Compare and contrast
clinical health services to public health and epidemiology in terms of a) how
they are defined, b) goals, c) their target focus and d) functions.
(Points : 10)
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Q2
Managerial epidemiology is integrated through general management
functions. Explain each of the management functions in terms of the
managerial epidemiology, i.e., what are the:
a. Planning functions, example(s)?
b. Directing functions, example(s)?
c. Controlling functions, example(s)?
d. Organizing functions, example(s)?
e. Financing function, example(s)?
(Points : 10)
Q3
Describe the “natural
history of disease” and disease progression from its inception to its
resolution. (Points : 10)
Q4
What are some of the many epidemiologic contributions to
quality assurance in healthcare and public health? (Points : 10)
Answer:
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Question 5 of 7
December 31, 2009: A 48 year old male computer technician with
hypertension, smoker, sedentary lifestyle, who does not do any aerobic exercise,
enjoys fast food, eating it three times per day, with a family history of
coronary artery disease (CAD), and a personal history of high cholesterol has
a stressful deadline at work, which requires him to travel 17 hours on a plan
to go on location in Australia. Unfortunately, he suffers an acute
myocardial infarction in route to location and dies. He is now part of
our epidemiology population mortality statistics. Calculate the U.S.
Mortality Rates, which includes our computer technician in terms of crude
rate of mortality, adjusted mortality rates and cause-Specific mortality rate
using the 2009 statistics.
Input Data for Calculations:
___________________
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-2009
U.S. Census: 305,529,237 Total
-2009 U.S. Census: Males 148,094,000
-2009 U.S. Census: Females 153,388,000
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Population
by Age and Sex: 2009
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Age
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Both sexes
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Male
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Female
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Number
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Percent
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Number
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Percent
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Number
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Percent
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.35 to 39
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20,445
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6.8
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10,169
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6.9
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10,275
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6.7
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.40 to 44
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20,877
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6.9
|
10,322
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7.0
|
10,556
|
6.9
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.45 to 49
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22,712
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7.5
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11,162
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7.5
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11,550
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7.5
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.50 to 54
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21,654
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7.2
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10,611
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7.2
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11,043
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7.2
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.55 to 59
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18,755
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6.2
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9,083
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6.1
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9,671
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6.3
|
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___________________
-2009 U.S. Deaths: 2,436,682
-2009 U.S. Male Deaths 1,217,047
-2009 U.S. Female Deaths 1,219,635
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___________________
2009 Deaths By Gender/Age All races, male
All ages……………1,217,047
1-4 years………………14,872
5-14 years………………2,507
15-24 years…….………3,244
25-34 years…..………22,294
35-44 years……………29,150
45-54 years……………46,498
55-64 years…….……114,615
65-74 years…….……183,945
75-74 years…….……225,740
75-84 years…….……311,135
>=85 years…….……262,839
Not stated……………………206
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2009 CVD/ Heart Attack
Mortality,
Male/Age
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Age (All)
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186,464
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35-44
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55,957
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45-54
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115,615
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55-64
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276,844
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65-74
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677,598
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Source:
CDC (2009)
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________________
Case
Questions:
a. Calculate
the Crude mortality rate for the entire U.S. in 2009.
b. Calculate
a total adjusted mortality rates by gender for all men (males-only).
c.
Calculate an age/sex adjusted mortality rate using the demographics of the
diseased computer technician.
d.
Compare b) morality rate calculated with c) mortality rate
calculated. Is the adjusted mortality rate for males, age 45-54 years
of age higher or lower than for all males, all ages?
e. Calculate
a Cause-Specific mortality rate for deaths related to Cardiovascular
Disease (Heart Attacks), using the demographics of our computer technician.
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Answer:
Q
250 words
Case Study #1:
2.1. Food poisoning outbreak at Bluegrass Hospital
An outbreak of food poisoning occurred among the 400 staff and patients at
Bluegrass Hospital a few hours after eating dinner. Among the 60 people who
became ill, the Symptoms were mainly nausea, vomiting and diarrhea. The
infection control nurse investigated the outbreak and reported results in
Table 2.5 Below
____________________
Questions: 5 pts each
1. What is the “crude” attack rate?
2. What are the food-specific attack rates for those who consumed, and did not
consume each food item?
3. How many times more likely are people who consumed specific food items to
get sick compared to those who did not consume each item?
4. Which food item is the most likely cause of this “common source” outbreak?
5. What are the incubation period and most likely cause of the outbreak?
(Points : 25)
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250 words
Question 7 of 7Case Study
#2: Osteoporosis Marketing Plan
You are the Director of Community Relations, reporting to the Chief
Operating Officer (COO) at Allright Memorial Hospital, Anywhere, USA.
You have been asked by your COO to spearhead a community council with local
public health officials, who will be focused on women over 50 for the
prevention of osteoporosis. Your committee’s strategic plan SWOT
analyses revealed the following information.
_________
Background:
The purpose of this project is to create an intervention prevention program
that minimizes osteoporosis in women over 50 and with the health risks
associated with the condition for Anywhere, USA. Per the Centers for
Medicare and Medicaid (CMS), abstracted from medical claims data, “an
estimated 10 million Americans have osteoporosis and 34 million Americans
have low bone mass, placing them at an increased risk for osteoporosis. An
analysis, using the Anywhere, USA state hospital database shows a slightly
higher rate of risk than the national average. The report shows that
osteoporosis is responsible for more than 1.5 million fractures annually,
including 300,000 hip fractures, 700,000 vertebral fractures, 250,000 wrist
fractures, and more than 300,000 fractures of other sites. Osteoporosis can
be prevented. Early diagnosis and treatment can reduce or prevent fractures
from occurring”. (CMS 2007)
The
Committee Objectives:
1. To research and identify best community partners and interventions
for prevention of high risk osteoporosis residents in Anywhere, USA.
2. To use create a health promotion marketing plan for early bone
density screening targeted throughout the Anywhere, USA communities.
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Targets: At Risk Population for Osteoporosis
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Age: Postmenopausal woman
over >= 50 years of age
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Race: Caucasian, Asian,
African-American and Hispanic women
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History: Women who have a
family or personal history of fractures after age 50
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Health Conditions: Women who have
menopause before the age of 45 due to a medical condition or unknown
cause.
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Healh Behaviors: Women who have
premature menopause due to anorexia, bulimia, tabacco and alcohol use,
or excessive exercise.
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Nutrient Deficiencies: Calcium and/or vitamin
D deficiency
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Lifestyle: Sedentary, inactive
lifestyle
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Medical Treatements: Steroid
(corticosteroids), radiation and/or chemotherapy treatments
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Source:
NIH 2010, Chart: Meyer 2010
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________________
Case Questions:
1. Using reliable primary resources do research and determine who the
best community partners, and the most effective interventions for
prevention promotion for high risk osteoporosis residents in Anywhere,
USA. Your own hospital is one community partner, and it radiology services
(bone density machines) are a resource. What other and resources
within the community would be appropriate?
2. Create a health promotion marketing plan for early bone density
screening targeted throughout the Anywhere, USA communities using the 4-Ps.
Your marketing plan also needs a mission statement, a statement of purpose,
objectives and timelines of how you will implement the program.
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