# Discussion: Non-invasive screening test

Discussion: Non-invasive screening test

Discussion: Non-invasive screening test

· Question 1

0 out of 2 points

What is the most appropriate graphical display for an ordinal variable?

· Question 2

2 out of 2 points

A new non-invasive screening test is proposed that is claimed to be able to identify patients with impaired glucose tolerance based on a battery of questions related to health behaviors. The new test is given to 75 patients. Based on each patient’s responses to the questions they are classified as positive or negative for impaired glucose tolerance. Each patient also submits a blood sample and their glucose tolerance status is determined. The results are tabulated below.

Screening Test Impaired Glucose Tolerance Not Impaired
Positive 17 13
Negative 8 37

What is the sensitivity of the screening test?

Discussion: Non-invasive screening test

· Question 3

2 out of 2 points

Which of the following is true concerning confounding?

Discussion: Non-invasive screening test

· Question 4

0 out of 2 points

With a binomial distribution with n = 25 and p = 0.48, which is larger?

· Question 5

0 out of 2 points

An experiment is designed to investigate the impact of different positions of the mother during ultrasound on fetal heart rate. Fetal heart rate is measured by ultrasound in beats per minute. The study includes 20 women who are assigned to one position and have the fetal heart rate measured in that position. Each woman is between 28 and 32 weeks gestation.

Source of variation Sums of Squares (SS) Degrees of Freedom (df) Mean Squares (MS) F F Critical
Between treatments 96.2 3 32.1 4.7 3.24
Error or residual 110.8 16 6.9

Total 207.0 19

Discussion: Non-invasive screening test
Based on the ANOVA results above which of the following is the correct conclusion?

Discussion: Non-invasive screening test

· Question 6

2 out of 2 points

The following are advantages of a prospective cohort study, except:

· Question 7

2 out of 2 points

Five hundred people are enrolled in a 10-year cohort study. At the start of the study, 50 have diagnosed CVD. Over the course of the study, 40 people who were free of CVD at baseline develop CVD. What is the cumulative incidence of CVD over 10 years?

· Question 8

0 out of 2 points

The following are HDL levels measured in healthy females. 60 63 60 58 60 70 54 72 80 75 78 77 Calculate the mean

· Question 9

2 out of 2 points

Which of the following measures is least affected by extreme or outlying values in a dataset?

· Question 10

2 out of 2 points

A simple random sample of 25,000 individuals are surveyed to determine the prevalence of individuals that contracted the flu in the past year. Assuming 4,250 individuals indicated they had been diagnosed with the flu at some point in the past year, what is the prevalence of flu for the past year, as indicated from the survey participants?

· Question 11

2 out of 2 points

The first large-scale use of DDT occurred in Italy in 1943 when the insecticide was used for dusting refugees in a successful attempt to prevent an outbreak of a deadly disease spread by body lice which frequently occurs under wartime conditions of overcrowding and poor sanitation. What disease did DDT prevent in this situation?

Discussion: Non-invasive screening test

· Question 12

2 out of 2 points

Why is radon gas in homes considered a problem?

Discussion: Non-invasive screening test

· Question 13

2 out of 2 points

The limit beyond which an environment cannot support a population is called its:

· Question 14

0 out of 2 points

Which of the following statements about noise is false?

· Question 15

2 out of 2 points

Which of the following foodborne diseases is particularly worrisome to public health officials because the pathogen involved can grow quite well at temperatures considerably lower than those within the “Danger Zone”?

Discussion: Non-invasive screening test

· Question 16

0 out of 2 points

Health consequences of secondhand tobacco smoke have been persistently observed. There is biological plausibility of exposure to secondhand smoke causing adverse neurodevelopmental effects in children whose parents smoke. Which of the following statements is (are) accurate concerning the health effects of secondhand smoke?

Discussion: Non-invasive screening test

· Question 17

0 out of 2 points

Transport is the dominant means of air pollution in urban areas. Which of the following is a (are) known source(s) of air pollution that has been associated with transport?

· Question 18

2 out of 2 points

Which waterborne disease that is caused by a protozoan present in the intestinal tract of both humans and wild animals may occur among campers in wilderness areas who unwittingly swallow pathogenic cysts when they drink unfiltered water from mountain streams?

