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Epidemiology Module Exercises

Contents

MODULE EXERCISE 2: Public health (large area) epidemiology.

Part 1:

Part 2:

MODULE EXERCISE 3: Bivariate linear regression analysis (correlation)

Part 1:

Part 2:

MODULE EXERCISE 4: Association Analysis

Part 1:

Part 2:

MODULE EXERCISE 5: Relative Risk Analysis

Part 1:

Part 2:

Sources:

Module Exercise 2: Public Health (large Area) Epidemiology

Part 1:

Across all states and dependencies, gonorrhea warnings have risen. Heterosexual women and children, including males who have intercourse with others, have raised Gonorrhoea. Two MDR reports have been identified in Australia that is highly immune to all drugs in normal use for the treatment of gonorrhea. Four cases have been reported with MDR gonorrhea.

Gonorrhea is a bacterial disease widespread globally and involving all genders that are sexually transmissible. In Australia, men who have sex with men (MSM), young heterosexual Aborigines, Torres Strait Islanders living in remote and very remote areas, and travelers from high prevalence areas in other countries are most commonly diagnosed. The outbreak with N anogenital. Gonorrhea raises the likelihood of HIV infection developed and spread. Other sexually transmitted infections (STI) are frequently co-infected.

Penicillin, tetracyclines, macrolides, and, more recently, fluoroquinolones are becoming more and more prevalent with antibiotic resistance. Substantial spatial variations currently occur in Australia 's reduced sensitivity trends and two-way counseling was suggested as a method for coping with increasing wider resistance. Pharyngeal infections and multi-drug resistance in the extra-genital sites are recorded to have declined in diagnosis. Distinguishing between reinfection and therapy failure is a challenge unless two weeks after treatment are performed with a nuclear acid amplification test (NAAT).

It should be recalled that NAAT does not provide for the testing of antimicrobial tolerance and that specimens should be obtained as much as practicable for cultivation. Male urethral are typically symptomatic but cervix, anus, and pharynx diseases are generally asymptomatic. If symptomatic, genital, anal, or pelvic discomfort may be felt in women with gonorrhea. Conjunctivitis happens in neonates and less commonly in adults which, if not immediately treated, can cause blindness. Infection dissemination can often lead to gonococcal septicemia, arthritis, meningitis, and endocarditis (OzFoodNet Working Group, 2018).

Male epididymitis and prostatitis can be the potential sequelae of gonococcal infection. The possible risk to pregnancy may be epi-dido orchids. In women, endometritis, salpingitis, and PIDs may contribute to inflammation, with recurrent pelvic sequelae, subfertility, and ectopic pregnancy.

Premature membrane rupture and premature delivery, with consequent morbidity and mortality, may lead to an infection during pregnancy. Gonorrhea can, typically at birth, be transferred to the neonate and cause eye and/or anogenital infection. A high percentage of contaminated mother-born children are diagnosed at birth. In very young children it can be difficult to differentiate between infection and sexual assault at conception. Consultations with mental wellbeing, pediatrics, and/or protection personnel might be required to assess if there is mental exposure and, therefore, the risk of sexual assault. (Odeyemi, 2016)

Module Exercise 3: Bivariate Linear Regression Analysis (correlation)

(for consolidation with other prescribed module exercises and submission for assessment)

Part 1:

 The coefficient of correlation between both variables is 0.2. It reflects there is a positive correlation between both variables. The strength of the relationship varies according to the value of the coefficient of correlation. For eg, a value of 0.2 indicates that two separate variables have a positive association, but it is small and potentially non-important. Analysts do not find associations significant in certain fields of analysis unless the significance reaches at least 0.8. An absolute correlation coefficient of 0.9 or higher will, therefore, be a very strong relationship. A positive correlation is a relationship between two variables, which move in the same direction from the two variables. Thus, when one variable increases with the other or one decreases with the other variable increases (Who et al., 2016).

Part 2:

The coefficient is computed as:

Where:

Based on the Given Data;

The correlation coefficient is:

There is no significant difference between my software generated results for the correlation coefficient and calculator based results. Both results show that there is a non-significant positive correlation between both variables.

