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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. Question 2. Question : 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)? Question 3. Question : Describe the “natural history of disease” and disease progression from its inception to its resolution. Question 4. Question : What are some of the many epidemiologic contributions to quality assurance in healthcare and public health? Question 5. Question : 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: ___________________ -2009 U.S. Census: 305,529,237 Total -2009 U.S. Census: Males 148,094,000 -2009 U.S. Census: Females 153,388,000 Population by Age and Sex: 2009 Age Both sexes Male Female Number Percent Number Percent Number Percent .35 to 39 20,445 6.8 10,169 6.9 10,275 6.7 .40 to 44 20,877 6.9 10,322 7.0 10,556 6.9 .45 to 49 22,712 7.5 11,162 7.5 11,550 7.5 .50 to 54 21,654 7.2 10,611 7.2 11,043 7.2 .55 to 59 18,755 6.2 9,083 6.1 9,671 6.3 ___________________ -2009 U.S. Deaths: 2,436,682 -2009 U.S. Male Deaths 1,217,047 -2009 U.S. Female Deaths 1,219,635 ___________________ 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 2009 CVD/ Heart Attack Mortality, Male/Age Age (All) 186,464 35-44 55,957 45-54 115,615 55-64 276,844 65-74 677,598 Source: CDC (2009) ________________ 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. Question 6. Question : 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 Case1Midterm ____________________ 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? Question 7. Question : Case 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. Targets: At Risk Population for Osteoporosis Age: Postmenopausal woman over >= 50 years of age Race: Caucasian, Asian, African-American and Hispanic women History: Women who have a family or personal history of fractures after age 50 Health Conditions: Women who have menopause before the age of 45 due to a medical condition or unknown cause. Healh Behaviors: Women who have premature menopause due to anorexia, bulimia, tabacco and alcohol use, or excessive exercise. Nutrient Deficiencies: Calcium and/or vitamin D deficiency Lifestyle: Sedentary, inactive lifestyle Medical Treatements: Steroid (corticosteroids), radiation and/or chemotherapy treatments Source: NIH 2010, Chart: Meyer 2010 ________________ 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.

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.

 

 

 

 

Question 2. Question :

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)?

 

Question 3. Question :

Describe the “natural history of disease” and disease progression from its inception to its resolution.

 

 

 

 

 

Question 4. Question :

What are some of the many epidemiologic contributions to quality assurance in healthcare and public health?

 

 

 

 

Question 5. Question :

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:

___________________

-2009 U.S. Census: 305,529,237 Total

-2009 U.S. Census: Males 148,094,000

-2009 U.S. Census: Females 153,388,000

 

Population by Age and Sex: 2009

Age

Both sexes

Male

Female

Number

Percent

Number

Percent

Number

Percent

.35 to 39

20,445

6.8

10,169

6.9

10,275

6.7

.40 to 44

20,877

6.9

10,322

7.0

10,556

6.9

.45 to 49

22,712

7.5

11,162

7.5

11,550

7.5

.50 to 54

21,654

7.2

10,611

7.2

11,043

7.2

.55 to 59

18,755

6.2

9,083

6.1

9,671

6.3

___________________

-2009 U.S. Deaths: 2,436,682

-2009 U.S. Male Deaths 1,217,047

-2009 U.S. Female Deaths 1,219,635

___________________

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

 

2009 CVD/ Heart Attack Mortality,

Male/Age

Age (All)

186,464

35-44

55,957

45-54

115,615

55-64

276,844

65-74

677,598

Source: CDC (2009)

________________

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.

 

 

 

 

 

Question 6. Question :

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

Case1Midterm

____________________

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?

 

 

 

 

Question 7. Question :

Case 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.

 

Targets: At Risk Population for Osteoporosis

Age: Postmenopausal woman over >= 50 years of age

Race: Caucasian, Asian, African-American and Hispanic women

History: Women who have a family or personal history of fractures after age 50

Health Conditions: Women who have menopause before the age of 45 due to a medical condition or unknown cause.

Healh Behaviors: Women who have premature menopause due to anorexia, bulimia, tabacco and alcohol use, or excessive exercise.

Nutrient Deficiencies: Calcium and/or vitamin D deficiency

Lifestyle: Sedentary, inactive lifestyle

Medical Treatements: Steroid (corticosteroids), radiation and/or chemotherapy treatments

Source: NIH 2010, Chart: Meyer 2010

________________

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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