# Simple exercises

Exam 1-Summer 2015

N642, Epidemiology & Population Statistics

N602, Principles of Epidemiology

UNIVERSITY OF SAN FRANCISCO

SCHOOL OF NURSING & HEALTH PROFESSIONS

Faculty:  Francine Serafin-Dickson, BSN, MBA, CNL

Match definition with term by writing definition letter next to term.

Term                                                                     Definition

 ___ 1. Annual Mortality Rate a)      Occurrence of death ___ 2. Case Fatality Rate b)      How good the organism is at producing disease ___ 3. Cause-Specific Rate c)      The overall mortality rate, without adjustments for age, race, or other factors ___ 4. Crude Mortality Rate d)      When disease is transmitted person to person ___ 5. Proportionate Mortality Ratio e)      Study of frequency and pattern of health events in the population ___ 6. Herd Immunity f)        When disease is transmitted by a common vehicle or vector. ___ 7. Virulence g)      The resistance of a group of people to an attack of a disease because a large percent are immune. ___ 8. Vector h)      Behavioral Risk Factor Surveillance System: Collects info on health risk behaviors, preventive health practices, & health care access primarily related to chronic disease & injury ___ 9. Direct Transmission i)        Study of chemicals or toxic agents found in the environment. ___ 10. Indirect Transmission j)        Deaths from a certain disease compared to deaths from all diseases. ___ 11. WHO k)      Number of existing cases of a disease (or other condition) in a population at risk during a specific period of time ___ 12. Mortality l)        A living organism that transmits a pathogen from reservoir to host. ___ 13. Morbidity m)    Total number of deaths from all causes in 1 year divided by the number of persons in the population at midyear multiplied by 1000 or 10,000, etc. ___ 14. Incidence n)      World Health Organization: an international data bank of disease & health ___ 15. Prevalence o)      The number of deaths from a disease after diagnosis divided by the total population diagnosed with the same disease. ___ 16. Distribution p)      The mortality or morbidity rate from a disease divided by the at risk population ___ 17. Determinants q)      Causes, events, and other factors that bring about a change in health status ___ 18. Pandemic r)       Occurrence of illness ___ 19. Epidemic s)       Number of new cases of a disease(or other condition) in a population at risk during a specific period of time ___ 20. BRFSS t)        An epidemic that spans a large geographic area, ie worldwide ___ 21. Toxicology u)      Occurrence of disease or health related behavior/events in excess of normal ____22. Surveillance v)      Monitors changes in disease frequency or prevalence

1. The uses of epidemiology include:
1. search for determinants (causes of disease)
2. estimation of individual risks and chances of contracting disease
3. evaluation of health services
4. all of the above

1. Epidemiology includes the study of:

1. Human behavior
2. Accidents
3. Disease
4. All of the above
5. None of the above

1. The epidemiologic triangle is based on the communicable disease model and is useful in showing the interaction and interdependence of certain factors. Which of the following best describes the Agent?

1. Cause of the disease
2. Afflicted by a disease
3. Allows disease transmission
4. Duration

1. The epidemiologic triangle is based on the communicable disease model and is useful in showing the interaction and interdependence of certain factors. Which of the following best describes the Host?
1. Cause of the disease
2. Susceptible to a disease
4. Inanimate substance that harbors disease

1. Humans can serve as all of the following EXCEPT:

1. Fomites
2. Reservoirs
3. Hosts
4. None of the above

1. Inanimate objects that serve a role in disease transmission are called:

1. Fomites
2. Vectors
3. Reservoirs
4. Carriers

1. What contains, spreads, or harbors an infectious organism?

1. Fomites
2. Vectors
3. Reservoirs
4. Carriers

1. Infectious disease is best defined as:
1. Harmful development in a microscopic organism.
2. Alteration of the organism’s normal functioning.
3. Disease caused by an invading pathogen.
4. Body not capable of carrying on its normal functions.

1. Which of the following stages is associated with the incubation period?
1. Stage of susceptibility
2. Stage of presymptomatic disease
3. Stage of clinical disease
4. Stage of recover, disability, or death

1. A clinician who works at a GYN office needs to report the number of Chlamydia cases this past month to the city department of public health.  This is an example of:

1. active surveillance
2. passive surveillance
3. a cross sectional study
4. variolation

1. All of the following are places where one may find mortality data except:

1. hospital records
2. disease reporting registries
3. death certificates

1. The prevalence of disease is influenced by which of the following:

1. Incidence
2. Survival
3. Mortality
4. Cure
5. All of the above

1. Public health surveillance involves all of the following except
1. Collection of health data
2. Analysis of health data
3. Interpretation of health data
4. Dissemination of health status
5. All of the above involves surveillance

1. A RN was trying to formulate a question to look up the evidence regarding a concern she had after working in the Emergency Unit. She recalled an acronym, “PICO,” that she learned in nursing school. She was having trouble recalling what the “C” stood for.  You helped her out and said it was:

1. Collaboration
3. Contrasting
4. Comparison

1. The best example of the (I)ntervention piece of the PICO stepwise process is:

1. decreased incidence of influenza
3. children age 6 months to 4 years
4. symptoms of flu

Please indicate what type of prevention each of the following examples are:

1. Physical therapy for stroke victims.
1. Primary prevention
2. Secondary prevention
3. Tertiary prevention

1. Education about the hazards of cigarette smoking.

a.Primary prevention

b.Secondary prevention

c.Tertiary prevention

1. Which of the following is an example of active primary prevention?

1. Screening
3. Immunization
4. All of the above

1. Who demonstrated that cholera could be transmitted through contaminated water?

1. Hippocrates
2. James Lind
3. John Snow
4. Louis Pasteur

1. Who introduced the words epidemic and endemics?

1. Hippocrates
2. John Graunt
3. James Lind
4. Thomas Sydenham

43.Who invented a vaccine against smallpox based on careful observation?

