Navajo Birth Cohort

Read these articles before answering the questions about the Navajo Birth Cohort study; http://nbcs.healthyvoices.org/?page_id=19. https://www.atsdr.cdc.gov/sites/navajo_birth_cohort_study/ https://www.sph.emory.edu/departments/eh/documents/HunterJEHColumnAugust2015.pdf this one choose the PDF. Please read the articles before answering them and understand the questions 1. What is the question that this study wants to answer? 2. How did this study come about? 3. What makes this a cohort study as compared to a case control survey? 4. Describe the participants in the study 5. What are 3 potential challenges to conducting this study? 6. What are 3 strategies that are being implemented to ensure the study is a success? 7. Since you are conducting a cohort study, you will calculate what measure? Odds Ratio Prevalence Relative Risk 8. The data collected by your team yield the following information: (This is not true data.) Number of cases of children with developmental delays among those born to mothers who lived within 20 miles from an uranium mill during her pregnancy – 74 Number of cases of children with developmental delays among those born to mothers who lived more than 20 miles from an uranium mill during her pregnancy- 120 Total number of exposed children - 1,900 Low Risk: Mothers who lived within 20-11 miles of an uranium mill during her pregnancy - 1,000 Medium Risk: Mothers who lived within 10-4 miles of an uranium mill during her pregnancy- 650 High Risk: Mothers who lived within 1-5 miles of an uranium mill during her pregnancy- 250 Total number of unexposed individuals - 7,400 Answer the following question: How would you present the data for all the individuals in a 2x2 table? 9. Use the information in question 8 to answer the following question: Calculate the risk of disease among the exposed. 10. Use the information in question 8 to answer the following question: Calculate the risk of disease among unexposed. 11. Use the information in question 8 to answer the following question: Calculate relative risk. 12. Use the information in question 8 to answer the following question: Interpret your findings. Use the following information to answer the questions below. 13. Use the following information to answer the questions below. In the preceding example, you estimated the magnitude of risk due to exposure by comparing those with exposure to those without exposure. However, the exposure data could be characterized more accurately by dividing into three exposure categories, i.e., low, medium and high exposure. If the risk increases with the increase in exposure level, then one can conclude that there is a dose-response relationship in the data, i.e. biological dose gradient. The presence of the dose-response relationship strengthens our conviction that the relationship is causal. Answer the following question: • Calculate risk in the three exposure groups using the following data: Level of Exposure Disease + Disease - Total Low 20 980 1000 Medium 30 620 650 High 24 226 250 Unexposed 120 7280 7400 14. Referring to the information and results from question 13, answer the following question: What do the results tell you? 15. Referring to the information and results from question 13, answer the following question: Propose a new study to investigate the relationship between exposure to uranium during pregnancy and birth outcomes. Formula http://sphweb.bumc.bu.edu/otlt/MPH-Modules/EP/EP713_Association/EP713_Association3.html https://www.cdc.gov/ophss/csels/dsepd/ss1978/lesson3/section5.html RR= le/lo Attributable risk percent : AR%=(le-l0 /le)* 100 =[(RR-1) /RR] *100 for disease case that are exposed, this statistic refers to the percentage of disease cases attributed to their exposure. (interpretation) Population attributable risk : PAR=lt -lo Interpretation ( the excess risk of disease in the population attributed to the exposure, typically expressed per 10n.) Population attributed risk percent: l_t=(l_t- l_o) /l_t*100. Interpretation ( Percentage of the disease in the population that can be attributed to the exposure.) Cumulative Incidence rate in the exposed group : le =[a/(a+b)] *10n Interpretation ( attack rate “risk” of the health -related state or event for those exposed.) Cumulative incidence rate in the exposed group : lo=[c/(c+d)] *10n . Interpretation ( Attack rate “risk” of the health -related state or event for those unexposed.) Cumulative incidence in the total group : lt=[(a+c)/n]*10n . Interpretation ( attack rate (risk) of the health -related state or event.)                                                                                                                                                              

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