Exit Exam Study Guide Biblical Worldview
Define A Biblical Basis For Personal And Public Health Practice
HLTH 503 - Epidemiology
1. Who were John Graunt and John Snow?
a. John Graunt: Epidemiologist who published a landmark analysis of mortality
data in 1662, quantifying data on patterns of birth, death, and disease occurrence,
noting disparities between males and females, high infant mortality, urban/rural
differences, and seasonal variations.
b. John Snow: Anesthesiologist, went on to become known as the <father of field
epidemiology.= Studied cholera outbreaks, found the cause and developed
prevention methods.
2. Define the point prevalence of a disease.
a. Point prevalence: # persons with disease in a given time interval/ # of persons in
the population
i. i.e Prevalence rate at the beginning of the time interval + any incident
cases.
3. Differentiate between primary, secondary, and tertiary prevention.
a. Primary: control of causal factors
b. Secondary: early detection and treatment of disease
c. Tertiary: minimizing the consequences of the disease and preventing the onset of
further consequences and/or disabilities
4. As an epidemiologist you are going to investigate the effect of a drug suspected of
causing malformations in newborn infants when the drug in question is taken by pregnant
women during the course of their pregnancies. As your sample you will use the next 200
single births occurring in a given hospital. For each birth a medication history will be
taken from the new mother and from her doctor; in addition, you will review medical
records to verify use of the drug. [N.B.: These mothers are considered to have been
followed prospectively during the entire course of their pregnancies, because a complete
and accurate record of drug use was maintained during pregnancy. The resultant data are:
Forty mothers have taken the suspected drug during their pregnancies. Of these mothers,
35 have delivered malformed infants. In addition, 10 other infants are born with
malfunctions.
What is the relative risk between exposure to the drug and malformations?
a. Relative Risk: (35/40)/(10/160) = (0.875/0.062) = 14
5. Define relative risk. Given a data set, how would this ratio be calculated?
a. Relative Risk: CIe/CIu
i. Indication of the strength of association between cause and effect
6. A new screening test for Lyme disease is developed for use in the general population.
The sensitivity and specificity of the new test are 60% and 70%, respectively. Three
hundred people are screened at a clinic during the first year the new test is implemented.
Assume the true prevalence of Lyme disease among clinic attendees is 10%.
Calculate the following values:
The predictive value of a positive test
The predictive value of a negative test
a. The predictive value of a positive test: # patients with disease with (+) screen/
total #patients who screened (+) i. Predictive value =
b. The predictive value of a negative test = # patients w/o disease with (–) screen/
total # patients who screened (-)
7. List the major sociocultural influences on health
a. Diet, perception of illness, and perception of medicine
8. What refers to the situation in which only a single copy of an altered gene located on a
non-sex chromosome is sufficient to cause an increased risk of disease
a. Dominance
9. Where does one find valid sources of clinical data?
a. Medex
10. Differentiate between recessive and dominant genetic traits.
a. Dominant traits: a single copy of an allele is sufficient to express the gene
phenotypically
b. Recessive traits: alleles are not expressed phenotypically unless two copies of
that allele are present
11. The 3 categories of descriptive epidemiologic variables are person, place, and time.
Describe each.
a. Person: age, sex, marital status, race, nativity/migration, religion, and
socioeconomic status
b. Place: with respect to disease prevalence – within-country geographic variation,
urban/rural differences, localized place comparisons, and reasons for place
variation
c. Time: cyclic fluctuation/ seasonal trends, secular time trends, temporal clustering,
and spatial clustering.
12. Differentiate a retrospective cohort study from a prospective cohort study.
a. Retrospective cohort study: makes use of historical data to determine exposure
level at some baseline in the past and followed-up to the present.
b. Prospective cohort study: prospective in nature and is characterized by
determination of exposure levels at baseline and follow-up for occurrence of
disease at some time in the future.