Discussion: Non-invasive screening test

· Question 19

2 out of 2 points

About ranges of tolerance for limiting factors, which of the following population groups is most sensitive to adverse environmental conditions?

Discussion: Non-invasive screening test

· Question 20

2 out of 2 points

Lyme disease is a newly recognized ailment transmitted by the bite of which of these pests?

· Question 21

2 out of 2 points

The major disadvantage of crude rates is that:

· Question 22

2 out of 2 points

Based on the following data, what is the most likely infective food that caused illness?

People Who Ate Food People Who Did Not Eat
Food Sick Well Sick Well
Herring 200 800 100 900
Oysters 300 700 400 600
Spinach 200 800 500 500
Chicken 650 350 100 900

· Question 23

2 out of 2 points

A total of 850 insulation workers employed between 1940 and 1945 was identified from the personnel records of three large insulation manufacturing plants in the Midwestern U.S. in 1980. During the period 1940-1980, 28 deaths from lung cancer were discovered among the workers. Only eight lung cancer deaths, however, were reported among a comparable group of 800 coworkers who did not work with insulation during the same time period. The investigators had hypothesized that exposure to the insulation material increases the risk of lung cancer. Which epidemiology study design best represents this description?

· Question 24

2 out of 2 points

A major health insurance company is considering nationwide implementation of a test using biomarkers to screen for colon cancer. The test is delivered in health clinics in two similar regions of the country, with the following results:

Region A Region B
Sensitivity 73% 84%
Specificity 86% 97%

What is the most likely cause of the difference in the test’s sensitivity and specificity between the two regions?

· Question 25

0 out of 2 points

In women with deep venous thrombosis (DVT), a case-control study was conducted to test the association between DVT and past exposure to oral contraceptive (OC) use. Based on the data below, what is the unadjusted odds of exposure to OC use among the cases of women with DVT compared to that among the controls without DVT? Oral Contraceptive Use Cases of DVT Controls Yes 67 23 No 108 152 Total 175 175

· Question 26

2 out of 2 points

Examples of descriptive epidemiologic studies do not usually include:

· Question 27

0 out of 2 points

An investigator wants to assess whether smoking is a risk factor for bladder cancer. Electronic medical records at a city hospital will be used to identify one hundred patients with pancreatic cancer. Two hundred patients who are similar but free of bladder cancer will also be selected. Each participant’s medical record will be analyzed for smoking history. Which of the following is not true about this study?

· Question 28

2 out of 2 points

Which of the following measures of disease burden is determined from a screening test?

· Question 29

2 out of 2 points

In a clinical trial, an important aspect of the study design often involves the subjects not being aware of their group assignment with regard to treatment or placebo; this technique is used to alleviate bias in study results and is known as:

· Question 30

0 out of 2 points

A new screening test for Lyme disease is developed for use in the general population. The sensitivity and specificity of the new test are 65% and 75%, respectively. Four 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 15%. Calculate the predictive value of a positive test.

· Question 31

0 out of 2 points

While some skills overlap, it is commonly agreed that leadership and management are distinct functions that require different skill sets. This is true in public health as well as in private industry. You are the director of a large voluntary health agency. Which one of the following activities are you likely to perform in your role as the leader of the organization? (Note: differentiate this activity from those normally performed by managers.)

· Question 32

0 out of 2 points

Which of the following national public health interventions for the primary prevention of tobacco use is likely to have the greatest effect?

· Question 33

2 out of 2 points

When you are working to identify social determinants of maternal health in a priority population, you are primarily operating in the essential public health service area of:

· Question 34

2 out of 2 points

The epidemiologic transition of mortality from communicable to noncommunicable diseases that occurred in the 18th-19th centuries, was mainly the result of widespread application of

· Question 35

2 out of 2 points

A sentinel health event is one in which public health alarm is triggered by:

· Question 36

0 out of 2 points

Ancient Israel’s health code, as stated in the biblical book of Leviticus, is an example of an __________ intervention at the community level.

· Question 37

2 out of 2 points

Your community health coalition is applying for a grant to address social determinants of health in your neighborhood. Which of the following would not be appropriate to include in the application because it is not an example of a social determinant of health?

