pub health 202
Which form of prevention takes place after the precursors of disease interact with the host?
Both secondary and tertiary
In epidemiology, sometimes there is an enlargement of the clinical picture of a certain disease because....
Mainly severe cases of the disease are reported
Which of the following terms is expressed as a ratio (as distinguished from a proportion)?
Male Births / Female Births
Based on these maps, is the burden of disease evenly distributed?
No
Which of the following is an example of exposure data in ecologic studies?
all are correct: Per capita income Mean ambient temperatures Smoking prevalence Per capita calorie intake
Before utilizing data for an epidemiologic study, the researcher must first consider the:
all are correct: nature of the data. availability of the data. completeness of coverage.
Which of the following is a characteristic of descriptive epidemiology?
all are correct: It provides the basis for planning and evaluation of health services. It allows comparisons by age, sex, and race. It uses case reports, case series, and cross-sectional studies. It identifies problems to be studied by analytic methods.
Identifying subgroups that are susceptible to disease can help us:
all are correct: help identify causes of the disease help with diagnosis best use scarce resources for interventions identify unfair burden of disease
The descriptive epidemiologic variable AGE is related to:
all are correct: homicides and suicides. mortality from unintentional injuries. the occurrence of chronic disease. congenital malformations and infectious disease incidence in childhood.
When comparing study designs, we can consider differences in
all of the above: Number of observations made directionality of the exposure data collection methods unit of observation
Experimental studies are used in clinical trials to
all of the above: test the efficacy of new therapies study surgical procedures evaluate new drugs and vaccines study the effects of interventions to modify health status
Certain diseases can occur more than once in the same individual during a stated period of time. Repeated cases of the disease have no effect upon incidence density. (T/F)
false
Health education programs about the hazards of starting smoking are examples of secondary prevention. (T/F)
false
Health insurance statistics provide a generally representative picture of the health status of the U.S. population. (T/F)
false
Socioeconomic status is an example of a place variable. (T/F)
false
The criterion of plausibility refers to the existence of a dose-response relationship. (T/F)
false
The existence of a dose-response relationship, that is, an increase in disease risk with an increase in the amount of exposure, does not support the view that an association is a causal one. (T/F)
false
The main differences between experimental and observational study designs include
manipulation of the study factor and randomization of the study subjects
What data source has the advantage of being almost complete in the United States?
mortality statistics and birth statistics
The Black Death is an example of a
pandemic
According to the natural history of disease model, the time before the precursors of disease and the host interact is called the period of:
prepathogenesis.
The difference between primary and secondary prevention of disease is:
primary prevention means control of causal factors, whereas secondary prevention means early detection and treatment of disease.
Original data collected by the researcher conducting an analysis is called _______ data, whereas data shared by another group that another researcher uses in an analysis is called ________ data.
primary; secondary
Types of probability samples include all of the following except
quota sample
A ______ must include a time element
rate
The best routinely available sources of data regarding the incidence of respiratory disease outbreaks and other rapidly spreading conditions are:
reports of absenteeism from work and school.
Based on the image above, what kind of descriptive pattern might one observe?
spatial clustering
^^^^ same blue light/ insomnia study What kind of sampling technique did this study employ?
stratified sampling
All are examples of a ratio except
the number of sunscreen wearers on July Fourth, 2022 in Miami, FL
Successful treatment programs that would shorten the duration of a disease primarily affect:
the prevalence of the disease.
What is Public Health Practice?
the strategic, organized and interdisciplinary application of knowledge, skills, and competencies necessary to perform essential public health services and other activities to improve the population's health.
Marital status is an important descriptive epidemiologic variable because it is:
theorized to be a protective and selective factor in health
A dynamic population is one that adds new members through immigration and births and loses members through emigration and deaths. (T/F)
true
A prerequisite for using the direct method of age adjustment is that the age-specific death rates in the study population must be stable. (T/F)
true
An ecologic study is one that examines a group as a unit of analysis. (T/F)
true
Data on mandatory reportable diseases are not always accurate because providers may fail to report a disease or individuals with the disease may not seek treatment (T/F)
true
For a chronic disease of low incidence and long duration, prevalence of the disease increases relative to incidence.
