Category: Epidemiology

The Gordis text describes the three types of prevention (Table 1.2, page 8, attached in files). Provide two examples of each type of prevention. Do not use the examples included in the table. For each example, describe (1) a population-based approach and (2) a high-risk population approach to each example. 
The book is attached in the files 

For this assignment, you will select an Open Access article on a topic that interests you from the American Journal of Public Health -https://ajph.aphapublications.org/ 
The article that you select should be on original research (not a meta-analysis, systematic review, or policy related) in which a  study was conducted. You will determine the study design and describe components of the study,
For instructions on how to select an open access article it is attached in the files 
Using the information contained within the article that you selected, in a 1 – 2 page documents, answer the following questions. These questions are found on the Study Designs – CEBM websiteLinks to an external site..
1.  What was the aim of the study?
a. To describe a population   descriptive
b. To quantify the relation between factors   analytic.
2A. If analytic, was the intervention randomly allocated?
a.  Yes? RCT
b.  No? Observational study
If your study is an observational study, answer the following question. All students will also respond to Question 4, regardless of the study design of your article.
3. When were the outcomes determined?
a. Some time after the exposure or intervention? cohort study (‘prospective study’)
b.  At the same time as the exposure or intervention? cross sectional study or survey
c.  Before the exposure was determined? case-control study (‘retrospective study’ based on recall of the exposure)
4. What was the research question proposed and evaluated by the researchers?
5.  Describe your study population: provide details about who was selected into the study and if there were any inclusion and/or exclusion criteria.
6. Describe the statistical model or test used to answer the research question (e.g., multiple logistic regression to estimate odds ratios).
7. Describe in 2-3 sentences the results of the study. What did the researchers learn as a result of the study?

Select one of the concepts on statistics covered during this week – I chose descriptive statistics
provide one example of the use of the statistical concept in a peer reviewed article, media article, or other statement found online. Was the concept interpreted and/described correctly? If not, how would you correctly interpret the concept in the article that you selected?

Outbreak Investigation
On February 7, 2018, a nurse employed at the Flinn Corporation noticed an increase in the number of employees who were sick. She was concerned that there may be a Salmonella outbreak at the company. She has interviewed each of the employees at the corporation. She has taken samples and sent them out for testing but has not received the results. She asks you, the local epidemiologist, to investigate to see if an outbreak exists and if so what the source of the outbreak is. You follow the Center for Disease Control and Prevention’s steps in outbreak investigation https://www.cdc.gov/foodsafety/outbreaks/steps/detection.html) and report your findings to her. Please note that we will not address all outbreak investigation steps in this assignment.  Here is an additional resource on epidemiology, https://www.cdc.gov/training/publichealth101/epidemiology.html
Use the attached Excel worksheet to produce graphs and statistics to answer the questions below. Submit your report as a Word doc and include figures and tables you generate. The report should be easy to follow and interpret and should be written as an academic paper in proper APA formatting.  This paper should be 8-10 pages in length (not including the title page, abstract or references.  The paper should also include properly formatted tables and graphs of the data you are given (please refer to the week 7 learning material on formatting tables and graphs), as well as, the data you analyzed.
1. Look at the Excel Spreadsheet attached. There are 3 worksheets (see tabs on bottom of page – “Nurse’s Interview”, “Epi Curve”, “Retrospective Cohort Study”). The first sheet “Nurse’s Interview” has a line list of employees who work at Flinn Corporation. This sheet represents the data the nurse has collected from those employees in an interview. Do you think that an outbreak exists? Why would you recommend to further investigate? Discuss your reasoning. (Step 2: Establish outbreak)
2. Research salmonellosis using academic sources. Are the symptoms that the ill employees exhibit consistent with salmonellosis? Provide a brief summary (1-2 paragraphs) of the disease and discuss the chain of infection for this disease. Use in-text citations in proper APA format and include all sources in your reference section. (Step 3: Verify diagnosis)
3. Identify the percentage of ill employees with each symptom. For example, 1 out of 12 ill employees had blood in stool (Bs) = 8.3%. (Step 4: Working case definition)
4. Conduct descriptive epidemiology (Step 6). Describe the characteristics of the ill employees to determine trends and risk factors.
a. Person – Calculate the percentage of ill employees that are male/female. Determine the mean age of the ill employees.
b. Place – What percentage of ill employees ate at the cafeteria? What percentage of well employees ate at the cafeteria?
c. Time – Using the data collected in the Nurse’s Interview, fill in the column “# of cases” in the “Epi Curve” worksheet. Use 0 if there are no cases. As you fill in the data, the graph will automatically generate. Choose an appropriate title for the graph. Copy and paste graph into your report. What type of epidemic curve is it ? (Hint: read https://www.cdc.gov/foodsafety/outbreaks/steps/detection.html)
5. Based on the information you have gathered, you have developed an hypothesis that there is a food being served at the cafeteria that is causing the employees to become ill. You need to further test this hypothesis by conducting a retrospective cohort study (Step 8). Use the worksheet “Retrospective Cohort Study” to calculate attack rates and risk ratios. The first food item Baked Chicken is done for you. You can also consult https://www.cdc.gov/foodsafety/outbreaks/steps/detection.html for help. Report the Risk ratio for each food item. Based on risk ratios, which is food is most likely to be the source of the illness? Explain.
6. Based on your findings, what would you recommend for prevention and control measures? Apply food safety principles from academic sources to discuss further prevention of Salmonella outbreaks in the cafeteria. (Step 11) Use in-text citations and include sources in reference section.
7. Include a properly formatted reference section in APA format that includes at least 3 academic sources (popular sources should not be used).
8.  Tips for writing your paper:  Include the entire table of risk ratios and attack rates as one table, make sure to include the graph of cases reported, and you can also include the tables from the Nurses interview in the attached Excel file.