13. Differentiate between formative, process, and outcome evaluation.
a. Formative: a way of making sure programs, plans, procedures, activities,
materials, and modifications will work as planned. Begun at conception of
program idea.
b. Process: learn whether the program is serving the target population as planned
and whether the number of people being served is more or less than expected.
Begun at inception of program operations.
c. Impact: measures the change the program creates in the target population’s
knowledge, attitudes, beliefs, or behaviors. Comparison of baseline data prior to
intervention and subsequent data after first encounter with the target group.
Method of tracking progress.
d. Outcome: learn how well the program has accomplished its ultimate goal.
HLTH 505 – Environmental Health
1. Differentiate between producers, primary consumers, and secondary consumers.
a. Producers: produce energy from organic matter
b. Primary consumers: consume the primary producers
c. Secondary consumers: consume the primary consumers
2. Approximately how much energy is lost going up the food chain?
a. 10%
3. How is nitrogen in the atmosphere changed to a usable form?
a. Fixation by bacteria (symbiotic with plants) into ammonia. Ammonia is then
converted to a biologically useful form by plants.
4. What do zebra mussels, Asian longhorned beetles, gypsy moths, and Formosan termites
have in common?
a. They’re all non-native invasive species
5. Which human population group is most sensitive to adverse environmental conditions?
a. Elderly and infants
6. Define carrying capacity.
a. The maximum population size that an environment can sustain
7. Discuss the theories of Thomas Mathus.
a. Population theory: Population would always tend to outpace additions to the food
supply
8. Differentiate between marasmus and kwashiorkor.
a. Both are nutritional disorders that result from starvation and/or inadequate diet.
b. Marasmus symptoms: dry, loose skin hanging over the glutei, loss of adipose
tissue, strong appetite and peeling or pigmented skin.
i. Severe nutritional deficiency in general. Usually found in very young
infants, and young children.
ii. Prevention: breastfeeding
c. Kwashiorkor symptoms: damaged nutrient absorption, abnormal burns,
nephrosis, chronic liver disease, loss of muscular mass, edema,
immunodeficiency, vomiting, heightened risk of infections, and diarrhea.
i. Lack of protein in diet. Usually affects slightly older children who have
been weaned too quickly
9. Discuss the impact of deficiencies of iodine and Vitamin A.
a. Iodine deficiency: one of the biggest public health problem worldwide
i. Leads to insufficient production of thyroid hormones, leading to
developmental and functional abnormalities.
ii. Symptoms: mental developmental problems, impaired reproductive
functions, lower IQ, and irreversible mental retardation.
b. Vitamin A deficiency: leading cause of blindness in children
i. Major public health problem in more than half of all countries
ii. Most vulnerable targets: low-income pregnant women and young
children
iii. Symptoms in children: severe visual impairment and blindness,
compromised immune function
iv. Symptoms in pregnant women: night blindness
10. What is the source of food production increases since the 1950s?
a. Green revolution: hybrid plants, large amounts of inorganic fertilizers,
technological advances in agricultural machinery
11. During which stage(s) of pregnancy is the developing human fetus most sensitive to the
exposure to a teratogen?
a. 18th day after conception to approximately the 60th day. Peak period: 30th day.
12. Neural tube defects can be prevented by the use of what substance?
a. Vitamin B folic acid
13. Where do PCBs, dioxins, or any of the chlorinated hydrocarbons concentrate in living
tissues?
a. Fat
14. Among the major atmospheric contaminants, which is the only one that is increasing?
What is the significance of this contaminant?
a. Particulates – decrease life-expectancy by at least 9 months as a result of air
pollution
15. How are inversion layers formed and why are they important?
a. Forms when a layer of cool surface air is trapped by an overlying layer of warmer
air. During an inversion the cool air, being heavier than the air above, is unable to
rise and mx, remaining atypically stable. If the inversion layer remains in place
for several days, pollutant emissions within the affected area have nowhere to
escape and can accumulate to health-threatening concentrations
16. The oncogenesis of cancer is often multifactorial. Discuss the interactions of the factors
involved in lung cancer from an environmental standpoint.
a. The ontogenesis of cancer is often multifactorial. There are a number of factors
that are involved in lung cancer from an environmental standpoint. The
interactions of the environmental factors are closely related to cancer.