· Question 38

2 out of 2 points

You are the recreation director at a large inner city. You notice a dramatic drop in attendance in a usually popular aerobics class shortly after hiring a new instructor. You interview the dropouts who inform you they don’t like the calisthenics-like exercise routines the new instructor, a former Marine Corps PT trainer, uses in the class. This is an example of what type of program evaluation?

· Question 39

0 out of 2 points

Geographical Information System (GIS) mapping has become an indispensable tool in public health needs assessment and intervention evaluation. It typically analyzes and integrates all of the following types of data into a digital display except:

· Question 40

0 out of 2 points

In an attempt to increase diversity in your local public health department workforce you decide to obtain more information from candidates than merely their skills and experience. Which of the following questions can you legally ask in a face-to-face job interview when the information is not provided on the application?

· Question 41

0 out of 2 points

Which of the following theoretical models is likely to help the most in moving an innovation across the social chasm defined in diffusion theory?

· Question 42

2 out of 2 points

To be a culturally competent public health professional with a diverse priority population, you must:

· Question 43

2 out of 2 points

Sam wants to maintain a consistent practice of Bible study and prayer. He has tried doing regular devotions a few times, but just can’t seem to stay with them. He is now looking for study resources that might help in stay on track. Which stage of the Transtheoretical Model of Change is Sam in?

· Question 44

2 out of 2 points

You wish to expand a new exercise program offered as part of the women’s ministry of your church. The most effective communication channel to influence attitudes about participating is:

· Question 45

2 out of 2 points

You are planning a weight control program in your church. You have assessed the need and interest; you have identified program goals and outcomes; you have selected resources and materials; all you have left to do is plan the evaluation. You choose several measures of process evaluation, some of which are listed below. Which one of the following would not be a measure of process evaluation for the program?

· Question 46

0 out of 2 points

“Upstream” public health interventions are typically more effective than “downstream” ones in mitigating a health problem. All but one of the following are examples of “upstream” public health approaches. Which one is it?

· Question 47

2 out of 2 points

You are a health counselor in an employee wellness program. In your intake interviews with employees joining the program, you identify many cigarette smokers who have never seriously considered quitting. Which of the following theoretical frameworks would be most effective in moving them from the precontemplation to contemplation stage of the Transtheoretical Model of Change?

· Question 48

2 out of 2 points

Which one of the following is associated with the PROCEED stage of the PRECEDE-PROCEED Model?

· Question 49

0 out of 2 points

You are a health educator in a local public health agency. The principal of a local high school has noticed an increase in cigarette smoking among its students and has appealed to the county school board for help. At a school board meeting, the superintendent asks you for ideas on how to mitigate the problem. One week later you submit your suggestions, all of which are shown in the responses below. Which of these is most likely to have the greatest deterrent effect on smoking among students in the high school?

· Question 50

2 out of 2 points

An investigator is interested in a behavioral intervention that will increase self-efficacy in participants. In which of the following conditions will self-efficacy be an effective intervention tool in reducing risky behavior and maintaining healthful behavior?

Exam 3

· Question 1

0 out of 2 points

A study is run to estimate the mean Systolic Blood Pressure level in adults 60 to 80 years of age. A sample of 10 participants is selected and their Systolic Blood Pressure levels are measured as follows. 125 135 160 146 135 140 154 170 110 140 Compute Quartiles 1 and 3

· Question 2

0 out of 2 points

Which of the following is true about a positively skewed distribution of data?

· Question 3

0 out of 2 points

Which of the following types of bias is most commonly associated with a case-control study?

· Question 4

0 out of 2 points

What is the most appropriate graphical display for an ordinal variable?

· Question 5

2 out of 2 points

A new non-invasive screening test is proposed that is claimed to be able to identify patients with impaired glucose tolerance based on a battery of questions related to health behaviors. The new test is given to 75 patients. Based on each patient’s responses to the questions they are classified as positive or negative for impaired glucose tolerance. Each patient also submits a blood sample and their glucose tolerance status is determined. The results are tabulated below.

Screening Test Impaired Glucose Tolerance Not Impaired
Positive 17 13
Negative 8 37

What is the false positive fraction of the screening test?

