Anne Lamott School Lunches From Bird By Bird New York Panthe

Anne Lamott School Lunches From Bird By Bird New York Pantheon

Anne Lamott, “School Lunches,” from Bird by Bird (New York: Pantheon, 1994).

Calculations Problem #1: Fill in the blank spaces in the chart:

Within this assignment, imagine that you have been hired as a new hospital infection control manager and are immediately welcomed by the chief of staff and house super who have grave issues regarding a recent state of nosocomial infections within the facility and they need some assistance determining the statistics related to the prevalence and incidence of the infections to get a better grasp of what clinical and countermeasures need to be taken at the hospital next.

Population = 82,438,000

Cause of Admission | Number of admits | Proportional Case Ratio (%) | Cause-specific rate per 100,000

Accidents and adverse effects | 26,526 | |

Malignant neoplasms | 22,228 | |

HIV infection | 21,747 | |

Diseases of the heart | 15,822 | |

Homicide and legal intervention | 12,372 | |

Suicide | 12,281 | |

Chronic liver disease and cirrhosis | 4,449 | |

Cerebrovascular diseases | 3,343 | |

Diabetes mellitus | 2,211 | |

Pneumonia and influenza | 2,203 | |

Calculations Problem #2: Calculate the Relative Risk:

An uptick in attempted suicides in teen boys has interested the State Health authorities and they are looking for some information on the data the hospital has received in the past calendar year.

The common exposure factor here is a history of parental abuse.

| | Reported Parental Abuse | No Reported Parental Abuse |

| --- | --- | --- |

| Attempted Suicide | 14 | 49 |

| No Attempted Suicide | 9 | 149 |

Calculate the Relative Risk.

Calculations Problem #3: Calculate the prevalence :

You are a physician who practices medicine in HappyVille, a community of 100,000 persons. During 2009, there were 1,000 deaths from all causes. All cases of cardiovascular disease were identified, and they totaled 300. During 2009, there were 60 deaths from cardiovascular disease.

The prevalence of cardiovascular disease in HappyVille in 2009 was:

Calculations Problem #4: Calculate the 10-day cumulative incidence:

Influenza is spread by close contact between an infected person and an uninfected person who has not had the infection and therefore is at risk. Imagine that there are 10 students living on your dorm floor, which is the second floor of the building. One of the students has returned on the evening of Sunday, October 3rd, from a weekend away at a friend’s wedding. On the morning of Tuesday, October 5th, he shows all the typical symptoms of influenza, including a mild fever and sore throat. By the end of the following Sunday, October 10th, four other students on the floor are showing identical symptoms.

What is the cumulative incidence rate for influenza for the period October 1 through October 10 on the second floor of the dorm?

The ten-day cumulative incidence for the second floor of the dorm is:

Calculations Problem #5: Calculate the prevalence per thousand:

125 people out of 5000 have food poisoning. Determine the disease prevalence per 1000 people. (Show your work).

Prevalence per 1000 =

Calculations Problem #6: Calculate the incidence rate:

4,875 healthy people are tracked over a two-year period. Over that two-year period, 75 of those people develop a particular disease. Determine the incidence rate of disease over the study period.

Show all your work.

Calculations Problem #7: Calculate the rate difference and provide an interpretation of the result:

You conduct a study to assess the association of traffic accidents to the use of cellular phones while driving. Your study reveals that per 10,000 miles, the incidence of traffic accidents for people that were using their cellular phones is 11.1; and the incidence of accidents for people not using their cellular phones is 8.6.

Determine the difference between accident rates for people that were driving and using their cellular phone versus those that were not using their phone while driving. Then write a paragraph or two explaining your findings or results.

Calculations Problem #8: Calculate category statistics:

Autism is a disability that is characterized by a severely decreased ability to engage in communication and social interaction. A study was undertaken to establish the prevalence of Autism in a community. Data from this study are reported below:

Children Diagnosed With Autism per Age Group

Age Group | Children With Autism

3–5 | 417

a. Calculate the prevalence rate of autism for the two age categories.

b. Calculate the prevalence to a rate per 1,000.

Calculations Problem #9: Complete the following calculations and provide an explanation of your findings:

A study of hypertension begins with 1,000 men (ages 40–45). Of the 1,000 men, 50 are already hypertensive. The remaining 950 are tracked over a span of five years, during which time 64 additional men develop hypertension.

1. Determine the prevalence of hypertension at the beginning of the study.

2. Calculate the five-year incidence proportion (risk) of hypertension.

3. Calculate the incidence rate of hypertension in the cohort with and without an actuarial adjustment. Did the actuarial adjustment make a difference? Explain your answer.

Calculations Problem #10: Determine if the prevalence will increase or decrease:

Write a few sentences that explain the effect that the following situations would have on a population (assume other dynamics of the population do not change).

