Posted: March 1st, 2023

saint HCM530 midterm exam [ spring 2104 ]

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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