Epidemiology (3 cr.)
10:832:335 – Section 1- Fall 2012
Tuesdays 2:50-5:50, Frelinghuysen Hall A6
Instructor: Amy Abruzzi, MPH & Doctoral Candidate (Epidemiology, UMDNJ)
Phone: (610) 330 5631 (sorry this number can’t receive text messages)
Email: abruzzi@rci.rutgers.edu
and abruzzi@alypso.net
Office Hours: 30 minutes before or after class, and other times by appointment
Course Web Site: http://eCollege.Rutgers.edu
Technical problems: eCollege tech support, available 24/7 at 877-778-8437
**Note to Mac users: students have sometimes reported problems using Safari as their internet browser. Please call the eCollege tech support as soon as possible to see if there are any reported problems with the version of your browser. Be sure to download and test a substitute such as Firefox well in advance of any quiz deadlines.
Course Description:
This course covers the principles and methods of epidemiology, the study of the distribution and determinants (causes) of disease and injury in human populations. Upon completion of this course, students will have an understanding of common study designs, be able to calculate typical outcome measures, and be able to critically read the public health literature and evaluate the results of epidemiologic studies.
Recommended text:
This book provides a useful overview to the field and will enhance your understanding of the lectures:
Robert H. Friis. Epidemiology 101. Boston: Jones and Bartlett Publishers, 2009/2010.
ISBN 0-7637-5443-9. Note: this book may be purchased as an eTextbook from CourseSmart
(www.coursesmart.com) or rented through the bookstore for a considerable discount.
Additional Readings: (articles available on eCollege)
You will notice I assign a number of articles during the semester as well as a research essay that will require you to discuss a few scientific articles in epidemiology. One of my goals for this class is to go beyond our lectures and textbooks, and teach you how to locate and critically evaluate epidemiologic reports in the news and professional press. Please do these readings when they are assigned and be prepared to discuss them the following class.
Films: (in class viewings)
Time permitting, I have scheduled two films for viewing during the semester. We will discuss them after the viewing or during the following class, and you are responsible for their content or concepts on the relevant unit exam. Some of the films I may use include:
Chernobyl heart
Deadly neighborhoods
Ebola: the plague fighters
Foreign body
Influenza, 1918
The Next plague: Avian flu
Typhoid Mary
Unnatural causes: is inequality making us sick?
Course Materials on eCollege (access with your Rutgers NetID account):
♦ The syllabus, including a calendar of class lectures topics, readings, weekly assignments and examination dates.
♦ Lecture notes and handouts, plus additional readings, such as newspaper and journal articles.
♦ Weekly untimed quiz (homework)
♦ Additional readings
♦ Links to helpful web sites, video links, podcasts or other interesting materials when appropriate
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Grading:
The course is based on a total of 400 points arranged over 14 weeks of instruction:
♦ Unit 1 and Unit 2 exams, each worth 115 points = 230 points total
♦ Ten untimed quizzes, each worth 10 points = 100 points total
♦ Final essay = 40 points total
♦ Group participation= 15 points
♦ Group study design assignment = 15 points
Grading is based on the timely and correct submission of all assignments and group participation. Final grades, but not grades on individual items (such as weekly quizzes or Unit exams) may be curved.
Final Grade cut-points:
Your final grade for this class will be assigned using this system:
A: 360 to 400 points (90 - 100%)
B+: 344 to 359 points (86 - 89 %)
B: 320 to 343 points (80 - 85 %)
C+: 304 to 319 points (76 - 79 %)
C: 280 to 303 points (70 - 75 %)
D: 240 to 279 points (60 - 69 %)
F: 239 or less points (59 % or lower)
I automatically round up to the next grade when you are within 0.5 points of the next cut-point. So, an average of 343.5 =
344 points = B+. If your grade is borderline (i.e., within a point or two from the next grade), I also consider your overall work record (including timeliness of submissions) and quality of your participation in the student discussion forum when your final grade is assigned.