· Question 6

2 out of 2 points

A researcher suspects that the actual prevalence of generalized anxiety among children and adolescents is higher than the previously reported prevalence of generalized anxiety disorder among children and adolescents. The previously reported prevalence of generalized anxiety disorder among children and adolescents is 3.9%, and the researcher conducts a study to test the accuracy of the previously reported prevalence of generalized anxiety disorder by recruiting 98 children and adolescents from various pediatricians’ offices and tests them for generalized anxiety disorder using the DSM-5. The researcher determines that the prevalence of generalized anxiety disorder among the participants of the study is 6.1%. For a level of significance of 5%, what should the researcher’s decision rule look like?

· Question 7

2 out of 2 points

What is the first summary statistic for a continuous variable?

· Question 8

0 out of 2 points

The following are advantages of a prospective cohort study, except:

· Question 9

0 out of 2 points

A school district has a population of 2,000 students. A researcher intends to select a small sample of these students for a study on physical activity. Using a simple random sampling technique, what is the probability that any of the students in the school is selected into the sample?

· Question 10

2 out of 2 points

Multiple logistic regression analysis applies when there is a single dichotomous outcome and more than one independent variable.

· Question 11

2 out of 2 points

About ranges of tolerance for limiting factors, which of the following population groups is most sensitive to adverse environmental conditions?

· Question 12

2 out of 2 points

Which of the following would be a likely target of public health efforts to control breeding of the Asian tiger mosquito?

· Question 13

2 out of 2 points

Long-term, low-level exposure electromagnetic fields may cause adverse health effects via “chronic” health impacts, or otherwise influence people’s wellbeing. Scientific knowledge about the health effects of electromagnetic fields is substantial and is based on a large number of epidemiological, animal, and in vitro studies. Many health outcomes have been examined. Which of the following health outcomes have been consistently linked with electromagnetic fields?

· Question 14

2 out of 2 points

Why is radon gas in homes considered a problem?

· Question 15

2 out of 2 points

Transport is the dominant means of air pollution in urban areas. Which of the following is a (are) known source(s) of air pollution that has been associated with transport?

· Question 16

0 out of 2 points

Which of the following is not one of the basic steps involved in risk assessment?

· Question 17

0 out of 2 points

Dioxin is chemically related to polychlorinated biphenyls (PCBs) and other chlorinated hydrocarbons. All the following are correct about dioxins, except:

· Question 18

2 out of 2 points

In the food chain, which of the following is a (are) producer(s)?

· Question 19

2 out of 2 points

Lyme disease is a newly recognized ailment transmitted by the bite of which of these pests?

· Question 20

2 out of 2 points

Cigarette smoking is the most common cause of lung cancer. The second leading cause of lung cancer is:

· Question 21

2 out of 2 points

An investigator wants to assess whether smoking is a risk factor for bladder cancer. Electronic medical records at a city hospital will be used to identify one hundred patients with pancreatic cancer. Two hundred patients who are similar but free of bladder cancer will also be selected. Each participant’s medical record will be analyzed for smoking history. Which of the following is not true about this study?

· Question 22

0 out of 2 points

In women with deep venous thrombosis (DVT), a case-control study was conducted to test the association between DVT and past exposure to oral contraceptive (OC) use. Based on the data below, what is the unadjusted odds of exposure to OC use among the cases of women with DVT compared to that among the controls without DVT? Oral Contraceptive Use Cases of DVT Controls Yes 67 23 No 108 152 Total 175 175

· Question 23

0 out of 2 points

In the following table, which value represents “false positives” in a screening test for diabetes?

Condition According to Gold Standard (True Diagnosis)
Screening Test Result Positive Negative Total
Positive 240 25 265
Negative 15 220 235
Total 255 245 500

· Question 24

2 out of 2 points

An outbreak due to exposure of a group of persons to the same harmful influence common to the individuals in the group is known as:

· Question 25

0 out of 2 points

Which screening measure best represents the following statement? Eighty percent of those with diabetes had a positive screening test.

· Question 26

2 out of 2 points

Based on the following data, what is the most likely infective food that caused illness?

People Who Ate Food People Who Did Not Eat
Food Sick Well Sick Well
Herring 200 800 100 900
Oysters 300 700 400 600
Spinach 200 800 500 500
Chicken 650 350 100 900

· Question 27

0 out of 2 points

A new screening test for Lyme disease is developed for use in the general population. The sensitivity and specificity of the new test are 65% and 75%, respectively. Four 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 15%. Calculate the predictive value of a negative test.