Module Exercise 4: Association Analysis

Part 1:

Total no. of children: 474

Age Range: 5-12

No. of Overweight children: 87

As per the given data, the school contains 474 children aged 5 to 12, and aged BMIs show that 87 children are overweight. That statistic contains a percentage of children that may be obese. Of these overweight men, 43 eat lunch in the private contractor's canteen. Nevertheless, 130 of the kids who do consume canteen lunch are not overweight. Children who don't eat in the canteen usually carry home lunch (prepared or served by their parents). The school recognized these children and equipped them with meals packaged to carry them home by a nutritionist.

The children who are not obese even they take their meal from the school canteen reveals that active children have not been obese. Food and physical exercise must be integrated into the program for health education in a classroom. Themes of nutrition and physical activity can also be taught in other fields of core classroom study, physical training, and post-school programming. Health in the school system will always discuss diet and physical education to provide wellbeing for the teachers, not only health for children (Barrera et al., 2016).

Given the Literature spotting similar issues, parents report finding issues for their children in terms of an affordable diet and/or physical activity, and it is especially hard when a child is overweight or obese when his weight has been normal. That can be because the infant is forced to consume certain amounts and forms of food and joins the low-energy loop that discourages the workout, as well as a low-nutrient, high-calorie diet, which often raises the obesity rate. Also, parental attitude can play a role as some parents do not understand that their child is overweight nor that overweight is an impairment of physical activity or impairment to health.

Products with added sugar are metabolized differently from other products, but the consequences of sugar calories are challenging to express as the majority assume that the nutritional of all food groups is similar. One popular misconception, for instance, is that people will sustain their existing weight for the same number of calories that they consume. This is not true – more than 100 Broccoli calories are metabolized differently from 100 Sugar-loaded Candy calories (Chen et al., 2017).

The fiber in broccoli is consuming natural sugar gradually without growing the amount of blood glucose as strongly or as rapidly as a candy bar and therefore will not boost the insulin reaction, which ultimately results in insulin resistance. The metabolic effects of food are therefore potentially as significant as the real energy content of the food (Who et al., 2016).

Schools may also encourage wellness in the school, by providing students nutritious meals and physical exercise. Schools can include healthier foods in cafes to improve nutrition and prevent unhealthy foods from being sold. Schools should establish healthy paths to school and cycle and encourage productive break time to boost health.

To the long-term well-being, both physical and mental wellbeing, regular exercise is important and may boost academic and cognitive efficiency. Increased self-esteem, musculoskeletal and cardiovascular wellbeing, and decreased anxiety and depression in teenagers are linked. It also supports society by enhanced social engagement and group participation. The physical exercise patterns in children and teenagers are expected to be continued into adulthood. Overweight, obesity, and health disorders like diabetes, asthma, and cardiovascular problems are linked with sedentary conduct and reduced physical activity. (Bates et al., 2018)

Adolescents are a critical stage in life that intervenes and promotes active lifestyles before long-term behavior patterns develop. This is especially important for young girls who have previously identified a sharp downturn in physical activity levels. To encourage safe growth for adolescents and young adults, encouraging physical exercise is of the utmost significance. Physical inactivity is a major health risk factor that extends beyond weight control and affects mental and physical wellbeing. Physical inactivity has been found to lead to a weight increasing energy deficit. Overall, physical inactivity has major implications not only for direct hospital expenses but also for higher indirect costs, because of the extended duration of maternity leave, occupational handicaps, and early deaths. (Baranowski et al., 2019)

The reasons for physical inactivity are largely influenced by social and environmental forces that have made modern life and job conditions more sedentary. In addition to the average duration of 2 hours regular, school children utilize screen terminals. At kindergarten or daycare infants and teenagers expend more hours than ever before. Academic demands are growing which may increase physical learning and productive gaming time.

Part 2:

 The obesity epidemic is not remedied by a single or simple solution. This is a difficult issue and a multi-faceted approach needs to be adopted. Politicians, state and municipal government companies and civic groups, colleges, health care providers, and people have to work together to build a safe living climate. State and state agencies should build a welcoming atmosphere and encourage healthier activity that reduces obesity. There are many avenues (Rothman, 2012).

