leading cause of death among both men and women in low- and middle-income countries a.Cancer b.Cardiovascular disease c. Diabetes d.Obesity e.Respiratory disease

QUESTION 8.Chronic disease in adults accounts for approximately 60% of all deaths worldwide. True False

QUESTION 9.The WHO's Innovative Care for Chronic Conditions Framework includes a positive policy environment. True False

QUESTION 10.It is estimated that the overall number of cancer cases will rise by 50% in the next 20 years. True False

QUESTION 11.Comorbidity refers to simultaneous occurrence in a person of two or more disorders; comorbid conditions can increase the risk of adverse outcomes. True False

QUESTION 12.Emerging evidence supports starting promotion efforts during pregnancy and early childhood and continuing efforts throughout life lower exposures to major chronic disease risk factors. True False

QUESTION 13. Increased cumulative exposure to risk factors over the lifecourse combined with social and economic inequalities, leads to the levels of inequalities seen in later adult life. True False

QUESTION 14.The "compression of morbidity" model proposes that morbidity due to aging cannot be postponed or mitigated by disease prevention programs True False

QUESTION 15.There is few significant funding sources for chronic diseases in low-and middle-income countries. True False

QUESTION 16.To combat chronic diseases, modern, evidence-based interventions emphasize shared decision making and collaborative goal setting among providers and patients. True False

QUESTION 17.In the absence of legislative, financial and engineering approaches, health education programs often have a limited impact on preventing or reducing chronic diseases. True False

QUESTION 18. It is estimated that deaths from diet-related chronic disease in China will triple between 1995 and 2025. True False

QUESTION 19.The third highest percent of global DALY's is attributed to which risk factor? a.Alcohol use b.Tobacco use c.Unsafe sex d.Childhood underweight

QUESTION 20.In the 1990's which country experienced a substantial decline in male life expectancy as a result of dramatic socio-political changes a.China b.Russia c. India d.Canada

jademole302

This includes showing all calculations and explaining why you selected a specific answer for each multiple choice question (i.e. donât just circle the correct answer). I am looking to see how you got the answer, not just that you have the correct answer.

Below is data from the United States Cancer Statistics about the number of news cases of lung cancer in males in the U.S. for 2011 for ages 30 and older.

Table 1: U.S. Population Size and Incidence Cases of Lung Cancer in Males for 2011

Age (Years)	U.S. Male Population	White Population	White Incidence Cases	Black Population	Black Incidence Cases
30-34	10,181,564	7,950,924	88	1,383,650	22
35-39	9,666,162	7,557,263	212	1,271,897	23
40-44	10,363,126	8,259,215	643	1,324,847	132
45-49	10,856,131	8,766,225	2,032	1,373,346	444
50-54	10,976,172	9,004,383	5,128	1,329,551	1,148
55-59	9,733,849	8,101,629	8,607	1,091,030	1,687
60-64	8,466,308	7,183,960	12,340	845,362	2,067
65-69	6,014,777	5,178,255	15,792	539,796	2,077
70-74	4,360,942	3,769,569	16,011	376,129	1,864
75-79	3,204,196	2,807,216	14,319	255,221	1,426
80-84	2,319,839	2,078,071	11,284	154,155	883
85+	1,873,942	1,688,433	7,616	117,267	545
Total	88,017,008	72,345,143	94,072	10,062,251	12,318

3. What is the age-specific incidence rate for lung cancer in white men age 75-79 for 2011?(1 pt)

0.005 per 1000

1.3 per 1000

1.2 per 1000

5.1 per 1000

5.6 per 1000

F. Cannot be calculated from the given information

4. What is the age-specific incidence rate for lung cancer in black men age 75-79 for 2011? (1 pt)

0.005 per 1000

1.3 per 1000

1.2 per 1000

5.1 per 1000

5.6 per 1000

F. Cannot be calculated from the given information

Questions 5 through 7 are based on the information below:

Using the information in Table 1, researchers calculated the crude incidence rates and age-adjusted incidence rates (via the direct method) for both groups.

Table 2: Crude incidence rates and age-adjusted incidence rates for white and black males

White Males		Black Males
Crude Incidence Rate	Age-adjusted Incidence Rate	Crude Incidence Rate	Age-adjusted Incidence Rate
1.3 per 1000	1.2 per 1000	1.2 per 1000	1.5 per 1000

5. True or False, there is likely a difference in the age composition between the white and black males. Explain your answer

6. Based on the information in Table 2, it was reported that there was an increased risk of lung cancer in black males in 2011. (1 pt)

The conclusion is:

Correct, the age-adjusted rate is higher in black males compared to white males

Correct, because both the crude and age-adjusted rates are higher in black males compared to white males

Incorrect, because the incidence rate for white males is actually higher than the incidence rate for black males

7. What type of age-adjusted rate was calculated in table 2? How does it differ from the age-adjusted rate in question 5 in the in-class exercise for age-adjustments? Hint: See slide title: Adjustments for Other Measures of Disease Frequency in the lecture title Adjusted Rates (1 pt)

Question 8 is based on the information given below:

Cause-specific mortality rates for men in 2010 in the U.S. from various types of cancers are shown in the table below:

Cause-Specific Mortality Rates

(per 100,000 Men)

Location of the Cancer

in the Body White Asian

Pancreas 13.2 5.7

Prostate 19.1 2.5

Lung 62.3 18.5

Skin 4.9 0.3

8. The inference that White men in the U.S. are at higher risk of death due to cancer of the pancreas, prostate, lung, and skin compared to Asian men in the U.S. is

A. correct

B. incorrect because of failure to determine cause-specific mortality rates

incorrect because proportionate mortality alone does not give an estimate of risk

D. incorrect because of failure to adjust for differences in the age composition of the two populations

E. incorrect because counts were used when cause-specific mortality rates were needed

9. In January 1996, a team of epidemiologists identified a sample of 4,500 men, 65-74 years of age, for a study of prostate cancer. Tests indicated that 315 of the men already had prostate cancer and, therefore, were not at risk. The rest of the men were followed prospectively for five years to determine the incidence rate of prostate cancer in the sample. By the end of the five years of follow-up 156 of the men had developed prostate cancer. What is the incidence rate of prostate cancer in this group?

10. An epidemiologic investigation that started on January 1, 2011, identified a population of 1,000 individuals. At the start of the study 4 were found to have the disease. During the year of study, 6 new cases were found; thus a total of 10 cases were identified. Among those 10 cases, 6 deaths occurred during the year. What was the prevalence of the disease during the 1-year study?

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PUBHLTH 1 Lecture Notes - Lecture 8: Cohort Study, Field Trial, Polio Vaccine

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