Transcript The Future of Public Health

PU499 Seminar
Tynan Weed
Comprehensive Exam Practice Test
Review
Health Insurance
• What was the main purpose of private health
insurance in the United States when it was
first started?
• To compensate for loss of income during
sickness and temporary disability (similar to
today’s disability insurance)
Toxic Tort
• Environmental tort lawsuits have been able to collect
damages for enhanced risk for future disease, fear of
contracting disease, and damage to the immune
system: T or F?
• Tort: Damage, injury, or a wrongful act done willfully,
negligently, or in circumstances involving strict
liability…for which a civil suit can be brought
• True: damages have been awarded for fear of
contracting a disease in toxic tort cases
Relative Risk
• Relative risk is the risk of an event (or of developing a disease)
relative to exposure
• Ratio of the probability of an event occurring in the exposed group
versus a non-exposed group:
– RR= P exposed group/P non-exposed group
– Probability=number with disease/number in population
– [A/(A+B)]/(Divided by)[C/(C+D)]
– Risk
Disease status
Present
Absent
– Smk
a
b
– Non-smk c
d
– If result=20, then “Smokers would be 20 times more likely than
non-smokers to develop lung cancer”
– Wikipedia has a great example and more explanation of this.
Variance
• Variance: used as a measure of how far a set
of numbers are spread out from each other
• Definition: variance is the expected value of
the squared difference between the variable's
realization and the variable's mean
• Standard deviation (SD): equation for SD is the
square root of the variance
Median
• How do you determine the median of a group
of numbers?
• Arrange the numbers in a sequence, it is the
sequentially middle number. If the sequence
totals to an even number, it is the average of
the two middle numbers.
• How can the median be more useful
information than the mean?
Code Vs. Regulations
• Violations of pubic health code tend to be
felonies whereas violations of public health
regulations are misdemeanors. T or F?
• Violations of public health code and
regulations tend to be misdemeanors, the
answer is False.
Infectious Disease
• Travelers diarrhea can be caused by:
• Traveler's diarrhea is usually caused by a
bacterial infection. Bacteria such as
Escherichia coli (E. coli), Campylobacter,
Shigella, or Salmonella are the most common
causes. These bacteria are in water
contaminated by human or animal stools.
Institute of Medicine
• The Institute of Medicine (IOM) suggests that
public health should focus on assessment,
policy development and assurance. T or F
• True. In IOM’s The Future of Public Health
(1988), a core functions of public health study,
these were the three areas listed.
Range
• Range is Not a measure of central tendency. T
or F?
• True. Range is the lowest point to the highest
point of a data set, not a measure of central
tendency. Central tendency relates to the way
in which quantitative data is clustered around
a middle or typical value, and this is described
by mean, median or mode.
Margin of Error
• Margin of error = Critical value x Standard
deviation of the statistic
Or: Margin of error = Critical value x Standard
error of the statistic
• When a researcher has a margin of error of
5%, they are working at a 95% confidence
interval. T or F?
• True.
Sensitivity and Specificity
• Sensitivity: measures the proportion of actual
positives which are correctly identified as such.
• Specificity: measures the proportion of negatives
which are correctly identified as such.
• The difference between sensitivity and specificity
is the proportion of subjects having positive
and/or negative results. T or F?
• False. These measures of performance also look
at correctness of the measurement.
Risk difference
• [A/(A+B)]-[C/(C+D)] is the formula for risk
difference. True or False.
• True. Risk difference is calculated as risk in the
experimental group minus risk in the control
group. For example this is: RD = Risk in
antibiotic group - Risk in placebo group.
Vaccines
• Vaccines:
– Are safe and effective
– Have minor adverse events, if any
– Are difficult to determine whether a reaction that
occurs is related to the vaccination or some other
factor
• All of the above
Data
• What is the correct order of the denominator
and numerator data?
– Event/population
– Population/event
– Date of event/population
– None of the above
• Answer: Population/event. Example: 25,000
deaths worldwide from 2009 Swine Flu
outbreak.
Surveillance
• Physicians, clinics and laboratories are
responsible for reporting disease outbreaks in
passive surveillance. T or F?
• Active surveillance: In this a special search is
done for finding cases in the community mainly
through door to door surveys.
• Passive surveillance: the routine reporting of the
cases of diseases reaching health care facilities
for treatment or service.
• Answer: True.
Foodborne Illness
• Unpasturized milk:
– Will not cause illness when consumed.
– Could potentially cause illness when consumed.
• Answer: Both FDA and CDC advise against raw
milk consumption due to possible presence of
pathogens.
Cohort Studies
• The difference between a prospective and
retrospective cohort study is:
–
–
–
–
Dose
Time
All of the above
None of the above
• Answer: Time. Prospective cohort=longitudinal
study of cohort of individuals through time,
Retrospective cohort=cohort is defined after the
data has been collected
Health Care Expenditure
• RAND Corporation states that new technologies
that improve health and longevity could increase
overall health care expenditures.
– True
– False
• Answer: True. RAND Coporation’s study
“Modeling the Health and Medical Care Spending
of the Future Elderly” (2008) found that medical
innovations will result in better health and longer
life, but they will likely increase, not decrease,
Medicare spending. (www.rand.org)
Communicable disease
• Which of these is considered a direct route of
transmission for a communicable disease?
– Arthropod vectors
– Food or water
– Fomites
– Respiratory droplets
• Answer: Respiratory droplets. No middleobject, or middle-vector.
Pathogen control
• Endospores are only killed by very high levels
of disinfectant.
– True
– False
• Answer: True. Bacterial endospores are
resistant to low levels of heat, freezing, and
regular-strength disinfectants. However, high
levels of disinfectant and autoclaving are
known ways to destroy them.
Questions?
• Thanks for attending
and good luck with your
exam!