true
High firearm death rates and homicide rates are indicators of adverse conditions within the community. (T/F)
true
In cross-sectional studies, the survey is the primary data collection tool. (T/F)
true
In less developed regions, triangular population distributions are linked to high mortality among younger age groups. (T/F)
true
In short, a hypothesis is a refutable prediction. (T/F)
true
Influenza typically follows a cyclic variation in cases (T/F)
true
MEDLINE, TOXLINE, and commercial databases are examples of online databases. (T/F)
true
Nativity refers to place of origin of an individual. (T/F)
true
One of three main purposes of descriptive epidemiology is to aid in the creation of hypotheses. (T/F)
true
Sexually transmitted diseases are examples of a residual disorder: one for which the contributing factors are known but for which methods of control have not been implemented effectively. (T/F)
true
The Behavioral Risk Factor Surveillance System uses a stratified sampling technique to select their survey participants. (T/F)
true
The National Health and Nutrition Examination Survey (NHANES) consists of several components conducted by the National Center for Health Statistics, including survey, examination, and lab data. (T/F)
true
The human biological clock phenomenon is linked to variations in diseases by age. (T/F)
true
The three categories of descriptive epidemiologic variables are person, place, and time. (T/F)
true
John Snow, in Snow on Cholera:
was an early epidemiologist who used natural experiments.
Based on the figure above, were there more 75-year-old males or females in the 2000 Census?
Females
A cross-sectional study was conducted to identify the association between blue-light exposure and insomnia in college students at UTK. Students were randomly sampled by class level (i.e., freshman, sophomore, junior, senior) and provided a survey that ask them to report their level of blue light exposure in the last 30 days and multiple questions regarding sleep, adapted by the Pittsburg Sleep Quality Index. Blue-light exposure was dichotomized into two groups: seven or more hours of blue-light exposure and less than seven hours of blue-light exposure. A total of 200 students responded to the survey: 60 freshmen, 60 sophomores, 50 juniors, and 30 seniors. Among the freshman, 20 were found to have insomnia. 40 were exposed to at least 7 hours of blue light per day of which 15 had insomnia. Among the sophomores, 35 were found to have insomnia. 45 were exposed to at least 7 hours of blue light per day of which 25 had insomnia. Among the juniors, 20 were found to have insomnia. 48 were exposed to at least seven hours of blue light per day of which 14 had insomnia. Among the seniors, 15 were found to have insomnia. 28 were exposed to at least seven hours of blue light per day of which 14 had insomnia. Among the freshmen, what is the odds of insomnia in the group exposed to at least seven hours of blue light as compared to the group exposed to less than seven hours of blue light? (hint: make a 2-by-2 table, OR=ad/bc)
15(15)/25(5)=1.8
^^^ same scenario Among all of the students sampled, what is the odds of insomnia in students exposed to at least seven hours of blue light per day as compared to students exposed to less than seven hours of blue light per day? (hint: make a 2-by-2 table. OR=ad/bc)
68(17)/93(22)=0.56
Based on the image above, what is the sex ratio among 75-year-olds in the 2000 Census?
80
In an incidence rate, the denominator represents:
?????
A null hypothesis is most similar to which of the following?
A negative declaration
Which of the following is not a clinical data source?
Absentee reports from public schools
Large international variations in rates of infectious and communicable diseases as well as other conditions are most likely explained by:
All are correct: differences in climate. differences in cultural factors. national dietary habits. access to health care.
Measures of morbidity and mortality help epidemiologists answer important questions such as:
All of the Above: Who is at risk for a condition? How do diseases spread throughout a population? How can we control a disease? How fast does a disease spread? How many deaths is the agent causing?
The number of deaths per 100,000 persons for a specific year is an example of a
All of the Above: ratio rate proportion
Epidemiology is the science for tracking......
All of the above (Disease Incidence, Disease Prevalence, Mortality, Morbidity)
Epidemiological studies are needed when
All of the above: It is unethical to experiment on living humans and/or animals There may be multiple risk factors related to the etiology of a disease There may be multiple diseases that one exposure contributes to
John Snow's investigation of cholera includes:
All of the above: natural experiment quantitative approach spot mapping
Which of the following is an example of a descriptive characteristic?
All of the above: 27% of all stroke patients were between the ages of 55-60 in a hypothetical study. A patient with a rare brain disease lives in an urban setting. Patient A in a case series of disease X has a family history of myocardial infarctions.
What factors should be considered in measuring long-term changes in disease frequency over time?
All of the above: Changes in diagnostic criteria Changes in the age distribution Changes in the fatal course of the condition
Which of Mill's four canons suggests that there is an association between frequency of disease and the potency of a causative factor? The method of....
Concomitant variation
The number of traffic fatalities in the borough Manhattan during a 24-hour period is an example of a
Count
The four main efforts of an epidemiologist include:
Determine the type of treatment that an individual will receive based on their specific symptoms and disease history
Mill's method of difference....
Examines a single causal factor in relation to an outcome and controls for all other factors.