Class rules:
Attendance and participation:
Students are expected to attend regularly and participation in your group counts toward your final grade (for details on points, see below under Guidelines). Since this course only meets once a week, missing one class means missing an entire week’s worth of material. If you have to miss a class, please use the University absence reporting website https://sims.rutgers.edu/ssra/ to indicate the date and reason for your absence. An email is automatically sent to me. If I notice that attendance is lacking, an attendance sheet will be used. Repeated absences will require a note from the Dean of
Students. In addition, if you have to arrive late or leave early, please notify me ahead of time. If I notice attendance is lacking, a sign-in sheet will be used and checked against the ssra data.
Electronic Devices:
I believe we all learn better with fewer distractions.
. If you have a special circumstance that makes using an electronic device necessary for learning during lectures, please talk with me about it. I may ask you to furnish the appropriate paperwork in order to use it. You will need a calculator for this class.
Homework typically requires it and so will portions of the in-class examinations. Sorry, but you can’t use cell phones or internet-enabled devices such as the iTouch or the iPad as calculators during exams. (I’ll ask you to put these items under your seat or zipped into a backpack during tests.) Also, calculators may not be shared during quizzes or examinations. I encourage you to bring a scientific calculator to every class.
Students with Learning Disabilities:
Please turn your paperwork in to me within the first two weeks of school or notify me within this period that you are in the process of obtaining a letter. If you are able to meet me at 12 noon on our scheduled exam days, you can start the exam with me as your proctor and complete it during the scheduled exam time. Otherwise, you will need to make arrangements with the Office of Disability Services for a proctor.
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Guidelines for Assignments and Projects
The class is divided into two units, typically with an untimed quiz (homework) per week, discussions on the readings, and a unit exam. While each exam focuses on the content of the materials discussed and assigned within that unit, the concepts are increasingly cumulative. The final essay, due at the end of the term, is also cumulative in nature in that it requires students to apply and synthesize concepts from the entire course. In general, my emphasis is on the lecture notes, discussion readings, and films that view in class. The text book is very good and intended to enhance your understanding of the lectures.
Unit Exams (together, worth 230 points) and Make-up Policy:
Two Unit exams (115 points each, worth 230 points total) will be given in class on the designated days. These tests are largely a combination of true and false, multiple choice, matching and include calculations similar to the online quizzes
(comprising 100 points of the 115 points). The remaining 15 points are in the form of short answer responses. The exams focus on the lectures and discussion readings covered in that unit. Please don’t make other appointments on exams days as I only administer a test early or give make-ups for truly extenuating circumstances and these must be discussed with me two weeks prior to the test date. In general, make-up exams taken after the test date carry a 10% penalty (15 points) and I am only able to administer them on Tuesdays, prior to class. In the event of an emergency or serious illness on the day of an exam, you must notify me prior to the start of the exam and provide the requested verification or you will receive a grade of “0” for that exam.
Quizzes (homework) (10 points each, worth 100 points total):
Homework is administered online in the form of ten untimed quizzes, available through our eCollege course site. Each quiz will become available on the date it is assigned and contain 6 to 8 questions, which are worth a point or two a piece.
Questions tend to emphasize calculations and the interpretation of data, and may be reasonably thought of as “problem sets”. Quizzes may be taken an unlimited number of times before the due date, and of course you are expected to use your notes. Each quiz must be submitted by Tuesdays at 12 noon on their due date. I will review the answers in class later that afternoon. Do not skip questions as they will register as a zero towards your score. There are no make-ups for
missed quizzes, but you will be allowed to drop your lowest Quiz grade.
Final essay (40 points):
A short (4 pages, double spaced) research essay answering a question I assign will be due in the drop-box by 12 noon on
Tuesday, November 27 (Week 12). Details and guidelines on this assignment will be distributed approximately 1 month prior to the due date. This project is essentially cumulative in nature in that it will require you to demonstrate your ability to select, locate and evaluate epidemiologic publications as part of your discussion. Essays received within a week of the due date will receive up to a 10% penalty (4 points total or about a half point a day) and must be arranged with me in advance. Sorry, no essays will be accepted after December 4 th as I need ample time to grade them.
Group participation, including group study design (30 points total):
Learning how to work in teams is a necessary part of the scientific process, particularly for epidemiology. Throughout the semester you will be asked to work periodically in small groups during class, culminating in a group study study design that will largely be completed during classtime. At the end of the semester you will receive a grade for your group’s work by me (15 points) as well as a peer evaluation score by your group members (anonymously, of course) for your overall participation (15 points).