Potential explanations for failing to comply with the cantina guidelines include a limited understanding of how important it is for the school leaders and teachers to follow the guidelines. Outsourcing to business operator's canteens would mean that poorer foods and beverages are available, but the danger of withdrawal could be enough to ensure that no such food and beverages occur. We also hypothesized that urban schools will be more likely to offer poor quality food and drinks on the demand of urbanized children, whose large availability in other shops might enable them to eat food daily outside school (de Bont et al., 2019).

However, our results allow the following suggestions known as the correlation between non-compliance with the canteen guidelines and student overweight and obesity:

(1) national authorities should provide clear, frequent instruction for schools on the application of the canteen guidelines;

(2) the canteen guidelines should be rigorously supervised.

Food and fitness services for teachers and workers will also help enhance the school atmosphere, not just to promote the wellbeing of staff and administrators, but also to generate excitement within the school for student programs. Schools may often act as critical student safety data points. Transparent indicators like the BMI will assist curriculum and decision leaders in measuring the effectiveness of existing initiatives in an anonymous manner and in determining the course of prospective programs.

Schools are prepared to form an integral part of the combat against the obesity epidemic with strong evidence that school-based prevention programs can successfully and without any additional resources help students to eat better, to become more active, and to reach a healthier weight. The faster we move, the stronger, as with schooling in general.

As childhood obesity usually transforms into adult obesity, efforts to avoid this should start "long before a child goes to school." The Institute of Medicine (2011) suggests the usage of common devices, such as the World Health Organisation (WHO) or Centres of Disease Control and Prevention (CDC) as a way to assess height and weight for all daily appointments. This helps to identify children who are at risk of obesity. Furthermore, research shows rising activity decreases the likelihood of overweight or obese children over time.

Increased chronic diseases from adult obesity and improvement in overall health in our patients, families and communities that delay the growth of children into whole foods, fruit, and nutrient-sensitive diets, in addition to increasing outdoor activities that include physical activity early in life. The group should improve the awareness of nutritious foods by public meetings, classrooms, and through visit to a healthcare professional in the workplace to make for improved decision-making about diet. Improved physical exercise and a decline in the amount of sugar introduced to the diet will reduce the likelihood and prevalence of obesity contributing to cardiovascular disease in children and adults, including diabetes, CVD, and HTN.

Module Exercise 5: Relative Risk Analysis

Table 3: Data Given

Food is eaten

Bankers ill

Bankers not ill

Cream of mushroom soup

83

30

Shrimp cocktail

44

36

Chicken a la king

74

34

Vegetarian platter

13

46

Ice cream with choc sauce

38

32

Coffee

11

42

Part 1:

Concerning the above results, Coffee is the least risky food while the Cream of Mushroom soup is the riskiest one.

The riskiest to least risky food list is as:

  1. Cream of Mushroom Soup
  2. Chicken a la King
  3. Shrimp Cocktail
  4. Ice Cream with Choc Sauce
  5. Vegetarian Platter
  6. Coffee

Part 2:

Acute diarrheal disease is globally widespread and is reported at 1.8 million deaths each year, mostly in developed countries. Even in developing countries, the incidence of diarrheal disease is also high. Several factors complicate foodborne disease burden estimates: different definitions of acute diarrheal disease are used in various studies, most diarrheal diseases are not reported in public health authorities, and few diseases can be associated with food.

Clinical samples of suspected food transmitting illness (e.g. fecal of patients with diarrhea) were obtained and examined by laboratories. The labs most frequently give the relevant public health authorities accurate microbiological results from such experiments. To validate, typed, or established the resistance trends, a few labs may often submit patient substances or insulates to a central reference center. The collection and thorough and timely review of such reports will provide valuable information for the identification of outbreaks, particularly if the case is widely distributed or clinical signs are not clear (Young et al., 2018).