· Question 28

0 out of 2 points

In a case-control study of osteoporosis, 150 women were enrolled as cases and an equal number as controls. Among the cases 50 reported low calcium intake, while only 20 of the controls reported low calcium intake. Calculate the odds ratio in the association between low calcium intake and developing osteoporosis in this population.

· Question 29

2 out of 2 points

The capacity of an agent to enter and multiply in a susceptible host and thus produce infection or disease is:

· Question 30

0 out of 2 points

Which of the following measures of disease burden is determined from a screening test?

· Question 31

2 out of 2 points

The Healthy People initiative was introduced in 1979 as a/an:

· Question 32

0 out of 2 points

Which of the following national public health interventions for the primary prevention of tobacco use is likely to have the greatest effect?

· Question 33

2 out of 2 points

The CDC administers a range of programs designed to prevent and control disease, injury, and disability risks on a national level. Which of the following activities does it not typically do?

· Question 34

2 out of 2 points

Your community health coalition is applying for a grant to address social determinants of health in your neighborhood. Which of the following would not be appropriate to include in the application because it is not an example of a social determinant of health?

· Question 35

0 out of 2 points

Given the responsibility to create an effective public health intervention on a limited budget, you start by exploring evidence-based approaches to address your area of interest. Which of the following published sources provides the best, most trustworthy evidence?

· Question 36

0 out of 2 points

You are an MPH student intern in a local church. Part of your assigned tasks is to research the possibility of getting a grant to fund a new Head Start preschool program in the church. You find out the following:

· Question 37

2 out of 2 points

Mobilizing community partnerships to identify and solve health problems is:

· Question 38

0 out of 2 points

Public health infrastructure can be measured in part by:

· Question 39

0 out of 2 points

The FDA functions as the nation’s largest consumer protection agency. Among its activities, it investigates and regulates the efficacy and safety of:

· Question 40

2 out of 2 points

Geographical Information System (GIS) mapping has become an indispensable tool in public health needs assessment and intervention evaluation. It typically analyzes and integrates all of the following types of data into a digital display except:

· Question 41

0 out of 2 points

To be a culturally competent public health professional with a diverse priority population, you must:

· Question 42

2 out of 2 points

An investigator is interested in a behavioral intervention that will increase self-efficacy in participants. In which of the following conditions will self-efficacy be an effective intervention tool in reducing risky behavior and maintaining healthful behavior?

· Question 43

2 out of 2 points

“Upstream” public health interventions are typically more effective than “downstream” ones in mitigating a health problem. All but one of the following are examples of “upstream” public health approaches. Which one is it?

Discussion: Non-invasive screening test

· Question 44

0 out of 2 points

Which aspect of health is not clearly identified in the World Health Organization’s definition of health?

· Question 45

0 out of 2 points

Which one of the following is associated with the PROCEED stage of the PRECEDE-PROCEED Model?

· Question 46

0 out of 2 points

You wish to test the validity of a questionnaire you designed for use with HIV patients attending a self-care educational program. The simplest and most common way to do this is by:

· Question 47

2 out of 2 points

You are planning a weight control program in your church. You have assessed the need and interest; you have identified program goals and outcomes; you have selected resources and materials; all you have left to do is plan the evaluation. You choose several measures of process evaluation, some of which are listed below. Which one of the following would not be a measure of process evaluation for the program?

· Question 48

0 out of 2 points

Which statement and its example is not true about self-efficacy as it relates to behavior change?

· Question 49

0 out of 2 points

Which part of a SMART objective is missing from the following learner outcome statement? Use the ABCDE model to guide your response. “By the end of the class on behavioral theory, students will accurately recall the stages of change in proper order, measured by a quiz.”

· Question 50

0 out of 2 points

You are providing prenatal counseling to a first time pregnant woman who continues to smoke a few cigarettes a day even after completing a stop smoking program. She explains that her mother smoked during all of her pregnancies and she and her siblings turned out fine. Which of the following constructs should be the initial focus of your attention to help motivate mental processing leading to her totally quitting smoking?