1. Managerial epidemiology is integrated through general management functions. Explain each of the management functions in terms of the managerial epidemiology, i.e., what are the: a. Planning functions, example(s)? b. Directing functions, example(s)? c. Controlling functions, example(s)? d. Organizing functions, example(s)? e. Financing function, example(s)? 2. Describe the “natural history of disease” and disease progression from its inception to its resolution. 3. What are some of the many epidemiologic contributions to quality assurance in healthcare and public health? 4. Case Study #1 . Food poisoning outbreak at Bluegrass Hospital An outbreak of food poisoning occurred among the 400 staff and patients at Bluegrass Hospital a few hours after eating dinner. Among the 60 people who became ill, the Symptoms were mainly nausea, vomiting and diarrhea. The infection control nurse investigated the outbreak and reported results in Table 2.5 Below ____________________ Questions: 5 pts each 1. How many times more likely are people who consumed specific food items to get sick compared to those who did not consume each item? 2.. Which food item is the most likely cause of this “common source” outbreak? 3.. What are the incubation period and most likely cause of the outbreak? 5. Case Study #2: Osteoporosis Marketing Plan You are the Director of Community Relations, reporting to the Chief Operating Officer (COO) at Allright Memorial Hospital, Anywhere, USA. You have been asked by your COO to spearhead a community council with local public health officials, who will be focused on women over 50 for the prevention of osteoporosis. Your committee’s strategic plan SWOT analyses revealed the following information. _________ Background: The purpose of this project is to create an intervention prevention program that minimizes osteoporosis in women over 50 and with the health risks associated with the condition for Anywhere, USA. Per the Centers for Medicare and Medicaid (CMS), abstracted from medical claims data, “an estimated 10 million Americans have osteoporosis and 34 million Americans have low bone mass, placing them at an increased risk for osteoporosis. An analysis, using the Anywhere, USA state hospital database shows a slightly higher rate of risk than the national average. The report shows that osteoporosis is responsible for more than 1.5 million fractures annually, including 300,000 hip fractures, 700,000 vertebral fractures, 250,000 wrist fractures, and more than 300,000 fractures of other sites. Osteoporosis can be prevented. Early diagnosis and treatment can reduce or prevent fractures from occurring”. (CMS 2007) The Committee Objectives: 1. To research and identify best community partners and interventions for prevention of high risk osteoporosis residents in Anywhere, USA. 2. To use create a health promotion marketing plan for early bone density screening targeted throughout the Anywhere, USA communities. Targets: At Risk Population for Osteoporosis Age: Postmenopausal woman over ˃＝ 50 years of age Race: Caucasian, Asian, African-American and Hispanic women History: Women who have a family or personal history of fractures after age 50 Health Conditions: Women who have menopause before the age of 45 due to a medical condition or unknown cause. Healh Behaviors: Women who have premature menopause due to anorexia, bulimia, tabacco and alcohol use, or excessive exercise. Nutrient Deficiencies: Calcium and/or vitamin D deficiency Lifestyle: Sedentary, inactive lifestyle Medical Treatements: Steroid (corticosteroids), radiation and/or chemotherapy treatments Source: NIH 2010, Chart: Meyer 2010 ________________ Case Questions: 1. Using reliable primary resources do research and determine who the best community partners, and the most effective interventions for prevention promotion for high risk osteoporosis residents in Anywhere, USA. Your own hospital is one community partner, and it radiology services (bone density machines) are a resource. What other and resources within the community would be appropriate? 2. Create a health promotion marketing plan for early bone density screening targeted throughout the Anywhere, USA communities using the 4-Ps. Your marketing plan also needs a mission statement, a statement of purpose, objectives and timelines of how you will implement the program.

• Describe the ethical issues related to cultural competence.
• Examine the influence of your own personal values as related to the diversity issues presented in this case. Reflect on how you felt as you read the case study, how your values came into play, and how you would handle your values in a situation such as this.

Course Case Study Joe, a thirty-five-year-old, male mental health counselor, received a client referral, thirty-five-year-old Jill, from a community counseling clinic. He began providing counseling services to her. Jill’s complaint was that she was unsatisfied with her current job as a bank teller and was experiencing mild anxiety and depression. Joe had been providing services to Jill for three weeks when she disclosed that she was confused about her sexuality because she experienced sexual attraction toward some women. Joe immediately responded to Jill with wide eyes and a shocked look. He told Jill that he was a traditional Catholic, who felt that this type of feeling was immoral and wrong. He informed her that she should avoid thinking about this and pray for forgiveness. He also told her that he felt uncomfortable talking about the issue any further. Jill continued to talk to Joe about dealing with her family issues. Joe had recently read about a new technique and immediately became excited about trying it. He explained to her that he had read an article in a magazine about a new technique called rebirthing. The new technique was being used in Europe to help people change their views about their relationships with their family. Joe said, “It is supposed to be really effective in almost wiping out your memory of your family; it is like hypnosis.” “I would really like to try it on you today, what do you think?” Jill declined his offer and continued to talk about her family. Joe thought to himself that even though Jill said no, he was still going to try to hypnotize her as they talked because he thought she could benefit from the technique. Jill disclosed that she was raised in a traditional Asian American home with many cultural influences and culture-specific rules and behavior. Jill was struggling with balancing her individualism and her cultural heritage. Joe explained to her that because he was living and working in a rural community, mostly consisting of people of East European descent, he could not relate to Jill’s culture and the issues with which she was struggling. He apologized and explained that he was not required to study these cultural issues because of his geographical location. Jill moved on to talk about her depression. She began talking about feeling lonely and how it contributed to her depression. During a counseling session several months later, she revealed that she was attracted to Joe and would like a closer, intimate relationship with him. Joe, aware that he was also attracted to Jill, talked about his feelings toward her but explained that engaging in a relationship outside the established counseling relationship was unethical. He informed her that because of the mutual feelings of attraction, the counseling relationship would be ineffective and that he would refer her to another counselor for continued services. Jill agreed, and they terminated the counseling relationship. Later, she contacted him to continue counseling and to discuss the referral. Joe agreed to meet her that evening at a restaurant and bring her the referral information. That night they began an intimate sexual relationship. Joe never got around to providing the referral for Jill even though he was aware of her ongoing state of depression and anxiety. Joe stopped seeing Jill after a month of intimate sexual encounters. Joe enjoyed the relationship but felt guilty due to the unethical nature of the relationship. Because of his continued concern about Jill’s depression, Joe considered going to his current clinical supervisor to discuss the case but decided against it. This was because he and his supervisor were good friends and he suspected his supervisor would be hurt by knowing the real reason he had been cancelling get-togethers. Joe decided to call Jill’s boss at the bank to check on her and see how she was doing. He called her boss and explained that he had been counseling her for anxiety and depression and wanted to check if she was Page 2 of 2 Ethics in Psychology © 2013 Argosy University 2 Course Case Study feeling fine. Her boss informed Joe that Jill had quit her job and was in the county hospital undergoing treatment for severe depression. Joe quickly hung up and decided not to call or visit the bank again. After thinking it over, Joe decided that general counseling might not be for him. He decided to begin marriage and family therapy. He ordered some business cards and advertised in the yellow pages. He thought, “After all, I am a mental health counselor, and it can’t be hard to counsel a couple. You don’t need anything special. I already have one degree, and that’s enough!”