The environmental factors that interact to increase the risk of developing lung
cancer include:
- Asbestos is an environmental factor which when inhaled its fibers irritate
the lung and eventually cause an abnormal growth in the lungs.
- Radon is an odorless gas in the environment released by some soil and
rocks that contain uranium.
- Industrial substances such as diesel and gasoline can cause lung cancer.
- The radiation exposure in the environment increases the risk of lung
cancer.
- The exposure to environmental tobacco smoke increases the risk for lung
cancer.
17. Discuss the control of nonpoint source contaminants.
a. To control nonpoint source pollutants from agricultural lands: conservation
tillage, terracing, contour plowing, applying pesticides when there is little wind
and the potential for heavy rain is low, using nonpersistent, low-toxicity
pesticides, disposing of containers properly, applying fertilizers or manures only
when they can be incorporated into the soil, using chemicals in the proper amount
and only when filed checks indicate they are needed, maintaining a buffer zone of
vegetation along waterways, and using fences to prevent livestock from walking
into streams.
b. Construction site management: owners and operations must monitor any
discharges and ensure that they don’t exceed specific limits in order to minimize
construction site storm-water discharges. Using mulches and fast-growing cover
vegetation, retaining as many existing trees and shrubs on the site as possible,
roughening the soil surface or constructing beams to slow down the velocity of
runoff water long enough to promote settling out of suspended sediment area ll
well-established management practices for reducing pollutant runoff from
construction sites.
c. Urban street runoff: Requires broad-based cooperation and effort on the part of
both municipal officials and citizens: more frequent street-sweeping to prevent
sediment accumulation on streets; proper disposal of pet wastes; careful and
limited application of lawn and garden fertilizers and pesticides; litter control on
both public and private property; judicious use of road salt and sand; application
of organic mulches to reduce erosion on bare ground; incorporating more green
space within urban areas and along waterways to allow runoff to filter into the
ground; use of surface ponds, holding tanks, roo-top catchments, substance
tunnels, or similar structures to hold, retain, and gradually release stormwater.
d. Acid mine drainage: legislatively mandated regrading and revegetation of
abandoned strip mines, sealing openings to abandoned underground mines,
thereby cutting off supply of oxygen and water that permit acid formation, using
engineered wetlands ro remove toxic chemicals from mine leachate, and
incorporating alkaline recharge zones. A proper/ideal solution is not yet found.
18. Explain the roles of the EPA, OSHA, and NIOSH.
a. EPA: stands for Environmental Protection Agency. The role of EPA is to protect
human health and the environment.
b. OSHA: stands for Occupational Safety and Health Administration. The role of
OSHA is to set and enforce standards and provide education, training, assistance
and outreach to ensure safe and healthful working conditions for working men
and women.
c. NIOSH: stands for National Institute for Occupational Safety and Health. The
role of NIOSH is to conduct research for the purpose of developing knowledge
and provide recommendations to ensure safety and health in the occupational
field.
19. Explain how the Resource Conservation and Recovery Act and <superfund= (CERCLA)
laws interrelate.
a. The Resource Conservation and Recovery Act and Superfund laws (CERCLA)
are interrelated. Here is a summary of how the two laws are interrelated.
b. Both the Resource Conservation and Recovery Act and Superfund laws
(CERCLA) are committed to coordinating with the local, state and federal
officials to address human health and environmental impacts of disasters and
hazardous substances.
c. Both the Resource Conservation and Recovery Act and Superfund laws
(CERCLA) are responsible for cleaning up the nation's most contaminated to
reduce the impacts of the hazardous substances such as oil spills.
d. Both the Resource Conservation and Recovery Act and Superfund laws
(CERCLA) are committed to ensuring that people can live and work in a healthy
environment free from hazards.