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Privacy statement:
The course web site may contain student information that is protected by the Family Educational Rights to Privacy Act
(FERPA). Disclosure to unauthorized parties violates the federal privacy laws. Email sent via our course website may make student names and email addresses visible to other students in class. Please remember that this information is protected by these federal privacy laws and must not be shared with anyone outside of class.
Academic Integrity:
Honesty and Integrity are an essential part of the educational experience. It is expected that students will complete all exams, and assignments in accordance with Rutgers University’s academic rules and regulations. See the current Rutgers
University Academic Catalog for details. Any evidence of academic misconduct, including cheating, failure to cite sources, plagiarism, stealing ideas, or deliberately slanting research results will result in appropriate action as dictated by Rutgers
University. Please note that taking information from an Internet site and placing it into text without proper citation is plagiarism and students are subject to the same consequences as they would face for copying information from a text or journal article without proper citation. If you are unsure of the rules of citation, please ask. Rutgers provides a wealth of resources to help students understand proper citation format and coping with the pressures of academic life. For the most up-to-date policy information on Academic Integrity http://academicintegrity.rutgers.edu/files/documents/AI_Policy_9_01_2011.pdf at Rutgers, see:
Academic Misconduct: A Bloustein School Perspective
Academic misconduct includes cheating, plagiarism, failure to cite sources, fabrication and falsification, stealing ideas, and deliberate slanting of research designs to achieve a pre-conceived result. We talk about misconduct and ethical behavior in classes and expectations are set forth in student handbooks and catalogues. We are not repeating that material here. Note, however, that penalties for misconduct can range from failing an assignment/exam or dismissal from the university. The
Bloustein School is appending this memorandum to your course syllabus because we recently have detected obvious cases of plagiarism. We have found far fewer cases of other forms of academic misconduct, but we find several every year. It is imperative that you understand that unethical academic conduct is intolerable, and it is completely preventable.
Academic misconduct almost always happens for two reasons. One is ignorance of academic rules and practices. For example, in virtually every recent plagiarism case in the School, material has been taken from an Internet site and placed in text without appropriate note or attribution. You must learn the proper rules for attribution. If you are not sure, ask your instructor! If you do not know the rules that govern the use of data sets, attribution, analysis and reporting of these sets, the faculty will help you. There is no such thing as a stupid question regarding this subject.
Pressure is the second common reason for academic misconduct. Students, faculty, every one of us is subject to deadline, financial, self-worth, peer, and other pressures. If you are potentially allowing pressure to drive you to misconduct, please step back and resist that urge. You can cope with pressure in a positive way by reaching out to friends, counselors, and faculty members. Within the Bloustein School community, you will find understanding people and positive direction.
The Bloustein School plays an important role in the planning and public policy agenda. Our work and our students must be above reproach. Updated 2/8/05
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All dates are
Tuesdays
Calendar of Lectures Topics, Readings, Quiz/Problem Sets, and Exam Dates in 2012
In class Lecture & Exam schedule
(please print lecture slides and worksheets before coming to class)
Homework
(all required readings and quizzes are on
eCollege)
Suggested
reading in Friis:
Week 1,
9/4
Week 2,
9/11
Week 3,
9/18
Week 4,
9/25
Week 5,
10/2
Week 6,
10/9
Week 7,
10/16
 Review syllabus
Unit 1 begins
 Lecture 1: Scope and History of
Epidemiology
 Lecture 2: Basic Outcome measures
 Group signups and intros
 Lecture 3: Inferring cause and preventing disease
 Discussion:“Eras and paradigms in
Epidemiology”
 Lecture 4: Working with Rates
 Discussion: on vaccine debate
 Hill’s Criteria worksheet (group assignment)
 Watch Film: “In sickness and in
Wealth”
 Lecture 5: Data sources
 Discussion: “Privacy vs. Public
Health” & “Is De-identification sufficient?”
 Lecture 6: Screening
 Discussion: What makes screening tests controversial?



