Epidemiology Exam 1

25 July 2022
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Epidemiological methods can be applied to which of the following public health-related fields...
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Health education Healthcare administration Environmental health
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Which of the following is not considered a use of epidemiology?
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To provide healthcare services to specific individuals
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Whether a contaminated food such as tomatoes caused an outbreak of gastrointestinal disease is a simple example of:
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A causal association
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Which of the following is considered a key characteristic of epidemiology?
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Distribution Population focus Quantification
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Variation in the occurrence of diseases and other health outcomes in populations relates most closely to:
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Distribution
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True or False Epidemiology is an observational science that capitalizes on naturally occurring situations.
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True
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True or False The history of epidemiology originated in the 20th century
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False
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John Graunt is said to be the first to employ quantitative methods to describe population vital statistics.
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True
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A method for providing quantitative measurements of risks to health is known as:
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Risk assessment
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A vaccine that provided immunity to smallpox was created by:
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Edward Jenner
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Any factor that brings about change in a health condition or other defined characteristic is known as:
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Determinant
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Epidemiology searches for associations between exposures and:
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Health outcomes
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Operations research illustrates which of the following uses of epidemiology:
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Health services use
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Specializations that contribute to epidemiology include:
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Sociology History Law
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The English anesthesiologist who linked cholera outbreaks to contaminated water and innovated several of the key epidemiologic methods that remain valid and in use today was:
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John Snow
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The occurrence in a community or region of cases of an illness, specific health behavior, or other health related events clearly in excess of normal expectancy is known as a(n):
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Epidemic
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True or False? A pandemic is an epidemic occurring worldwide or crossing international boundaries.
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True
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True or False? Descriptive epidemiology refers to studies that are concerned with characterizing the amount and distribution of health and disease within a population.
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True
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True or False? Epidemiology can help solve a variety of today's health-related problems, ranging from smoking to youth violence.
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True
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True or False? Epidemiology is concerned with the distribution and determinants of health and diseases, morbidity, injuries, disability and mortality in populations.
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True
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True or False? It is possible for a single case of a disease to represent an epidemic.
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True
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True or False? The term epidemiologic transition describes a shift in the patterns of morbidity and mortality from causes related primarily to infectious diseases to causes associated with chronic diseases.
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True
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Which of the following disease outbreaks occurred between 1346 and 1352 and claimed up to one-third of the population of Europe:
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Black Death
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What is one of the first steps in presenting data after they have been reviewed for accuracy and completeness?
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Count and tabulate cases
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According to the Generic Contingency table, the letter of the cell that shows that the exposure is absent and disease is absent is
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D
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An r of +1 is
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A perfect direct linear associtation
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If the mean and the median are identical, this means that:
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The distribution is symmetrical
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In a dose-response curve, the ________ refers to the lowest dose at which a particular response occurs.
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Threshold
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Multimodal distributions can reflect age-related
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changes in immune status operation of latency effects changes in lifestyle
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True or False: The closer the points lie on a scatter plot, with respect to the straight line of best fit through them, the stronger the association between the variables.
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True
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A value that describes a characteristic of a population is called a ____________?
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Parameter
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A value that describes a characteristic of a sample is called a ___________
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Statistic
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What is this type of graphical plotting called that shows the distribution of cases over time?
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Epidemic Curve
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On what scale of measurement is age?
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interval or ratio (continuous)
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What are the main differences between simple random sampling and stratified sampling?
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Simple random sampling is the use of random process to select a sample that has the least amount of bias. Stratified sampling is when a a stratum, or subgroup of the population is oversampled to ensure sufficient number of individuals from that stratum are included
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How many % of people in a sample lie within +/- 2 standard deviations from the mean?
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94.5%
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What would happen to a 95% confidence interval range if you increased the sample size?
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The 95% confidence range would decrease
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If the mean is higher than the mode, what type of distribution would you suspect that you have?
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A right skewed distribution
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All of the following are considered ratios except
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Time
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Epidemiologic measures provide the following type of information:
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Frequency of disease or condition Association between exposure and disease Strength of relationship between exposure and disease
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A new drug is developed that can cure ALS. What would happen to the incidence of ALS?
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The incidence would stay the same
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On June 30, 2017, the number of residents of Oklahoma who had been diagnosed with asthma at any time during their life was A. The population on June 30, 2017, was B. During the same year, the number of new cases of asthma was C. Which of the following expressions represents the incidence rate of asthma (per 100,000)?
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(C/B) * 100,000
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On June 30, 2017, the number of residents of Oklahoma who had been diagnosed with asthma at any time during their life was A. The population on June 30, 2017, was B. During the same year, the number of new cases of asthma was C. Which of the following expressions represents the point prevalence of asthma?