HLTH 507 – Public Health Administration
1. Identify the main components and issues of the organization, financing and delivery of
health services and public health systems in the U.S.
2. Describe the legal and ethical basis for public health and health services.
3. Explain methods of ensuring community health safety and preparedness.
4. Discuss the policy process for improving the health status of populations.
HLTH 509 - Social and Behavior Theory Application
1. Identify social, cultural, and behavioral factors that influence health disparities and
impact population health.
2. Identify basic theories and conceptual models from the social and behavioral disciplines
useful in public health research and practice.
3. Identify individual, organizational, and community concerns, assets, resources, and
deficits for social and behavioral science interventions.
4. Enlist critical stakeholders in the planning, implementation, and evaluation of public
health programs, policies, and interventions.
5. Describe steps and procedures for planning, implementing, and evaluating public health
programs and policies.
6. Apply evidence-based approaches in the development and evaluation of social and
behavioral interventions to address health disparities.
7. Apply ethical principles to public health program planning, implementation, and
evaluation.
8. Examine health behavior from the perspective of God’s purposes for humanity in
creation, fall, and redemption.
HLTH 501/511 – Biostatistics and Research
1. The following table describes the distribution of health rating for a sample of patients:
a. What is the variable described by this table? At what level is this variable measured?
- Health Rating
b. What are the cases that are the units of analysis?
- Good and Poor are the Cases.
c. What is the central tendency of this distribution?
- The Central is towards the poor since it overweight the good (in the table).
2. The following data are ages at death for a sample of people who were all born in the same
year: 12, 34, 42, 48, 50, 54, 55,55,58, 59, 60, 65, 67, 68, 68, 69, 70, 70, 72, 74, 76, 76, 79, 81, 85,
87
a. Why is mode not an appropriate measure of central tendency for these data? - The mode
is not appropriate because it occurs more than once.
b. What is the mean age at death for these data (include the relevant units of measurement
in your answer) - Mean = sum of all values / # of values - Mean = 1634/26 - Mean =
62.85 years
c. Calculate the median age at death for these data - Median = (67+68) / 2 = 67.5
d. Calculate the range for these data -
e. Calculate the interquartile range for these data - Interquartile range = Q3 – Q1 - Q3 =
(74+76) /2 = 75 - Q1 = (54+55) /2 = 54.5 - IQR = 75 -54.5 = 20.5 f.
Based on your calculations write a short description of this distribution - The mode of the
data set is 50, 68, 70 and 76. The mean and median are 62.9 and 67.5 years respectively.
The interquartile range is 20.5.
3. A company is interested in the use-life of its products as an indicator of product quality. It sets
a use-life of 200 hours as the average length of use with which it believes its products should
last. The Quality Control Department randomly samples 120 products and finds the mean
use-life of these to be 203 hours. What will be the appropriate test to see if its products are
produced at the desired sample?
4. If you reject a null hypothesis at the 1% level of significance (that is, alpha = 0.01) will you
also reject it at the 5% level of significance? Why or why not? - No, we can only reject the null
hypothesis if p-value is less than or equal to significance level. Here, if p-value is between 0.05
and 0.01, we will fail to reject null at a = 0.01 even when we reject null at a = 0.05.
Global Health Cognate
1. Discuss the concept of sustainability.
a. Capacity to maintain program services at a level that will provide ongoing
prevention and treatment for a health problem after termination of major financial,
managerial, and technical assistance from an external donor.
2. Differentiate between vertical and horizontal approaches to public health in developing
countries.