Lecture 7: Descriptive Epi;
Discussion: “Advances elusive in
War on Cancer” and “Legislatures fall short on cancer prevention”/
“Nearly 800,000 deaths prevented”
Additional slides: “Breaking down the All-cancer death rate”
EXAM on Unit 1, covering Lectures
1-7 and class discussion readings
 Read: “Eras and paradigms in
Epidemiology” article
 Work on Quiz 1 (lectures 1 and 2) and submit answers by noon on Tuesday
9/18
 Read: Vaccine debate articles (t.b.a.)
(assigned by group)






Work on Quiz 2 (lectures 3 and 4) and submit answers by noon on Tuesday
9/25
Read: “Privacy vs. Public Health” or
“Is De-identification sufficient?”
(assigned by group)
Work on Quiz 3 (lecture 5) and submit answers by noon on Tuesday 10/2
Read: (t.b.a.) on screening
Work on Quiz 4 (lecture 6) and submit answers by noon on Tuesday 10/9
Read: “Advances elusive in War on
Cancer” and “Legislatures fall short on cancer prevention”/ “Nearly 800,000 deaths prevented”
 Work on Quiz 5 (lecture 7 and additional slides) and submit answers by noon on Tuesday 10/16 (no calculations this week!)
 Study for EXAM
 Read: “Practical guide to understanding case reports” & examine landmark AIDS articles
Chapter 1
Start Chapter 2
Chapter 7
Chapter 4
Finish Chapter 2,
Chapter 5
Chapter 3
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Week 8,
10/23
Week 9,
10/30
Week 10,
11/6
Week 11,
11/13
Week 12,
11/27
Week 13,
12/4
Week 14,
12/11
Unit 2 begins
 Lecture 8: Intro to Study Designs;
 Discussion: “Practical guide to understanding case reports” & landmark AIDS articles
 Lecture 9: Case Control Studies
 Review Final essay guidelines
(due 11/27)
 Lecture 10: Cohort Studies Part I and Part II
 Discussion: “Do Cell phones cause brain cancer?” and same case control and cohort articles
 Risk ratio vs. odds ratio exercise
 Lecture 11: Experimental
(Intervention) Studies
 Discussion: “Unethical trials in
Guatemala articles” & “Prison as laboratory”
 Group study design project



Lecture 12: Data Interpretation
Issues
Discussion on: “The Evidence
Gap” & “Treating an Illness is one thing”
Group study design reports.
11/20  No class this week (Thursday
classes meet today)
 Work on Quiz 6 (lectures 8 and 9) and
 Read: “Do Cell phones cause brain



 submit answers by noon on Tuesday
10/30 cancer?” and examine sample case control and cohort articles
Work on Quiz 7 (lecture 10) and submit answers by noon on Tuesday
11/6
Read:“Unethical trials in Guatemala articles” & “Prison as laboratory”
No Quiz this week in order to give you time to complete the Study Design
Assignment
Read: “The Evidence Gap” or
“Treating an Illness is one thing”
(assigned by group)
 Work on Quiz 8 (lectures 11 and 12) and submit answers by noon on
Tuesday 11/20
 Read: “Haiti’s cholera outraced the experts” and examine Ice Cream outbreak report
Thanksgiving Break
 Reminder: Final essay due in dropbox by noon on Tuesday 11/27
Start
Chapter 6
Finish Chapter 6
Start Chapter 9
Finish Chapter 9
 Final essay due by noon today!
 Lecture 13: Infectious disease
Epidemiology Part I and II
(outbreak investigation)
 Discussion: “Haiti’s cholera outraced the experts” and Ice Cream outbreak report


Work on Quiz 9 (lecture 13 Part I and
II) and submit answers by noon on
Tuesday 12/4
Read: t.b.a.
Chapter 8
 Lecture 14: Environmental and
Occupational Epidemiology
 Discussion: t.b.a
 SMR worksheet (Group exercise)
EXAM on Unit 2, covering Lectures
8-14 and discussion readings


Work on Quiz 10 (lecture 14) and submit answers by noon on Tuesday
12/11 (no calculations this week!)
Study for exam
For Add Drop dates, see the Office of Academic Services: http://sasundergrad.rutgers.edu/academics/registration/index.html
The Academic Calendar is available from the Registrar at: http://scheduling.rutgers.edu/calendar.shtml
Chapter 10
6