1. Benjamin Jesty
2. Edward Jenner
3. Louis Pasteur
4. Robert Koch

1. Characterizing the distribution of health-related states or events according to person, place, and time is

1. Descriptive epidemiology
2. Analytic epidemiology
3. Cohort study designs
4. Case control study designs
5. Experimental study designs

1. Which of the following involve the population as the unit of analysis?
1. Ecologic study
2. Case report, case series
3. Cohort
4. Cross-sectional

1. Which of the following study designs have been associated with prevalence data?

1. Ecologic study
2. Case report, case series
3. Cohort
4. Cross-sectional

1. True or false? The correlation coefficient is useful for measuring associations among variables in ecologic studies.

1. True
2. False

1. Describing health-related states or events by person, place, and time allows us to do all of the following EXCEPT:
2. Identify the extent of the public health problem.
3. Describe the public health problem in a way that can be communicated easily.
4. Identify who is at greatest risk.
5. Provide clues as to the causes of disease.
6. All of the above

1. The number of deaths among children aged 1-5 year during a specified time period divided by the number of children aged 1-5 in the population in the same time period is called

1. Case fatality rate
2. Age specific mortality rate
3. Cause specific mortality rate
4. Crude mortality rate
5. None of the above

1. The Framingham study was a:

1. Retrospective cohort study
2. Case-control study
3. Cross-sectional study
4. Prospective cohort study

1. Which study design is most effective at determining the incidence of disease and establishing a temporal sequence of events?

1. Ecologic
2. Cross-sectional
3. Case control
4. Cohort

1. Which of these is used to express prognosis?

1. case fatality rate
2. 5 year survival
3. person years
4. median survival time
5. all of the above

1. Determining the why & how a illness/event occurs in a population is:

1. Descriptive epidemiology
2. Analytic epidemiology
3. Cohort study designs
4. Case control study designs
5. Experimental study designs

1. A retrospective cohort study is one in which:
1. the investigator identifies the original population at the beginning of the study and accompanies the subjects concurrently through calendar time until the point at which the disease does or does not develop
2. the investigator inquires about past exposure in diseased folks and compares it to past exposure in non diseased folks
3. the investigator uses historical data to compare the incidence of disease in an exposed and nonexposed group

1. What statistic is most appropriate for measuring the strength of the association between an exposure and disease outcome in a cohort study?

1. Correlation coefficient
2. Simple regression coefficient
3. Odds ratio
4. Risk ratio (or relative risk)

1. The most accurate way to state an odds ratio is:
2. The risk of acquiring the disease among the exposed versus the non exposed
3. The odds of a disease being attributed to a certain exposure.
4. The odds of getting a disease in the exposed versus the odds of getting the disease in the non-exposed

1. You are reading a study about the Nurses Health Study which followed nurses who used oral contraceptives to see if they developed breast cancer at a higher rate than those who didn’t use oral contraceptives. They explained to you that the majority of the participants were enrolled in 1970s and were followed up until now. You realized that this could be called a:

1.   prospective cohort study
2. retrospective cohort study
3. cross-sectional study
4. case control study

Scenario for next two questions:

1. You just read a study that revealed an association between liver cancer and exposure to harmful chemicals in the workplace. They examined people with liver cancer and people without liver cancer and asked where they worked, how long they had worked at their place of employment, and what possible chemicals they may have been exposed to. You decided this was a:

1. cohort study
2. case control study
3. experimental study
4. quasi-experimental study

1. You also remembered that one of the cons of this type of design was:
2. that it was good for studying rare diseases
3. that you didn’t have to expose anyone to harmful products
4. that it relies on recall to determine exposure
5. that you need a large sample size or longer follow up

1. Fang and colleagues (2007) stated the aim to their study was to “explore differences in self-care behavior according to demographic and illness characteristics.” They also stated that persons diagnosed with Type II Diabetes were asked to complete a questionnaire at an outpatient clinic.  Even though they did not mention their study design, based on what they said, you decided that it was a  _____________________ study.

1. quasi-experimental
2. case-control

1. cross-sectional survey
2. longitudinal cohort

1. Ensuring a valid study is most often determined at what stage of the study?

1. The design stage
2. The analysis stage
3. The interpretation stage

1. How can confounding be controlled at the design level of a case-control study?

1. Matching
2. Multiple regression
3. Stratification
4. All of the above

 Statements (True) or (False) 63.  Analytical bias is when researchers slant the information to meet their expected outcomes. 64.  An individual’s reluctance to share information is considered recall bias. 65.  RR < 1=exposure is a risk factor for disease thus is a harmful exposure.

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