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(A/B) Ɨ 100
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This rate refers to the number of deaths due to a disease that occur among people who are afflicted with that disease.
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case fatality rate
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Those members of the population who are capable of developing a disease or condition are known as:
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The population at risk
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What would happen to the prevalence if the incidence goes up?
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The prevalence would increase
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What is "infant mortality rate" and give one example of how this rate is varies in the U.S. population.
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Infant mortality rate is the number of infant deaths during a year divided by the number of live births. It could vary due to poverty levels as those with less income and less access to medical care can afford to treat ill children
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1. What is the general fertility rate and 2. what can it be used for?
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General fertility rate is the number of live births in one area during a certain time divided by the number of women age 15 to 44. It can be used to figure out how many one in a certain area can have a child and is used to see if that number is increasing or decreased
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If you want to compare the differences in disease or death rates between for example two states, why is it often better to use adjusted rates instead of crude rates?
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It is better to use adjusted rates as some states, like Florida, have a larger elder population then states like California which could then throw off the data. More elders lead to more death
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A hospital can release medical records with personally identifying information (such as a patient's identity, diagnosis, treatment or source of payment) to a researcher without the person's consent
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False
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Reportable disease statistics is reliable in the US. Almost all cases of reportable and notifiable diseases are reported by health care workers to the authorities
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False
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Mortality and birth statistics from the vital registration system is reliable in the US. Almost all vital events are reported to the authorities.
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True
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A reportable disease with a high number of asymptomatic or subclinical illnesses is more likely to be underreported.
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True
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Together, the National Program of Cancer Registries (NPCR) and the Surveillance, Epidemiology and End Results Program (SEER) , cover 100% of the US population.
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True
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The National Vital Statistics System can be used to track C-section deliveries
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True
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The systematic and continuous gathering of information about the occurence of diseases and other health phenomena is known as
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public health surveillance
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Using health-related data that precede diagnosis and signal a sufficient probability of a case or an outbreak to warant further public health response is known as
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syndromic surveillance
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Some examples of surveillance systems include those for:
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communicable and infectious diseases noninfectious diseases risk factors for chronic diseases
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Examples of information collected by fetal death certificates include
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name disposition congenital abnormalities
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Since when has the US collected reports on infectious diseases such as cholera, smallpox, and plague?
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Late 1800's
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Which population survey include a mobile examination center where physical examinations, laboratory tests and interviews are performed?
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National Health and Nutrition Examination Survey (NHANES)
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Vital events are collected by each state and sent to the National Center for Health Statistics (NCHS), the vital registration system in the US. What are vital events? Mark all that apply.
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Deaths, births, fetal deaths, divorce
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Examples of nationally reportable and notifiable diseases are
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HIV, Gonorrhea, Mumps, Anthrax
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What are the three defining features of Big Data (three Vs)?
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Volume, Variety, Velocity
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Which factors affect the quality of epidemiologic data?
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1) Source of Data 2) How available the data is 3) How representative it is
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Epidemiology
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Concerns with with distribution and determinants of health and disease in a population
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Epidemic
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Illness or health related disease that occurs in excess of normal expectancy
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Pandemic
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Epidemic that crosses boarders infecting large numbers of peopel
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John Snow
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Tracked cholera by using a map and natural experiment
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Sir Pervical Pott
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Found chimney sweeps had high rates of scrotal cancer and suggested they shower once a week
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Epidemiological Transition
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Shift in mortality and morbidity from causes related to illness
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Demographic Transition
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Shifts from high birth and death rates to low rates after epidemiological transitions
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On what scale is occupation?
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Nominal
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On what scale are height and weight?
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Interval/Ratio (Continuous)
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On what scale is gender?
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Nominal
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On what scale of measurement is pain
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Ordinal
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In what type of sampling does every person in a population have an equal chance of being selected to participate?
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Simple Random Sampling
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Stratified Sampling
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Researchers oversimple small subgroups to make an accurate representation
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What type of sampling is most like to produce bias?
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Convenience Sampling
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What type of bias could occur if each individual in sample does not have equal chance of being selected?
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Sampling bias
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If you have a continuous variable, what type of graph should you use?
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Histogram
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Which measure of central tendency is most vulnerable to outliers?
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Mean
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What percent of data lie with in 1 standard deviation?
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68.3%
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What percent of data lie with in 2 standard deviation?
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95.5%
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What percent of data lie with in 3 standard deviation?
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99.9%
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What happens to the confidence interval range if n increases or decrease?
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If range decreases n increases and visa versa
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Using health-related data that precede diagnosis and signal a sufficient probability of a case or an outbreak to warrant further public health response is known as ___________________.
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Syndromic Surveillance
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The National Program of Cancer Registries (NPCR) and the Surveillance, Epidemiology, and End Results (SEER) Program are two examples of cancer registries covering the US. These registries are examples of _____________________.
