Which of the following is NOT an example of an analytic study?
A) A study that examines whether infant mortality rates in 100 low income countries are associated with income inequality
B)An outbreak investigation of which food item caused gastrointestinal illness among people attending a wedding reception dinner.
C)A study describing 8 patients diagnosed with a new infectious agent with unusual symptoms that did not respond well to standard treatment.
D)A double blind randomized trial of a new drug therapy for prostate cancer.
-In an effort to promote oral health a city requires that schools implement programs that educate students about the benefits of brushing their teeth twice a day. Researchers compared 10 city schools that exposed their students to this educational program to 10 similar schools from the suburbs that did not offer this educational program. Three months later, researchers found that students in city schools who had received this educational program touting the benefits of brushing their teeth twice a day were 10 times as likely to have self reported brushing their teeth twice a day each day in the past week as students in suburban schools who were not exposed to this educational program. Which statement is most correct?
A)This is an example of policy/program evaluation the program was successful.
B) This is an example of policy/program evaluation the program did not work.
C)This is an example of the process of problem definition
D) This is an example of the process of agenda setting
E) This is an example of policy/program evaluation the program was harmful.
-The bacteria that cause anthrax can live in the soil and remain infective for years. Cows sometimes become infected ( and often die) when grazing on pastures that are contaminated with anthrax. Humans may become infected with anthrax from handling sick cows butchering their carcasses or working with dried hides. Indeed, anthrax can live for years in dried hides from infected cows. In this example, What is the reservoir?
A)Both soil and dried hides from infected cows
B)Soil
C)Dried hides from infected cows
D)Sick cows
E)The bacteria that cause anthrax
-What is the best study design for examining whether a new drug regimen is associated with a slower progression of tumors of the pituitary gland? Tumors of the pituitary gland are rare, so you have to enroll patients from multiple large cancer treatment centers around the country to ensure an adequate sample size.
A)A case report
B)An ecological study
C)A diagnostic accuracy study
D)A multi level observational study
E) A multi site trial
-Which of the following lines best shows the effects of herd immunity? ( picture)
A) Line C B) Lines C and D C) Line A D) Line B E) Line D
-You believe children who begin reading by age 5 will be more likely to read for fun when they are aged 60 or older. What type of study design would be the best for you to conduct and why?
A) A randomized controlled study because it will allow you to assign the exposure of interest to your intervention and control group.
B) An ecological study because it provides better individual level assessment of risk.
C) A retrospective cohort study because the study sample is well defined and good records are available to evaluate the exposure of interest.
D) A cross sectional study because you want to evaluate several exposures and several outcomes of interest in this study sample
E) A case control study because it will allow you to evaluate an exposure that occurred long ago and for which there are no reliable records in a relatively quick study.
-Those who eat broccoli every day have 0.75 times the risk of death ( 95% CI-0.64 to 0.83) as compared to those who do not eat broccoli every day. Those who eat cheese every day have 1.15 times the risk of death ( 95% CI-1.11 to 1.19) as compared to those who do not eat cheese every day. Which of the following is true?
YOU MAY SELECT MORE THAN ONE CORRECT ANSWER FOR THIS QUESTION
A) The association between eating cheese and the risk of death is stronger than the association between eating broccoli and the risk of death.
B) The association between eating cheese and the risk of death is weaker than the association between eating broccoli and the risk of death.
C) The risk ratio for the association between eating broccoli and the risk of death is significantly different from the risk ratio for the association between eating cheese and the risk of death.
D)The risk ratio for the association between eating broccoli and the risk of death is not significantly different from the risk ratio for the association between eating cheese and the risk of death.
The bacteria that cause anthrax can live in the soil and remain infective for years. Cows sometimes become infected ( and often die) when grazing on pastures that are contaminated with anthrax. Humans may become infected with anthrax from handling sick cows, butchering their carcasses, or working with dried hides. Indeed, anthrax can live for years in dried hides from infected cows. In this example what is the agent?