3. Discuss the initial steps in assessing a community for basic healthcare needs.
4. Describe direct observational therapy (DOT) for tuberculosis.
5. Distinguish between cultural sensitivity and cultural competence.
6. Discuss high and low context and give an example of a culture for each.
7. How does culture create health disparities?
8. Analyze challenges to overcoming infrastructure disparities in a developing nation.
9. Describe alternative solutions for meeting sanitation needs in developing communities.
10. Demonstrate affordable technologies to provide potable water for communities in need.
11. Describe water-washed and water-borne diseases.
12. Link major vector-borne diseases with the vector.
13. Discuss control of outbreaks of a vector-borne disease.
Health Promotion Cognate
1. It was becoming obvious to many that the suburb of Kingsville now had a drug problem,
but few wanted to admit it. The community’s residents liked their quiet neighborhoods
and most never thought that drugs would be a problem. Within the past year, the climate
of the town had changed considerably. Incidents of teenagers being arrested for
possession of alcohol or even other drugs, such as marijuana, were being reported more
regularly in the newspaper. There seemed to be more reports of burglaries too. There had
even been a robbery and two assaults reported within the last month. The population of
young adults in the community seemed to be increasing, and many of these individuals
seemed to be driving impressive cars, using the hottest new digital devices, and wearing
the latest clothes. All of these signs were obvious to a group of concerned citizens in
Kingsville and suggested the possibility of a drug problem. So the concerned citizens
decided to take their concern to the city council.
Based on what you know about the problem in the scenario, answer the following questions:
a. How would you find out the real problem?
b. Who do you think are the gatekeepers in the community?
c. What groups of people in the community might be interested in solving the
problem?
d. How would you organize these groups of people?
e. What groups might have a vested interest in seeing the problem unsolved?
f. What interventions would be useful in dealing with the problem?
g. How would you evaluate your efforts to solve the problem?
h. What strategies might you recommend to make the solution lasting?
2. The fundamental premise in the Guide to Community Preventive Services’ Social
Environment and Health Model is that access to societal resources determines community health
outcomes.
a. What are societal resources?
b. How do societal resources influence intermediate outcomes and ultimately, health
outcomes
3. Differentiate among the core concepts, models, theories, and strategies related to health
education program planning.
4. Create a program rationale using valid and reliable secondary data.
5. Describe the main health program planning models and behavior change theories.
6. Relate public health program planning strategies to Healthy People 2020.
7. Explain the value of logic models in analyzing the components and desired outcomes/outputs
of a health program/system.
8. Discuss the use and creation of research questions to answer questions using quantitative and
qualitative evaluation techniques, such as value assessments of products, pretest/posttest
measures, ethnographic considerations, cost benefit analysis, etc.
9. List procedures for disseminating the results of evaluations in order to craft future health
programs and to redesign existing ones with augmented ethnographic insights, enhanced
productivity, and improved efficiency.
10. Describe how societal, organizational, and individual factors influence and are influenced by
public health communications.
11. Explain the application of evidence-based approaches in the communication and evaluation
of public health information.
12. Discuss the use of media, politics, agencies and churches to advocate for community health
programs and policies.
13. Discuss acquisition and management of organizational resources.
14. List the human aspects needed to maintain a successful organization.
15. How does one determine the scope and limits to the activities of public health organizations?
Nutrition Cognate
1. A group of football student athletes ask if you would come and speak to their team about
protein and protein supplements for performance. Explain the main points with which
you want this group to walk away.
2. You have been asked to speak to a local woman’s group. They want to know how to <eat
healthy.= Develop a balanced menu for a day and explain the main function of the various
food choices you select.
3. Discuss the following concepts:
a. Variety
b. Moderation
c. Adequacy
d. Balance
e. Complete protein sources
f. Incomplete protein sources
4. Discuss carbohydrates as a source of fuel
5. Distinguish between the following types of fat/lipids, their origin and their implications
for health: Saturated fat, Unsaturated (poly and mono),Trans-fat, Cholesterol, and
Essential Fatty Acids
6. A fellow student learned that you are studying nutrition and told you he/she wants to eat
more healthily. What public health education tools would you recommend for him/her to
use? Explain your answer.
7. Throughout this concentration, we have talked about food and eating in light of God’s
word. Expand on how your views of this concept have developed, changed, or stayed the
same.