According to the situation and analysis, the illness is a foodborne illness. Non-specific effects and neurologic indications can often arise in people with foodborne diseases, who usually include manifestations in the gastrointestinal tract (for example vomiting, diarrhea, and stomach pain). An index patient might not be critically sick, beginning with an epidemic. A doctor who sees this person can only be willing to render an early and expeditious diagnosis. The practitioner also has to have a strong degree of skepticism and raise concerns to detect a foodborne etiology of a disease.

Important signs to assess a foodborne disease's etiology are:

  • Period of incubation;
  • the subsequent disease's duration;
  • Clinical signs predominant; and
  • Outbreak populations involved.

Further signs may be extracted from the fact that the individual has eaten unpasteurized milk, home-canned items, fresh fruit, or soft cheese produced of unpasteurized milk, egg raw or undercooked eggs, poultry, shellfish, shrimp, unpasteurized food or raw or badly cooked.

There is a need to Inquire whether there are common signs among the patient's relatives or personal associates. Investigations regarding working or visiting a farm, interaction with wildlife, daycare, profession, international travels, mountain trip, and hiking excursions to or from unregulated water areas or community picnics or other related trips may often offer information on the etiology of the disease. In the case of reported foodborne disease, have suitable laboratory check specimens, and suggest epidemiological analysis for the national or local health authorities.

In comparison to the symptoms of foodborne infection, clinical diagnosis includes chronic psychiatric disorders such as irritable bowel syndrome, infectious bowel diseases such as Kron disorder and ulcerate colitis; malignancy, surgical treatment; gastrointestinal tract operation or radiation. Exogenous causes, such as travel-related sickness, employment, mental tension, sexual activity, other illnesses' presence, recent hospitalization, caring for children, and nursing homes can also be taken into consideration (Small, and Aplasca, 2016).

Also complex are differential diagnoses of neurologically symptomatic patients due to nutritional disease. Recent samples of tainted foods, mushroom contamination, and chemical toxicity are potential food-related factors to be considered. Due to the potential threat for the life of certain toxins (such as botulinum toxins, tetrodotoxins) and chemicals (such as organophosphates), a differential diagnosis should be made with ease of aggressive treatment and life support measures (such as respiratory supports, antitoxin or atropine) and possible hospital admission (Willett, 2012).

Foodborne disease is a significant public health concern and is a globally leading source of sickness and death. The public trust and financial harm involved in the businesses and related food industry can be affected by outbreaks related to contaminated foods. Examples of government actions and control of the food health were given by the assessments of symptoms of foodborne illness and human pathogens. However, projections of improvements in the prevalence and overall efficacy of food safety requirements and control in foodborne diseases and hospitalizations provide detail (Simpson et al., 2018).

Foodborne illness is highly prevalent, with an outbreak of gastroenteritis episodic in Australia, on average, around every 5 years. Although foodborne gastroenteritis is mostly not a major issue, the cost to the community is substantial due to direct medical costs and working days. Around 1 person out of 5 seeks medical treatment with gastroenteritis. Up to 1 million hospital visits a year for foodborne diseases may also occur.

In the food, microorganisms can be present. For instance, boneless plastic breasts of chicken and ground meat were once part of live chickens or bovine animals. Fresh beef is not safe, nor are fish, seafood, and eggs. New foods, such as spinach, onions, germs, and melons, are not included. In our atmosphere, there are thousands of varieties of bacteria. Pathogenic are known as microorganisms causing disease. Many pathogens can lead to foodborne diseases if they get into the food supply. Each bacterium in humans does not cause disease. These bacteria are used to produce cheese and yogurt (Ford et al., 2016).

Foodborne disease is triggered by food or alcohol intake. Many different kinds of foodborne diseases can cause disease, microbial, or pathogens, which can contaminate the food. Infections triggered by a combination of bacteria, viruses, and parasites are more popular foodborne diseases. Many illnesses contain infections induced by toxic pollutants or by food infected chemicals. It's also noteworthy that certain foodborne pathogens may be transmitted through drinking or potable water, through animal interaction or personal transmission of the disease.