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Chronic Disease Surveillance
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The systematic and continuous gathering of information about the occurrence of diseases and other health phenomena is known as _____________________.
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Public Health Surveillance
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Examples of Notifiable Disease
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HIV, Hepatitis, Botulism
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The Behavioral Risk Factor Surveillance System (BRFSS) is an example of __________________.
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Risk Factors for Chronic Disease
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How accurate are they when it comes to # of deaths / # of births ?
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Very Accurate
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What information is listed on death certificates?
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Cause and age
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What are some potential sources of error when it comes to "immediate cause of death" or "underlying cause of death" ?
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Could be many causes, could be based on billing insurance
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What information is listed on birth and fetal death certificates?
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Congenital abnormalities and maternal health issues
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What are some potential sources of error when it comes to "risk factors in pregnancy" and "congenital anomalies" ?
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Not 100% accurate as we rely on mothers memory and abnormalities may not be visible
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What other vital events are recorded besides birth statistics and mortality data?
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Marriage and divorce
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Case Report
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Single occurrence of noteworthy health event
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Case Series
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Large collection of cases of disease grouped by common features
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Cross Sectional Study
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Examines relationship between disease and variables of interest
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Descriptive Epidemiology
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Concerned with characterizing the amount and distribution of health and disease in a population and provides info for prevention, intervention and research
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Health Disparities
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Differences in occurrence of disease and adverse health conditions in population
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Secular Trends
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Gradual changes in frequency of disease over long period of time (suicide)
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Cyclic Trends
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Increase and decrease in frequency of disease over year(s)
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Point Epidemic
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Indicate response of group of people with common source of infection
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Clustering
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Closely grouped series of events with well defined distribution patterns
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Spatial Clustering
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Specific region
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Temporal Clustering
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Time
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SES
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Socioeconomic status based on income, education level and occupation
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Exposure
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Contact with risk factors either directly or indirectly
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Determinants
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Any factors that bring about changes in health conditions
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Distribution
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Occurence of disease and health outcomes that vary in population
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Interdisciplinary Science
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Used information from many fields
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Observational Science
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Capitalize upon naturally occurring situations in order to study occurrence of disease
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Analytical Epidemiology
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Testing of hypothesis to find association
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Edward Jenner
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Studies and noticed dairymaids were exposed to cowpox and did not get smallpox
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Risk Assessment
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Estimate peoples chances of avoiding individual risk of disease
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Population
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Community being studies or those who share common characteristic
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Sample
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Those in population that are being studied
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Convenience Sampling
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Asking people where it is easy but this produces bias
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Sample Random Sampling
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Equal chance of being selected
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Systematic Sampling
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Has some order and every x person is selected
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Representativness
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Degree to which characteristics of sample correspond to those of population
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Statistics
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Numbers used to describe sample
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Estimation
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Using sample based data to infer conclusion about population
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Qualitative Data
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No numerical data
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Quantitative Data
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Numerical
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Discrete Variable
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Numbers 0-9, no halves
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Continuous Data
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Things like heart rate, can be halves
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Nominal
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No order and does not make sense with numbers
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Ordinal
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Has order but is subjective
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Ratio
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Value obtained by dividing one quantity by another
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Bar Chart
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Graph that shows frequency of cases for discrete categories
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Line Graph
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Shows change over time
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Cluster Sampling
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Whole group of people like a school
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Mode
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Most occurring number
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Median
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Middle point of set
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Mean
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Average
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Range
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Difference between highest and lowest vale
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Variance
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Degree of variability in set, how different the numbers are
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Standard Deviation
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Square root of variance
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Epidemic Curve
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Graph of distribution of cases and time of onset
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Incubation Period
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How long for a disease to begin to effect one
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Correlation Coefficiant
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Measure of association used with continuous variables from -1 to +1 with a value of zero meaning no correlation
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Dose Response
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Type of associations between exposure and effects
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Contingency Table
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Tabulates data according to two dimensions
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Proportion
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Type if ratio in which numerator is part of denominator
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Percentage
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Proportion multiplied by 100
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Rate
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Denominator involves measure of time
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Incidence
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Occurrence of new diseases within a population
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Prevalence
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Total number of case in population in percent
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Life Expectancy
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Number of years person is expected to live
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Crude Death Rate