1. Immigration of cases (unhealthy persons) into the population.

2. Emigration of cases (unhealthy persons) out of the population.

3. Emigration of healthy persons out of the population.

4. Immigration of healthy persons into the population.

5. Increase in the fatality rate among the cases (unhealthy persons).

Calculations Problem #11: Complete the calculations:

Population Size: 255,078,000

Approximate number of live births: 4,065,014

Number of deaths (all ages): 2,175,631

Approximate number of deaths in infants under 1 year of age: 34,000

1. Compute the birth rate per 1,000.

2. Compute the overall death rate per 100,000.

3. Compute the infant mortality rate per 1,000.

Calculations Problem #12: Review the chief resident’s conclusion on the following data and make a comment regarding the validity of the conclusion (include reasons why or why not):

Your local hospital reports some data on accidents presenting in their emergency room and has broken down the data for 82 patients who have presented to the emergency department in the past year (use the following table):

| Age in Years | Number of Accidents |

| --- | --- |

| 0–5 | 21 |

| 6–14 | 24 |

| 15–24 | 17 |

| 25–44 | 12 |

| 45–64 | 5 |

| 65+ | 3 |

Based on this data, the chief resident has concluded that “the data concludes that the age group containing persons age 62 and older are the most prone to accidents. The category that holds the second greatest risk is 6–14 year olds.”

Comment on the chief resident’s misinterpretation of the data.

Calculations Problem #13: The following vital statistics are demonstrated within a population:

Total mid-year population = 25,000.

Population 65+ years old = 2,500.

Number of live births = 300.

Total deaths (for all causes) = 250.

Deaths in infants less than 1 year old = 3.

Deaths in persons 65+ years old = 75.

Complete the following calculations:

1. Calculate the birth rate per 1,000.

2. Calculate the mortality rate per 1,000.

3. Calculate the infant mortality rate per 1,000.

4. Calculate the mortality rate for 65+ years old per 1,000.

Calculations Problem #14: Calculate the odds ratio of neural tube defects in pregnant women taking folic acid as a supplement. Interpret your findings:

| | Neural Tube Defect (+) | Neural Tube Defect (-) | Total |

| --- | --- | --- | --- |

| Folic Acid (+) | | 713 | |

| Folic Acid (-) | | 157 | |

| Total | | | |

---

Sample Paper For Above instruction

The provided assignment encompasses an extensive series of epidemiological and biostatistical calculations across diverse health scenarios, including hospital infection data, risk assessments related to parental abuse and suicide, community prevalence and incidence rates, and demographic statistics. This comprehensive analysis demands both competence in quantitative methods and an understanding of public health principles.

Introduction

In epidemiology, quantitative measures such as prevalence, incidence, relative risk, and odds ratios serve as cornerstones for understanding disease dynamics, informing clinical decisions, and shaping public health policies. Accurate calculation and interpretation of these measures enable health professionals to identify risk factors, monitor disease trends, and evaluate intervention effectiveness. The following analysis systematically addresses the stipulated problems, illustrating practical application of epidemiological concepts through real-world scenarios.

Calculations and discussions

Problem #1: Hospital Infection Statistics

The first task involves completing a chart with detailed statistics on hospital admissions for various causes within a population of 82,438,000. To fill in the 'Cause-specific rate per 100,000,' one applies the formula: (Number of admits / Population) x 100,000. For example, for accidents and adverse effects: (26,526 / 82,438,000) x 100,000 ≈ 32.2 per 100,000. Similarly, calculations for other causes follow the same formula, providing context for hospital infection control priorities.

This data aids in identifying leading causes of admissions and understanding their relative frequencies, thereby guiding targeted interventions.

Problem #2: Relative Risk Calculation

The second scenario assesses the association between parental abuse and attempted suicide among teens. The relative risk (RR) is computed as the incidence among exposed divided by the incidence among unexposed: RR = (14/23) / (49/198). Calculating numerator: 14 / (14 + 9) = 14 / 23 ≈ 0.6087; denominator: 49 / (49 + 149) = 49 / 198 ≈ 0.2475. Thus, RR ≈ 0.6087 / 0.2475 ≈ 2.461. An RR greater than 1 indicates that parental abuse is associated with a higher risk of attempting suicide.

Problem #3: Prevalence Calculation

The prevalence is calculated as the number of existing cases divided by the total population at a specific time. With 300 cases of cardiovascular disease out of 100,000 residents, prevalence = (300 / 100,000) x 100 = 0.3%. The proportion of deaths from cardiovascular causes (60) among total deaths (1,000) highlights the disease's impact within the community.

Problem #4: Cumulative Incidence

The cumulative incidence rate over ten days involves counting new cases occurring in a population at risk during this period. The original at-risk population is 10 students. One develops influenza on October 5th, and four more develop symptoms by October 10th. Since the initial case is known, the number at risk after October 3rd is 9. The total new cases over 10 days are 4. The cumulative incidence is calculated as (Number of new cases / Population at risk at start) x 1000 = (4 / 10) x 1000 = 400 per 1000 students.

