Essentials of Epidemiology in Public Health

Question: Discuss about the Essentials of Epidemiology in Public Health? Answer: Solution 1 The exposures of interest considered in this study are total fat intake, Saturated fat intake, monounsaturated fat intake, polyunsaturated fat intake and trans-fat intake (Oh, 2005). Inorder to ascertain dietary information, a questionnaire was used. They were updated in 1986, 1990, 1994 and 1998. A rational determination of total fat and specific types of fat was made in this study (Nelson, 2009). The study results are found to be consistent with other studies. The results of the study clearly give the information about the effect of dietary intake on CHD risk (Nelson, 2009). Blood lipid levels are not measured in the study and this is another limitation of the study (Oh, 2005). Solution 2 Myocardial infarction (nonfatal) or Coronary heart disease (fatal) was the outcome measured. In the case of nonfatal MI, the medical records were collected for reporting women. Deaths from fatal CHD were recognized by the US postal system or from the National Death Index (Oh, 2005). The results of the study are evidenced to be consistent with several other studies (Oh, 2005). Change in diet was one of the factors responsible for evidence of decline in CHD incidence (Oh, 2005). Solution 3 The source population of the study is 30-55 aged female nurses. The target population does not differ from the source population (Oh, 2005). The results are analyzed evidently in the population by the age of 65 years or younger and with age above 65 (Oh, 2005) In, the elderly population, the study results were influenced by factors like an increase in intensity of chronic diseases or weakened health status or change in metabolism with aging (Oh, 2005). Solution 4 In 1976 the study was started with 1,21,700 female nurses whose age is 3055 years. The participants who returned the 1980 questionnaire were included in the study and participants with cardiovascular disease, cancer, improbable intake of energy, diabetes, cancer, hypercholesterolemia was excluded from the study. So after exclusions, 78,778 women were studied (Oh, 2005). Solution 5 The risk measures calculated in the study are age, smoking, BMI, alcohol intake, history of menopausal state, hormone use, hypertension, MI, use of aspirin, Vitamin E, multivitamin, physical activity and intake of fat; fatty acids; fruits, vegetables and fiber(Taylor Zahradka, 2013). Solution 6 The incidence of various diseases may change the diet of women and hence are excluded from the study. But Excluding such women didnot affect the study results (Oh, 2005). Solution 7 The overall motor vehicle-related mortality risk is 1.8%. Solution 8 (100/2000)*100 = 5% (80/8000)*100 = 1% (100/10,000) * 100 = 1 % Solution 9 (45/300)*100 = 15% (135 /7000)*100 = 1.9% (45/10000) *100 = 0.45% Solution 10 The cumulative incidence ratio of death by driving speed is 1%, and the cumulative incidence ratio of death by DWI status is 0.45 %. The values indicate that death by speed is very high in comparison to death by DWI status. Solution 11 1900-100 = 1800 255-45 = 210 Solution 12 A direct relationship was observed between trans-fat and CHD, whereas inverse relation was observed between CHD and polyunsaturated fat. In women aged less than 65 the results were evidenced to be more prominent and relevant. Among women with a higher BMI, the risk of CHD was increased with intake of Polyunsaturated fat intake. Solution 13 (180/10000) * 100 = 1.8 % (180/10000)*100 = 1.8% Solution 14 Mortality risk = (180/10000) * 100= 1.8%. Solution 15 {(5-1)/5 } * 100 = 80 % {(15-1.9)/15} * 100 = 87.33 % Solution 16 Mortality risk = (180/10000) * 100= 1.8%. Solution 18 Inorder to eradicate motor related deaths, the funding should be allocated equally to two risk factors. The speed limit should be strictly monitored and drive while intoxicated should be severely penalized. References Ndrepepa, G. (2015). BMI and coronary heart disease: no difference according to sex. The Lancet Diabetes Endocrinology, 3(6), 398-400. https://dx.doi.org/10.1016/s2213-8587(15)00103-5 Nelson, G. (2009). Dietary Fat, Trans Fatty Acids, and Risk of Coronary Heart Disease.Nutrition Reviews, 56(8), 250-252. https://dx.doi.org/10.1111/j.1753-4887.1998.tb01758.x Oh, K. (2005). Dietary Fat Intake and Risk of Coronary Heart Disease in Women: 20 Years of Follow-up of the Nurses' Health Study. American Journal Of Epidemiology, 161(7), 672-679. https://dx.doi.org/10.1093/aje/kwi085 Sedgwick, P. (2010). Incidence rate ratio.BMJ, 341(sep08 1), c4804-c4804. https://dx.doi.org/10.1136/bmj.c4804 Taylor, C., Zahradka, P. (2013). Do high dietary intakes of linoleic acid protect against death from coronary heart disease and cardiovascular disease?.Clinical Lipidology, 8(5), 493-495. https://dx.doi.org/10.2217/clp.13.48 Uhry, Z., Belot, A., Colonna, M., Bossard, N., Rogel, A., Iwaz, J. et al. (2013). National cancer incidence is estimated using the incidence/mortality ratio in countries with local incidence data: Is this estimation correct?.Cancer Epidemiology, 37(3), 270-277. https://dx.doi.org/10.1016/j.canep.2012.12.007