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Rates have not been modified to take into account factors that may effect it
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Case Fatality
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Number of deaths due to disease that occur among those infected
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Proportional Mortality Rate
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Number of deaths within population due to specific disease dived by number of deaths in pop
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Case Specific
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Measure that refers to mortality divided by population size at midpoint
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Age Specific
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Number of cases per age group of population during specific time period
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Adjusted Rates
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Morbidity or mortality in a population in which statistical procedures have been applied to permit fair comparisons across pop by removing the effect of difference in varying population
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Maternal Mortality
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Mothers that die due to pregnancy
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Infant Mortality
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Number of deaths among infants age 0-365 days
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Fetal Mortality
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Death of fetus when in utero
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Crude Birth Rates
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Number of live births during specific year
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General Fertility Rate
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Number of live births reported in area divided by women age 15-44
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Perinatal Mortality
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Include both late fetal deaths and infant deaths among newborns under seven days
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Three features of Vital Stats
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Volume, variety and velocity
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Quality
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How complete the data is
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Quantity
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How many sources
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HIPPA
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Health insurance portability and accountability act that protects personal info from being released
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US Census
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Provides data used to estimate issues
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Representativenss
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Data has to match population
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Vital Events
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Death, births, marriage and divorce
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Deaths
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Mortality rate that certificate includes name and cause and place of death, may not be completely accurate
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Birth Stats
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Includes live births and fetal deaths which helps understand birth defects
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Public Health Surveillance Program
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Refers to systematic and continuous gathering of info about occurrence of diseases
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Syndromic Surveillance
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Uses health related date that precedes diagnosis and signals probability of outbreaks
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Reportable and Notifiable Disease Stats
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Legal status that health care providers must report including anthrax and HIV
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Chronic Disease Survellance
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Provides data necessary for development and evaluation of health are services
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Behavioral Risk Factor Surveillance System
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Used by Us to monitor state level risk factors associated with chronic disease
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Case Registries
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Database for collecting info about disease
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National Health Interview Survey
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Data used for monitoring how well the nation is progressing toward specific health objective
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National Vital Statistic System
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Standard forms and registration of vital events
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Age
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Most important factor when describing occurrence of disease
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Sex
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Lead to wide scope in phenomena
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Race
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Increasingly diverse in US
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Navity
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Place of origin of relatives
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After Hurricane Katrina, there was an outbreak of Vibrio infections. The Vibrio bacteria was spread by the flood water and caused wound infections that killed five 5 people. This is an example of
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A point epidemic
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By measuring income level, researchers can fully account for an individual's socioeconomic status
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False
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Define the term descriptive epidemiology
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Occurence of disease according to the variables of a person, place and time.
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Describe the process of epidemiologic inference in the context of descriptive epidemiology.
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Descriptive epidemiology provides a basis for generating hypothesis and the drawing of conclusions about exposure and health outcomes to be studied in analytical research
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Every winter in Canada, there is a large increase in coronary deaths among men 65 years and older. Researchers believe this is caused by the physical exertion from shuffling snow in combination with cold temperatures (temporarily increasing blood pressure). What is this an example of?
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A cyclic trend
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Gradual changes in the frequency of diseases over long periods are known as:
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Secular trends
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In epidemiology, place variables include:
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localized occurrence of disease
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Increases and decreases in the frequency of a disease within a year or over a period of several years are known as:
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cyclic trends
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Malignant Mesothelomia is a rare, aggressive cancer in the lining of the lungs. Researchers in Italy found a higher proportion of this rare type of cancer among people who lived close to asbestos cement plants. This is an example of
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spatial clustering
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The Behavioral Risk Factor Surveillance System (BRFSS) is a health-related telephone survey that collect state data about U.S. residents regarding their health-related risk behaviors, chronic health conditions, and use of preventive services. What type of study is the BRFSS?
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A cross-sectional study
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The cause of neuroblastic tumors in children and youth are largely unknown and researchers suspect that both genetic and environmental factors contribute. Researchers in England found evidence suggesting temporal clustering of neuroblastic tumors. What does this mean? (choose the answer that best describes what temporal clustering is)
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Temporal clustering means that cases occur close together in time. Because of this, we can suspect that transient environmental agents (such as common infections like the influenza or atmoshperic pollution) may be involved in the aetiology of neuroblastic tumors.
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Those who occupy the lowest socioeconomic positions have excesses of morbidity and mortality from several causes
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True
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Urban diseases and causes of mortality are more likely to be those associated with:
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person-to-person contact
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Variations in infectious and chronic diseases from one country to another may be attributed to:
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climate access to health care cultural factors
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What is Health Disparities?
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Differences in the occurrence of disease and health conditions in a population
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When conducting a descriptive epidemiologic study, it is important to know how the results should and should not be used because of the inherent limitations of the descriptive study design. Give two examples of how descriptive epidemiologic studies CAN be used.
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To provide a basis for planning and evaluating health services as well as to identify problems to be studies analytically
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Which person variable is the largest contributor to overall disease?
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Age
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In what type of study can you estimate how many % in a population have been diagnosed cancer?
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Cross-sectional
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What kind of descriptive study design is called a "prevalence study"?
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Cross sectional