A) Soil B) Both soil and dried hides from infected cows
C)Dried hides from infected cows D) The bacteria that cause anthrax
E)Sick cows
– Information to Questions 1 through 3
A small town had a population of 1000 people at the beginning of 2019, 5 people were newly diagnosed with lung cancer during 2019. By the end of 2019, 100 people who were alive at the beginning of 2019 had died. Of the dead, 3 died from lung cancer. No one had moved into or out of the town during the year and there were no births in the town during the year.
1- What was the crude mortality rate in this town in 2019?
A) 3.0/1,000 persons per year
B) 3.2/1,000 persons per year
C) 105.3/1,000 persons per year
D) 100.0/1,000 persons per year
E) 111.0/1,000 persons per year
2-What was the cause specific mortality rate for lung cancer in this town in 2019?
A) 600/1,000 persons per year
B) 3.16/1,000 persons per year
C) 20/1,000 persons per year
D) 3.00/1,000 persons per year
E) 3.33/1,000 persons per year
3-Assuming all 3 who died from lung cancer had been newly diagnosed in 2019, what was the case fatality rate for patients newly diagnosed with cancer in this town in 2019?
A) 3.0% B) 3.2 per 1,000 C)60.0% D) 3.3 per 1,000 E) 0.3%
-Information for questions 4 through 11
In the United States, people who have monthly family incomes that are below 1.30% of the Federal poverty level are eligible to participate in the Supplemental Nutritional Assistance Program ( SNAP), a federal program that provides vouchers for the purchase of food. Not all people who are eligible to participate in SNAP based on their family income actually participate. A team of researchers designed a study to examine whether participation in SNAP is associated with reduced mortality among those who are eligible to participate in SNAP.
On January1, 2018 the research team enrolled over 55,000 people who had monthly family income below 1.30% of the federal poverty level in their study. Roughly half of the study subjects participated in SNAP on the first day of the study and the rest of the study subjects had not. On January 1, 2019, the researchers examined mortality outcomes among the study subjects. SNAP participants had a crude death rate of 601.7 per 100,000person years, whereas non-participants had a crude death rate of 938.2 per 100,000 person years.
4- What study design did the researcher use?
A) RCT B)Case Control Study C) Retrospective cohort study
D)Prospective cohort study E) Cross sectional study
F)Ecological study
5-Calculate the relative risk of death for non-participants in SNAP compared to participants in SNAP. Report your answer to one decimal place ( i.e. to one number beyond the decimal point)
6-Interpret the relative risk of death for non-participants in SNAP compared to those who participate in SNAP ( write a concrete sentence less than 30 words)
7-Calculate the risk attributable to non- participation in the SNAP program. Provide your answer to one decimal place (i.e. to one number beyond the decimal point)
8-Based on the attributable risk calculations ( Based on your answer to question 7). If all of the people who were eligible to participate in SNAP were enrolled in SNAP. What would happen to the number of deaths in the eligible population?
A) The number of deaths would increase because participants in SNAP is protective
B) The number of deaths would decrease because participants in SNAP is harmful
C)The number of deaths would increase because participants in SNAP is harmful
D)The number of deaths would decrease because participants in SNAP is protective
9-What part of the policy cycle are the researchers conducting this study engaged in?
A)Assess policy participation in SNAP results in increased mortality
B)Assess policy participation in SNAP results in reduced mortality
C)Agenda setting
D)Policy establishment
E) Policy implementation
10- The researchers examine whether the following variables are associated with participation in SNAP among those who are eligible. Based on the odds ratios shown in the following table , which risk factor does NOT meet the necessary criteria to be considered a confounder of the association between participation in SNAP and subsequent mortality?
A) Aged 65 or older
B) Less than 12 years of education
C) Presence of children aged 12 or younger
D) Residence in a rural area
E) Residence in the Northeast
11-How do you know that the risk factor you selected in Question 10 is not a confounder? Limit answer to 20 words