Problem #5: Prevalence per Thousand

Prevalence per 1000 = (Number of cases / Population) x 1000. With 125 cases in a population of 5000, prevalence per 1000 = (125 / 5000) x 1000 = 25 per 1000.

Problem #6: Incidence Rate

The incidence rate is calculated as (Number of new cases / Person-time at risk). Over 2 years, tracking 4,875 individuals with 75 incident cases, the incidence rate per person-year = 75 / (4875 x 2) = 75 / 9750 ≈ 0.00769 per person-year.

Problem #7: Rate Difference and Interpretation

The rate difference is 11.1 - 8.6 = 2.5 accidents per 10,000 miles. This indicates that using a cellular phone while driving increases the accident rate by approximately 2.5 accidents per 10,000 miles driven. It underscores the heightened risk associated with distracted driving, emphasizing the need for policies limiting phone use.

Problem #8: Category Statistics for Autism

a. Prevalence in age group 3–5: (417 / total population in that group) x 100; b. Rate per 1,000: (Number of autistic children / total children in group) x 1,000. Precise calculations depend on the total number of children in each age group, which, if known, allows for tailored prevalence estimates.

Problem #9: Hypertension Study

Prevalence at baseline = (50 / 1000) x 100 = 5%. Incidence proportion over 5 years: (64 / 950) ≈ 6.74%. Incidence rate calculations involve dividing incident cases by person-time, adjusting for at-risk periods. The actuarial adjustment refines the rate by accounting for differential risk exposure times.

Problem #10: Effect on Prevalence

Immigration of unhealthy individuals increases prevalence by adding cases, while emigration of such cases decreases it. Conversely, emigration of healthy individuals reduces prevalence, whereas immigration of healthy persons might dilute it. An increase in the fatality rate among cases tends to decrease prevalence over time by reducing the number of surviving cases.

Problem #11: Demographic Rates

Birth rate per 1000 = (Number of live births / Population) x 1000 = (4,065,014 / 255,078,000) x 1000 ≈ 15.94 per 1000.

Overall death rate per 100,000 = (2,175,631 / 255,078,000) x 100,000 ≈ 852.88 per 100,000.

Infant mortality rate per 1000 = (34,000 / 4,065,014) x 1000 ≈ 8.36 per 1000.

Problem #12: Data Interpretation and Validity of Conclusions

The data shows the distribution of accidents across age groups, with 21 in 0–5, 24 in 6–14, 17 in 15–24, 12 in 25–44, 5 in 45–64, and 3 in 65+. The resident’s conclusion that persons 62 and older are most prone is inaccurate because the data for the 65+ group is only 3 incidents, which is the lowest. The greater number in the 6–14 group (24 incidents) indicates this subgroup has a higher relative risk compared to older adults. The conclusion likely misinterprets raw counts as indicative of risk without considering population sizes within each group, a common statistical error leading to incorrect assumptions.

Problem #13: Vital Statistics and Population Dynamics

Birth rate per 1,000 = (300 / 25,000) x 1000 = 12 per 1000.

Mortality rate per 1000 = (250 / 25,000) x 1000 = 10 per 1000.

Infant mortality rate per 1000 = (3 / 300) x 1000 = 10 per 1000.

Mortality rate for 65+ years old = (75 / 2500) x 1000 = 30 per 1000.

Problem #14: Odds Ratio in Neural Tube Defects

Constructing a 2x2 table and calculating the odds ratio yields: (713 / (total with defect and folic acid)) divided by (157 / (total without defect and folic acid)). Assuming totals are known, the OR > 1 would suggest folic acid reduces neural tube defects, indicating a protective effect. Precise computation requires complete data, but the interpretation generally supports folic acid supplementation as beneficial during pregnancy.

Conclusion

This comprehensive exercise emphasizes the importance of accurate calculations and cautious interpretation in epidemiology and public health. Understanding these statistical measures enables health professionals to identify at-risk populations, evaluate interventions, and formulate policies effectively, ultimately contributing to improved health outcomes across communities.

References

• Katz, S. L. (2019). Epidemiology: An Introduction. Oxford University Press.
• Gordis, L. (2014). Epidemiology. Elsevier Saunders.
• Last, J. M. (2001). A Dictionary of Epidemiology. Oxford University Press.
• Rothman, K. J., Greenland, S., & Lash, T. L. (2008). Modern Epidemiology. Lippincott Williams & Wilkins.
• Thacker, S. B., et al. (2012). Public Health Surveillance and Epidemiology. Oxford University Press.
• Porta, M. (2014). A Dictionary of Epidemiology. Oxford University Press.
• Schneider, J. (2018). Biostatistics in Public Health. Jones & Bartlett Learning.
• World Health Organization. (2019). Global Report on Diabetes. WHO Press.
• CDC. (2020