An infected stomach and intestine is a foodborne illness. Infection may arise when anything infected with a bacterium, virus, or parasite is ingested or consumed. Inflammation also contributes to diarrhea, diarrhea, vomits, stomach discomfort, cramps and, sometimes, fever (Franz et al., 2019).

It triggers a severe gastrointestinal condition that clears within two days, typically with more vomiting than diarrhea. In comparison to other nutrient-borne diseases of animal packaging, Norwalk-like viruses primarily propagate from one contaminated person to another. If you have the virus on your hands, you infected kitchen personnel can infect a salad or sandwich during their preparation. When they were picked, poisoned fishermen tainted oysters.

Sources for Multi-Etiological Perspective on Child Obesity Prevention

Bates, C.R., Buscemi, J., Nicholson, L.M., Cory, M., Jagpal, A. and Bohnert, A.M., 2018. Links between the organization of the family home environment and child obesity: a systematic review. Obesity Reviews19(5), pp.716-727.

Baranowski, T., Motil, K.J. and Moreno, J.P., 2019. Multi-etiological perspective on child obesity prevention. Current nutrition reports8(1), pp.1-10.

Barrera, C.M., Perrine, C.G., Li, R. and Scanlon, K.S., 2016. Age at introduction to solid foods and child obesity at 6 years. Childhood Obesity12(3), pp.188-192.

Chen, Z., Salam, M.T., Alderete, T.L., Habre, R., Bastain, T.M., Berhane, K. and Gilliland, F.D., 2017. Effects of childhood asthma on the development of obesity among school-aged children. American journal of respiratory and critical care medicine195(9), pp.1181-1188.

de Bont, J., Casas, M., Barrera-Gómez, J., Cirach, M., Rivas, I., Valvi, D., Álvarez, M., Dadvand, P., Sunyer, J. and Vrijheid, M., 2019. Ambient air pollution and overweight and obesity in school-aged children in Barcelona, Spain. Environment international125, pp.58-64.

Ford, L., Glass, K., Veitch, M., Wardell, R., Polkinghorne, B., Dobbins, T., Lal, A. and Kirk, M.D., 2016. Increasing incidence of Salmonella in Australia, 2000-2013. PLoS One11(10), p.e0163989.

Franz, C.M., den Besten, H.M., Boehnlein, C., Gareis, M., Zwietering, M.H. and Fusco, V., 2019. Reprint of: Microbial food safety in the 21st century: Emerging challenges and foodborne pathogenic bacteria. Trends in Food Science & Technology84, pp.34-37.

Odeyemi, O.A., 2016. Public health implications of microbial food safety and foodborne diseases in developing countries. Food & nutrition research60.

OzFoodNet Working Group, 2018. Monitoring the incidence and causes of diseases potentially transmitted by food in Australia: annual report of the OzFoodNet network, 2012. Communicable diseases intelligence (2018)42, pp.S2209-6051.

Rothman, K.J., 2012. Epidemiology: an introduction. Oxford university press.

Small, L. and Aplasca, A., 2016. Child obesity and mental health: a complex interaction. Child and Adolescent Psychiatric Clinics25(2), pp.269-282.

Simpson, K.M., Hill-Cawthorne, G.A., Ward, M.P. and Mor, S.M., 2018. Diversity of Salmonella serotypes from humans, food, domestic animals and wildlife in New South Wales, Australia. BMC infectious diseases18(1), p.623.

The State of Queensland (Queensland Health) and the Royal Flying Doctor Service (Queensland Section), 2016. 

Willett, W., 2012. Nutritional epidemiology. Oxford university press.

Woh, P.Y., Thong, K.L., Behnke, J.M., Lewis, J.W. and Zain, S.N.M., 2016. Evaluation of basic knowledge on food safety and food handling practices amongst migrant food handlers in Peninsular Malaysia. Food Control70, pp.64-73.

Young, I., Thaivalappil, A., Greig, J., Meldrum, R. and Waddell, L., 2018. Explaining the food safety behaviours of food handlers using theories of behaviour change: a systematic review. International journal of environmental health research28(3), pp.323-340.

Remember, at the center of any academic work, lies clarity and evidence. Should you need further assistance, do look up to our Epidemiology Assignment Help

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