In current thinking, the term epidemic is used only to describe outbreaks of infectious disease. (T/F)
False
John Snow is credited with developing the smallpox vaccination. (T/F)
False
The MMWR only describes infectious and chronic diseases, not behaviors. (T/F)
False
The study of diseases linked to harmful physical energy, such as ionizing radiation, would be outside the scope of epidemiology. (T/F)
False
What are the three defining features of big data?
High variety, High volume, High velocity
A cumulative incidence
Is best for a fixed population
Which of the following statements about case clustering is incorrect.
It is called temporal clustering for geographic concentrations of cases.
All are characteristics of a cross-sectional study except
Participants are randomized to treatment and control groups
Which of the following is NOT one of the objectives of epidemiology?
Prescribe medications to individuals seen by a doctor
What level of prevention is represented by immunization against rubella?
Primary prevention, active
What level of prevention is represented by nutritional counseling for pregnant women?
Primary prevention, passive
What level of prevention is represented by vitamin fortification of milk?
Primary prevention, passive
A _______ is a value obtained by dividing one quantity by another.
Ratio
Data with external validity is
Representative of the population of interest
_____ is a statement of probability, while the _____ is a statement of frequency
Risk, rate
What level of prevention is represented by screening for breast cancer?
Secondary prevention
The ______ is an important tool in epidemiology that allows researchers to evaluate the associations between exposure and disease status
The 2-by-2 table
Cross-sectional studies are...
Surveys of the population to estimate the prevalence of a disease or exposures (think snap-shot look at one point in time)
What level of prevention is represented by halfway houses for persons recovering from substance abuse?
Tertiary prevention
Koch's Postulates does NOT include:
The microorganism must always cause death
In a proportion,
The numerator is part of the denominator
Which of the following is not one of the four criteria for the quality of epidemiologic data?
The price of survey materials
Based on the results in the figure above, what can we conclude?
There is a positive association between a the percent of raised cholesterol among women and age-standardized rates of breast cancer in a country and
Prevalence estimates are beneficial for all of the following reasons, except:
They can help us determine if the number of new cases are rising
Which of the following is true of ecologic studies?
They may be affected by the ecologic fallacy.
Which of the following reasons might account for place variation in disease?
all are correct: Concentration of high-risk groups within an area Genetic and environment interactions Influence of climate Presence of environmental carcinogens
Which of the following is not usually an aim of epidemiology?
To fund new public health programs
Environmental and occupational health problems are a specialization of epidemiology. (T/F)
True
In cases where a disease is short-lived and does not usually lead to death, the prevalence and the incidence during a specific period of time are relatively comparable. (T/F)
True
Public health practice is oriented toward disease prevention and continuing health improvement. (T/F)
True
The Framingham Heart Study, begun in 1948, pioneered research into coronary heart disease risk factors. (T/F)
True
The Freedom of Information Act exempts (does not allow) the release of personal medical data. (T/F)
True
The epidemiologic and clinical descriptions of a disease are different. (T/F)
True
Which of the following data sources is most likely to provide a representative sample of the general health status of a population?
a morbidity survey of the general population
The Morbidity and Mortality Weekly Report (MMWR) is:
a report by the CDC that published accounts of public health investigations and related matters.
____________________ can be used to compare disease rates among populations with differences in composition of age, sex, gender, race and ethnicity, etc.
adjusted rates
Morbidity surveys of the general population:
all are correct : include the Health and Nutrition Examination Survey. collect data on the health status of a population group. typically use a scientifically designed representative sample.
The Vital Statistics Registration System in the United States collects data on all vital events including:
births, deaths, and fetal deaths.
Cautious use of information from death certificates is warranted because:
cause of death information may not be accurate.
Examples of descriptive epidemiologic studies do not usually include:
cohort studies
Using epidemiology for operational research involves the study of:
community health services
When deciding which study design to use, it is important to consider how much is already known about the issue. This is because as knowledge increases, we can use more _____ study designs.
complex
What is one of the widely used sources of statistical data on cancer?
disease registries
The image above represents data from what kind of study?
ecological comparison study
All are examples of public databases except:
electronic medical records
A cross-sectional study allows measurement of the temporal ordering of cause and effect. (T/F)
false
An important risk factor for the population is always important for the individual. (T/F)
false
An ecological fallacy
is when an erroneous inference occurs when an association observed between variables on an aggregate level is not equivalent to an association that exists at an individual level
Which of the following statements about the U.S. Census is incorrect?
it is administered every 5 years
Descriptive epidemiology characterizes the amount and distribution of disease within a population and enables the researcher to do all of the following except:
make direct tests of etiologic hypotheses (ie: assess a causal relationship)
